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Abstract

Understanding the population distribution and dynamics of intimate partner violence (IPV) perpetration is necessary for designing effective prevention strategies and informing public health responses. While general population health surveys are widely used to estimate the prevalence and burden of IPV victimisation, the extent to which they capture IPV perpetration is under-explored. This review systematically identified and assessed general population health surveys measuring IPV perpetration, focusing on their methodological and measurement approaches. Searches of four electronic databases identified 39 papers reporting on 27 survey data sources. Five broad categories of measurement tools are described: survey data sources using or adapting the UN Multi-Country Study; the 2005 WHO research tool for violence against women and girls; the Conflicts Tactics Scale (CTS) and its subsequent versions, and two categories of ad hoc measures (with either more than two items, or one or two items). Substantial variation was found in the measurement of forms of IPV perpetration measured, particularly in the inclusion of non-physical forms, the use of frequency and reference periods, and the assessment of harm. Most surveys did not collect information on the sex or number of victims, escalation, or repeat perpetration, and few described item development or validation. Improved and standardised measurement of IPV perpetration in general population health surveys is essential to strengthen the evidence base and inform effective prevention strategies, service responses, and public policy.

Keywords

intimate partner violence (IPV)IPV perpetration health surveys

Introduction

Preventing the perpetration of intimate partner violence (IPV) is a priority for policymakers and researchers around the world. Broadly defined as deliberate or intended physical, sexual, emotional, psychological, and/or financial harm toward a partner or ex-partner, IPV is highly prevalent (World Health Organization, 2023) and associated with mental and physical morbidity and with death from homicide, suicide, and internal medical causes (Stubbs & Szoeke, 2022; White et al., 2024) . It is widely held that research on IPV should attend not only to victims of IPV, but also to those who perpetrate IPV and to other parties who may be affected by IPV including children in the family/household, and the wider population (Oram et al., 2022). Despite decades of research on interventions, theories, and evidence concerning IPV perpetrators (Devaney & Lazenbatt, 2016, policies and programmes to address IPV perpetrators remain underdeveloped. Internationally, there are calls for coordinated policy responses to IPV perpetration amidst widespread concerns about inadequate criminal justice systems responses (Hester et al., 2020). Perpetration of IPV is relevant to public health and health systems, both as a distal driver of morbidity and as an indicator of poor mental health, substance use difficulties, and exposure to interpersonal trauma (Grace & Anderson, 2018; Jewkes et al., 2012). Research studies on IPV perpetrators have clarified the factors which shape IPV perpetration risk, including the role of alcohol and substance misuse, childhood trauma exposure, and mental ill health (reviewed in e.g., [Kim, 2023; Spencer & Stith, 2020]). This work has contributed important evidence on the impact of key factors, including previous use of weapons, educational attainment, and recent separation or threat of separation, in increasing risk of IPV perpetration. However, many of these studies have selected research participants based on receiving behavioural interventions, or criminal justice contact.

General population health surveys employ random sampling of residents within defined geographic catchments to arrive at representative estimates for disease and risk factor burden (Porta et al., 2014). They are sources of evidence on the population distribution of health states and associated risk factors, informing the development of national and local health policy (Corsi et al., 2012; Hatch et al., 2012; Jenkins et al., 1997; Kilpeläinen et al., 2019) to address a range of challenges including mental ill health (Jenkins, 2001) and childhood disease (Rodríguez et al., 2015). In particular, general population health surveys have been critical to the characterisation of the public health burden of IPV suffered by victims (Leung et al., 2019). General population health surveys are an important resource to improve understanding of IPV including the role of mental health and substance misuse, allowing triangulation with data from statutory agencies (Bunce et al., 2023).

The use of general population health surveys to answer research questions on the perpetration of IPV is more limited. The extent and quality of data collection on IPV perpetration within general population health surveys has not been comprehensively reported. In a narrative review of IPV measurement in surveys, Campbell et al. (2006) highlighted the measurement of IPV perpetration in the National Survey on Drug Use and Health (NSDUH), but did not describe or evaluate the measurement of IPV perpetration in depth, and examined only surveys from the United States. More recently, Skafida et al. (2023) considered IPV measurement in cohort and cross-sectional data for any purpose (including health data as well as criminological studies) but did so for England only.

In this paper, we systematically review the literature to consolidate existing sources of general population health survey data collected on IPV perpetration and to describe and evaluate the measurement tools used by these surveys. We then use this evidence to consider the current capability of these data to inform policy and practice, and to make recommendations for future collection of general population data on IPV perpetration.

Methods

Study Design

We carried out a systematic review of peer reviewed research studies/articles. The review was conducted and reported in accordance with the PRISMA 2020 guidelines. The review protocol was not prospectively registered. The review question, eligibility criteria, and analytic approach were specified a priori and adhered to throughout the review process.

Inclusion and Exclusion Criteria

We included peer-reviewed studies/articles which measured IPV perpetration using adult general population health survey data. We defined a general population health survey (or survey data source) as a survey which used a specified sampling frame for random (or probability) sampling and reported collection of data on information on one or more health outcome, with the aim of generating representative estimates for the prevalence of health-related states, or risk factor associations (Porta et al., 2014). We included surveys where the target population was restricted based on age, gender, and ethnicity. We placed no limits on geographic location but only included studies/articles reported in English. We excluded studies/articles which, for example, examined only samples of IPV perpetrators, only sampled currently coupled individuals, or only sampled military populations. We also excluded cohorts of individuals of fixed age (i.e., birth cohorts and school cohorts).

Search Strategy

We searched the literature for the following search terms: “partner violence” or “couple violence” or “spousal violence” or “domestic violence” or “domestic abuse” and perpetration or offending or batterer or aggress*; AND survey or cross-section*; AND representative or representative*. Search terms were applied to the following databases on December 14, 2025: Embase, Ovid MEDLINE/PubMed, Global Health, and APA PsycINFO.

Screening and Extraction of Measurement Characteristics

Screening and data extraction were carried out by VB. Titles and abstracts were screened against inclusion criteria, and potentially eligible articles/studies retrieved for full-text screening. Data were extracted from both eligible articles/studies and web-based information on the underlying survey data sources (where publicly available), based on a pre-specified extraction form. We extracted details of the items used by each survey data source to measure IPV perpetration, the study setting and sampling procedure, forms of IPV harmful behaviour captured, health outcomes collected/analysed, and prevalence estimates (disaggregated by sex where possible) for IPV perpetration. Where multiple articles/studies reported the same survey data source, discrepancies between studies (e.g. in the number of forms of IPV harmful behaviour captured) were described.

We also extracted information to support the description and evaluation of the measurement of IPV perpetration in the included articles/studies and associated survey data sources, including findings on the prevalence of IPV perpetration disaggregated by gender where possible. As there is no current consensus on the adequate measurement of IPV perpetration in epidemiological research, we defined a set of characteristics based on the work of Heise and Hossain (2017), Bender (2017), and Walby et al. (2017):

(1) IPV perpetration items align with a stated definition of IPV or IPV perpetration.

(2) Measurements of perpetrated IPV are not limited to physical IPV.

(3) Information is gathered on the sex of the victims of IPV perpetrated by the respondent.

(4) Information is gathered on the nature of intimate relationship in which IPV was perpetrated by the respondent (for example, whether it was in a current or previous relationship).

(5) The frequency and/or repetition of IPV perpetration (including the number of separate victims of IPV) are measured, and reference periods for IPV perpetration provided.

(6) The harmful impact of perpetrated IPV (in addition to IPV behaviours) is measured.

(7) There is description of item development and testing.

(8) There is reported involvement of victim/survivors and/or perpetrators of IPV in item development.

Results

Searches identified 3,283 records (2,283 from four databases and 1,000 from Google Scholar). After title and abstract screening, 231 full-text reports were sought and retrieved. Following full-text assessment, 39 reports, analysing 27 eligible survey data sources, were included in the review; the most common reasons for exclusion were non-representative sampling, restriction to currently partnered samples, and studies focusing on IPV victimisation rather than perpetration (a PRISMA flow diagram is provided as supplementary information). Survey data sources are reported in Table 1, grouped by measurement tool/approach. All survey data sources used multi-stage stage area-based random (or probability) sampling procedures. Fourteen survey data sources collected information on perpetration of physical and sexual IPV, with eight of these survey data sources further collecting information on emotional/psychological IPV. Among these eight survey data sources which collected information on emotional/psychological IPV, three collected data on economic/financial IPV perpetration. One survey data source collected information on perpetration of cyber IPV as well as physical, sexual, and emotional/psychological IPV. We identified no survey data sources collecting general population data on perpetration of stalking and harassment in IPV. No survey data sources assessed the impact on child victims of IPV perpetrated by respondents. Thirteen survey data sources included information on IPV perpetration in men only, with three sources reporting information on IPV perpetration by women only. Nine survey data sources contained information on IPV perpetration in both men and women.

Table 1.

Overview of Data Sources and Measurement of IPV Perpetration.

Measurement approach	Name of survey data source and publications	Setting and sampling procedure	Forms of IPV harmful behaviour captured	Health outcomes collected	Overview of prevalence findings
UN-MCS	Original MCS: (Fulu et al., 2013, Fonseka et al., 2015, Willie et al., 2022, Jewkes et al., 2025)	Original MCS: multi-stage representative sampling of households in Bangladesh, Cambodia, Chine, Indonesia, Papua New Guinea, and Sri Lanka	Physical, sexual, and emotional /psychological IPV. Economic/financial IPV perpetration collected in original MCS and Germany survey, not in Zimbabwe.	Depression, self-rated health, and self-harm/suicide attempt.	In the original UN-MCS, the prevalence of IPV perpetration in Bangladesh was 32.4%; China 16.0%; Indonesia 38.1%; Papua New Guinea 13.5%, and 49.4% in Sri Lanka.
		Zimbabwe: Machisa and Shamu (2018)	Zimbabwe: multistage random sampling of households in Zimbabwe with the 2002 Zimbabwe population census as the sampling frame.		PTSD, depressive symptoms.	In the Zimbabwe survey, among 2,838 men who had previously been in heterosexual intimate relationships, 41% perpetrated IPV in lifetime and 8.8% perpetrated IPV in the 12 months before the survey.
		Germany: Clemens et al. (2023), (Berthold et al., 2024)	Multi-stage sampling incorporating a random route procedure and a probability sample of the German general population.		Self-described as a survey of psychological health	In the survey of Germany, psychological IPV was reported most frequently by a total of by 247 (10.0%) of participants, followed by sexual IPV; reported by 235 (9.5%) Participants, and physical IPV was reported by 144 (5.8%) participants.
2005 WHO instrument	Ghana RRS study (Chirwa et al., 2018)	Ghana: population based survey of men living in 4 districts of central Ghana, sampled according to cluster definitions used in the Ghana DHS, using a multistage stratified cluster random sampling.	Physical, sexual, emotional and economic IPV perpetration	Depression, PTSD, substance use.	In the Ghana RRS, around 50% of men reported perpetrating any form of IPV in their lifetime.
	Dagoretti IPV HIV Survey: (Ringwald et al., 2022)	Random sample of a residents living in an informal settlement in Nairobi, Kenya.	Emotional, physical and sexual IPV measured.	Survey conducted within an evaluation of integrated HIV and IPV management	In the Dagoretti survey, the prevalence of emotional IPV perpetration was 34.4% in women, and 40.9% in men, the prevalence of physical IPV perpetration was 9.9% in women and 26.4% in men, and the prevalence of sexual IPV was 3.3% for women and 23.6% for men.
	Gauteng WHO Survey: (Machisa et al., 2016)	Two stage random sampling of households in Gauteng Province, South Africa	Physical and sexual IPV	Mental health, substance use, depression, and PTSD symptoms.	In the Gauteng survey, nearly a third of men reported perpetrating sexual IPV, and 56% reported perpetrating physical IPV, in their lifetime.
	North West Province Survey: (Treves-Kagan et al., 2021)	Multi-stage sampling of 23 enumeration areas in two subdistricts of NW Province.	Physical and sexual IPV	Survey to characterise HIV and risk factors in the study area	In the survey of North West Province, lifetime perpetration of IPV was 11.1% in men and 7.0% in women.
CTS/CTSSF	The NESARC: (Roberts et al., 2010; Maldonado et al., 2020; Okuda et al., 2015; Lee et al., 2023; Hahn et al., 2015)	Multi-stage cluster sampling of the U.S. adult population, oversampling, Black, Latino, and younger individuals.	Physical and sexual IPV in all studies except Lee, which did not collect sexual IPV	Problem drinking and smoking, and mental health and suicide	The NESARC 12-month prevalence of any IPV perpetration in the general population was 5.7% (4.2% in men and 7.0% in women) and significantly more common for females than males (p < 0.001).
	The HANDLS study: (Maldonado et al., 2022)	Area probability sample of Baltimore, Maryland, aiming to be representative of age, sex, race, and socioeconomic status.	Physical and sexual IPV	Anxiety, depressive and post-traumatic stress symptoms	In HANDLS wave 4, 71% reported engaging in at least one form of IPV. Maldonado et al. (2022) state that women self-reported more IPV perpetration than men but prevalence estimates are not reported.
	Bangladesh DHS: (Murshid, 2017)	Two-stage stratified sampling to identify a list of households and individuals for data collection.	Physical IPV and sexual IPV	Self-described as a health survey	Murshid reports that that approximately 16% of the study population (n = 542, 16.4%) indicated domestic violence perpetration in the previous year based on weighted estimates.
	BNADS: (Ally et al., 2016; Madruga et al., 2017)	Multistage cluster sampling, sampling counties, census areas, households and finally adults within households	Physical and sexual IPV	Depression, substance use	In BNADS, the prevalence of IPV perpetration was 8.4% in 2012, and 10.6% in 2006.
	The Men’s Health, Fatherhood, and Relationships Study: (Walsh et al., 2020)	Probability-based web panel of the civilian, non-institutionalised American population, selecting respondents using random-digit dialling and address-based sampling	Physical IPV	Asks about respondent experiences of health professional enquiry and attitudes	The prevalence of any IPV perpetration in the Men’s Health, Fatherhood, and Relationships Study 19.2%.
	Ghent Survey: (Schokkenbroek et al., 2024)	Stratified survey of Ghent in Belgium aiming for representativeness in terms of sex, age, and nationality	Physical and sexual IPV using the CTS, and cyber-IPV and psychological IPV using the Multidimensional Measure of Emotional Abuse (Murphy & Hoover, 1999) and an abbreviated three-item scale adapted from the Cyber Dating Abuse Questionnaire (Borrajo et al., 2015).	Anxiety and depression symptoms	In the Ghent survey, IPV prevalence rates ranging from 4.3% (perpetration of physical IPV) to 68.4% (victimisation of psychological IPV).
	The Collaborative Psychiatric Epidemiology Surveys comprise the NCS-R, the NAALS, and the NSAL, in which IPV and IPV perpetration are measured in the NCS-R and the NAALS: NCS-R only: Afifi et al. (2010), Singh et al. (2014).	All CPES surveys used a multistage clustered sampling design and face-to-face interviews	Physical IPV	Physical and mental health symptoms and diagnoses, and indicators of health service use	Estimates from Afifi were not disaggregated by gender: prevalence of minor dating violence perpetration:10.8%; severe dating violence perpetration: 4.23%; prevalence of minor marital violence perpetration: 25.66%; severe marital violence: 3.14%. In an analysis of male respondents only, Singh et al. (2014) reported a prevalence of IPV perpetration of 19.2%.
	NAALS and NCS-R combined: Cho (2012) analysed data from the National Asian American and Latino Survey, in addition to the NCS-R.				Cho found a prevalence of less severe IPV (minor IPV) of 12.2% in men, and 17.6% in women; for severe IPV perpetration in men:2.0% and in women:1.9%.
	The following paper analysed Asian American respondents to NAALS only: (Chang et al., 2009)				Among Asian American respondents to NAALS: Prevalence of minor IPV perpetration among men: 14.65%; women: 19.02%; prevalence of severe IPV perpetration among men:1.78%; women:2.40%.
	Jamaica RHS: (Priestley & Lee, 2021)	National population-based probability survey of men aged 15 to 24 years and women aged 15 to 49 years	Physical IPV	Self-reported health, recent marijuana use	The overall prevalence of IPV perpetration in the Jamaica RHS is not reported but was calculated at 17.49% from the report.
Ad hoc extensive, i.e. more than two items)	Men’s Health and Modern Lifestyles Survey 2009: (Roberts et al., 2016)	The Men’s Health and Modern Lifestyles Survey employed a one-stage survey using a random location methodological approach.	Physical IPV	Alcohol and drug misuse, lifetime mental illness, pathological gambling	The prevalence of IPV perpetration is not reported in the Men’s Health and Modern Lifestyles Survey but calculated by the authors of this review as 2%.
	YSS: (Zhang et al., 2019)	A random sample of households provided by the Hong Kong Census and Statistics Department, selecting individuals aged 18–27 at random using the Kish method (Kish, 1949).	Physical, psychological, and sexual IPV	Drug and alcohol misuse, self-harm, suicide ideation, and suicide attempt	In YSS, the 1-year prevalence of IPV perpetration from a current or former partner was 5.3%in total, and the prevalence of physical, psychological, and sexual violence by intimate partners was 1.9%, 2.9%, and 0.5% respectively in the past 1 year. In contrast, the preceding 1-year prevalence of IPV victimisation from a current or former partner was 9.1% in total, and the prevalence of physical, psychological, and sexual violence by intimate partners was 2.8%, 5.1%, and 1.2% respectively in the past 1 year.
	Adult Psychiatric Morbidity Survey 2014: (Bhavsar et al., 2023, González et al., 2016)	Stratified, multistage random sampling study. Sampling frame was based on the national Small User Postcode Address File.	Physical, sexual and emotional IPV	Mental health, psychiatric diagnoses, and physical health	In APMS 2014, the prevalence of reported lifetime IPVP was similar for men and women (8.0% and 8.6%, respectively).
	South Sudan Survey: (Khalaf et al., 2022)	Population-based household survey using multistage cluster sampling, of men and boys aged 15–64 in Juba and Rumbek in South Sudan.	Physical and sexual IPV	No health outcome analysed	In the South Sudan Survey, 44.81% of respondents reported ever perpetrating physical IPV. 30.86% of respondents reported ever perpetrating sexual IPV. 56.97% reported ever perpetrating physical and/or sexual IPV.
Ad hoc minimal (i.e. one or two binary items)	Adult Psychiatric Morbidity Survey 2000 and 2007: González et al. (2016)	Stratified, multistage random sampling study. Sampling frame was based on the national Small User Postcode Address File.	Physical IPV	Mental health status and psychiatric diagnoses.	The prevalence of IPV perpetration is not reported.
	Tanzania DHS: (Reese et al., 2021)	Nationally representative survey generated by a two-stage clustered sampling design	Physical IPV	Drug and alcohol misuse	In the Tanzania DHS, approximately 1.5% (n = 94) of women reported perpetrating isolated physical IPV against their intimate partners in the past 12 months and approximately 35% (n = 1,628) reported being victims of IPV in the past 12 months. There were high rates of co-occurrence of IPV victimisation and isolated IPV perpetration. A majority (84%) of women reporting past 12-month isolated IPV perpetration also reported being victims of IPV within the same period. Of those who reported being a victim within the past 12 months, 7% also reported perpetrating physical IPV that was not in self-defence within that period.
	Timor Leste DHS 2016: (Pengpid et al., 2018)	Stratified two stage sample design employing the list of 2011 Census enumeration areas as a sampling frame	Physical IPV	Health variables collected but not analysed	In the TL DHS, 3.1% of respondents reported any lifetime perpetration of physical IPV.
	NSDUH: (Lipsky & Caetano, 2011)	Multistage area probability sample of the non-institutionalised civilian population of the United States	Physical IPV	Substance use, health insurance, serious mental illness.	Weighted for the sample design, 4% of males in NSDUH reported perpetrating IPV at least once in the past year.
	South Africa Stress and Health Study: (Gupta et al., 2008; Stein et al., 2009; Stein, 2008)	3-stage area probability sample of adult household residents living in households, sampling enumeration areas within strata of province, urban status and racial group, and selecting five households within each selected enumeration area, and using the Kish procedure to select respondents within households.	Physical IPV	Health outcomes collected but not analysed	In the South Africa Stress and Health Study, more than one-quarter of respondents (27.5%) reported having perpetrated physical violence against their most recent female partner.
	National Family Health Survey: (Sabri et al., 2014)	United States nationally representative cross-sectional sample survey using a multistage stratified sampling technique	Physical IPV	Alcohol use	In the NFHS-4 about 29 per 1000 currently married women were perpetrating spousal violence in the form of physical assault against their husband when he was not already beating or physically hurting them.

Note. BNADS = Brazilian National Alcohol and Drugs Surveys; CTS/CTSSF = Conflicts Tactics Scale/Conflicts Tactics Scale Short Form; DHS = Demographic and Health Survey; HANDLS = Healthy Aging in Neighborhoods of Diversity across the Life Span; IPV = Intimate Partner Violence; MCS = Multi-Country Study; NAALS = National Asian American and Latino Survey; NCS-R = National Comorbidity Survey-Replication; NESARC = National Epidemiologic Survey of Alcohol and Related Condition; NSAL = National Survey of American Life; NSDUH = National Survey on Drug Use and Health; PTSD = Post-traumatic Stress Disorder; RHS = Reproductive Health Survey; RRS = Rural Response System; UN-MCS = UN Multi-Country Study; YSS = Youth Sexuality Survey.

Five groups of measurement approaches were identified: (a) measures using or adapted from the United Nations Multi-Country Study (UN-MCS); (b) measures adapted from the WHO Instrument for Research on Violence Against Women and Girls; (c) measures using or adapted from the Conflict Tactics Scales; (d) ad hoc scales with more than 2 items; and (e) ad hoc scales with two items or fewer. We assess each included measurement approach against criteria described above, in Table 2.

Table 2.

Critical Assessment of Measurement Approaches.

Survey data source	Measurement approach	Number of included studies/articles	Forms of IPV harmful behaviour and number of items				Frequency, repetition, number of victims	Reference periods	Definition of IPV in study	Alignment of article/study’s definition of IPV with measurement approach	Information on sex of victim	Information on the nature of the intimate relationship	Measurement of IPV harmful impact	Description of item development and testing	User involvement
Survey data source	Measurement approach	Number of included studies/articles	Ph	Sex	Em/psy	Ec/fin	Frequency, repetition, number of victims	Reference periods	Definition of IPV in study		Information on sex of victim	Information on the nature of the intimate relationship	Measurement of IPV harmful impact	Description of item development and testing	User involvement
Original MCS	UN-MCS	5	6	2	5	5	Likert system with options: none, once, a few times, or many times	12 months	No	No	No	No	No	Yes	No
Zimbabwe		1	5	3	6	-	Not reported	12 months	No	No	No	No	No	Yes	No
Germany		2	3	4	5	3	Not reported	No	Yes	No	No	No	No	Yes	No
Ghana RRS	WHO 2005 Instrument	1	5	3	4	1	Likert system with options: none, once, a few times, or many times	12 months	Yes	No	No	No	No	Yes	No
Dagoretti		1	6	3	4	-	No	12 months	No	No	No	No	No	Yes	No
Gauteng		1	5	3	-	-	Yes but not further reported	No	No	No	No	No	No	Yes	No
NW Province		1	5	2	-	-	No	12 months and lifetime	Yes	Yes	No	No	No	Yes	No
NESARC	CTS/CTS-SF	5	5	1^a	-	-	Not stated in Roberts et al. (2010) or Hahn et al. (2015); Lee et al. (2023) describes Likert system with response options: never; once; 2–3 times; once per month; and more than once per month, which is the same as Okuda et al. (2015) and Maldonado et al.	12 months	Yes	No	No	No	No	Yes	No
HANDLS		1	8^b	-	-	-	Likert system with options: never, once, twice, 3–4 times, 6–10 times, 11–20 times, and more than 20 times.	12 months	No	No	No	No	No	Yes	No
BDHS		1	7	2	-	-	Likert system for sometimes, often and never	12 months	No	No	No	No	No	Yes	No
BNADS		1	8	1	-	-	Not reported	12 months	No	No	No	No	No	Yes	No
MHFRS		1	1	-	-	-	Likert system with response options: often, sometimes, rarely and never; and number of days IPV was perpetrated in the past year	Current relationship	No	No	No	No	No	Yes	No
Ghent^c		1	1	1	7	-	Likert system with 5 options from never to very often	12 months	No	No	No	No	No	Yes	No
CPES-NCSR		2	8	-	-	-	No measurement in Afifi, Likert system with four response options in Singh	Lifetime (with count of relationships- so possibly count of victims) in Afifi, Singh current relationship only	No	No	No	No	No	Yes	No
CPES-NCSR+NLAAS		1	1	-	-	-	Likert system for often, sometimes, rarely and never; and number of days in the past year	Based on the current relationship	No	No	No	No	No	Yes	No
CPES-NLAAS only		1	1	-	-	-	Likert system with response options: often, sometimes,rarely, or never	Based on current relationship	No	No	No	No	No	Yes	No
JRHS		1	6	-	-	-	Not reported	12 months	Yes	No	No	No	No	No	No
MHMLS	Ad hoc extensive	1	2	-	-		No measurement	5 years	No	No	No	No	No	No	No
YSS		1	10	3	10	-	No measurement	12 months	Yes	No	No	No	No	No	No
APMS2014		1	3	1	1	-	No measurement	12 months and lifetime	Yes	No	No	No	No	No	No
SSS		1	6	3	-	-	No measurement	Lifetime	Yes	No	No	No	No	No	No
APMS2000/2007	Ad hoc minimal	1	1	-	-	-	No measurement	5 years	No	No	No	No	No	No	No
TDHS		1	1	-	-	-	Yes but not further reported	12 months	Yes	No	No	No	No	No	No
TLDHS		1	1	-	-	-	Yes but not further reported	12 months	Yes	No	No	No	No	No	No
NSDUH		1	1	-	-	-	Likert system with response options: 0,1,2,few,many times	12 months	No	No	No	No	No	No	No
SASH		3	1	-	-	-	Yes but not further reported	Most recent partner	No	No	No	No	No	No	No
NFHS		1	1	-	-	-	No measurement	Current or most recent	No	No	No	No	No	No	No

Note. Ph = physical IPV perpetration; Sex = sexual IPV perpetration; Em/psy = emotional/psychological IPV perpetration; Ec/fin = economic/financial IPV perpetration

One NESARC publication does not report sexual violence perpetration data (Lee et al., 2023).

HANDLS does not further describe how the eight items measure different forms of IPV harmful behaviour, but states that physical, sexual, and emotional/psychological IPV perpetration were measured.

Ghent survey also collected information on cyber IPV perpetration.

APMS = Adult Psychiatric Morbidity Survey; BDHS = Bangladesh Demographic and Health Survey; BNADS = Brazilian National Alcohol and Drugs Surveys; CPES = Collective Psychiatric Epidemiology Surveys; CTS/CTSSF = Conflicts Tactics Scale/Conflicts Tactics Scale Short Form; HANDLS = Healthy Aging in Neighborhoods of Diversity across the Life Span; JRHS = Jamaica Reproductive Health Survey; MCS = Multi-Country Study; MHFRS = Men’s Health, Fatherhood, and Relationships Study; MHMLS = Men’s Health and Modern Lifestyles Survey; NCSR = National Comorbidity Survey Replication; NESARC = National Epidemiologic Survey of Alcohol and Related Condition; NFHS = National Family Health Survey; NLAAS = National Latino and Asian American Study; RRS = Rural Response System; SASH = South Africa Stress and Health Study; UN-MCS = UN Multi-Country Study; YSS = Youth Sexuality Survey.

Critical Findings

This review identified 39 original research articles reporting analyses of 27 general population health surveys.

Measurement of IPV perpetration in included surveys employed the UN-MCS; the 2005 WHO research tool for violence against women and girls; the CTS and its subsequent versions, and ad hoc measures which we grouped into those more than two items, or one or two items.

There was substantial variable in how IPV perpetration was measured between surveys, especially on the measurement of non-physical forms of IPV, frequency and reference periods, and the assessment of harmful impact of IPV.

Most surveys did not collect information on the sex of victims, or on repeat IPV perpetration, and reporting of item development and validation was inconsistent

Implications for practice, policy, and research

Existing health care and public health policymaking on IPV perpetration is limited by significant variation in how IPV perpetration is measured in health survey data.

Improved measurement of IPV perpetration in general population health surveys could strengthen future research by permitting triangulation with administrative data sources such as police records, health service data, and population registers.

Improved data collection on IPV perpetration as part of general population health surveys, e.g., through collection of information on harmful impacts of perpetrated IPV, could support improved prevention efforts, by highlighting specific population groups for intervention.

Note. CTS = Conflicts Tactics Scale; UN-MCS = UN Multi-Country Study.

Measures Using or Adapted from the UN-MCS tool

Three survey data sources were identified which used the UN-MCS tool to measure IPV perpetration, reporting prevalence estimates for Bangladesh, China, Indonesia, Papua New Guinea, and Sri Lanka (Fonseka et al., 2015; Fulu et al., 2017; Jewkes et al., 2025; Willie et al., 2022), Zimbabwe (Machisa & Shamu, 2018), and Germany (Berthold et al., 2024; Clemens et al., 2023). Health outcomes studied in these data sources included depression, self-rated health, and self-harm/suicide attempt.

The original multi-country study (MCS) was accompanied by online information that framed IPV as a form of gender-based violence, defined as “an umbrella concept that describes any form of violence used to establish, enforce, or perpetuate gender inequalities and keep in place unequal gender-power relations. In other words, it is violence that is used as a policing mechanism of gender norms and relations and is intended to result in the subordination of women.” Papers reporting the original MCS data and the Zimbabwe survey did not provide a definition of IPV, and the report of the Germany survey referred to the WHO (2021) definition, where IPV “refers to behaviour by an intimate partner or ex-partner that causes physical, sexual or psychological harm, including physical aggression, sexual coercion, psychological abuse and controlling behaviours” (World Health Organization, 2021). The original MCS tool measures four forms of IPV harmful behaviour. It includes five questions about psychological/emotional IPV (e.g., “Have you ever threatened to hurt a partner?”); four questions about economic/financial IPV (e.g., “Have you ever prohibited a partner from earning money?”); five questions about physical IPV (e.g., “Have you ever pushed or shoved a partner?”); and two questions about sexual IPV (e.g., “Have you ever forced your current or previous partner to have sex with you when she did not want to?). Studies using this measurement approach varied in the number of forms of IPV harmful behaviour they measured (one did not measure economic/financial IPV perpetration) and in the number of items they used to measure forms of IPV perpetration (between 3 and 6 for physical IPV, between 2 and 4 for sexual IPV perpetration, between 5 and 6 for emotional/psychological IPV perpetration, and 3 and 5 for economic/financial IPV perpetration).

The original MCS instrument does not collect data on victim sex; instead, it asks specifically about perpetration of IPV against female partners. Data on the nature of intimate partnerships are not collected, and skip questions limit data collection to perpetration of IPV within sexual relationships. Frequency of perpetrated IPV is measured via Likert responses in the original MCS tool, but not in data reported by Machisa and Shamu (2018) on Zimbabwe or by Clemens et al. (2023) on Germany. Reference periods for measurement of IPV perpetration are 12 months for the original MCS tool. Machisa and Shamu (2018) report prevalence estimates for both lifetime and 12-month perpetration, while reference periods are not made explicit in Clemens et al. (2023). With regard to the collection of data on the impact of IPV perpetration, MCS items for emotional IPV refer to causing fear, but physical and sexual items do not refer to the occurrence of harm (e.g., occasioning medical care or disability).

The development of the MCS questionnaire is described in an appendix to the main report on the study website (Fulu et al., 2013). Questionnaire development focused on sequencing items (going from less sensitive to more sensitive topics), inclusion of sources of support, non-judgmental phrasing, deliberate non-use of the words “violence” and “rape,” and welcoming/reassuring introductory statements. Gibbs et al. (2019) report the test–retest reliability of MCS items for physical IPV perpetration in a sample of 112 South African men. User involvement in the development of MCS items is not reported.

Measures Adapted from the 2005 WHO Instrument for Research on Violence Against Women and Girls

Four survey data sources were identified that measured IPV perpetration by “transposing” items from the 2005 WHO Instrument for Research on Violence Against Women and Girls, which was designed to measure IPV victimisation (Ellsberg & Heise, 2005). These datasets provide estimates of IPV perpetration in Ghana (Chirwa et al., 2018), the district of Dagoretti in Nairobi, Kenya (Ringwald et al., 2022), and two settings in South Africa (Gauteng and North West Province, (Machisa et al., 2016; Treves-Kagan et al., 2021). Health outcomes collected in this group of studies included depression, post-traumatic stress disorder (PTSD), and substance use.

The original WHO instrument is aligned to the 2003 WHO definition of IPV, referring to aggressive or coercive behaviours among marital, dating, or cohabiting partners. Among the four survey data sources employing this measurement approach, reports from two data sources did not state a definition of IPV perpetration. A report from the Ghana Rural Response System (RRS) referred to a United States Centre for Disease Prevention and Control (CDC) definition (Chirwa et al., 2018), and a report from the North West Province survey referred to a definition from a 2013 article with WHO authors (Devries et al., 2013; Treves-Kagan et al., 2021).

Three forms of IPV victimisation are measured by the original WHO instrument, ever and in the past year, using binary “yes” or “no” response options. Transposing the tool in full would allow for four items about emotional IPV (e.g., belittling or humiliating someone in front of other people), six items about physical IPV (e.g., slapping or throwing something that could hurt someone), and three items on sexual IPV (e.g., physically forcing someone to have sexual intercourse when they didn’t want to). The four survey data sources varied in their measurement of these forms of IPV. The Dagoretti IPV/HIV survey asked about the perpetration of all three forms of IPV described above in the past year only and used a binary response option. The Ghana RRS measured economic/financial IPV perpetration with a single item, in addition to these three domains. The Gauteng and NW Province surveys measured lifetime perpetration of physical and sexual IPV only (i.e., omitting measurement of emotional/psychological and economic/financial IPV). Likert systems were used to measure frequency of IPV behaviours by two of the four studies.

Regarding victim sex and the nature of the relationship, questions in the original WHO Instrument refer specifically to behaviour towards a husband or partner (Ellsberg & Heise, 2005). In adapting these questions, the Ghana RRS, Gauteng Survey, and Dagoretti Survey specified behaviour by men towards female partners but did not further differentiate between types of intimate relationships. Whether the North West Province Survey specified behaviour from men towards women partners is not stated. Data collection on IPV related harmful impact was limited in studies in this group. Items for emotional IPV referred to causing someone to feel bad, belittled, or humiliated, and sexual IPV items referred to behaviour causing humiliation. Neither physical nor sexual IPV items referred to the occurrence of physical harm (e.g., resulting in medical care or disability).

No studies/articles reported work to assess the suitability of the adapted items for measuring IPV perpetration, including wording of items or phrasing of introductory statements. No articles/studies referred to validation work on transposed WHO instrument items, although the WHO instrument has been evaluated in relation to experiences of IPV victimisation (Schraiber et al., 2010). User involvement in the development of items was not reported.

Adaptations of the CTS and the Subsequent CTS Short Form

Ten survey data sources employed items from the CTS short form (CTS-SF) to measure IPV perpetration. These included the National Epidemiologic Survey of Alcohol and Related Condition (NESARC) (Hahn et al., 2015; Lee et al., 2023; Maldonado et al., 2020; Okuda et al., 2015; Roberts et al., 2010), the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (Maldonado et al., 2022), the Bangladesh Demographic and Health Survey (Murshid, 2017), the Brazilian National Alcohol and Drugs Surveys (BNADS) (Ally et al., 2016; Madruga et al., 2017), the Men’s Health, Fatherhood, and Relationships Study: Walsh et al. (2020), the Ghent Survey (Schokkenbroek et al., 2024), and the Jamaica Reproductive Health Survey (Priestley & Lee, 2021). We grouped measurements of IPV perpetration in the Collective Psychiatric Epidemiology Surveys into three survey data sources to align with eligible reports: studies based only on the National Comorbidity Survey Replication (NCS-R) (Afifi et al., 2010; Singh et al., 2014), an analysis of the combined NCS-R and National Asian American and Latino Survey data source (Cho, 2012), and a separate analysis of National Latino and Asian American Study (NAALS) data only (Chang et al., 2009). Collectively, they provide estimates of IPV perpetration for the USA, Bangladesh, Brazil, Jamaica, and Ghent, Belgium. Health outcomes collected in these sources included problem drinking, smoking, suicide attempt, depression, and PTSD.

The original CTS defines IPV as means for resolving conflict within relationships and measure both IPV victimisation and perpetration. Studies/articles employing CTS-derived items typically did not provide a definition of IPV.

The CTS measures physical IPV, with a later version—the revised CTS (CTS2)—additionally measuring sexual IPV and psychological IPV (Straus, 1996). The CTS-SF measures physical, sexual, and psychological IPV (Straus & Douglas, 2004). Survey data sources employing CTS-derived measurements for IPV perpetration varied with regards to the forms of IPV perpetration measured (although all measured physical IPV) and the number of items used to measure these forms of IPV perpetration. This ranged from a single item to measure past year physical IPV perpetration in the Ghent Survey (purposefully hitting, scratching, pushing, biting or in another way physically hurting a partner) to 7 items measuring lifetime IPV perpetration in the 2007 Bangladesh Demographic and Health Survey (DHS) Survey (pushing, shaking, or throwing an object; slapping; pulling hair or twisting an arm; punching or hitting with a fist or something harmful; kicking or dragging; choking or burning; and threatening or attacking with a knife or gun). Four data sources measured sexual IPV perpetration (NESARC, HANDLS, BNADS, the Ghent Survey) using one or two items, and the Ghent survey measured psychological IPV perpetration using seven items. The report of the HANDLS data source reported using eight items to measure IPV perpetration but did not state which forms of perpetration were captured or how many items related to each form. Cyber IPV perpetration was measured by the Ghent survey using an abbreviated three-item scale adapted from the Cyber Dating Abuse Questionnaire (Borrajo et al., 2015).

Studies/articles employing CTS/Conflicts Tactics Scale Short Form (CTSSF) derived items did not collect information on the sex of the victim or the nature of the relationship in which IPV was perpetrated, although the 2007 Bangladesh DHS measured IPV perpetration only in men and questions referred specifically to female partners/wives. Likewise, the Men’s Health, Fatherhood, and Relationships Study studied only men.

Response options in the CTS, CTS2, and CTS2-SF allow participants to report that they have never used a particular behaviour, that they have used a behaviour but not in the past year, or that they used a behaviour in the past year once, twice, 3 to 5 times, 6 to 10 times, 11 to 20 times, or more than 20 times. Data sources using this measurement approach typically measured IPV perpetration with reference to the previous 12 months (6 data sources), or based only on the current/most recent relationship (2 data sources), with one survey collecting information with a lifetime reference period (and on number of relationships). Likert methods for collecting frequency were used by 7 data sources (with some inconsistency in reporting among included studies/articles, see Table 2), with frequency recording not measured or described for 4 data sources. Items to measure physical IPV numbered between 1 and 8, and for sexual IPV, 1 or 2. One survey measuring psychological IPV collected information on this with seven. The report from the HANDLS data source described eight items for data collection on IPV perpetration but did not specify how they broke down in terms of forms of harmful behaviour in IPV. The Ghent Survey also measured psychological IPV perpetration and cyber IPV perpetration, using an abbreviated version of the Multidimensional Measure of Emotional Abuse (Murphy & Hoover, 1999) and an abbreviated three-item scale adapted from the Cyber Dating Abuse Questionnaire (Borrajo et al., 2015), respectively.

Few studies collected data on the number of separate victims of IPV; the NCS-R did so by asking about the number of relationships in which each behaviour occurred. With regard to IPV-related harms, the NESARC assessed harmful impact of perpetrated IPV through a CTS item referring to the injured partner requiring medical care. Other studies/articles in this group did not measure harmful impact of perpetrated IPV.

The derivation of the short form CTS from the full CTS is reported in Straus and Douglas (2004). The development of the measure for psychological IPV in the Ghent survey is described in Murphy and Hooper (2005), and the measurement of cyber IPV perpetration described in Borrajo et al. (2015). Test–retest reliability and internal validity of the CTS2 and CTS-SF are reported (Chapman & Gillespie, 2019; Straus & Douglas, 2004; Vega & O’Leary, 2007). Included articles/studies described above did not describe testing carried out on the items selected by each particular article/study (e.g. validation for that specific geographic population). No involvement of victim/survivors was reported.

Ad hoc Measurement (More Than Two Items)

Four included survey data sources measured IPV perpetration using items not directly derived from a specific cited measurement tool. Included in this group were the Men’s Health and Modern Lifestyles Survey 2009 (Roberts et al., 2016), the Youth Sexuality Survey (YSS) (Zhang et al., 2019), the Adult Psychiatric Morbidity Survey 2014 (Bhavsar et al., 2023), and the South Sudan Survey (Khalaf et al., 2022).

One article in this group did not provide a definition of IPV, and three referred to a WHO definition of IPV. The Men’s Health and Modern Lifestyles Survey asked questions only about physical IPV perpetration. The YSS asked questions about sexual and psychological IPV perpetration, as well as physical IPV. Adult Psychiatric Morbidity Survey (APMS) 2014 measured perpetration of physical IPV, sexual IPV, and psychological IPV (threats). The South Sudan Survey measured physical and sexual IPV perpetration. No studies/articles reporting survey data sources in this group gathered information on the sex of victims, or other information on the nature of the relationship. No reports of data sources in this group measured harmful impact of perpetrated IPV, although APMS 2014 included “behaviour causing fear” in one item. No survey data sources in this group measured frequency of IPV perpetration or the number of victims. No item development process, or evaluation of psychometric properties, was reported by studies/articles in this group. No user involvement was reported.

Ad hoc Measurement Using Two Items or Fewer

Six survey data sources used one or two binary items to measure IPV perpetration. These were the Tanzania DHS (Reese et al., 2021),the Timor Leste (TL) DHS 2016 (Pengpid et al., 2018), National Survey on Drug Use and Health (NSDUH), (Lipsky & Caetano, 2011), the South Africa Stress and Health (SASH) Study: (Gupta et al., 2008; Stein, 2008; Stein et al., 2009), the Adult Psychiatric Morbidity Surveys 2000 and 2007 (González et al., 2016), and the National Family Health Survey (Sabri et al., 2014). Health outcomes studied in the included articles included drug and alcohol misuse, health insurance status, and self-reported diagnoses of serious mental illness.

Two survey data sources in this group gave definitions of IPV, and the remaining four did not provide a definition of IPV. Survey data sources in this group measured only physical IPV perpetration. Sex of victim and other information on the nature of intimate relationships in which IPV was perpetrated were not reported by of studies/articles based on these data sources, although DHS introductory text providing context to IPV items referred to heterosexual relationships. Measurement of frequency was mentioned in reports from the Tanzania DHS, the SASH, and the TL DHS, but was not further described. The NSDUH measured frequency using response options for 0, 1, 2, few and many times. Reference periods were 12 months for the Tanzania DHS, the TL DHS, and for NSDUH, and the SASH and NFHS collected information referring to the current or most recent relationship. Information on number of victims was not collected. This group of survey data sources did not include measurement of harmful impact of perpetrated IPV, based on published reports, and there was no reporting of how items were developed or evaluated prior to formal data collection, or of user involvement in the development of items.

Estimated prevalences of IPV perpetration varied across measurement approaches—given substantial heterogeneity in measurement instruments, reference periods, and forms of IPV captured, these differences should not be interpreted as reflecting variation in underlying IPV perpetration risk. Lifetime prevalence ranged from very low prevalences in some national surveys using minimal or ad hoc items (e.g., around 2%—5% in Men’s Health and Modern Lifestyles Survey, NSDUH, and Timor-Leste DHS) to higher prevalences in studies using more extensive instruments or conducted in low resource contexts (e.g., around 50% in the Ghana Rural Response System, 41% lifetime in Zimbabwe, 56–57% for physical and/or sexual IPV in South Sudan, and 71% reporting at least one form of IPV perpetration in HANDLS). In the UN-MCS, lifetime perpetration ranged from 13.5% in Papua New Guinea to 49.4% in Sri Lanka. Surveys using CTS-based measures in high-income countries typically reported 12-month or lifetime prevalence between 5% and 20%, though some sub-analyses showed higher rates for minor or psychological forms of IPV. Across studies that disaggregated by form, psychological or emotional IPV was generally the most prevalent, followed by physical IPV, with sexual IPV least frequently reported.

Discussion

Summary of Findings

We identified 39 studies reporting 27 survey data sources which measured IPV perpetration in general population health surveys. There was substantial heterogeneity in the forms of IPV perpetration measured, the comprehensiveness and conceptual clarity of measurement tools, and the rigour with which these tools were developed and applied. While most surveys captured physical IPV perpetration, fewer included sexual, emotional/psychological, and economic/financial IPV perpetration. No surveys measured perpetration of stalking or harassment, or the impact of perpetrated IPV on children, highlighting critical gaps in the scope of current measurement practices.

Five broad measurement approaches were identified: adaptations of the UN-MCS tool (Fulu et al., 2013), the WHO instrument (Ellsberg & Heise, 2005), the CTS/CTSSF (Straus, 1973; Straus et al., 1996), and ad hoc measurement approaches which we grouped into extensive and minimal approaches. Approaches to measuring IPV perpetration varied widely in how comprehensively they measured different forms of harmful behaviour within IPV, whether they captured frequency or repetition, and whether they collected data on victims’ sex or the nature of the relationship. The absence of data on victims’ sex limits the ability of existing research to examine IPV perpetrated in same-sex relationships. Moreover, no studies collected data on the number of victims, despite evidence suggesting that perpetrators often engage in repeated IPV against multiple partners (Gondolf, 1997, 2004). This lack of data on repetition and relational contexts also limits the ability to disentangle different patterns of abuse, which may have distinct risk factors, consequences, and intervention needs.

Measurement of IPV-related harm was also inconsistent. Where included, harm was typically inferred from specific behaviours (e.g., causing fear, or requiring medical care) rather than being measured directly. This distinction between behaviours and their subjective or objective impact is crucial for understanding severity and consequences of IPV. Accurately capturing severity, frequency, and related harm is also critical to describing the sex differences in IPV perpetration that are indicated by victimisation research. Improving the measurement of harmful impact of IPV perpetration in general population health surveys could be informed by criminological work to develop and evaluate scales for the measurement of harm, including the crime harm index and the crime severity score (Ashby, 2017). There is also a need to develop measures capable of assessing escalation of violence—an important predictor of serious adverse outcomes including homicide.

The variability in approaches identified in this review points to broader challenges and opportunities in developing a stronger evidence base on IPV perpetration. A key issue is the inconsistent use of definitions of IPV; few studies explicitly referenced such definitions, and many employed transposed victimisation items with little or no adaptation. Employing measurement tools anchored in clear, theoretically informed definitions of IPV perpetration could improve the coherence and interpretability of findings and ensure alignment between measurement and research objectives (Walby & Myhill, 2001).

The development and validation of IPV perpetration items was rarely reported. While the UN-MCS instrument has documented item development and testing (Fulu et al., 2013; Gibbs et al., 2019), other commonly used instruments were applied without attention to local context or validation for perpetration-specific use. No study reported item development processes for new or adapted measures, nor reported on the involvement of survivors or perpetrations in design. This lack of participatory and context-sensitive development risks introducing measurement error and underreporting, particularly given known challenges of disclosure (Krumpal, 2013).

Under- and over-reporting of IPV perpetration have substantial implications for prevalence estimates and inferences about associations with health. Studies of crime surveys suggest that misreporting can distort theories of IPV and policy responses (Ackerman, 2016). Without better evidence on how IPV perpetration is reported in representative samples, our ability to interpret survey data and use it to inform prevention and intervention remains limited.

Future work should prioritise the development and use of comprehensive, theoretically grounded, and psychometrically robust IPV perpetration measures. These tools must extend beyond physical IPV to encompass emotional/psychological, sexual, and economic forms of abuse, with attention to frequency, pattern, escalation, and context. Items should be developed through transparent processes, include local pilot testing, and involve the perspectives of both survivors and perpetrators of IPV. Incorporating measures of harm and the number of victims could allow better understanding of severity and chronicity, while collecting data on the sex of victims and nature of relationships is essential for inclusive, intersectional analysis. Improving IPV perpetration measurement in general population surveys is not only a methodological priority but a necessary step toward developing research-based policy and prevention strategies grounded in representative data.

Strengths and Limitations

This review provides the first systematic synthesis of how IPV perpetration is measured in general population health surveys across a range of geographic and socioeconomic settings. A key strength is our use of a structured evaluation framework, informed by conceptual and methodological work on violence measurement (Heise & Hossain, 2017; Walby et al., 2017) allowing for a comparative assessment of measurement quality across diverse tools and approaches. By focusing on general population health surveys, the review specifically highlights the extent to which epidemiological studies are equipped to inform policy and prevention efforts.

However, our approach has limitations. While our search terms were designed to capture studies measuring IPV perpetration, eligible studies/articles may have been missed if they did not explicitly refer to IPV in their titles, abstracts, or indexing terms—for example, where IPV was embedded within broader community violence or public health surveys. We excluded studies/articles restricted to currently partnered individuals, which may have led to the omission of studies using robust sampling strategies but narrowly defined target populations. We examined peer-reviewed articles published in English, which may have excluded relevant evidence published in other languages or grey literature sources, including reports that might have provided more detailed accounts of item development or piloting. Our decision to limit the scope of eligible articles to those explicitly addressing public health outcomes in our inclusion criteria may have excluded studies grounded in other disciplinary approaches, such as criminology. We recognise that studies excluded from our review on this basis may also relevant to future improvements in data collection on IPV perpetration in health research, in addition to the health survey data reviewed in this paper. Finally, study screening and data extraction were conducted by a single reviewer, which may have increased risk of selection bias compared with reviews using independent duplicate processes. This may have resulted in the inadvertent exclusion of eligible studies or minor inaccuracies in extracted information. Despite these limitations, this review highlights critical methodological gaps in the measurement of IPV perpetration in epidemiological research and provides a foundation for improving measurement practice in future population-based studies. We did not include the involvement of victim/survivors of IPV into the design of the review. The potential benefit of involving victim/survivors of IPV in developing measurement approaches to IPV perpetration should be evaluated in future research.

Conclusions

Substantial evidence on IPV has been generated by general population health surveys, yet most of this research overlooks IPV perpetration and, therefore, addresses only part of the problem. The limited number of surveys identified which measured IPV perpetration represents a significant gap in the evidence base. Strengthening data collection on IPV perpetration in general population health surveys would enable triangulation with administrative data sources such as police records, health data, and population registers, supporting more comprehensive surveillance and intervention planning. Future general population health surveys should routinely collect data on the sex and number of victims, harmful impacts of perpetrated IPV, and the escalation and repetition of abusive behaviours, as well as explicitly report the definition of IPV perpetration used and the process of item development and validation. Addressing these gaps is essential to generate the high-quality, inclusive, and actionable evidence needed to inform IPV policies and services.

Footnotes

ORCID iDs

Vishal Bhavsar

Siân Oram

Ethical Considerations

This is a systematic review of existing research and ethical approval and informed consent were not sought.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was funded by an NIHR Advanced Fellowship awarded to Dr Bhavsar (NIHR AF302243).

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data Availability Statement

Data on which this review is based are available from the authors upon request.

Supplemental Material

Supplemental material for this article is available online.

Author Biographies

Vishal Bhavsar, MRCPsych PhD, is an honorary consultant psychiatrist and NIHR Advanced Fellow in Women’s Mental Health at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK.

Siân Oram, PhD, is the head of King’s Women’s Mental Health and Professor of Trauma and Recovery at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK.

References

Ackerman

J. M.

(2016). Over-reporting intimate partner violence in Australian survey research. British Journal of Criminology, 56(4), 646–667.

Afifi

T. O.

Brownridge

D. A.

MacMillan

Sareen

(2010). The relationship of gambling to intimate partner violence and child maltreatment in a nationally representative sample. Journal of Psychiatric Research, 44(5), 331–337.

Ally

E. Z.

Laranjeira

Viana

M. C.

Pinsky

Caetano

Mitsuhiro

Madruga

C. S.

(2016). Intimate partner violence trends in Brazil: Data from two waves of the Brazilian National Alcohol and Drugs Survey. Revista brasileira de psiquiatria, 38(2), 98–105.

Ashby

M. P. J.

(2017). Comparing methods for measuring crime harm/severity. Policing: A Journal of Policy and Practice, 12(4), 439–454. https://academic.oup.com/policing/article-abstract/12/4/439/4092861

Bender

A. K.

(2017). Ethics, methods, and measures in intimate partner violence research: The current state of the field. Violence Against Women, 23(11), 1382–1413. https://doi.org/10.1177/1077801216658977

Berthold

Fegert

J. M.

Brähler

Jud

Clemens

(2024). Abusive head trauma: The body of the iceberg–A population-based survey on prevalence and perpetrators. Child Abuse & Neglect, 149, 106660.

Bhavsar

McManus

Saunders

Howard

L. M.

(2023). Intimate partner violence perpetration and mental health service use in England: Analysis of nationally representative survey data. British Journal of Psychiatry Open, 9(3), e64.

Borrajo

Gámez-Guadix

Pereda

Calvete

(2015). The development and validation of the cyber dating abuse questionnaire among young couples. Computers in Human Behavior, 48, 358–365.

Bunce

Carlisle

Capelas Barbosa

(2023). The concept and measurement of interpersonal violence in specialist services data: Inconsistencies, outcomes and the challenges of synthesising evidence. Social Sciences, 12(7), 366. https://www.mdpi.com/2076-0760/12/7/366

10.

Campbell

J. C.

Martin

S. L.

Moracco

K. E.

Manganello

J. A.

Macy

R. J.

(2006). Survey data sets pertinent to the study of intimate partner violence and health. Truama, Violence, & Abuse, 7(1), 3–18. https://doi.org/10.1177/1524838005282571

11.

Chang

D. F.

Shen

B. J.

Takeuchi

D. T.

(2009). Prevalence and demographic correlates of intimate partner violence in Asian Americans. International Journal of Law and Psychiatry, 32(3), 167–175.

12.

Chapman

Gillespie

S. M.

(2019). The Revised Conflict Tactics Scales (CTS2): A review of the properties, reliability, and validity of the CTS2 as a measure of partner abuse in community and clinical samples. Aggression and Violent Behavior, 44, 27–35. https://doi.org/10.1016/j.avb.2018.10.006

13.

Chirwa

E. D.

Sikweyiya

Addo-Lartey

A. A.

Ogum Alangea

Coker-Appiah

Adanu

R. M.

Jewkes

(2018). Prevalence and risk factors of physical or sexual intimate violence perpetration amongst men in four districts in the central region of Ghana: Baseline findings from a cluster randomised controlled trial. PLOS ONE, 13(3), e0191663.

14.

Cho

(2012). Examining gender differences in the nature and context of intimate partner violence. Journal of Interpersonal Violence, 27(13), 2665–2684.

15.

Clemens

Fegert

J. M.

Kavemann

Meysen

Ziegenhain

Brähler

Jud

(2023). Epidemiology of intimate partner violence perpetration and victimisation in a representative sample. Epidemiology and Psychiatric Sciences, 32, e25.

16.

Corsi

D. J.

Neuman

Finlay

J. E.

Subramanian

(2012). Demographic and health surveys: A profile. International Journal of Epidemiology, 41(6), 1602–1613.

17.

Devaney

Lazenbatt

(2016). Domestic violence perpetrators: Evidence-informed responses. Routledge.

18.

Devries

K. M.

Mak

J. Y.

Garcia-Moreno

Petzold

Child

J. C.

Falder

Lim

Bacchus

L. J.

Engell

R. E.

Rosenfeld

Pallitto

Vos

Abrahams

Watts

C. H.

(2013). The global prevalence of intimate partner violence against women. Science, 340(6140), 1527–1528.

19.

Ellsberg

Heise

(2005). Researching violence against women: A practical guide for researchers and activists. World Health Organization.

20.

Fonseka

R. W.

Minnis

A. M.

Gomez

A. M.

(2015). Impact of adverse childhood experiences on intimate partner violence perpetration among Sri Lankan men. PLOS ONE, 10(8), e0136321.

21.

Fulu

Miedema

Roselli

McCook

Chan

K. L.

Haardörfer

Jewkes

, & UN Multi-country on Men and Violence Study Team. (2017). Pathways between childhood trauma, intimate partner violence, and harsh parenting: Findings from the UN Multi-country Study on Men and Violence in Asia and the Pacific. The Lancet Global Health, 5(5), e512–e522.

22.

Fulu

Warner

Miedema

Jewkes

Roselli

Lang

. (2013). Annex I: Additional information on methodology. In Why do some men use violence against women and how can we prevent it? Quantitative findings from the United Nations multi-country study on men and violence in Asia and the Pacific. United Nations Development Programme, United Nations Population Fund, UN Women, and United Nations Volunteers (Partners for Prevention).

23.

Gibbs

Pretorius

Jewkes

(2019). Test-retest stability of self-reported violence against women measures: Results from the stepping stones and creating futures pilot. Global Health Action, 12(1), 1671663.

24.

Gondolf

E. W.

(1997). Patterns of reassault in batterer programs. Violence and Victims, 12(4), 373–387.

25.

Gondolf

E. W.

(2004). Evaluating batterer counseling programs: A difficult task showing some effects and implications. Aggression and Violent Behavior, 9(6), 605–631.

26.

González

R. A.

Igoumenou

Kallis

Coid

J. W.

(2016). Borderline personality disorder and violence in the UK population: Categorical and dimensional trait assessment. BMC Psychiatry, 16(1), 180.

27.

Grace

K. T.

Anderson

J. C.

(2018). Reproductive coercion: A systematic review. Trauma, Violence, & Abuse, 19(4), 371–390.

28.

Gupta

Silverman

J. G.

Hemenway

Acevedo-Garcia

Stein

D. J.

Williams

D. R.

(2008). Physical violence against intimate partners and related exposures to violence among South African men. Canadian Medical Association Journal, 179(6), 535–541.

29.

Hahn

J. W.

Aldarondo

Silverman

J. G.

McCormick

M. C.

Koenen

K. C.

(2015). Examining the association between posttraumatic stress disorder and intimate partner violence perpetration. Journal of Family Violence, 30, 743–752.

30.

Hatch

S. L.

Woodhead

Frissa

Fear

N. T.

Verdecchia

Stewart

Reichenberg

Morgan

Bebbington

McManus

Brugha

Kankulu

Clark

J. L.

Gazard

Medcalf

Hotopf

, & the SELCoH study team. (2012). Importance of thinking locally for mental health: Data from cross-sectional surveys representing South East London and England. PLOS ONE, 7(12), e48012. https://doi.org/10.1371/journal.pone.0048012

31.

Heise

Hossain

(2017). Measuring intimate partner violence. London School of Hygiene & Tropical Medicine (LSHTM).

32.

Hester

Feder

Westmarland

Burrell

Gilchrist

Gadd

Kirk

Bellini

Donovan

Katz

Howard

L. M.

Robinson

. (2020). A domestic abuse perpetrator strategy for England and Wales. The Drive Partnership.

33.

Jenkins

(2001). Making psychiatric epidemiology useful: The contribution of epidemiology to government policy. Acta Psychiatrica Scandinavica, 103(1), 2–14. https://doi.org/10.1111/j.1600-0447.2001.00004.x

34.

Jenkins

Bebbington

Brugha

Farrell

Gill

Lewis

Meltzer

Petticrew

(1997). The national psychiatric morbidity surveys of Great Britain–strategy and methods. Psychological Medicine, 27(4), 765–774.

35.

Jewkes

Naved

R. T.

Abrahams

Shai

Ramsoomar

Dekel

Gibbs

Nöthling

Willian

Chirwa

(2025). Impact of witnessing abuse of their mother and childhood trauma on men’s perpetration of intimate partner violence in the cross-sectional UN multi-country study on men and violence in Asia and the Pacific. SSM-Mental Health, 7, 100391.

36.

Jewkes

Nduna

Jama Shai

Dunkle

(2012). Prospective study of rape perpetration by young South African men: Incidence & risk factors. PLOS ONE, 7(5), e38210.

37.

Khalaf

Contreras-Urbina

Murphy

Ellsberg

(2022). Factors influencing lifetime perpetration of intimate partner violence among ever-partnered men in South Sudan. Men and Masculinities, 25(5), 802–824.

38.

Kilpeläinen

Koponen

Tolonen

Koskinen

Borodulin

Gissler

(2019). From monitoring to action: Utilising health survey data in national policy development and implementation in Finland. Archives of Public Health, 77(1), 48. https://doi.org/10.1186/s13690-019-0374-9

39.

Kim

(2023). Ecological system levels of risk factors for intimate partner homicide perpetration and victimization: A three-level meta-analysis. Trauma, Violence, & Abuse, 24(4), 2082–2096. https://doi.org/10.1177/15248380221082154

40.

Kish

. (1949). A procedure for objective respondent selection within the household. Journal of the American Statistical Association, 44(247), 380–387.

41.

Krumpal

(2013). Determinants of social desirability bias in sensitive surveys: A literature review. Quality & Quantity, 47(4), 2025–2047.

42.

Lee

K. A.

Smith

M. E.

Bright

C. L.

(2023). Alcohol use and physical intimate partner violence perpetration among Black men: The moderating effect of interpersonal social support. Journal of Interpersonal Violence, 38(13–14), 8542–8562.

43.

Leung

Miedema

Warner

Homan

Fulu

(2019). Making feminism count: Integrating feminist research principles in large-scale quantitative research on violence against women and girls. Gender & Development, 27(3), 427–447.

44.

Lipsky

Caetano

(2011). Intimate partner violence perpetration among men and emergency department use. The Journal of Emergency Medicine, 40(6), 696–703.

45.

Machisa

Shamu

(2018). Mental ill health and factors associated with men’s use of intimate partner violence in Zimbabwe. BMC Public Health, 18, 1–11.

46.

Machisa

M. T.

Christofides

Jewkes

(2016). Structural pathways between child abuse, poor mental health outcomes and male-perpetrated intimate partner violence (IPV). PLOS ONE, 11(3), e0150986.

47.

Madruga

C. S.

Viana

M. C.

Abdalla

R. R.

Caetano

Laranjeira

(2017). Pathways from witnessing parental violence during childhood to involvement in intimate partner violence in adult life: The roles of depression and substance use. Drug and Alcohol Review, 36(1), 107–114.

48.

Maldonado

A. I.

Cunradi

C. B.

Nápoles

A. M.

(2020). Racial/ethnic discrimination and intimate partner violence perpetration in Latino men: the mediating effects of mental health. International Journal of Environmental Research and Public Health, 17(21), 8148.

49.

Maldonado

A. I.

Murphy

C. M.

Davis

Evans

M. K.

Zonderman

A. B.

(2022). Racial discrimination, mental health symptoms, and intimate partner violence perpetration in Black adults. Journal of Consulting and Clinical Psychology, 90(3), 209.

50.

Murphy

C. M.

Hoover

S. A.

(1999). Measuring emotional abuse in dating relationships as a multifactorial construct. Violence and Victims, 14(1), 39–53.

51.

Murshid

N. S.

(2017). Men’s report of domestic violence perpetration in Bangladesh: Correlates from a nationally representative survey. Journal of Interpersonal Violence, 32(2), 290–307.

52.

Okuda

Olfson

Wang

Rubio

J. M.

Blanco

(2015). Correlates of intimate partner violence perpetration: Results from a National Epidemiologic Survey. Journal of Traumatic Stress, 28(1), 49–56. https://dx.doi.org/10.1002/jts.21986

53.

Oram

Fisher

H. L.

Minnis

Seedat

Walby

Hegarty

Rouf

Angénieux

Callard

Chandra

P. S.

Fazel

Garcia-Moreno

Henderson

Howarth

MacMillan

H. L.

Murray

L. K.

Othman

Robotham

Rondon

M. B.

. . . Chandra

P. S.

(2022). The Lancet Psychiatry Commission on intimate partner violence and mental health: advancing mental health services, research, and policy. The Lancet Psychiatry, 9(6), 487–524.

54.

World Health Organization. (2021). Violence against women prevalence estimates, 2018: Global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women.

55.

World Health Organization. (2023). Violence against women prevalence estimates 2023.

56.

Pengpid

Peltzer

K. J. G.

(2018). Intimate partner violence victimization and perpetration among female adolescents and adults in Timor-Leste. Gender and Behaviour, 16(1), 11055–11064.

57.

Porta

M. S.

Greenland

Hernán

dos Santos Silva

Last

J. M.

(2014). A dictionary of epidemiology. Oxford University Press.

58.

Priestley

Lee

K. A.

(2021). Understanding IPV perpetration among young Jamaican men: The role of socialization and attitudinal factors. Journal of Interpersonal Violence, 36(17–18), NP9053–NP9077.

59.

Reese

B. M.

Chen

M. S.

Nekkanti

Mulawa

M. I.

(2021). Prevalence and risk factors of women’s past-year physical IPV perpetration and victimization in Tanzania. Journal of Interpersonal Violence, 36(3–4), 1141–1167.

60.

Ringwald

Kababu

Ochieng

C. B.

Taegtmeyer

Zulaika

Phillips-Howard

P. A.

Digolo

(2022). Experiences and perpetration of recent intimate partner violence among women and men living in an informal settlement in Nairobi, Kenya: A secondary data analysis. Journal of Interpersonal Violence, 37(1–2), NP423–NP448.

61.

Roberts

Coid

King

Murphy

Turner

Bowden-Jones

Du Preez

K. P.

Landon

(2016). Gambling and violence in a nationally representative sample of UK men. Addiction, 111(12), 2196–2207.

62.

Roberts

A. L.

Gilman

S. E.

Fitzmaurice

Decker

M. R.

Koenen

K. C.

(2010). Witness of intimate partner violence in childhood and perpetration of intimate partner violence in adulthood. Epidemiology, 21(6), 809–818.

63.

Rodríguez

D. C.

Shearer

Mariano

A. R.

Juma

P. A.

Dalglish

S. L.

Bennett

(2015). Evidence-informed policymaking in practice: country-level examples of use of evidence for iCCM policy. Health Policy and Planning, 30(suppl_2), ii36–ii45.

64.

Sabri

Renner

L. M.

Stockman

J. K.

Mittal

Decker

M. R.

(2014). Risk factors for severe intimate partner violence and violence-related injuries among women in India. Women & Health, 54(4), 281–300. http://shibboleth.ovid.com/secure/?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=medl&AN=24617959

65.

Schokkenbroek

J. M.

Ponnet

Hardyns

(2024). Men’s (online) intimate partner violence experiences and mental health: Polyvictimization, polyperpetration and victim-perpetrator overlap. Journal of Aggression, Maltreatment & Trauma, 33(1), 46–66.

66.

Schraiber

L. B.

Latorre

M. d. R. D. O.

França Jr

Segri

N. J.

d’Oliveira

A. F. P. L

. (2010). Validity of the WHO VAW study instrument for estimating gender-based violence against women. Revista de Saude Publica, 44, 658–666.

67.

Singh

Tolman

Walton

Chermack

Cunningham

(2014). Characteristics of men who perpetrate intimate partner violence. The Journal of the American Board of Family Medicine, 27(5), 661–668.

68.

Skafida

Feder

Barter

(2023). Asking the right questions? A critical overview of longitudinal survey data on intimate partner violence and abuse among adults and young people in the UK. Journal of Family Violence, 38(6), 1095–1109. https://doi.org/10.1007/s10896-023-00501-1

69.

Spencer

C. M.

Stith

S. M.

(2020). Risk factors for male perpetration and female victimization of intimate partner homicide: A meta-analysis. Trauma, Violence, & Abuse, 21(3), 527–540. https://doi.org/10.1177/1524838018781101

70.

Stein

D. J.

(2008). Physical violence against intimate partners and related exposures to violence among South African men. Canadian Medical Association Journal, 179(6), 535.

71.

Stein

D. J.

Williams

S. L.

Jackson

P. B.

Seedat

Myer

Herman

Williams

D. R.

(2009). Perpetration of gross human rights violations in South Africa: Association with psychiatric disorders: mental health. South African Medical Journal, 99(5), 390–395.

72.

Straus

M. A.

(1973). A general systems theory approach to a theory of violence between family members. Social Science Information, 12(3), 105–125.

73.

Straus

M. A.

Douglas

E. M.

(2004). A short form of the Revised Conflict Tactics Scales, and typologies for severity and mutuality. Violence and Victims, 19(5), 507–520.

74.

Straus

M. A.

Hamby

S. L.

Boney-McCoy

Sugarman

D. B.

(1996). The revised conflict tactics scales (CTS2) development and preliminary psychometric data. Journal of Family Issues, 17(3), 283–316.

75.

Stubbs

Szoeke

(2022). The effect of intimate partner violence on the physical health and health-related behaviors of women: A systematic review of the literature. Trauma Violence Abuse, 23(4), 1157–1172. https://doi.org/10.1177/1524838020985541

76.

Treves-Kagan

El Ayadi

A. M.

Morris

J. L.

Graham

L. M.

Grignon

J. S.

Ntswane

Gilvydis

J. M.

Barnhart

Lippman

S. A.

(2021). Sexual and physical violence in childhood is associated with adult intimate partner violence and nonpartner sexual violence in a representative sample of rural South African men and women. Journal of Interpersonal Violence, 36(13–14), NP7415–NP7438.

77.

Vega

E. M.

O’Leary

K. D.

(2007). Test–retest reliability of the revised conflict tactics scales (CTS2). Journal of Family Violence, 22(8), 703–708. https://doi.org/10.1007/s10896-007-9118-7

78.

Walby

Myhill

(2001). New survey methodologies in researching violence against women. The British Journal of Criminology, 41(3), 502–522. https://doi.org/10.1093/bjc/41.3.502

79.

Walby

Towers

Balderston

Corradi

Francis

Heiskanen

Palmer

(2017). The concept and measurement of violence against women and men. Policy Press.

80.

Walsh

T. B.

Seabrook

R. C.

Tolman

R. M.

Lee

S. J.

Singh

(2020). Prevalence of intimate partner violence and beliefs about partner violence screening among young men. The Annals of Family Medicine, 18(4), 303–308.

81.

White

S. J.

Sin

Sweeney

Salisbury

Wahlich

Montesinos Guevara

C. M.

Gillard

Brett

Allwright

Iqbal

Khan

Perot

Marks

Mantovani

(2024). Global prevalence and mental health outcomes of intimate partner violence among women: A systematic review and meta-analysis. Trauma Violence Abuse, 25(1), 494–511. https://doi.org/10.1177/15248380231155529

82.

Willie

T. C.

Katague

Halim

Gupta

(2022). Latent classes of men’s intimate partner violence perpetration and attitudes towards gender norms: A UN multi-country, cross-sectional study in Asia and the Pacific. PLOS ONE, 17(9), e0264156.

83.

Zhang

Wong

Fan

Yip

P. S. F.

(2019). Intimate partner violence perpetration and victimization among Chinese young adults: Profiles and associated health problems. Violence & Victims, 34(5), 838–849.

The Measurement of Perpetration of Intimate Partner Violence in General Population Health Surveys: Systematic Review

Abstract

Keywords

Introduction

Methods

Study Design

Inclusion and Exclusion Criteria

Search Strategy

Screening and Extraction of Measurement Characteristics

Results

Measures Using or Adapted from the UN-MCS tool

Measures Adapted from the 2005 WHO Instrument for Research on Violence Against Women and Girls

Adaptations of the CTS and the Subsequent CTS Short Form

Ad hoc Measurement (More Than Two Items)

Ad hoc Measurement Using Two Items or Fewer

Discussion

Summary of Findings

Strengths and Limitations

Conclusions

Footnotes

ORCID iDs

Ethical Considerations

Funding

Declaration of Conflicting Interests

Data Availability Statement

Supplemental Material

Author Biographies

References