DAILY / MAY 21, 2019  
Psychiatric News Update

Intimate Partner Homicide Least Studied, Most Common Form of Family Murder

Crime scene
By far the most common form of familial homicide is men who kill their female intimate partner, according to Alec Buchanan, M.D., Ph.D., who spoke at a Sunday session on the dynamics and risk factors for murder in the family.

Such homicides committed by men account for about 1,500 of the 14,000 annual homicides in the United States, he said. “It has only been in the latter half of the last century that intimate partner homicide was consistently regarded as both a criminal act and social and societal problem.”

Buchanan, a professor of psychiatry at Yale University School of Medicine and member of the Group for the Advancement of Psychiatry (GAP) Committee on Psychiatry and the Law, was joined by several other co-authors of their book Family Murder: Pathologies of Love and Hate.

Up to half of women who are murdered are killed by a past or present male intimate partner, which is the most personalized form of homicide, said Buchanan.

“Many of the other forms of familial violence have been subject to extensive psychiatric study. That’s not the case for intimate partner violence, which has been little studied from a psychiatric perspective,” Buchanan said. “So most of the literature comes from sociology and criminology.”

Ethnic and racial minority women living in poverty are disproportionately affected by such crimes, he said. Both victims and perpetrators tend to be younger, and the crimes tend to more violent, with multiple blows, knife wounds, or gunshots, compared with other forms of homicide. These crimes tend to happen late at night and behind closed doors, often in the bedroom.

Typically, these homicides are preceded by less serious violence, and prior arrests for domestic violence may be seen in up to 80% of cases, he said. “Knowledge of the relationship is critical to understanding what happened.” The perpetrators of such crimes tend to self-report fighting about real or suspected affairs. What escalates the situation tends to be social isolation, longstanding physical abuse, and alcohol and drug use.

Such crimes result from both a culture of patriarchy and control of women as well as the psychopathology of the perpetrator, Buchanan said. Some perpetrators may see their victims as part of themselves and, as such, see their partner’s desire to separate as a threat to themselves.

Many of the perpetrators are in psychiatric treatment for depression, substance use, or pathological jealousy at the time of the crime, possibly presenting an opportunity for psychiatrists to recognize potential cases and intervene to prevent these horrific crimes. Risk factors for violence include past threats, past violence, current access to weapons, escalation of violence or jealousy, violent fantasies, and depression.

For many patients, the risks posed by anger issues and delusions of infidelity decrease as the patient ages, Buchanan said. “The same is not true, however for pathological jealousy, for which the risk seems to continue into old age.”

When it comes to prevention of such crimes, the use of protective orders for the women is controversial because they often don’t serve as a deterrent and they are frequently broken with no legal consequence. In fact, one-third of women murdered by an intimate partner had a protective order in place at the time, Buchanan said. Court-ordered treatment is now commonly deployed, but evidence of its effectiveness in preventing intimate partner violence and homicides is mixed.

What has been the most effective are changes in law enforcement practice in some high-poverty areas that have made the police far more responsive to intimate partner violence, Buchanan said.

(Image: iStock/Prathaan)


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