The effect of economic, physical, and psychological abuse on mental health: a population-based study of women in the Philippines

Adverse childhood experiences and intimate partner violence: A meta-analysis

Intimate partner violence (IPV) represents a significant public health concern. Adverse childhood experiences (ACEs) represent one risk factor for IPV, however, the results of existing research on the association between ACEs and IPV demonstrate mixed findings. The present research sought to meta-analytically examine the association between ACEs and (a) IPV perpetration and (b) IPV victimization. Moderator analyses were conducted to determine factors that may impact the association between ACEs and IPV involvement. Electronic searches were conducted in MEDLINE, Embase, and PsycINFO in August of 2021. One-hundred and twenty-three records were screened for inclusion. All studies included a measure of ACEs and IPV victimization or perpetration. Among the 27 studies and 41 samples included in the meta-analysis, 65,330 participants were included. The results of the meta-analyses demonstrated that ACEs were positively associated with IPV perpetration and victimization. Significant methodological and measurement moderators further inform our understanding of ACEs and IPV involvement. The present meta-analyses demonstrates that trauma-informed approaches to IPV screening, prevention, and intervention may be useful, given that individuals who are involved with IPV may be more likely to possess a history of ACEs exposure.

Types of Economic Abuse in Postseparation Lives of Women Experiencing IPV: A Qualitative Study from Finland

There is growing interest in economic abuse as a form of violence against women, but the research has largely addressed cohabiting couples thus far, with few detailed explorations of women's experiences of economic abuse in postseparation life. Using interviews with 11 women experiencing intimate partner violence (IPV), this study investigates the types of economic abuse in the lives of these women. Inductive thematic analysis revealed four types of postseparation economic abuse (PSEA): economic sabotage, withholding resources, financial harassment, and stealing. These results help better understand and recognize the different forms of PSEA. Recommendations are provided for incorporating PSEA as a central component of IPV research, practice, and policy.

Prevalence and Correlates of Economic Abuse Among Married Women in a Nigerian Population

Economic abuse (EA) is a form of intimate partner violence (IPV) whereby abusers employ various tactics to control their partners' ability to acquire, access, and maintain economic resources thus threatening their economic security and potential for self-sufficiency. It poses a global public health challenge as economic concern is a significant reason for the observed persistent high prevalence of IPV given that even when women want to leave abusive relationships, they are less likely to if they lack the means to cater for themselves and their children upon doing so. However, very few studies in Nigeria have focused on EA. The current study assessed the prevalence and correlates of EA among a Nigerian population of married women. Survey responses of 480 randomly selected married women were used for analysis. The prevalence of EA among respondents was found to be 64.2% while that for emotional abuse, sexual abuse, and physical abuse were 40.2%, 17.3%, and 16.7%, respectively. EA was also found to be significantly associated with other forms of IPV such as physical abuse, emotional abuse, and sexual abuse. The study findings add to the literature by highlighting the high prevalence of EA among Nigerian women. It also underscores the importance of empowering women to minimize victimization. Study limitations are discussed and directions for future research are presented.

Examining the Psychometric Properties of the Revised Scale of Economic Abuse among Iranian Women

Economic abuse, in the context of intimate relationships, is a pervasive form of violence that merits further empirical attention. We know from limited research that the rates of economic abuse appear to be high in Iran; however, there is a lack of culturally appropriate measures that can assess the extent to which women experience economic harm as a result of their partners' actions. The present study was conducted with the aims of (a) investigating the psychometric properties of the 14-item Revised Scale of Economic Abuse (SEA2) which was translated into Persian for this study and (b) examining the prevalence of economic abuse among a sample of 371 married housewives in Qazvin, Iran. Confirmatory factor analysis supports the two-factor structure of the SEA2, with the exception of one item. Composite reliability and Cronbach's alpha demonstrated good internal consistency. The average variance extracted method, along with correlations with other financial variables, demonstrated evidence of good convergent validity. Correlations with related, but distinct forms of abuse, support the scale's discriminant validity. Based on the collective findings, this measure can be used as a reliable and valid tool to study economic abuse among Iranian women which, within our sample, appears to be a common phenomenon. Implications for future research and practice are discussed.

The Effects of Polyvictimization by Intimate Partners on Suicidality Among Salvadoran Women

Intimate partner violence (IPV) victims tend to suffer from various mental health issues. Mental health issues, including suicidal thoughts and attempts caused by IPV victimization, might be more severe among women in El Salvador, where violence against women is prevalent overall. Although polyvictimization, which is defined as experiencing more than one type of violence by one or multiple partners, is associated with more severe mental health consequences than victimization by just a single form of violence due to accumulative trauma, not enough attention has been paid to this phenomenon among Salvadoran women. Thus, guided by trauma theory, this study aimed to examine the impact of polyvictimization from different types of violence (i.e., physical, sexual, emotional, and economic) on suicidal thoughts and attempts among Salvadoran women using the 2017 Violence Against Women National Survey. A nationally representative sample of 3,074 Salvadoran women aged 15 years or older and who had experienced an intimate relationship in their lifetime, recruited through a multistage random sampling design, was analyzed in this study using logistic regression analyses. We found that psychological and economic violence, along with physical and sexual violence, had statistically significant associations with suicidal thoughts and attempts, and polyvictimization increased suicidal thoughts and attempts. Based on this study's findings, we recommend effective research and practice or intervention implementation for addressing IPV and associated mental health problems among Salvadoran women.

Gender Patterns in the Use of Physical Violence Against a Violent Partner: Results of a Cross-Sectional Population-Based Study in New Zealand

We examine gendered patterns in the use of violence in response to the partner's violence ("fighting back"). Within each gender, we examined if socio-demographic differences in prevalence were present, and if contextual factors influenced the use of violence against a violent partner. Data from a large, population-based sample of New Zealand adults was used to identify ever-partnered respondents who had experienced physical IPV (n = 407 women, and n = 391 men). Weighted percentages and 95% confidence intervals (95%CIs) were calculated for the use of violence against a violent partner, stratified by gender. Multivariable logistic regression was used to assess the association between each contextual risk factors and the use of violence against a violent partner. For both men and women, at the multivariable level, use of violence against a violent partner was associated with contextual factors related to the abuse. However, for almost all of these variables a higher proportion of women than men experienced the risk factor; for example, a higher proportion of women than men reported having experienced severe IPV (57.6% women; 43.7% men), injuries resulting from IPV (44.5% women, 15.0% men), and fear of a partner (22.7% women, 4.9% men). Women were also more likely to report experiencing other types of IPV (particularly sexual IPV) and were more likely to report that their children were present at the time of violence. These factors contributed to the higher proportion of women who reported fighting back at least once (53.4% of women and 22.3% of men). Health, social, and legal services need to conduct appropriate and thorough assessment of nature and context (current and historical) of the violence that individuals have been exposed to as part of service provision. Assessments need to be carried out with a gender-lens in order to provide comprehensive and appropriate responses.

Psychological Reactions to Different Types of Gender-Based Violence in Women Survivors of Violence in the Context of a Developing Country

Literature on the psychological effects on women survivors of violence (WSV) suggests there may be a relationship between the specific type of gender-based violence and patterns in the development of mental health consequences. Understanding these relationships would support early targeted (or early specialist) intervention. Since violence against women in families is a common social health problem in developing countries, the study attempted to explore the abuse specific reaction patterns within such a context. A total of 600 WSV (mean age = 26.86, SD = 7.47) were recruited from different social service organizations working for WSV in Bangladesh. To identify the type of gender-based violence (i.e., physical, sexual, emotional, psychological, and economic violence) experienced and psychiatric sequelae (i.e., post-traumatic stress disorder (PTSD), anxiety, depression, suicidal ideation, and substance abuse) in WSV, multiple reliable and valid measures were used. The results of the hierarchical multiple regression analysis showed that amongst the various different types of violence, only psychological, sexual, and economic violence have a significant independent predictive ability on PTSD, anxiety, and depression in the Bangladeshi WSV. Violence related factors such as witnessing violence in childhood among parents and history of childhood abuse had the unique predictive ability on suicidal ideation and substance abuse, respectively. Our result suggested that accepting physical and emotional abuse at any stage of life is very common for Bangladeshi women. This study suggested that non-physical forms of violence have the most significant independent predictive ability in the development of psychiatric symptoms. It is suggested that to develop appropriate support services for WSV within this socio-cultural context, further research is required which focuses on the psychological impact of non-physical forms of violence.

What Matters When Examining Attitudes of Economic Abuse? Gender and Student Status as Predictors of Blaming, Minimizing, and Excusing Economic Abuse

Extensive research has been conducted regarding attitudes toward various types and patterns of violence against intimate partners, but there is a lack of research on attitudes toward economic abuse in general. In the current study, we examined attitudes toward economic abuse by examining how participants blamed the victim, minimized the economic abuse, and excused the perpetrator in hypothetical scenarios. We also examined two characteristics of participants: binary gender differences (i.e., woman, man) and differences between students and non-students. Participants (N = 239) were recruited via the SONA system of a private university (n = 120) and via Amazon's Mechanical Turk (n = 119). Participants were randomly assigned to read one of two hypothetical scenarios to evaluate how scenario condition (i.e., victim employed, victim unemployed), participant gender, and participant student status predicted attitudes toward economic abuse involving blaming, minimizing, and excusing. Moreover, we also examined ambivalent sexism and gender role ideology as predictors. A 2 (scenario condition: job, no job) × 2 (participant gender: woman, man) × 2 (student status: college student, non-college student) MANOVA indicated main effects of both participant gender and participant student status. Follow-up ANOVAs revealed that men were more likely to blame victims, minimize the economic abuse, and excuse perpetrators compared to women. Additionally, students were less likely to minimize the economic abuse compared to non-students. Moreover, both hostile sexism and traditional gender role ideology were significant predictors. Implications of the findings and future directions for researchers are discussed.

Prevalence of Violence in Iranian Pregnant Women: A Systematic Review and Meta-Analysis

BACKGROUND AND AIMS

Violence against pregnant women is a significant public health problem, resulting in disability and various physical and mental health disorders. This systematic review and meta-analysis explored the prevalence of physical, verbal, sexual, psychological, emotional, economic, and other types of violence among pregnant women in Iran.

METHODS

Bibliographic databases including PubMed, Embase, Web of Science (WoS), and Scopus, and also Iranian databases including Scientific Information Database (SID), Magiran, and Civilica were searched from 2002 to September 16, 2020. Following a random-effects meta-analysis, we estimated the pooled prevalence of exposure to different types of violence among Iranian pregnant women. Overall, 61 articles that met the inclusion criteria were analyzed in this systematic review.

RESULTS

The prevalence of physical violence was 19.0% (95% confidence intervals [CI]: 14.0, 24.0), verbal violence was 42.0% (95% CI: 24.0, 61.0), sexual violence was 26.0% (95% CI: 20.0, 32.0), psychological violence was 37.0% (95% CI: 28.0, 46.0), emotional violence was 51.0% (95% CI: 40.0, 62.0), economic 39.0% (95% CI: 19.0, 60.0), and the prevalence of other types of violence was 54.0% (95% CI: 46.0, 62.0).

CONCLUSIONS

This study revealed that Iranian pregnant women are often exposed to different types of violence. Therefore, screening for violence in this vulnerable group seems necessary due to the sensitive nature of pregnancy and its importance in maternal ‎health. This alarming rate of violence calls for adopting upstream policies and interventions to reduce violent practices against pregnant women in Iran.

Women's Economic Abuse Experiences: Results from the UN Multi-Country Study on Men and Violence in Asia and the Pacific

Economic abuse is a poorly understood form of intimate partner violence but may have far-reaching implications for the financial health of the survivor. Additionally, very little is known about whether depressive symptoms, education, employment, or attitudes about relations between men and women mediate or moderate the relationship between economic abuse and their financial circumstances. The purpose of this study was to answer these two research questions: (a) Is there a relationship between the experience of economic abuse and food insecurity (as a measure of poverty)? (b) Is the relationship between economic abuse and food insecurity impacted by women's education, women's and men's employment, women's attitudes towards gender relations, or women's depressive symptoms? We used quantitative data from the "UN Multi-Country Study on Men and Violence," analyzing data on 3,105 women aged 18-49 years who were interviewed. Initial logistic regressions were conducted followed by introducing moderators and mediators to the model using path analyses to test the relationship between economic abuse and food insecurity in the household. Significant predictors of food insecurity included several types of abuse and partners' employment, women's own employment, and education. The only type of IPV not associated with food insecurity was physical abuse. Experiences of economic abuse were associated with a 1.69 times greater likelihood of reporting food insecurity which was higher than experiences of psychological or sexual abuse. Additionally, women's experiences of economic abuse over their lifetime were significantly associated with an increase in depressive symptoms which in turn was associated with greater likelihood of experiencing food insecurity. Such relationships warrant attention to economic abuse and depressive symptoms as part of the interventions used when working with survivors. Additional research could also help further our understanding of how these variables interact together and how best to address its impact on survivors.

Traumatic Associations amongst Men and Women Selling Sex in the Philippines

Background: The present study explores trauma-related factors (human trafficking or physical or sexual violence during transactional sex) associated with interest in future community mobilization around health and human rights. Community mobilization among persons selling sex aims to help participants overcome trauma and increase self-reliance through peer advocacy and collective action for improved human conditions. However, how violence and human trafficking impact community mobilization participation among men and women selling sex is less known. Methods: The current study uses data (n = 96) from the baseline survey of participants in the pilot Kapihan community mobilization intervention, which recruited 37 men and 59 women from Metro Manila, Philippines. Multiple logistic regression was used to analyze factors (violence, human trafficking) independently associated with the desire to participate in community mobilization, adjusting for socio-demographic variables. Results: An increased interest in participating in community mobilization around health and human rights was significantly associated with having experienced physical or sexual abuse in the sex trade (AOR = 10.86; CI 1.48–79.69) and less history of trafficking (AOR = 0.14; 95% CI 0.02–0.97), adjusting for age, gender, income, number of children, and whether they considered group goals or had previously participated in community mobilization. Conclusion: Understanding the impact of experiences with physical and sexual violence and human trafficking on health and human rights mobilization participation can inform the design and recruitment for future community-based interventions. Further investigation needs to explore why experiences with human trafficking, having more children, or being a woman lessened the desire to mobilize in this Philippines context. Findings imply that trauma may be more complex. More work is needed to better identify interventions for those with a history of being trafficked or victimized by physical or sexual violence during transactional sex exchanges.

Intimate Partner Violence and Sexual Agency in a Nationally Representative Sample of Women and Girls in the Philippines

This study examined the prevalence of intimate partner violence (Intimate Partner Violence) and its associations with sexual agency among women and adolescent girls in the Philippines. Data came from the 2017 Philippines National Demographic and Health Survey (DHS), a nationally representative, cross-sectional survey of women and girls ages 15-49. Participants included 11,727 women and girls who reported having a current male partner. Survey measures included three indicators of Intimate Partner Violence (physical, sexual, emotional), ability to refuse sex, ability to insist on condom use, perception that a husband/boyfriend can be justified in hitting or beating his wife/girlfriend, and sociodemographic characteristics. Descriptive and multivariable statistical analyses were conducted, with survey weightings used to account for the complex survey design. Overall, 23.9% reported Intimate Partner Violence in their current partnership (10.1% physical violence, 3.4% sexual violence, 19.0% emotional violence), 11.2% believed a husband or partner could be justified in hitting or beating their wife, 10.5% reported being unable to refuse sex with their partner, and 20.4% were unable to ask their partner to use a condom. In multivariable analyses, experiences of sexual (OR .68; 95% CI .50, .92), physical (OR .83; 95% CI .68, 1.02), and emotional violence (OR .69; 95% CI .58, .81) were associated with lower adjusted odds of being able to ask a partner to use a condom. When placed in the same model, emotional violence had the strongest association with lower odds of negotiating condom use with partner (OR .70; 95% CI .57, .85). Perception that a husband/boyfriend can be justified in hitting or beating his wife/girlfriend was associated with lower ability to refuse sex and ask a partner to use a condom. Findings indicate a need for further investment in interventions to prevent Intimate Partner Violence and support the sexual health and agency of women and girls who have experienced Intimate Partner Violence in the Philippines.

Examining the impact of economic abuse on survivors of intimate partner violence: a scoping review

Background

Economic abuse is a unique form of intimate partner violence (IPV) and includes behaviors that control a survivor’s ability to acquire, use, and maintain resources. These tactics can result in someone becoming economically dependent on their partner and may limit their ability to leave the relationship and establish independence. The aim of this study was to conduct a scoping review focused on the impact of economic abuse on survivors of IPV.

Methods

A total of 14 databases were reviewed, which resulted in 35 peer-reviewed manuscripts for inclusion in the study. Manuscripts were included if they were: written in English, published since the year 2000, focused specifically on the impact of economic abuse perpetrated by an intimate partner, economic abuse was measured as an independent variable, and if economic abuse was looked at separately from other forms of IPV. Both convenience and population-based samples were included in the review. Information was extracted using a data charting form. The data were analyzed using a combination of grouping techniques and constant comparison methods to identify key findings.

Results

Studies found significant associations between economic abuse and a range of outcomes, such as mental and physical health, financial impacts, parent-child interactions, and quality of life. The most frequently examined were mental health, followed by financial issues.

Conclusions

Limitations of these studies included a lack of longitudinal research and a focus on heterosexual relationships with male-perpetrated violence toward female survivors. Study findings highlight the wide-ranging potential impacts of economic abuse on survivors and the need for additional research to better understand potential outcomes and implement and evaluate interventions to address them.

Women's participation in microfinance: Effects on Women's agency, exposure to partner violence, and mental health

OBJECTIVES

The health and social effects of women's microfinance participation remain debated.

METHODS

Using propensity-score methods, we assessed effects of microfinance participation on novel measures of agency; intimate partner violence (IPV) exposure; and depressive symptoms in 930 wives in Matlab, Bangladesh interviewed 11/2018-01/2019.

RESULTS

Participants, versus non-participants, were married younger (16.7 vs. 17.4 years), more often Muslim (90.7% vs. 86.2%), less schooled (5.4 vs. 6.8 grades), and more often had husbands (27.0% vs. 19.6%) and mothers (63.2% vs. 50.5%) without schooling. Participants and non-participants had similar unadjusted mean scores for prior-week depressive symptoms, prior-year IPV, and intrinsic attitudinal agency (gender-equitable attitudes; non-justification of wife beating). Participants had higher unadjusted mean scores for intrinsic voice/mobility; instrumental agency (using financial services, voice with husband, voice/mobility outside home); and collective agency. Average adjusted treatment effects were non-significant for depressive symptoms, IPV, and attitudinal intrinsic agency, and significantly favorable for other agency outcomes.

CONCLUSIONS

Microfinance participation had no adverse health effects and favorable empowerment effects in Bangladeshi wives.

POLICY IMPLICATIONS

Microfinance can empower women without adverse health effects. Social-norms programming with men and women may be needed to change gendered expectations about the distribution of unpaid labor and the rights of women.

Holes in the wall: Examining gaps in knowledge in child and adolescent mental health in Tanzania - Scoping review

OBJECTIVES

To perform scoping review of the existing literature available specific to child and adolescent mental health in Tanzania.

METHODS

An extensive literature search of PubMed, Scopus, MEDLINE and EMBASE was undertaken to identify studies that focussed specifically on mental illness in children and young people in Tanzania. This included neurological and functional disorders, affective disorders, psychosis, epidemiological, intervention and treatment-based studies. Qualitative analysis of the studies was then undertaken to assess what is currently known about the subject and how reliable this information is and to identify areas for further research.

RESULTS

Of 23 studies were included in the final synthesis, which could be broadly split into studies focussing on the prevalence and incidence of child and adolescent mental illness, hypothesised causes and correlations, identified treatments and interventions and qualitative studies of human experience.

CONCLUSION

There is a dearth of published research regarding child and adolescent mental health in Tanzania. Although some high-quality studies allow us good insight into the epidemiology of mental illness, interventional studies are often small and low-power, and significant correlational relationships are yet to be drawn. There is significant scope for further child and adolescent mental health research in Tanzania.

Domestic Violence as a Risk Factor for Attempted Suicide in Married Women

High rates of suicide attempts and domestic violence (DV) in women of reproductive age group have been reported from South India, but the association between them was not studied. Hence, this study was undertaken to assess whether DV is a risk factor for attempted suicide in married women of reproductive age group. A hospital-based case-control study with 77 incident cases of attempted suicide in married women of the age group of 18 to 45 years and 153 controls belonging to the same age group, without history of suicide attempt, was undertaken over a period of 6 months. Univariate and multivariate analyses were done. The crude odds ratio (cOR) for DV was found to be 6.15 (95% confidence interval [95% CI] = [2.95, 12.82], p value = .0001). Other statistically significant risk factors included younger age group (below 30 years); gross family income > Rs. 5,000; higher occupational status of spouse; having poor social support; having a family history of psychiatric disorders, substance use disorders, and suicide/suicide attempt; higher impulsiveness scores; having higher scores of stressful life events over the past 12 months, and alcohol use disorder in husband. Islamic faith was found to be a significant protective factor. On logistic regression, DV was found to be an independent risk factor for attempted suicide in this study population (adjusted OR = 3.79, 95% CI = [1.35, 10.62], p value = .011). Age groups, stressful life events, impulsiveness, and alcohol use disorder in husband were the confounders adjusted for in logistic regression along with other significant risk and protective factors. Significant dose-response relationship was also observed between DV and attempted suicide. In accordance with the stress-diathesis model for suicidal behavior, DV is found to be a stressor which precipitates suicide attempt in those with diathesis like family history of psychiatric disorders. Clinical, research, and policy implications of the findings are discussed.

Prevalence and risk factors of domestic violence and its impacts on women's mental health in Gilgit-Baltistan, Pakistan

Objective:

To assess the prevalence of domestic violence, associated risk factors, and its impacts on women’s mental health in Gilgit-Baltistan (GB), Pakistan.

Methods:

This is a sequential explanatory strategy that is a mixed-method research design was conducted at Department of Behavioral Sciences, Karakoram International University Gilgit from January 2017 to June 2018 on 160 married women. Quantitative data were collected using Karachi domestic violence screening scale and mental health inventory and qualitative data were collected through interview guides. Descriptive and inferential statistical techniques were applied to analyze quantitative data while qualitative data were analyzed using thematic analysis.

Results:

Married women in GB reported higher levels of domestic violence (88.8%; psychological (69.4%), physical (37.5%) & sexual (21.2%). Abused women reported lower levels of mental health (t=3.19, p=0.00); psychological wellbeing (t=2.03, p=0.04), general positive affect (t=2.09, p=0.03), and life satisfaction (t=2.39, p=0.01) and higher levels of psychological distress (t=3.27, p=0.00), anxiety (t=3.06, p=0.00), depression (t=2.60, p=0.01), and loss of emotional/behavioral control (t=3.05, p=0.00) as compared to non-abused women. Risk factors behind domestic violence were identified as; poverty, the influence of in-laws, second marriage, stepchildren, forceful intimate relationships, husband’s irresponsibility, and addiction, and handicapped children.

Conclusions:

We found higher level of domestic violence, associated risk factors, and poor mental health of abused women in GB.

Economic Abuse as an Invisible Form of Domestic Violence: A Multicountry Review

The predominant perception of intimate partner violence (IPV) as constituting physical violence can still dominate, particularly in research and media reports, despite research documenting multiple forms of IPV including sexual violence occurring between intimate partners and various forms of psychological and emotional abuse. One frequently hidden or "invisible" form of abuse perpetrated within intimate partner relationships is economic abuse, also referred to as financial abuse in much of the literature. While the links between gendered economic insecurity and economic abuse are emerging, there remains a lack of consistency about definitions within the United States and globally, as there is no agreed upon index with which to measure economic abuse. As such, the purpose of this article is to review and analyze the global literature focused on either economic or financial abuse to determine how it is defined and what measures are used to capture its prevalence and impact. The 46 peer-reviewed articles that met all inclusion criteria for analysis came from a range of countries across six continents. Our review found that there is growing clarity and consistency of terminologies being used in these articles and found some consistency in the use of validated measures. Since this research is in its "infancy," we need to have stronger collaborative efforts to use similar measures and terminology. Part of that collaborative effort is to consider how language and cultural differences may play a part in our understanding of economic abuse.

Risk Factors for and Mental Well-Being Outcomes of Economic Abuse in Hong Kong Chinese Population

Although economic abuse is one of the major tactics of intimate partner violence, there has been a lack of empirical evidence on the factors associated with economic abuse and its mental well-being outcomes in Chinese population. This study aimed to identify risk factors for and mental well-being of economic abuse in Chinese population. This was a cross-sectional household survey with 504 Chinese adults in Hong Kong. It was found that unmarried individuals and individuals with tertiary education or above were at risk of economic abuse. Moreover, there were significant association between economic abuse experience and anxiety, depression, and psychosomatic symptoms. Resilience was the protective factor against anxiety, depression, and psychosomatic symptoms. The findings were discussed alongside with Chinese culture.

Mental Disorders Among Elderly People in Baghdad, Iraq, 2017

This study aimed to estimate the prevalence and determinants of mental disorders (MDs) among elderly people residing in nursing homes (NHs) and those living with their families (WF) in Baghdad, Iraq, 2017. A cross-sectional study was conducted on all elderly individuals residing in all NHs in Baghdad and an equal number of elderly people residing WF. MDs were defined based on Kessler Psychological Distress Scale (K10). We used relevant World Health Organization-accredited tools to identify the types of MDs. The prevalence of MDs among elderly people was 38.7%, being statistically significantly ( P < .01) higher among those in NH (55.8%) compared with those living WF (21.5%). The proportion of types of MDs among NH versus WF residents was as follows: depression (35.4% vs 16.6%), anxiety (32.6% vs 9.9%), dementia (19.3% vs 5%), and suicide thoughts (25.4% vs 4.4%). The multivariate analysis showed many factors that were associated with MD. Low income, dependency on others, and being neglected were stronger determinant of MD among elderly people living WF. However, chronic joint pain, visual impairment, auditory impairment, and economic status deterioration were stronger determinant among those in NHs. The prevalence of MDs in the NH is more than double the prevalence in the community. We recommended enhancing elderly mental health care services including curative, preventive, and promotive activities.

Domestic violence and suicide attempts among married women: A case-control study

AIMS AND OBJECTIVES

To investigate the impact of domestic violence-related factors on suicide attempt in married women.

BACKGROUND

Suicide is a global public health concern that poses significant burden on individuals, families and communities. There is limited research on factors predicting suicide attempt in women.

DESIGN

A retrospective case-control design was adopted.

METHODS

Using a convenience sampling method, 610 participants, admitted to a teaching referral hospital in Northwest of Iran, were recruited to the study and assigned to case or control groups based on whether or not they had attempted suicide. The participants in two groups were matched in the terms of important demographic characteristics. Domestic violence-related factors were considered as independent variables and suicide attempt as dependent variable. Descriptive statistics, and simple and multivariate logistic regression analysis were used to analyse the data. Odds ratios (OR) of domestic violence-related factors were compared between the groups. We used STROBE checklist as an EQUATOR in this study.

RESULTS

The mean age of participants in the case and control groups was 28.4 and 29.45 years, respectively. The infidelity was the strongest predictor of suicide attempt in women (OR 44.57, 95%CI 6.08-326. 63, p < 0.001), followed by being threatened to physical assault by husband (OR 37.01, 95%CI 11.54-118.67, p < 0.001), jealousy of husband (OR 23.46, 95%CI 11.63-47.30, p < 0.001), and previous attempts to divorce (OR 16.55, 95%CI 5.91-46.31, p < 0.001). Suicide attempt was significantly lower in women who reported a sense of peace in life or lived with their mother or father-in-law (p < 0.001).

CONCLUSIONS

To reduce the risk of suicide in women, violence against women should be condemned and appropriate prevention measures be taken by health professionals.

RELEVANCE TO CLINICAL PRACTICE

Recognising risk, assessment and referral of victims of domestic violence should be an integral part of healthcare systems.

Physical, Sexual, Emotional and Economic Intimate Partner Violence and Controlling Behaviors during Pregnancy and Postpartum among Women in Dar es Salaam, Tanzania

Background

Intimate partner violence (IPV) during pregnancy and postpartum is a serious global health problem affecting millions of women worldwide. This study sought to determine the prevalence of different forms of IPV during pregnancy and postpartum and associated factors among women in Dar es Salaam, Tanzania.

Methods

We conducted a cross-sectional study among 500 women at one to nine months postpartum in three health facilities in the three districts of Dar es Salaam: Temeke, Kinondoni and Illala. Two trained research assistants administered the questionnaire, which aimed to examine sociodemographic characteristics and different forms of IPV.

Results

Of the 500 women who were interviewed, 18.8% experienced some physical and/or sexual violence during pregnancy. Forty-one women (9%) reported having experienced some physical and/or sexual violence at one to nine months postpartum. Physical and/or sexual IPV during pregnancy was associated with cohabiting (AOR 2.2, 95% CI 1.24–4.03) and having a partner who was 25 years old or younger (AOR 2.7, 95% CI 1.08–6.71). Postpartum, physical and/or sexual IPV was associated with having a partner who was 25 years old or younger (AOR 4.4, 95% CI 1.24–15.6).

Conclusion

We found that IPV is more prevalent during pregnancy than during the postpartum phase. There is also continuity and maintenance of IPV during and after pregnancy. These results call for policy and interventions to be tailored for pregnant and postpartum women.

Husband/Partner Intoxication and Intimate Partner Violence Against Women in the Philippines

This study examined husband/partner intoxication and experience with physical, sexual, and emotional intimate partner violence against women (IPVAW) using data derived from a nationally representative survey conducted in the Philippines in 2013. Multivariate logistic regression analyses were used to examine the association between intoxication and 3 different types of intimate partner violence against women. Multinomial logistic regression was used to examine intoxication and severity of violence. In this sample, 28.8% of women reported experiencing any form of intimate partner violence and 92.9% of women reported their partner being intoxicated at least sometimes. Intoxication was significantly associated with all 3 types of intimate partner violence, while the odds of experiencing one form of IPVAW versus no form of IPVAW and 2 forms of IPVAW versus 1 form of IPVAW was greater among women reporting frequency of husband/partner intoxication as often.