Sarah C Haight1, John A Gallis2,3, Esther O Chung4,5, Victoria Baranov6, Amina Bibi7,8, Allison Frost5, Ashley Hagaman9,10, Siham Sikander7,11, Joanna Maselko4,5, Lisa M Bates12. 1. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA. shaight@unc.edu. 2. Duke Global Health Institute, Duke University, Durham, NC, USA. 3. Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA. 4. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA. 5. Carolina Population Center, North Carolina, Chapel Hill, NC, USA. 6. Department of Economics, The University of Melbourne, Melbourne, VIC, Australia. 7. Global Institute of Human Development, Shifa Tameer-E-Millat University, Islamabad, Pakistan. 8. Human Development Research Foundation, Islamabad, Pakistan. 9. Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA. 10. Center for Methods in Implementation and Prevention Science, Yale School of Public Health, New Haven, CT, USA. 11. Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK. 12. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY, USA.
Abstract
PURPOSE: While the association between intimate partner violence (IPV) and stress is well documented, the directionality of this relationship is unclear. We use an adjusted longitudinal study design to better understand if stressful life events in the home precipitate or exacerbate intimate partner violence (IPV) and if experiences of IPV, in turn, increase levels of perceived stress. METHODS: Longitudinal data were collected among married women in rural Pakistan at 12 and 24 months postpartum (N = 815). Adjusted Poisson and linear regression models were used to examine stressful life events, past year IPV and severity (number and frequency of violent acts), and perceived stress (Cohen Perceived Stress Scale). RESULTS: At 12 months postpartum, the prevalence of past year physical, psychological, and sexual IPV was 8.5%, 25.7%, and 25.1%, respectively, with 42.6% experiencing any IPV. After adjustment, stressful life events were associated with a subsequent increased likelihood of all IPV types and increased severity of all but physical IPV. Any past year IPV (versus none) and greater IPV severity were associated with 3.43 (95% CI 2.33-4.52) and 2.57 (95% CI 1.87-3.27) point subsequent increases in perceived stress. Physical, psychological, and sexual IPV and their respective severities were all independently associated with increased perceived stress. CONCLUSIONS: Among postpartum women in Pakistan, stressful life events increase the likelihood of IPV and, in turn, experiences of IPV increase stress levels. Support to families undergoing stressful circumstances may be critical to reducing women's IPV exposure and resulting elevated stress.
PURPOSE: While the association between intimate partner violence (IPV) and stress is well documented, the directionality of this relationship is unclear. We use an adjusted longitudinal study design to better understand if stressful life events in the home precipitate or exacerbate intimate partner violence (IPV) and if experiences of IPV, in turn, increase levels of perceived stress. METHODS: Longitudinal data were collected among married women in rural Pakistan at 12 and 24 months postpartum (N = 815). Adjusted Poisson and linear regression models were used to examine stressful life events, past year IPV and severity (number and frequency of violent acts), and perceived stress (Cohen Perceived Stress Scale). RESULTS: At 12 months postpartum, the prevalence of past year physical, psychological, and sexual IPV was 8.5%, 25.7%, and 25.1%, respectively, with 42.6% experiencing any IPV. After adjustment, stressful life events were associated with a subsequent increased likelihood of all IPV types and increased severity of all but physical IPV. Any past year IPV (versus none) and greater IPV severity were associated with 3.43 (95% CI 2.33-4.52) and 2.57 (95% CI 1.87-3.27) point subsequent increases in perceived stress. Physical, psychological, and sexual IPV and their respective severities were all independently associated with increased perceived stress. CONCLUSIONS: Among postpartum women in Pakistan, stressful life events increase the likelihood of IPV and, in turn, experiences of IPV increase stress levels. Support to families undergoing stressful circumstances may be critical to reducing women's IPV exposure and resulting elevated stress.
Authors: Ann L Coker; Keith E Davis; Ileana Arias; Sujata Desai; Maureen Sanderson; Heather M Brandt; Paige H Smith Journal: Am J Prev Med Date: 2002-11 Impact factor: 5.043