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Bentley A, Riutort-Mayol G. The association between intimate partner violence type and mental health in migrant women living in Spain: findings from a cross-sectional study. Front Public Health 2023; 11:1307841. [PMID: 38145064 PMCID: PMC10740158 DOI: 10.3389/fpubh.2023.1307841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/21/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction The association between intimate partner violence (IPV) and mental health has been clearly established in the literature, however the differential associations between IPV type and mental health are less well understood, particularly in migrant groups who are at increased risk of both IPV and poor mental health. Under-studied and emerging forms of violence such as economic abuse and technology-facilitated abuse must be considered alongside more traditionally studied forms of IPV in order to fully understand the complex nature of violence. This study makes a novel contribution to the literature by assessing multiple forms of IPV including psychological, physical, sexual, economic and technology-facilitated IPV and their relationship with symptoms of depression and anxiety in migrant women, disaggregated by IPV type. Methods A cross-sectional survey of migrant women living in the Valencian Community of Spain was conducted, to assess experiences of IPV and symptoms of mental health. Regression analysis from the Bayesian perspective was performed. Results 1,998 women accessed the survey. They had an average age of 37, and came predominantly from Europe (49%), namely Western Europe, followed by Latin America (38%). The majority had been in Spain between 1 and 3 years, and 80% had resident status. A total of 1,156 responded to questions on violence and mental health. Results showed that the prevalence of IPV was high, with 59% of women reporting any experience of violence. Economic abuse was the most commonly reported form of violence, and showed the strongest relationship with symptoms of depression. Sexual violence was the strongest predictor of anxiety. In both cases, in the presence of violence, the odds of having more severe symptoms of depression and anxiety increases by over 2.25. Technology-facilitated abuse was as detrimental to women's mental health as face-to-face violence. Discussion The findings from the study are relevant to researchers, policy-makers and service providers. They highlight the complex nature of IPV experiences faced by migrant women and the importance of understanding how different types of IPV can impact migrant mental health, in order to ensure survivors receive adequate care.
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Affiliation(s)
- Abigail Bentley
- Instituto de Investigación en Políticas de Bienestar Social (Polibienestar), University of Valencia, Valencia, Spain
| | - Gabriel Riutort-Mayol
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
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Rothschild J, Haase E. Women's mental health and climate change Part II: Socioeconomic stresses of climate change and eco-anxiety for women and their children. Int J Gynaecol Obstet 2023; 160:414-420. [PMID: 36254375 DOI: 10.1002/ijgo.14514] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 10/04/2022] [Accepted: 10/13/2022] [Indexed: 01/20/2023]
Abstract
Climate change is a significant public health crisis that is both rooted in pre-existing inequitable socioeconomic and racial systems and will further worsen these social injustices. In the face of acute and slow-moving natural disasters, women, and particularly women of color, will be more susceptible to gender-based violence, displacement, and other socioeconomic stressors, all of which have adverse mental health outcomes. Among the social consequences of climate change, eco-anxiety resulting from these negative impacts is also increasingly a significant factor in family planning and reproductive justice, as well as disruptions of the feminine connection to nature that numerous cultures historically and currently honor. This narrative review will discuss these sociologic factors and also touch on ways that practitioners can become involved in climate-related advocacy for the physical and mental well-being of their patients.
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Affiliation(s)
- Julia Rothschild
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Elizabeth Haase
- Department of Psychiatry, Carson Tahoe Regional Medical Center, Nevada, Carson City, USA.,University of Nevada School of Medicine at Reno, Reno, Nevada, USA
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Zinyemba KG, Hlongwana K. Men's conceptualization of gender-based violence directed to women in Alexandra Township, Johannesburg, South Africa. BMC Public Health 2022; 22:2235. [PMID: 36451124 PMCID: PMC9713989 DOI: 10.1186/s12889-022-14616-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Gender-based violence (GBV) is a crucial global public health challenge disenfranchising women and girls from enjoying their fundamental human rights, thereby threatening their well-being. While the concept of GBV does not imply that violence is always unidirectional, literature shows that women and girls are the most common victims of this type of violence. One in three women, globally, have suffered physical or sexual violence by an intimate partner or non-partner. Evidence has shown that a number of women who experience GBV varies widely, with 37% being in Eastern Mediterranean, 37.7% in South-East Asia, 29.8% in America, 36.6% in Africa, 44% in sub-Saharan Africa (SSA) and 53% in South Africa. METHODS Using a semi-structured face-to-face interview with fifteen conveniently sampled adult males, who met the selection criteria, this study explored men's conceptualisation of GBV in Alexandra Township, using qualitative research methods. RESULTS Socio-economic factors and evolving cultural dynamics were perceived to be among the key factors aggravating gender-based violence. Participants viewed poverty and substance abuse as the main causes of violence towards women, a phenomenon tied to the growing frustration emanating from men's inability to provide for their families. Cultural factors related to the patriarchal system and diminishing value of respect between men and women were identified as root causes of GBV. The participants also blamed the government for what they considered to be "too many rights" for women, resulting in men exerting their authority through abuse. Participants also expressed concerns over feminisation of GBV, asserting that men fall prey to GBV too. Partner infidelity and insecurities also contributed to GBV. CONCLUSION The study results provided important insights on how men conceptualize GBV in Alexandra Township, South Africa. These results revealed that socio-economic conditions, alongside some gender stereotypes are pervasive and shape how men view GBV in Alexandra Township. This evidence is necessary for developing interventions aimed at curbing GBV and may also be suggestive of the need to redesign programmes targeting men, so that certain stereotypes can be uprooted.
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Affiliation(s)
- Kudakwashe Gracious Zinyemba
- grid.16463.360000 0001 0723 4123Discipline of Public Health Medicine, University of KwaZulu Natal, Durban, South Africa
| | - Khumbulani Hlongwana
- grid.16463.360000 0001 0723 4123Discipline of Public Health Medicine, University of KwaZulu Natal, Durban, South Africa ,grid.16463.360000 0001 0723 4123Cancer & Infectious Diseases Epidemiology Research Unit (CIDERU), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Rees S, Mohsin M, Moussa B, Fisher J, Steel Z, Nadar N, Hassoun F, Khalil B, Youssef M, Krishna Y. Cohort profile: intimate partner violence and mental health among women from refugee background and a comparison group of Australian-born - the WATCH cohort study. BMJ Open 2022; 12:e051887. [PMID: 35534066 PMCID: PMC9086637 DOI: 10.1136/bmjopen-2021-051887] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE The Women Aware with Their Children study was created because prospective data are required to accurately guide prevention programmes for intimate partner violence (IPV) and to improve the mental health and resettlement trajectories of women from refugee backgrounds in Australia. PARTICIPANTS 1335 women (685 consecutively enrolled from refugee backgrounds and 650 randomly selected Australian-born) recruited during pregnancy from three public antenatal clinics in Sydney and Melbourne, Australia. The mean age was 29.7 years among women from refugee backgrounds and 29.0 years among women born in the host nation. Main measures include IPV, mood, panic, post-traumatic stress disorder, disability and living difficulties. FINDINGS TO DATE Prevalence of IPV at all three time points is significantly higher for refugee-background women. The trend data showed that reported IPV rates among Australian-born women increased from 25.8% at time 1 to 30.1% at time 3, while for refugee-background women this rate declined from 44.4% at time 1 to 42.6% at time 3. Prevalence of major depressive disorder (MDD) at all three time points is higher for refugee-background women. MDD among Australian-born women significantly declined from 14.5% at time 1 to 9.9% at time 3, while for refugee-background women it fluctuated from 25.1% at time 1 to 17.3% at time 2 and to 19.1% at time 3. FUTURE PLANS We are currently examining trajectories of IPV and mental disorder across four time points. Time 4 occurred during the COVID-19 pandemic, enabling a unique opportunity to examine the impacts of the pandemic over time. Time 5 started in August 2021 and time 6 will begin approximately 12 months later. The children at time 5 are in the early school years, providing the capacity to examine behaviour, development and well-being of the index child.
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Affiliation(s)
- Susan Rees
- Discipline of Psychiatry, School of Clinical Medicine, Faculty of Medicine, University of New South Wales, Kensington Campus, Sydney, New South Wales, Australia
| | - Mohammed Mohsin
- Discipline of Psychiatry, School of Clinical Medicine, Faculty of Medicine, University of New South Wales, Kensington Campus, Sydney, New South Wales, Australia
- Mental Health Research Unit, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Batool Moussa
- Discipline of Psychiatry, School of Clinical Medicine, Faculty of Medicine, University of New South Wales, Kensington Campus, Sydney, New South Wales, Australia
| | - Jane Fisher
- Global and Women's Health Unit, Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Zachary Steel
- Discipline of Psychiatry, School of Clinical Medicine, Faculty of Medicine, University of New South Wales, Kensington Campus, Sydney, New South Wales, Australia
| | - Nawal Nadar
- Discipline of Psychiatry, School of Clinical Medicine, Faculty of Medicine, University of New South Wales, Kensington Campus, Sydney, New South Wales, Australia
| | - Fatima Hassoun
- Discipline of Psychiatry, School of Clinical Medicine, Faculty of Medicine, University of New South Wales, Kensington Campus, Sydney, New South Wales, Australia
| | - Batoul Khalil
- Discipline of Psychiatry, School of Clinical Medicine, Faculty of Medicine, University of New South Wales, Kensington Campus, Sydney, New South Wales, Australia
| | - Mariam Youssef
- Discipline of Psychiatry, School of Clinical Medicine, Faculty of Medicine, University of New South Wales, Kensington Campus, Sydney, New South Wales, Australia
| | - Yalini Krishna
- Discipline of Psychiatry, School of Clinical Medicine, Faculty of Medicine, University of New South Wales, Kensington Campus, Sydney, New South Wales, Australia
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St John L, Walmsley R. The Latest Treatment Interventions Improving Mental Health Outcomes for Women, Following Gender-Based Violence in Low-and-Middle-Income Countries: A Mini Review. Front Glob Womens Health 2022; 2:792399. [PMID: 34977864 PMCID: PMC8716596 DOI: 10.3389/fgwh.2021.792399] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
Gender-based violence (GBV), specifically violence against women, is a worldwide pandemic. Prevalence is further escalated in low-and-middle-income countries and in humanitarian crises. Survivors are left with a combination of post-traumatic stress disorder, depression and anxiety. These mental health disorders lead to further morbidity and mortality. Despite its high prevalence and co-morbidities, gender disparities and mental health stigma globally lead to few interventions developed for this population. The aim of this review is to highlight the mental health interventions developed in the past 5 years, for women following GBV in low-and-middle-income countries. It aims to discuss their efficacy and controversies when implemented into healthcare systems, understand the gaps that remain in the field and suggest future research developments. A thorough literature search revealed 16 new interventions available for improving mental health outcomes for women following GBV in low-and-middle-income countries. Following an in-depth evaluation of the papers, one intervention was successful in effectively implementing treatment into healthcare systems-"PM+." However, it proved only to be effective in the short term. Further research must be done for improving long-term mental health outcomes. Results demonstrated poor follow-up for women engaging in group therapy. The review also highlights community workers were used in service delivery to reduce barriers accessing care. No interventions proved effective in humanitarian crises, despite GBV escalated in these settings. There are very few interventions available in comparison to the prevalence of this global health issue. Therefore, this review encourages further research and improvements in mental healthcare interventions following GBV.
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Affiliation(s)
- Lily St John
- School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Rebecca Walmsley
- School of Medicine, University of St Andrews, Fife, United Kingdom
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Greene MC, Bencomo C, Rees S, Ventevogel P, Likindikoki S, Nemiro A, Bonz A, Mbwambo JKK, Tol WA, McGovern TM. Multilevel Determinants of Integrated Service Delivery for Intimate Partner Violence and Mental Health in Humanitarian Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12484. [PMID: 34886211 PMCID: PMC8656517 DOI: 10.3390/ijerph182312484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022]
Abstract
Inter-agency guidelines recommend that survivors of intimate partner violence in humanitarian settings receive multisectoral services consistent with a survivor-centered approach. Providing integrated services across sectors is challenging, and aspirations often fall short in practice. In this study, we explore factors that influence the implementation of a multisectoral, integrated intervention intended to reduce psychological distress and intimate partner violence in Nyarugusu Refugee Camp, Tanzania. We analyzed data from a desk review of donor, legal, and policy documents; a gender-based violence services mapping conducted through 15 interviews and 6 focus group discussions; and a qualitative process evaluation with 29 stakeholders involved in the implementation of the integrated psychosocial program. We identified the challenges of implementing a multisectoral, integrated intervention for refugee survivors of intimate partner violence at the structural, inter-institutional, intra-institutional, and in social and interpersonal levels. Key determinants of successful implementation included the legal context, financing, inter-agency coordination, engagement and ownership, and the ability to manage competing priorities. Implementing a multisectoral, integrated response for survivors of intimate partner violence is complex and influenced by interrelated factors from policy and financing to institutional and stakeholder engagement. Further investment in identifying strategies to overcome the existing challenges of implementing multisectoral approaches that align with global guidelines is needed to effectively address the burden of intimate partner violence in humanitarian settings.
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Affiliation(s)
- M. Claire Greene
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY 10032, USA; (M.C.G.); (C.B.)
| | - Clarisa Bencomo
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY 10032, USA; (M.C.G.); (C.B.)
| | - Susan Rees
- School of Psychiatry, University of New South Wales, Sydney, NSW 2033, Australia;
| | - Peter Ventevogel
- Public Health Section, United Nations High Commissioner for Refugees (UNHCR), Rue de Montbrillant 94, 1201 Geneva, Switzerland;
| | - Samuel Likindikoki
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, United Nations Road, Dar es Salaam P.O. Box 65001, Tanzania; (S.L.); (J.K.K.M.)
| | - Ashley Nemiro
- The MHPSS Collaborative, Rosenørns Allé 12, 1634 Copenhagen, Denmark;
| | | | - Jessie K. K. Mbwambo
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, United Nations Road, Dar es Salaam P.O. Box 65001, Tanzania; (S.L.); (J.K.K.M.)
| | - Wietse A. Tol
- Department of Public Health, Global Health Section, University of Copenhagen, Nørregade 10, 1165 Copenhagen, Denmark;
| | - Terry M. McGovern
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY 10032, USA; (M.C.G.); (C.B.)
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Bezerra HDS, Alves RM, Nunes ADD, Barbosa IR. Prevalence and Associated Factors of Common Mental Disorders in Women: A Systematic Review. Public Health Rev 2021; 42:1604234. [PMID: 34692182 PMCID: PMC8419231 DOI: 10.3389/phrs.2021.1604234] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/06/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives: To identify the prevalence and factors associated with common mental disorders in adult women. Methods: Searches were carried out in the PubMed, Web of Science, Science Direct, Scopus, Cinahl, Google Scholar and Open Gray databases. The study protocol was registered with PROSPERO under number CRD42020168231. Cross-sectional studies showing the prevalence of common mental disorders in women over 18 years were included. Studies with men, children and pregnant women of another age group and with other mental disorders and other types of studies were excluded. The Joanna Briggs Institute checklist was used to assess the risk of bias. Results: Nineteen studies were included in this review. The prevalence of CMD ranged from 9.6% to 69.3%. The main associated factors were unemployment, indebtedness, low income, being a housewife, smoking, low education, poor self-rated health, being single, divorced or widowed. The risk of bias in the studies was classified as low and moderate. Conclusion: This review revealed a variable prevalence rate of CMD in adult women. Public policies are needed to create strategies to prevent the mental illness of these women.
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Talevi D, Collazzoni A, Rossi A, Stratta P, Mazza M, Pacitti F, Costa M, Crescini C, Rossi R. Cues for different diagnostic patterns of interpersonal violence in a psychiatric sample: an observational study. BMC Psychiatry 2020; 20:196. [PMID: 32357860 PMCID: PMC7193401 DOI: 10.1186/s12888-020-02594-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 04/12/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Interpersonal violence has increased as a health concern, especially in psychiatry practice, over the last decades. Nevertheless, most patients with stable mental disorders do not present an increased risk of violence, and mental disorder is not a necessary or sufficient cause of violent behaviours. People with mental disorders endorse more often a number of risk factors for violence that could confound this association, such as young age and male gender. The aim of this study was to investigate the effect of age, gender, and diagnosis on reported levels of interpersonal violence in a sample of people with severe mental illness. METHODS The sample was composed of 160 inpatients: 73 with a psychosis within the schizophrenia spectrum, 53 with a mood disorder and 34 with a personality disorder. All patients enrolled in the study were assessed for experiences of victimization and perpetration of interpersonal violence using the Karolinska Interpersonal Violence Scale interview. Demographic variables were also collected. RESULTS Both violence perpetration and victimization negatively correlated with age. Compared to males, females were exposed to higher degree of victimization in childhood and adulthood, whereas males were more involved in the perpetration of violence in childhood. Personality disorders were associated with higher levels of interpersonal violence, both perpetration and victimization; an interaction effect of gender and diagnosis was also observed for violence perpetration in adulthood. Distinct patterns of interpersonal violence did emerge for the diagnostic groups with mood disorder showing a victimization pattern, personality disorders a perpetration pattern and psychoses less defined patterns. CONCLUSIONS The main finding is that psychotic disorders, mood disorders and personality disorders have different patterns of violent experiences interacting with age and gender. This study offers a better understanding of how gender and age could affect violent behaviours. Moreover, study findings may increase the comprehension of the reason why some mental disorders, compared to others, are more associated with the risk of victimization or perpetration of violence. These patterns could have pathophysiological or pathoplastic meaning addressing clinical and diagnostic trajectories and they could interact with other intervening risk factors.
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Affiliation(s)
- Dalila Talevi
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy.
| | - Alberto Collazzoni
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Paolo Stratta
- Department of Mental Health, ASL 1 Avezzano Sulmona L'Aquila, L'Aquila, Italy
| | - Monica Mazza
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Francesca Pacitti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Manuela Costa
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Claudio Crescini
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy
| | - Rodolfo Rossi
- Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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Greene MC, Rees S, Likindikoki S, Bonz AG, Joscelyne A, Kaysen D, Nixon RDV, Njau T, Tankink MTA, Tiwari A, Ventevogel P, Mbwambo JKK, Tol WA. Developing an integrated intervention to address intimate partner violence and psychological distress in Congolese refugee women in Tanzania. Confl Health 2019; 13:38. [PMID: 31428190 PMCID: PMC6697920 DOI: 10.1186/s13031-019-0222-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 08/05/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Multi-sectoral, integrated interventions have long been recommended for addressing mental health and its social determinants (e.g., gender-based violence) in settings of ongoing adversity. We developed an integrated health and protection intervention to reduce psychological distress and intimate partner violence (IPV), and tested its delivery by lay facilitators in a low-resource refugee setting. METHODS Formative research to develop the intervention consisted of a structured desk review, consultation with experts and local stakeholders (refugee incentive workers, representatives of humanitarian agencies, and clinical experts), and qualitative interviews (40 free list interviews with refugees, 15 key informant interviews). Given existing efforts by humanitarian agencies to prevent gender-based violence in this particular refugee camp, including with (potential) perpetrators, we focused on a complementary effort to develop an integrated intervention with potential to reduce IPV and associated mental health impacts with female IPV survivors. We enrolled Congolese refugee women with elevated psychological distress and past-year histories of IPV (n = 60) who received the intervention delivered by trained and supervised lay refugee facilitators. Relevance, feasibility and acceptability of the intervention were evaluated through quantitative and qualitative interviews with participants. We assessed instrument test-retest reliability (n = 24), inter-rater reliability (n = 5 interviews), internal consistency, and construct validity (n = 60). RESULTS We designed an 8-session intervention, termed Nguvu ('strength'), incorporating brief Cognitive Processing Therapy (focused on helping clients obtaining skills to overcome negative thoughts and self-perceptions and gain control over the impact these have on their lives) and Advocacy Counseling (focused on increasing autonomy, empowerment and strengthening linkages to community supports). On average, participants attended two-thirds of the sessions. In qualitative interviews, participants recommended adaptations to specific intervention components and provided recommendations regarding coordination, retention, safety concerns and intervention participation incentives. Analysis of the performance of outcome instruments overall revealed acceptable reliability and validity. CONCLUSIONS We found it feasible to develop and implement an integrated, multi-sectoral mental health and IPV intervention in a refugee camp setting. Implementation challenges were identified and may be informative for future implementation and evaluation of multi-sectoral strategies for populations facing ongoing adversity. TRIAL REGISTRATION ISRCTN65771265, June 27, 2016.
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Affiliation(s)
- M. Claire Greene
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
- Department of Psychiatry, Columbia University Medical Center & New York State Psychiatric Institute, 40 Haven Avenue, Rm. 171, New York, NY 10005 USA
| | - Susan Rees
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, Sydney, NSW Australia
| | - Samuel Likindikoki
- Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ann G. Bonz
- HIAS, Silver Spring, MD USA
- International Rescue Committee, New York, NY USA
| | - Amy Joscelyne
- Program for Survivors of Torture, Bellevue Hospital/New York University School of Medicine, New York, NY USA
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA
| | | | - Tasiana Njau
- Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Marian T. A. Tankink
- Consultant Anthropological Research & Training on Gender, Violence and Health, Amsterdam, the Netherlands
| | - Agnes Tiwari
- School of Nursing, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Peter Ventevogel
- Public Health Section, United Nations High Commissioner for Refugees, Geneva, Switzerland
| | - Jessie K. K. Mbwambo
- Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Wietse A. Tol
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
- Peter C. Alderman Foundation, HealthRight International, New York, NY USA
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Rees S, Simpson L, McCormack CA, Moussa B, Amanatidis S. Believe #metoo: sexual violence and interpersonal disclosure experiences among women attending a sexual assault service in Australia: a mixed-methods study. BMJ Open 2019; 9:e026773. [PMID: 31366639 PMCID: PMC6677975 DOI: 10.1136/bmjopen-2018-026773] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 06/26/2019] [Accepted: 07/04/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Sexual abuse is a strong predictor of future psychiatric problems. A more nuanced qualitative understanding of mental health outcomes, in the context of interpersonal responses from family members towards survivors after sexual abuse, may help to better inform prevention and interventions. DESIGN A mixed-methods approach included a qualitative timeline method to map and identify contextual factors and mediating emotional responses associated with mental disorder following sexual abuse. SETTING Participants were adult survivors of sexual abuse, seeking support from the Sexual Assault Counselling Service, Sydney Local Health District, Australia. PARTICIPANTS Thirty women 18 years and older with current or past mental disorder or symptoms were interviewed between August 2015 and May 2016. OUTCOME MEASURES A qualitative timeline interview and the Mini-International Neuropsychiatric Interview (MINI, 5.5.0) were applied. RESULTS The MINI prevalence of current post-traumatic stress disorder was 96.6% (n=28) and of major depressive disorder was 82.8% (n=24). More than half (53%) reported suicidal ideation at some time in their lives. Women exposed to childhood sexual abuse reported being ignored, not believed, or threatened with retribution on disclosing the abuse to others, usually adult family members, at or close to the time of the violation(s). Participants described experiences of self-blame, betrayal, and psychosocial vulnerability as being the responses that connected negative disclosure experiences with mental disorder. Participant accounts suggest that these reactions created the foundations for both immediate and long-term adverse psychological outcomes. CONCLUSION A more in-depth understanding of the type and emotional impact of negative responses to disclosure by parents and other family members, and the barriers to adequate support, validation and trust, may inform strategies to avert much of the longer-term emotional difficulties and risks that survivors encounter following childhood abuse experiences. These issues should receive closer attention in research, policy, and practice.
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Affiliation(s)
- Susan Rees
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Lisa Simpson
- Community Health, Sydney Local Area Health District, Sydney, New South Wales, Australia
| | - Clare A McCormack
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Batool Moussa
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Sue Amanatidis
- Community Health, Sydney Local Area Health District, Sydney, New South Wales, Australia
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11
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Matos M, Gonçalves M. Sleep and women intimate partner victimization: prevalence, effects and good practices in health care settings. ACTA ACUST UNITED AC 2019; 12:35-42. [PMID: 31105893 PMCID: PMC6508940 DOI: 10.5935/1984-0063.20190057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Intimate Partner Violence is a global health issue with higher prevalence
worldwide, mostly in women, higher social and economic costs and devastating
physical and mental health consequences for the victims. Sleep disturbances has
been associated with other mental health issues, being an important symptom when
diagnosing post-traumatic stress disorder, depression or anxiety. It can also
constitute an important sign to help health professionals to identify potential
victims of intimate partner violence. This review paper main objectives are to
address the connection between intimate partner violence and sleep disruption,
the role and barriers of health professionals in screening this type of violence
when sleep problems are present, and to describe good practices in order to
identify these victims and to provide support. It has been found that intimate
partner victims commonly experience significant sleep disturbances that include
truncated sleep, nightmares and less restful sleep. Health professionals are
first-line professionals with a pivot role to screen and identify women victims.
However, a set of personal (e.g., lack of knowledge and inadequate perceptions
about violence, cultural issues) and organizational barriers (e.g., time
constraints, lack of training, absence of institutional protocols) may limit the
accurate reading of those symptoms. Accordingly, health professionals must be
alert not only to physical health conditions associated with violence (acute
physical injuries, chronic physical injuries, obstetric and genital injuries),
but also psychological problems, like depression, anxiety, post-traumatic stress
disorder, alcohol or drug misuse, sleep disturbances, insomnia and nightmares.
In the presence of alert symptoms related to violence, health professionals
become able to screen, identify and provide ongoing care for women, promoting a
trusting relationship and assuming an attentive non-judgmental listening.
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Affiliation(s)
- Marlene Matos
- Assistant Professor, PhD, Psychology Research Center, School of Psychology, University of Minho, Braga, Portugal
| | - Mariana Gonçalves
- Researcher, PhD, Psychology Research Center, School of Psychology, University of Minho, Braga, Portugal
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12
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Usuda K, Nishi D, Makino M, Tachimori H, Matsuoka Y, Sano Y, Konishi T, Takeshima T. Prevalence and related factors of common mental disorders during pregnancy in Japan: a cross-sectional study. Biopsychosoc Med 2016; 10:17. [PMID: 27213012 PMCID: PMC4874014 DOI: 10.1186/s13030-016-0069-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 05/02/2016] [Indexed: 11/10/2022] Open
Abstract
Background Common mental disorders (CMD) during pregnancy can have a clearly harmful influence on both mothers and children. Some studies have reported related factors for mental disorders, such as region-specific background. This study examined the prevalence of CMD and its related factors in mid-pregnancy in Japan. Methods Pregnant women between 12 and 24 weeks gestation and aged ≥20 years were consecutively recruited at a maternity hospital in Japan between May 2014 and September 2014. CMD were diagnosed using the Mini-International Neuropsychiatric Interview (MINI), self-rated depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale, and interpersonal traumatic experience was measured using the Life Events Checklist. Results Among 297 eligible pregnant women, 177 participated in the study. Two participants (1.1 %) met the criteria for major depressive disorder. The most frequent diagnosis was agoraphobia (n = 7; 3.9 %). Eleven participants (6.2 %) met the criteria for one or more diagnoses, with 2 participants having two mental disorders and 3 having three mental disorders. Six participants developed CMD after gestation. Logistic regression analysis revealed history of psychiatric disorder, past interpersonal traumatic experience, and feeling pressure to have a child were associated with CMD. Conclusion These findings indicate a lower prevalence of CMD in mid-pregnancy in Japan than reported in most other countries. Besides the related factors reported previously, feeling pressure to have a child might increase risk for CMD among pregnant women in Japan. Asian cultural background might be related to the lower CMD prevalence and risk factors identified in this study.
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Affiliation(s)
- Kentaro Usuda
- Toda Chuo Women's Hospital, 2-26-3 Kamitoda, Toda, Saitama 335-0022 Japan ; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023 Japan ; Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553 Japan
| | - Daisuke Nishi
- Toda Chuo Women's Hospital, 2-26-3 Kamitoda, Toda, Saitama 335-0022 Japan ; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023 Japan ; Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553 Japan
| | - Miyuki Makino
- Toda Chuo Women's Hospital, 2-26-3 Kamitoda, Toda, Saitama 335-0022 Japan ; National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553 Japan
| | - Hisateru Tachimori
- Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553 Japan
| | - Yutaka Matsuoka
- Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukizi, Chuo-ku, Tokyo, 104-0045 Japan
| | - Yo Sano
- Toda Chuo Women's Hospital, 2-26-3 Kamitoda, Toda, Saitama 335-0022 Japan
| | - Takako Konishi
- Musashino University, 3-3-3 Ariake, Koto-ku, Tokyo, 135-8181 Japan
| | - Tadashi Takeshima
- Health and Social Welfare Bureau, Kawasaki City Office, 3-16-1 Ida, Nakahara-ku, Kawasaki, Kanagawa 211-0035 Japan
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Onu C, Ongeri L, Bukusi E, Cohen CR, Neylan TC, Oyaro P, Rota G, Otewa F, Delucchi KL, Meffert SM. Interpersonal psychotherapy for depression and posttraumatic stress disorder among HIV-positive women in Kisumu, Kenya: study protocol for a randomized controlled trial. Trials 2016; 17:64. [PMID: 26841875 PMCID: PMC4738764 DOI: 10.1186/s13063-016-1187-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 01/20/2016] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Mental disorders are the leading global cause of years lived with disability; the majority of this burden exists in low and middle income countries (LMICs). Over half of mental illness is attributable to depression and anxiety disorders, both of which have known treatments. While the scarcity of mental health care providers is recognized as a major contributor to the magnitude of untreated disorders in LMICs, studies in LMICs find that evidence-based treatments for depression and anxiety disorders, such as brief, structured psychotherapies, are feasible, acceptable and have strong efficacy when delivered by local non-specialist personnel. However, most mental health treatment studies using non-specialist providers in LMICs deploy traditional efficacy designs (T1) without the benefit of integrated mental health treatment models shown to succeed over vertical interventions or methods derived from new implementation science to speed policy change. Here, we describe an effectiveness-implementation hybrid study that evaluates non-specialist delivery of mental health treatment within an HIV clinic for HIV-positive (HIV+) women affected by gender- based violence (GBV) (HIV+ GBV+) in the Nyanza region of Kenya. METHODS/DESIGN In this effectiveness-implementation hybrid type I design, 200 HIV+ women with major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) who are receiving care at a Family AIDS Care Education and Services (FACES)-supported clinic in Kisumu, Kenya will be randomized to: (1) interpersonal psychotherapy (IPT) + treatment as usual (TAU) or (2) TAU, both delivered within the HIV clinic. IPT will consist of 12 weekly 60-minute individual IPT sessions, delivered by non-specialists trained to provide IPT. Primary effectiveness outcomes will include MDD and PTSD diagnosis on the Mini International Diagnostic Interview (MINI). Primary implementation outcomes will include treatment cost-benefit, acceptability, appropriateness, feasibility and fidelity of the IPT delivery within an HIV clinic. DISCUSSION This trial leverages newly defined effectiveness-implementation hybrid designs to gather data on mental health treatment implementation within an HIV care clinic, while testing the effectiveness of an evidence-based treatment for use with a large underserved population (HIV+ GBV+ women) in Kenya. TRIAL REGISTRATION CLINICAL TRIALS IDENTIFIER NCT02320799, registered on 9 September 2014.
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Affiliation(s)
- Chinwe Onu
- School of Medicine, University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA, 94121, USA.
| | - Linnet Ongeri
- Kenya Medical Research Institute, PO Box 54840, 00200, Nairobi, Kenya.
| | - Elizabeth Bukusi
- Department of Psychiatry, University of Nairobi, Kenya, PO Box 19676, Nairobi, Kenya.
- Department of Obstetrics and Gynecology, University of Nairobi, Kenya, PO Box 19676, Nairobi, Kenya.
| | - Craig R Cohen
- Department of Obstetrics and Gynecology, University of California, San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.
| | - Thomas C Neylan
- Department of Psychiatry, University of California, San Francisco, 4150 Clement Street, San Francisco, CA, 94121, USA.
| | - Patrick Oyaro
- Family AIDS Care Education and Services, Kenya, PO Box 614-40100, Kisumu, Kenya.
| | - Grace Rota
- Family AIDS Care Education and Services, Kenya, PO Box 614-40100, Kisumu, Kenya.
| | - Faith Otewa
- Family AIDS Care Education and Services, Kenya, PO Box 614-40100, Kisumu, Kenya.
| | - Kevin L Delucchi
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus avenue, San Francisco, CA, 94143, USA.
| | - Susan M Meffert
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus avenue, San Francisco, CA, 94143, USA.
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Tsai AC, Tomlinson M, Comulada WS, Rotheram-Borus MJ. Food insufficiency, depression, and the modifying role of social support: Evidence from a population-based, prospective cohort of pregnant women in peri-urban South Africa. Soc Sci Med 2016; 151:69-77. [PMID: 26773296 DOI: 10.1016/j.socscimed.2015.12.042] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 11/03/2015] [Accepted: 12/28/2015] [Indexed: 02/06/2023]
Abstract
RATIONALE Food insecurity has emerged as an important, and potentially modifiable, risk factor for depression. Few studies have brought longitudinal data to bear on investigating this association in sub-Saharan Africa. OBJECTIVE To estimate the association between food insufficiency and depression symptom severity, and to determine the extent to which any observed associations were modified by social support. METHODS AND RESULTS We conducted a secondary analysis of population-based, longitudinal data collected from 1238 pregnant women during a three-year cluster-randomized trial of a home visiting intervention in Cape Town, South Africa. Surveys were conducted at baseline, 6 months, 18 months, and 36 months (85% retention). A validated, single-item food insufficiency measure inquired about the number of days of hunger in the past week. Depression symptom severity was measured using the Xhosa version of the 10-item Edinburgh Postnatal Depression Scale. In multivariable regression models with cluster-correlated robust estimates of variance, lagged food insufficiency had a strong and statistically significant association with depression symptom severity (β = 0.70; 95% CI, 0.46-0.94), suggesting a 6.5% relative difference in depression symptom severity per day of hunger. In stratified analyses, food insufficiency had a statistically significant association with depression only among women with low levels of instrumental support. Using quantile regression, we found that the adverse impacts of food insufficiency were experienced to a greater degree by women in the upper end of the conditional distribution of depression symptom severity. Estimates from fixed-effects regression models and fixed-effects quantile regression models, accounting for unobserved confounding by time-invariant characteristics, were similar. CONCLUSIONS Food insufficiency was associated with depression symptom severity, particularly for women in the upper end of the conditional depression distribution. Instrumental social support buffered women against the adverse impacts of food insufficiency.
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Affiliation(s)
- Alexander C Tsai
- Massachusetts General Hospital, MGH Global Health, Boston, USA; Harvard Center for Population and Development Studies, Cambridge, USA; Mbarara University of Science and Technology, Mbarara, Uganda.
| | | | - W Scott Comulada
- Center for HIV Identification, Prevention and Treatment Services, University of California at Los Angeles, Los Angeles, USA; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, USA
| | - Mary Jane Rotheram-Borus
- Center for HIV Identification, Prevention and Treatment Services, University of California at Los Angeles, Los Angeles, USA; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, USA
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15
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Tsai AC, Tomlinson M, Comulada WS, Rotheram-Borus MJ. Intimate Partner Violence and Depression Symptom Severity among South African Women during Pregnancy and Postpartum: Population-Based Prospective Cohort Study. PLoS Med 2016; 13:e1001943. [PMID: 26784110 PMCID: PMC4718639 DOI: 10.1371/journal.pmed.1001943] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 12/10/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Violence against women by intimate partners remains unacceptably common worldwide. The evidence base for the assumed psychological impacts of intimate partner violence (IPV) is derived primarily from studies conducted in high-income countries. A recently published systematic review identified 13 studies linking IPV to incident depression, none of which were conducted in sub-Saharan Africa. To address this gap in the literature, we analyzed longitudinal data collected during the course of a 3-y cluster-randomized trial with the aim of estimating the association between IPV and depression symptom severity. METHODS AND FINDINGS We conducted a secondary analysis of population-based, longitudinal data collected from 1,238 pregnant women during a 3-y cluster-randomized trial of a home visiting intervention in Cape Town, South Africa. Surveys were conducted at baseline, 6 mo, 18 mo, and 36 mo (85% retention). The primary explanatory variable of interest was exposure to four types of physical IPV in the past year. Depression symptom severity was measured using the Xhosa version of the ten-item Edinburgh Postnatal Depression Scale. In a pooled cross-sectional multivariable regression model adjusting for potentially confounding time-fixed and time-varying covariates, lagged IPV intensity had a statistically significant association with depression symptom severity (regression coefficient b = 1.04; 95% CI, 0.61-1.47), with estimates from a quantile regression model showing greater adverse impacts at the upper end of the conditional depression distribution. Fitting a fixed effects regression model accounting for all time-invariant confounding (e.g., history of childhood sexual abuse) yielded similar findings (b = 1.54; 95% CI, 1.13-1.96). The magnitudes of the coefficients indicated that a one-standard-deviation increase in IPV intensity was associated with a 12.3% relative increase in depression symptom severity over the same time period. The most important limitations of our study include exposure assessment that lacked measurement of sexual violence, which could have caused us to underestimate the severity of exposure; the extended latency period in the lagged analysis, which could have caused us to underestimate the strength of the association; and outcome assessment that was limited to the use of a screening instrument for depression symptom severity. CONCLUSIONS In this secondary analysis of data from a population-based, 3-y cluster-randomized controlled trial, IPV had a statistically significant association with depression symptom severity. The estimated associations were relatively large in magnitude, consistent with findings from high-income countries, and robust to potential confounding by time-invariant factors. Intensive health sector responses to reduce IPV and improve women's mental health should be explored.
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Affiliation(s)
- Alexander C. Tsai
- Massachusetts General Hospital, MGH Global Health, Boston, Massachusetts, United States of America
- Harvard Center for Population and Development Studies, Cambridge, Massachusetts, United States of America
- Mbarara University of Science and Technology, Mbarara, Uganda
- * E-mail:
| | | | - W. Scott Comulada
- Center for HIV Identification, Prevention and Treatment Services, University of California at Los Angeles, Los Angeles, California, United States of America
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California, United States of America
| | - Mary Jane Rotheram-Borus
- Center for HIV Identification, Prevention and Treatment Services, University of California at Los Angeles, Los Angeles, California, United States of America
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California, United States of America
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Walsh K, Keyes KM, Koenen KC, Hasin D. Lifetime prevalence of gender-based violence in US women: associations with mood/anxiety and substance use disorders. J Psychiatr Res 2015; 62:7-13. [PMID: 25648384 PMCID: PMC4386280 DOI: 10.1016/j.jpsychires.2015.01.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 01/05/2015] [Accepted: 01/08/2015] [Indexed: 10/24/2022]
Abstract
No population-representative US study has examined how lifetime exposure to gender-based violence (GBV) is related to a broad range of mood/anxiety and substance use disorders. The current study advances the literature by examining the relative contributions of developmental timing of earliest GBV exposure and amount of lifetime GBV exposure on risk for eight mood/anxiety and ten substance use disorders. Participants were 20,089 women from wave 2 (2004-2005) of the National Epidemiologic Survey of Alcohol and Related Conditions. Women reporting lifetime GBV (25%; n = 5284) had 3.6 and 2.5 times the odds of meeting lifetime mood/anxiety and substance use disorder criteria, respectively. Number of types and number of incidents of GBV were associated with risk for both types of disorders in a dose-response fashion; when examined simultaneously, number of types of GBV was the stronger predictor of mood/anxiety and substance use disorders. Relative to those who first experienced GBV during adulthood, first exposure during childhood and adolescence was associated with increased risk for mood/anxiety and substance use disorders. One in four women reported lifetime GBV, which had pernicious effects on mood/anxiety and substance use disorders, particularly for women who had experienced multiple types of GBV. The GBV effect varied by developmental period of exposure. Prevention of GBV is critical to reducing its burden. Among those exposed to GBV, clinicians should consider assessing a range of disorders and providing integrated treatment targeting multiple outcomes.
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Affiliation(s)
- Kate Walsh
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 520, New York, NY 10032, USA.
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 520, New York, NY 10032, USA
| | - Karestan C. Koenen
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 520, New York, NY 10032, USA
| | - Deborah Hasin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 520, New York, NY 10032, USA,Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA,New York State Psychiatric Institute, New York, NY 10032, USA
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