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1999) Considers The Possibility That The Personality Traits That Can Be ...

1999) considers the possibility that the personality traits that can be frequently associated with both a depressive personality and also the tendency to deliberate self harm, may also confer an increased risk of entering an abusive relationship. Examination of the current literature on this element does not help us to reach any clearer view on the issue other than to allow us to present the fact that there is clearly a dichotomy of opinion on the subject.

In specific regard to issues surrounding pregnancy we can also note that there is evidence to suggest that violence can be specifically related to such issues. (CMO 2000). Of all the women who died in a three year period (‘97-'99) with a death related to pregnancy, 12% had reported domestic violence at some stage prior to their death. The study did not make any direct observation (because it couldn't) of a direct link between domestic violence and the death.

Although not specifically in the direct province of the midwife, one can also consider the effects of domestic violence on other family members. Such studies are clearly difficult to construct and conduct as the element of denial and the element of secrecy will obviously be large and significant confounding factors in any investigation or statistical analysis. (Mohammed, D et al. 2003).


Studies such as that by Berrios (D C et al. 1991) shows strong circumstantial evidence that children who are brought up in situations with physically violent parents have a greater incidence of suffering direct physical abuse from either or both of their parents. We shall return to this point later, but observe that this knowledge puts a further obligation upon healthcare professionals in general to try to predict and detect domestic violence, not only from the point of view of the direct victims, but also from the viewpoint of the peripheral or indirect victims as well.

The psychopathology of the perpetrators (and to a lesser extent the victims) of domestic violence is examined in the thought provoking paper by Zink (T et al. 2004). This paper considers the features of medical management of the perpetrators, which is not particularly relevant to our considerations here. What is of far greater relevance is the section of the paper where the authors consider the mechanisms whereby the offenders come to a position where they indulge in domestic violence. This gives the healthcare professional a useful insight into the possible dynamics of the situation. (Fawcett J 2005)

In terms of the victim coming to the stage where they feel that support and action is necessary, the authors identify a five stage model of change which is clearly heavily based on the trans theoretical model. (Prochaska J O et al. 1992). They enumerate the five stages as :
pre-contemplation, contemplation, preparation, action, and maintenance.

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