Theories of Relational Health in Interpersonal Violence Research: A Scoping Review

Background and Purpose: Interpersonal violence is a pervasive public health problem that leads to emotional, behavioral, and physical health challenges. While recent research has highlighted the need for a greater focus on the role of relational health in interpersonal violence research, the use of such theories in existing research is not well understood. Relational health–defined as the presence of supportive, authentic, and mutually empathetic relationships–is influenced by early life experiences via caregivers and the family system, which presents an opportunity for early intervention to mitigate long-term adverse health outcomes due to interpersonal violence. To better understand the use of relational health theories in interpersonal violence research, the present scoping review was guided by two key research questions: (1) What theories of relational health are used in interpersonal violence research? and (2) What are the types of relational protective factors that are being measured/conceptualized within theories?

Methods: Using a scoping review methodology, this study synthesized characteristics of included studies, study design and methodology, study findings, and theoretical or conceptual frameworks. Social science, behavioral and mental health, and gender studies databases were searched using terms that were selected to best capture theories of relational health in the body of interpersonal violence literature. Examples of key search terms include “interpersonal violence,” “intimate partner violence,” abuse*, maltreat*, injur*, neglect, relational, relationship*, health, quality, theor*, “theoretical model,” and “conceptual framework.” Research studies that examined a form of interpersonal violence or included an interpersonal violence-exposed population and explicitly described theories or conceptual models of relational health in the context of interpersonal violence were included.

Results: 797 articles were identified in the literature; the majority were quantitative studies. The most frequently observed theories in the literature included attachment theory, relational-cultural theory, and object-relations theory. Qualitative articles largely utilized a grounded theory methodology to inductively produce theory where constructs of relational health emerged. Represented populations included women-identified survivors of interpersonal violence and intimate partner violence, adolescent girls, young adults in relationships, and community samples that included people exposed to interpersonal violence and non-exposed individuals. Populations notably missing from the research literature are men-identified victims, gender and sexual minorities, and woman-identified perpetrators. Key concepts in the literature that highlighted protective factors rooted in relational theoretical concepts included relationship satisfaction, relationship quality, previous positive relational experiences, attachment style, and social support.

Conclusions and Implications: Future research on interpersonal violence should focus on protective or promotive factors situated within theories of relational health. Strengths-based, relational perspectives in interpersonal violence research that involve men who are victims and sexual and gender minorities would fill important gaps in the body of research literature. Relational ecologies for intervention, such as the family unit, should be targeted for research and practice to help strengthen relational health for victims and perpetrators of interpersonal violence.