A study published in the January edition of the Journal of Women’s Health concludes healthcare providers should look beyond physical injuries when considering the impact of gun use in cases of intimate partner violence.

Instead, says Dr. Susan Sorenson, professor of social policy at the University of Pennsylvania, guns should be viewed as tools of intimidation and psychological control, thus perpetuating the cycle of abuse.

Sorenson analyzed domestic violence incident reports collected by law enforcement officers in Philadelphia over the course of a year to determine how often an offender threatened a victim with a gun — and what impact it had on the victim.

The results showed guns were involved in 1.6 percent of the 35,413 incidents Philadelphia police responded to in 2013. Of those cases, Sorenson determined victims were less likely to display physical injuries, but more likely to be frightened. Similarly, offenders brandishing guns — as opposed to other types of weapons — were less likely to have assaulted the victim. In 70 percent of the cases, the victims reported only being “threatened” with the gun.

“Medicine and public health focus primarily on physical injuries (both fatal and nonfatal) to document the nature and scope of gun violence,” Sorenson wrote. “Such a focus may need to be reconsidered if gun use in IPV is primarily a means to an end. In this situation, guns would heighten fear and compliance and likely would reduce willingness to leave or otherwise end the relationship, thus promoting chronic abuse.”

Sorenson said, “in general,” injury to the victim was most common when the offender used a bodily weapon — hands, fists or feet — or a non-gun external weapon and least common when a gun was used.

“As a whole, findings suggest that persons who use a gun against their intimate partners are less intent on inflicting physical harm than are those who use another type of weapon; intimates use a gun to intimidate and coerce (i.e., to increase victim compliance during an assault), which results in fewer visible injuries and greater victim fear; or some combination of the two,” she concluded.