Abstract
BackgroundMost research on the health impacts of intimate partner violence (IPV) and child abuse has been conducted in Western countries and may not be generalizable to women living in different contexts, such as Saudi Arabia. Chronic pain, a disabling health issue associated with experiences of both child abuse and IPV among women, negatively impacts women’s well-being, quality of life, and level of functioning. Yet, the psychosocial mechanisms that explain how abuse relates to chronic pain are poorly understood. We developed and tested a theoretical model that explains how both IPV and child abuse are related to chronic pain.MethodsWe recruited a convenience sample of 299 Saudi women, who had experienced IPV in the past 12 months, from nine primary health care centers in Saudi Arabia between June and August 2015. Women completed a structured interview comprised of self-report measures of IPV, child abuse, PTSD, depressive symptoms, chronic pain, and social support. Using Structural equation modeling (SEM), we analyzed the proposed model twice with different mental health indicators as mediators: PTSD symptoms (Model 1) and depressive symptoms (Model 2).ResultsBoth models were found to fit the data, accounting for 31.6% (Model 1) and 32.4% (Model 2) of the variance in chronic pain severity. In both models, mental health problems (PTSD and depressive symptoms) fully mediated the relationship between severity of IPV and child abuse and chronic pain severity. Perceived family support partially mediated the relationship between abuse severity and depressive symptoms.ConclusionsThese results underscore the significance of considering lifetime abuse, women’s mental health (depressive and PTSD symptoms) and their social resources in chronic pain management and treatment.
Highlights
Most research on the health impacts of intimate partner violence (IPV) and child abuse has been conducted in Western countries and may not be generalizable to women living in different contexts, such as Saudi Arabia
We proposed that more severe child abuse and IPV are related to increased mental health problems (PTSD and depressive symptoms), and to lower perceived family support, each of which are related to more severe chronic pain
All women screened positive for IPV, only 31.4% of women reported that they believed that their husbands were abusive
Summary
Most research on the health impacts of intimate partner violence (IPV) and child abuse has been conducted in Western countries and may not be generalizable to women living in different contexts, such as Saudi Arabia. A disabling health issue associated with experiences of both child abuse and IPV among women, negatively impacts women’s well-being, quality of life, and level of functioning. We developed and tested a theoretical model that explains how both IPV and child abuse are related to chronic pain. Disability related to chronic pain is common among abused women and limits their ability to carry out important social roles and lead satisfying lives [20, 26]. Chronic pain is costly as a result of healthcare utilization [27]
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