Psychological Abuse as Harmful to Health as Physical Abuse
Victims of abuse—physical, sexual, or psychological—may be prone to health problems, such as injuries, depression, substance abuse, and even chronic disease. New research in the November 2002 American Journal of Preventive Medicine evaluated the health effects of each type of abuse. The results suggest that psychological abuse may be even more strongly linked with poor health than physical abuse.
About the Study
Researchers at the Universities of South Carolina, Texas, and North Carolina (Greensboro) and the Centers for Disease Control and Prevention collaborated on this study. They analyzed data from the National Violence Against Women Survey—a telephone interview survey of 8005 women and 8001 men conducted between November 1995 and May 1996. The survey included questions about physical, sexual, verbal, and psychological abuse by an intimate partner, and health problems, both physical and mental. Using several standard scales, participants rated their abuse experiences, overall health, and depressive symptoms.
For this recent analysis of 6790 women and 7122 men, researchers excluded victims who had health problems that developed before they became victims of intimate partner violence. This was done to help establish a timeline of violence occurring before poor health. Health problems included overall poor health, depressive symptoms, substance use, injury, mental illness, chronic disease, and abuse of prescription drugs.
The researchers compared the health problems of people who experienced the various types of abuse with the health problems of people who were not victims of abuse.
Women were two times more likely than men to experience physical or sexual abuse, but women were less likely than men to experience verbal abuse. Victims of physical intimate partner violence were significantly more likely to experience injury, poor health, depressive symptoms, substance abuse, chronic disease or mental illness than nonvictims. However, victims of their partners’ psychological abuse were slightly more likely to have these health problems than victims of physical abuse.
These findings were adjusted for age, race, childhood abuse, and health insurance status (used as a proxy measure for economic status).
Even though these findings suggest that both physical and psychological abuse can lead to health problems, the study has its limitations. First, participants self-reported their medical conditions, age at diagnosis, and age the first time they experienced intimate partner violence. Because none of this information was confirmed via medical records, the accuracy of this information is unknown. Second, victims of intimate partner violence may be more likely to seek medical care than nonvictims, making the diagnosis of poor health seem more prevalent in that group. Third, because a large number of participants refused to disclose their incomes, the researchers had to use private health insurance as a substitute measure of economic status. This is important because it hindered researchers’ ability to account for the role of poverty in intimate partner violence. Finally, this study does not contain enough information to evaluate the risks of each type of abuse on specific chronic diseases.
How Does This Affect You?
This study adds to growing evidence that intimate partner violence of any kind can lead to a range of health problems. Efforts to improve health and prevent disease often focus on eating right and exercising but fail to address the impact of physical and psychological abuse on health and disease. The study authors call for health screenings to include assessments of physical, sexual, and psychological abuse, so that victims can be identified and treated.
If you or someone you know is the victim of intimate partner violence, whether physical or psychological, don’t ignore it. Even if the violence doesn’t lead to injury today, it may well take its toll on health tomorrow. See the resources below for more information on seeking help.
National Colation Against Domestic Violence
Family Violence Prevention Fund
Coker AL, Davis KE, Arias I, et al. Physical and mental health effects of intimate partner violence for men and women. Am J Prev Med. 2002;23:260-268.
Last reviewed Oct 24, 2002 by ]]>Richard Glickman-Simon, MD]]>
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