Ellsberg M, Jansen HA, Heise L, Watts CH, García-Moreno C, WHO Multi-country Study, Women's Health and Domestic Violence against Women Study Team. Intimate partner violence and women's physical and mental health in the WHO multi-country study on women's health and domestic violence: an observational study

PATH, Washington, DC, USA.
The Lancet (Impact Factor: 45.22). 05/2008; 371(9619):1165-72. DOI: 10.1016/S0140-6736(08)60522-X
Source: PubMed

ABSTRACT This article summarises findings from ten countries from the WHO multi-country study on women's health and domestic violence against women.
Standardised population-based surveys were done between 2000 and 2003. Women aged 15-49 years were interviewed about their experiences of physically and sexually violent acts by a current or former intimate male partner, and about selected symptoms associated with physical and mental health. The women reporting physical violence by a partner were asked about injuries that resulted from this type of violence.
24,097 women completed interviews. Pooled analysis of all sites found significant associations between lifetime experiences of partner violence and self-reported poor health (odds ratio 1.6 [95% CI 1.5-1.8]), and with specific health problems in the previous 4 weeks: difficulty walking (1.6 [1.5-1.8]), difficulty with daily activities (1.6 [1.5-1.8]), pain (1.6 [1.5-1.7]), memory loss (1.8 [1.6-2.0]), dizziness (1.7 [1.6-1.8]), and vaginal discharge (1.8 [1.7-2.0]). For all settings combined, women who reported partner violence at least once in their life reported significantly more emotional distress, suicidal thoughts (2.9 [2.7-3.2]), and suicidal attempts (3.8 [3.3-4.5]), than non-abused women. These significant associations were maintained in almost all of the sites. Between 19% and 55% of women who had ever been physically abused by their partner were ever injured.
In addition to being a breach of human rights, intimate partner violence is associated with serious public-health consequences that should be addressed in national and global health policies and programmes.

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Available from: Mary Ellsberg, Nov 25, 2014
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    • "Previous studies have found reproductive coercion to be associated with poor reproductive health outcomes and childlessness [2] [6]. Although the links between reproductive coercion and mental health have not been assessed, poor mental health resulting from IPV has been documented to be of great concern [9] [10]. For example, a nationally representative survey of more than 4000 South African adults found that women who experienced physical IPV were more than three times as likely to have been diagnosed with post-traumatic stress disorder (PTSD) during their lifetime compared with women without this exposure [11]. "
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    ABSTRACT: Objective : To assess the independent associations of partner-perpetrated reproductive coercion, intimate partner violence (IPV), in-law reproductive coercion, and in-law abuse with recent probable post-traumatic stress disorder (PTSD), and to test their relationship with PTSD symptoms when controlling for the other types of abuse among partnered women in rural Côte d’Ivoire. Methods : Cross-sectional analyses were conducted using logistic generalized estimating equations, which accounted for village-level clustering. Data were drawn from baseline data from a randomized controlled trial among 24 villages in rural Côte d’Ivoire (n = 953 partnered women). Three adjusted models were used to test associations of reproductive coercion and abuse with probable PTSD. Results : Partner-perpetrated reproductive coercion was experienced by 176 (18.5%) women. In model 3, which accounted for the co-occurrence of abuses, partner-perpetrated reproductive coercion (odds ratio [OR] 2.3; 95% confidence interval [CI], 1.4–3.9) and partner-perpetrated IPV (OR 1.7; 95% CI, 1.1–2.7) were the most significant predictors of past-week probable PTSD (P < 0.05). Conclusion : Reproductive coercion may be a significant contributor to poor mental health. The mental health impacts of reproductive coercion and IPV should be considered within psychosocial programming for rural Ivorian communities to address the full range of traumatic experiences that may have been experienced by women.
    International Journal of Gynecology & Obstetrics 10/2014; 127(1). DOI:10.1016/j.ijgo.2014.04.011 · 1.56 Impact Factor
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    • "In the general population, domestic and sexual violence are a public health priority due to their significant morbidity and mortality; including injuries, chronic physical illness, poor sexual health, adverse perinatal outcomes, substance misuse, mental illness and suicidal behaviour (Ellsberg et al. 2008; Devries et al. 2013; WHO, 2013a). There is some evidence that the health burden is even greater among those with pre-existing disability (Khalifeh et al. 2013), but the health burden among people with SMI is unknown. "
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    ABSTRACT: Background Domestic and sexual violence are significant public health problems but little is known about the extent to which men and women with severe mental illness (SMI) are at risk compared with the general population. We aimed to compare the prevalence and impact of violence against SMI patients and the general population.Method Three hundred and three randomly recruited psychiatric patients, in contact with community services for ≥1 year, were interviewed using the British Crime Survey domestic/sexual violence questionnaire. Prevalence and correlates of violence in this sample were compared with those from 22 606 general population controls participating in the contemporaneous 2011/12 national crime survey.Results Past-year domestic violence was reported by 27% v. 9% of SMI and control women, respectively [odds ratio (OR) adjusted for socio-demographics, aOR 2.7, 95% confidence interval (CI) 1.7-4.0], and by 13% v. 5% of SMI and control men, respectively (aOR 1.6, 95% CI 1.0-2.8). Past-year sexual violence was reported by 10% v. 2.0% of SMI and control women respectively (aOR 2.9, 95% CI 1.4-5.8). Family (non-partner) violence comprised a greater proportion of overall domestic violence among SMI than control victims (63% v. 35%, p < 0.01). Adulthood serious sexual assault led to attempted suicide more often among SMI than control female victims (53% v. 3.4%, p < 0.001).Conclusions Compared to the general population, patients with SMI are at substantially increased risk of domestic and sexual violence, with a relative excess of family violence and adverse health impact following victimization. Psychiatric services, and public health and criminal justice policies, need to address domestic and sexual violence in this at-risk group.
    Psychological Medicine 09/2014; 45(04):1-12. DOI:10.1017/S0033291714001962 · 5.43 Impact Factor
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    • "Health problems associated with IPV include digestive problems, eating disorders, abdominal pain, bladder and kidney infections, vaginal infections and bleeding, pelvic pain, headaches, fainting, seizures, chronic neck and back pain, and hypertension (Campbell, 2002; Ellsberg et al., 2008). Lifetime experiences of partner violence is significantly associated with self-reported poor health, specific health problems in the previous four weeks, difficulty walking, difficulty with daily activities, memory loss, emotional distress, suicidal thoughts, and suicidal attempts (Ellsberg et al., 2008). Children are hurt when they witness abuse, and may experience it themselves from the same perpetrator, and children in abusive households may became abusers themselves (Langhinrichsen- Rohling, 2005). "
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    ABSTRACT: Intimate Partner Violence (IPV) is a global public health problem. IPV prevalence in Indonesia has been estimated to be less than 1%, based on reported cases. It is likely that IPV prevalence is underreported in Indonesia, as it is in many other countries. Screening for IPV has been found to increase IPV identification, but no screening tools are in use in Indonesia. The aim of this study was to test the translated Woman Abuse Screening Tool (WAST) for detecting IPV in Indonesia. The WAST was tested against a diagnostic interview by a trained psychologist on 240 women attending two Primary Health Centers in Jakarta. IPV prevalence and the reliability, sensitivity, and specificity of the WAST were estimated. Prevalence of IPV by diagnostic interview was 36.3%, much higher than published estimates. The most common forms of IPV identified were psychological (85%) and physical abuse (24%). Internal reliability of the WAST was high (α = .801). A WAST score of 13 (out of 24) is the recommended cutoff for identifying IPV, but only 17% of the Indonesian sample scored 13 or higher. Test sensitivity of the WAST with a cutoff score of 13 was only 41.9%, with a specificity of 96.8%. With a cutoff score of 10, the sensitivity improved to 84.9%, while the specificity decreased to 61.0%. Use of the WAST with a cutoff score of 10 provides good sensitivity and reasonable specificity and would provide a much-needed screening tool for use in Indonesia. Although a lower cutoff would yield a greater proportion of false positives, most of the true cases would be identified, increasing the possibility that women experiencing abuse would receive needed assistance.
    Journal of Interpersonal Violence 07/2014; 30(7). DOI:10.1177/0886260514539844 · 1.64 Impact Factor
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