Intimate Partner Aggression (IPA): A Focus on Couples

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Intimate partner aggression (IPA) is a significant public health problem. In the United States, 1 in 5 women and 1 in 7 men report experiencing severe IPA at some point in their lifetime (1). Experience of IPA is associated with a range of poor mental health outcomes (2) and a population economic burden of approximately $3.5 trillion USD over a survivor’s lifetime (3). While research has historically examined how one’s disposition and situational context contributes to IPA, advancements in analytic methods now allow us to consider how both partners’ characteristics play a role (4-6) that may ultimately help inform prevention and treatment efforts. Indeed, both partners’ dispositional characteristics, relationship context, and situational contexts influences IPA, and it is important that researchers address these factors using a dyadic framework (7).

Intimate Partner Aggression: The Perfect Storm

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Numerous theories have been proposed to explain how non-aggressive interaction can evolve into an aggressive one. However, one of the most prominent is the I3 (I cubed) meta-theoretical model (8). According to the I3 model, the likelihood of partner conflict is best conceptualized in terms of three process factors: (1) instigating triggers, (2) impelling influences, and (3) inhibiting influences. Instigating triggers are contextual or situational (e.g., verbal provocation) factors that result in an urge to behave aggressively. Impelling influences are individual or situational factors that alone may not lead to aggression, but when combined with an instigating influence, increases the aggressive urge (e.g., poor martial functioning). Instigating and impelling factors in tandem lead to aggressive behaviour unless there is an equally strong inhibiting influence. Inhibiting influences are those which increase the likelihood that an individual will resist an urge to behave aggressively (e.g., adaptive emotion regulation skills, relationship commitment). On the other hand, disinhibiting influences compromise inhibitory control and thus decrease the likelihood that an individual will resist an aggressive urge (e.g., pain, alcohol intoxication). Derived from the I3 model, the “perfect storm theory” suggests that IPA is most likely to occur when there are instigating triggers and impelling influences are strong and inhibiting influences are weak. This model, along with analytic methods that consider dyadic influences on behaviour, allow researchers to examine how these factors interact within and between partners to facilitate or buffer against IPA.

How Can We Prevent Intimate Partner Aggression?

Many couples choose to remain together despite experience of IPA in the relationship. However, intervention efforts to reduce intimate partner aggression disproportionately focus on treating perpetrators and victims independently. Batterer intervention programs aimed at reducing perpetration and promoting victim safety disproportionately target individuals referred by the criminal justice system, often as an alternative to incarceration (9). Unfortunately, these programs have little impact on curbing IPA recidivism (10), likely because they are unable to account for and target the dyadic nature of aggression that occurs within a relationship. As such, a couples-based approach to treatment is worthy of consideration, particularly for situationally violent couples. However, couple-based treatment for IPA has been controversial. Many risks associated with the delivery of interventions for IPA have been identified (11), including that it contradicts the feminist perspective of IPA which is based on an inequality of power in a relationship; that it assumes that each partner plays an equal role in the aggressive or violent behaviour; the risk of the therapist colluding with the perpetrator; an increased risk of harm for the victim; and the inability to effectively develop safety plans.

In contrast, many benefits of couple’s treatment have been identified (11). The most important of these is that gender-specific interventions have not been able to effectively reduce IPA, and as such different approaches are required (12). Further, the importance of addressing the reciprocal patterns of violence in both partners may be necessary, as is understanding the instigating, impelling, and inhibiting factors that may precipitate or perpetuate violence (i.e. relationship dynamics, marital discord, emotion distress). Importantly, these factors may not only occur within the perpetrator of IPA, but may also interact across partners and lead to unidirectional or bidirectional IPA. These factors can only be identified and addressed if both members of the couple are present.

Approximately 50 percent of individuals attending couples therapy report some form of IPA in the past year (13). Addressing IPA in couples therapy has been most effective in the context of treating substance use problems (14). For example, Behavioural Couples Therapy (BCT) has consistently demonstrated strong outcomes in reducing alcohol use problems in couples, where one partner has an alcohol use issue (15). Importantly, research has demonstrated that BCT leads to reductions in IPA when problematic alcohol use is addressed (16); however, more work is needed to target the contributing factors for aggression within couples treatment. Given the association between IPA and alcohol use, it is unlikely that addressing each in isolation, or with only one member of a couple, will result in positive outcomes. Developing new interventions, or modifying existing efforts, that seek to identify and target the interaction between instigating, impelling, and inhibiting factors from a dyadic perspective are needed to provide evidence for a new way forward in this space.

Ashlee Curtis, Ph.D, is a Research Fellow in the Centre for Drug use, Addictive, and Anti-social Behaviour Research in the School of Psychology at Deakin University. Ruschelle Leone, Ph.D., is a postdoctoral fellow in the School of Public Health at Georgia State University.

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