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Whether we’re taking an online class, catching up with friends, reading the news, checking our favorite Reddit thread, or watching videos of baby pandas sneezing, we all spend a lot of time online. Our online communities are full of opportunities for connection, sharing, and positivity, but sometimes we may encounter negativity and downright nastiness, to put it mildly.

We can all play a role in shaping online communities in which everyone can thrive. Disrespect and harassment are less likely when digital spaces reflect our values. For example, building supportive communities makes sexual harassment and violence less likely. Creating respectful spaces online is a critical part of these efforts. So how do we make the online communities we participate in feel more positive, especially in an era where we might feel particularly divided? And how do we respond when we see negative posts in a group page we’re in charge of? Or when we notice a hurtful comment in a community we participate in?

Whether you have a leadership role in an online space or you’re just a casual participant, there’s plenty you can do to help keep things positive.

If you create, manage, or moderate an online space, you have a key role to play in building a supportive community. But being a member matters just as much. You get to model and shape the online community you participate in. Here’s a four-step guide to making it work—no matter your role.

Whether you’re starting a new group or taking over an existing one, start by reflecting on your goals.

Consider the following questions:

• If this group is new, why are you starting it? If you’re taking over an existing page, what are the group’s shared goals?
• How do you want members to experience the group?
• What would be the best possible version of this group?

It’s essential to define your goals even if your group is small and informal. For example: Imagine that you create a GroupMe for the people living on your res hall floor. The following goals could take the group in three very different directions and would call for different leadership:

• Planning large parties for everyone in the hall
• Upholding community standards (e.g., reminding people to be quiet during finals)
• Meeting new people

Goals matter for members too. In fact, knowing what they are and communicating them effectively sets the tone for the rest of the group. This doesn’t have to be formal. It’s about having a shared purpose.

Think about this: If you share a group chat with your friends from high school, what’s your purpose for doing so? How can you make sure others are on board? Your personal goal might be to stay in touch while building stronger connections with everyone. What are some small steps you can take to reach this goal?

• Model what you’re looking for by offering it first: Share updates about your life and ask others to do the same.
• Open participation: Invite other people to participate and pull quiet, shy, or disengaged people into the conversation.
• Make concrete plans: Suggest group activities or meet-ups.

By actively engaging in the group in a positive way, you’re setting an example for other members. A significant body of research shows that when we believe our peers expect us to behave a certain way, we’re more likely to behave that way (this is called social norms theory). This means that when we’re positive and don’t tolerate harmful behavior in an online setting, it sets the tone for others to follow suit.

Explicitly communicate your expectations. People are surprisingly attentive to group guidelines. A 2016 analysis of the Reddit thread r/science (which has more than 13 million subscribers) found that posting page rules increased users’ compliance with the rules and even increased the number of comments made by newcomers on certain posts.

“It’s important that the standard be set right from the beginning that mistreatment of any kind will not be tolerated,” says Dr. Justin Patchin, professor of criminal science at the University of Wisconsin-Eau Claire and codirector of the Cyberbullying Research Center.

Let’s say you take over the Facebook page of a campus multicultural center with several hundred members. How might you create guidelines for the group?

It’s also important to create guidelines for informal groups. If you created a small Facebook group for your friends in the multicultural center, you could casually communicate your expectations. Try statements like:

• “Let’s use this group to stay in touch over the summer!”
• “If anyone has questions about this group, I’m happy to help out.”

Point out behaviors that positively reinforce your group standards and support the community guidelines—you can keep it casual. This sets the expectation that people will interact in positive ways. Try out statements such as, “It’s awesome how we can disagree without things getting ugly.”

It’s easiest to take action at the first sign of disrespect or someone behaving outside of the group guidelines. Don’t wait for problems to escalate before you step in.

Just like in social situations or in the classroom, you can practice bystander intervention by stepping in to address disrespect and prevent harm. In a 2015 study of adolescents and young adults, bystanders stepped in at similar rates when someone was being harassed online as they did when an incident happened in person (Journal of Youth and Adolescence). In fact, bystanders were most likely to step in when someone was being harassed both in person and online.

Imagine that you’re the moderator of an online study group. You all use the group to share study tips, ask questions, and set up times to work together. One day, the posts start to stray from the class material to people complaining about the course and insulting the professor’s looks. How do you handle it?

Try privately messaging the people involved, or leave a comment of your own. Assuming good intent can make these conversations easier. For example:

Private messages

• “You probably don’t mean any harm, but your comments came off negatively.”
• “Please refer to the community guidelines.”

Comments to redirect the group

• “We have that big test coming up, so let’s focus and be prepared.”
• “Let’s stick to the focus of this group.”

It’s not just the leader’s responsibility to uphold community standards; it’s on you as a community member to redirect group members who fall short of your goals. It can be as easy as asking a different question.

Here’s how you might step in as a community member in the study group scenario:

• Distract the group with a question that relates to the original goal (e.g., post a question about the homework).
• Redirect the group: “We have to get through this critical analysis, so let’s focus and be prepared.”
• Find an ally: Talk to a friend in the group about the behavior and come up with a plan for approaching it as a team.
• Go undercover: Anonymously post a comment saying the behavior is unacceptable.
• Ask for help: Ask a moderator to reiterate the group values—or establish them if there aren’t any.

What can you do if serious disrespect, harassment, or hateful behavior emerges in an online space that you manage?

For example, imagine you’re managing a student publication’s website. Debate in the comments section is usually respectful. One day, a regular commenter calls another a slur. Here are four options for how to intervene:

1) Delete the harmful content, and consider banning the commenter.

“Delete the person whose posts are negative. By proactively doing this, [you show] that [you] have had enough and will not engage in their negative and hurtful behaviors.”
—Ross Ellis, founder and CEO of STOMP Out Bullying, a national bullying and harassment prevention organization

“If [people] see hurtful posts quickly removed and frequent violators banned, this will set the tone that online abuse is not allowed here.”
—Dr. Patchin

2) Reach out to the people who were targeted.

Write to the targeted commenter. Let them know that you have deleted the content, you support them, and offer to direct them to university resources.

3) Report the incident—if the targeted person wishes that you do so.

Consider reporting the behavior to a campus official, such as a dean. Check with the person who was targeted to ask for their permission first.

4) Reiterate your group expectations.

After you have dealt with the harm, work with other members of the publication team to refocus on your core goals.

What if you see this happening in an online community you’re a part of? As an active member of the community, stepping in reinforces the standards of the whole group and sends the message that this behavior isn’t tolerated here. Here’s how to do it:

• If the behavior affects someone you know, privately reach out and express support. Try language such as, “That was messed up. Is there anything I can do?”
• Consider contributing some positive words. Offering encouragement and support is a simple way to mitigate the effect of online harassment. Manners (good and bad) are contagious. Modeling civility and constructive commentary online can potentially dissuade others from trolling, according to a 2017 study by researchers at Cornell University.
• Ask before you act on someone else’s behalf. If you want to confront the aggressor or request an apology on behalf of the person who has been wronged, this isn’t a decision to make alone. Work with the targeted person and respect their wishes about how to proceed. They might prefer to not confront the aggressor or to report the issue to the relevant site directly. Except for situations of acute danger, don’t take action on their behalf if you haven’t been asked to do so.

“At the beginning of the year, we have a discussion about what’s appropriate to post and what isn’t. If something negative is posted, it’s removed, and we have a discussion with the person who posted.”
—Jeanette A., fourth-year undergraduate, Kutztown University, Pennsylvania

“It’s not a controversial forum. We have rules, but we’re relaxed and work together in a group rather than talk about conflicting ideas.”
—Eliot A., recent graduate, Metropolitan State University of Denver

“I monitor the page though my manager app that I’ve installed on my phone. I posted guidelines and must approve all comments and posts before they’re allowed to be posted. If someone complains about harassment or being messaged, I’ll check out the situation, take proper steps to stop it, and prevent it in the future.”
—Angel P., fourth-year undergraduate, Governors State University, Illinois

“Anything that’s posted that’s disrespectful is deleted and that person is warned through a personal message. If they continue, they’re removed from the page.”
—Leah H., third-year undergraduate, Northern Illinois University

Strategies developed by the Communication and Consent Educator program at Yale University.

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Most of us have witnessed online harassment. For that matter, most of us report that we’ve experienced it, according to surveys. Young adults are the most likely to be abused online. That experience can make it harder for students to attend class or concentrate on learning, according to a survey by Hollaback!, a coalition to prevent harassment. Online harassment can raise the risk of suicide in adults who are already experiencing emotional or situational stress, according to a 2011 study in Educational Leadership.

How can you respond if you or a friend is harassed online? How can you make sure your own online presence is positive? The prevalence of trolling, roasting, stalking, and other forms of harassment gives us all opportunities to intervene. Online behavior is contagious, studies show. We are all well positioned to model respectful behavior on social networks, influence a comment thread that’s veering toward abuse, and help build more positive online spaces in which everyone can participate freely. Leaders in the tech industry have our backs on this as they work to make online spaces more accommodating for all. For six steps to keeping the cyber-peace, see below. For resources and tools, see Get help or find out more. For guidance on how to argue constructively online and off, see Tame the tension: Science-backed ways to talk it out in this issue.

1. Set a respectful and considerate tone and standard

The majority of our online presence is communal. Every contribution we make adds to the overall tone of the online space. Kindness is contagious. By engaging respectfully with others, you reinforce the expectation that others do the same.

2. Practice engaging constructively on difficult or contentious topics

Disagreeing with a friend’s opinion or disputing someone’s argument is all well and good—depending on how we go about it. For a guide to constructive arguing and how to influence someone’s opinion, see Tame the tension: Science-backed ways to talk it out in this issue of SH101.

3. Apologize when it’s merited, even if your slight was unintentional

If you hear that you have hurt someone, apologize. Communicating digitally can sometimes obscure the very real three-dimensional people who are reading and hearing our words. It’s important to remember that, even in the midst of heated or highly charged conversations. If the platform allows you to delete, retract, or qualify a contentious comment, do so.

4. Ask for clarification if you need it

If you don’t know why what you said was hurtful, you can ask for clarification. To the best of your ability, do so with respect and compassion. You could say something like, “I’m sorry that I upset you with my comment. Could you tell me why that word is hurtful? I want to be sure I don’t make the same mistake again.”

5. Stay chill when you feel misunderstood

Resist calling people out personally with inflammatory and divisive terms. If you think a comment has racist or sexist implications, try assuming those were unintentional and pointing them out gently. By the same token, if you see yourself as a fair person and someone says that your comment was discriminatory, try to resist getting defensive. We are all coming from our own complex places. If you’ve asked for clarification and didn’t get it, reiterate that your intention was positive, and let it go.

6. Use the reporting tools

Platforms and sites rely on their users to report abusive or disrespectful behavior that violates community standards. You can help create a safer environment by reporting harassment and abuse when you see or experience it.

7. Use your moderator powers for good

If you’re the administrator or moderator of an online group, forum, or list, take initiative to set the tone for positive, respectful interactions. You can do so by:

• Establishing community standards or guidelines (pinning a post about rules to the top of a page helps reduce trolling, according to a 2016 experiment by r/science, a Reddit community)
• Creating a clear reporting structure for harassment or abuse
• Reaching out for help and support if you run into trouble
• Being open to feedback from your community and others

8. Support people and platforms doing good work

In recent years, the tech industry has been taking a more active approach to preventing and addressing cyberbullying and harassment. There are several great initiatives you can learn from and support, including:

Facebook’s Bullying Prevention Hub
This online resource, developed in partnership with the Yale Center for Emotional Intelligence, offers information on and strategies for addressing cyberbullying. It includes detailed and practical conversation starters and step-by-step plans for students, parents, and educators looking to address a bullying incident, whether they are speaking with the person being bullied or the person inflicting the bullying. This resource also offers concrete strategies for proactively preventing online harassment and cyberbullying.

Hack Harassment
This coalition, led by Intel, Vox Media, and Lady Gaga’s Born This Way Foundation, aims to build a more inclusive and supportive online community. You can get involved and commit to building that more inclusive and supportive online community through the Hack Harassment website. There, you can sign up to be a Campus Ambassador, host a #HackHarassment hackathon, or apply for a grant to fund your own harassment-hacking project.

People who are harassed online tend to turn to trusted friends, teachers, and family members for help, according to a 2012 study in the Journal of School Violence. Receiving support, both online and off, can have a tremendously positive impact on how someone copes with and responds to online harassment. Here’s how to go about it:

1. Think about what you can potentially accomplish

“Your goal might be to approach a friend involved in a bullying incident, but you don’t know how to approach them or what to say. Or you might choose to report something that you see online that seems unsafe for one of the people involved,” says Dr. Robin Stern, associate director of the Yale Center for Emotional Intelligence at Yale University, Connecticut.

2. Reach out and offer support

You can reach out directly to the person experiencing harassment. Express your alarm at what’s happened and ask what you can do to help. Bear in mind that responding with emojis or “likes” can sometimes be misleading.

3.Add positive comments to a negative thread

If you see insults or attacks online—for example, against a writer discussing sexual violence—consider contributing some positive words. Offering encouragement and support is a simple way to mitigate the effect of online harassment. Manners (good and bad) are contagious. Modeling civility and constructive commentary online can potentially dissuade others from trolling, according to a 2017 study by researchers at Cornell University. That said…

4. Ask before you act on someone else’s behalf

If you want to confront the aggressor or request an apology on behalf of the person who’s been wronged, this is not a decision to make alone. Work with the targeted person and respect their wishes about how to proceed. They might prefer to not confront the aggressor, or to report the issue to the relevant site directly. Except for situations of acute danger, do not take action on their behalf if you have not been asked to do so.

5. Check in with your own feelings

“It is important to reflect on your own feelings before talking with someone affected by a bullying incident because you want to make sure that you are in a place where you can have that conversation,” says Dr. Stern. “If you yourself are emotionally activated, which is understandable and may well be the case, then you won’t be able to have that conversation from a place of calm. If you lower your own emotional activation, you are going to be able to more effectively help the person in the interaction regulate their own emotions.”

6. Seek support, off-line and on

“It is important to talk it through with someone you trust and who you believe is wise about this sort of thing. You might turn to a trusted peer or RA or dean who can help you think about how to approach the incident, depending on your goal,” says Dr. Stern. Tell someone you trust and who is in a position to help. Alternatively, you might report the incident to the site or platform, group administrator, or moderator. If someone is being harmed, about to be harmed, or threatening harm, take that seriously and get help immediately.

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What do you know about opioid abuse and addiction? Take our quiz to see how your knowledge compares to other students’, and find answers to questions like these:

• Is it risky to take prescription pain meds?
• Who’s at risk for addiction?
• How rare is opioid abuse among college students?
• Does opioid overdose reversal always work?

The US is experiencing a brutal opioid epidemic. In 2015, 33,000 Americans died from overdoses involving prescription painkillers, heroin, and synthetic opioids, according to the National Institutes of Health. Many opioid overdoses can be reversed with timely medical treatment, however—someday, you may be in a position to save a life. This brief guide shows you how.

The illicit use of heroin and prescription painkillers is rare among college students. Yet this epidemic is affecting demographics that were previously considered relatively immune to drug crises. “My freshman year of college, my older sister went to rehab for heroin addiction. People from all ethnicities and social classes are struggling with opioid addiction,” says a third-year undergraduate at Saint Louis University, Missouri.

In this article, “opioid” covers heroin, prescription painkillers, and synthetic opioids sold on the street. For info on getting help with abuse and addiction, see Get help or find out more.

What to do if someone may have overdosed: Call 911 immediately

• Act quickly: Most deaths occur one to three hours after the overdose, so you have a window for intervention.
• Get medical help: When people survive an overdose, it is because professional help was available. You do not need to be sure the person has overdosed on opioids (or any other substance) before calling 911. Calling 911 usually ensures quicker medical help than taking the victim to the hospital yourself.
• Tell the 911 dispatcher: Let them know if the person’s breathing has slowed or stopped and if they are unresponsive. Give the dispatcher the exact location.
• Be aware of Good Samaritan laws: In most states, people who seek help with a suspected overdose are immune from drug-related criminal charges under Good Samaritan laws (also known as 911 Immunity Laws). Your college may have similar policies (sometimes called medical amnesty). For information about your state, see Get help or find out more.

What does an opioid overdose look like?

» The signs of opioid overdose include:

• Small pupils
• Droopy arms and legs, and the inability to stand or walk
• Itching
• Slurred speech
• Shallow and uneven breathing
• Being unresponsive
• Loss of consciousness

» As the window for intervening narrows, signs include:

• Pale face
• Blue lips
• Gurgling chest sounds

Could I be at risk for opioid abuse?

Opioid addiction is difficult to treat. Avoiding illicit drug use is the safest strategy. Here’s how to look out for yourself:

• If you are using a prescription opioid medication that was not prescribed to you, seek help.
• If you are using an opioid medication prescribed to you, be self-aware about your reasons: Opioid medications are prescribed for long-term pain associated with various medical issues or for short-term pain control after surgery or an injury. If you are using opioids for other reasons—e.g., to get high or buzzed—seek help.
• If you are using opioids for pain relief, and your pain is becoming more difficult to control, discuss that with your physician immediately.
• If you have a family history of drug abuse/addiction and need medication for short-term pain, consider asking your physician for a pain medication other than opioids. Having a family history of drug abuse/addiction puts you at a higher risk for abuse/addiction.
• If you are abusing opioids or may be addicted, you will need support with your recovery. See Get help or find out more (below).

Where can I get help with opioid abuse or addiction?

• Ask your physician or other health care provider for a referral to an addiction specialist.
• If you have health insurance, check the insurance company website for addiction specialists covered by your plan.
• Ask at your student health center, counseling center, place of worship, or community center about addiction assistance.
• Call your local hospital for help finding medical professionals with addiction expertise.
• Look at community directories or online for a specialist in your area: Make sure the person is licensed or certified in mental or behavioral health, or is a licensed counselor in social work or professional counseling.
• Try Narcotics Anonymous for local, free, anonymous support groups.
• Many detox centers offer free initial consultations.
• For more key info and resources, see Get help or find out more (below).

What are the options for accessing reversal treatment?

Many opioid overdoses can be reversed with treatment. The opioid reversal medications naloxone and naltrexone can be delivered via a nasal spray, by injection, or intravenously. These reversal drugs (or antidotes) are also known by various brand names (e.g., Narcan®).

Naloxone treatment can be accessed in several ways:

• At hospital emergency rooms
• Via police departments and paramedics (ambulance responders), after calling 911
• Via some fire departments
• In most states, via some trained laypeople (not medical professionals) who may have a history of opioid abuse or family members who are abusing opioids
• Some states allow pharmacies to dispense naloxone to people meeting certain criteria without a physician’s direct involvement (this is often reported as over-the-counter availability, although that term is technically incorrect)

What exactly does “unresponsive” mean?

Here’s what being unresponsive looks like, according to the Harm Reduction Coalition:

• Not answering to their name
• Not responding to information they may not want to hear (e.g., “I’m going to call 911”)
• Not responding to physical stimulation (e.g., rubbing your knuckles into their sternum, the place in the middle of their chest where the ribs meet, or pinching their earlobes)
• If the person wakes up but their breathing seems shallow or their chest feels tight, call 911 anyway
  

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Romantic relationships can be a great source of joy and fulfillment. But when a relationship is unhealthy or abusive, it can cause major harm. Relationship abuse is characterized by a pattern of control, disrespect, and emotional manipulation. Sometimes that pattern involves sexual or physical assault or coercion.

“My boyfriend refused to listen to my explicit ‘Nos’ or even ‘It hurts,’” wrote an undergraduate in New Hampshire. “At the time, I didn’t realize it was considered sexual assault. I thought that because we were dating, that wasn’t a thing.”

When sexual assault or coercion happens within the context of a relationship, it is still sexual assault or coercion. Most likely it isn’t an isolated incident but instead part of a pattern of abusive behaviors. “After I broke up with him, I started to realize how abusive the relationship was and how badly it impacted my self-esteem and grades,” the student said (in a recent survey by SH101). “It took a long time for me to realize that this problem did not have to define my time in college.”

Abuse can be emotional or physical

Sexual assault or coercion within relationships is only one category of abusive relationship behavior. It is common for abuse to be entirely or largely emotional, not physical. That said, studies suggest that sexual violence by partners is not rare. Like all unmistakable signs of abuse, it tends to happen out of sight. We are more likely to witness the “small things”—incidents of disrespectful or belittling behavior by one partner to another. These may signal that abuse is happening, or will happen in future.

We can look out for each other

Most of the steps for supporting a friend are actions that people appreciate whether or not they are experiencing abuse. Being an active bystander is about the things we do every day to look out for our friends and communities. In short: Know the warning signs of relationship abuse, and if you’re not sure, check in anyway.

Why does this matter so much? Unconditional support via social networks is vital to coping with relationship abuse, research shows. Supportive friends may be especially important for people of color, who tend to receive less backup than white women (Women’s Studies International Forum, 2004).

Abuse does not target any one type of person

Research has traditionally focused on abuse experienced by women in heterosexual relationships. Male and LBGTQ survivors have been overlooked until relatively recently. Men and women may experience emotional abuse at similar rates, according to the Centers for Disease Control and Prevention (2014). “Anyone can be in an abusive relationship: female/male, gay/straight, any ethnic or cultural background, any physical size, ability, or strength,” says Dr. Rachel Pain, a professor of human geography at Durham University in the UK, who studies relationship abuse. “We all have a strong tendency to think it would never happen to us, but abusive partners are not abusive when we meet them.”

Common signs of abuse

You don’t have to be sure that this is abuse, but it’s helpful to know the signs. Abusive behaviors form a pattern of control, disrespect, and emotional manipulation. Click for info and examples.

8 steps to supporting a friend in an abusive relationship

People experiencing abusive encounters and relationships tend to tell a friend, studies show. If you are that friend, you can make a difference. If you are experiencing abuse, these steps can help outline what seeking support may look like.

1   Be there and listen

This sounds simple, and it goes a long way. Abusive relationships often function by isolating the abused person from their support network, especially friends and family. Being present for your friend can be powerful in and of itself, counteracting the isolation they experience.

2  Be open to individual experiences

Stay attuned to your friend’s needs, regardless of whether or not their relationship conforms to what you’ve heard before about abuse. Be alert to common misconceptions about what abusive relationships look like and who they happen to.

3  Be clear that your friend is not to blame

Part of your role is to emphasize that the abuser is responsible for the abuse. Aggressors try to shift the blame: “I wouldn’t have to shout if you listened the first time”; “It wouldn’t be like this if I could trust you.” Self-blame is a common and powerful obstacle to disclosing abuse and seeking help.

4  Show your support

Ask: “What can I do to help?” The answer may be something seemingly small, like having breakfast with your friend regularly or walking them to class. Maybe you can help schedule an appointment with a doctor or counselor. In any case, follow your friend’s lead on how to help. Avoid saying anything that might trivialize your friend’s experience.

5  Remind yourself that your friend is in charge

Abusive relationships often involve repeated violations of a person’s autonomy. It is crucial that you not replicate that dynamic when you offer help. Your friend is (and should remain in) the driver’s seat. The decision of what to do and when is theirs.

6  Resist advising your friend to leave the relationship

Dumping the abuser may seem like a no-brainer. But many people find this advice unhelpful, in part because it can come across as victim blaming. Consider asking for guidance: “I’m not here to tell you to leave. That said, if you ever want to leave, I’ll support you. I’ll have your back, whatever your decision.”

7  Suggest helpful resources

Suggest additional sources of support that might help your friend. These may be on campus, in the community, or online. Whatever you suggest, the decision on how to proceed belongs to your friend.

8  Seek out support for yourself too

Supporting a friend through an abusive relationship can take a toll on you. Seek support whenever you need it from friends, family, mentors, or professionals. Relationship abuse hotlines are for you too (see Find out more today). Respect your friend’s privacy throughout.

Why it’s important to reach out

You may have noticed similarities between abusive relationships and abuse or misconduct in other contexts. You can likely tell when someone is experiencing pressure, disrespect, or unwanted attention. This makes your job as an active bystander that much easier.

What to do when you’re not sure this is abuse—and why their relationship is your business
Recognizing troubling dynamics within established relationships is not much different from recognizing such dynamics elsewhere. Whether the interaction involves a couple, acquaintances, or strangers, you can likely tell when someone is experiencing pressure, disrespect, or unwanted attention.

What if I’m not sure this is abuse?
You might be thinking of a friend whose relationship is not entirely respectful or fulfilling. Low-level disregard and disrespect are not the same as a pattern of controlling behaviors. Still, we should be wary. Everyone deserves to have their boundaries and desires respected. As a good friend, you would still be concerned for your friend, their well-being, and their happiness. These skills and strategies—listening, being present, showing support—are still useful in these contexts.

And what if it’s actually abusive?
The negative consequences of relationship abuse are far-reaching, both for individuals, communities, and society. These examples may surprise you:

Mass shootings
“Many high-profile mass shooters are also domestic abusers, and most ‘mass shootings’ are actually domestic violence incidents,” reported Vox, following the shooting at Fort Lauderdale airport in January. Researchers are exploring the parallels between relationship abuse and acts of terror. “While the two forms of violence are different in important ways, they are similar in the way that they work: largely, through fear,” says Dr. Rachel Pain, who co-directs the Centre for Social Justice and Community Action at Durham University, UK. “The physical incidents of violence are only part of the story; the threat of violence is used to exert control. And the fear that creates—either for the individual, children, or for a wider community—is one of the most important effects.”

Economic impact
Relationship abuse accounts for enormous costs in healthcare services, lost productivity, missed work, homelessness, and the ripple effects of intergenerational trauma (the impact on children and teens who are exposed to relationship abuse in their families). In the US, the cost of relationship abuse exceeded $5.8 billion a year, in a 2003 study for the Centers for Disease Control and Prevention (CDC).

The frequency and health impact of sexual assault by partners
Abuse of all types can affect people in relationships of any sexual orientation or gender-identity. The research on sexual assault and coercion within relationships is limited. Existing studies focus primarily on women experiencing abuse in heterosexual relationships.

• Sexual assault and coercion in relationships is not rare: In several studies of women who had been married or cohabiting, 8 to 23 percent reported having been sexually assaulted by an intimate partner, according to a 2003 review in Trauma, Violence, & Abuse. The study definitions of intimate partner and sexual assault varied.
• Sexual violence may be relatively common in young people’s relationships: In a UK study involving teens, 31 percent of girls and 16 percent of boys reported some form of sexual coercion or assault (NSPCC, 2009).
• Physical and sexual violence may go together: Many abusive relationships that involve physical violence involve sexual violence too, research shows (Department of Justice, 2005). Within relationships, the mental and physical health impact of sexual assault can be worse than the harms caused by physical violence, according to the same study. Sexual assaults by partners are more likely to cause physical injury than sexual assaults by strangers or acquaintances are (Partner Abuse, 2012).
• Sexual assault by partners can cause serious physical and emotional harm: Women who have been sexually assaulted within relationships had more post-traumatic stress disorder (PTSD) symptoms, more pregnancies resulting from rape, more sexually transmitted infections, and more suicide attempts, compared to women who had been physically but not sexually assaulted by partners, according to the 2005 study for the Department of Justice.
• Sexual assault by partners is a risk factor for drug use: In the 2005 study, 27 percent of the women began or increased their use of nicotine, alcohol, or illicit drugs (usually cocaine) after they were sexually assaulted by an intimate partner.
• The sexual assault risk can vary according to circumstances: Women who are disabled, pregnant, or attempting to leave their abusers are at greatest risk for intimate partner rape, says the National Coalition Against Domestic Abuse.

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