Leaving violent intimate relationships: a literature review

Abstract

This article analyzes the advances and limitations in the scientific production regarding the process of leaving violent intimate relationships. For that, articles addressing leaving violent relationships or the stay/leave process as the main theme, written in English, Portuguese, Spanish, and French, were searched in Periódicos Capes and SciELO Web searches. The search resulted in 14 articles published between 1999 and 2015 - half with a quantitative design and the other half with a qualitative design. Investment, commitment, subjective norms, responsibility attribution, anger, and structural barriers and facilitators were correlated with the leaving process. These studies also understood the end of relationship as a process. Qualitative studies proposed new models, focused on strategies that enable the leaving process, and considered the post-separation period in the analysis. Thus, this study provides recommendations for professional practice and further research on the theme.

Keywords:
domestic violence; intimate partner violence; violence against women

Resumo

Este artigo analisa avanços e limitações na produção científica acerca do processo de término de relações íntimas violentas. Realizou-se busca nas bases de dados Portal de Periódicos Capes e SciELO, com entradas em inglês, francês, espanhol e português. O critério de inclusão foi tratar do término de relações amorosas violentas ou de aspectos da decisão ficar versus sair. Encontraram-se catorze estudos publicados entre 1999 e 2015, dos quais metade tinha design quantitativo e a outra metade, qualitativo. Estas variáveis mostraram correlação com o avanço rumo ao término nos estudos quantitativos: nível de investimento, comprometimento, normas subjetivas, atribuir ao agressor a responsabilidade pela agressão, sentimento de raiva, barreiras e facilitadores estruturais. Para os sete estudos qualitativos, observaram-se: a proposta de novos modelos de compreensão, a maior variabilidade de recrutamento das amostras e a consideração do período pós-separação nas análises. Discutem-se recomendações para a prática profissional e a pesquisa.

Palavras-chave:
violência doméstica; violência por parceiro íntimo; violência contra a mulher

Resumen

Este artículo analiza los avances y las limitaciones en la producción científica sobre el proceso de término de relaciones de parejas violentas. Se realizaron búsquedas en las bases de datos Portal de Periódicos Capes y SciELO con entradas en inglés, español, francés y portugués. Los criterios de inclusión fueron tratar del término de relaciones de pareja violentas o de aspectos de la decisión de quedarse versus dejar. Se incluyeron 14 estudios publicados entre 1999 y 2015, los cuales la mitad fue de enfoque cuantitativo, y la otra mitad, cualitativo. Estas variables tuvieron correlación con el avance al término en los estudios cuantitativos: nivel de inversión, compromiso, normas subjetivas, atribuir responsabilidad al agresor por la agresión, sentimiento de rabia, barreras y facilitadores estructurales. Para los siete estudios cualitativos se observó: la propuesta de nuevos modelos de comprensión, la variabilidad de reclutamiento de los muestreos y la consideración del período que sigue la separación en los análisis. Se discuten recomendaciones para la práctica profesional e investigación.

Palabras clave:
violencia doméstica; violencia de pareja; violencia contra la mujer

Résumé

Cet article analyse les avances et les limites de la production scientifique sur le processus de rompre des relations intimes violentes. On a mené une recherche dans les bases de données Portal Periódico Capes et SciELO, avec des mots-clés en anglais, français, espagnol et portugais. Les études discutant la fin des relations amoureuses violentes ou les aspects de la décision de rester ou de partir ont été incluses. On a trouvé 14 études publiées entre 1999 et 2015, dont la moitié avait une conception quantitative et l’autre moitié, qualitative. Dans les sept études quantitatives, les variables suivantes ont montré une corrélation avec la progression vers la fin de la relation : niveau d’investissement, engagement, normes subjectives, attribution de la responsabilité de l’agression à l’agresseur, colère, obstacles et facilitateurs structurels. Pour les sept études qualitatives, on a observé : la proposition de nouveaux modèles de compréhension, la plus grande variabilité dans le recrutement des échantillons et la prise en compte de la période post-séparation dans les analyses. Des recommandations pour la pratique professionnelle et la recherche sont discutées.

Mots-clés:
violence domestique; violence envers le partenaire intime; violence contre les femmes

Studies on the prevalence and impacts of violence in intimate relationships are growing and have become increasingly important, both in understanding this phenomenon and in constructing public policy guidelines related to the issue (Brasil, 2006). Data on prevalence indicate that at least one in five Brazilian women suffer from violence in relationships (DataSenado, 2013), 43% of women who seek help via telephone assistance are battered daily, and 35% weekly (Secretaria Especial de Políticas para as Mulheres, 2012). These data, however, should still be treated as minimum limits, since it is common that both women and men do not know how to recognize forms of violence different from physical aggression.

In this context, studies on leaving violent relationships have the potential to shed more light on the processes that cause the end of this type of relationship. Expanding the understanding of this complex process may generate relevant and applicable conclusions to public policies and prevention services - regarding the early abandonment of abusive relationships - and support to victims of violence.

Overcoming the condition of violence in the relationship includes more than one possible way. A first variant would be the interruption of violence within the relationship. Another possibility would be to leave the violent relationship. Regarding the first option, systematic reviews and meta-analyses have pointed to the inconsistency of results of interventions with male perpetrators of violence referred by the courts (Akoensi, Koehler, Lösel, & Humphreys, 2013; Feder & Wilson 2005; Feder, Wilson, & Austin, 2008). Reviews of the literature on the subject (Feder & Wilson 2005; Feder et al., 2008) have shown that studies using experimental methods to evaluate the effects of these interventions presented modest effects when comparing treatment and control groups. Those of quasi-experimental design with an untreated comparison group indicated inconsistent results, with the possibility of small detrimental effects. The evidence, therefore, points to the weak effect of the interventions targeting perpetrators that currently exist. On the one hand, this raises the need for researches allowing the development of more effective techniques and interventions and, on the other hand, that interventions aimed at overcoming violence focus on changes in the aggressor’s behavior and on the possibility of the victim leaving the relationship.

It remains to analyze the possibilities related to the other possible path: the leaving of the relationship. This, however, is not a simple path, involving many other ramifications of possibilities with regard to continuing versus overcoming violence. First of all, it is known that breaking up does not necessarily mean the end of the violence and, in some cases, the assessment of the risks before one or another option leads the victim to conclude that permanence, at least in the short term, is the safest option (Anderson, 2003; Bell, Goodman, & Dutton, 2007; Meyer, 2012).

Second, the results of some studies have shown that the breakup of a relationship is not necessarily definitive (Bell et al., 2007; Shurman & Rodrigues, 2007) and, furthermore, that it is not always accompanied by well-being. Shurman and Rodriguez (2007), in this regard, found depression as an emotional aspect associated with the period following the end of the relationship. These results point to the need for studies to clarify which other factors contribute to improving the quality of life of people who are successful in leaving violent relationships, and to review public policies, whose actions do not end when the separation occurs.

Third, there is the possibility of engagement in new violent relationships after leaving the previous one. Martsof, Draucker, Stephenson, Cook, and Heckman (2012), in a qualitative study with 88 participants, found that 32 had experienced more than one violent dating relationship during adolescence. This highlights the fact that overcoming the cycle of violence is a complex and still little known phenomenon that deserves much attention.

Although abandoning the relationship is not a viable option in all cases - at least in the short term - or does not necessarily mean the end of the violence, it continues to be a possible path, aimed at empowerment and whose understanding has the potential to improve policies for assisting victims of intimate partner aggression. This can happen by offering new services aimed at needs that are not currently met or have not been included in the agenda, by developing preventive perspectives, especially indicated prevention (the one aimed at people who already have a problem at an early stage), or by qualifying more effective techniques and methods of intervention in existing services.

In the only previous article found reviewing the literature on the issue of leaving violent relationships, Anderson and Saunders (2003) highlighted the consistency of variables and trends in the research agenda in 20 quantitative studies and 28 qualitative studies published between 1976 and 2001. With regard to quantitative studies, this review identified the existence of four groups of variables on which the studies focused: frequency and severity of violence, history of victimization of the woman in childhood or of familial origin, psychosocial factors, external resources, and previous coping strategies. Regarding the relationship between frequency and severity of violence and the breakup of the relationship, the studies were inconsistent, probably due to the conceptualization of severity and the measures used. The same occurred with regard to the experience of violence in childhood or of familial origin, and the results among the studies were inconsistent to point to this as a factor that facilitates or hinders the abandonment of the relationship.

Concerning psychosocial factors, the most studied in the research included in Anderson and Saunders’ (2003) review was the concept of commitment to the relationship, hypothesizing that women with higher commitment would tend to stay in the relationship longer. This relationship was observed when subjective measures were used (e.g., positive feelings toward the partner), but was weaker when objective measures were used (e.g., time and status of the relationship). The variables linked to external resources, especially those related to income, were the most consistent and had the greatest predictive power among the studies. Therefore, less access to their own income or other external resources made it more difficult to leave the relationship.

Finally, the studies that inserted variables related to coping strategies for violence are pointed out by Anderson and Saunders (2003) as precursors of the idea of abandonment as a process. These researches showed that women with a greater number of breakup attempts were more likely to get it, and that those who used multiple coping strategies in addition to the breakup were more likely to be able to separate. The authors also indicate the change provided by these researches in the focus of interest, which changes from the reasons why women stay in the relationship to the reasons that allow them to leave it (Anderson & Saunders, 2003).

With regard to qualitative research, Anderson and Saunders (2003) pointed to a greater tendency in these studies to conceptualize abandonment as a process that is not restricted to definitive leaving, but involves decisions and actions that occur over months or years. The researchers interpret the phenomenon, therefore, as active and cumulative efforts by which women gradually learn more effective strategies for dealing with abuse, including abandonment. The transtheoretical model of change (Prochaska, DiClemente, & Norcross, 1984) stood out as the benchmark for interpreting the qualitative data among the studies included in the review. They identified that the women experienced an increase in their perspectives that in some cases occurred suddenly, but mostly developed from elusive perceptions about the relationship and about themselves. As facilitators in the process of leaving the relationship, the qualitative research included by the review found increased levels of violence, less affection and dedication for the partner, loss of hope for improvement in the relationship, perceived effect of the abuse on the children, and the community and professional social support network.

Anderson and Saunders (2003) also highlight aspects related to psychological well-being after the separation. This was a gap identified by them at that moment of scientific production. Among the few studies they reviewed that were concerned with this, the results showed that as time passes since separation, psychological well-being increases. On the other hand, when distinct groups were considered instead of general averages, a considerable prevalence of symptoms of depression, post-traumatic stress and anxiety was found after the leaving of the violent relationship. This point to the need for a better understanding of this period in these groups, and to investigate possible socio-demographic, health, or social support weaknesses associated with these outcomes.

This article aims to analyze the advances, limitations, and gaps in research published after the previous review (Anderson & Saunders, 2003) or not included in it about leaving violent intimate relationships and its implications. Intimate relationships are defined as premarital or marital affective-sexual relationships. It is considered that this effort may contribute to a better understanding of the state of the art in relation to the issue, whose deepening will allow the development and revision of directions for both treatment and prevention indicated in situations of intimate partner violence.

Method

A search was carried out in the Capes Periodicals and SciELO portals, using combinations of words in Portuguese, English, Spanish and French: abandonar, terminar, sair, deixar, namoros, relacionamentos, relação, casamento, violento(as), violência por parceiro íntimo (Portuguese); leave, stay/leave, abandon, end, date, relationship, IPV, partner, violence, violent, aggressive (English); dejar, salir, acabar, romper, relación, noviazgo, violento(a) (Spanish); laisser, finire, couple, relation, violent(e) (French).

The inclusion criteria were to address the process of leaving or the dynamics of staying in or leaving the relationship. The exclusion criteria were to address violence in non-love relationships and to be published before 2001 (year of publication of the most recent article of Anderson & Saunders’ review, 2003). An exception was made in relation to an article published in 1999 that had not been included in the previous review. In addition, the review included articles accessed by authors who investigate this topic.

For analysis purposes, the fourteen articles were separated into studies with quantitative and qualitative methods, for these two groups there were analysis criteria whose interest was common to both types of method and others specific to quantitative studies. The criteria common to both groups were related to the method (design, sample, sample recruitment, collection procedures, and instruments), the theoretical model(s) adopted, the types of relationships included (whether dating, marriage, stable relationship, or other), and the results found. The specific information for analysis of the quantitative studies were: independent variables, mediator variables, and dependent variables.

Results and discussion

Fourteen articles published between 1999 and 2015 were found. The search originated twelve studies in English and one in Portuguese. The countries of operation of the authors were United States (eleven articles), Brazil (one), Australia (one) and Sweden (one). The data will be presented based on the types of study: quantitative or qualitative.

Quantitative Studies

Of the fourteen articles included in this review, seven used quantitative methods. The analysis of the design of the studies showed that all of them adopted observational models, mostly cross-sectional (Alexander, Tracy, Radek, & Koverola, 2009; Choice & Lanke, 1999; Pape & Arias, 2000; Shorey, Tirone, Nathanson, Handsel, & Rhatigan, 2013; Shurman & Rodriguez, 2006). The advantages of such a design are that it fits better with the financial possibilities of the research, as well as saving time. On the other hand, it allows the observation of a limited chronological cut, implying a more fragile delineation when one wants to attribute a relation of antecedence and succession of events. Furthermore, the complexity and volatility of the dynamics of leaving and returning to the relationship cannot be captured by this type of method. Among the other studies, two were longitudinal (Bell et al., 2007; Edwards, Gidycs, & Murphy, 2015), which has greater power to establish relationships of antecedence and succession between events.

Among the adopted scales, the revised version of the Conflict Tactics Scale (revised - CTS-2), by Straus, Hamby, Boney-McCoy and Sugarman, 1996, has been relevant to studies in this field. The use of the same instrument in different studies has the advantage of allowing comparisons between data from different surveys. On the other hand, this instrument is restricted to accessing violence in conflict situations. This is an important dimension of violence, but it does not include the entire phenomenon, since other forms of violence, especially of a symbolic nature (Bourdieu, 2019), do not usually generate conflict, and even when it does, symbolic violence is commonly ignored in the situation. This term is used to define forms of violence legitimized in social relations and structures, and are culturally accepted (Bourdieu, 2019). For this reason, they go unnoticed in common sense and even in the evaluation of many experts. Its impacts, however, are quite devastating, as it creates hierarchies in how people will be able to access opportunities and rights. Gender violence and racial violence, for example, are forms of symbolic violence. With regard to domestic violence, for example, a significant expression of symbolic violence concerns the burdening of women with housework and children. Although it is naturalized, accepted, and occurs in almost all homes, this inequality has significant consequences for women: it represents a loss of possibilities for career, leisure, rest, and acceptance in the social group. It therefore has great potential for harm to financial autonomy, mental health, the development of life skills, and even access to protection (which is often wrongly denied by public officials to women who do not play this role, a risk that men do not suffer despite the degree of abandonment they may leave their children in, for example). The lack of instruments that access this dimension represents a significant gap in the studies on violent relationships. For example, take a conflict in which the man is justified in refusing to take care of the children so that the woman can study. In a situation like this, it can happen that the offense or the hostile yell comes from the woman. In the instrument that is based on behaviors in conflict situations, it is registered her shouting and offending. However, gender violence, which denies the woman the possibility of exercising basic rights of freedom, autonomy and, more seriously, of structuring her life to overcome the violence in a relationship, is completely unnoticed in this type of instrument.

The first characteristic that stands out regarding the theoretical models adopted is the increasing insertion of the transtheoretical model of change as a theoretical reference in these studies. Of the seven quantitative surveys, three use this model as the basis for data collection and analysis (Alexander et al., 2009; Shorey et al., 2013; Shurman & Rodriguez, 2006). Anderson and Saunders (2003) had pointed to its use in qualitative studies and to the tendency, in these, considering the procedural character of the abandonment of the relationship. This understanding seems to be gradually absorbed in quantitative research, which observed how demographic characteristics and other independent variables of interest were related to the stages of change, thus bringing the possibility of understanding, even in quantitative studies, abandonment not as a point in time, but as a construct that goes through different stages. The variables studied were: attachment styles, attribution (of responsibility), depression, hopelessness, anxiety and anger (Shurman & Rodriguez, 2006), demographic characteristics, attachment style, characteristic of violence, nature of the relationship and social support (Alexander et al., 2009), as well as subjective norms and commitment (Shorey et al., 2013). Another theoretical model adopted was the investment model, used in three investigations (Choice & Lanke, 1999; Edwards et al., 2014; Shorey et al., 2013).

The data pointed to a diversity of variables investigated in all the studies analyzed (Table 1).

Table 1
Study frequency of each variable

Independent or mediator variable	Nº
Characteristics of violence	3
Subjective normsb	3
Level of investment in the relationship (satisfaction with the relationship, quality of alternatives, and unrecoverable investments)	2
Commitmentb	2
Attachment Styles	2
Attributing the responsibility for violence to the partnera	2
Resources and structural barriers (income, expenses, common assets)	2
Planned behavior (intentions to leave the relationship, attitudes and control over behavior)	2
Feelings (anger, sadness, nervousness, hopelessness)	2
Mental health impacts (depression and anxiety)	1
Satisfaction with social support	1
Nature of the relationship	1

• ^a
  Pape & Arias (2000) studied emotional reactions and attribution of responsibility for violence as mediator variables between severity of violence and intention to leave the relationship.
• ^b
  Shorey et al. (2013), in addition to studying commitment and subjective norms as independent variables, checked whether there is mediation between the two variables.

Among these variables, those for which correlation with the intention, effectuation, or process of leaving the relationship was found consistently across studies or with considerable indication in just one study (in cases where it was studied only once) were subjective norms (n=3; Choice & Lanke, 1999; Shorey et al., 2013; Edwards et al., 2015), relationship investment and commitment (n=3, with Choice and Lanke studying the two variables as separate constructs) (Choice & Lanke, 1999; Shorey et al., 2013; Edwards et al., 2015), attribution of responsibility for violence to the perpetrator (n=2; Pape & Arias, 2000; Shurman & Rodriguez, 2006), resources and structural barriers (n=2; Choice & Lanke, 1999; Alexander et al., 2009), planned behavior (n=1; Edwards et al., 2015), and feeling angry (n=1; Shurman & Rodriguez, 2006). Subjective norms favoring the breakup, attribution of responsibility for the violence to the perpetrator, existence of structural resources (e.g., having own income), planned behavior, and feeling angry were positively correlated with relationship leaving. Investment in the relationship, commitment, and the existence of structural barriers (e.g., with no own income) were negatively correlated with the breakup. It is worth noting that relationship investment and commitment are defined by very close factors in the articles studying these variables.

Such results reveal a wide variety of aspects related to the progression towards abandoning the violent relationship, pointing to the considerable number of determinants operating in this process. Aspects of the social context (subjective norms), of the structural context (income, having a place to live etc.), and personal aspects (investment in the relationship, commitment, emotions, attribution of responsibility) can contribute or constitute barriers to the process of overcoming violence.

The variables for which no correlation was found were violence characteristics and satisfaction with social support (Alexander et al. 2009). Regarding the first, Anderson and Saunders (2003) had already pointed to this result among the studies, highlighting the lack of standardization of concepts and classification. The persistence of such findings reinforces the evidence that the severity of the violence is unrelated to the leaving process. About the second one, the authors discuss that the social network, although satisfactory, can be shared with the aggressor and does not offer support to leave the relationship, even though it protects regarding the severity of the violence. Thus, they consider the variability and breadth of the support network to be more important than satisfaction with it.

The results regarding attachment style were inconsistent between the two studies that considered this variable. Alexander et al. (2009) found worried attachment associated with the early stages of the transtheoretical model of change. Shurman and Rodriguez (2006), in turn, found a connection between this attachment style and readiness for change between stages. Sample differences may have generated such results, especially considering that Shurman and Rodriguez worked with women who were in shelters or temporary support residences, and it is common, in these cases, for them to be associated with other vulnerability factors, especially those related to lack of income and social support. If on the one hand this aspect brings considerable bias to the sample profile, on the other hand it highlights the characteristics of a group in a very vulnerable situation and, therefore, whose needs must be prioritized.

An important aspect to be observed is the great diversity of variables investigated in the reduced number of articles found, so that each one was studied in, at most, three research studies. Likewise, there is no in-depth study about characteristics related to any variable of interest, nor segmentation between distinct groups. This picture points to the multicausal character of the aspects related to the abandonment of violent relationships, which generates very varied hypotheses arising from observations in specific contexts and from distinct theories.

The dependent variables studied were the intention to leave the relationship, staying in or leaving the relationship, and the stages of the transtheoretical model of change focusing on the final relationship leaving. It is important to point out that, although they can be considered as a continuum, they do not necessarily express gradations of the same phenomenon, since the intention to leave the relationship does not always come true, and that being out of it does not mean that this condition will continue. Both aspects, however, are encompassed when thinking of abandonment as a process, as occurs in the stages of the transtheoretical model of change.

Analysis of the recruitment characteristics of the samples revealed four environments or strategies: community recruitment (n=3), among students (n=2), in victim or batterer service centers (n=3), and in shelters (n=3). About these forms, it is important to make some considerations. Possibly none of them can recruit cases in which the battered person is isolated from the network of services for attention to violence or inhibited in making known the situation of aggression, either for individual reasons (shame, lack of access), for those referring to the characteristics of violence (fear, serious threat) or for being in a situation of great social exclusion (people living on the street or illiterate, for example). These conditions lead to higher levels of vulnerability and stress, and samples that include these conditions can generate results to inform about unaddressed needs in existing care services. Given that some of these conditions may be more common than one might think and that it carries serious risks, strategies that allow access to them in the research context are important. Some alternatives are related to the use of existing contexts in public policies, such as those of facilitated access (for example, Call 180, in Brazil), of active search (such as cases identified in the context of the Family Health or Military Police teams) or the realization of case studies (since it is unlikely that the number of participants allows other designs) in situations identified in services not directed to the treatment of cases of violence, for example, in general hospitals.

Another considerable limitation is the power of generalization and the limitations to interpreting the data with samples recruited from shelters. In general, the researches did not bring detailed information about the social vulnerability situation (except those related to income) and the existence or not of social and family support. On the other hand, the public served by this type of service usually includes people with a high level of social vulnerability, financial difficulties, and a scarce and ineffective social support network. Hence, data such as that found by Shurman and Rodriguez (2006), that depression was a predictor of the maintenance stage in the transtheoretical model of changes, may be more related to these sample characteristics than to the stage of change, and may not be generalizable to other groups. Nevertheless, studies with women living in shelters are extremely important precisely because they shed light on a very vulnerable part of the population. However, it is necessary to make reservations about its generalization power. This aspect reinforces the thought that the groups should not be treated as homogeneous, but should be analyzed according to their specificities.

Regarding the types of relationships researched, only one study was exclusively dedicated to pre-marital relationships (Choice & Lanke, 1999). Another three involved, albeit in a minority, dating relationships in the sample (Bell et al., 2007; Edwards et al., 2015; Shurman & Rodriguez, 2006). However, they do not segment their analysis according to the type of relationship. Thus, it is not possible to clarify whether there are particularities in the process of leaving this type of relationship when compared to marriages or cohabiting relationships. This remains a gap in the literature limiting the forms of intervention for people in dating relationships and presents a large opportunity cost with regard to prevention.

Among the quantitative studies, only one (Bell et al, 2007) looked at the period following the end of the relationship and investigated well-being and exposure to violence under different outcomes that followed the condition of being separated from the partner at the beginning of the study (maintain separation, restart the relationship stably or restart the relationship alternately). This study is considered especially relevant because it sheds light on the events following the end of the relationship, pointing out that not all breakup experiences indicate the same phenomenon and opening a precious research path in the quantitative field for the generation of knowledge that allows the design of more adequate public policies and care strategies. Anderson and Saunders (2003), in their review, identified the lack of studies on the period after the end of the relationship as an important gap. Since then, there has been little progress on this point in quantitative studies.

Qualitative studies

Seven of the fourteen articles included in this review adopted qualitative methods. Regarding the method aspects, the interview was the most common data collection procedure, with the exception of two, all of the others used this resource (Cluss et al., 2006; Few & Rosen, 2005; Meyer, 2012; Murta, Ramos, Cangussú, Tavares, & Costa, 2014; Wiklund, Malmgren-Olsson, Bengs & Öhman, 2010). Anderson (2003) applied the Delphi technique, which aims to collect data with experts, and Edwards et al. (2012) used written responses to open-ended questions. The interview as a data collection strategy has the advantage of being accessible and easier for the researcher. On the other hand, the almost non-existence of other data collection strategies may limit access to some kinds of information not accessible via interviews.

Most of the studies used the transtheoretical model of change, following what had already been observed by Anderson and Saunders (2003). Of the seven studies, four used it, one related to the analysis of its adequacy to the phenomenon (Anderson, 2003), one starting from this reference and questioning it later - generating the Psychosocial Readiness Model - (Cluss et al., 2006); one using it to analyze the advancement in the stages in an interval of two months (Edwards et al., 2012) and the last one deepening the analysis in the identification of strategies that contribute to the passage from one stage to another (Murta et al., 2014).

A relevant aspect in these studies is the frequency they are devoted to analyzing the adequacy or generation of models. All of them involve one of these strands to some degree. In addition to the verifications already mentioned around the transtheoretical model of change, the adequacy to rational choice theory and the generation of new models are identified: the psychosocial readiness model (Cluss et al., 2006) and the conceptual model of vulnerability (Few & Rosen, 2005). Wiklund et al. (2010), although they do not propose a new model, they adopt stages and build a timeline for confronting violence (Wiklund et al., 2010). All the models include aspects concerning the internal and external barriers and coping resources that allow leaving the relationship and the maintenance of this condition.

The psychosocial readiness model (Cluss et al., 2006) is composed of three internal factors - perceived social support, self-efficacy, and awareness raising - situated along a continuum from fully maintaining the status quo to overcoming violence. Two external factors - social support and situational conditions (e.g., having income, having a home etc.) - push the internal factors to one side or the other of the continuum.

The conceptual model of vulnerability (Few & Rosen, 2005) is characterized by two dimensions: relational vulnerability (self-beliefs in relating to others or regarding what is acceptable in a relationship) and structural vulnerability (stressors arising from changes both inherent in the life cycle and unexpected, or from not being able to meet social expectations linked to relationship status). The model is represented in a Cartesian plane. These two dimensions are immersed in the sociocultural context.

The timeline of coping with violence (Wiklund et al., 2010) is not proposed by the authors as a theoretical model; although a common analysis framework is presented for the two cases studied, based on the timeline of events, differentiating phases towards the leaving relationship and coping with the consequences of violence after its breakup. She starts with “being under the control of a violent boyfriend”, moving through “struggling to stop the violence and leaving the relationship”, “getting back to live by herself and make a new beginning”, and finishing with “leaving the relationship and dealing with the consequences of the violence”. For each point in this process, the challenges and behaviors adopted are described.

In the scope of qualitative studies, some of the strategies to which participants resorted in the process of leaving the relationship were identified. Self-observation, social support, self-care, information seeking, solution testing (e.g., break up and restart, try to end the violence within the relationship), risk assessment for others, stimulus control, risk-benefit analysis, emotion regulation, empowerment (Murta et al., 2014). After the breakup, awareness raising about the negative emotions related to the relationship and the dysfunctional schemas that operate in love relationships, management of risky situations, attention to needs in other areas of life, analysis of losses and gains, self-worth, and dedication to new interests were the mapped strategies (Murta et al., 2014). Anderson (2003) classified the strategies according to the change processes predicted by the transtheoretical model of change.

Regarding sample recruitment, the characteristics were distinct in some points when compared to quantitative studies. The following were used as recruitment environments/groups: health services not directly related to violence (n=3), shelters for women victims of violence (n=2), community leaders in combating relationship violence who have experienced this type of situation (n=1), university students (n=1), services for victims of violence (n=1), and a convenience sample (n=1).

Although it did not include community recruitment, the significant inclusion of recruitment in health services not directly related to violence increases the chances of access to people who do not seek services directed to this issue or who are unwilling to disclose the condition of abuse in the relationship spontaneously. These places are considered privileged in the access to victims of violence, because they most often seek them with complaints that are not explicitly related to violence (e.g., pain, injuries, depressive symptoms). Therefore, a careful approach by the health professional or researcher can be an important step in addressing the problem, contributing to the generation of new knowledges (Zuma, Mendes, Cavalcanti, & Gomes, 2014). This aspect, once again, reveals the importance of using qualitative designs to elucidate situations in which access to cases is very difficult, limiting their number.

Finally, the approach of the post-breakup relationship period, noted as a gap in the previous review by Anderson and Saunders (2003), was addressed in some way in six of the seven qualitative studies (Anderson, 2003; Cluss et al., 2006; Few & Rosen, 2005; Meyer, 2012; Murta et al., 2014; Wiklund et al., 2010). Two studies addressed coping strategies for difficulties and barriers to maintaining the relationship termination (Anderson, 2003; Murta et al., 2014), one pointed the protective strategies developed after the end of the relationship and health impacts (Wilklund et al, 2010), one focused the discussion of decisions informed by the evaluation of increased risk for woman and children in the case of leaving the relationship and the planning strategies needed to leave the relationship (Meyer, 2012), and two addressed it through the insertion of facilitating aspects and barriers in the models generated for the understanding of the phenomenon (Cluss et al., 2006; Few & Rosen, 2005). If on the one hand there is concern about the period after the breakup in qualitative studies, whether in relation to the impacts or the strategies and barriers experienced, on the other hand the target and the reference remain in a single relationship and its impacts. Considering experiences with violent relationships are not necessarily restricted to a single relationship (Martsof et al., 2012), there remains as a gap the need for studies deepening the transition between relationships and whose reference is not in only one of them.

Final considerations

Some characteristics of the production of articles on the topic of leaving violent relationships between 1999 and 2015 were identified in this review. The quantitative studies reviewed were marked by the early insertion of the procedural dimension by the transtheoretical model of change in explaining the leaving of violent relationships, the large diversity of variables, the little differentiation when analyzing the data between dating and marriage relationships, and the limitation in the variety of recruitment of the sample. Qualitative studies had as characteristics the significant adoption of the procedural dimension of abandoning a violent relationship, the search for adequacy and generation of models for understanding the phenomenon, the variety of sample recruitment with the inclusion of groups recruited in health services not directly related to violence, and the consideration of aspects related to the post-breakup of the relationship.

The qualitative articles were unanimous in their use of theories that understand the leaving as a process, either through the transtheoretical model of change, or from the perspective of generating other theories, such as the psychosocial readiness model (Cluss et al., 2006) or the conceptual model of vulnerability (Few & Rosen, 2005). Regarding quantitative studies, the understanding of the processual character of the phenomenon consists more specifically in the adoption of the transtheoretical model of change. These aspects confirm the analysis of the review by Anderson and Saunders (2003), pointing to the adoption of the understanding of abandonment as a process in the qualitative studies produced until then. In recent years, therefore, this trend has also been observed in quantitative studies.

The production of knowledge about the period after the end of violent intimate relationships was indicated by Anderson and Saunders (2003) as a gap. Apparently, although advances have been made in this field, they were small. Among the qualitative studies, the investigation of aspects related to the period after the breakup has focused on the period immediately following the breakup (or the maintenance of the end of the relationship). Among the quantitative studies, only two mention themes related to this moment in their discussions, without, however, addressing them centrally, and only one focuses on elucidating the conditions experienced in this period and their impact on well-being and on the experience of violence.

The implications of the findings for professional practice point to strategies valuable to be adopted by care services. The importance of subjective norms as facilitators (or barriers) to the breakup emphasizes the need for interventions not to focus exclusively on the victim or perpetrator of the violence, but including other important people. In the macro context, addressing the issue in the media with a focus on breaking prejudices and disseminating ideas encouraging protection and support by peers or family members to people who suffer violence has great potential to contribute to more adequate social support, which tends to generate positive impacts on ending the relationship. Investment in the quality of supportive relationships also gains prominence in the face of the results that showed investment in the relationship as a factor related to the breakup. Since the quality of alternatives is part of the construct that defines investment, positive friendship social relationships tend to increase the evaluation of the alternative of leaving a relationship and remaining without a partner. Thus, people who have social support in other spheres of their lives also have emotional support to face the difficult task of leaving and staying out of a relationship.

The emphasis on the quality of the alternatives to the relationship brings another consequence for the services for victims of violence: the creation of living spaces based on leisure and socialization activities that do not directly address violence can be an important strategy in combating it by fostering social interactions and expanding repertoires. Furthermore, such strategies have the advantage of being more attractive to the public that still has difficulty in perceiving itself in a violent condition.

The need to address external structural barriers to breakup is once again evident from the results presented. Such barriers coincide with contexts of social vulnerability, especially those related to poverty. Initiatives related to income generation, housing (especially on an emergency basis), and providing emergency basic needs (such as the emergency aid foreseen in the Unified Social Assistance System - SUAS - Sistema Único de Assistência Social) demand attention from the services. Apparently, interdisciplinary professional approaches that address the practical needs (which act as external structural barriers) and those that permeate the psychosocial issues (internal) have a greater potential for effectiveness.

Regarding the structural barriers, it is important to highlight the importance of the existence of a legal framework to protect women, as occurred in Brazil with the Maria da Penha Law, which inaugurated a new era in the assistance to situations of violence in the domestic and family sphere. The existence of State policies allows for a significant decrease in external barriers, since it removes from the individual and family sphere the exclusive burden of dealing with violence and inserts legal protections that instrumentalize the search for rights, enforce the individual’s will about leaving the relationship, and create, in a longer time, social changes favorable to the end of violence.

The results of this review should be interpreted in light of its limitations. Among these, we point out the difficulty of replicating the search processes, which reduces its systematization character. Furthermore, we highlight that the data were analyzed by only one author, without verification of agreement between coders, which limits the reliability of the analyses. Finally, the epistemological context was not among the analysis criteria of the identified studies, which can be solved in new reviews.

Some gaps are identified in the literature from this review. First, there is a need for more researches focusing on the post-separation period, a gap that had already been pointed out in the previous review and for which there has been little progress since then. This aspect has special importance when considering that separations are not always final and, in some cases, not enough to generate well-being. Apart from the period immediately following the breakup, the transition to new relationships has been neglected by scientific studies. Given that the social interest in clarifying the issues concerning leaving violent relationships is not only that people breakup specific relationships, but that they live free from violence in intimate relationships, a greater understanding of the processes of transition to new relationships is urgent and may allow for the improvement of the provision of support for people leaving violent relationships.

Another aspect that needs explanation concerns the generation of more knowledge about people and groups that do not access the services directed to the attention to violence or that do not even reveal this condition. This group is in a condition of extreme vulnerability, which highlights the need for an active search for these subjects and demands, as a priority, the use of qualitative methods, both because they allow an in-depth understanding of individual realities and because of the difficulty of access to these people who do not ask for help. Strategies that use the Internet for research and intervention are also promising.

From the perspective of prevention, the need for greater knowledge of the initial processes that favor termination stands out as a precious strategy to improve indicated prevention programs, especially in dating relationships in which violence initially appears. Entering into violent relationships still deserves attention from this perspective. Understanding how people enter into violent relationships can point to meaningful strategies for universal prevention (directed at the entire population).

Finally, the need for stratification of the data on dating relationships and marriage/stable relationships is emphasized, both because of the specificities of intervention needs in each type of relationship and because of the great potential for generating preventive interventions existing in the greater understanding of the processes involved in the dating relationship. Treating the data as characterizing the same group may be hiding relevant specificities and obscuring the analyses. Furthermore, the importance of studies considering the stratification of groups and profiles, adopting moderator variables, is emphasized, given the great variety of internal and external conditions to which people are exposed in the context of leaving violent relationships and the potential to elucidate the divergence of results from data from different samples. Vulnerabilities related to poverty are more evident in the studies, but other social issues - such as those concerning race, sexual orientation, having a disability, for example - whose intersection relates to the experience of violent relationships, should not be ignored and could be better studied in future research. In addition, differences between dating relationships and marriage should be more explored.

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Publication Dates

• Publication in this collection
  23 Aug 2021
• Date of issue
  2021

History

• Received
  13 Mar 2018
• Reviewed
  01 Sept 2020
• Accepted
  23 June 2021