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Understanding FDSV

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Factors associated with FDSV

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Family, domestic and sexual violence (FDSV) can affect any individual, family or community in Australia. The majority of people who experience these forms of violence are women, and gender inequality is considered to be an underlying driver of FDSV (DSS 2022; Phillips and Vandebroek 2014; Our Watch 2022; WHO 2010). However, the context in which violence occurs varies and there are many factors that can combine to create a risk and experience of violence that is unique to each person. There are also many factors and intersecting forms of disadvantage or discrimination that can increase the likelihood of a person becoming a perpetrator of FDSV. Protective factors that may provide a buffer against the risk and effects of violence also need to be considered (Conley Wright 2021; Flood et al. 2022, WHO 2010).

This topic page provides an overview of factors that may be associated with FDSV and the intersections between them.

What do we know?

In Australia, the conceptual understanding of FDSV emphasises the role of gender inequality. However, some forms of violence may be better understood as involving power imbalance in a relationship of trust. For example, elder abuse that is often perpetrated by adult children against their parent with age-related dependencies (Qu et al. 2021).

What are the gendered drivers of FDSV?

Gender inequality is “A social condition characterised by unequal value afforded to men and women and an unequal distribution of power, resources and opportunity between them” (DSS 2022 pp.128). Drivers of violence are factors that create the conditions for violence to occur. The following distinct gendered drivers of violence have been identified:

  • condoning of violence against women
  • men’s control of decision-making and limits to women’s independence in public and private life
  • rigid gender stereotyping and dominant forms of masculinity
  • male peer relations and cultures of masculinity that emphasise aggression, dominance and control (Our Watch 2022).

Addressing the gendered drivers of violence and understanding how they intersect with other forms of disadvantage and discrimination is central to reducing the prevalence of, and preventing, violence against women (Our Watch 2022).

The National Community Attitudes towards Violence against Women Survey (NCAS) is a national survey that measures community knowledge of, and attitudes towards, violence against women and gender inequality. For results from the 2021 NCAS, please see Community attitudes.

What other factors contribute to the risk of FDSV?

Risk factors increase the likelihood of a person becoming a victim and/or perpetrator of violence and can exist at the individual, relationship/family, community and broader social level. Risk factors for the experience and/or use of violence can include age, gender, sexual orientation, race, culture, history of child maltreatment (including exposure to violence as a child), alcohol and other drug use, mental health issues, lower levels of educational attainment, employment (including job loss), financial or personal stress (including poverty) and lack of social support (DSS 2022; WHO 2010). These factors may be static (for example, the history of child maltreatment) or dynamic (for example, alcohol and other drug use) (Backhouse and Toivonen 2018; DSS 2022; Our Watch 2022; Phillips and Vandenbroek 2014; WHO 2010).

Risk factors associated with a higher likelihood of violence reoccurring or resulting in serious injury or death, include history of FDV, intimate partner sexual violence, non-lethal strangulation (choking), stalking, threats to kill, perpetrator’s access to weapons, escalation in terms of frequency and/or severity and coercive control. Specific times of heightened risk can include during periods of separation (actual or pending), parenting proceedings and pregnancy and new birth (AIJA 2022; Backhouse and Toivonen 2018).

There are also links between incarceration and the experience of FDSV for women. Studies have indicated that the majority (70-90%) of women in prison have experienced FDSV. Incarceration may be related to factors associated with the experience of FDSV, including attempts to protect themselves (violent offences) and substance use (where criminalised). Women who have been incarcerated are more likely to experience violence after they are released and are also more likely to return to prison (ANROWS 2020).

Understanding the nature of risk factors and appropriate interventions can assist in changing perpetrator behaviours and strengthen protective strategies for victim-survivors (Backhouse and Toivonen 2018).

Intersecting risk factors and other forms of disadvantage

Known risk factors for FDSV can intersect with gender inequality and other forms of disadvantage and discrimination, including racism, ableism, cisgenderism, heteronormativity, culturally specific norms about relationships, systemic barriers and social and economic disadvantage (Backhouse and Toivonen 2018; DSS 2022). See the Glossary for definitions.

These intersections can increase the likelihood, frequency or severity of violence, the experience of distinct types of violence, and/or barriers to seeking support for specific groups of people in Australia. These include:

  • Aboriginal and Torres Strait Islander (First Nations) women and families
  • women from culturally and linguistically diverse backgrounds
  • people with disability
  • lesbian, gay, bisexual, transgender, intersex, queer, asexual people, or people otherwise diverse in gender, sex or sexual orientation (LGBTIQA+ people)
  • people in regional, rural and remote areas (AIHW 2019b; Backhouse and Toivonen 2018; DSS 2022; Phillips and Vandenbroek 2014).

The AIHW’s national routine reporting on FDSV includes data for specific population groups, wherever possible. While this reporting provides useful high-level insights, it is based on a single characteristic and conceals diversity within the group. More detailed analysis is required to understand the impact of the combination or intersection of multiple characteristics. The available research regarding the prevalence and impact of FDSV for specific population groups varies and is particularly limited where there are intersections across groups (DSS 2022).

For more information, see Population groups and How do people respond to FDSV?.

What protective factors can moderate the risk of FDSV?

While risk factors can combine to increase the risk and severity of violence, protective factors may reduce the likelihood of perpetration and/or victimisation, and moderate the effects of, violence. For example, women who have a lower level of education may have reduced awareness of, and access to resources (WHO 2010) which can limit their capacity to seek support and leave a violent relationship. Conversely, a higher level of education may act as a protective factor and reduce some of the barriers to seeking support and achieving ongoing safety. Other protective factors can include the experience of healthy parenting as a child, having supportive family and/or living with extended family, culture, social support and the ability to recognise risk (Backhouse and Toivonen 2018; WHO 2010).

What do the data tell us about risk factors and the intersections between them?

There are limited national data on the risk factors of FDSV perpetration in Australia (Flood et al. 2022) and in most cases, the data available can only be used to show associations between risk factors and FDSV. Available data cannot show that a specific risk factor caused the FDSV to occur. For example, although research shows an association between alcohol use and violence against women, there is little evidence that alcohol use is a primary cause of violence (Noonan et al. 2017).

Some of the factors below can be both risk factors for, and outcomes of, FDSV. For further information on outcomes, see Health outcomes and Behavioural outcomes.

Associations between alcohol and other drug use and FDSV

Alcohol and other drug (AOD) use can be a risk factor or coping mechanism for FDSV, has been associated with both perpetration and victimisation and may precede or follow violence (Coomber et al. 2019; Noonan et al. 2017). Both misuse and cessation of use (particularly in the context of dependence) of AOD can be considered a risk factor for FDSV (Backhouse and Toivonen 2018).

In 2021, people who self-reported experiences of child maltreatment were 6.2 times more likely to have cannabis dependence than people who had not experienced child maltreatment.

The 2021 Australian Child Maltreatment Study (ACMS) found associations between adults with self-reported experiences of child maltreatment and cannabis dependence, smoking and binge drinking. One of the strongest associations was for current cannabis dependence – people who had experienced child maltreatment were 6.2 times more likely to have cannabis dependence when compared with people who had not experienced child maltreatment (Haslam et al. 2023). For more information about this study, see Children and young people: Measuring the extent of violence against children and young people and  Data sources and technical notes.

According to the Australian Longitudinal Study of Women’s Health (ALSWH), women who have experienced sexual violence may be more likely to engage in smoking, high-risk alcohol consumption and illicit drug use, than women who have not experienced sexual violence (Townsend et al. 2022). For more information see Behavioural outcomes and Data sources and technical notes.

  • In 2021–22, almost half (47%) of the women who had experienced male perpetrated sexual assault in the past 10 years believed alcohol or another substance contributed to the most recent incident

    Source: ABS Personal Safety Survey

Estimates of incidents of FDSV involving alcohol or other drugs are available from two routine national surveys:

  • The 2021–22 Personal Safety Survey (PSS) showed that almost half (47%, or an estimated 348,300) of the women who had experienced male perpetrated sexual assault in the past 10 years, reported that they believed alcohol or another substance contributed to the most recent incident (ABS 2023, Table 4.1). PSS reporting is based on respondents’ perception that the respondent, perpetrator or both may have been affected (ABS 2017).
  • The 2019 National Drug Strategy Household Survey showed that 21% of respondents aged 14 and over (an estimated 4.5 million people) had been verbally or physically abused, or put in fear by someone under the influence of alcohol in the previous 12 months. Of these, the perpetrator was a current or ex-spouse or partner for:
    • almost 1 in 5 (19%) of those who had been physically abused
    • 17% of those who had been verbally abused
    • 13% of those who had been put in fear (AIHW 2020, Table 3.53).

Females were more likely than males to report their perpetrator as being a current or ex-spouse or partner (AIHW 2020, Table 3.53).

Data from the Drug Use Monitoring in Australia (DUMA) Program found that men detained by police for sexual assault felt their use of illicit drugs and/or alcohol contributed to the offence for which they were detained. Of the 125 males detained by police for sexual assault who were interviewed as part of the DUMA Program throughout 2017 and 2018: 

  • 2 in 7 (28%) believed alcohol contributed to the offence 
  • 2 in 25 (8.0%) believed drug use contributed to the offence
  • 1 in 25 (4.0%) believed both drugs and alcohol contributed (AIC 2020).
  • Intimate partner violence incidents involving alcohol or drug use were more likely to result in physical injury than incidents that did not involve alcohol or drug use

    Source: The role of illicit drug use in family and domestic violence in Australia

The Alcohol/Drug-Involved Family Violence in Australia (ADIVA) project (see Box 1) surveyed around 5,100 Australian residents aged 18 years and older and found:

  • alcohol was involved (consumed by the respondent and/or other person) in around 1 in 3 (34%) incidents of intimate partner violence and 29% of family violence incidents
  • drugs were consumed by someone involved in the incident in 1 in 8 (13%) incidents of intimate partner violence and 12% of family violence incidents
  • intimate partner violence incidents involving alcohol or drug use were more likely to result in a physical injury than incidents that did not involve alcohol or drug use:
    • 34% of alcohol-related intimate partner violence incidents resulted in physical injury, compared with 20% of incidents that were not alcohol-related
    • 43% of drug-related intimate partner violence incidents resulted in physical injury, compared with 22% of incidents that were not drug-related (Miller et al. 2016)

Drug involvement was significantly more likely (1.65 times more likely) in family and domestic violence incidents than other violent incidents and was associated with significantly greater self-reported negative life impact (Coomber et al. 2019).

The analysis of police offence data showed that across jurisdictions, 24% to 54% of FDV incidents were recorded as alcohol-related and 1.1% to 8.9% were drug-related (Miller et al. 2016).

Dependence on illicit drugs may be more likely than drug use itself to contribute to the risk of domestic violence perpetration.

People who are dependent on drugs use them more frequently, possibly in higher doses, and are more likely to experience withdrawal symptoms. As such, dependence on illicit drugs may be more likely than drug use itself, to contribute to the risk of domestic violence perpetration (Morgan and Gannoni 2020). Data from the DUMA program showed that detainees who reported dependence on methamphetamine or cannabis reported higher rates of domestic violence (Morgan and Gannoni 2020). In 2012, recent violence towards a current or former intimate partner was self-reported by:

  • 61% of detainees who reported being dependent on methamphetamine. This is substantially higher than the 37% of detainees who said they had used methamphetamine but were not dependent and 32% of detainees who said they had not used methamphetamine
  • 58% of detainees who reported being dependent on cannabis, compared with 41% for detainees who had used cannabis but were not dependent and 25% for detainees who had not used cannabis (Morgan and Gannoni 2020).

Over 1 in 5 (22%) hospitalisations due to assault by a spouse, domestic partner or family member in 2019–20 involved consumption of alcohol by the person who was hospitalised.

Analysis of the National Hospital Morbidity Database found that in 2019–20, where the perpetrator relationship was specified:

  • 3 in 5 (60% or 1,700) alcohol-related hospitalisations for assault were due to assault by a family member, including a spouse or domestic partner, parent or other family member.
  • Over 1 in 5 (22%) hospitalisations due to assault by a family member involved consumption of alcohol by the person who was hospitalised (AIHW 2023a).

These data do not include whether the perpetrator also consumed alcohol (AIHW 2023a).

  • Many domestic homicides

    involve alcohol or illicit drug use

    Source: AIC National Homicide Monitoring Program

The National Homicide Monitoring Program reported that in 2020-21:

  • 20% of victims of domestic homicide had consumed alcohol and 12% had illicit drugs or non-therapeutic levels of pharmaceutical drugs in their system (based on toxicology results)
  • domestic homicide offenders had consumed alcohol in 12% of incidents where an offender had been identified and used illicit drugs and/or prescription drugs at non-therapeutic levels in 9.2% of incidents. Findings are based on police observation and there was a large proportion of not/stated unknown responses (35% for alcohol use and 38% for drug use) – as such, the findings may be an underestimate (Bricknell 2023).

Other risk factors for intimate partner homicide include offender experiences of childhood trauma, including experiencing family and domestic violence, and offender mental health (Boxall et al. 2022).

Associations between mental health and FDSV

Mental health issues (including mental illness and other manifestations, such as high psychological distress due to a stressor) can be a risk factor for the perpetration and/or victimisation of FDSV and an outcome of FDSV.

Perpetrators may use a victim-survivor’s mental health issues to control them and prevent them from seeking help. For example, a perpetrator may dismiss a victim-survivor’s reports of violence as being related to the victim-survivor having a mental health episode (ANROWS 2020) and victim-survivors may be led to believe their mental health issues caused or provoked the violence (Backhouse and Toivonen 2018).

  • 48%

    In 2021, almost half of respondents who had experienced child maltreatment met the criteria for a mental health disorder

    Source: Australian Child Maltreatment Study

Victim-survivors of FDSV may experience short and/or long-term mental health outcomes and impacts on parenting and mother–child relationships (see also Health outcomes and Mothers and their children).

The 2021 Australian Child Maltreatment Study (ACMS) found associations between child maltreatment and 4 mental health disorders – lifetime major depressive disorder (MDD), current generalised anxiety disorder (GAD), current severe alcohol use disorder (SAUD) and current post-traumatic stress disorder (PTSD). Almost half (48%) of respondents who had experienced child maltreatment met the criteria for 1 of the 4 mental health disorders. This compares with 22% for people who had not experienced maltreatment (Haslam et al. 2023). For more information about this study, see Children and young people: Measuring the extent of violence against children and young people and Data sources and technical notes.

PTSD, depression, suicidal ideation and personality disorders have been associated with family violence perpetrators.

Mental health issues that have been associated with family violence perpetrators include PTSD, depression, suicidal ideation and personality disorders (Boxall et al. 2022; Flood et al. 2022; Guedes et al. 2016; Lawler et al. 2023; Thomas 2019).

A mixed-model study involving online surveys and qualitative interviews with around 560 people (mostly males) who had used intimate partner and/or sexual violence against women found that:

  • more than 1 in 2 (51%) screened positive for PTSD
  • just under 1 in 3 met the core criteria for anxiety (30%) or depression (29%) (Hegarty et al. 2022).

People with depression are over-represented among perpetrators of intimate partner homicide. However, Lawler et al. (2023) found that depression should be considered in the context of co-occurring risk factors for intimate partner homicide (see also Domestic homicide).

Limited data are available for reporting on the association between mental health and police-recorded FDV events (see Box 2).

The overlap of AOD use, mental health issues and FDV

Many clients of specialist homelessness services who have experienced FDV have a mental health issue or problematic drug and/or alcohol use.

In 2021–22, of the around 84,400 specialist homelessness services clients aged 10 and over who have experienced family and domestic violence:

  • 4 in 10 (40%) also had a current mental health issue
  • over 1 in 10 (11%) had problematic drug and/or alcohol use
  • around 7,500 (8.9%) had both of the additional selected vulnerabilities (AIHW 2022).

Between 2011–12 and 2021–22, the proportion of specialist homelessness services clients who have experienced family and domestic violence and had a current mental health issue increased for both females and males. Over the same period, the proportion of specialist homelessness services clients who have experienced family and domestic violence and problematic drug/alcohol use decreased for both males and females, however there was greater fluctuation for females (Figure 1).

Figure 1: Specialist homelessness services clients aged 10 and over who have experienced family and domestic violence, by select vulnerabilities, 2011–12 to 2021–22

Source: AIHW SHSC | Data source overview

Violence-related ambulance attendances commonly involve alcohol and other drug use, mental health symptoms and/or self-harm.

Violence is a complex and significant public health issue. Understanding violence at the public health level in Australia has typically relied on disparate data sources, including jurisdictional police data and population level surveys (Scott et al, 2020). However, each of these data sources have limitations including sampling issues and recall biases which make it difficult to assess the interrelationship among AOD use, mental health symptoms and violence.

Data from the National Ambulance Surveillance System (see Box 3 and Data sources and technical notes) demonstrate that violence-related ambulance attendances across Victoria and Tasmania often involve alcohol and other drug (AOD) use, most commonly alcohol. Mental health symptoms and self-harm are also factors that may be involved in these attendances (Scott et al. 2020).

Financial and economic hardship

Although family, domestic and sexual violence can occur across all socioeconomic groups, studies consistently show that the risk of these forms of violence increases as financial stress and economic hardship increases. For example, a study by Morgan and Boxall (2020) found that women in households with an increase in financial stress during the COVID-19 pandemic were 1.8 times as likely to experience violence for the first time (see also FDSV and COVID-19).

This may be because of low income alone and/or other factors that combine to increase the risk, such as overcrowding (WHO 2010). The consequences of FDV can also produce financial hardships for victim-survivors, particularly if there is loss of income and/or housing (Renzetti and Larkin 2009; Weatherburn 2011). See also Economic and financial impacts.

The 2021–22 PSS showed that the rate of experiences of sexual violence (that is, the occurrence, attempt or threat of sexual assault) in the last 2 years was higher for women living in households that experienced financial stress:

  • 8.1% for women living in households that experienced one or more cash flow problems in the last 12 months, compared with 2.2% for those living in households that did not experience cash flow problems
  • 6.6% for women living in households that were unable to raise $2,000 within a week for something important, compared with 2.4% for those in households that could raise the money (ABS 2023).

People living in regional and remote areas

The Australian Statistical Geography Standard is used to classify areas of Australia as Major cities, Inner regional, Outer regional, Remote or Very remote (see Methods). People living in Australian regional and remote communities have higher rates of alcohol consumption and greater access to firearms, both of which increase the risk of partner violence (AIHW 2019a; Campo and Tayton 2015; Noonan et al. 2017; Wendt et al. 2015).

People living in regional and remote areas experience the same gendered drivers of violence as those living in other areas. However, some studies have indicated that people living in regional and remote areas may have more rigid values and beliefs about traditional gender roles and may be less likely to disclose or ask for help about FDV (Wendt et al. 2015).

People living in regional and remote areas may experience geographical and social isolation from support and have limited access to services, particularly specialist services and crisis and long-term accommodation. They may also have fewer employment opportunities and limited access to cash or assets due to financial dependency on their partner or their extended family (Backhouse and Toivonen 2018; Wendt et al. 2015). These factors restrict a victim-survivor’s ability to receive support, and this may be heightened for specific population groups who also live in regional and remote areas. For example, First Nations women living in remote communities may have increased concerns about confidentiality within tight family and community networks and they may need to travel long distances to seek support or rely on phone support (Backhouse and Toivonen 2018).

Services in these areas may also be limited in their ability to provide specialist support for perpetrators to address behaviour change (Wendt et al. 2015).

The rate of FDV hospitalisations in 2021–22 was highest for people aged 15 and over living in Very remote areas.

In 2021–22, the rate of FDV hospitalisations for people aged 15 and over for people living in Very remote areas (814 per 100,000 hospitalisations) was 48 times higher than the rate for people living in Major cities (17 per 100,000) (Figure 2) (AIHW 2023b).

Figure 2: FDV hospitalisations for people aged 15 and over by remoteness of usual place of residence, 2021–22

Source: AIHW NHMD | Data source overview

The 2021–22 PSS showed that the rate of experiences of sexual violence (that is, the occurrence, attempt or threat of sexual assault) in the last 2 years was higher for women living in a capital city than for women living outside of a capital city (3.4% compared with 2.3%, respectively) (ABS 2023).

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