Psychosocial Effects of Physical and Verbal Abuse in Postmenopausal Women

Abstract

PURPOSE The purpose of this study was to examine the psychological effects of physical and verbal abuse in a cohort of older women.METHODS This observational cohort study was conducted at 40 clinical sites nationwide that are part of the Women's Health Initiative (WHI) Observational Study. We surveyed 93,676 women aged 50 to 79 years using the mental health subscales and the combined mental component summary (MCS) score of the RAND Medical Outcomes Study 36-item instrument.RESULTS At baseline, women reporting exposure to physical abuse only, verbal abuse only, or both physical and verbal abuse had a greater number of depressive symptoms (1.6,1.6, and 3 more symptoms, respectively) and lower MCS scores (4.6, 5.4, and 8.1 lower scores, respectively) than women not reporting abuse. Compared with women who had no exposure to abuse, women had a greater increase in the number of depressive symptoms when they reported a 3-year incident exposure to physical abuse only (0.2; 95% confi dence interval [CI], -0.21 to 0.60), verbal abuse only (0.18; 95% CI, 0.11 to 0.24), or both physical and verbal abuse (0.15; 95% CI, -0.05 to 0.36); and they had a decrease in MCS scores when they reported a 3-year incident exposure to physical abuse only (-1.12; 95% CI, -2.45 to 0.12), verbal abuse only (-0.55; 95% CI, -0.75 to -0.34), and both physical and verbal abuse (-0.44; 95% CI, -1.11 to -0.22) even after adjustment for sociodemographic characteristics.CONCLUSION Exposure to abuse in older, functionally independent women is associated with poorer mental health. The persistence of these fi ndings suggests that clinicians need to consider abuse exposure in their older female patients who have depressive symptoms. Clinicians caring for older women should identify women at risk for physical and verbal abuse and intervene appropriately. Ann Fam Med 2010;8:206-213. doi:10.1370/afm.1095. INTRODUCTIONA buse is an ongoing concern for older women.1 Physical abuse is the infl iction of physical pain, injury, or physical coercion, and involves at least 1 act of violence. Verbal abuse is the infl iction of mental anguish through yelling, screaming, threatening, humiliating, infantilizing, or provoking intentional fear.1,2 Exposure to acts of abuse is a stressful event that has a negative effect on a woman's psychological well-being. It is known that in younger age-groups, domestic violence victims are at increased risk for psychological problems. [3][4][5] Female victims are 2 times more likely to have a psychiatric diagnosis and 1.7 to 4.6 times more likely to develop an anxiety disorder, a mood disorder, posttraumatic stress disorder, or an eating disorder.6,7 Women exposed to abuse are more than 3 times as likely to report poor overall mental health, lower SF-12 Health Survey short-form mental component summary (MCS) scores, and lower vitality.3,7-10 Abused women are 2.4 to 3 times more likely to report depression. 6,[11][12][13][14] In addition to the direct psychological effects, abuse may negatively affect the factors that improve...

Maus-tratos contra idosos em Porto Alegre, Rio Grande do Sul: um estudo documental

“…O abuso físico pode ocasionar contusões e quedas. O financeiro pode levar à perda da autonomia e o psicológico pode resultar em transtornos psiquiátricos e estresse emocional (Mouton, Rodabough, Rovi, Brzyski, & Katerndahl, 2010). Lasch, Williams, O'Brien, Pillemer e Charlson (1998), realizaram um estudo longitudinal com 2.812 idosos da comunidade e follow-up de nove anos e verificaram uma forte associação entre a incidência de maus-tratos e auto-negligência e o aumento da mortalidade das vítimas.…”

In This Issue: The Nourishment and Support of Family Medicine

“…Mouton and colleagues 3 show how prolonged exposure to physical or psychological abuse in personal relationships is an important factor in caring for patients with depression. In a longitudinal study of postmenopausal women, they point out that the effects of abuse can continue long after the abusive relationship ends.…”

Cross-Sectional and Longitudinal Risk of Physical Impairment in a Cohort of Postmenopausal Women Who Experience Physical and Verbal Abuse

“…While the disproportionate risk of young women (e.g., of childbearing age), particularly those who are pregnant, is well documented [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16], a growing empirical literature also characterizes the significant prevalence and public health implications of interpersonal abuse exposure, including verbal, physical or sexual abuse, neglect, and financial exploitation, among older, post-menopausal women [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. For example, Zink et al [33] conducted a telephone survey investigating prevalence of abuse exposure among more than 3500 women over age 55.…”