Violence in the family often follows other forms of more subtle and long-term abuse: verbal, emotional, psychological sexual, or financial.

It is closely correlated with alcoholism, drug consumption, intimate-partner homicide, teen pregnancy, infant and child mortality, spontaneous abortion, reckless behaviours, suicide, and the onset of mental health disorders.

Most abusers and batterers are males – but a significant minority are women. This being a 'Women's Issue', the problem was swept under the carpet for generations and only recently has it come to public awareness. Yet, even today, society – for instance, through the court and the mental health systems – largely ignores domestic violence and abuse in the family. This induces feelings of shame and guilt in the victims and 'legitimizes' the role of the abuser.

Violence in the family is mostly spousal – one spouse beating, raping, or otherwise physically harming and torturing the other. But children are also and often victims – either directly, or indirectly. Other vulnerable familial groups include the elderly and the disabled.

Abuse and violence cross geographical and cultural boundaries and social and economic strata. It is common among the rich and the poor, the well-educated and the less so, the young and the middle-aged, city dwellers and rural folk. It is a universal phenomenon.

The marked reduction in domestic violence in the last decade and the fact that different societies and cultures have widely disparate rates of intimate partner abuse – give the lie to the assumption that abusive conduct is the inevitable outcome of mental illness. Though the offenders' mental problems do play their part – it would seem that cultural, social, and even historical factors are the determinants of spousal abuse and domestic violence.

Contrary to common opinion, there has been a marked decline in domestic violence in the last decade. Moreover, rates of domestic violence and intimate partner abuse in various societies and cultures – vary widely. It is, therefore, safe to conclude that abusive conduct is not inevitable and is only loosely connected to the prevalence of mental illness (which is stable across ethnic, social, cultural, national, and economic barriers).

There is no denying that the mental problems of some offenders do play a part – but it is smaller than we intuit. Cultural, social, and even historical factors are the decisive determinants of spousal abuse and domestic violence.