Black women in the United States with a history of severe physical intimate partner violence (SPIPV) are at greater risk for mental disorders than other US Black women, researchers found in a study published in Journal of Women’s Health.
Data were taken from a part of the Collaborative Psychiatric Epidemiological Study (CPES), the National Survey of American Life (NSAL) study on mental and physical health of African American adults in the 48 contiguous states. This information was collected between February 2001 and March 2003. Institutionalized persons and those not able to communicate in English were not included in the study.
SPIPV was assessed in the NSAL with a question of whether the participant had ever “been badly beaten up by a spouse or romantic partner” and compared with the CPES’s National Comorbidity Study Replication severe partner violence Conflict Tactic Scale.
Black women with a history of SPIPV met criteria for any mood disorder at about twice the rate of women without a history of SPIPV (29.3% vs 14.1%, P <.001) and had more than twice the rate of major depressive episode (26.9% vs 12.1%), major depressive disorder (26.9% vs 12.1%), and anxiety disorders (36.9% vs 16.3%; all P <.001).
They had about 3 times the rate of dysthymia (9.5% vs 3.0%; P <.001), panic disorder (9.9% vs 3.0%; P <.001), and agoraphobia (7.4% vs 2.1%; P <.001). They had more than twice the rate of obsessive compulsive disorder (3.2% vs 1.2%; P <.01) and PTSD (25.9% vs 9.1%; P =.001) and almost twice the percentage of generalized anxiety disorder (9.0% vs 4.7%; P =.05).
Women with a history of SPIPV had nearly 4 times the rate of criteria for substance disorder (15.7% vs 4.1%, P <.001), roughly 4 times the rate of substance use, more than 3 times the percentage of suicide attempts (11.1% vs 3.6%, P <.001), and more than 2 times the percentage of suicidal ideation than those with such history. They had 2.32 (CI, 1.719-2.121, P <.001) times higher odds of meeting criteria for a lifetime mood disorder and 2.67 (CI=1.912-3.739, P <.001) times greater odds of suicidal ideation than women without SPIPV history.
Racial discrimination was associated with higher odds of anxiety and substance disorder while gender discrimination was related to higher odds of mood disorders. Each racial discrimination instance was associated with 20.4% (CI = 1.053-1.377, P <.01) higher odds of anxiety disorder.
Women who reported a serious drug problem in their neighborhood had 33.8% (CI=1.071–1.673, P <.05) higher odds of anxiety disorder. Odds of mood, anxiety, and suicide ideation decreased with age.
Foreign-born Caribbean Black women were less likely than African American women to meet criteria for anxiety disorders, substance disorders, and suicidal ideation.
Limitations of the study included its focus on individuals who experienced SPIPV at any point in their lives because lapses in memory could cause participants to attribute conditions to other traumatic experiences that were not necessarily the result of SPIPV and the possible different meanings of the term “badly beaten” in varying cultural groups.
“This study suggests an urgent need for examining multifactorial origins of SPIPV for Black women with the goal of developing wide-ranging community and clinical interventions aimed at ending IPV among Black women, the study authors concluded.
Lacey KK, Mouzon DM, Parnell RN, Laws T. Severe intimate partner violence, sources of stress and the mental health of U.S. black women. J Womens Health (Larchmt). 2021;30(1):17-28. doi:10.1089/jwh.2019.8215