Evidence map›Paper›PMID 42204516›Full record

ArticleBMC women's health2026

AWhen screams go unheard: covert violence, women victims, and social denial.

Zahra Saedi, Fatemeh Norouzi Aliabad, Elham Taheri, Elham Azmoude

Abstract readScoping Review
In one paragraph

Article in BMC women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Zahra SaediDepartment of Clinical Psychology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Fatemeh Norouzi AliabadDepartment of Clinical Psychology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Elham TaheriDepartment of Clinical Psychology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Elham AzmoudeDepartment of Midwifery, School of Nursing and Midwifery, Neyshabur University of Medical Sciences, Neyshabur, Iran. azmoudehe@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCovert violence-defined as a pattern of subtle, intentionally hidden, and socially camouflaged abusive behaviors that systematically erode a victim's reality, autonomy, and self-worth-remains a critically understudied dimension of gender-based violence. Distinct from overt psychological aggression, covert violence operates through tactics such as gaslighting, micro-invalidations, coercive control, and economic manipulation, often evading detection while inflicting profound harm. This scoping review systematically maps the evidence on its manifestations, psychosocial impacts, and the mechanisms of institutional and cultural denial that compound women's victimization.

methodsFollowing Arksey & O'Malley's framework and PRISMA-ScR guidelines, we conducted systematic searches across five databases (PubMed, Scopus, Web of Science, PsycINFO, CINAHL) for English-language studies published between 1992 and 2025. The search strategy prioritized terms specific to covert violence (e.g., "covert abuse," "invisible violence," "subtle psychological aggression") alongside related concepts. From 1,325 identified records, 43 resources met inclusion criteria after rigorous screening. Data were extracted into a structured table cataloging study characteristics (design, population, abuse type, key findings) and synthesized thematically.

resultCovert violence emerges as a complex and multifaceted phenomenon characterized by systemic psychological, emotional, and economic abuse that deeply undermines women's autonomy, mental health, and social functioning. Key manifestations include gaslighting, coercive control, financial restriction, and relational manipulation, which lead to severe mental health outcomes-such as anxiety, depression, and PTSD-as well as physical health deterioration and social isolation. Despite its profound impact, covert violence remains largely invisible and underrecognized due to social denial, cultural minimization, and institutional shortcomings. Barriers to disclosure and support include the absence of physical evidence, fear of retaliation, stigma, and fragmented service systems. Importantly, covert violence frequently intersects with and precedes overt physical abuse, underscoring its role in sustaining cycles of control. Addressing covert violence requires urgent legal reforms to recognize non-physical abuse, trauma-informed training for professionals, integrated support services, and public health initiatives aimed at shifting societal attitudes.

conclusionsOur analysis reveals covert violence as a widespread and deeply embedded issue sustained by structural indifference and epistemic injustice. To effectively address this problem, multi-level interventions are needed, including the legal recognition of non-physical abuse, specialized training for frontline responders, and public campaigns that challenge the normalization of covert harm. Future research should prioritize longitudinal designs, cross-cultural comparisons, and the evaluation of integrated intervention models, with particular attention to marginalized populations.

Indexed as

Crime VictimsDenial, PsychologicalGender-Based ViolenceAggressionCoercionFemaleHumansCoercive controlCovert violenceGaslightingGender-based violenceInstitutional betrayalPsychological abuseScoping reviewSocial denial

Identifiers

PMID42204516
PMCPMC13430805

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.