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Mental ill health in structural pathways to women ’ s experiences of intimate partner violence

View Article: PubMed Central - PubMed

ABSTRACT

Background: Depression, post-traumatic stress disorder (PTSD), and binge drinking are among mental health effects of child abuse and intimate partner violence (IPV) experiences among women. Emerging data show the potential mediating role of mental ill health in the relationship of child abuse and IPV. There is evidence that PTSD, depression and alcohol abuse are comorbid common mental disorders and that a bidirectional relationship exists between depression and IPV in some settings. Furthermore, the temporal direction in the relationship of alcohol abuse and women’s IPV experiences from different studies is unclear. We undertook a study with women from the general population to investigate the associations of child abuse, mental ill health and IPV; and describe the underlying pathways between them.

Methods: Data is from a household survey employing a multi-stage random sampling approach with 511 women from Gauteng, South Africa. IPV was measured using the WHO Multi-country Study on Women's Health and Domestic Violence Questionnaire. Child abuse was measured using a short form of the Childhood Trauma Questionnaire. Depression was measured using the Centre for Epidemiologic Studies Depression Scale (CESD). PTSD symptoms were measured using the Harvard Trauma Questionnaire. Binge drinking was measured using the Alcohol Use Disorders Identification Test (AUDIT) scale. All data analyses were conducted in Stata 13. Regression modelling was used to test the association between variables. Structural equation modelling with full information maximum likelihood estimation accounting for missing data was done to analyse the underlying pathways between variables.

Results: Fifty percent of women experienced IPV in their lifetime and 18% experienced IPV in the 12 months before the survey. Twenty three percent of women were depressed, 14% binge drank and 11.6% had PTSD symptoms. Eighty six percent of women had experienced some form of child abuse. Sociodemographic factors associated with recent IPV in multivariate models were younger age and foreign nationality. Depression, PTSD and binge drinking mediated the relationship of child abuse and recent IPV. Depression, PTSD and binge drinking were also effects of recent IPV. Other factors associated with recent IPV experience included relationship control, having a partner who regularly consumed alcohol and experiencing other life traumatic experiences

Conclusion: Mental ill health plays a mediating role in the relationship of child abuse and recent IPV experiences among women. Conversely, IPV also negatively affects women’s mental health. Interventions to reducing the incidence of IPV could help alleviate the burden of mental ill health among women and vice versa. Effective integration of mental health services in primary health care, detection of symptoms, brief interventions and strengthened referral mechanisms for sustained community-based care are necessary in responding to victims of intimate partner violence. Response for abused children needs to take similar approaches and reduce the long-term mental health effects associated with violent exposures.

No MeSH data available.


Mental ill health in pathways to IPV experiences.
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pone.0175240.g001: Mental ill health in pathways to IPV experiences.

Mentions: Fig 1. shows that mental ill health mediated the relationship of child abuse and recent IPV. There were no direct pathways between child abuse and IPV, but there was one pathway mediated by depression and another mediated by PTSD. There was also a pathway mediated by both depression and binge drinking. Other life trauma events had indirect effects on IPV, mediating a pathway from child abuse through PTSD and another through binge drinking. Sexual Relationship Power also mediated the relationship of child abuse and recent IPV. The final modified model fit the data well (CFI = 0.92; TLI = 0.91; RMSEA = 0.04); p value = <0.0001). Table 5. shows the model statistics observed in the path diagram in Fig 1.


Mental ill health in structural pathways to women ’ s experiences of intimate partner violence
Mental ill health in pathways to IPV experiences.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383260&req=5

pone.0175240.g001: Mental ill health in pathways to IPV experiences.
Mentions: Fig 1. shows that mental ill health mediated the relationship of child abuse and recent IPV. There were no direct pathways between child abuse and IPV, but there was one pathway mediated by depression and another mediated by PTSD. There was also a pathway mediated by both depression and binge drinking. Other life trauma events had indirect effects on IPV, mediating a pathway from child abuse through PTSD and another through binge drinking. Sexual Relationship Power also mediated the relationship of child abuse and recent IPV. The final modified model fit the data well (CFI = 0.92; TLI = 0.91; RMSEA = 0.04); p value = <0.0001). Table 5. shows the model statistics observed in the path diagram in Fig 1.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Depression, post-traumatic stress disorder (PTSD), and binge drinking are among mental health effects of child abuse and intimate partner violence (IPV) experiences among women. Emerging data show the potential mediating role of mental ill health in the relationship of child abuse and IPV. There is evidence that PTSD, depression and alcohol abuse are comorbid common mental disorders and that a bidirectional relationship exists between depression and IPV in some settings. Furthermore, the temporal direction in the relationship of alcohol abuse and women&rsquo;s IPV experiences from different studies is unclear. We undertook a study with women from the general population to investigate the associations of child abuse, mental ill health and IPV; and describe the underlying pathways between them.

Methods: Data is from a household survey employing a multi-stage random sampling approach with 511 women from Gauteng, South Africa. IPV was measured using the WHO Multi-country Study on Women's Health and Domestic Violence Questionnaire. Child abuse was measured using a short form of the Childhood Trauma Questionnaire. Depression was measured using the Centre for Epidemiologic Studies Depression Scale (CESD). PTSD symptoms were measured using the Harvard Trauma Questionnaire. Binge drinking was measured using the Alcohol Use Disorders Identification Test (AUDIT) scale. All data analyses were conducted in Stata 13. Regression modelling was used to test the association between variables. Structural equation modelling with full information maximum likelihood estimation accounting for missing data was done to analyse the underlying pathways between variables.

Results: Fifty percent of women experienced IPV in their lifetime and 18% experienced IPV in the 12 months before the survey. Twenty three percent of women were depressed, 14% binge drank and 11.6% had PTSD symptoms. Eighty six percent of women had experienced some form of child abuse. Sociodemographic factors associated with recent IPV in multivariate models were younger age and foreign nationality. Depression, PTSD and binge drinking mediated the relationship of child abuse and recent IPV. Depression, PTSD and binge drinking were also effects of recent IPV. Other factors associated with recent IPV experience included relationship control, having a partner who regularly consumed alcohol and experiencing other life traumatic experiences

Conclusion: Mental ill health plays a mediating role in the relationship of child abuse and recent IPV experiences among women. Conversely, IPV also negatively affects women&rsquo;s mental health. Interventions to reducing the incidence of IPV could help alleviate the burden of mental ill health among women and vice versa. Effective integration of mental health services in primary health care, detection of symptoms, brief interventions and strengthened referral mechanisms for sustained community-based care are necessary in responding to victims of intimate partner violence. Response for abused children needs to take similar approaches and reduce the long-term mental health effects associated with violent exposures.

No MeSH data available.