Intimate Partner Violence, Mental Health Symptoms, and Modifiable Health Factors in Women During the COVID-19 Pandemic in the US

Abstract

ImportanceDuring the COVID-19 pandemic, the prevalence and severity of intimate partner violence (IPV) increased. Associations between IPV and mental health symptoms and modifiable health factors early in the pandemic have yet to be explored.ObjectiveTo prospectively investigate the association of IPV with greater risk of mental health symptoms and adverse health factors during the COVID-19 pandemic in 3 cohorts of female participants.Design, Setting, and ParticipantsThis cohort study used observational data from 3 prospective, population-based, longitudinal cohorts in the US: the Nurses’ Health Study II, Growing Up Today Study, and Nurses’ Health Study 3. Data analyzed included baseline and follow-up survey responses about IPV experiences early in the pandemic (March-September 2020); mental health domains of depression, anxiety, and posttraumatic stress symptoms (PTSS); and modifiable health factors (May 2020-October 2021). Female participants (both health care professionals and non–health care workers) aged 21 to 60 years from the 3 cohorts were included in the full analytic sample.ExposuresExperience of IPV measured by the Relationship Assessment Tool and fear of partner.Main Outcomes and MeasuresMental health symptoms, including depression, anxiety, and PTSS, and modifiable health factors, including sleep duration, sleep quality, physical activity, alcohol use, and use of alcohol or other substances to cope with stress.ResultsThe full analytic sample included 13 597 female participants with a mean (SD) age of 44 (10.6) years. Accounting for sociodemographic factors and prepandemic mental health symptoms and correcting for multiple testing, experiencing IPV was associated with higher endorsement of depression (odds ratio [OR], 1.44; 95% CI, 1.38-1.50), anxiety (OR, 1.31; 95% CI, 1.26-1.36), and PTSS (OR, 1.22; 95% CI, 1.15-1.29) in random-effects meta-analyses across the 3 cohorts. The IPV experience was also associated with poorer sleep quality (OR, 1.21; 95% CI, 1.16-1.26), shorter sleep duration (OR, 1.13; 95% CI, 1.08-1.19), increased use of alcohol (OR, 1.10; 95% CI, 1.06-1.14), and use of alcohol or other substances to cope with stress (OR, 1.13; 95% CI, 1.08-1.18) across all cohorts as well as decreased physical activity (OR, 1.17; 95% CI, 1.09-1.26) in the Nurses’ Health Study II only.Conclusions and RelevanceResults of the study showed that IPV experiences at the start of the pandemic were associated with worse mental health symptoms and modifiable health factors for female participants younger than 60 years. Screening and interventions for IPV and related health factors are needed to prevent severe, long-term health consequences.

COVID-19, new challenges to human safety: a global review

“…Studies in Belgium have shown that victims of violence are more likely to be dissatisfied with their social interactions, and their weak social support and low trust in health services may lead to more incidents of violence during the pandemic ( 31 ). In the United States, a social survey of 13,597 female participants found that IPV experience was associated with poorer sleep quality, shorter sleep duration, and increased alcohol consumption, and that IPV experience at the onset of the pandemic was associated with more severe mental health symptoms and modifiable health factors in female participants under the age of 60 ( 9 ). IPV is significantly associated with unemployment, women who do not work and whose partners do not work have higher levels of emotional violence during the pandemic in Turkey ( 32 , 33 ).…”

Gender-based Violence (GBV) on Bangladeshi Women and Girls during COVID-19 in Toronto: Forms, Causes, and Mental Health Impacts

“…Furthermore, this study found that gender-based violence often results in anxiety and depression among women and girls. These mental health issues have become even more prevalent across the world during the COVID-19 pandemic [36,[48][49][50][51]. Therefore, taking action and focusing on promoting wellness outcomes is essential.…”

Identifying best practices for substance-related intimate partner violence screening and referral: a narrative review

“…( 15 – 19 ). Recent research in a large sample of women (N = 13,597) demonstrated that IPV during the COVID-19 pandemic was associated with a 17% increase in using substances to cope with stress ( 20 ). It is also well established that IPV exposure often occurs in the context of substance use, and thus substance use is a modifiable risk factor for IPV ( 21 , 22 ).…”

“…Individuals who survive IPV may use substances to selfmedicate the consequences of IPV (e.g., pain, depressive symptoms, trauma symptoms, etc.) (15)(16)(17)(18)(19). Recent research in a large sample of women (N = 13,597) demonstrated that IPV during the COVID-19 pandemic was associated with a 17% increase in using substances to cope with stress (20).…”

“…It is also well established that IPV exposure often occurs in the context of substance use, and thus substance use is a modifiable risk factor for IPV (21,22). Treating substance use disorders (SUD) or integrating content about IPV into SUD treatment reduces IPV perpetration, whereas active IPV interferes with treatment engagement and retention among individuals with SUD (16, 19,23). Given extensive data demonstrating strong, bidirectional links between substance use and IPV, there is a need for comprehensive screening and referral programs for cooccurring IPV and substance use (19,(24)(25)(26)(27)(28).…”