Depressive symptoms and suicidality in women experiencing intimate partner violence

Abstract

Study objectives: We compare 2 groups of abused black female emergency department (ED) patients (suicide attempters and nonattempters) with regard to specific depressive symptoms. Methods: The study was a cross-sectional examination of intimate partner violence (IPV)–positive black women who presented to the medical or psychiatric ED for treatment. Black women with a recent history of IPV who presented after an attempted suicide (n=100) were compared with demographically comparable IPV-positive black women who had not attempted suicide and presented for treatment of another condition (n=100). Women completed face-to-face interviews on several measures, including demographics and the Beck Depression Inventory-II (BDI-II). Multivariate analysis of variance was used to test the hypothesis that attempters would report higher levels on the BDI-II items compared with their nonattempting counterparts. Analyses of variance were used to assess on which specific BDI-II items the groups differed. A logistic regression analysis, using the BDI-II variables with moderate effect sizes, was conducted to predict group status. Results: Overall, there were no demographic differences between cases and controls. Attempters reported statistically significant higher scores on all 21 BDI-II items than did nonattempters. Four BDI-II items had effect size values in the medium range: sadness, self-dislike, suicidal thoughts, and feelings of worthlessness. The logistic regression model using these 4 variables correctly predicted group status 78% of the time. Conclusion: IPV patients who attempt suicide have higher levels of depressive symptoms than nonattempters. Symptoms of sadness, self-dislike, suicidal thoughts, and feelings of worthlessness had the highest predictive value. These 4 items can be used as a brief screen in the ED to detect female IPV patients at increased risk for suicidal behavior. Study objectives: We compare 2 groups of abused black female emergency department (ED) patients (suicide attempters and nonattempters) with regard to specific depressive symptoms. Methods: The study was a cross-sectional examination of intimate partner violence (IPV)–positive black women who presented to the medical or psychiatric ED for treatment. Black women with a recent history of IPV who presented after an attempted suicide (n=100) were compared with demographically comparable IPV-positive black women who had not attempted suicide and presented for treatment of another condition (n=100). Women completed face-to-face interviews on several measures, including demographics and the Beck Depression Inventory-II (BDI-II). Multivariate analysis of variance was used to test the hypothesis that attempters would report higher levels on the BDI-II items compared with their nonattempting counterparts. Analyses of variance were used to assess on which specific BDI-II items the groups differed. A logistic regression analysis, using the BDI-II variables with moderate effect sizes, was conducted to predict group status. Results: Overall, there were no demographic differences between cases and controls. Attempters reported statistically significant higher scores on all 21 BDI-II items than did nonattempters. Four BDI-II items had effect size values in the medium range: sadness, self-dislike, suicidal thoughts, and feelings of worthlessness. The logistic regression model using these 4 variables correctly predicted group status 78% of the time. Conclusion: IPV patients who attempt suicide have higher levels of depressive symptoms than nonattempters. Symptoms of sadness, self-dislike, suicidal thoughts, and feelings of worthlessness had the highest predictive value. These 4 items can be used as a brief screen in the ED to detect female IPV patients at increased risk for suicidal behavior.