Non-Fatal Strangulation Research

Although awareness has increased significantly in recent years, major gaps in non-fatal strangulation (NFS) research remain. Further gaps remain in how these assaults are understood, recognized, investigated, and responded to across healthcare, policing, safeguarding, forensic, legal, and criminal justice systems. In many cases, victim-survivors may display little or no visible injury despite potentially life-threatening neurological, vascular, psychological, or airway-related harm. These realities continue to create substantial operational, evidential, safeguarding, and institutional challenges internationally.

A major new interdisciplinary book on non-fatal strangulation is currently in development and will form the centerpiece of this research section. Provisionally titled Non-Fatal Strangulation: Understanding Escalation and Lethality Risk in Intimate Partner Violence, the book examines non-fatal strangulation within the broader context of intimate partner violence (IPV), coercive control, escalating abuse, and homicide risk. Drawing together medical, forensic, criminological, psychological, safeguarding, and operational perspectives, the project will be the most comprehensive examination of non-fatal strangulation to date.

Rather than approaching strangulation solely as an isolated medical or criminal event, the book examines non-fatal strangulation within wider behavioral patterns involving intimidation, domination, coercive control, escalating violence, and increasing lethality risk. Particular attention is given to hidden injury, delayed medical complications, trauma-informed investigation, offender behavior, institutional minimization, safeguarding failures, and homicide prevention.

Additional Non-Fatal Strangulation Research Studies:

Bichard, H., Byrne, C., Saville, C. W. N., & Coetzer, R. (2022). The neuropsychological outcomes of non-fatal strangulation in domestic and sexual violence: A systematic review. Neuropsychological Rehabilitation, 32(6), 1164-1192. https://doi.org/10.1080/09602011.2020.1868537
De Boos, J. (2019). Review article: Non-fatal strangulation: Hidden injuries, hidden risks. Emergency Medicine Australasia, 31(3), 302-308. https://doi.org/10.1111/1742-6723.13243
Donaldson, A. E., Hurren, E., Harvey, C., Baldwin, A., & Solomon, B. (2023). Front-line health professionals’ recognition and responses to nonfatal strangulation events: An integrative review. Journal of Advanced Nursing, 79(4), 1290-1302. https://doi.org/10.1111/jan.15601
Donaldson, A. E., Ravono, A., Hurren, E., Harvey, C., Baldwin, A., & Solomon, B. (2024). An exploration of frontline health professional’s current understanding of non-fatal strangulation. Journal of Advanced Nursing, 80(12), 5090-5101. https://doi.org/10.1111/jan.16311
Glass, N., Laughon, K., Campbell, J., Block, C. R., Hanson, G., Sharps, P. W., & Taliaferro, E. (2008). Non-fatal Strangulation is an Important Risk Factor for Homicide of Women. The Journal of Emergency Medicine, 35(3), 329-335. https://doi.org/10.1016/j.jemermed.2007.02.065
Institute for Addressing Strangulation. (2024). Domestic homicide reviews and non-fatal strangulation: Lessons for practice. https://ifas.org.uk/wp-content/uploads/2024/08/Domestic-Homicide-Review-Analysis-Fatal-Strangulation-_final-August-2024.pdf
Kaiser, R. (2026). Escalation pattern analysis in non-fatal strangulation: Lethality risk and safeguarding in intimate partner violence. Partner Abuse. Advance online publication. https://doi.org/10.1891/PA-2025-0043
Messing, J. T., Patch, M., Wilson, J. S., Kelen, G. D., & Campbell, J. (2018). Differentiating among Attempted, Completed, and Multiple Nonfatal Strangulation in Women Experiencing Intimate Partner Violence. Women’s Health Issues, 28(1), 104-111. https://doi.org/10.1016/j.whi.2017.10.002
Patch, M., Anderson, J. C., Alexander, K. A., Somoano, F. A., Kelen, G., Holbrook, D. S., & Campbell, J. C. (2023). Didn’t put a label on it: Examining intimate partner strangulation within a diagnostic framework. Journal of Advanced Nursing, 79(4), 1575-1588. https://doi.org/10.1111/jan.15380
Payne-James, J. (2023). Non-Fatal Strangulation. Forensic and Legal Medicine, 803-814. https://doi.org/10.1201/9781003138754-87
Pritchard, A. J., Reckdenwald, A., & Nordham, C. (2017). Nonfatal Strangulation as Part of Domestic Violence: A Review of Research. Trauma, Violence, & Abuse, 18(4), 407-424. https://doi.org/10.1177/1524838015622439
Sorenson, S. B., Joshi, M., & Sivitz, E. (2014). A Systematic Review of the Epidemiology of Nonfatal Strangulation, a Human Rights and Health Concern. American Journal of Public Health, 104(11), e54-e61. https://doi.org/10.2105/ajph.2014.302191
Strack, G. B., & Gwinn, C. G. (2011). On the edge of homicide: Strangulation as a prelude. Criminal Justice, 26(3), 32–35.
Thomas, K. A., Joshi, M., & Sorenson, S. B. (2014). “Do You Know What It Feels Like to Drown?”: Strangulation as Coercive Control in Intimate Relationships. Psychology of Women Quarterly, 38(1), 124-137. https://doi.org/10.1177/0361684313488354
Vella, S. A., Miller, M. M., Lambert, J. E., & Morgan, M. L. (2017). “I Felt Close to Death”: A Phenomenological Study of Female Strangulation Survivors of Intimate Terrorism. Journal of Feminist Family Therapy, 29(4), 171-188. https://doi.org/10.1080/08952833.2017.1370572
White, C., Martin, G., Schofield, A. M., & Majeed-Ariss, R. (2021). ‘I thought he was going to kill me’: Analysis of 204 case files of adults reporting non-fatal strangulation as part of a sexual assault over a 3 year period. Journal of Forensic and Legal Medicine, 79, 102128. https://doi.org/10.1016/j.jflm.2021.102128
Zilkens, R. R., Phillips, M. A., Kelly, M. C., Mukhtar, S. A., Semmens, J. B., & Smith, D. A. (2016). Non-fatal strangulation in sexual assault: A study of clinical and assault characteristics highlighting the role of intimate partner violence. Journal of Forensic and Legal Medicine, 43, 1-7. https://doi.org/10.1016/j.jflm.2016.06.005