Epidemiology of Injuries among Women after Physical Assaults: The Role of Self-protective Behaviors

Why is this study important?

More than 5,000 women die each year and approximately 1 million suffer from injuries as a result of physical assault. Recent epidemiological studies have suggested that when a woman defends herself during an assault, she increases her risk of injury, but it is unclear why more injuries occur when female assault victims try to defend themselves. The data do not distinguish whether the victim initiated self-protective behaviors before, during or after the assault began.
Reviewed by
Priscilla Schulz, LCSW

from an article of the same title by:

Martie P. Thompson, Thomas R. Simon, Linda E. Saltzman, and James A. Mercy, Centers for Disease Control and Prevention, Atlanta, GA

Published: American Journal of Epidemiology,
V. 150 (3), 235-244, 1999

It can be argued that the women surveyed in these studies were already injured when they began to fight back, and that this is just as likely as the scenario that fighting the perpetrator incited him to injure them. While not a replacement for primary prevention of violence against women, understanding the relationship between self-defense and injury could inform secondary prevention efforts. The present study uses data from the National Crime Victimization Survey (NCVS) 1992-1995 in which the timing of victims' self-defense behavior is noted.

What is the purpose of this study?

The purpose of this study was to:
Explore whether female victims' use of self-protective behaviors at different times (before, during, or after the assault had begun) affected risk of injury
Examine female victims' perceptions concerning how their efforts to defend themselves affected the outcome of the assault
Explore how the victim's relationship to the offender affected the outcome of the assault when the victim tried to defend herself.

The study looked at 3,206 incidents between 1992 and 1995 in which females 12 years and older were victimized. The study included only physical assaults in which a woman was assaulted by a lone, male perpetrator. The study did not include robberies or sexual assaults.

What did the study find?

The study conducted a number of multivariable analyses permitting researchers to conclude that each of the listed findings were unique predictors of injury reduction.
Women who try to protect themselves from an assailant before or during and attack are less likely to be injured from the assault than those who did not try to protect themselves or only did so after already being injured by the assailant. This result is further bolstered by the finding that 75% of women who tried to protect themselves before or during the assault perceived their efforts as helping the situation. However compelling these results are, researchers urge caution in making recommendations from them at this time.

Victims of intimate partner violence were at greater risk of injury than were victims of non-intimate partner violence.

Women with less than a high school education were at increased risk of sustaining an injury after a physical assault.

Women assaulted by male assailants with firearms were significantly less likely to be injured compared with those assaulted by assailants without a gun.

When injury severity was classified as minor versus serious, self-protective behaviors significantly reduced minor injury. Self-protective behaviors also markedly reduced the risk of serious injury though this was not a significant reduction.
What are the study's limitations?
The study did not examine how different types of self-protective behaviors affected injury outcomes. That is, self-protection includes forceful efforts (e.g., fighting back) as well as non-forceful efforts (e.g., pleading). Other studies have found that the type of self-protective behavior results in significantly different outcomes.

Information about the context of the assaults was not available so it is unknown, for example, whether a woman had an opportunity to try to defend herself or if the assault happened too suddenly for her to respond.

There was no data available on assaults resulting in death to explore victims' behaviors during those attacks.

The study's results (correlative) do not suggest that self-protective behaviors during a physical assault prevent injury. For example, victims' use of self-protective behaviors may just be more likely in less dangerous situations.

It is unknown whether this study's results would be found in an examination of victims' self-protective behaviors in other kinds of violent crimes such as rape and robberies.

Reviewed by Priscilla Schulz, September 1999
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