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If doctors suspect a patient has been abused, they generally check for telltale signs, such as multiple injuries in various stages of healing. But new research suggests they may be missing an important clue: fractures around the eye or upper face.

A study published today in the Archives of Facial Plastic Surgery found that such injuries are more common in female victims of intimate partner violence (IPV) — defined as physical, sexual or emotional violence between partners or former partners — than among women who were assaulted during, say, a robbery, or hurt in a car accident, who are more likely to suffer broken jaws. 

(Intimate partner violence is sometimes referred to as domestic violence, but that term encompasses violence perpetrated between any members of a household, not specifically those who are current or former sexual partners.)

Study co-author Oneida Arosarena, an associate professor of otolaryngology at Temple University School of Medicine, says researchers were surprised by the findings, which they reached after reviewing the medical and dental records of 326 women treated for facial wounds from a variety of sources. "We expected the injuries to be distributed the way they are for other facial traumas, such as motor vehicle accidents, and they weren’t," Arosarena tells ScientificAmerican.com.

But David Greene, an otolaryngologist in Naples, Fla. (and adjunt faculty member at the Cleveland Clinic) who has studied intimate partner violence, says the pattern makes sense.

"The jaw is the type of place where if you fall down, it's predominant," he says. "The trajectory of someone taller than you and striking down at you will be to the upper face. If someone is hitting down on you with a cell phone or vase, it's going to hit you around the eye or nose.

"There's a lot of hitting in the face because a woman's face is the most meaningful area — a hand slap, bruises are typical of that," Greene adds. "If someone is robbing you, they're not going to slap you in the face; the goal of the assailant in robbery is to knock you out once or twice and get out, which is a different type of thing" than the repetitive nature of intimate violence injuries. Robbers are also more likely than batterers to know how to perform upper cuts, he says, which strike at the junction of the neck, ear and jaw and can cause an immediate knockout.

Each year, an estimated 4.8 million women in the U.S. and 2.9 million men are the victims of intimate partner-related physical assaults and rapes, according to the Centers for Disease Control and Prevention (CDC). Worldwide, four times as many women as men are victims of intimate partner violence, today's study says.

Image © iStockhoto/Amanda Rohde
 
 

4 Comments

1. 1. euphobot 01:33 PM 1/22/09

   There is nothing uglier than science used to justify bigotry. That is as true for phrenology as for domestic violence. While good research has shown for 30 years that conflict is a human problem. most government funding is based on gender-biased dogma. While IPV is a real problem, and there are real solutions, dogma has lead to none, and, in fact, markedly impeded progress. Readers should be wary of any research that smacks of gender one-sidedness. Greene's statement is a case in point. It implies that the shorter person, presumably female, could not commit IPV on the taller. One only need remember the video of Mary Winkler driving her Mercedes back and forth over her husband's body as their daughter cried from the back seat, "please, don't kill my Daddy."

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2. 2. kremvax 01:54 AM 1/23/09

   I don't believe that there was any justification, either implicit or explicit, in this piece. Rather, this is merely a presentation of an anatomical pattern found among victims of IPV. It does not- and does not appear to intend to- delve into the causes of or solutions to IPV. Greene's statement does not imply gender bias- he is speaking about a pattern of injury which happens to match a pattern of abuse- let's face it, physical abuse does generally (not always) fit the pattern he gives.
   On a separate note, I believe you are referring to the Clara Harris case- the Texan who allegedly ran her husband over- and not the Mary Winkler case (she allegedly shot her husband in the back, although she still fits the point you are making).

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3. 3. euphobot in reply to kremvax 03:38 AM 1/23/09

   Thanks for fixing my Harris, Winkler switch, but there is inherent bias in selecting a female only pool of victims and saying you know something about IPV. Even the Tjader,Thonnes CDC report cited in the article counters the common media myth that victims are only female. Murray Straus years ago found 50 percent of IPV is mutual and the rest is divided equally male and female perpetration. A more recent CDC study by Whitaker finds a higher rate of female perpetrators than Straus. So a female only sample cannot fit the actual pattern of abuse. The evidence is not slight. The Martin Fiebert bibliography at CSULB counts n > 200,000. The risk is real, particularly if it is your brother whose wounds are excused because they do not match the IPV pattern mentioned in SciAm.

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4. 4. kremvax 07:29 PM 1/23/09

   Interesting point. Studies over time have shown conflictingly both genders to be at greater risk (including the CDC and Department of Justice) and I agree that both men and women are capable of inflicting violence. One major difference, however is that women are far more likely than men to suffer physical injury from such abuse. The nature of physical abuse is such that any new means to detect effects (and consequently uncover the abuse) has potential to be highly beneficial, especially given the tendency of victims of abuse to remain silent. This is not to say that abuse of males does not occur, nor that it does not produce injury. In fact, I wonder if such a study had been done with males, whether or not it would find its own characteristic patterns of injury.
   At the end of the day, abuse in any of its forms in incredibly destructive, and is something which deserves due attention.

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