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Obstetrics268 papers

Coercive sexual sadism

Last edited: 4/14/2026

Overview

Coercive sexual sadism involves patterns of behavior characterized by the use of force, threat, or intimidation to exert dominance and control over a partner, often leading to severe psychological and physical harm. It is a subset of intimate partner violence (IPV) with specific manifestations of sexual abuse and control 1222.

Diagnosis

  • Clinical Presentation: Physical injuries, psychological distress, and behavioral indicators of control and coercion 111.
  • Screening Tools: Routine screening in healthcare settings, including emergency departments and obstetrician-gynecologist clinics, using validated instruments 513.
  • Assessment: Comprehensive evaluation including history of abuse, current safety concerns, and mental health status 424.

    • Management

  • Immediate Safety: Ensuring physical safety and providing emergency medical care for injuries 15.
  • Psychological Support: Referral to mental health professionals for trauma-informed therapy and counseling 424.
  • Legal and Social Services: Connecting patients with legal aid, shelters, and social support services 119.
  • Education and Empowerment: Providing education on rights, resources, and safety planning 119.

    • Special Populations

  • Pregnancy: Special attention to reproductive coercion and its impact on maternal and fetal health; routine screening recommended 1121.
  • Pediatrics: Screening and intervention in pediatric settings for children exposed to IPV, recognizing developmental impacts 1529.
  • Elderly: Recognition of IPV in older adults, often underreported; tailored screening approaches needed 27.

    • Key Recommendations

  • Routine Screening: Implement routine screening for IPV in all healthcare settings, particularly in emergency departments and obstetrician-gynecologist clinics 513 (Evidence: Strong).
  • Trauma-Informed Care: Adopt trauma-informed care practices to enhance patient trust and improve outcomes 424 (Evidence: Strong).
  • Interdisciplinary Collaboration: Foster collaboration between healthcare providers, social services, and legal authorities to provide comprehensive support 119 (Evidence: Moderate).
  • Education for Providers: Enhance training and education for healthcare professionals on recognizing and managing IPV 1720 (Evidence: Moderate).
  • Addressing Reproductive Coercion: Screen for reproductive coercion in obstetrics and gynecology settings 21 (Evidence: Moderate).

    • References

    1 Matsas B, Edwards A, Birch EM, Ramsey S, Benesch H, Goller S et al.. Trauma-Informed Care for Intimate Partner Violence and Sexual Assault: Simulated Participant Cases for Emergency Medicine Learners. MedEdPORTAL : the journal of teaching and learning resources 2025. link 2 Bourey C, Murray SM, Tol WA, Bass JK, Ba A, Mahenge B et al.. Integrating mental health care to reduce intimate partner violence in complex humanitarian emergencies. The Lancet. Global health 2025. link00191-3) 3 White SJ, Sin J, Sweeney A, Salisbury T, Wahlich C, Montesinos Guevara CM et al.. Global Prevalence and Mental Health Outcomes of Intimate Partner Violence Among Women: A Systematic Review and Meta-Analysis. Trauma, violence & abuse 2024. link 4 Chu YC, Wang HH, Chou FH, Hsu YF, Liao KL. Outcomes of trauma-informed care on the psychological health of women experiencing intimate partner violence: A systematic review and meta-analysis. Journal of psychiatric and mental health nursing 2024. link 5 Ziola EA, Gimenez MA, Stevenson AP, Newberry JA. The Role of Emergency Medicine in Intimate Partner Violence: A Scoping Review of Screening, Survivor Resources, and Barriers. Trauma, violence & abuse 2024. link 6 Thackeray J, Livingston N, Ragavan MI, Schaechter J, Sigel E. Intimate Partner Violence: Role of the Pediatrician. Pediatrics 2023. link 7 Hooker L, Nicholson J, Hegarty K, Ridgway L, Taft A. Maternal and Child Health nurse's preparedness to respond to women and children experiencing intimate partner violence: A cross sectional study. Nurse education today 2021. link 8 Taillieu TL, Brownridge DA, Brownell M. Screening for intimate partner violence in the early postpartum period: Maternal and child health and social outcomes from birth to 5-years post-delivery. Child abuse & neglect 2021. link 9 Anderzén Carlsson A, Bäccman C, Almqvist K. The professional relationship forms the base: Swedish child health care nurses' experiences of encountering mothers exposed to intimate partner violence. International journal of qualitative studies on health and well-being 2021. link 10 Manuel B, Roelens K, Tiago A, Keygnaert I, Valcke M. Medical Curricula on Intimate Partner Violence in Mozambique. Acta medica portuguesa 2020. link 11 Jones KM, Carter MM, Bianchi AL, Zeglin RJ, Schulkin J. Obstetrician-gynecologist and patient factors associated with intimate partner violence screening in a clinical setting. Women & health 2020. link 12 Lutgendorf MA. Intimate Partner Violence and Women's Health. Obstetrics and gynecology 2019. link 13 Long AJ, Golfar A, Olson DM. Screening in the Prenatal Period for Intimate Partner Violence and History of Abuse: A Survey of Edmonton Obstetrician/Gynaecologists. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2019. link 14 Frade S, De Wet-Billings N. The relationship between women's experience of intimate partner violence and other socio-demographic factors, and under-5 children's health in South Africa. PloS one 2019. link 15 Randell KA, Harris D, Stallbaumer-Rouyer J. Immediate and Late Response to Intimate Partner Violence Intervention in the Pediatric Emergency Department: A Case Report. Pediatric emergency care 2018. link 16 Chabot HF, Gray ML, Makande TB, Hoyt RL. Beyond Sex: Likelihood and Predictors of Effective and Ineffective Intervention in Intimate Partner Violence in Bystanders Perceiving an Emergency. Journal of interpersonal violence 2018. link 17 Sawyer S, Coles J, Williams A, Lucas P, Williams B. Paramedic Students' Knowledge, Attitudes, and Preparedness to Manage Intimate Partner Violence Patients. Prehospital emergency care 2017. link 18 Cohen AR, Renner LM, Shriver EM. Intimate partner violence in ophthalmology: a global call to action. Current opinion in ophthalmology 2017. link 19 LaPlante LM, Gopalan P, Glance J. Addressing Intimate Partner Violence: Reducing Barriers and Improving Residents' Attitudes, Knowledge, and Practices. Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry 2016. link 20 Grimley-Baker K. Ethical implications of mandatory reporting of intimate partner violence. Creative nursing 2014. link 21 Clark LE, Allen RH, Goyal V, Raker C, Gottlieb AS. Reproductive coercion and co-occurring intimate partner violence in obstetrics and gynecology patients. American journal of obstetrics and gynecology 2014. link 22 Siegel JP. An expanded approach to batterer intervention programs incorporating neuroscience research. Trauma, violence & abuse 2013. link 23 . ACOG Committee Opinion No. 518: Intimate partner violence. Obstetrics and gynecology 2012. link 24 Spangaro JM, Zwi AB, Poulos RG, Man WY. Who tells and what happens: disclosure and health service responses to screening for intimate partner violence. Health & social care in the community 2010. link 25 Roelens K. Intimate partner violence. The gynaecologist's perspective. Verhandelingen - Koninklijke Academie voor Geneeskunde van Belgie 2010. link 26 Calkins L. Detained and drugged: a brief overview of the use of pharmaceuticals for the interrogation of suspects, prisoners, patients, and POWs in the US. Bioethics 2010. link 27 Aksan HA, Aksu F. The training needs of Turkish emergency department personnel regarding intimate partner violence. BMC public health 2007. link 28 Roelens K, Verstraelen H, Van Egmond K, Temmerman M. A knowledge, attitudes, and practice survey among obstetrician-gynaecologists on intimate partner violence in Flanders, Belgium. BMC public health 2006. link 29 Jaffee KD, Epling JW, Grant W, Ghandour RM, Callendar E. Physician-identified barriers to intimate partner violence screening. Journal of women's health (2002) 2005. link 30 McCloskey LA, Lichter E, Ganz ML, Williams CM, Gerber MR, Sege R et al.. Intimate partner violence and patient screening across medical specialties. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2005. link 31 Ernst AA, Weiss SJ. Intimate partner violence from the emergency medicine perspective. Women & health 2002. link 32 Rodriguez MA, Bauer HM, McLoughlin E, Grumbach K. Screening and intervention for intimate partner abuse: practices and attitudes of primary care physicians. JAMA 1999. link

    Original source

    1. [1]
      Trauma-Informed Care for Intimate Partner Violence and Sexual Assault: Simulated Participant Cases for Emergency Medicine Learners. — Matsas B, Edwards A, Birch EM, Ramsey S, Benesch H, Goller S et al. MedEdPORTAL : the journal of teaching and learning resources (2025)
    2. [2]
      Integrating mental health care to reduce intimate partner violence in complex humanitarian emergencies. — Bourey C, Murray SM, Tol WA, Bass JK, Ba A, Mahenge B et al. The Lancet. Global health (2025)
    3. [3]
      Global Prevalence and Mental Health Outcomes of Intimate Partner Violence Among Women: A Systematic Review and Meta-Analysis. — White SJ, Sin J, Sweeney A, Salisbury T, Wahlich C, Montesinos Guevara CM et al. Trauma, violence & abuse (2024)
    4. [4]
      Outcomes of trauma-informed care on the psychological health of women experiencing intimate partner violence: A systematic review and meta-analysis. — Chu YC, Wang HH, Chou FH, Hsu YF, Liao KL Journal of psychiatric and mental health nursing (2024)
    5. [5]
      The Role of Emergency Medicine in Intimate Partner Violence: A Scoping Review of Screening, Survivor Resources, and Barriers. — Ziola EA, Gimenez MA, Stevenson AP, Newberry JA Trauma, violence & abuse (2024)
    6. [6]
      Intimate Partner Violence: Role of the Pediatrician. — Thackeray J, Livingston N, Ragavan MI, Schaechter J, Sigel E Pediatrics (2023)
    7. [7]
      Maternal and Child Health nurse's preparedness to respond to women and children experiencing intimate partner violence: A cross sectional study. — Hooker L, Nicholson J, Hegarty K, Ridgway L, Taft A Nurse education today (2021)
    8. [8]
      Screening for intimate partner violence in the early postpartum period: Maternal and child health and social outcomes from birth to 5-years post-delivery. — Taillieu TL, Brownridge DA, Brownell M Child abuse & neglect (2021)
    9. [9]
      The professional relationship forms the base: Swedish child health care nurses' experiences of encountering mothers exposed to intimate partner violence. — Anderzén Carlsson A, Bäccman C, Almqvist K International journal of qualitative studies on health and well-being (2021)
    10. [10]
      Medical Curricula on Intimate Partner Violence in Mozambique. — Manuel B, Roelens K, Tiago A, Keygnaert I, Valcke M Acta medica portuguesa (2020)
    11. [11]
      Obstetrician-gynecologist and patient factors associated with intimate partner violence screening in a clinical setting. — Jones KM, Carter MM, Bianchi AL, Zeglin RJ, Schulkin J Women & health (2020)
    12. [12]
      Intimate Partner Violence and Women's Health. — Lutgendorf MA Obstetrics and gynecology (2019)
    13. [13]
      Screening in the Prenatal Period for Intimate Partner Violence and History of Abuse: A Survey of Edmonton Obstetrician/Gynaecologists. — Long AJ, Golfar A, Olson DM Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (2019)
    14. [14]
      The relationship between women's experience of intimate partner violence and other socio-demographic factors, and under-5 children's health in South Africa. — Frade S, De Wet-Billings N PloS one (2019)
    15. [15]
      Immediate and Late Response to Intimate Partner Violence Intervention in the Pediatric Emergency Department: A Case Report. — Randell KA, Harris D, Stallbaumer-Rouyer J Pediatric emergency care (2018)
    16. [16]
      Beyond Sex: Likelihood and Predictors of Effective and Ineffective Intervention in Intimate Partner Violence in Bystanders Perceiving an Emergency. — Chabot HF, Gray ML, Makande TB, Hoyt RL Journal of interpersonal violence (2018)
    17. [17]
      Paramedic Students' Knowledge, Attitudes, and Preparedness to Manage Intimate Partner Violence Patients. — Sawyer S, Coles J, Williams A, Lucas P, Williams B Prehospital emergency care (2017)
    18. [18]
      Intimate partner violence in ophthalmology: a global call to action. — Cohen AR, Renner LM, Shriver EM Current opinion in ophthalmology (2017)
    19. [19]
      Addressing Intimate Partner Violence: Reducing Barriers and Improving Residents' Attitudes, Knowledge, and Practices. — LaPlante LM, Gopalan P, Glance J Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry (2016)
    20. [20]
      Ethical implications of mandatory reporting of intimate partner violence. — Grimley-Baker K Creative nursing (2014)
    21. [21]
      Reproductive coercion and co-occurring intimate partner violence in obstetrics and gynecology patients. — Clark LE, Allen RH, Goyal V, Raker C, Gottlieb AS American journal of obstetrics and gynecology (2014)
    22. [22]
      An expanded approach to batterer intervention programs incorporating neuroscience research. — Siegel JP Trauma, violence & abuse (2013)
    23. [23]
      ACOG Committee Opinion No. 518: Intimate partner violence. Obstetrics and gynecology (2012)
    24. [24]
      Who tells and what happens: disclosure and health service responses to screening for intimate partner violence. — Spangaro JM, Zwi AB, Poulos RG, Man WY Health & social care in the community (2010)
    25. [25]
      Intimate partner violence. The gynaecologist's perspective. — Roelens K Verhandelingen - Koninklijke Academie voor Geneeskunde van Belgie (2010)
    26. [26]
      Detained and drugged: a brief overview of the use of pharmaceuticals for the interrogation of suspects, prisoners, patients, and POWs in the US. — Calkins L Bioethics (2010)
    27. [27]
      The training needs of Turkish emergency department personnel regarding intimate partner violence. — Aksan HA, Aksu F BMC public health (2007)
    28. [28]
      A knowledge, attitudes, and practice survey among obstetrician-gynaecologists on intimate partner violence in Flanders, Belgium. — Roelens K, Verstraelen H, Van Egmond K, Temmerman M BMC public health (2006)
    29. [29]
      Physician-identified barriers to intimate partner violence screening. — Jaffee KD, Epling JW, Grant W, Ghandour RM, Callendar E Journal of women's health (2002) (2005)
    30. [30]
      Intimate partner violence and patient screening across medical specialties. — McCloskey LA, Lichter E, Ganz ML, Williams CM, Gerber MR, Sege R et al. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine (2005)
    31. [31]
      Intimate partner violence from the emergency medicine perspective. — Ernst AA, Weiss SJ Women & health (2002)
    32. [32]
      Screening and intervention for intimate partner abuse: practices and attitudes of primary care physicians. — Rodriguez MA, Bauer HM, McLoughlin E, Grumbach K JAMA (1999)
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