Modeling lifetime abuse and cardiovascular disease risk among women

Abstract

Background Cardiovascular disease (CVD) is one of the most significant health challenges facing women today. Abuse is a serious gendered issue also affecting the health of women. Despite beginning evidence that abuse may increase the risk of CVD among women, causal pathways linking abuse to CVD have received little attention. Our purpose was to test Scott-Storey’s conceptual model showing direct and indirect pathways through which lifetime abuse severity may affect women’s CVD risk. Methods Using data collected from a community sample of 227 Canadian women who had left an abusive partner, we conducted structural equation modeling with latent growth curve analysis using a phantom variable approach to test the direct effects of severity of lifetime abuse on CVD risk (indicated by measures of systolic and diastolic blood pressure) as well as its indirect effects through CVD risk behaviors and through women’s initial level of depressive symptoms and the observed rate of change in their depressive symptoms over time. Results Women in this sample had above average CVD risk factors (i.e., smoking, overweight/obesity, depressive symptoms, high blood pressure) in comparison to women in the general population. Further, CVD risk behaviors increased with severity of lifetime abuse and remained present long after leaving the abusive relationship. Results of the tested model provide preliminary evidence supporting many of the hypothesized pathways by which severity of lifetime abuse can increase CVD risk among women; the model fit the data reasonably well explaining 41% of the variance in CVD risk. Conclusions Findings support the growing recognition of the long-term effects of lifetime abuse on cardiovascular health, suggest important implications for clinicians working with women, and provide a novel approach for studying the concept of cumulative lifetime abuse through the use of a phantom variable.

Obesity in women who have experienced intimate partner violence

“…child abuse, partner abuse, sexual assault during adulthood) directly predicted obesity after 4 years of follow up (Scott‐Storey, ). This incongruence might relate to how abuse is measured as well as variation in sample characteristics; this study included married women in abusive relationships, while Scott‐Storey () included women who left abusive partners.…”

Cumulative lifetime violence severity scale: development and initial testing among men

“…Together, these conceptual underpinnings informed the dimensions of CLVS included in our scale development. We also drew on our 20-year history in studying violence and health for women and men, using qualitative and quantitative methods [23][24][25]. The scale development process included multiple steps, each of which was approved by our institution's research ethics board.…”

Pathways leading to prevention of fatal and non-fatal cardiovascular disease: An interaction model on 15 years population-based cohort study

“…Many studies examined CVD risk factors [16][17][18][19][20][21]. However, they cannot usually detect causal pathways between the associated factors and CVD.…”