Burden of Abuse: Violent partners take mental toll on women

Physical abuse doled out by husbands or male live-in partners contributes substantially to major depression and other mental disorders among women of childbearing age, a long-term study finds. In contrast, men subjected to violent abuse by their female partners show psychiatric disorders no more often than they did before entering those relationships.

“Partner abuse should be assessed routinely during psychiatric evaluations,” remarks psychologist Miriam K. Ehrensaft of Columbia University.

The new investigation by Ehrensaft and her colleagues, published in the May American Journal of Psychiatry, offers a rare before-and-after look at the mental impact of abusive relationships. It focuses on 449 women and 456 men in New Zealand whose physical and psychological development was tracked from ages 3 to 26.

The researchers evaluated psychiatric interviews done at ages 18 and 26. In separate assessments at age 26, participants reported on any abusive partner relationships—entailing physical injury, medical treatment, or involvement by police and other agencies—from the previous 3 years.

The researchers identified 37 men and 38 women subjected to partner abuse producing physical injuries, such as cuts and broken bones. Abusive incidents occurred with equal frequency in both groups.

People who ended up in abusive relationships displayed higher rates of some mental disorders at age 18 than their peers did. Battered women were more likely to have had depression and marijuana dependence, and battered men had had those problems plus alcohol dependence and anxiety disorders. As suggested by previous studies, childhood abuse frequently foreshadowed a person’s abuse by a partner.

At age 26, women in abusive relationships displayed elevated rates of depression, marijuana dependence, and post-traumatic stress disorder, compared with their rates of those disorders at age 18. No such trend appeared for the women not in abusive relationships or for men, regardless of whether they were in abusive relationships.

Since men, who tend to have greater financial resources and less responsibility for child rearing, can often leave abusive relationships more easily than women can, it makes sense that partner abuse weighs more heavily on women’s mental health, remarks psychologist Mary P. Koss of the University of Arizona in Tucson.

Still, it’s unclear why marijuana but not alcohol problems appeared in New Zealand women subjected to partner abuse, Koss says. An examination of other illicit drug use is also needed, in her view.

Related findings appear in the June American Journal of Preventive Medicine. In the United States, women commonly encounter domestic violence, reports a team led by physician Robert S. Thompson and psychologist Amy E. Bonomi, both of the Group Health Cooperative in Seattle.

Depression, physical complaints, and social isolation increase as women experience more partner abuse, these researchers say.

In a random sample of 3,568 women, ages 18 to 64, enrolled in a health maintenance organization, 44 percent reported having experienced abuse by a husband or live-in partner in the preceding 5 years. Abuse typically included physical injury, fear resulting from a partner’s anger or threats, or frequent attempts by a partner to control the victim. About one-third of women cited instances of physical injury, and 17 percent reported rapes or forced sexual contact.

The predominantly white, employed women in this study provide a conservative estimate of the prevalence of partner abuse, comments physician James S. Marks of the Robert Wood Johnson Foundation in Princeton, N.J. “This is a national scourge,” he says.