A Kāne'ohe man became the fifth person to die as a result of domestic violence this year when he stabbed himself after allegedly attacking his ex-girlfriend at a Kailua bowling alley.

Terry Paulo, 38, was left in critical condition with multiple stab wounds after the attack on Tuesday. However, friends say she has improved enough to receive visitors at the hospital.

Police said Harlan Bruce Kamekona confronted Paulo at Pali Lanes early Tuesday morning. Shots were fired and she was stabbed, police said. Kamekona then stabbed himself, they said, and later died at Castle Medical Center.

Aside from Kamekona, all the other domestic violence deaths this year were allegedly at the hands of a family member or ex-partners.

From 1996 through 2006, Hawai'i averaged about nine domestic violence-related murders a year, according to data from the state Attorney General's office.

The peak was in 2000, when 15 homicides were recorded, the state figures show.

In 2007, O'ahu alone had six domestic-violence murders, according to Honolulu police.

Some believe the numbers may actually be higher.

"The Department of Health considers these figures to be underestimates because there are so many women who don't report things going on so (police) probably wouldn't know if a certain death may be attributed to (domestic violence),"said DOH spokeswoman Janice Okubo.

Art Machado, part owner of Pali Lanes, said he met Paulo and her mother 15 years ago when they all bowled together. Friends say Paulo is a good bowler and has three children, two in high school and one of elementary-school age.

"Terry is a really friendly person," Machado said. "A real attractive girl ... very down to earth, loved bowling, loved people."

Machado was not at the bowling alley the morning Paulo was attacked but when an employee called to report the stabbing, he said he knew it was Paulo because Kamekona had harassed her there about four weeks ago, he said.

"He was giving her a bad time," Machado said. "I approached him and said this is not the place because he was very vocal."

Carol Lee, executive director for the Hawaii State Coalition Against Domestic Violence, said domestic violence must be addressed at the first signs of a problem.

"In cases of domestic violence, it rarely gets better on its own," Lee said. "The violence almost always becomes more frequent and more severe over time. If it isn't addressed earlier, then it can result in these horrible situations like this woman being stabbed."