Intimate partner violence against women remains a widespread public health problem in European countries and seriously undermines women’s physical, mental and social well-being.¹1 Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: World Health Organization; 2013. According to a recent report by the World Health Organization,¹1 Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: World Health Organization; 2013. the lifetime prevalence of intimate partner violence among women who have had an intimate partner in high-income countries of western Europe is 19.3%, whereas in central and eastern Europe it is around 27%. The prevalence of intimate partner violence against women is 30% globally and about 23% in high-income countries.¹1 Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: World Health Organization; 2013.

Violence against women on the part of an intimate partner is a complex problem that needs to be understood within the wider social context. Public perceptions and attitudes shape the social climate in which such violence takes place and either perpetuate or deter its occurrence. A substantial reduction of the problem cannot be achieved without addressing societal attitudes leading to tolerance or justification of violence against women at the hands of an intimate partner.²2 Gracia E, Herrero J. Acceptability of domestic violence against women in the European Union: a multilevel analysis. J Epidemiol Community Health 2006;60:123–9. doi: http://dx.doi.org/10.1136/jech.2005.036533
https://doi.org/10.1136/jech.2005.036533... ^–44 Waltermaurer E. Public justification of intimate partner violence: a review of the literature. Trauma Violence Abuse 2012;13:167–75. doi: http://dx.doi.org/10.1177/1524838012447699
https://doi.org/10.1177/1524838012447699... Gaining a better understanding of public attitudes is increasingly recognized in international research as crucial in preventing intimate partner violence against women. For example, a recent review identified 23 studies whose authors examined how participants of population-based surveys in 61 countries – a mix of low-, middle- and high-income countries – explained the reasons for intimate partner violence against women in various hypothetical situations.⁴4 Waltermaurer E. Public justification of intimate partner violence: a review of the literature. Trauma Violence Abuse 2012;13:167–75. doi: http://dx.doi.org/10.1177/1524838012447699
https://doi.org/10.1177/1524838012447699... Almost invariably, the explanations given implied that the woman was to blame. For example, in Demographic and Health Surveys in sub-Saharan Africa and Asia, as well as in places such as Jordan, Turkey, the West Bank and Gaza Strip, people mentioned as justifications burning a meal or serving it late, neglecting a child, refusing to have sex or talking back to the husband. Assessments of victim-blaming attitudes in high-income countries have included justifications such as infidelity or women “asking for it” (United States of America) and women’s provocative behaviour (European countries).

In Europe, the main sources of information about public attitudes in justification of intimate partner violence against women are two surveys conducted in the 15 and 27 countries that were members of the European Union (EU) in 1999 and 2010, respectively, which allowed trend analyses to be conducted for the 15 countries with data from both surveys.⁵5 European Commission. Domestic violence against women report. Brussels: Directorate-General for Justice; 2010. Available from: http://ec.europa.eu/public_opinion/archives/ebs/ebs_344_en.pdf [accessed 1 February 2014].
http://ec.europa.eu/public_opinion/archi... One puzzling finding was the widespread nature of victim-blaming attitudes among European citizens even today. For example, in the 2010 survey people were asked whether women’s provocative behaviour was a cause of domestic violence against women. Those who agreed with this statement averaged 52% and ranged from 33% to 86% across countries. Clearly, the 27 members of the EU are very heterogeneous in terms of income, gender equality and policies against intimate partner violence. The problem is most pronounced in new members such as Lithuania (86%), Estonia (84%) and Latvia (79%), lower-income members and members where policies to curb domestic violence have only been in place for a short time. However, low income and the absence of gender equality are clearly not the explanation for the high frequency of victim-blaming attitudes in other European countries. Another surprising result of the 2010 survey was that countries such as Finland (74%), Denmark (71%), Sweden (59%) and the United Kingdom of Great Britain and Northern Ireland (63%) – all advanced countries economically and in terms of gender equality – had some of the highest frequencies. Even the 33% frequency found in Spain can be considered high.

More puzzling still is the persistence of victim-blaming attitudes despite years of public awareness and education efforts. For example, the question about women’s provocative behaviour was asked of residents of EU countries in 1999. In 2010, such behaviour was given as an explanation for violence against women at the hands of their intimate partners by the same or a higher fraction of respondents in all but three of the countries also surveyed in 1999. That this explanation was still so prevalent is alarming because such attitudes contribute to a social climate in which intimate partner violence against women is tolerated and legitimized.²2 Gracia E, Herrero J. Acceptability of domestic violence against women in the European Union: a multilevel analysis. J Epidemiol Community Health 2006;60:123–9. doi: http://dx.doi.org/10.1136/jech.2005.036533
https://doi.org/10.1136/jech.2005.036533... ^–44 Waltermaurer E. Public justification of intimate partner violence: a review of the literature. Trauma Violence Abuse 2012;13:167–75. doi: http://dx.doi.org/10.1177/1524838012447699
https://doi.org/10.1177/1524838012447699... To ignore this issue in preventive efforts is tantamount to ignoring the detrimental influence that these attitudes can exert.

Public attitudes that place the responsibility for violence on the victims’ shoulders often conceal a lack of sympathy or insensitivity towards victims that creates a psychological distance between victims and their observers.⁶6 Kogut T. Someone to blame: when identifying a victim decreases helping. J Exp Soc Psychol 2011;47:748–55. doi: http://dx.doi.org/10.1016/j.jesp.2011.02.011
https://doi.org/10.1016/j.jesp.2011.02.0... When the cause of the violence is attributed to the victims, incidents are more likely to be trivialized and seen as understandable or deserved, and hence as less unjust and more admissible. Such attitudes serve to excuse and partly absolve the perpetrators of violence²2 Gracia E, Herrero J. Acceptability of domestic violence against women in the European Union: a multilevel analysis. J Epidemiol Community Health 2006;60:123–9. doi: http://dx.doi.org/10.1136/jech.2005.036533
https://doi.org/10.1136/jech.2005.036533... ^,44 Waltermaurer E. Public justification of intimate partner violence: a review of the literature. Trauma Violence Abuse 2012;13:167–75. doi: http://dx.doi.org/10.1177/1524838012447699
https://doi.org/10.1177/1524838012447699... ^,77 Gracia E, García F, Lila M. Public responses to intimate partner violence against women: the influence of perceived severity and personal responsibility. Span J Psychol 2009;12:648–56. doi: http://dx.doi.org/10.1017/S1138741600002018
https://doi.org/10.1017/S113874160000201... and add to the notion in the public’s mind that sometimes women are justifiably the victims of intimate partner violence.⁴4 Waltermaurer E. Public justification of intimate partner violence: a review of the literature. Trauma Violence Abuse 2012;13:167–75. doi: http://dx.doi.org/10.1177/1524838012447699
https://doi.org/10.1177/1524838012447699... ^,88 Taylor CA, Sorenson SB. Community-based norms about intimate partner violence: putting attributions of fault and responsibility into context. Sex Roles 2005;53:573–89. doi: http://dx.doi.org/10.1007/s11199-005-7143-7
https://doi.org/10.1007/s11199-005-7143-... Implicit in victim-blaming attitudes is the idea that, under certain circumstances (e.g. when a woman behaves provocatively), violence is justified and therefore legitimate, as long as no red line is crossed.²2 Gracia E, Herrero J. Acceptability of domestic violence against women in the European Union: a multilevel analysis. J Epidemiol Community Health 2006;60:123–9. doi: http://dx.doi.org/10.1136/jech.2005.036533
https://doi.org/10.1136/jech.2005.036533... ^,44 Waltermaurer E. Public justification of intimate partner violence: a review of the literature. Trauma Violence Abuse 2012;13:167–75. doi: http://dx.doi.org/10.1177/1524838012447699
https://doi.org/10.1177/1524838012447699... ^,77 Gracia E, García F, Lila M. Public responses to intimate partner violence against women: the influence of perceived severity and personal responsibility. Span J Psychol 2009;12:648–56. doi: http://dx.doi.org/10.1017/S1138741600002018
https://doi.org/10.1017/S113874160000201... Also, those who blame victims for their own misfortunes are less willing to help them.²2 Gracia E, Herrero J. Acceptability of domestic violence against women in the European Union: a multilevel analysis. J Epidemiol Community Health 2006;60:123–9. doi: http://dx.doi.org/10.1136/jech.2005.036533
https://doi.org/10.1136/jech.2005.036533... ^,77 Gracia E, García F, Lila M. Public responses to intimate partner violence against women: the influence of perceived severity and personal responsibility. Span J Psychol 2009;12:648–56. doi: http://dx.doi.org/10.1017/S1138741600002018
https://doi.org/10.1017/S113874160000201... Intimate partner violence is not only a widespread problem, but one with which many people are familiar. In the 2010 European survey, 25% of respondents reported knowing a woman who was a victim of intimate partner violence among their friends and family. Therefore, people’s perception of who is responsible for the violence is extremely important. If people blame the woman who is the victim of the violence, they are likely to place the responsibility for solving the problem – at least partly – on her shoulders as well.⁴4 Waltermaurer E. Public justification of intimate partner violence: a review of the literature. Trauma Violence Abuse 2012;13:167–75. doi: http://dx.doi.org/10.1177/1524838012447699
https://doi.org/10.1177/1524838012447699... ^,88 Taylor CA, Sorenson SB. Community-based norms about intimate partner violence: putting attributions of fault and responsibility into context. Sex Roles 2005;53:573–89. doi: http://dx.doi.org/10.1007/s11199-005-7143-7
https://doi.org/10.1007/s11199-005-7143-... They will also be less likely to report known incidents of such violence, and the people surrounding the victims will not become a part of the informal social network that can help to keep intimate partner violence under control.⁴4 Waltermaurer E. Public justification of intimate partner violence: a review of the literature. Trauma Violence Abuse 2012;13:167–75. doi: http://dx.doi.org/10.1177/1524838012447699
https://doi.org/10.1177/1524838012447699... ^,66 Kogut T. Someone to blame: when identifying a victim decreases helping. J Exp Soc Psychol 2011;47:748–55. doi: http://dx.doi.org/10.1016/j.jesp.2011.02.011
https://doi.org/10.1016/j.jesp.2011.02.0... ^,77 Gracia E, García F, Lila M. Public responses to intimate partner violence against women: the influence of perceived severity and personal responsibility. Span J Psychol 2009;12:648–56. doi: http://dx.doi.org/10.1017/S1138741600002018
https://doi.org/10.1017/S113874160000201... The fact that intimate partner violence against women is not only a major social and public health problem, but also a largely unreported one,⁷7 Gracia E, García F, Lila M. Public responses to intimate partner violence against women: the influence of perceived severity and personal responsibility. Span J Psychol 2009;12:648–56. doi: http://dx.doi.org/10.1017/S1138741600002018
https://doi.org/10.1017/S113874160000201... ^,99 Gracia E. Unreported cases of domestic violence against women: Towards an epidemiology of social silence, tolerance, and inhibition. J Epidemiol Community Health 2004;58:536–7. doi: http://dx.doi.org/10.1136/jech.2003.019604
https://doi.org/10.1136/jech.2003.019604... makes it even more imperative to try to change victim-blaming attitudes.

Public attitudes also exercise an important influence on the perpetrators of intimate partner violence and the women who are its victims. Such women are judged by the people who surround them (e.g. family, friends, neighbours, co-workers) and by society’s institutions (e.g. the media, law enforcement personnel, health services).⁷7 Gracia E, García F, Lila M. Public responses to intimate partner violence against women: the influence of perceived severity and personal responsibility. Span J Psychol 2009;12:648–56. doi: http://dx.doi.org/10.1017/S1138741600002018
https://doi.org/10.1017/S113874160000201... ^,1010 Gracia E, García F, Lila M. Police attitudes toward policing partner violence against women: Do they correspond to different psychosocial profiles? J Interpers Violence 2011;26:189–207. doi: http://dx.doi.org/10.1177/0886260510362892
https://doi.org/10.1177/0886260510362892... A social climate of tolerance towards this form of violence can influence women’s response to their victimization by deterring them from seeking help or disclosing or reporting the violence.²2 Gracia E, Herrero J. Acceptability of domestic violence against women in the European Union: a multilevel analysis. J Epidemiol Community Health 2006;60:123–9. doi: http://dx.doi.org/10.1136/jech.2005.036533
https://doi.org/10.1136/jech.2005.036533... ^–44 Waltermaurer E. Public justification of intimate partner violence: a review of the literature. Trauma Violence Abuse 2012;13:167–75. doi: http://dx.doi.org/10.1177/1524838012447699
https://doi.org/10.1177/1524838012447699... ^,77 Gracia E, García F, Lila M. Public responses to intimate partner violence against women: the influence of perceived severity and personal responsibility. Span J Psychol 2009;12:648–56. doi: http://dx.doi.org/10.1017/S1138741600002018
https://doi.org/10.1017/S113874160000201... ^–1010 Gracia E, García F, Lila M. Police attitudes toward policing partner violence against women: Do they correspond to different psychosocial profiles? J Interpers Violence 2011;26:189–207. doi: http://dx.doi.org/10.1177/0886260510362892
https://doi.org/10.1177/0886260510362892... Blaming the women who are treated with violence by their intimate partners is a form of second victimization that can undermine their mental health and hinder their recovery and psychosocial adjustment.¹1 Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: World Health Organization; 2013. Finally, victim-blaming attitudes can make perpetrators feel publicly justified in acting violently and reinforce their behaviour by making them less fearful of the social costs of their actions, which would hence lose their power to inhibit or deter violent behaviour.⁴4 Waltermaurer E. Public justification of intimate partner violence: a review of the literature. Trauma Violence Abuse 2012;13:167–75. doi: http://dx.doi.org/10.1177/1524838012447699
https://doi.org/10.1177/1524838012447699... ^,77 Gracia E, García F, Lila M. Public responses to intimate partner violence against women: the influence of perceived severity and personal responsibility. Span J Psychol 2009;12:648–56. doi: http://dx.doi.org/10.1017/S1138741600002018
https://doi.org/10.1017/S113874160000201... ^,88 Taylor CA, Sorenson SB. Community-based norms about intimate partner violence: putting attributions of fault and responsibility into context. Sex Roles 2005;53:573–89. doi: http://dx.doi.org/10.1007/s11199-005-7143-7
https://doi.org/10.1007/s11199-005-7143-...

Victim-blaming attitudes need to be targeted in public awareness and education efforts, but to better inform these, a better understanding of these attitudes is required. Research on these issues is clearly insufficient; important research questions remain open. In future, research should explore the reasons for victim-blaming attitudes by examining how these are influenced by factors at the individual, group and community levels and by macro-cultural determinants such as income inequality, legislative framework, gender role beliefs, patriarchal or “honour” cultures and gender inequality.³3 Flood M, Pease B. Factors influencing attitudes to violence against women. Trauma Violence Abuse 2009;10:125–42. doi: http://dx.doi.org/10.1177/1524838009334131
https://doi.org/10.1177/1524838009334131... A multifactorial approach of this type should also shed light on the reasons for the large variations identified in the literature – between countries and within them – in the prevalence of victim-blaming attitudes.⁴4 Waltermaurer E. Public justification of intimate partner violence: a review of the literature. Trauma Violence Abuse 2012;13:167–75. doi: http://dx.doi.org/10.1177/1524838012447699
https://doi.org/10.1177/1524838012447699... Research is also needed to explore whether such attitudes are more common among certain groups defined by age, education, income or culture or in specific contexts, such as socially and economically segregated urban areas.¹¹11 Gracia E, López-Quílez A, Marco M, Lladosa S, Lila M. Exploring neighborhood influences on small-area variations in intimate partner violence risk: a Bayesian random-effects modeling approach. Int J Environ Res Public Health 2014;11:866–82. doi: http://dx.doi.org/10.3390/ijerph110100866
https://doi.org/10.3390/ijerph110100866... Focusing research not only on the country-level prevalence of victim-blaming attitudes, but also on their unequal distribution across different groups and contexts,¹¹11 Gracia E, López-Quílez A, Marco M, Lladosa S, Lila M. Exploring neighborhood influences on small-area variations in intimate partner violence risk: a Bayesian random-effects modeling approach. Int J Environ Res Public Health 2014;11:866–82. doi: http://dx.doi.org/10.3390/ijerph110100866
https://doi.org/10.3390/ijerph110100866... ^,1212 Merlo J. Contextual influences on the individual life course: building a research framework for social epidemiology. Psychosoc Interv 2011;20:111–21. might help to better understand the factors that influence attitudinal change and resistance to change in particular groups or settings. It would be revealing, for example, to monitor the prevalence and correlates of victim-blaming attitudes among younger generations in different countries, since a recent review suggests that younger people tend to justify intimate partner violence against women more often than their elders.⁴4 Waltermaurer E. Public justification of intimate partner violence: a review of the literature. Trauma Violence Abuse 2012;13:167–75. doi: http://dx.doi.org/10.1177/1524838012447699
https://doi.org/10.1177/1524838012447699... Similarly, research on what groups and settings to target through educational and preventive strategies, and on the differences in victim-blaming attitudes within and across countries, might help to improve the design and effectiveness of such strategies.

In summary, academics and policy-makers face many challenges in their efforts to reduce intimate partner violence against women. Investing in public education and awareness initiatives is critically important, as is ensuring that these initiatives are well informed, appropriately targeted and properly designed. Finally, constant monitoring will be needed to assess the effectiveness of efforts to change public attitudes that further victimize the women who are victims of intimate partner violence.

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