Skip to main content

Family violence in Victoria, Australia: a retrospective case-control study of forensic medical casework



To identify the risk factors and assault characteristics of family violence among victims referred for forensic medical examination in Victoria, Australia.


A retrospective 1:1 case-control study was conducted, comparing adult family violence victims and non-family violence victims examined by clinical forensic practitioners from the Victorian Institute of Forensic Medicine, between July 2015 and June 2016. Data were extracted from victims’ forensic medical casework. Chi-square or Fisher’s exact tests and Mann-Whitney U tests were used to examine group differences. A multiple logistic regression analysis was used to determine independent predictors of family violence.


One hundred and forty-three family violence victims (97.2% female, Mdnage = 29, 90.2% intimate partner violence) were identified and gender- and age-matched with controls. Family violence victims had significantly higher odds of reporting a history of violence victimisation (OR = 5.20; 95% CI, 2.54 to 10.66) and current pregnancy (OR = 5.28; 95% CI, 1.09 to 25.46) than controls. Family violence was significantly more likely than non-family violence to occur in the victim’s home, and to involve physical assault, use of weapon(s), trauma to the neck and anal sexual assault. Family violence victims sustained significantly more physical injuries, and were more likely to be injured to almost every bodily location, than controls.


This study highlights the importance of assessing and managing risk for family violence following initial victimisation and throughout pregnancy. Findings further indicate that family violence is more dangerous (i.e. more likely to involve severe forms of assault and cause injury) than non-family violence.

This is a preview of subscription content, access via your institution.


  1. 1.

    Exceptions include examinations conducted at the request of the Department of Health and Human Services or defence counsel. A small number of sexual assault examinations are also conducted as part of a ‘Just in Case’ program run by the Department of Justice and Regulation without Victoria Police involvement.

  2. 2.

    Forensic ‘recency’ is determined by the biological sampling time threshold, which depends on the nature of allegations and is subject to protocol change determined by scientific advice. It is generally approximately 72 h.

  3. 3.

    During the timeframe of this study. CASA now attend examinations of family violence victims as part of a pilot to implement recommendations from the Royal Commission into Family Violence.


  1. 1.

    Family Violence Protection Act 2008 (Vic).$FILE/08-52a.pdf. Accessed 10 April 2017

  2. 2.

    Ranson D, Williams A, Thorne B, Ryan J (2016) Family violence and clinical forensic medicine – the forgotten service? J Law Med 23(4):780–784

    PubMed  Google Scholar 

  3. 3.

    Tomison AM (2000) Exploring family violence: links between child maltreatment and domestic violence. In: National child protection clearinghouse issues in child abuse prevention paper No. 13. Australian Institute of Family Studies. Accessed 29 July 2017

  4. 4.

    Phillips J, Vandenbroek P (2014) Domestic, family and sexual violence in Australia: an overview of the issues. Parliament of Australia. Accessed 20 May 2017

  5. 5.

    Crime Statistics Agency (2017) Family violence data portal. Accessed 17 Aug 2017

  6. 6.

    State of Victoria (2016) Royal Commission into family violence: summary and recommendations. Parliamentary Paper No. 132 (2014-16). Accessed 10 April 2017

  7. 7.

    Adams CM (2006) The consequences of witnessing family violence on children and implications for family counselors. Fam J 14(4):334–341.

    Google Scholar 

  8. 8.

    Campbell JC (2002) Health consequences of intimate partner violence. Lancet 359(9314):1331–1336.

    PubMed  Google Scholar 

  9. 9.

    Dillon G, Hussain R, Loxton D, Rahman S (2013) Mental and physical health and intimate partner violence against women: a review of the literature. Int J Fam Med 2013:1–15.

    Google Scholar 

  10. 10.

    Lagdon S, Armour C, Stringer M (2014) Adult experience of mental health outcomes as a result of intimate partner violence victimisation: a systematic review. Eur J Psychotraumatol 5:1–12.

    Google Scholar 

  11. 11.

    Costa BM, Kaestle CE, Walker A, Curtis A, Day A, Toumbourou JW, Miller P (2015) Longitudinal predictors of domestic violence perpetration and victimization: a systematic review. Aggress Violent Behav 24:261–272.

    Google Scholar 

  12. 12.

    Heyman R, Smith Slep A (2001) Risk factors for family violence: introduction to the special series. Aggress Violent Behav 6(2–3):115–119.

    Google Scholar 

  13. 13.

    Australia’s National Research Organisation for Women’s Safety (2014) Violence against women: key statistics. Accessed 29 July 2017

  14. 14.

    Crime Statistics Agency (2016) An overview of family violence in Victoria: findings from the Victorian Family Violence Database 2009–10 to 2013–14. Provided to the Royal Commission into Family Violence on 8 January 2016. Accessed 10 April 2017

  15. 15.

    People with Disability Australia, Domestic Violence NSW (2015) Women with disability and domestic and family violence: a guide for policy and practice. Accessed 24 Jan 2018

  16. 16.

    Campo M, Tayton S (2015) Intimate partner violence in lesbian, gay, bisexual, trans, intersex and queer communities: key issues. Australian Institute of Family Studies. Accessed 17 Aug 2017

  17. 17.

    Horsley P (2015) Family violence and the LGBTI community: submission to the Victorian Royal Commission into Family Violence. Gay and lesbian health Victoria, Australian Research Centre in Sex, Health & Society, La Trobe University. Accessed 17 Aug 2017

  18. 18.

    Stanley J, Kovacs K, Tomison AM, Cripps K (2002) Child abuse and family violence in Aboriginal communities: exploring child sexual abuse in Western Australia. National Child Protection Clearinghouse, Australian Institute of Family Studies. Accessed 24 Jan 2018

  19. 19.

    Department of Human Services (2012) Family violence risk assessment and risk management framework and practice guides 1–3, 2nd edn. Victorian Government, Department of Human Services. Accessed 20 May 2017

  20. 20.

    Coohey C (2007) The relationship between mothers’ social networks and severe domestic violence: a test of the social isolation hypothesis. Violence Vict 22(4):503–512.

    PubMed  Google Scholar 

  21. 21.

    Logan TK, Walker R (2004) Separation as a risk factor for victims of intimate partner violence: beyond lethality and injury. J Interpers Violence 19(12):1478–1486.

    CAS  PubMed  Google Scholar 

  22. 22.

    Riggs DS, Caulfield MB, Street AE (2000) Risk for domestic violence: factors associated with perpetration and victimization. J Clin Psychol 56(10):1289–1316.<1289::AID-JCLP4>3.0.CO;2-Z

    CAS  PubMed  Google Scholar 

  23. 23.

    Trevillion K, Oram S, Feder G, Howard LM (2012) Experiences of domestic violence and mental disorders: a systematic review and meta-analysis. PLoS One 7(12):e51740.

    CAS  PubMed  PubMed Central  Google Scholar 

  24. 24.

    Abramsky T, Watts C, Garcia-Moreno C, Devries K, Kiss L, Ellsberg M et al (2011) What factors are associated with recent intimate partner violence? Findings from the WHO multi-country study on women’s health and domestic violence. BMC Public Health 11:109.

    PubMed  PubMed Central  Google Scholar 

  25. 25.

    Smith CA, Ireland TO, Park A, Elwyn L, Thornberry TP (2011) Intergenerational continuities and discontinuities in intimate partner violence: a two-generational prospective study. J Interpers Violence 26(18):3720–3752.

    PubMed  Google Scholar 

  26. 26.

    Smith-Marek EN, Cafferky B, Dharnidharka P, Mallory AB, Dominguez M, High J, Stith SM, Mendez M (2015) Effects of childhood experiences of family violence on adult partner violence: a meta-analytic review. J Fam Theory Rev 7(4):498–519.

    Google Scholar 

  27. 27.

    Stith SM, Rosen KH, Middleton KA, Busch AL, Lundeberg K, Carlton RP (2000) The intergenerational transmission of spouse abuse: a meta-analysis. J Marriage Fam 62(3):640–654.

    Google Scholar 

  28. 28.

    Vezina J, Hebert M (2007) Risk factors for victimization in romantic relationships of young women: a review of empirical studies and implications for prevention. Trauma Violence Abuse 8(1):33–66.

    PubMed  Google Scholar 

  29. 29.

    Cox P (2015) Violence against women in Australia: additional analysis of the Australian Bureau of Statistics’ Personal Safety Survey, 2012. Australian National Research Organisation for Women’s Safety. Accessed 14 Sept 2017

  30. 30.

    Mouzos J, Makkai T (2004) Women’s experiences of male violence: findings from the Australian component of the International Violence Against Women Survey (IVAWS). Research and Public Policy Series 56. Australian Institute of Criminology. Accessed 19 Sept 2017

  31. 31.

    Bonomi A, Anderson M, Nemeth J, Bartle-Haring S, Buettner C, Schipper D (2012) Dating violence victimization across the teen years: abuse frequency, number of abusive partners, and age at first occurrence. BMC Public Health 12:637–647.

    PubMed  PubMed Central  Google Scholar 

  32. 32.

    Exner-Cortens D, Eckenrode J, Bunge J, Rothman E (2017) Revictimization after adolescent dating violence in a matched, national sample of youth. J Adolesc Health 60(2):176–183.

    PubMed  Google Scholar 

  33. 33.

    Walby S, Allen J (2004) Domestic violence, sexual assault and stalking: findings from the British Crime Survey. Home Office. Accessed 17 Jan 2018

  34. 34.

    Iverson KM, Litwack SD, Pineles SL, Suvak MK, Vaughn RA, Resick PA (2013) Predictors of intimate partner violence revictimization: the relative impact of distinct PTSD symptoms, dissociation, and coping strategies. J Trauma Stress 26(1):102–110.

    PubMed  Google Scholar 

  35. 35.

    Kuijpers KF, van der Knaap LM, Winkel FW (2012) Risk of revictimization of intimate partner violence: the role of attachment, anger and violent behavior of the victim. J Fam Violence 27(1):33–44.

    PubMed  Google Scholar 

  36. 36.

    Bacchus L, Mezey G, Bewley S (2006) A qualitative exploration of the nature of domestic violence in pregnancy. Violence Against Women 12(6):588–604.

    PubMed  Google Scholar 

  37. 37.

    Campo M (2015) Domestic and family violence in pregnancy and early parenthood: overview and emerging interventions. Australian Institute of Family Studies. Accessed 19 Sept 2017

  38. 38.

    Atkinson A, Anderson Z, Hughes K, Bellis MA, Sumnall H, Syed Q (2009) Interpersonal violence and illicit drugs. World Health Organization Collaborating Centre for Violence Prevention. Accessed 30 Sept 2017

  39. 39.

    Hughes K, Bellis MA, Jones L, Wood S, Bates G, Eckley L, McCoy E, Mikton C, Shakespeare T, Officer A (2012) Prevalence and risk of violence against adults with disabilities: a systematic review and meta-analysis of observational studies. Lancet 379(9826):1621–1629.

    PubMed  Google Scholar 

  40. 40.

    Krnjacki L, Emerson E, Llewellyn G, Kavanagh AM (2016) Prevalence and risk of violence against people with and without disabilities: findings from an Australian population-based study. Aust N Z J Public Health 40(1):16–21.

    PubMed  Google Scholar 

  41. 41.

    Victorian Health Promotion Foundation (2013) Australians’ attitudes to violence against women: findings from the 2013 National Community Attitudes towards Violence Against Women Survey (NCAS). Accessed 19 Sept 2017

  42. 42.

    Erez E (2002) Domestic violence and the criminal justice system: an overview. Online J Issues Nurs 7(1) Accessed 24 Jan 2018

  43. 43.

    Swan S, Gambone L, Caldwell J, Sullivan T, Snow D (2008) A review of research on women’s use of violence with male intimate partners. Violence Vict 23(3):301–314.

    PubMed  PubMed Central  Google Scholar 

  44. 44.

    Garcia-Moreno C, Jansen H, Ellsberg M, Heise L, Watts C (2006) Prevalence of intimate partner violence: findings from the WHO multi-country study on women’s health and domestic violence. Lancet 368(9543):1260–1269.

    PubMed  Google Scholar 

  45. 45.

    Sheridan DJ, Nash KR (2007) Acute injury patterns of intimate partner violence victims. Trauma Violence Abuse 8(3):281–289.

    PubMed  Google Scholar 

  46. 46.

    Mcquown C, Frey J, Steer S, Fletcher GE, Kinkopf B, Fakler M, Prulhiere V (2016) Prevalence of strangulation in survivors of sexual assault and domestic violence. Am J Emerg Med 34(7):1281–1285.

    PubMed  Google Scholar 

  47. 47.

    Shields LB, Corey TS, Weakley-Jones B, Stewart D (2010) Living victims of strangulation: a 10-year review of cases in a metropolitan community. Am J Forensic Med Pathol 31(4):320–325

    PubMed  Google Scholar 

  48. 48.

    Zilkens RR, Phillips MA, Kelly MC, Mukhtar SA, Semmens JB, Smith DA (2016) Non-fatal strangulation in sexual assault: a study of clinical and assault characteristics highlighting the role of intimate partner violence. J Forensic Legal Med 43:1–7.

    Google Scholar 

  49. 49.

    Thomas KA, Joshi M, Sorenson SB (2014) “Do you know what it feels like to drown?”: strangulation as coercive control in intimate relationships. Psychol Women Q 38(1):124–137.

    Google Scholar 

  50. 50.

    Du Mont J, Woldeyohannes M, Macdonald S, Kosa D, Turner L (2017) A comparison of intimate partner and other sexual assault survivors’ use of different types of specialized hospital-based violence services. BMC Womens Health 17(1):59.

    PubMed  PubMed Central  Google Scholar 

  51. 51.

    Möller A, Bäckström T, Söndergaard H, Helström L (2012) Patterns of injury and reported violence depending on relationship to assailant in female Swedish sexual assault victims. J Interpers Violence 27(16):3131–3148.

    PubMed  Google Scholar 

  52. 52.

    Zilkens RR, Smith DA, Kelly MC, Mukhtar SA, Semmens JB, Phillips MA (2017) Sexual assault and general body injuries: a detailed cross-sectional Australian study of 1163 women. Forensic Sci Int 279:112–120.

    PubMed  Google Scholar 

  53. 53.

    Logan TK, Cole J, Capillo A (2007) Differential characteristics of intimate partner, acquaintance, and stranger rape survivors examined by a Sexual Assault Nurse Examiner (SANE). J Interpers Violence 22(8):1066–1076.

    CAS  PubMed  Google Scholar 

  54. 54.

    Curca GC, Dermengiu D, Hostiuc S (2012) Patterns of injuries in domestic violence in a Romanian population. J Interpers Violence 27(14):2889–2902.

    PubMed  Google Scholar 

  55. 55.

    Biroscak BJ, Smith PK, Roznowski H, Tucker J, Carlson G (2006) Intimate partner violence against women: findings from one state’s ED surveillance system. J Emerg Nurs 32(1):12–16.

    PubMed  Google Scholar 

  56. 56.

    Centers for Disease Control and Prevention (2005) Intimate partner violence injuries – Oklahoma, 2002. Morb Mortal Wkly Rep 54(41):1041–1045

    Google Scholar 

  57. 57.

    Wong JY, Choi AW, Fong DY, Wong JK, Lau CL, Kam CW (2014) Patterns, aetiology and risk factors of intimate partner violence-related injuries to head, neck and face in Chinese women. BMC Womens Health 14:6–14.

    PubMed  PubMed Central  Google Scholar 

  58. 58.

    Saddki N, Suhaimi AA, Daud R (2010) Maxillofacial injuries associated with intimate partner violence in women. BMC Public Health 10:268–273.

    PubMed  PubMed Central  Google Scholar 

  59. 59.

    Borooah VK, Mangan J (2009) Home is where the hurt is: an econometric analysis of injuries caused by spousal assault. Appl Econ 41(21):2779–2787.

    Google Scholar 

  60. 60.

    Matteoli M, Piacentino D, Kotzalidis GD, Serata D, Rapinesi C, Angeletti G, Rossi M, David V, De Dominicis C (2016) The clinical and radiological examination of acute intimate partner violence injuries: a retrospective analysis of an Italian cohort of women. Violence Vict 31(1):85–102.

    PubMed  Google Scholar 

  61. 61.

    Wu V, Huff H, Bhandari M (2010) Pattern of physical injury associated with intimate partner violence in women presenting to the emergency department: a systematic review and meta-analysis. Trauma Violence Abuse 11(2):71–82.

    PubMed  Google Scholar 

  62. 62.

    Department of Health and Human Services (2017) Victorian data linkages. Accessed 24 Jan 2018

Download references


The authors would like to thank Maaike Moller, Lyndal Bugeja and Nikolaos Kazantzis for their assistance with interpretation and presentation of the data. We are also grateful to the staff at the VIFM who assisted us in the collection of cases, especially Alexander Gillard.

Author information



Corresponding author

Correspondence to Laura Zark.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Approval for this study was obtained from the VIFM Research Advisory Committee (RAC 008/17) and VIFM Human Research Ethics Committee (EC 06/2017).

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Zark, L., Hammond, S.M., Williams, A. et al. Family violence in Victoria, Australia: a retrospective case-control study of forensic medical casework. Int J Legal Med 133, 1537–1547 (2019).

Download citation


  • Family violence
  • Domestic violence
  • Clinical forensic medicine
  • Medicolegal casework