Intimate partner violence during COVID and physical and mental outcomes in women

Intimate partner violence (IPV) at the start of the COVID-19 pandemic was linked to adverse mental health symptoms and modifiable health factors in women, according to a recent study.

Physical, sexual, or psychological harm from a former or current partner is known as IPV and is experienced by about one-third of women in a relationship. Concerns arose at the start of the COVID-19 pandemic that mitigation efforts such as stay at home orders would isolate individuals in abusive relationships and increase the rate and severity of violence.

The severity of external stressors worsened from the COVID-19 pandemic may be associated with increased risk of IPV exposure, with a worldwide increase of IPV recorded in 2020. Outcomes such as depression and cardiometabolic diseases have been associated with IPV outside of the pandemic, but it is unknown how these factors were affected during the pandemic.

To determine the association between IPV and increased risk of adverse health outcomes in women during the COVID-19 pandemic, investigators conducted a cohort study including 3 cohort samples of women aged 21 to 60 years. Participants filled out an online COVID-19 survey, followed by 3 monthly and 3 quarterly administered surveys.

IPV experiences, mental health symptoms, modifiable health factors, covariates, and history of IPV were measured. Two exposures of IPV experience were measured, the first being a report of having a partner since March 1, 2000, and completing a 6-item version of the Relationship Assessment Tool (RAT).

The second exposure measured was a single item assessing fear of partner. Associations between both exposure measures and health outcomes were measured independently.

Domains of mental health measured include depression, anxiety, and posttraumatic stress symptoms (PTSS). A 4-item Patient Health Questionnaire was used to measure current anxiety and depression, while a 6-item Impact of Events Scale was used to measure current PTSS.

Modifiable health factors measured include sleep quality, sleep duration, physical activity, alcohol use, and alcohol or other substance use for stress management during 2020 and 2021. Adjustments were made for sociodemographic factors such as sex, age, race and ethnicity, educational level, active health care status, partnership status, sexual orientation, and depression and anxiety before exposure ascertainment.

There were 13,597 participants included in the final analysis, aged an average 44 years. Of these, 96.3% were non-Hispanic White, and 92.8% heterosexual. RAT score was associated with a fear of partner, with more participants in the highest RAT score quartile displaying a fear of partner.

An association was found between IPV experiences and depression, anxiety, and PTSS. An IPV experience at 1 month was linked to increased risk of poor mental health outcomes during follow-up. Fear of one’s partner was also associated with worse mental health outcomes during follow-up.

Poorer sleep quality, decreased sleep duration, increased alcohol use, and increased use of alcohol and other substances to manage stress were outcomes associated with IPV experience, with decreased physical activity found in 1 of the 3 cohorts. These outcomes were also associated with fear of one’s partner.

Reference

Scoglio AAJ, Zhu Y, Lawn RB, et al. Intimate partner violence, mental health symptoms, and modifiable health factors in women during the COVID-19 Pandemic in the US. JAMA Netw Open. 2023;6(3):e232977. doi:10.1001/jamanetworkopen.2023.2977