Battering Typologies, Attachment Insecurity, and Personality Disorders-A Comprehensive Literature Review

Aggression and Violent Behavior 28 (2016) 2946
Contents lists available at ScienceDirect
Aggression and Violent Behavior
Battering typologies, attachment insecurity, and personality disorders: A

comprehensive literature review
Margherita Cameranesi
University of Manitoba, 66 Chancellors Cir., Winnipeg, Manitoba R3T 2N2, Canada
Applied Health Sciences PhD Program, Faculty of Graduate Studies
a r t i c l e
i n f o
Article history:
Received 18 December 2014
Received in revised form 29 November 2015
Accepted 8 March 2016
Available online 14 March 2016
Keywords:
Intimate Partner Violence
Battering
Battering typologies
Attachment styles
Personality disorders
a b s t r a c t
Woman battering is a serious social problem that occurs across all racial, ethnic, and socioeconomic boundaries,
and that affects not only the physical, mental, and emotional health of victims but also that of perpetrators. This
article is a comprehensive literature review on battering typologies that explores also the mediating role that antisocial and borderline personality traits may play in explaining the relationship observed in a number of studies
between insecure attachment styles and battering perpetration. Since the groundbreaking work that
Holtzworth-Munroe and Stuart conducted in 1994, research on battering typologies has consistently shown
that male batterers do not represent a homogeneous group of persons. Specically, different studies have classied batterers in two or three subtypes that differ in terms of severity of intimate partner violence perpetrated,
generality of the violence, psychopathology of Axis I and Axis II, drug and alcohol use, and attachment styles. Recent studies have also detected a consistent association between insecure attachment styles and battering that
may be mediated by dysfunctional personality traits, specically borderline and antisocial personality disorders.
Implications for clinical practice, limitations of existing research, and suggestions for future research are
discussed.
2016 Elsevier Ltd. All rights reserved.
Contents
1.
2.
3.
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Search strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Theoretical perspectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.1.
Psychological theories . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.
Psychopathology and battering. . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.1.
Personality disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.
Batterer typologies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.1.
Batterer typologies identied from 1994 to the present . . . . . . . . . . . . .
6.
Attachment theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6.1.
Infantcaregiver attachment . . . . . . . . . . . . . . . . . . . . . . . . .
6.2.
Adult romantic attachment and personality disorders . . . . . . . . . . . . . .
6.3.
Attachment insecurity, personality disorders, and battering . . . . . . . . . . .
7.
Attachment insecurity and battering: the potential mediating role of personality disorders.
8.
Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9.
Implications for prevention and treatment . . . . . . . . . . . . . . . . . . . . . .
10.
Strengths and limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11.
Agenda for future research . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
E-mail address: cameranm@myumanitoba.ca.
http://dx.doi.org/10.1016/j.avb.2016.03.005
1359-1789/ 2016 Elsevier Ltd. All rights reserved.
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M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946
1. Introduction
Family violence is the most prevalent form of violence in the United
States (Owen, Thompson, Shaffer, Jackson, & Kaslow, 2009). One type of
family violence is Intimate Partner Violence (IPV), which can be dened
as a pattern of violent and coercive behaviors that involve physical, sexual, psychological, and/or emotional harm perpetrated by one dating,
cohabitant, or married partner against the other, either in an existing
or past relationship (Family Violence Prevention Found, 2008;
Saltzman, Fanslow, McMahon, & Shelley, 2002). IPV is a widespread
problem and every year over 20% of women worldwide experience at
least one act of physical or sexual assault from a male partner (Tjaden
& Thoennes, 2000), with even more women victimized by psychological
aggression (Ro & Lawrence, 2007). While the majority of IPV is mutually
perpetrated and experienced as low-level violence, similar to situational
couple violence (Johnson, 1995, 2006), a portion of IPV is predominantly perpetrated by men and involves severe levels of violence, similar to
intimate terrorism (Johnson, 1995, 2006) or, in other words, battering.
Woman battering is the most severe type of IPV. Prior research with
battered women suggests that battering is a chronic, continuous phenomenon that is empirically and conceptually distinct from episodic
discrete acts of physical assault (Ferraro & Johnson, 1983). The term
battering is conventionally used to refer to severe male partner violence,
although there is disagreement regarding exactly what denes a batterer (Holtzworth-Munroe & Meehan, 2004). In fact, while some researchers describe battering exclusively as the presence of severe and/
or frequent violence, others insist that battering involves also wife injury or fear of the husband, or that the violence must function to control
and dominate the victim. In the present paper I adopt a comprehensive
framework referring to battering as the use of patterned physical and/or
sexual violence combined with psychological, emotional, and/or economical abuse from a male partner toward his female partner in the
context of a current or former heterosexual intimate relationship
(Smith, Thornton, DeVellis, Earp, & Coker, 2002). According to this formalization, battering consists of a variety of abusive tactics executed
by intimate partners including physical and/or sexual assault; threat, intimidation, and humiliation; isolation and restriction of resource access;
threat to the safety of children and other family members or close
friends; control of activities and time spent outside the home; and use
of any weapons to force unwanted activities.
Woman battering is a serious social problem that occurs across all
racial, ethnic, and socioeconomic boundaries, and that affects not only
the physical, mental, and emotional health of victims but also that of
perpetrators (Family Violence Prevention, 2008). Due to the severity
and chronicity of the violence that characterizes battering and because
of the associated intense fear generated in victims, it is very likely that
this phenomenon is highly unreported in the general population,
make it a challenge for researchers to gather reliable statistics about
its prevalence and incidence. Nevertheless, a few studies reported recent estimates showing that every nine seconds, somewhere in the
United States, a woman is battered by someone she knows (Roberts &
Roberts, 2005) and approximately 30% of all female homicides in a
given year occur as a consequence of battering (Koziol-McLain et al.,
2006; Shackelford & Mouzos, 2005). According to a recent estimation,
every year as many as 8.7 million women are abused by their partners
(roughly 20% worldwide) and approximately 2 million of them needed
emergency medical attention as a result of battering (Roberts & Roberts,
2005; Smith et al., 2002). In addition, close to 500 chronically battered
women have killed their partners each year in the attempt to cope
with the explicit terroristic death threats, because of post-traumatic
stress disorder (PTSD) symptoms, or while in a condition of psychosis
inducted by alcohol or drug used with the purpose of self-medicating
themselves (Richardson, 2003; Roberts & Roberts, 2005).
The aftermaths of battering often have a physically and psychologically destructive impact upon the battered woman. Research indicates
that intimate partner abuse can serve as a catalyst for both direct and
indirect physical health problems and that these victimization experiences are often associated with an increase in mental health symptomatology (Archer, 2000; Breiding, Black, & Ryan, 2008; Coker et al., 2002;
Follingstad, 2009; Robertiello, 2006; Roberts & Kim, 2006; Shorey,
Febres, Braseld, & Stuart, 2012; Sillito, 2012; Smith et al., 2002). In addition to the health risks associated with injuries such as, head and neck
injuries, and miscarriage, battering is associated with higher rates of
self-reported overall poor health and development of chronic diseases
such as, diabetes, arthritis, asthma, and heart diseases. Furthermore,
the impact of the battered woman syndrome results in subsequent
higher risks of depression, anxiety, PTSD symptoms, alcohol and drug
abuse, suicide attempts, and feelings of fear.
Even though numerous theories have been developed and employed
to account for the occurrence and maintenance of woman battering
such as feminist theories, social learning theory, sociological theories,
and psychological theories, no one has been able to completely elucidate the mechanisms involved in the phenomenon and to explain the
complex interaction of several risk and protective factors correlated
with battering perpetration and victimization (Schumacher, FeldbauKohn, Smith Slep, & Heyman, 2001). Moreover, because numerous empirical studies, literature reviews, and meta-analyses of standard model
interventions with perpetrators of IPV have found little or no effects on
decreasing violent behavior (Dutton & Corvo, 2006), there is a clear
need for studies laying the basis for evidence-based practice with
battering perpetrators (Corvo, Dutton, & Chen, 2008).
Previous studies adopting a psychological perspective have shown
that male batterers are not a homogeneous group of persons and have
identied several subtypes among batterers that differ regarding severity of marital violence, generality of the violence (toward the partner
only or toward others as well), psychopathology of Axis I and Axis II
(i.e., clinical syndromes and personality disorders), drug and alcohol
use, and attachment styles (e.g. Dutton & Golant, 1995, Gottman et al.,
1995, Holtzworth-Munroe & Stuart, 1994, Holtzworth-Munroe, Stuart,
& Hutchinson, 1997, Tweed & Dutton, 1998). Therefore, it is highly
probable that one standard intervention for battering does not t the
needs of all the perpetrators and consequently that it shows a different
degree of effectiveness according to the specic personality characteristics of the beneciaries. Further research on batterer characteristics can
help improve current interventions and develop if necessary different
intervention programs for subgroups of batterers with specic personality traits (Buck, Leenaars, Emmelkamp, & van Marle, 2012).
In light of the aforementioned ndings of previous research, and
considering the existing gap between research and treatment programs,
the purpose of the present paper is to provide a comprehensive literature review on battering typologies presenting also the most recent
ndings on the association found between attachment insecurity and
battering perpetration and the mediating role that personality disorder
traits may play in explaining this association. Initially I will review the
research on batterer typologies focusing specically on the differences
found in personality characteristics and attachment styles of different
batterer types. My hope is that a deeper knowledge of psychological,
emotional, and behavioral tendencies specic to different personality
organizations and attachment styles will be valuable in the development of future tailored intervention programs that will be more adequate and effective (Buck et al., 2012; Mauricio & Gormley, 2001).
Since the vast majority of studies conducted on battering consider exclusively male batterers, I decided to focus the present literature review
on battering perpetrated by men. Despite that, it is necessary to highlight that more and more studies over the past 30 years have reported
a high prevalence of IPV perpetrated by female partners, with part of
this abuse representing high levels of violence and falling under the category of battering (e.g.Ansara & Hindin, 2009, Capaldi & Owen, 2001,
Langhinrichsen-Rohling, Selwyn, & Rohling, 2012, Straus, 2011). Therefore, for a prevention and intervention perspective it is also crucial to
start studying also this new phenomenon that has heretofore been
neglected by family violence scholars.
2. Search strategy
The literature review was structured to nd research articles that
investigate the mediating role of personality disorder traits in the
relationship between attachment insecurity and perpetration of IPV. I
searched four online databases, Psyc-INFO, Medline (PubMed), Google
Scholar, Scirus (ScienceDirect), and Scopus for the following key
terms: battering, or intimate partner violence, or domestic violence, and personality, or personality disorder*, and attachment,
or insecure attachment, or attachment insecurity. The asterisk
(i.e., the truncation symbol) allowed for the inclusion of alternate
words ending of the search term (i.e., disorder* yielded articles containing disorder and disorders). Finally, all reference lists of the articles included in the manuscript were reviewed in order to nd more articles
that meet the following criteria.
Adopting these search criteria, three different literatures that have
largely developed separately from one another have been combined:
literature on battering typologies, literature on batterers' attachment
patterns, and literature on the specic role that personality disorder
characteristics play in explaining the relationship between insecure attachment and perpetration of IPV.
Since the purpose of the present work is to generate a comprehensive literature review, I did not include a specic timeframe while
researching articles. However, in order to review the most current theoretical thinking and experimental ndings on the topic, in synthetizing
the literature on battering typologies, I focused predominantly on studies carried out in the last two decades, from 1994 to present. The decision to focus the review to the past 20 years was generated noticing
that the most recent ndings are comparable to those of previous
research. Furthermore, from the 90s to the present, research methods
changed improving sample techniques, modifying research designs,
and rening statistical analyses. Focusing the discussion on the most
up-dated research allows a complete critical synthesis of the state of
current knowledge on the topic, and a discussion of the most relevant
directions for future research. In addition, numerous review articles
and meta-analyses were collected and used to gather a broad in depth
understanding of the topic.
Despite its relevance for the development of more effective prevention and intervention programs, the specic role that personality disorder traits may play in explaining the relationship observed in research
between insecure attachment patterns and battering perpetration, has
been relatively neglected by researchers studying battering and by
family violence scholars. In fact, the search of the psychological and
sociological manuscripts yielded only a few articles. It is important to
emphasize the need for more up-to-date research that discusses the
specic role that various factors, especially personality disorder features, may perform in explaining the connection between attachment
insecurity and perpetration of violence by batterers.
3. Theoretical perspectives
Over the years several theoretical frameworks have been adopted in
order to explain the dynamics of battering and the persistence of abusive relationships (Chornesky, 2000). Most of the traditional explanations of violence against women have focused on a unidimensional
explanation of battering that takes into account only one factor involved
such as feminist theories, social learning theory, family systems theory,
sociological theories, and psychological theories (e.g. Bandura, 1977,
Gelles, 1993, O'Leary, 1993, Yll & Bograd, 1988). Conversely, more
recent and comprehensive theorizations have adopted a multilevel
explanation that considers factors related to different and various
aspects of woman battering such as attachment theory (e.g., Dutton,
1995a, 1995b, 1995c, 1995d, 1995e; Dutton, Saunders, Starzomski, &
Bartholomew, 1994; Stosny, 1995). It is important to note that there is
some overlap in the theories and that no single theory provides a complete explanation of battering (Schumacher et al., 2001). Moreover,
31
each theory carries with it certain implications about the factors most
likely to be associated with increased risk for woman battering.
3.1. Psychological theories
Psychological theories place emphasis on individual differences in
personality traits of batterers to explain partner aggression, such that
individuals who show certain personality characteristics are more likely
to perpetrate violence in the context of a romantic relationship than
other people with different personality features (e.g., O'Leary, 1993).
According to this perspective, in attempting to understand male violence, early attention to this problem focused on the psychopathology
of batterers. In the literature, men who physically abuse women have
been described as manifesting a variety of impairments in cognitive,
emotional, and social functioning, including low self-esteem, lack of impulse control, high levels of anger and hostility, lack of assertiveness,
and the use and abuse of alcohol and drugs (Beasley & Stoltenberg,
1992; Dinwiddie, 1992; Dutton et al., 1994; Dutton, 1995a, 1995b,
1995c, 1995d, 1995e; Dutton, Starzomski, & Ryan, 1996; Hastings &
Hamberger, 1988; Kantor & Straus, 1989; Moore et al., 2008;
Schumacher et al., 2001; Stuart et al., 2006; Stuart et al., 2008; Stuart,
O'Farrell, & Temple, 2009). Moreover, a wide range of mental conditions
of Axis I and Axis II have been commonly correlated to increased rates of
IPV perpetration. Indeed, early research demonstrated that, relative to
comparison groups of nonviolent men, men entering batterer treatment
programs evidenced more psychopathology (see review by HoltzworthMunroe, Bates, Smutzler, & Sandin, 1997). In particular, batterers reported depressive symptomatology, bipolar disorder symptoms, anxiety,
PTSD symptoms, hysteria, and paranoia (Bell & Orcutt, 2009;
Danielson, Moftt, Caspi, & Silva, 1998; Dinwiddie, 1992; Gleason,
1997; Hamberger & Hastings, 1991; Hastings & Hamberger, 1994;
Julian & McKenry, 1993; Maiuro, Cahn, Vitaliano, Wagner, & Zegree,
1988; McKenry, Julian, & Gavazzi, 1995; Schumacher et al., 2001;
Shorey et al., 2012).
Regarding Axis II personality disorders, research has shown that Antisocial Personality Disorder (ASPD) and Borderline Personality Disorder (BPD) traits are often associated with the perpetration of woman
battering, combined with narcissism, avoidance, and aggressiveness
(e.g., Beasley & Stoltenberg, 1992; Danielson et al., 1998; Dinwiddie,
1992; Dutton et al., 1996; Gleason, 1997; Hamberger & Hastings,
1991; Hastings & Hamberger, 1994; O'Leary, Malone, & Tyree, 1994;
Murphy, Meyer, & O'Leary, 1993; Stuart et al., 2008).
4. Psychopathology and battering
In attempting to understand the correlates and potential causes of
battering, numerous studies have been conducted comparing violent
men with nonviolent men in order to investigate the relationship between psychopathology and IPV (e.g. Danielson et al., 1998, Hastings
& Hamberger, 1988, Murphy et al., 1993). Even though early research
reported high levels of psychopathology in batterers, the majority of
these studies did not include comparison groups, and instead researchers either reported the percentage of batterers who received
various psychiatric diagnoses or compared violent batterer scores on
standardized tests to test norms (Holtzworth-Munroe, Bates, et al.,
1997). In more recent studies, researchers have compared batterers
with non-batterers administering self-report measures of psychopathology mostly the Millon Clinical Multiaxial Inventory in its three editions (MCMI, MCMI-II, MCMI-III; Millon, 1983, 1987, 1994), and the
Minnesota Multiphasic Personality Inventory in its two editions
(MMPI; Hathaway & McKinley, 1967; MMPI-2; Butcher, Dahlstrom,
Graham, Tellegen, & Kaemmer, 1989) indicating that, as a group, violent men evidence more psychopathological symptoms than do their
nonviolent counterparts.
Hastings and Hamberger (1988), using the MCMI (Millon, 1983)
scores, compared the personality proles of 29 alcoholic batterers, 35
32
non-alcoholic batterers, and 43 non-abusive men in either a discordant

(n = 22) or satisfying (n = 21) marital relationship. The authors found
that both groups of batterers scored signicantly higher than nonviolent
men on scales evaluating anxiety, depression, psychotic depression, and
psychotic thinking, and on scales concerning avoidant, asocial, negativistic, aggressive, and borderline personality features. Moreover, alcohol
abuse was related to greater differences between the two groups of
men.
In a subsequent study conducted by the same authors (Hamberger &
Hastings, 1991), they investigated personality differences among three
groups of domestically violent men 38 agency identied alcoholic
batterers, 61 non-alcoholic batterers referred for treatment, and 28
men identied through community sampling as maritally violent
and a nonviolent comparison group of 31 maritally discordant and 33
maritally satised men matched for age and education level. Batterers
scored signicantly higher than the nonviolent men on anxiety, depression, hysteria, neuroticism, and alcohol and drug scales. Signicant
group differences also emerged for scores on the scales assessing borderline personality characteristics, psychotic thinking, and psychotic
depression.
Murphy et al. (1993) administered the MCMI-II (Millon, 1987) to 24
domestically violent men, 24 nonviolent maritally discordant men, and
24 nonviolent happily married men in order to examine the association
between self-report of psychopathology and current spousal abuse. Violent men evidenced higher levels of personality disorder features than
did nonviolent men involved in both discordant and happy romantic relationships; however, after controlling for social desirability, batterers
differed from the other two groups only on the antisocial and aggressive
scales.
One of the most consistent ndings of the literature on violent men
is the association between battering and depression as measured administering the MCMI (Millon, 1983) and other self-report instruments
appositely designed to evaluate depressive symptoms such as the Beck
Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh,
1961). Pan, Neidig, and O'Leary (1994a), replicating ndings of previous
research (Julian & McKenry, 1993; Maiuro et al., 1988), found that
among the 11,870 White men in the military they tested, those who
were physically aggressive toward their partners reported more depressive symptomatology than those who were nonaggressive. Further,
severely aggressive men reported a greater number and more severe
depressive symptoms in comparison to those reported by mild aggressive men. In a more recent study on the prevalence of mental disorders
and IPV, Danielson et al. (1998) reported that the most prevailing psychiatric disorders among batterers are anxiety disorders, mood disorders, specically depression and bipolar disorders, ASPD, substance
use, and psychosis.
4.1. Personality disorders
The available data suggests that batterers may be more likely than
nonviolent men to evidence personality characteristics typical of personality disorders, particularly BPD and ASPD (Holtzworth-Munroe,
Bates, et al., 1997). In the Diagnostic and Statistical Manual of Mental
Disorders (DSM-V; American Psychiatric Association [APA], 2013) a
personality disorder is dened as an enduring pattern of inner experience and behavior that deviates markedly from the expectation
of the individual's culture (p. 646), and that can be manifested in
the individual's cognition, affectivity, interpersonal functioning,
and/or impulse control. The DSM-V classication distinguishes 10
formal personality disorders diagnosed on Axis II that are grouped
into three clusters based on descriptive similarities. Cluster A comprises
paranoid, schizoid, and schizotypal personality disorders, idiosyncratic
of individuals who appear odd or eccentric. Cluster B includes antisocial,
borderline, histrionic, and narcissistic personality disorders that characterized individuals who appear dramatic, emotional, or erratic. Lastly,
Cluster C comprises avoidant, dependent, and obsessivecompulsive
personality disorders, and portrays individuals who appear anxious or

fearful.
In a study of men who were federally incarcerated, Dutton and Hart
(1992) examined institutional records of Axis II diagnoses made by
psychiatrists or psychologists to compare 74 prisoners whose records
contained no report of violence with 346 prisoners whose records
only contained reports of violence toward strangers and 177 prisoners
whose records indicated that they had engaged in family violence. The
authors reported that the nonviolent prisoners were signicantly less
likely to receive a diagnosis of ASPD than the two violent groups. Moreover, the prisoners with a history of family violence were more likely to
be diagnosed with BPD and Narcissistic Personality Disorder (NPD) than
the other two groups of prisoners.
Grounded in previous ndings that batterers often show personality
characteristics typical of BPD and ASPD, more recent research on
battering has begun to focus on these two particular personality disorders (Holtzworth-Munroe & Meehan, 2002; Holtzworth-Munroe,
Bates et al., 1997).
Based on studies comparing maritally violent men to nonviolent
men, Dutton (1994a, 1995a, 1995b, 2007) proposed the existence of a
batterer prole of associated abuse features labeled the abusive personality, which is characterized by Borderline Personality Organization
(BPO). The BPO is a clinical category that is less severe than the BPD described by intense, unstable interpersonal relationships, an unstable
sense of self, and intense anger and impulsivity (Gunderson, 1984).
The essential features of the BPO include (a) a disposition to engage in
intense, unstable interpersonal relationships characterized by intermittent idealization and devaluation of signicant others, manipulation,
and masked dependency; (b) an unstable sense of self associated with
intolerance of being alone and abandonment anxiety; and (c) intense
anger, demandingness, and impulsivity, usually tied to substance
abuse or promiscuity (Dutton, 1994a). According to Dutton's theorization, the abusive personality includes, combined with a BPO, a fearful
attachment style (Dutton et al., 1994), chronic anger (Dutton &
Starzomski, 1994), and trauma symptoms (Dutton, 1995c). Given the
great dependency experienced by borderline men in relationships,
these men become violent when they fear partner abandonment. In
one of the numerous studies that Dutton (1994b) conducted in order
to test his theory, 60 court-referred and 60 self-referred male batterers
were interviewed and assessed on BPO traits (Self-Report Instrument
for BPO; Oldham et al., 1985), use of violence, verbal abuse, anger, jealousy, trauma symptoms, and substance abuse. Results showed that the
BPO scale scores were signicantly and positively correlated with anger,
jealousy, experienced trauma, and frequency of use of both verbal and
physical aggression. Therefore, men who more frequently used verbal
and physical aggression were also those with a BPO, who experienced
more anger and trauma symptoms, and who were more jealous of
their partners.
Other researchers have drawn attention to the role of antisocial personality characteristics in understanding male perpetration of IPV. The
methodologically strongest studies have been conducted examining
large, preexisting samples originally recruited in childhood to investigate the development of delinquency, criminal behavior, and aggression
(Holtzworth-Munroe & Meehan, 2002). These samples have now
reached adulthood and researchers have assessed for the occurrence
of IPV demonstrating a relationship between antisocial personality features and battering in men (Andrew, Foster, Capaldi, & Hops, 2000;
Capaldi & Clark, 1998; Magdol et al., 1997). It is noteworthy that these
researchers do not use the MCMI (Millon, 1983) as a measure of personality disorders, but rather they use other established objective procedures and data sources such as arrest records and teacher, parent, or
partner reports of aggression.
Despite these two new promising lines of work, there is an ongoing
debate surrounding the potential relevance of personality disorders in
understanding male battering (Holtzworth-Munroe & Meehan, 2002).
In particular, the available data suggests that although pathologic
personality features are important for understanding IPV, not all

batterers show diagnosable personality disorders. An example is the
study conducted by Gondolf (1999) examining MCMI-III (Millon,
1994) data of 800 men beginning violence treatment and leading him
to conclude that batterers are less pathological than expected in accordance with previous research ndings. Indeed, Gondolf found that relative to studies using earlier version of the MCMI a smaller percentage of
men scored on any personality subscale high enough to indicate the
presence of a clinical syndrome only 48% in his sample versus up to
80% in previous samples. These mixed ndings about the role of personality disorders in battering has led researchers to conclude that there is
not a unitary batterer prole, and therefore to consider batterers as a
heterogeneous group of individuals. The most recent batterer literature,
in fact, suggests that domestically violent men can be categorized into
subgroups labeled typologies based on individual characteristics including personality traits, psychopathology, and the nature of their violence
generalized versus family only. These batterer typologies are particularly likely to be useful in tailoring specic and more effective intervention programs (Dutton, Bodnarchuk, Kropp, Hart, & Ogloff, 1997;
Saunders, 1992).
5. Batterer typologies
Researchers have studied batterers for the purpose of identifying homogeneous subcategories of male batterers in order to match specic
treatments to specic subgroups of individuals (Healey, Smith, &
OSullivan, 1998; Holtzworth-Munroe & Stuart, 1994). Most batterer
typologies focus on personality characteristics from a dimensional
perspective proposing that personality features are crucial for understanding IPV and that different typologies of batterer can be distinguished according to the degree of personality pathology reported
(Holtzworth-Munroe & Meehan, 2002). In addition, although there is
no agreement about the numbers and particular individual features of
batterer subgroups, there has been consistency in the identication of
at least two subgroups of batterers, one characterized by borderline
personality traits, and a second characterized by antisocial personality
traits (Chase, O'Leary, & Heyman, 2001; Gottman et al., 1995;
Hamberger, Lohr, Bonge, & Tolin, 1996; Hamberger & Hastings, 1986;
Holtzworth-Munroe & Stuart, 1994; Langhinrichsen-Rohling, Huss, &
Ramsey, 2000; Tweed & Dutton, 1998; Waltz, Babcock, Jacobson, &
Gottman, 2000; White & Gondolf, 2000).
Early attempts to develop typologies of batterers usually used one or
two rational/deductive strategies, either describing subtypes of
batterers on the basis of the clinical observations (e.g., Elbow, 1977),
or grouping batterers into types on the basis of a priori theoretical
speculation and comparing them on available data (e.g., Hershorn &
Rosenbaum, 1991).
In 1974, Faulk proposed the rst categorization of batterers reported
in the literature after interviewing 23 men arrested for marital violence
and grouping them into ve categories (Faulk, 1974). The stable/affectionate batterers had stable marriages and used violence in concomitance with psychopathology, particularly during an episode of major
depression, while the dependent/suspicious batterers were irrationally
jealous of their wives, very dependent on them, controlling of their actions, and used violence in response to perceived indelity. The largest
category was composed of dependent/passive batterers almost 40%
of the sample who generally tried to please their wives exploding violently in response to some unexpected actions performed by their
partners. The dominating batterers wanted to control their wives and
use violence to do so, while the fth and more pathologic subtype described violent/bullying batterers who used violence and intimidation
to solve many of their problems and to obtain what they wanted in
their everyday life.
A few years later, on the basis of clinical observation of violent men
in treatment, Elbow (1977) identied four typologies of batterers. The
approval seekers needed their wives to approve their behaviors and
33
used violence to sustain and reinforce their self-image and selfesteem, whereas the defenders were dependent on their wives and
overprotected them, mixing love and hate. The incorporators saw
their partners as part of their self and needed them to dene themselves, while the controllers viewed their wives as objects and used violence to control them.
Several subsequent studies have factor or cluster analyzed batterers'
scores on standardized tests, particularly the MCMI (Millon, 1983) and
the MMPI (Hathaway & McKinley, 1967), to identify subgroups of
batterers on the basis of the psychopathology/personality disorders reported by the violent men.
The rst typology derived by employing this method was developed
and replicated by Hamberger and Hastings (1985, 1986) in two empirical studies that used factor analysis to examine batterers' scores on the
MCMI (Millon, 1983), and then compared the subtypes on measures of
depression and anger. On the basis of the key personality features reported by batterers on the MCMI, the authors identifying three batterer
subtypes: passive-dependent/compulsive, schizoidal/borderline, and
narcissistic/antisocial. The passive-dependent/compulsive men were
anxious, depressed, and rigid individuals who lacked self-esteem and
depended on others, becoming hostile when others did not meet their
needs. Schizoidal/borderline men were withdrawn, asocial, moody, volatile, hypersensitive to interpersonal affronts, and likely to overreact to
trivial interpersonal disputes. Further, the men in this group had high
levels of anxiety, depression, and anger proneness, and may have had
alcohol problems. Narcissistic/antisocial men showed tendencies for alcohol and drug abuse, and had a self-centered approach to life using
others to meet their own needs and believing to deserve others appreciation and love.
In 1992 Saunders performed a cluster analysis of self-report data
gathered from 165 maritally violent men entering treatment for spouse
abuse, identifying three subtypes of batterers. Family only aggressors,
who represented more than 50% of the sample, perpetrated violence exclusively within their romantic relationships and largely in association
with alcohol abuse, were overall satised with their marriages, and reported low levels of anger, depression, and jealousy. Conversely, emotionally volatile aggressors reported high levels of anger, depression,
and jealousy, and had the most suicidal ideation and guilt. These men
were the least satised with their marriages and the most psychologically abusive. Finally, generally violent aggressors engaged in the
highest levels of violence both within their romantic relationships and
outside the family, and reported the most severe abuse as children.
Their violence was often associated with alcohol abuse, and they
showed moderate to low levels of anger, depression, marital satisfaction, and marital conicts.
5.1. Batterer typologies identied from 1994 to the present
In 1994, Holtzworth-Munroe and Stuart conducted a comprehensive
review of 15 existing batterer typologies (e.g. Hamberger & Hastings,
1985, 1986, Saunders, 1992), including some using deductive approaches like subgroups formed using clinical observations or a priori
hypotheses, and others using inductive approaches such as factor or
cluster analysis of participants' scores on various instruments
(Holtzworth-Munroe & Meehan, 2002, 2004). Summarizing data across
these studies, the authors observed that batterer subtypes could be classied along three descriptive dimensions namely (1) the severity and
frequency of IPV, (2) the generality of violence, marital only or also
extra-familial, and (3) the batterer's psychopathology or personality
disorder traits. According to the authors, using these dimensions,
three subtypes of batterers would be identied namely family only
(FO), borderline or dysphoric (BD), and generally violent or antisocial
(GVA).
FO batterers were predicted to engage in the least marital violence
and the least violence outside the home. Men in this group were expected to show little or no psychopathology since they were not
34
characterized by either BPD or ASPD. Conversely, BD batterers were predicted to engage in moderate or severe IPV, but only in low or moderate
levels of extra-familial violence. This group would be the most psychologically distressed, presenting depression and anxiety, and the most
likely to evidence borderline personality traits. GVA batterers were expected to engage in the highest level of violence both within and outside
the intimate relationship, and would be the most likely to display features of ASPD.
The authors then integrated several interpersonal theories of aggression into a developmental model of these three different batterer typologies. The model emphasized the role of numerous correlates of male
violence as risk factors for specic batterer subtypes, including distal
or historical correlates such as violence in the family of origin and association with delinquent peers, and proximal correlates such as attachment style, dependency, impulsivity, social skills, and attitude toward
women and toward violence.
Consistent with this model, the authors predicted that among maritally violent men, FO batterers would report the lowest levels of risk
factors. The violence of these men was assumed to result from a combination of stress, marital and/or personal, and low level risk factors such
as exposure to IPV as a child and lack of relationship skills, such that on
some occasions of marital conict escalations these men use physical
aggression to manage a situation otherwise experienced as uncontrollable. Following the episode of violence, the low levels of psychopathology and related problems that distinguish this group such as low
impulsivity and low attachment dysfunctions, combined with a lack of
hostility toward women and a lack of positive attitude toward violence,
would led these men to experience remorse preventing their aggression
from escalating.
Conversely, BD batterers were expected to report a history of parental abuse and rejection resulting in a difculty to construct a stable,
trusting attachment to an intimate partner and in high levels of jealous,
dependency, and fearful of loosing their wives. These men are impulsive, they lack marital skills, and show attitudes that are hostile toward
women and supportive of violence.
Finally, the batterers included in the GVA group were predicted to
show the highest levels of involvement with deviant peers and of family
of origin violence, and to resemble the main characteristics of the antisocial aggressive personality. These men would exercise IPV as a part
of a more general pattern of aggression and antisocial behavior also extended outside the family context since they view violence as an acceptable way to achieve their goals and to solve conicts, lack general social
skills, and express hostile attitudes toward women.
In a more recent work, Holtzworth-Munroe, Meehan, Herron,
Rehman, and Stuart (2000) tested this tripartite batterer typology
among a community sample of 102 physically violent men conducting
a series of cluster analyses and assessing borderline and antisocial personality traits employing two scales appositely derived from the
MCMI-III (Millon, 1994) and labeled fear of abandonment and
antisociality, respectively. The author detected the three expected typologies namely FO, BD, and GVA, along with one additional subgroup
labeled low-level antisocial (LLA). Men included in the fourth unexpected cluster, the LLA batterers, scored moderately on measures of
antisociality, marital violence, and general violence, falling intermediate
on most of the measures compared to the FO batterers and the GVA
batterers. Therefore, conceptualizing the FO, LLA, and GVA groups as
falling along a continuum of antisociality and given that it is unreasonable to place the BD group along this continuum, the authors' data suggest that two personality dimensions are still needed in order to
describe completely the four batterer typologies, namely borderline
and antisocial.
In a subsequent study (Holtzworth-Munroe, Meehan, Herron,
Rehman, & Stuart, 2003), the same authors tested the validity and the
predictive value of the four-typology groups gathering longitudinal
data at an 18 month follow-up and again after another 1 to 2 years
and, obtaining information from 95 of the 102 batterers, they veried
that over time the subtypes formed at Time 1 remained unchanged,

continuing to differ as predicted over a 3-year period. However, although many group differences emerged in the predicted direction,
not all reached statistical signicance, possibly due to the small sample
size.
Battered typologies identied since the review conducted by
Holtzworth-Munroe and Stuart (1994) have generally supported their
proposed typology recognizing the existence of two to six different subgroups of batterers depending on the sampling characteristics, that is
community samples versus clinic or forensic samples, and on the measures used to assess personality traits, that is MCMI questionnaires
(Millon, 1983, 1987, 1994) versus other instruments (see Table 1).
However, it is necessary to mention that a few studies failed in replicating the tripartite typology described by Holtzworth-Munro and Stuart
as they found either mixed proles with elevation on both BPD and
ASPD scales or a unique batterer prole characterized by only borderline or antisocial personality traits (e.g. Delsol, Margolin, & John, 2003,
Edwards, Scott, Yarvis, Paizis, & Panizzon, 2003, Mauricio & Lopez,
2009). Other scholars, instead, grouped batterers according to different
criteria such as the kind of violence perpetrated, namely psychological,
physical, and sexual (e.g., Chiffriller, Hennessy, & Zappone, 2006).
In the attempt to identify a distinctive and more reliable battering
typology, Gottman et al. (1995) examined the relationships among
heart rate reactivity during marital conict, emotionally aggressive behaviors, and violence in battering couples. The authors recruited 61
married couples from the community who engaged in husband-towife IPV and used as an index of physiological response the men's
heart rate reactivity during a marital conict interaction to divide the violent men into two groups based on whether the men's heart rate increased or decreased from baseline during engagement in a marital
conict discussion. Violent husbands whose heart rate decreased
below baseline during marital interaction, labeled as Type 1 batterers
or cobras, resembled GVA batterers, since they were more verbally
aggressive toward their wives and when compared to the remaining violent husbands, labeled Type 2 batterers or pitbulls, they were also
more violent toward others outside the family, less dependent, and
scored higher on antisocial behavior, sadistic aggression, and drug dependence. Conversely, Type 2 batterers resembled the BD group identied by Holtzworth-Munroe and Stuart (1994), since during the marital
interaction they were less aggressive, and they also showed the lowest
levels of anger and violence outside the family, and reported great dependence upon their wives. This analysis is particularly remarkable for
two main reasons: rst, because together with the aforementioned
work that Holtzworth-Munroe Meehan, Herron, Rehman, and Stuart
carried out in 2003, this represents one of the few studies conducted
on batterer typologies examining longitudinal data; second, because
this was the rst study conducted combining different methods of evaluation, specically self-report, physiological, and observational measures. In fact, in the rst experimental session with the couples
Gottman et al. (1995) administered an array of standardized measures
including the MCMI II (Millon, 1987), observed the couples during a
marital conict, and measured a set of physiological indicators in the
male participants. Furthermore, since the authors' interest was to empirically study the longitudinal course of abusive marriages, they also
examined the status of the marriages 2 years later using self-reported
questionnaires.
Hamberger et al. (1996) cluster analyzed the MCMI (Millon, 1983)
scores of 833 court-referred batterers for participation in an intervention program, and the three main clusters identied closely resembled
those in the Holtzworth-Munroe and Stuart typology. The non-pathological subgroup reported the lowest levels of partner aggression,
anger, and substance abuse; they restricted their violence primarily to
intimate relationships, had the fewest police contacts, and were the
least likely to report a history of abuse or exposure to IPV as children.
Passiveaggressive-dependent batterers and antisocial batterers did not
differ in the severity of IPV perpetrated, but passiveaggressive-
Psychopathic
Antisocial
Proactive
Reactive
Borderline/dysphoric Borderline/dependent
Hostile/controlling
Non-pathological
Low personality
dysfunction
Severe personality
dysfunction (borderline)
Moderate personality
dysfunction (antisocial)
Generally
violent
Generally violent antisocial
(GVA)
Family only (FO)
Borderline dysphoric (BD)
Type 2 Impulsive
(pitbulls)
Type 1 antisocial
(cobras)
Non-pathological
group
Passiveaggressivedependent group
Antisocial group
Type 1
instrumental
Type 2 impulsive
Pathological
Normal/non-pathological
(fake good)
seriously disturbed
(fake bad)
Psychopathic/deviance
Family only
Waltz et al.
(2000)
Tweed and
Dutton (1998)
Hamberger et al.
(1996)
Gottman et al.
(1995)
Holtzworth-Munroe
and Stuart (1994)
Table 1
Comparison of batterer typologies in studies published from 1994 that examined personality disorder characteristics.
Langhinrichsen-Rohling
et al. (2000)
White and Gondolf

(2000)
Chase et al.,
2001 + Ross &
Babcock, 2009
Lawson et al. (2003)
Fowler and Westen

(2011)
35
dependent men reported the highest frequency of physical violence toward the intimate partner. Moreover, while antisocial batterers showed
the highest levels of generalized violence outside the family and the
greater number of police contacts, the passiveaggressive-dependent
batterers reported the highest levels of depression and were the most
likely to be abused as children.
Tweed and Dutton (1998) employed measures of marital violence
and personality characteristics and used a cluster analysis to group personality traits of 79 physically abusive men referred to treatment for DV.
Subsequently, they associated each personality trait cluster to the most
common attachment style identied in the participants (Relationship
Styles Questionnaire [RSQ]; Bartholomew & Horowitz, 1991) and to
their average anger level, reporting also if the men in each cluster
showed trauma symptoms. The authors identied two subtypes of
batterers: an instrumental group, or Type 1 (comparable to the GVA)
and an impulsive group, or Type 2 (resembled the BD). Batterers in the
instrumental subtype showed an antisocialnarcissisticaggressive prole on the MCMI-II (Millon, 1987) and reported more severe physical
violence toward their partners. Batterers in the impulsive subtype
showed a mixed prole to the MCMI-II with passiveaggressive, borderline, and avoidant elevations, high scores on the BPO scale, higher
chronic anger, and fearful attachment style. Further, both types of abusive men reported a preoccupied attachment style, but only the impulsive group showed an associated fearful attachment style. Despite the
small sample size, Tweed and Dutton's work is remarkable because it
extended the knowledge on battering typologies including into the
analyses a measure of attachment that allowed them to connect each
specic typology of batterers to particular attachment styles.
Waltz et al. (2000) examined a sample of 75 domestically violent
men and their partners, and 32 maritally distressed nonviolent comparison couples adopting measures of all three descriptive dimensions
identied by Holtzworth-Munroe and Stuart (1994) that is marital violence, general violence, and psychopathology. Furthermore, the authors
assessed the batterers' attachment style using the Adult Attachment
Scale (AAS; Collins & Read, 1990). Mixed analyses led to the identication of three batterer subtypes largely resembling the HoltzworthMunro and Stuart taxonomy. The rst group, labeled family only, engaged in the least levels of violence and reported only few psychopathological symptoms and high levels of compulsive care seeking. Generally
violent batterers showed the greatest levels of violence both within and
outside the intimate relationship, scored highest on alcohol and drug
dependence scales and within the clinical range on antisocial and narcissistic scales, and displayed mainly an avoidant attachment pattern.
Conversely, pathological batterers, comparable to the BD group except
that they reported the highest antisocial scores, displayed mostly an
anxiousambivalent attachment pattern combined with self-reliance
and angry withdrawal. They engaged in moderate levels of violence
within and outside the family context, and scored highest on the aggressivesadistic and narcissistic scales, and within the clinical range on the
schizotypal scale. Further, batterers in the generally violent and pathological groups reported exposure to the most frequent and severe IPV
as children.
In an attempt to test the clinical utility of the batterer typologies distinguished by Holtzworth-Munroe and Stuart (1994); LanghinrichsenRohling et al. (2000) gathered data from 49 male batterers in treatment
for DV administering the BDI (Beck et al., 1961) and the MMPI
(Hathaway & McKinley, 1967). Employing cluster analysis in order to
derive the empirical batterer subtypes, the author identied three subgroups of batterers labeled normal/non-pathological/fake good, seriously
disturbed/fake bad, and psychopathic-deviant. Contrary to the researchers' expectations, the ve mental health professionals expressed
considerable disagreement about how to classify batterer proles. However, when they compared the three empirically derived clusters to the
three theoretical typologies, FO, BD, and GVA, they placed three-fourths
of the sample into the FO, BD, and GVA groups and the three subgroups
observed clearly reected the psychopathology traits identied in these
36
subgroups of batterers. Indeed, the proles of batterers in the nonpathological subgroup showed no clinical elevations of any of the clinical or validity scales, while the prole of the psychopathic-deviance
subgroup was characterized by a clinical elevation on the psychopathic
deviant scale. Finally, the prole of the seriously disturbed cluster had
elevations on almost all of the clinical scales and an unusual validity pattern. Further, these men reported the most frequent suicidal ideation,
while the other two clusters showed the highest levels of alcohol and
drug abuse.
In order to examine the treatment needs of batterers, White and
Gondolf (2000) drew a stratied random subsample of 100 cases from
a larger sample of 840 men in treatment for battering, and grouped
the proles of the 100 batterers using the exclusive criterion of severity
of personality pathology. The interpretation of the MCMI-III (Millon,
1994) proles produced three levels of personality pathology referred
to as low dysfunction (56%), moderate dysfunction (29%), and severe dysfunction (15%) associated to specic personality traits. The personality
proles of men in the low dysfunction group did not indicate elevation
on personality disorder scales or clinical personality traits, while the
proles of men in the moderate dysfunction group suggested the presence of moderate symptoms of narcissistic and antisocial personality
disorders not associated with any Axis I condition. Lastly, the proles
of batterers with severe personality dysfunction included men who presented severe symptoms of paranoid and borderline personality disorders, accompanied by Axis I conditions such as thought disorder and
major depression. The authors further divided these three proles into
six groupings based on the specic personality traits detected, and provided recommendations for treatment.
Chase et al. (2001) used descriptions of episodes of male violence
among a sample of 60 couples seeking marital therapy for IPV to categorize men as perpetrating either proactive or reactive violence. Proactively violent men, similar to GVA men, planned how to use violence in an
instrumental way, and were goal oriented. They were more dominant
and angry during the marital discussion, reported higher scores on measures of antisocial and aggressivesadistic personality, and were more
frequently classied as psychopathic. On the other hand, similar to BD
men, batterers who used violence reactively were more dependent
reacting emotionally to perceived threats and frustrations, and showed
borderline and dysphoric personality traits.
In a more recent work, Ross and Babcock (2009) administered the
Structured Clinical Interview for DSM-IV (SCID-II; First, Spitzer,
Gibbon, & Williams, 1997) to 124 men recruited from the community
that reported to be physically abusive toward their partners, and their
female partners were interviewed to investigate the reactive or proactive nature of the violence sustained. The ndings, consistent with previous research, showed that personality-disordered batterers were
signicantly more violent toward their partners and inicted more
injuries than the non-diagnosed men, and that the violence of men
with different personality disorders appeared to differ in its function.
Specically, while batterers with BPD appeared to engage largely in reactive violence, batterers with ASPD tended to use violence both proactively and reactively. Surprisingly domestically violent men reporting
BPD did not differ from their counterpart showing ASPD with regard
to number of incarcerations, partner injury, and the severity and frequency of IPV.
In 2003, Lawson and his colleagues conducted a study in order to examine the differences among FO, BD, and GVA batterers, and a group of
generally violent men in a sample of 153 participants who were on probation for either IPV or non-intimate violence. The authors conducted a
cluster analysis on MMPI-2 (Butcher et al., 1989) proles of the subsample of 91 domestically violent men identifying three clusters of psychopathology, namely non-pathological (62%), borderline/dysphoric (14.3%),
and antisocial (24.2%). The rst cluster of non-pathological batterers
was comprised of men who scored within normal limits on the MMPI2 scales. The borderline/dysphoric cluster identied a psychopathological pattern often associated with borderline personality disorder and
characterized by emotional instability, impulsivity, irritability, anxiety,

dysphoria, problems with anger management, severe distress, and destructive behavior. Conversely, the antisocial batterers reported having
experienced little emotional distress, low frustration tolerance, undercontrolled anger, and poor self-control that may result in outbursts of
physical aggression. Moreover, these individuals tended to be egocentric lacking insight into their own behavior, impulsive, rebellious, deant, and to have poor relationships with authority gures. Despite the
psychopathological similarities between these tripartite typologies
and those identied by Holtzworth-Munroe and Stuart (1994), when
compared on the violence variables namely severity of violence, generality of violence, and exposure to IPV as a child, only severity of violence
approximated the correlation expected across the three clusters. Indeed, on these variables only the non-intimate violent group differed
signicantly from the others, reporting considerably less severe violence than the borderline/dysphoric and antisocial group.
Lastly, in a recent work, Fowler and Westen (2011), applied a new
methodology to derive subtypes of male perpetrators of IPV as part of
a larger National Institute of Mental Health (NIMH) study. A national
sample of randomly selected psychologists and psychiatrists described
188 adult male patients, 59 with a history of partner violence, 97 with
a history of arrests but not partner violence, and 57 with either partner
violence or arrests, using the Shedler-Westen Assessment Procedure-II
(SWAP-II; Shedler & Westen, 2007; Westen & Shedler, 2007), a Q-sort
procedure for assessing personality pathology (see Shedler & Westen,
2007; Westen & Shedler, 1999a, 1999b, 2007). Using Q-factor analysis,
the authors identied three personality constellations among batterers
that largely resembled those described by Holtzworth-Munroe and Stuart (1994) psychopathic, hostile/controlling, and borderline/dependent.
Psychopathic batterers were described by clinicians as impulsive, and
with a lack of remorse and empathy. They tended to be generally violent
with a history of criminality and assaultive behavior across relationships
begun in childhood, and to use violence instrumentally, possibly to
dominate others. Moreover, the psychopathic group reported having
experienced the most severe childhood adversity showing the earliest
onset of delinquent or aggressive behavior, the poorest adaptive functioning, and the triad of enuresis, re setting, and animal torture long
described in the clinical literature (e.g., Wax & Haddox, 1974). Men
who matched the hostile/controlling subtype were described as angry,
controlling, suspicious, hypersensitive to perceived criticism tending
to hold grudges, and seemed to have a hair trigger propensity for
rage. They were inclined to externalizing blame and to view themselves
as misunderstood with a consequent alienation of others and the presence of just a few friends. Finally, the borderline/dependent batterers
were described as unhappy, anxious, depressed, and prone to emotions
that spiral out of control. These men were very dependent on their intimate partners to soothe their feelings of failure, anxiety, and emptiness,
and they also suffered from deep fears of abandonment and tended to
blame the person they love and needed the most for their negative
feelings. As in Holtzworth-Munroe and Stuart classication, of the
battering subtypes, these men were intermediate in global functioning,
psychopathology, alcohol and substance use, and adverse childhood
experiences.
It clearly emerges from this brief review of the most relevant and recent literature on batterer typologies that there is a strong association
between battering and both BPD and ASPD. However, doubts persist regarding the specic developmental trajectories that lead men to
become perpetrators of IPV. The most recent research on battering suggests that attachment theory (Bowlby, 1988) may provide an appropriate and comprehensive framework capable to explain the complex
mechanisms involved in the development of the batterer personality.
6. Attachment theory
In the twofold effort of constructing theories about the development
of abusive personalities relevant to the different subtypes of abusers and
of improving intervention programs for batterers, some researchers

have begun to explore the use of attachment theory in explaining abusive and violent behavior perpetrated by men toward their intimate
partners. Therefore, attachment theory has been proposed as a conceptual framework for understanding interpersonal dynamics in battering
(Bowlby, 1984; Dutton, 1995b; Fonagy, 1999; Mayseless, 1991). Interestingly, the focus on attachment theory was the direct result of observations made in clinical settings that batterers were overly dependent
on their intimate partners but incapable of initiating and maintaining
an emotionally supportive relationship (Buttell, Muldoon, & Carney,
2005). As a result, these men desired closeness with their partner yet,
given their inability to achieve emotional intimacy, engaged in violent
and controlling behaviors to ensure physical closeness rather than emotional intimacy (Murphy, Meyer, & O'Leary, 1994). Conceptually, the excessive interpersonal dependency shown by batterers is viewed as a
consequence of insecure attachment styles built in childhood (Dutton,
1995a; Holtzworth-Munroe, Bates, et al., 1997).
6.1. Infantcaregiver attachment
Attachment theory, historically rooted in evolutionary theory and
ethology, was formulated by John Bowlby, a British psychiatrist who
studied institutionalized war orphans following World Wars I and II
(Eckerman, 1996). Bowlby (1977) conceptualized that infants have an
innate instinct to create strong affectional bonds to signicant others
in order to protect themselves and enhance their chances of survival
by ensuring that they maintain close proximity to their caregivers
under conditions of danger or threat (e.g., Bowlby, 1973). The attachment system also provides children with a sense of security or a secure
base that facilitates exploration of the world outside the caregiving relationship (Ainsworth, Blehar, Waters, & Wall, 1978; Bowlby, 1988;
Sroufe & Waters, 1977). The quality of early attachment relationships
is thus grounded in the degree to which the infant has come to rely on
the attachment gure as a source of security, and, depending on the history of interactions with this gure, different attachment styles can be
developed.
On the basis of infants' behavioral responses during separation and
reunion phases of a structured laboratory procedure identied as the
strange situation, Ainsworth et al. (1978) originally identied three
major categories of infant attachment, namely secure, anxious-resistant,
and avoidant. Children classied as securely attached welcome their
caretaker's return after a separation and, if distressed, seek proximity
and are easily comforted (Main, Kaplan, & Cassidy, 1985). Infants classied as anxious-resistant seek contact with the mother upon reunion but
are unable to be comforted and show ambivalent behavior manifesting
anger and resistance toward her, while avoidant children ignore the
mother upon reunion and avoid proximity and interaction with her.
More recently, Main and Solomon (1990) identied a fourth attachment
category labeled disorganizeddisoriented, which is typical of infants
who manifest a distinct and wide variety of behaviors indicating a
temporary breakdown in strategy and a disorganized response to the
caregiver such as displays of fear, contradictory behaviors or affects
occurring simultaneously or sequentially, stereotypic or misdirected
movements, freezing, and apparent dissociation.
According to Bowlby (1982), children over time internalize experiences with caretakers in the form of internal representations or internal
working models of the interpersonal attachment relationship, developing a prototype for later relationships outside the family, and involving
expectations about the behavior of individuals in close relationships.
Internal working models are mental representations that the child develops over time about images of others and the self, based on whether
or not the attachment gure is respondent to needs of support and protection and whether or not the self is worthy of support and protection
from others, in particular the attachment gure. Recent research, examining the nature of internal working models in relation to the attachment styles of children, showed that children classied as ambivalent
37
hold negative images of themselves, while, even though not fully consistent, data on infants classied as avoidant suggest the presence of
negative images of others (Cassidy, 1988; Kaplan & Main, 1985). A considerable body of research also links the attachment style of children at
12 or 18 months to their social and emotional adjustment through
childhood (e.g., Bretherton, 1985).
6.2. Adult romantic attachment and personality disorders
A central principle of attachment theory is that attachment relationships continue to be signicant and to inuence individuals throughout
the life span (Ainsworth, 1982, 1989; Bowlby, 1977, 1980, 1982).
Although attachment processes have been extensively investigated in
parentchild relationships (Bartholomew & Horowitz; Benware, 2014;
Zhao, 2013), scholars have only recently started to examine the
relationships between internal working models and adjustment in
adulthood.
Hazan and Shaver (1987) conceptualized romantic love as an attachment process and developed a self-report instrument to classify adults
into three categories that correspond to the three attachment styles of
childhood secure, anxiousambivalent, and avoidant. Their work
showed that compared with the secure group, the two insecure groups
reported higher adverse romantic experiences and more negative beliefs about love (see also Collins & Read, 1990). They had a history of
shorter romantic relationships, and provided less favorable descriptions
of their relationships with parents in childhood. Subsequent research
has indicated that enduring romantic relationships are the most important attachment relationships in adult life (Hazan & Zeifman, 1994), and
that adult attachment patterns are associated with a range of relationship outcomes including satisfaction, trust, communication, and conict
resolution (Bartholomew, 1993; Hazan & Shaver, 1994; Shaver & Hazan,
1993).
Building on the work of Hazan and Shaver (1987), Bartholomew and
Horowitz (1991) developed a fourth-category model of adult attachment that denes attachment patterns according to specic combinations of positive or negative representations of the self and others, or
in other words, specic internal working models (see Table 2). Models
of the self describe the degree to which individuals have internalized a
sense of their own self-worth and if negative may be associated with excessive anxiety and dependency, while models of others indicate the degree to which people expect signicant others to be supportive and
trustworthy and are associated with the tendency to seek out or avoid
intimacy in relationships.
The secure pattern is dened in terms of a positive self-model and
positive other model, and is expected to be negatively associated with
emotional reactivity and abuse in intimate relationships since secure individuals are both condent and comfortable with intimacy. The
dismissing attachment pattern is described in terms of a positive selfmodel and negative other model that lead individuals to maintain a positive self-image by defensively devaluating the importance of attachment needs and maintaining emotional distance in their relationships.
People with a dismissing pattern of attachment are described as
counter-dependent and deny their need for intimacy. Although the frustration of attachment needs may give rise to anger (Kobak & Sceery,
1988), due to deactivation of the attachment system, dismissing
Table 2
Attachment styles continuity from childhood throughout adulthood.
Childhood
Adulthood
Ainsworth et al. (1978)
Bartholomew & Horowitz (1991)
Secure
Anxious-resistant
Avoidant
Disorganizeddisoriented
(Main & Solomon, 1990)
Secure positive self-model + Positive other model

Preoccupied negative self-model + Positive other model
Dismissed positive self-model + Negative other model
Fearful negative self-model + Negative other model
38
individuals are not prone to insecurity in close relationships. However

those individuals may use violence as a distancing strategy to push a
partner back when the perpetrator had been approached too closely
and perceived no other means of escape or self-protection (Allison,
Bartholomew, Mayseless, & Dutton, 2008).
Preoccupied and fearful individuals who show the two attachment
styles characterized by a negative self-model, are chronically anxious
about rejection and abandonment in their close relationships and therefore are expected to show high levels of negative affects, including anger
and jealousy in intimate relationships (see also Buunk, 1997; Dutton &
Starzomski, 1993; Schumacher et al., 2001). Specically, preoccupied
individuals with a negative self-model and positive other model, actively seek to gain other's approval in order to validate their fragile sense of
self-worth and due to this combination of feeling of unworthiness and
strong orientation toward intimacy with others are expected to experience high levels of anger in close relationships.
People with a preoccupied attachment style seek self-acceptance
by recognition from others and tend to continually strive to become
relatively closer to them, sometimes to the detriment of the relationships. Conversely, the fearful attachment pattern, characterized by
negative self-model and negative other model, is expected to be
the most strongly associated with intimacy anger. Fearful individuals
desire social contact and intimacy but experience pervasive interpersonal distrust and fear of rejection. They are hypersensitive to rejection and actively avoid close relationships when they feel
vulnerable to rejection.
Although both fearful and preoccupied attachment patterns are dened by anxiety over abandonment, the orientation to actively avoid intimate relationships characteristics of fearful individuals may lead them
to a more chronic frustration of attachment needs. According to this theory of attachment in adulthood, individuals showing fearful and preoccupied attachment styles are prone to the experience of anxiety about
abandonment in their intimate relationships and consequently they
are highly dependent on their partners and prone to anger, jealousy,
and affective instability (Dutton et al., 1994).
In 1988 Bowlby conceptualized a connection between insecure attachment and personality disorders arguing that the mental representations of the self and the others developed through interactions with the
main caregivers during childhood inuence interpersonal functioning
during adulthood impacting also adults' psychological health. Secure attachment early in life contributes to healthy psychological development, whereas insecure attachments predispose to psychopathology
vulnerability in adolescence throughout adulthood.
Specically, anxious attachment is accompanied by clinging behaviors and overwhelming negative affects due to fear of abandonment
combined with uncertainty as to whether the attachment gure will respond to them. This uncertainty originates a vulnerability to disorders
that exaggerate negative affects and distress in an effort to get the attention of the caregiver. In contrast, individuals showing an avoidant
attachment are prone to behaviors that minimize distress and are vulnerable to disorders that deny the presence of negative affects. Due to
their expectation to be rebuffed, they become compulsively selfreliant and rejecting toward intimacy needs. Therefore, anxious attached individuals are more likely to develop psychopathology
reecting borderline personality traits, while people with an avoidant
attachment pattern are more likely to show psychopathology traits
reecting the ASPD.
Consistent with theoretical hypotheses, many researchers following
Bowlby (1988) have emphasized the importance of attachment insecurity in understanding the development of personality disorders
(Brennan & Shaver, 1998; Livesley, Schroeder, & Jackson, 1990;
Sheldon & West, 1990), providing evidence of relationships between
anxious attachment and BPD (Fonagy et al., 1996; Patrick, Hobson,
Castle, Howard, & Maughan, 1994; Rosenstein & Horowitz, 1996;
West, Keller, Links, & Patrick, 1993), as well as between avoidant attachment and ASPD (Gacono & Meloy, 1992; Gacono, Meloy, & Berg, 1992).
Given the body of research highlighting the signicance of attachment styles in the quality of adult romantic relationships, researchers
and clinicians have turned their attention to exploring the role of attachment patterns in the perpetration of IPV, with strong evidence suggesting that insecurely attached persons, dismissed, preoccupied, and
fearful, exhibit greater relational abuse than securely attached persons.
6.3. Attachment insecurity, personality disorders, and battering
Over the years a body of research has identied the association between insecure attachment and perpetration of IPV by employing two
main research strategies that are the direct assessment of batterers' attachment patterns, and the indirect evaluation of personality characteristics theoretically linked to insecure attachment styles such as intimacy
anger, interpersonal dependency, and jealousy. Moreover, attachment
insecurity has often been found to correlate with personality disorder
traits, specically borderline and antisocial (e.g., Brennan & Shaver,
1998; Dutton, 1995d, 1995e; Dutton & Starzomski, 1993; Dutton et al.,
1996; Edwards et al., 2003; Holtzworth-Munroe, Stuart, et al., 1997;
Kesner, Julian, & McKenry, 1997; Mauricio & Gormley, 2001; Murphy
et al., 1994; Scott, Levy, & Pincus, 2009).
In a series of studies, Dutton and his colleagues (Dutton, 1994a,
1994b, 1995d, 1995e, 2000; Dutton & Starzomski, 1993, 1994; Dutton
& White, 2012; Dutton et al., 1994; Dutton et al., 1996) employed the
concept of functional anger theorized by Bowlby (1988) in examining
proles of assaultive men in order to demonstrate the existence of an
abusive personality. Bowlby states that anger is the natural response
of the child when the expectation of safety and physical proximity to
the attachment gure is jeopardized. During a separation when the
child perceives that the attachment gure is unavailable, angry behavior
is a way to communicate that the attachment behavioral system has
been activated and that attachment needs are not being met. Bowlby
termed this mode of expressing displeasure to the attachment gure
functional anger because if the attachment gure responds appropriately to it, this expression of anger will facilitate the development of a
secure relationship. Thus, Bowlby viewed interpersonal anger as arising
from frustrated attachment needs and functioning as a form of protest
behavior directed at regaining contact with an attachment gure. However, when the caregiver shows pervasive insensitivity and the child
needs are constantly and repetitively neglected, a consistent history of
insecure attachment experiences may distort this functional anger
into aggression (see also Fonagy, 1999; Kesner et al., 1997).
According to this conceptualization, when men with an insecure attachment style perceive that their attachment needs are not met, they
may use physical violence toward their intimate partners as a dysfunctional coping mechanism in the attempt to deal with their partners' perceived unresponsiveness or rejection. In adulthood, psychological
availability of the attachment gure replaces the need for physical
closeness that is important in childhood, and therefore the batterer's
perception of the relational support provided to him by his intimate
partner may impact the perpetration of violence within the relationship.
Grounded on previous studies showing that anger, jealousy, and affective instability were all strongly and signicantly associated to the
frequency of abuse in intimate relationships (Dutton, 1994b; Dutton &
Starzomski, 1993), Dutton et al. (1994) tested the hypothesis that
attachment insecurity, chronic anger, and affective instability are
produced by chronically frustrating attachment needs and are risk factors for increased abusiveness in romantic relationships. The authors
administered self-report measures to a sample of 120 men referred for
treatment for wife assault and 40 nonviolent men matching on demographic variables, assessing adult attachment patterns the RSQ
(Bartholomew & Horowitz, 1991), BPO, anger, jealousy, trauma symptoms, and abuse in romantic relationships. This constellation of variables was found to represent a prole related signicantly to the
frequency of both physical and verbal abuse. Moreover, secure attachment correlated signicantly but negatively with the constellation
variables, while fearful attachment was positively and signicantly correlated with the measures, and the dismissing pattern was not associated to any variable considered. Specically, violent men scored on the
BPO scale similar to those with a diagnosis of BPD and were signicantly
more likely than nonviolent men to show a fearful attachment pattern.
They reported signicantly more anger of greater magnitude, frequency, and duration, higher levels of jealousy, and more trauma symptoms
in comparison to non-batterers. Notably, participants not enrolled in the
IPV intervention program the control group were signicantly more
likely to show a secure pattern of attachment.
In a subsequent study, Dutton et al. (1996) examined the same constellation of variables in a sample of 140 men referred for wife assault
and 45 demographically matched controls nding further validation of
an abusive personality grounded in the early experiences of batterers
within the family of origin. Findings showed that a composite of BPO,
anger, trauma symptoms, and fearful attachment was positively and
signicantly correlated with perpetration of violence in romantic relationships. Moreover, the abusive personality was predicted by paternal
rejection, physical abuse, and absence of maternal warmth in childhood,
suggesting that the experience of a neglecting and abusive family of origin environment plays a key role in the development of batterers'
personalities.
In a more recent work, Dutton (2000) included parental shaming
and exposure to IPV as a child in his model and found that insecure attachment combined with parental shaming and rejection acts as the
mediator of the relationship between abuse and/or exposure to IPV during childhood and the perpetration of violence in romantic relationships
in adulthood.
Parallel to the research conducted by Dutton and his colleagues
(see for instance Dutton, 2000, Dutton et al., 1996, and Dutton et
al., 1994), Murphy et al. (1994) compared 24 married or cohabitant
men in treatment for partner abuse with 24 maritally discordant
non-violent men, and 24 happily married nonviolent men using
two measures of dependency. Findings revealed that men who had
physically assaulted female partners reported greater interpersonal
dependency as well as spouse-specic dependency combined with
higher perceived personal inadequacy and higher emotional investment in the romantic relationships.
Attachment is also investigated by using the Anxious Romantic Attachment Test (ARAT; White, 1984). Barnett, Martinez, and Bluestein
(1995) applied the ARAT to investigate attachment patterns of batterers
as compared to unhappily and happily married men, nding that domestically violent men were signicantly more jealous and insecurely
attached than their nonviolent counterparts.
Holtzworth-Munroe, Stuart, et al. (1997) further investigate attachment in domestically violent men conducting two studies to compare
the attachment patterns, dependency, and jealousy of violent and maritally distressed husbands with that of nonviolent-distressed and
nonviolent-non-distressed husbands. The combined sample of 103
batterers consisted of two subgroups of 55 violent-distressed men
recruited from the community (n1 = 36, n2 = 19) and 48 violentdistressed men attending marital violence treatment (n1 = 22, n2 =
26), while the two comparison groups of nonviolent men were both
recruited from the community (nT = 109). The authors administered
a wide range of self-report attachment measures including the Adult Attachment Scale (AAS; Collins & Read, 1990) and the RSQ (Bartholomew
& Horowitz, 1991). The semi-structured Adult Attachment Interview
(AAI; George, Kaplan, & Main, 1985) was also used to assess the state
of mind of batterers regarding their childhood attachment. Findings of
both studies were generally consistent with hypotheses showing that
relative to nonviolent men, batterers demonstrated more insecure, preoccupied, and disorganized attachment as shown by anxiety about
abandonment, discomfort with closeness, and difculty in classifying attachment (AAI). In addition, violent men displayed more dependency
on and preoccupation with their wives, and more jealousy and less
trust in their marriages.
39
Babcock, Jacobson, Gottman, and Yerington (2000) recruited 23 men

with a history of domestic violent perpetration and 13 maritally distressed but nonviolent men from the community, and administer
them the AAI (George et al., 1985). A greater number of nonviolent
men were categorized as securely attached as opposed to the batterer
group (61.5% versus 26.1%), with the violent group showing a larger
proportion of dismissing and preoccupied attachment styles. Thus,
physically violent men were more likely to be classied as having an insecure attachment style compared to men who were non-violent but
reported marital distress. Findings showed also that men with a secure
attachment style displayed the least dominance and contempt toward
their wives, while preoccupied participants were the most belligerent
toward their partners and were also the most likely to exhibit violent reactions in response to their wives withdrawal.
In the study conducted by Mauricio and Gormley (2001), in order to
further explore attachment styles of batterers, 60 men arrested for domestic violence and court referred to a batterer intervention program
completed measures of frequency of physical violence, need for dominance in relationships, social desirability, and adult attachment patterns
(RSQ; Bartholomew & Horowitz, 1991). Interestingly, almost 60% of
court-mandated batterers reported an insecure attachment style that
however was signicantly associated with the social desirability scores,
notably compromising the results. A hierarchical regression analysis indicated that, after adjusting for the effect of social desirability, adult attachment styles signicantly moderated the relationship between need
for dominance and frequency of violence, with insecurely attached men
who also reported a need for dominance in their relationships showing
the highest levels of violence toward their partners.
Buttell and Jones (2001) investigated levels of interpersonal dependency of 105 men court-ordered into a treatment program for domestic
violence offenders and 25 nonviolent men. Surprisingly, results indicated no signicant differences in levels of interpersonal dependency
between the court-ordered batterers and the nonviolent men. Conversely, in a subsequent study employing the same measure of interpersonal dependency, Buttell et al. (2005) collected data from 158 batterers
beginning treatment and 25 nonviolent men, and analysis indicated
that batterers reported signicantly higher level of interpersonal dependency in comparison to the nonviolent group. Most likely this contradiction occurred due to the different samples employed in the studies;
court-ordered batterers vs. non court-ordered batterers.
Godbout, Dutton, Lussier, and Sabourin (2009) assessed, in a nonclinical sample of 644 couples, exposure to IPV in childhood, marital
adjustment, and IPV, using an attachment framework. A structural
equation model indicated that early experience of parental violence affects use of IPV directly and indirectly through attachment anxiety.
In conclusion, attachment theory has been theoretically, clinically,
and empirically linked to perpetration of IPV. While several studies revealed that batterers have insecure attachment styles (e.g. Barnett
et al., 1995, Dutton et al., 1994, Holtzworth-Munroe, Stuart, et al.,
1997, Murphy et al., 1994), others are more inconclusive in demonstrating a clear link between perpetration of violence in intimate relationships and attachment insecurity (e.g. Buttell & Jones, 2001, Tasso,
Brown, Griffo, & Maxwell, 2012). As a number of authors pointed out,
this inconsistency in ndings may be due to methodological issues related to the particular measures and the sampling techniques adopted
in different studies (see Dutton & White, 2012; Holtzworth-Munroe,
Stuart, et al., 1997). Yet, mixed ndings can also be explained considering the specic mediating variables that may account for the relationship between attachment insecurity and battering. For instance, if
antisocial and borderline personality traits in some cases mediate this
relationship, studies that use samples of batterers without such dysfunctional personalities will not detect the association between attachment insecurity and perpetration of violence in romantic relationships.
Therefore, even though the association between attachment insecurity
and battering is present, such studies will not be able to detect it.
Given the established correlation identied between insecure
40
attachment patterns and personality disorders traits (e.g. Brennan &

Shaver, 1998, Scott et al., 2009), the most recent research on battering
has focused on the possible mediating role that personality disorder
characteristics may play in explaining the association between attachment insecurity and perpetration of IPV.
7. Attachment insecurity and battering: the potential mediating role
of personality disorders
In spite of the recognition that childhood adverse experiences within
the family of origin may lead to the development of insecure attachment
patterns, and that in turn insecurely attached individuals are more likely
to perpetrate violence in romantic relationships, not all children who
are abused or exposed to IPV in childhood become abusers as adults
(McClellan & Killeen, 2000) and not all the men insecurely attached become batterers. This variability in outcomes may be explained calling
into question the specic mechanisms responsible for the association
identied in previous research between insecure attachment patterns
and perpetration of abuse in romantic relationships. The associations
between anxious attachment and BPD as well as between avoidant attachment and ASPD, combined with the known role that both insecure
attachment and personality disorder traits play in battering, raises questions about whether these adult attachment orientations and personality disorders operate independently in predicting IPV or whether the
presence or absence of personality disorders functionally mediate the
relationship between insecure adult attachment and battering.
Despite being potentially an extremely fruitful ramication of DV research for the development of more effective prevention and intervention programs, only in recent years have studies on battering started to
focus on the investigation of the mediating role that personality disorder traits may play in the detected relationship between insecure attachment, specically preoccupied and avoidant, and perpetration of
IPV. Buck et al. (2012) investigated which personality characteristics
play a signicant role in explaining the relationship between insecure
attachments and battering perpetration. First, the authors allocated 72
mainly court-mandated men in treatment for battering to a securely
and an insecurely attached group according to the scores those
participants had obtained at the Relationship Questionnaire (RQ;
Bartholomew & Horowitz, 1991) and compared them to 62 nonviolent
men. Further, administering a range of self-report measures, distrust,
desire for control, separation anxiety, lack of empathy, dependency jealousy self-esteem, impulsivity, and perpetration of partner abuse were
assessed. Comparisons of batterers to controls showed that only 40%
of batterers versus 75% of non-batterers reported a secure attachment
pattern, with the insecure attachment batterers (60%) scored signicantly higher on separation anxiety and dependency compared to
both controls and secure attachment batterers. All the batterers, despite
their attachment style, scored signicantly higher than controls on general distrust and distrust to partner. Moreover, compared with the securely attached batterers, those with an insecure attachment patterns
scored signicantly higher on separation anxiety, general distrust,
distrust in partner, and dependency. Finally, the results showed that
the relationship between insecure attachment and perpetration of IPV
can be explained taking into account separation anxiety and partner distrust, with partner distrust increasing the risk for battering over and
above insecure attachment. In this work, even though antisocial and
borderline personality traits were not directly assessed, three key personality features namely separation anxiety, and partner distrust and
dependency, theoretically associated to ASPD and BPD, characterized
insecurely attached batterers. Specically, compared with the securely
attached batterers, insecurely attached batterers showed higher levels
of separation anxiety, distrust in partner, and dependency on partner,
reporting also lower self-esteem and more impulsivity than the securely
attached batterers.
Similarly, Lawson and Malnar (2011) examined whether hostile
dominant interpersonal problems (HDIP) namely domineering,
vindictive, and intrusive mediate the relationship between anxious

and avoidant attachment styles and physical IPV severity and psychological aggression. The authors recruited 100 men on probation for IPV
who volunteered to participate in the study and using data collected
through self-reported measures including the Adult Attachment Scale
(AAS; Collins & Read, 1990), the Modied Conict Tactics Scale
(MCTS; Pan, Neidig, & O'Leary, 1994b), and the short-form of the Inventory of Interpersonal Problems (IIP-SC; Soldz, Budman, Demby, & Merry,
1995), they performed a set of mediational analyses. Results showed
that HDIP mediated the relationship between avoidant attachment
and violence severity, as well as the relationship between avoidant attachment and psychological aggression. However, HDIP did not mediate
the relationship between anxious attachment and violence severity or
psychological aggression.
Mauricio, Tein, and Lopez (2007) investigated the mediating role of
borderline and antisocial personality traits in the relationship between
attachment and IPV. One hundred and ninety two court-mandated
male batterers attending an intervention program completed measures
examining antisocial and borderline personality traits, the Personality
Diagnostic Questionnaire-Revised (PDQ-R; Hyler et al., 1988), anxious
and avoidant attachment patterns, the Experience in Close Relationships (ECR; Brennan, Clark, & Shaver, 1998), intimate partner physical
and psychological violence, and social desirability. Structural equation
modeling was employed to determine whether there were signicant
relationships between anxious and avoidant attachment patterns on
one side and physical and psychological IPV on the other side that are
mediated by either BPD or ASPD. Social desirability was included in
both models as a covariate. Results indicated that both borderline and
antisocial personality disorders fully mediated the relationship between
avoidant attachment and physical as well as psychological perpetration
of violence in romantic relationships. Contrarily, while BPD and ASPD
fully mediated the relationship between anxious attachment and perpetration of physical IPV, these personality traits only partially mediated
the relationship between anxious attachment and psychological
violence.
In a recent work, Lawson and Brossart (2013) examined whether
antisocial personality traits, borderline personality traits, and hostile
dominant interpersonal problems (HDIP) mediated the relationship between insecure attachments, anxious and avoidant, and perpetration of
IPV. A sample of 132 men on probation for IPV completed self-measures
of attachment patterns (AAS; Collins & Read, 1990), psychopathology of
personality (MCMI-III; Millon, 1994), interpersonal functioning, and
severity of partner abuse.
The authors conducted two path analysis with avoidant attachment
as the predictor in one model, and anxious attachment as the predictor
in the second model. In both models, HDIP, antisocial personality features, and borderline personality features were the mediators, and IPV
perpetration was the criterion. Even though, in both models, anxious
and avoidant attachment patterns had statistically signicant path
values to the mediators (HDIP, BPD, and ASPD), neither antisocial personality traits, nor borderline personality traits had statistically signicant path value to the criterion (IPV), in both models. Only HDIP had a
statistically signicant path value to the criterion (IPV) in both models,
and only the avoidant model produced a statistically signicant indirect
specic effect indicating that HDIP mediated the relationship between
attachment style and IPV perpetration. Findings suggested that
batterers with predominantly avoidant and, to a lesser degree anxious
attachment may be at increased risk for addressing conicts in a coercive, controlling, and vengeful manner that is manifested in physical
aggression toward intimate partners.
This failure of antisocial and borderline personality traits to be significant mediators in either path models contradicts the ndings of Mauricio
et al. (2007) suggesting a clear mediating role of these personality
features in explaining the relationship between insecure attachment dimensions and battering perpetration. The explanation suggested by
Lawson and Brossart (2013) is that HDIP was a stronger mediator than
antisocial or borderline personality characteristics when all three mediators were included in the path analyses. There are, however, two additional factors that should be taken into account when interpreting these
mixed ndings; the sample characteristics and the self-report instruments employed in assessing both psychopathology of personality and
attachment styles. Indeed, while Mauricio and colleagues recruited men
attending a batterer intervention program and used the PDQ-R (Hyler
et al., 1988) and the ECR to evaluate attachment patterns and personality
disorders traits, respectively, Lawson and Brossart recruited men on probation for IPV perpetration and, for the same purpose, employed the AAS
(Collins & Read, 1990) and the MCMI-III (Millon, 1994). These divergences imply distinct motivations of the batterers to participate in the
studies and dissimilar validity and reliability of the instruments
employed for their evaluation.
Given the potential prevention and treatment relevance of individuating the specic psychological factors that explain the relationship between insecure attachment patterns and perpetration of violence in
romantic relationships, this inconsistency of ndings across studies
should capture the attention of researchers and be the starting point
for future research.
8. Discussion
Research that examines attachment styles and personality disorders
in batterers can be an extremely valuable resource that both scholars
and clinicians can use to interpret and better understand the distinctive
ndings reviewed here on batterer typologies. The variability in the
number of batterer typologies identied across studies is probably due
to a set of peculiarities concerning the research methods specically
used in each study. Particularly, the different and unique purposefully
recruited samples of male batterers employed in each analysis, the
broad variety of standardized measures and techniques used to classify
them across different studies, and the specic personality characteristics assessed in each investigation, represent methodology features
that provide a unique standpoint on batterers and affect the reliability
of comparisons across studies. The samples used in the reviewed studies
on battering typologies were recruited from different settings, such as
clinical, forensic, and community, in most of the cases the severity and
chronicity of violence were not systematically assessed for example
using the Conict Tactic Scale (CTS2; Straus, Hamby, Boney-McCoy, &
Sugarman, 1996) as well as the unidirectionality or bidirectionality
of the violence because no information were provided regarding the
batterers' intimate partners. Across studies different instruments were
employed to assess personality traits such as self-reported standardized
measures, clinical evaluations, and intimate partner reports, and each
study examined a peculiar set of dysfunctional personality characteristics that even though can be considered personality traits, do not represent the specic DSM criteria (American Psychiatric Association, 2013)
employed to diagnose personality disorders in clinical settings.
Given these characteristics of the investigations on batterer typologies and considering the ndings of research on attachment styles and
personality disorders in batterers, it is likely that male batterers follow
in two broad categories characterized by borderline and antisocial personality traits, respectively, as well as by insecure attachment. These
men suffer from severe personality dysfunctions that reach the DSM-V
(American Psychiatric Association, 2013) cut-offs for a diagnosis of personality disorders often in comorbidity with other mental disorders of
Axis I, they tend to be violent in a number of settings that go beyond
their intimate relationships, and perpetrate severe and chronic physical
and psychological violence toward their intimate partners. It is expected
that the third group of male batterers identied in some of the studies
on battering typologies, characterized by a non-pathological or low
dysfunctional personality and insecure attachment, includes men who
perpetrate intimate partner violence in the context of the less severe situational couple violence (Johnson, 1995). These men are characterized
by a personality showing some clinical indicators that however do not
41
reach the cut-offs for a DSM diagnosis of personality disorders, they

are violent exclusively in the context of their romantic relationships,
and accordingly with Johnson's typology (1995), perpetrate infrequent
acts of less severe physical violence that most likely is bidirectional. Indubitably, there is a great variability in the degree of psychopathology
and severity of violence observed across these three typologies, and
batterers included in the rst two groups are not only a threat for
their intimate partners' health and for the society as a whole, but also
difcult patients to treat in psychotherapy therefore representing a
challenge for clinicians. The knowledge that we acquired in recent
years regarding attachment styles and dysfunctional personality characteristics of batterers hopefully will inform the development of more effective intervention treatments specically tailored to address each
batterer typology's unique personality characteristics. In fact, research
on battering typologies has consistently revealed the relevance of antisocial and borderline personality characteristics as well as of attachment insecurity in understanding batterers' personality.
Understanding mediational processes between attachment and personality dysfunction will uncover the dynamics by which attachment and
personality may operate to inuence intimate partner violence perpetration for particular subgroups of batterers. The detection of these specic factors responsible for the association between attachment
insecurity and perpetration of IPV will be a valuable asset in planning future, more effective prevention and intervention programs for batterers.
9. Implications for prevention and treatment

Knowledge of the specic mechanisms involved in the development
of an abusive personality, and awareness that batterers may exhibit
emotional and behavioral tendencies specic to different attachment
styles, including fearful and preoccupied, and to different personality
disorder traits, including borderline and antisocial, may determine the
development of future batterer prevention and intervention programs.
From a prevention perspective, considering the strong correlations
that previous research detected between insecure attachment patterns
and both antisocial as well as borderline personality traits on one side,
and perpetration of IPV on the other side (e.g., Holtzworth-Munroe &
Stuart, 1994), knowledge about the adverse childhood experiences
that may predispose to the development of both insecure attachments
and pathological personality traits, especially antisocial and borderline,
may inform prevention programs directed to both the general population and specic at-risk populations of families and couples. These prevention programs may be focused on the enhancement of parental
abilities preventing parents from being aggressive, insensitive and
rejecting toward their children. Adequate parental skills may promote
the development of warm and nurturing parentchild relationships
that may protect children from developing insecure attachment to
their caregivers and later in life antisocial and borderline personality
characteristics.
The major implications of identifying batterer typologies grouped in
accordance with psychopathology and attachment patterns, and of detecting the specic mediating role that different personality disorders
play in explaining the relationship between attachment insecurity and
perpetration of IPV are reected in clinical practice with batterers. Although the issue is still debated, the overall effectiveness of batterers'
treatment is not impressive (e.g. Babcock, Green, & Robie, 2004,
Rosenfeld, 1992), and standard batterers' treatment may be ineffective
for certain subtypes of maritally violent men. For instance, Dutton
et al. (1997) reported that batterers with severe borderline, antisocial,
and avoidant personality traits had the poorest outcomes among men
completing domestic violence treatment programs, whereas
Langhinrichsen-Rohling et al. (2000) found that, relative to other subtypes, GVA batterers were the least likely to complete treatment and,
were rated by their therapists as being signicantly more inclined to
commit recidivism at 6 months post-treatment.
42
Jones and Gondolf (2001), examining personality proles of more

than 800 batterers in a study of batterer interventions, reported that severe psychopathology at intake, presence of psychopathic tendencies,
severity of violence, history of arrest, violence outside the family context, substance use, and drunkenness during the follow-up period, all
factors theoretically related to differentiating batterer subtypes, were
signicantly related to the odds of being a re-assaulter at the followup. In another study, Eckhardt et al. (2003) examined almost 200 men
court-mandated to batterers' intervention programs and found that
the subtypes differed in rates of treatment completion, with the GVA
group being the most likely to drop out of treatment and the FO group
being the most likely to complete treatment. Therefore, across the available studies on batterers' treatment outcomes, the data suggests that
identication of diverse subtypes of batterers characterized by specic
psychopathology traits and attachment patterns is predictive of treatment outcomes in standard batterers' treatment programs, allowing to
discriminate between those subtypes who are likely to benet from
this specic kind of treatment program and those who are unlikely to
improve if enrolled in the standard program. A clinical implication
of these ndings is that treatment outcomes may be improved by
matching interventions to batterer subtypes and by tailoring specic
intervention programs in accordance with the particular personality
features, specically personality disorder traits and attachment styles
characteristic of each batterer subtype.
In investigating this issue, Saunders (1996) has demonstrated the
utility of taking personality disorder traits into account in predicting
treatment outcomes. In a post hoc analysis of data from a study comparing cognitivebehavioral-feminist treatment to a new processpsychodynamic treatment, Saunders found that batterers with antisocial personality features showed better outcomes in the structured
cognitivebehavioral intervention, while batterers with dependent
personality traits did better in the new treatment. It is plausible
that a long-term therapy approach is more effective for GVA and
BD batterers who engage in the highest levels of violence, show attachment problems and psychopathology of personality, and experience posttraumatic symptoms that are often seen in individuals who
have experienced childhood trauma. At the broadest level, the results of the studies summarized in the present literature review suggest that for GVA and BD batterers treatment is unlikely to be
successful unless it takes into account the Axis II and Axis I pathology
that aficts these men. Moreover, the FO batterers may be better
treated separately, and may be the group that most benet from
the standard treatment programs consisting in a short-term
psycho-educational, cognitivebehavioral, and feminist approach
focused on anger management and re-socialization (Gondolf, 1997;
Lawson et al., 2003). Indeed, such approaches may better serve
men with little or no psychopathology who need primarily anger
management skills acquisition and relationship enhancement
through group and couple treatment programs (O'Leary, 1999).
Furthermore, even if the focus of prevention and intervention programs for IPV is the treatment of batterers, victims should be included
as beneciaries of such programs as well. Indeed, as has been shown
in the literature, women who are involved and decide to remain in violent romantic relationships present specic personality characteristics
that could be the focus of prevention and intervention approaches,
with the main purpose of changing these pathological personality
features and consequently breaking the cycle of violence observed in
these couples (Dutton, 1994c; Walker, 1979). In a study of attachment
styles of female college students and IPV, O'Hearn and Davis (1997)
found that women with secure attachment style were less likely to
receive and inict emotional abuse than were women with insecure,
preoccupied attachment style. Thus, programs targeted to help victims
of battering to develop a more secure and stable romantic attachment
may have the twofold effect of enhancing well-being of these women
and supporting the process through which the cycle of violence may
be interrupted.
10. Strengths and limitations

At the broadest level, the few studies that have been conducted on
battering indicate that not enough attention has been given to a topic
that has the potential of improving the effectiveness of batterer treatment programs and, thereby, of reducing the prevalence of battering
by decreasing the number of men who recidivate. Even though studies
on battering typologies, as well as on attachment styles of batterers, represented a critical step in understanding the specic psychological factors involved in the perpetration of IPV, these studies suffer from
several limitations that are reected in the design of more recent studies
investigating the mediating role that personality disorders play in
explaining the link between insecure attachment and battering perpetration. Specically, the vast majority of the studies on this topic followed a cross-sectional design, which prevents researchers from testing for
causality relationships, as well as for individual and cohort changes over
time.
In addition, there are some methodological issues regarding the
sampling techniques and the measures used that should be considered
when interpreting results of these studies. Since usually only a minority
of batterers in treatment or enrolled in the criminal justice system are
willing to participate in research, samples were in all cases small and
not randomly chosen from clinical populations of batterers in treatment
for DV or enrolled in the criminal justice system because found guilty of
perpetrating DV. Therefore, the recruitment procedures may have introduced unknown self-selection biases, with a consequent restriction of
the generalizability of ndings to population of batterers with different
characteristics. The mixed ndings of these studies may be due to differences relating to the specic subsamples of batterers considered, that is
the particular personality characteristics of men who spontaneously decide to undertake a therapeutic process, those who are court-mandated
to an intervention program, and those who have been to jail charged of
IPV perpetration. Thus, direct comparisons of results are not completely
appropriate, considering also that in these studies different self-report
measures of personality and attachment were employed. In fact, as several authors pointed out in discussing their ndings (e.g., HoltzworthMunroe, Stuart, et al., 1997), results of studies assessing batterers' attachment styles as well as personality characteristics using different instruments, should be carefully compared to each other.
All of these studies employed a self-report measure to assess both
attachment styles and personality disorder features and in only one
of them the authors controlled for social desirability effects
(i.e., Mauricio et al., 2007). Mauricio et al. (2007) reported that the signicance of insecure attachment in these court-mandated batterers
emerged only when controlling for social desirability, calling into question the validity of self-report measures with persons who tend to portray themselves in a favorable light. Moreover, the use of a singular selfreport measure of attachment styles and personality traits of batterers
has been frequently called into question by previous investigators
since it does not allow one to validly and objectively assess batterer's attachment and personality traits (e.g. Eckhardt & Utschig, 2007, Gibbons,
Collins, & Reid, 2011, Helfritz et al., 2006, Mauricio & Gormley, 2001).
Therefore, a marked limitation of these studies is that they relied only
on mono-measures and mono-methods because measures were exclusively self-report, and data were collected from only one source with the
absence of additional subjective and objective measures of adult attachment and personality disorder characteristics.
11. Agenda for future research
The main purpose of the present work is to provide a complete and
accurate literature review on battering typologies presenting also the
most recent existing literature on the possible role that insecure attachment styles and dysfunction personality traits may play in the context of
battering. Furthermore, it is the authors' hope to capture the attention of
family violence scholars and clinicians who work with batterers in order
to promote the development of further research on this topic and the

development of effective treatment programs for batterers. The present
literature review clearly identies the need for more research on the
mediating role that personality disorder characteristics may play in
explaining the link between attachment insecurity and perpetration of
IPV. Given the high prevalence of IPV in the general population, and considering the high costs that battering produces both on the psychological adjustment of the people involved and at a broader community level,
it is crucial to conduct a greater number of studies in this area. Indeed, in
spite of the important efforts made by scholars in order to understand
the specic psychological variables involved in battering perpetration,
the lack of studies investigating the role that personality disorder traits
may play in explaining the link between insecure attachment patterns
and perpetration of IPV leave an important gap that future research is
called to ll.
Above all, future research should dedicate more attention to the test
of this mediational model. Although challenging because of the specic
phenomenon under study, future research should recruit larger community and clinical samples that will ensure greater representation of
the distinct personality disorder traits BPD and ASPD and insecure
attachment styles fearful, preoccupied, and dismissed under examination, and allow for hypotheses regarding mediational relationships
specic to each of the personality disorders and insecure attachment
patterns.
Adopting a multi-method and multi-source approach, researchers
should employ more than just one instrument to assess both personality
disorder features and attachment styles, combining one self-report
measure with one more objective measure and controlling for social desirability effects. Future studies could include partner reports, data gathered from behavioral observation of actual couple interactions, and in
the case of batterers in treatment personality evaluations made from clinicians. Although battering represents a dynamic particularly delicate
for the people involved and extremely challenging for investigators
and clinicians, batterers' personality assessment should be conducted
not relying simply upon self-report instruments but also through observation of couple interactions and personality assessment conducted by
trained clinicians. However, the suggested assessment techniques are
not feasible when researchers recruit batterers who are currently single
or who are currently at the onset of a new intimate relationship in the
context of which they have not been violent. As Shedler and Westen
(2007) observed, self-report personality assessment of patients affected
by moderate to severe personality disorders are not accurate and reliable, as compared to clinical reports of their therapists. Furthermore,
previous studies comparing antisocial and borderline subscale scores
on the PDQ and MCMI-II (Millon, 1987) yielded at best only moderate
intercorrelations (Wierzbicki & Gorman, 1995) highlighting the need
for studies using more diverse samples of batterers, as well as multiple
measures of personality disorders. Finally, the design of longitudinal research will allow scholars to draw conclusions regarding the supposed
temporal precedence of attachment and to test for causality relationships between attachment styles, personality disorder traits, and perpetration of IPV.
From a prevention and intervention perspective, future research
should test mediational models across treatments exploring more accurately the effectiveness of batterers' intervention programs that specically address batterer personality disorders and attachment patterns.
These studies should examine if separate and distinct intervention
approaches for batterers with and without personality disorders and insecure attachment will result in improved outcomes for each of these
groups. Treatment approaches that focus on the development of a
secure attachment style through reprocessing and elaboration of childhood interactions experienced in the relationship with the main caregivers may be more successful when employed in the treatment of
batterers who present only insecure attachment styles. Conversely,
when treating batterers with personality disorders, approaches whose
main focus is on modifying the dysfunctional personality traits building
43
a healthy and well-adjusted adult personality may prove to be more

effective.
It is hoped that this review will capture the attention of family
scholars, encourage researchers to address more accurately the study
of battering, and foster prevention and intervention scientists to project
plans designed to be more effective in treating this population. Understanding mediational processes between attachment and personality
dysfunction will uncover the dynamics by which attachment and
personality may operate to inuence IPV perpetration for particular
subgroups of batterers.
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Aggression and Violent Behavior

Battering typologies, attachment insecurity, and personality disorders: A

E-mail address: cameranm@myumanitoba.ca.

M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946

M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946

M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946

non-alcoholic batterers, and 43 non-abusive men in either a discordant

personality disorders, and portrays individuals who appear anxious or

M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946

personality features are important for understanding IPV, not all

M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946

that over time the subtypes formed at Time 1 remained unchanged,

Family only (FO)

Borderline dysphoric (BD)

White and Gondolf

Lawson et al. (2003)

Fowler and Westen

M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946

M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946

characterized by emotional instability, impulsivity, irritability, anxiety,

M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946

of improving intervention programs for batterers, some researchers

Ainsworth et al. (1978)

Bartholomew & Horowitz (1991)

Secure positive self-model + Positive other model

M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946

individuals are not prone to insecurity in close relationships. However

M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946

Babcock, Jacobson, Gottman, and Yerington (2000) recruited 23 men

M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946

attachment patterns and personality disorders traits (e.g. Brennan &

vindictive, and intrusive mediate the relationship between anxious

M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946

reach the cut-offs for a DSM diagnosis of personality disorders, they

9. Implications for prevention and treatment

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Jones and Gondolf (2001), examining personality proles of more

10. Strengths and limitations

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to promote the development of further research on this topic and the

a healthy and well-adjusted adult personality may prove to be more

M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946

parental caregiving. Journal of Personality, 66(5), 835878. http://dx.doi.org/10.1111/

Therapy and Comparative Criminology, 36(2), 129137. http://dx.doi.org/10.1177/

M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946

M. Cameranesi / Aggression and Violent Behavior 28 (2016) 2946

Straus, M. A. (2011). Gender symmetry and mutuality in perpetration of clinical-level

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