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Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (15 September 2022) | Viewed by 52697

Special Issue Editors

Prof. Dr. Lindsay Stark

E-Mail Website
Guest Editor
Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA
Interests: violence prevention; gender based violence; child protection, mental health and psychosocial wellbeing; refugees and displaced populations
Dr. Emma Fulu

E-Mail Website
Guest Editor
The Equality Institute, Melbourne, VIC 3070, Australia
Interests: violence prevention; gender-based violence; child abuse; masculinities; feminist movements; health and well-being; intersectionality; social norms
Dr. Ilana Seff

E-Mail Website
Guest Editor
Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA
Interests: violence prevention; gender-based violence; social norms; mental health and psychosocial wellbeing; refugees and displaced populations; innovative measurement methods
Dr. Massy Mutumba

E-Mail Website
Guest Editor
Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI 48109, USA
Interests: health promotion; self-management; infectious diseases; children and adolescents

Special Issue Information

Dear Colleagues,

Intimate partner violence (IPV) poses a significant threat to the human rights, safety, and health of women and girls across the globe. Recent estimates suggest that approximately one-third of women globally have experienced physical or sexual IPV, though the risk of lifetime incidence can be as high as 40% in some regions. In addition to any physical or sexual injury sustained by survivors of IPV, research shows women who have experienced IPV are more likely to develop a range of mental health symptoms and disorders both at the time of abuse and later in life. Studies also outline a relationship between witnessing IPV in childhood and experiencing mental illness in adulthood. While these associations between IPV and mental health are well-evidenced in high-income countries, there is a dearth of evidence about this topic in low- and middle-income countries (LMICs) and humanitarian contexts. This Special Issue will help to fill this gap by elucidating the mechanistic pathways between witnessing, experiencing, and perpetrating IPV, and mental health, as well as by identifying strategies for successfully mitigating the negative mental health consequences of IPV in LMIC and humanitarian contexts.

Prof. Dr. Lindsay Stark
Dr. Emma Fulu
Dr. Ilana Seff
Dr. Massy Mutumba
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • intimate partner violence
  • domestic violence
  • spouse abuse
  • mental health
  • PTSD
  • depression
  • anxiety
  • psychosocial wellbeing
  • gender
  • LMICs
  • humanitarian

Published Papers (15 papers)

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Editorial

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4 pages, 288 KiB  
Editorial
Intimate Partner Violence and Mental Health: Deepening Our Understanding of Associations, Pathways, and Prevention in Low- and Middle-Income Countries
by Lindsay Stark, Ilana Seff, Massy Mutumba and Emma Fulu
Int. J. Environ. Res. Public Health 2023, 20(2), 1505; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20021505 - 13 Jan 2023
Cited by 2 | Viewed by 1697
Abstract
Mental health disorders and related symptoms are among the top leading causes of disability adjusted life years (DALYs) among youth (10–24 years) and adults (25–49 years) [...] Full article
(This article belongs to the Special Issue Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings)

Research

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17 pages, 937 KiB  
Article
Exploring the Impact of a Family-Focused, Gender-Transformative Intervention on Adolescent Girls’ Well-Being in a Humanitarian Context
by Ilana Seff, Andrea Koris, Monica Giuffrida, Reine Ibala, Kristine Anderson, Hana Shalouf, Julianne Deitch and Lindsay Stark
Int. J. Environ. Res. Public Health 2022, 19(22), 15357; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192215357 - 21 Nov 2022
Cited by 4 | Viewed by 1884
Abstract
While family functioning interventions show promise for improving adolescent girls’ well-being in humanitarian contexts, few programs employ a gender-transformative approach to maximize benefits for adolescent girls. This paper presents findings from a mixed-methods pilot evaluation of a whole-family, gender-transformative intervention conducted with Syrian [...] Read more.
While family functioning interventions show promise for improving adolescent girls’ well-being in humanitarian contexts, few programs employ a gender-transformative approach to maximize benefits for adolescent girls. This paper presents findings from a mixed-methods pilot evaluation of a whole-family, gender-transformative intervention conducted with Syrian refugee families in Jordan. The Siblings Support of Adolescent Girls in Emergencies program was implemented with 60 Syrian refugee households in Azraq and Za’atari camps in Jordan. A quantitative survey was administered to 18 households at baseline and endline, and researchers conducted qualitative interviews and focus group discussions with caregivers, paired interviews and participatory discussions with adolescents, and key informant interviews with program mentors. Paired t-tests revealed statistically significant improvements in mental distress, resilience, and gender equitable attitudes in the full sample and for girls only and marginally significant improvements in family functioning. Qualitative findings revealed improvements in four domains of girls’ well-being—self-efficacy, self-confidence, pro-social behavior, and mental health—through three primary pathways: family members’ increased gender equitable attitudes, healthier intrahousehold communication, and greater affective involvement. Findings from this mixed-methods evaluation point to the potential value in merging gender-transformative and whole-family approaches in humanitarian programming to maximize positive impacts for adolescent girls. Full article
(This article belongs to the Special Issue Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings)
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20 pages, 407 KiB  
Article
The Psychosocial Impacts of Intimate Partner Violence against Women in LMIC Contexts: Toward a Holistic Approach
by Michael G. Wessells and Kathleen Kostelny
Int. J. Environ. Res. Public Health 2022, 19(21), 14488; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192114488 - 04 Nov 2022
Cited by 4 | Viewed by 2910
Abstract
Work on the mental health impacts of intimate partner violence in low-and middle-income countries has focused primarily on clinical disorders such as post-traumatic stress disorder, depression, and substance abuse. This paper analyzes how non-clinical, psychosocial impacts from everyday stressors, particularly economic hardships and [...] Read more.
Work on the mental health impacts of intimate partner violence in low-and middle-income countries has focused primarily on clinical disorders such as post-traumatic stress disorder, depression, and substance abuse. This paper analyzes how non-clinical, psychosocial impacts from everyday stressors, particularly economic hardships and concern over one’s children, cause extensive suffering and damage women survivors’ well-being, influencing the development and expression of clinical disorders. Using a social ecological framework, the paper analyzes how psychosocial impacts arise at multiple levels, including societal levels where social norms often devalue women and privilege men, and how the stressor accumulation increases the harm caused by intimate partner violence (IPV) against women (IPVAW). Drawing on survivors’ narratives and studies from diverse low and middle income country (LMIC) settings, including armed conflict and natural disaster settings, the paper underscores the importance of understanding both clinical impacts and the non-clinical, psychosocial impacts, which interact with and complement one another. Recognizing the interplay also between IPVAW and other forms of violence against girls and women, the paper calls for a more comprehensive approach to understanding and addressing the impacts of IPVAW. Recognizing the enormous variety within and across countries that are considered to be LMIC settings, the paper cautions against universalized approaches to understanding the effects of IPVAW and helping to support survivors. Full article
(This article belongs to the Special Issue Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings)
15 pages, 379 KiB  
Article
“At the Root of COVID Grew a More Complicated Situation”: A Qualitative Analysis of the Guatemalan Gender-Based Violence Prevention and Response System during the COVID-19 Pandemic
by Luissa Vahedi, Ilana Seff, Deidi Olaya Rodriguez, Samantha McNelly, Ana Isabel Interiano Perez, Dorcas Erskine, Catherine Poulton and Lindsay Stark
Int. J. Environ. Res. Public Health 2022, 19(17), 10998; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191710998 - 02 Sep 2022
Cited by 3 | Viewed by 2321
Abstract
A growing body of literature has documented an increased risk of gender-based violence (GBV) within the context of COVID-19 and service providers’ reduced capacity to address this vulnerability. Less examined are the system-level impacts of the pandemic on the GBV sector in low- [...] Read more.
A growing body of literature has documented an increased risk of gender-based violence (GBV) within the context of COVID-19 and service providers’ reduced capacity to address this vulnerability. Less examined are the system-level impacts of the pandemic on the GBV sector in low- and middle-income countries. Drawing on the perspectives of 18 service providers working across various GBV-related sectors in Guatemala, we explored how the Guatemalan GBV prevention and response system operated during the COVID-19 pandemic. Findings highlight that the pandemic reinforced survivors’ existing adversities (inadequate transportation access, food insecurity, digital divides), which subsequently reduced access to reporting, justice, and support. Consequently, the GBV prevention and response system had to absorb the responsibility of securing survivors’ essential social determinants of health, further limiting already inflexible budgets. The pandemic also imposed new challenges, such as service gridlocks, that negatively affected survivors’ system navigation and impaired service providers’ abilities to efficiently receive reports and mobilize harm reduction and prevention programming. The findings underscore the systemic challenges faced by GBV service providers and the need to incorporate gender mainstreaming across public service sectors—namely, transportation and information/communication—to improve lifesaving GBV service delivery for Guatemalan survivors, particularly survivors in rural/remote regions. Full article
(This article belongs to the Special Issue Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings)
17 pages, 980 KiB  
Article
Suicidal Thoughts, Depression, Post-Traumatic Stress, and Harmful Alcohol Use Associated with Intimate Partner Violence and Rape Exposures among Female Students in South Africa
by Mercilene Tanyaradzwa Machisa, Esnat Chirwa, Pinky Mahlangu, Ncediswa Nunze, Yandisa Sikweyiya, Elizabeth Dartnall, Managa Pillay and Rachel Jewkes
Int. J. Environ. Res. Public Health 2022, 19(13), 7913; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19137913 - 28 Jun 2022
Cited by 5 | Viewed by 2582
Abstract
While ample evidence from high-income country settings indicates the prevalence and risk factors for multiple mental ill-health symptoms in student populations, evidence from low- and middle-income higher education settings remains limited. We determined the frequency, associations, and structural pathways between mental health outcomes [...] Read more.
While ample evidence from high-income country settings indicates the prevalence and risk factors for multiple mental ill-health symptoms in student populations, evidence from low- and middle-income higher education settings remains limited. We determined the frequency, associations, and structural pathways between mental health outcomes and possible risk factors among a sample of 1292 predominantly Black African and female students ages 18–30 years, enrolled at nine purposefully selected public universities and Technical Vocational Education and Training (TVET) campuses. We measured and created a mental ill-health latent outcome consisting of depressive symptoms, post-traumatic stress disorder (PTSD), and suicidal thoughts. We also measured traumatic exposures including childhood trauma, recent intimate partner violence (IPV), non-partner rape, and other life traumatic events. We used structural equation modelling to analyse data. We found that 50% of the surveyed students binge drank, 43% reported depressive symptoms, 9% reported PTSD symptoms, and 21% had suicidal thoughts. Students’ experiences of childhood trauma, food insecurity, other traumatic events, non-partner rape, and IPV impacted the mental ill-health latent. IPV experiences mediated the relationships between experiences of childhood trauma or other trauma and the mental ill-health latent, and the relationship between binge drinking and other life traumatic events. Non-partner rape mediated the relationship between food insecurity and the mental ill-health latent. Binge drinking directly impacted non-partner rape experience. The findings substantiate the need for campus-based mental health promotion, psychosocial services and treatments, and implementation of combined interventions that address the intersections of violence against women and mental health among students in South Africa. Full article
(This article belongs to the Special Issue Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings)
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17 pages, 751 KiB  
Article
Multilevel Determinants of Integrated Service Delivery for Intimate Partner Violence and Mental Health in Humanitarian Settings
by M. Claire Greene, Clarisa Bencomo, Susan Rees, Peter Ventevogel, Samuel Likindikoki, Ashley Nemiro, Annie Bonz, Jessie K. K. Mbwambo, Wietse A. Tol and Terry M. McGovern
Int. J. Environ. Res. Public Health 2021, 18(23), 12484; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182312484 - 26 Nov 2021
Cited by 3 | Viewed by 3327
Abstract
Inter-agency guidelines recommend that survivors of intimate partner violence in humanitarian settings receive multisectoral services consistent with a survivor-centered approach. Providing integrated services across sectors is challenging, and aspirations often fall short in practice. In this study, we explore factors that influence the [...] Read more.
Inter-agency guidelines recommend that survivors of intimate partner violence in humanitarian settings receive multisectoral services consistent with a survivor-centered approach. Providing integrated services across sectors is challenging, and aspirations often fall short in practice. In this study, we explore factors that influence the implementation of a multisectoral, integrated intervention intended to reduce psychological distress and intimate partner violence in Nyarugusu Refugee Camp, Tanzania. We analyzed data from a desk review of donor, legal, and policy documents; a gender-based violence services mapping conducted through 15 interviews and 6 focus group discussions; and a qualitative process evaluation with 29 stakeholders involved in the implementation of the integrated psychosocial program. We identified the challenges of implementing a multisectoral, integrated intervention for refugee survivors of intimate partner violence at the structural, inter-institutional, intra-institutional, and in social and interpersonal levels. Key determinants of successful implementation included the legal context, financing, inter-agency coordination, engagement and ownership, and the ability to manage competing priorities. Implementing a multisectoral, integrated response for survivors of intimate partner violence is complex and influenced by interrelated factors from policy and financing to institutional and stakeholder engagement. Further investment in identifying strategies to overcome the existing challenges of implementing multisectoral approaches that align with global guidelines is needed to effectively address the burden of intimate partner violence in humanitarian settings. Full article
(This article belongs to the Special Issue Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings)
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16 pages, 480 KiB  
Article
Elements of the Design and Implementation of Interventions to Prevent Violence against Women and Girls Associated with Success: Reflections from the What Works to Prevent Violence against Women and Girls? Global Programme
by Rachel Jewkes, Samantha Willan, Lori Heise, Laura Washington, Nwabisa Shai, Alice Kerr-Wilson, Andrew Gibbs, Erin Stern and Nicola Christofides
Int. J. Environ. Res. Public Health 2021, 18(22), 12129; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182212129 - 19 Nov 2021
Cited by 27 | Viewed by 5247
Abstract
Intimate partner violence (IPV) has a large and sustained impact on women’s mental health, and so effective prevention is critical. A review of 96 rigorous evaluations of interventions for their impact on violence against women and girls (mostly IPV) found that several intervention [...] Read more.
Intimate partner violence (IPV) has a large and sustained impact on women’s mental health, and so effective prevention is critical. A review of 96 rigorous evaluations of interventions for their impact on violence against women and girls (mostly IPV) found that several intervention approaches were effective. However, not every evaluation of a ‘successful approach’ showed success in reducing IPV. In order to understand what else impacts success, we analysed practitioners’ accounts and documentation of the design and implementation of seventeen interventions evaluated as part of What Works to Prevent Violence against Women and Girls (VAWG). Six features were identified as characteristics of all successful interventions: a rigorously planned intervention with a robust theory of change (ToC), attuned to the local context; addressing multiple drivers of VAWG; support for survivors; working with women and men; implementing at optimal intensity and having sufficient, well-selected, trained and supported staff and volunteers. Four features were necessary for success when relevant for the intervention approach: gender and social empowerment group activities and promoting positive interpersonal relations; participatory learning methods, emphasising empowerment, critical reflection and communication skills; carefully designed user-friendly manuals systematically followed; and when working with children, having an age-appropriate design with time for learning and an engaging pedagogy. This analysis provides the IPV prevention field with critical information for enhancing the impact of group- and community-based interventions in IPV prevention and through this strengthening women’s mental health. Full article
(This article belongs to the Special Issue Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings)
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13 pages, 780 KiB  
Article
Intersections of Sex Work, Mental Ill-Health, IPV and Other Violence Experienced by Female Sex Workers: Findings from a Cross-Sectional Community-Centric National Study in South Africa
by Rachel Jewkes, Minja Milovanovic, Kennedy Otwombe, Esnat Chirwa, Khuthadzo Hlongwane, Naomi Hill, Venice Mbowane, Mokgadi Matuludi, Kathryn Hopkins, Glenda Gray and Jenny Coetzee
Int. J. Environ. Res. Public Health 2021, 18(22), 11971; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182211971 - 15 Nov 2021
Cited by 10 | Viewed by 3972
Abstract
Female sex workers (FSWs) are at increased risk of mental health problems, including mood disorders and substance abuse, and we need to understand the origins of these to treat and prevent them, and particularly understand how the context in which they sell sex [...] Read more.
Female sex workers (FSWs) are at increased risk of mental health problems, including mood disorders and substance abuse, and we need to understand the origins of these to treat and prevent them, and particularly understand how the context in which they sell sex impacts their mental health. We conducted a multi-stage, community-centric, cross-sectional survey of 3005 FSWs linked to SW programmes in twelve sites across all nine provinces of South Africa. We interviewed adult women who had sold sex in the preceding six months, who were recruited via SW networks. We found that FSWs have very poor mental health as 52.7% had depression and 53.6% has post-traumatic stress disorder (PTSD). The structural equation model showed direct pathways from childhood trauma and having HIV+ status to mental ill-health. Indirect pathways were mediated by food insecurity, controlling partners, non-partner rape, harmful alcohol use, substance use to cope with SW, indicators of the circumstances of SW, i.e., selling location (on streets, in taverns and brothels), frequency of selling and experiencing SW stigma. All paths from childhood trauma had final common pathways from exposure to gender-based violence (non-partner rape or intimate partner violence) to mental ill-health, except for one that was mediated by food insecurity. Thus, FSWs’ poor mental health risk was often mediated by their work location and vulnerability to violence, substance abuse and stigma. The potential contribution of legal reform to mitigate the risks of violence and mental ill-health are inescapable. Treatment of mental ill-health and substance abuse should be an essential element of FSW programmes. Full article
(This article belongs to the Special Issue Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings)
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25 pages, 2216 KiB  
Article
Development and Testing of a Community-Based Intervention to Address Intimate Partner Violence among Rohingya and Syrian Refugees: A Social Norms-Based Mental Health-Integrated Approach
by Leah Emily James, Courtney Welton-Mitchell, Saja Michael, Fajar Santoadi, Sharifah Shakirah, Hasnah Hussin, Mohammed Anwar, Lama Kilzar and Alexander James
Int. J. Environ. Res. Public Health 2021, 18(21), 11674; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111674 - 07 Nov 2021
Cited by 5 | Viewed by 3927
Abstract
Intimate partner violence (IPV) is the leading form of gender-based violence globally and increases during times of conflict and displacement. To reduce IPV and encourage help-seeking, a two-phase community-based intervention was co-designed with Rohingya in Malaysia and Syrians in Lebanon. Three day workshops, [...] Read more.
Intimate partner violence (IPV) is the leading form of gender-based violence globally and increases during times of conflict and displacement. To reduce IPV and encourage help-seeking, a two-phase community-based intervention was co-designed with Rohingya in Malaysia and Syrians in Lebanon. Three day workshops, utilizing a social norms-based mental health-integrated approach, were implemented for women and men in each country (n = 148). Pre- to post-measures indicated reductions in beliefs about acceptability of violence and rigid gender norms, and improvements in mental health, functioning, coping, and self-efficacy for women and men following workshop participation. Workshop participation was also associated with increased help-seeking intent, for both mental health and IPV (victims and perpetrators). Workshops included community design of poster campaigns to address IPV, which were then tested in each setting using a randomized controlled trial in Malaysia (n = 240) and a matched cluster comparison in Lebanon (n = 260). Women in both settings found IPV less acceptable in the poster condition. Help-seeking preferences were also influenced by the poster for women and men in both countries. This participatory intervention research can provide a roadmap for use in other settings, emphasizing the value of community-generated solutions to IPV among displaced populations. Full article
(This article belongs to the Special Issue Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings)
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11 pages, 960 KiB  
Article
Tolerance of Violence against Women and the Risk of Psychosocial Distress in Humanitarian Settings in Northern Uganda
by Paul Bukuluki, Peter Kisaakye, Bonny Etti, Micheal Ocircan and Roberts-Reites Bev
Int. J. Environ. Res. Public Health 2021, 18(15), 8103; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18158103 - 30 Jul 2021
Cited by 3 | Viewed by 2506
Abstract
Background: Violence against women (VAW) remains a public health concern, which can sometimes lead to mental or psychological stress among other negative consequences. Data and methods: we fitted a binary logistic regression model on 657 respondents from host and refugee settings in three [...] Read more.
Background: Violence against women (VAW) remains a public health concern, which can sometimes lead to mental or psychological stress among other negative consequences. Data and methods: we fitted a binary logistic regression model on 657 respondents from host and refugee settings in three humanitarian districts (Adjumani, Obongi, and Lamwo) to examine the determinants of psychosocial stress. Results: experience of psychosocial distress is higher among refugees than host populations. Results indicate a higher proportion of respondents who ever experienced psychosocial stress in the 6 months preceding the survey among those who believed that a woman should tolerate violence (59% vs. 53%). Respondents who believed that a woman should tolerate violence had higher odds of experiencing psychosocial stress than their counterparts who believed a woman should not tolerate violence (OR = 6.86; 95%CI = 1.23–38.22). The likelihood to experience psychosocial stress was higher among females (OR = 6.94; 95%CI = 1.76–27.32), those with primary education (OR = 4.73; 95%CI = 1.24–18.00), and respondents with less than USD 2.7 as personal income one month before the survey (OR = 3.37; 95%CI = 1.32–8.62). Respondents who said that women should engage in income generation activities had higher odds to experience psychosocial stress (OR = 0.39; 95%CI = 0.17–0.89). Conclusion: results suggest that income and positive attitudes toward female-led income generating activities act as protective measures against psychosocial distress. Given the associations between VAW and psychosocial distress, efforts aimed at prevention and response to VAW in humanitarian settings should integrate mental health and psychosocial support interventions. Full article
(This article belongs to the Special Issue Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings)
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8 pages, 284 KiB  
Article
Attitudinal Acceptance of Intimate Partner Violence and Mental Health Outcomes for Female Survivors in Sub-Saharan Africa
by Reine-Marcelle Ibala, Ilana Seff and Lindsay Stark
Int. J. Environ. Res. Public Health 2021, 18(10), 5099; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18105099 - 12 May 2021
Cited by 8 | Viewed by 2662
Abstract
While current literature evidences a strong association between gender-based violence exposure and adverse mental health outcomes, few studies have explored how attitudinal acceptance of intimate partner violence (IPV) might impact this relationship. This analysis employed data from 13–24-year-old females as part of the [...] Read more.
While current literature evidences a strong association between gender-based violence exposure and adverse mental health outcomes, few studies have explored how attitudinal acceptance of intimate partner violence (IPV) might impact this relationship. This analysis employed data from 13–24-year-old females as part of the Violence Against Children Surveys in Nigeria, Uganda, and Malawi. Mental health status, defined by the Kessler Screening Scale for Psychological Distress, and suicide ideation served as outcome measures. Predictors of interest included lifetime experiences of IPV and attitudinal acceptance of IPV. Country-stratified logistic and ordinary least squares regressions were used to predict outcomes and included interactions between violence exposure and attitudinal acceptance of IPV. Violence exposure was associated with increased symptoms of mental distress and increased suicide ideation in all countries. Among those who experienced IPV, exhibiting attitudinal acceptance of IPV was associated with improved mental health in Nigeria and Malawi. IPV tolerance conferred lower odds of suicide ideation following IPV exposure in Nigeria. The findings suggest that programs aiming to reduce attitudinal acceptance of IPV must consider how these changes may interact with women’s exposure to IPV. Full article
(This article belongs to the Special Issue Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings)
16 pages, 346 KiB  
Article
“I Go up to the Edge of the Valley, and I Talk to God”: Using Mixed Methods to Understand the Relationship between Gender-Based Violence and Mental Health among Lebanese and Syrian Refugee Women Engaged in Psychosocial Programming
by Rassil Barada, Alina Potts, Angela Bourassa, Manuel Contreras-Urbina and Krystel Nasr
Int. J. Environ. Res. Public Health 2021, 18(9), 4500; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18094500 - 23 Apr 2021
Cited by 8 | Viewed by 3944
Abstract
Lebanon’s intersecting economic and political crises exacerbate complex public health issues among both host and refugee populations. This mixed-methods study by a Lebanese service provider, in partnership with an international research institute, seeks to better understand how experiences of gender-based violence (GBV) and [...] Read more.
Lebanon’s intersecting economic and political crises exacerbate complex public health issues among both host and refugee populations. This mixed-methods study by a Lebanese service provider, in partnership with an international research institute, seeks to better understand how experiences of gender-based violence (GBV) and mental health intersect in the lives of Syrian and Lebanese women, and how to better meet these needs. It employs a randomized cross-sectional survey of 969 Abaad service users and focus groups with community members and service providers. There were significant associations between GBV and ill mental health; notably, respondents reporting transactional sex had 4 times the likelihood of severe distress (aOR 4.2; 95% CI 1.2–14.8; p ≤ 0.05). Focus groups emphasized less-visible forms of violence, such as emotional violence, and the importance of environmental factors in one’s ability to cope, noting “it always came back to the economy”. Recommendations include providing a more holistic and coordinated approach between GBV, mental health, livelihood, and basic assistance sectors; and sensitive, accessible, and higher-quality mental health services informed by GBV response actors’ experience putting in place survivor-centered programming and made available to both host and refugee community members. Full article
(This article belongs to the Special Issue Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings)
14 pages, 373 KiB  
Article
A Latent Class Analysis of Gender Attitudes and Their Associations with Intimate Partner Violence and Mental Health in the Democratic Republic of Congo
by Andrew Corley, Nancy Glass, Mitima Mpanano Remy and Nancy Perrin
Int. J. Environ. Res. Public Health 2021, 18(8), 4063; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084063 - 12 Apr 2021
Cited by 5 | Viewed by 3082
Abstract
Gender role attitudes, views held by individuals regarding the roles men and women should play in society, are a powerful social determinant of health. However, work remains in elucidating the associations between gender attitudes and intimate partner violence (IPV) perpetration or victimization and [...] Read more.
Gender role attitudes, views held by individuals regarding the roles men and women should play in society, are a powerful social determinant of health. However, work remains in elucidating the associations between gender attitudes and intimate partner violence (IPV) perpetration or victimization and mental health problems. We used latent class analysis to classify patterns of responses on survey items on gender attitudes by male and female adults in households that participated in an economic empowerment intervention and evaluation in rural villages in the Democratic Republic of Congo. Attitudes about IPV and gender equality were two subdomains to emerge from analysis and a 3-class model solution was found to best fit response patterns. Results indicated that, as compared to the least gender equitable class, individuals in the moderately gender equitable and fully gender equitable classes had lower odds of having experienced or perpetrated psychological abuse. Individuals within the moderately gender equitable class were at lower odds of having experienced or perpetrated physical or sexual violence. Further, individuals in the moderately gender equitable and fully gender equitable classes had significantly lower mean scores on symptoms associated with PTSD than individuals in the least gender equitable class. Future research should explore the relationships between gender attitudes, partner violence and mental health to build resilient families. Full article
(This article belongs to the Special Issue Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings)

Review

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19 pages, 402 KiB  
Review
Psychological Interventions for Survivors of Intimate Partner Violence in Humanitarian Settings: An Overview of the Evidence and Implementation Considerations
by Daniel P. Lakin, Claudia García-Moreno and Elisabeth Roesch
Int. J. Environ. Res. Public Health 2022, 19(5), 2916; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19052916 - 02 Mar 2022
Cited by 5 | Viewed by 5492
Abstract
This paper provides an analytical overview of different types of psychological interventions that have demonstrated efficacy in low-income and/or humanitarian settings and points to special considerations that may be needed if used with women who have been subjected to gender-based violence (GBV). This [...] Read more.
This paper provides an analytical overview of different types of psychological interventions that have demonstrated efficacy in low-income and/or humanitarian settings and points to special considerations that may be needed if used with women who have been subjected to gender-based violence (GBV). This paper reviews diverse therapeutic modalities and contrasts them across several domains, including their conventional use and principles; their documented use and efficacy in humanitarian settings; any special considerations or modifications necessary for GBV-affected clients; and any additional resources or implementation concerns when working in low-income contexts. By examining the evidence base of multiple interventions, we hope to provide clinicians and GBV-prevention advocates with an overview of tools/approaches to provide survivor-centered, trauma-informed responses to GBV survivors. This analysis responds to the growing recognition that gender-based violence, in particular intimate partner violence and sexual violence, is strongly associated with mental health problems, including anxiety, depression, and post-traumatic stress. This is likely to be exacerbated in humanitarian contexts, where people often experience multiple and intersecting traumatic experiences. The need for mental health services in these settings is increasingly recognized, and a growing number of psychological interventions have been shown to be effective when delivered by lay providers and in humanitarian settings. Full article
(This article belongs to the Special Issue Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings)

Other

19 pages, 1869 KiB  
Systematic Review
Identifying the Impact of Intimate Partner Violence in Humanitarian Settings: Using an Ecological Framework to Review 15 Years of Evidence
by Melissa Meinhart, Ilana Seff, Katrina Troy, Samantha McNelly, Luissa Vahedi, Catherine Poulton and Lindsay Stark
Int. J. Environ. Res. Public Health 2021, 18(13), 6963; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18136963 - 29 Jun 2021
Cited by 16 | Viewed by 4314
Abstract
Intimate partner violence (IPV) is a pervasive form of gender-based violence that exacerbates in humanitarian settings. This systematic review examined the myriad IPV impacts and the quality of existing evidence of IPV in humanitarian settings. Following the Preferred Reporting Items for Systematic Reviews [...] Read more.
Intimate partner violence (IPV) is a pervasive form of gender-based violence that exacerbates in humanitarian settings. This systematic review examined the myriad IPV impacts and the quality of existing evidence of IPV in humanitarian settings. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) procedures, a total of 51 articles were included from the 3924 screened. We identified the impact of IPV across two levels of the ecological framework: individual and microsystem. Our findings corroborated previous evidence that indicated IPV to be associated with adverse physical and mental health for survivors. Our findings also uniquely synthesized the intergenerational impact of IPV in humanitarian settings. However, findings highlighted a glaring gap in evidence examining the non-health impact of IPV for survivors in humanitarian settings and across levels of the ecological framework. Without enhanced research of women and girls and the violence they experience, humanitarian responses will continue to underachieve, and the needs of women and girls will continue to be relegated as secondary interests. Investment should prioritize addressing the range of both health and non-health impacts of IPV among individuals, families, and communities, as well as consider how the humanitarian environment influences these linkages. Full article
(This article belongs to the Special Issue Intimate Partner Violence and Mental Health in Low- and Middle-Income Settings)
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