Abstract
Background:
Domestic violence is defined as the combined pattern of physical, psychological, economic and/or sexual violence against a family member. Intimate partner violence is the most common form. We aimed to present the basic characteristics of the Montenegrin families and family members affected by domestic violence, with the intent to inform the global mosaic of differences related to cultural specificities.
Methods:
A cross-sectional study was performed using 323 cases judicially processed and officially judged according to Criminal Act from 2015–2017 in Montenegro. Socioeconomic characteristic were investigated followed by analysis of many variables.
Results:
Demographic characteristics, socio-economic status, and other characteristics of the perpetrators and the victims, as well as characteristics of violent act with posible risk factors, are presented. The results of case-control analyisis of intimate-partner relationships are given, too.
Conclusion:
A typical example of domestic violence in Montenegro shows an intimate couple with a violent male and a victimized female partner, living in a rented residence in the suburbs, with both partners in the fourth decade of their lives. The most frequent income level was poor, with half of the batterers and nearly three quarters of the victims unsatisfied with their marriage. The increased presence of such factors (both modifiable and unmodifiable) in the partiarchical families suffering from domestic violence should spark interest in public health and government authorities regarding domestic violence screening adapted for patriarchical societies.
Keywords: Domestic violence, Intimate partner violence, Socio-economic factors, Injury, Social health
Introduction
Domestic violence (DV) is defined as the combined pattern of physical, psychological, economic and/or sexual violence against a family member. Intimate partner violence is the most common form of DV, but child abuse, elder abuse, and other violent acts between family members are not rare (1,2). Even though the estimated prevalence of DV is much higher than other health issues, screening is not a routine in most health systems, and it is believed that physicians detect as few as 1 in 20 victims of abuse (3, 4).
Domestic violence persists across diverse societies and cultures. A 2005 WHO study based on data from over 24,000 women in 10 countries (representing diverse cultural and geographical settings) found that, in the majority of countries, 29–62% women suffered violence from their male intimate partner (5). Data provided by the Council of Europe indicate that 12–16% of European women over the age of 16 have experienced physical intimate partner violence as adults (6). The 2013 police reports published by the Canadian Centre for Justice Statistics reported a rate of 252.9 family violence victims per 100.000 individuals in the Canadian population (7). About 25–30% of women in the United States have reported acts of physical and/or sexual violence by an intimate partner during their lifetime, with 2–12% of women suffering within the past year (8). Furthermore, the 2010 National Intimate Partner and Sexual Violence Survey found that 32.9% of women and 28.2% of men suffered physical violence from their intimate partner during their lifetime, with 47% of women and 39% of men being between the ages of 18 and 24 when victimized (9).
Domestic violence characteristics have been well documented with attention to the psychological, medical, social, and economic implications, burdens, and consequences. Robust research evidence in different cultural settings consistently identifies common risk factors for domestic violence, such as victim predictions of future harm, previous physical assault by the perpetrator, perpetrator use of weapons, suicidality, forced sex, separation, jealousy, extensive dominance, low socioeconomic status, experience of child abuse, psychological issues (such as anger, depression and substance abuse), marital dissatisfaction, traditional sex role ideology, and violence-condoning attitudes.
The current study considers socio-economic characteristics and risk factors associated with the outbreak of DV in Montenegro. Montenegro is a small Southern European country with approximately 600.000 inhabitants, and mostly patriarchal households. Orthodox Christians are the majority (72%), followed by Muslims (19%), and Catholic Christians (3 %). As males in patriarchal societies behave violently towards their wives and children more than males in egalitarian societies, these societies tend to have a higher tolerance of DV (10), and, consequently, DV is a more common problem.
We aimed to present the basic characteristics of the Montenegrin families and family members affected by DV, with the intent to inform the global mosaic of DV differences related to cultural specificities. The subsidiary aim was to describe the victims of intimate partner violence, the most frequent type of DV. We performed a case-control analysis of victims and perpetrators in this subgroup, highlighting important characteristics of intimate pairs suffering from DV. The comparison of characteristics between intimate DV couples and control couples should elucidate factors associated with intimate DV in Montenegro.
Materials and Methods
A cross-sectional study was performed using 323 cases of DV judicially processed and officially judged as DV according to Montenegrin Criminal Act. All cases are from the period 2015–2017 (during which roughly 1000 cases of DV occurred), and were randomly selected from Montenegrin courts databases. Data were extracted from court files, and no direct interviews of perpetrators or victims were conducted by the researchers. Court files provides information about the family and family members, including their socio-economic status, education levels, other family issues, vices (alcohol and drugs abuse, gambling, etc.), history of DV in family, past criminal activity, attitudes towards the act of violence (regret, confess and justification), marital circumstances, pregnancy, and physical and mental illness among family members.
A case-control analysis was performed on a subgroup of 238 intimate partners DV cases and 103 controls. Controls were randomly selected from the cases in court databases, excluding those with DV in their criminal history. The majority of controls were persons from traffic accidents cases. For some specific questions which could not be obtained from the court files (e.g. alcoholism, drug abuse, gambling, jealousy, history of forced sex, marriage dissatisfaction, etc.) controls were contacted by phone and interviewed by send-return annonymous written questionnaire.
The standard protocol for descriptive statistics was used, as well as the Student’s t-test, the χ2 test, the Pearson correlation coefficient.
The study was approved ethically by Harvard Longwood Campus Institutional Review Board (HLC IRB) which is in charge for studies performed on T.H.Chan School of Public Health, Harvard University. Boston, US.
Results
Demographic characteristics of the cases
We divided the 323 cases of DV sampled into five groups based on the relationship between perpetrator and victim(s): 238 cases were intimate partners (the Intimate Partners – IP group), 18 cases were a perpetrator parent and a victim child (the Perpetrator Parent and Victim Child – PPVC group), 19 cases were a victim parent and a perpetrator child (the Victim Parent and Perpetrator Child – VPPC group), 22 cases were a brother/sister perpetrator and a brother/sister victim (the Brother and Sister – BS group), and 26 cases designated as “others” (O group) containing cases of violence among relatives who live together.
In the total sample, and in the IP group, there were significant age differences between the perpetrator and the victim (P < 0.01, for both). The majority of perpetrators were male (88.9%), and there was a positive correlation between the perpetrators’ and the victims’ age (r = 0.653, P < 0.001).
The χ2 test yielded statistical significance in the distribution of the sexes among different types of relationships, with the majority of intimate relationships associated with a male batterer (P < 0.001) and a female victim (P < 0.001). The most frequent combination of sexes is male perpetrator and female victim (238 cases, 73.7%), with this frequency significantly greater than the other combination, according to the χ2 test (P < 0.001). There were not difference between perpetrator and victim ethnicity in 91.6% of cases.
Socio-economic status
The socioeconomic status of the analyzed pairs was determined to be poor in 180 cases (55.7%), middle-income in 111 cases (34.4%), and rich in 32 (9.9%) cases. These classifications are defined as self-reported socioeconomic status, and is not validated by actual income level. Current financial issues, also self-reported, were identified in 164 cases (50.8%), while 176 cases (54.5%) had long-lasting financial issues.
The majority of the examined couples resided in suburban areas (44.6%), followed by the downtown residence (25.4%), the outskirts (24.5%), and finally, the countryside (5.6%). More than a half of the couples rented the property of their residence (55.4%).
Education and employment data is given in Table 1.
Table 1:
The education and the employment in IP group (number and % in brackets; NQ – non-qualified, elementary school completed only; Q – qualifeid, high school level; HE – high education, university graduate)
| Variable | Perpetrator | Victim | |
|---|---|---|---|
| Education | NQ | 97 (40.8) | 111 (46.6) |
| Q | 120 (50.4) | 101 (42.4) | |
| HE or higher | 21 (8.8) | 26 (10.9) | |
| Employment | Unemployed | 120 (50.4) | 71 (29.8) |
| Employed | 118 (49.6) | 167 (70.2) |
Other characteristics of the perpetrators and the victims
Table 2 contains the frequencies of certain examined characteristics of the perpetrators and the victims. There was a strong correlation between the perpetrators’ regret and confession (34.7%, P < 0.001). The crosstabulation and the χ2 test of the distribution of perpetrators’ sex across the perpetrator characteristics in Table 2 did not find statistical significance.
Table 2:
The frequencies of certain characteristics of the perpetrators and the victims examined in the study (* – data for IP group; ** – data present for 305 cases (data lacking for 1 IP case and 17 PPVC cases))
| Perpetrator’s characteristics | Number of cases (%) |
|---|---|
| Perpetrators’ lack of regret | 208 (64.4) |
| Perpetrators’ justification of the act | 155 (48) |
| Perpetrators’ lack of confession | 139 (43) |
| History of perpetrator being violated as a sense of perpetrator | 101 (31.3) |
| History of perpetrator being violated if asked was he/she ever been beaten by a member of family | 274 (84.8) |
| History of perpetrator being witness of domestic violence during childhood** | 169 (55.4) |
| Other violent criminal history of perpetrators | 122 (37.8) |
| Victim’s characteristics | Number of cases (%) |
| Victims’ predictions of future harm | 205 (63.5) |
| Previous attempts at leaving the batterer* | 65 (27.4) |
| Suicidal thoughts of the victim | 26 (8) |
The majority of male perpetrators did not regret the violent act (65.5%), a rate that was similar in female perpetrators (55.6%). Regarding confession of the current violent act, a weak majority of male perpetrators confessed the crime (57.8%), in contrast to female perpetrators (50%). Almost similar diversity is observed in justification of the act, but in favour of female batterers (61.1 % vs. 50.9%).
The majority of male (68.6%) and female perpetrators (69.4%) did not report a history of violation once they had been asked in general; but when asked if they had been occasionally beaten by a family members during their childhood, the majority of male perpetrators (85%) and female perpetrators (83.3%) answered positively.
More than a half of male (60.3%) and female (64.3%) victims reported a fear of posible future harm in their relationships. Similarly, 80% of male and 71.9% female victims showed previous failed attempts to leave their abuser. Suicidal thought were present in 8.8 % of male and 7.8 % of female victims.
Characteristics of violent act and posible risk factors
Frequencies of certain characteristics of the violent act and personal characteristics are given in Table 3.
Table 3:
The frequencies of characteristics of the violent, personal characteristics and risk factors (* – data for IP group)
| Variable | Number of cases (%) | |
|---|---|---|
| DV cases | Control group | |
| Use of tools and weapons in injuring in current act | 89 (27.6) | - |
| Previous physical injuries | 96 (29.7) | - |
| Unprocessed previous history of physical violence | 203 (62.8) | - |
| Unprocessed previous history of psychical violence | 235 (72.8) | - |
| History of child abuse in family by victim testimony (non judically processed) | 74 (22.9) | 16 (15.5) |
| Alcohol abuse | 169 (52.3) | 19 (18.4) |
| Drug abuse | 74 (22.9) | 18 (17.5) |
| Gambling | 132 (40.9) | 31 (30.1) |
| Physical disability in the family | 91 (28.2) | 16 (15.5) |
| Mental illness in the family | 85 (26.3) | 13 (12.6) |
| Marital dissatisfaction assumed by perpetrator | 127 (53.6)* | 13 (12.6) |
| Marital dissatisfaction assumed by victim | 170 (71.7)* | 17 (16.5) |
| History of forced sex | 25 (10.5)* | 8 (7.8) |
| Obsessive jealousy, stalking behaviour and extensive dominance | 150 (63.3)* | 20 (19.4) |
| Separation or ongoing divorce | 50 (21.1)* | 4 (3.9) |
| Pregnancy | 31 (13.1) | 2 (1.9) |
A significant correlation was found between the relationship types and the unprocessed previous history of physical violence (P < 0.001), while there was no significant difference between the relationship types and the unprocessed previous history of psychical violence (P = 0.623), (Table 4). In IP group, 61.3 % had both the unprocessed previous history of physical and psychological violence, with a strong correlation between them (P < 0.001). Previous acts of DV without sustaining physical injuries is siginificanlty correlated with unprocessed previous history of both types of violence (P < 0.01).
Table 4:
The distribution of the unprocessed previous history of physical or psychical violence among different relationship types (number of cases and % in brackets)
| Types of relationships | Unprocessed previous history of physical violence | Unprocessed previous history of psychical violence | ||
|---|---|---|---|---|
|
| ||||
| No | Yes | No | Yes | |
| Intimate partners | 73 (30.7) | 165 (69.3) | 60 (25.2) | 178 (74.8) |
| Perpetrator parent and victim child | 9 (50) | 9 (50) | 7 (38.9) | 11 (61.1) |
| Victim parent and perpetrator child | 14 (73.7) | 5 (26.3) | 6 (31.6) | 13 (68.4) |
| Brothers/sisters | 12 (54.5) | 10 (45.5) | 6 (27.3) | 16 (72.7) |
| Others | 12 (46.2) | 14 (53.8) | 9 (34.6) | 17 (65.4) |
IP group: case-control study
Table 5 contains the comparison of various characteristics between the IP group and the control group according to the t-test and the χ2 test, as well as the results of the post hoc power calculation for each variable.
Table 5:
Comparison of the intimate partner group with the control group (NS – non significant)
| Compared characteristics between the IP group and the control group | P value | Significantly greater in… (% in IP and Control group) | Post-hoc power analysis (%) | |
|---|---|---|---|---|
| Perpetrator age in IP group vs. Male partner age in Controls | 0.024 | Control | 100 | |
| Victim age in IP group vs. Female partner age in Controls | 0.046 | Control | 100 | |
| Different ethnicity of perpetrator and victim in | 0.824 | NS | 100 | |
| IP group vs. Different ethnicity of partners in Controls | ||||
| Socio-economic status | Poor | 0.001 | IP (57.6, 38.8) | 89.5 |
| Middle | 0.021 | Control (35.3, 48.5) | 62.9 | |
| Rich | 0.101 | NS | 38.9 | |
| Current financial issues | 0.001 | IP (51.7, 33) | 89.8 | |
| Long-lasting financial issues | 0.058 | NS | 47.6 | |
| Type of neighborhood (suburban, downtown, outstriks or rural) | 0.156 | NS | 44.7 | |
| Living place renting | 0.127 | NS | 33.2 | |
| Education of perpetrator in IP group vs. Education of male partner in Controls | NQ | < 0.001 | IP (40.8, 20.4) | 96.8 |
| Q | 0.046 | Control (50.4, 62.1) | 51.2 | |
| HE | 0.021 | Control (8.8, 17.5) | 62.7 | |
| Education of victim in IP group vs. Education of female partner in Controls | NQ | < 0.001 | IP (46.6, 11.7) | 100 |
| Q | < 0.001 | Control (42.4, 72.8) | 100 | |
| HE | 0.154 | NS | 31 | |
| Education difference | < 0.001 | IP (51.3, 28.2) | 98.3 | |
| Unemployment of perpetrator in IP group vs. Unemployment of male partner in Controls | < 0.001 | IP (50.4, 23.3) | 99.9 | |
| Unemployment of victim in IP group vs. Unemployment of female partner in Controls | 0.388 | NS | 13.2 | |
| Marital dissatisfaction assumed by perpetrator in IP group vs. Marital dissatisfaction assumed by male partner in Controls | < 0.001 | IP (53.6, 12.6) | 100 | |
| Marital dissatisfaction assumed by victim in IP group vs. Marital dissatisfaction assumed by female partner in Controls | < 0.001 | IP (71.7, 16.5) | 100 | |
| Alcohol use | < 0.001 | IP (51.3, 18.4) | 100 | |
| Drug use | 0.688 | NS | 5.6 | |
| Gambling | 0.004 | IP (47.1, 30.1) | 84.3 | |
| History of forced sex | 0.441 | NS | 10.5 | |
| Obsessive jealoulsy, stalking behavior, extensive dominance | < 0.001 | IP (63.3, 19.4) | 100 | |
| Separation / ongoing divorce | < 0.001 | IP (21.1, 3.9) | 99.6 | |
| History of perpetrator being violated as a sense of his own in IP group vs. History of at least one partner being violated as a sense of its own in Controls | 0.036 | IP (31.5, 20.4) | 55.6 | |
| History of perpetrator being beaten by a family member in IP group vs. History of at least one partner being beaten by a family member in Controls | < 0.001 | IP (84.5, 35.9) | 100 | |
| History of perpetrator witnessing domestic violence during childhood in IP group vs. History of at least one partner witnessing domestic violence during childhood in Controls | 0.002 | IP (55.3, 36.9) | 88.3 | |
| Other violent criminal history of perpetrator in IP group vs. Other violent criminal history of any partner in Controls | 0.017 | IP (33.2, 20.4) | 67.5 | |
| Pregnancy | 0.001 | IP (13.1, 1.9) | 95.5 | |
| Physical disability | 0.019 | IP (27.3, 15.5) | 66.6 | |
| Mental illness | 0.007 | IP (25.6, 12.6) | 78.9 | |
Discussion
The worldwide research on domestic violence resulted in identifying multiple risk factors: witnessing or experiencing child abuse, psychiatric disease, substance abuse, low socioeconomic status, perpetrator previous physical assault and use of weapons etc. With addition to the previously identified risk factors, patriarchic societies exhibit family power imbalance with a dominant, violent man and a submissive, victimized woman.
Presented case-control study showed that childhood experience of domestic violence, marital problems, psycho-social issues, as well as criminal history and perpetrator unemployment were more frequent in the cases of intimate partner violence. These results indicate that certain risk factors may be specific for patriarchal societies. As almost worldwide, bad socioeconomic occasion is an important determinant even for DV, but depending on different cultural enviroment and socio-economic development of the country various risk factors can be in focus. Montenegrin data shows an mixture of risk factors which can be seen in both patriarchal and egalitarian societies. In general, it is a reflection of contextual geopolitical situation for Montenegro in many other issues, which is in the same time strached and trapped between the East and the West, historically influenced by both Ottoman and Austro-Hungarian civilisations.
The results of the present study yield several interesting points regarding DV in Montenegro. First, persons engaged in DV cases are younger than pairs from controls, and suffer from poverty and current financial issues more frequently than controls. Second, prevalence of DV is more common among persons with lower levels of education, for both perpetrators and victims. The difference in education level is observed significantly more often between IP pairs than between control pairs. Third, perpetrator unemployment, marital dissatisfaction, alcohol use, gambling, obsessive jealoulsy, stalking behavior, extensive dominance, separation and/or ongoing divorce, history of victimization within the family, witnessing domestic violence during childhood, perpetrator history of other violent criminal acts, pregnancy, physical disability and mental illnesses were all observed at significantly higher rates in IP group than in control couples, and could be recognized as risk factors for Montenegrin setting as well.
Compared to egalitarian societies, patriarchal societies exhibit more violence from male perpetrators against their wives and children (10). This study of DV in Montenegro, a typical patriarchal society, supports this theory; we found that the majority (88.9%) of DV cases had male perpetrators, similar to the US rate of 80% of cases of DV against women. The issue of underreporting DV is also a characteristic of patriarchal societies, where there is a power disbalance between “submissive” woman and “dominant” man. This disbalance is not only enforced biologically, but socio-economically as well (11). In the current study, previous acts of DV frequently were not legally proceeded (62.8% of physical and 72.8% of psychical violence with significant correlation between them in IP group), an occurrence that was accompanied with many cases of female victim’s providing testimony in favor of the male perpetrator’s innocence, improving his chance to escape the penalty by law. This may be an attempt to preserve the family integrity and dignity in society and avoid further suffering, as observed in another study (12). Nevertheless, serious episodes of DV are usually reported to the police (13).
We also observed high rates of perpetrator’s lack of regret, lack of confession, and justification of the act (ranging from 64.4% to 43%, respectfully). Justification of violent act as an acquired attitude in a patriarchal society might be derived from a perpetrator’s own history of being violated (84.8%) or of witnessing DV (55.4%) during childhood.
Some studies worldwide have highlighted the impact of socio-economic characteristics that influence DV (14). Lower education level of females (15) is a documented risk factor for violation at home, which we also observed in our sample. The majority of victims are persons who have only completed elementary school, in contrast to the data presented ealrlier (16). Suburban parts of Montenegro are dominantly settled by low-paid or unemployed ones, with outburst of drug addiction, which are also comfort with DV since 44.6% of all DV cases from our sample are from suburbs.
A high percentage of perpetrators of DV have vices and a history o non-DV related crimes; e.g. alcohol abuse is a dominant finding in 52.3% of cases. Since alcohol use is linked with other social pathologies, the relationship between alcohol abuse and DV may be part of the association with bad social circumstances in the family. The IP group suffered from marital dissatisfaction (in both parpetrator and victim), obsessive jealousy, stalking behaviour, extensive dominance, separation and/or ongoing divorce.
Experiencing or witnessing DV in childhood may lead to violent behavior in adulthood (17,18) suported by the theory that children adopt the conflict-resolution strategies that they witnessed during childhood (19). Our data did not show that ethicity difference among pairs is an important factor, neither was long-lasting financial issues, type of neighbourhood, living in rented home, unemployment of victims, drug abuse, or history of forced sex.
Our main conclusion is that patriarchal societies have a unique pattern of characteristics and risk factors of DV associated with gender inequalities (including male against female violence, repetitive acts of unreported DV in the criminal history, pereptrator’s lack of regret, confession and justification of the act, and acquired attitude to DV), while socio-economic risk factors seem to be universal. A prospective analysis of various patriarchal societies should aim at determining the role of modifiable factors (e.g. place of residence, socioeconomic status, alcohol and drug abuse, marriage satisfaction etc., unlike the uncontrollable risk factors; such as age or previous history of suffering/committing violence), and whether they are causative or consequential to DV. Given the fact that DV is a significant public health burden in Montenegro and neighboring countries (which also exhibit patriarchic societal norms), a precise description of the relationship between these factors and DV serves as basis for practical intervention in the suppression of DV.
Conclusion
A typical example of DV in Montenegro shows an intimate couple with a violent male and a victimized female partner, living in a rented residence in the suburbs, with both partners in the fourth decade of their lives. The most frequent income level was poor, with half of the batterers and nearly three quarters of the victims unsatisfied with their marriage. The increased presence of such factors (both modifiable and unmodifiable) in the partiarchical families suffering from DV should spark interest in public health and government authorities regarding DV screening adapted for patriarchical societies.
Journalism Ethics considerations
Ethical issues (Including plagiarism, informed consent, misconduct, data fabrication and/or falsification, double publication and/or submission, redundancy, etc.) have been completely observed by the authors.
Acknowledgements
Authors did not have any support funding of the paper.
Dr Radojevic was a fellow at Takemi Program in International Health at Harvard School of Public Health, Boston, USA. Dr Radojevic was also a fellow of Fogarty International Center of the National Institutes of Health’s “Research Ethics Education in the Balkans and Black Sea Countries” (Award Number R25TW008171), provided by Icahn School of Medicine at Mount Sinai, New York USA and School of Medicine University of Belgrade Serbia.
Footnotes
Conflict of Interest
The authors of this paper hereby declare that have not received nor shall receive any financial benefits from publishing the paper, neither they have received any financial incentive from a third party. This research process under full professional responsibility does not include any conflict of interests.
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