The Prevalence of Posttraumatic Stress Disorder and Posttraumatic Stress Symptoms in Intimate Partner Violence Perpetrators: A Systematic Review

Background and Purpose: Intimate partner violence (IPV) is an urgent and costly public health problem. Studies have found that individuals with posttraumatic stress disorder (PTSD) and symptomology are significantly more likely to perpetrate IPV. Despite evidence suggesting that PTSD is a significant contributor to the etiology of this violent behavior, current interventions and prevention efforts do not reflect these findings. For example, trauma-informed care is not incorporated in current best practices with IPV perpetrators. This review seeks to synthesize the epidemiological studies that report prevalence rates of PTSD and/or post-traumatic stress symptoms (PTSS) among IPV perpetrators to provide valuable information to practitioners and policymakers on next steps for assessment and treatment.

Methods: Following PRISMA guidelines, a systematic search of 5 electronic databases was conducted to search for all available articles published between 2009 and 2016 using search terms related to IPV and PTSS/PTSD. Reference harvesting and conference proceeding were also conducted. Each article was assessed using the following criteria: reported prevalence rates of post-traumatic stress among IPV perpetrators, and was available in English. The search returned 191 articles for title and abstract review; 53 articles were selected for full text review; and a total of nine studies met inclusion criteria. Data extraction forms were created, pilot tested and modified based on expert feedback.

Results: There was a wide range of PTSD and PTSS rates reported across the nine studies. Studies that examined PTSS in general reported rates ranging from 10% to 21%, whereas those that examined PTSD reported rates ranging from 8% to 55.9%. Variability was likely related to differences in the operationalization and measurement of these concepts, as well as differences in sampling and other methodological considerations. Specifically, only two of the nine studies used the same measure to assess PTSD and only three studies used the same measure to assess perpetration.

 Conclusion/Implications: Studies reported rates of PTSD among perpetrators that are much higher than averages among the general population. Specifically, while these studies reported rates for PTSD that ranged from 8% to 55.9%, estimates for lifetime PTSD prevalence among general populations in 27 countries ranges from 0.3% to 6.1%. Further, it is likely that PTSS rates are even higher among perpetrators because PTSS requires any number of symptoms, whereas a PTSD diagnosis requires that all symptom clusters are met. Therefore, while some perpetrators don’t meet the full criteria for PTSD, their symptomology may still make it difficult for them to manage their emotions. This underscores the need to introduce trauma-informed interventions to the IPV treatment field. Also important is the need for greater consistency in how IPV perpetration and PTSD/PTSS are operationalized and measured in order to reduce the variability in empirical findings and, thus, more reliably inform future research, practice and policy.