Intimate partner violence types and symptoms of common mental disorders in a rural community of Chiapas, Mexico: Implications for global mental-health practice.

Mercedes Aguerrebere,Mary C Smith Fawzi,Sonia M Frías,Rocío López,Giuseppe Raviola,José J López-Goñi

doi:10.1371/journal.pone.0256850

Abstract

This paper examines the scope and characteristics of male-to-female intimate partner violence in southern rural Chiapas, Mexico, and its association with depression and anxiety symptoms, highlighting the role of partner controlling behaviors. Participants were selected by random sampling. One-hundred and forty-one women >15 years participated in the study. Data was obtained through an adapted version of the National Survey of the Dynamics of Household Relationships (ENDIREH) intimate partner violence scale, the Patient Health Questionnaire-9 for depression symptoms and the Generalized Anxiety Disorder-7 for anxiety symptoms. Quantitative results indicated a 66.4% lifetime prevalence of physical and/or sexual IPV among ever-partnered women 15 years or older (95% CI: 57.5–74.5%). Forty percent (95% CI: 32.0–49.7%) of them reported having experienced physical and/or sexual violence with high partner control (HC-IPV), and 25.8% (95% CI: 18.5–34.3%) reported having experienced physical and/or sexual violence with low or moderate partner control (MC-IPV). Lifetime experience of HC-IPV was significantly associated with moderate-severe depression symptoms (RR = 5.8) and suicidality (RR = 2.08). While partner alcohol abuse was associated with a 3.06 times higher risk of lifetime physical and/or sexual IPV, 30.9% of women mentioned that their partners were never drunk when violence occurred. Interestingly, high partner alcohol abuse was more frequent among women who reported HC-IPV compared to MC-IPV. Implications for global mental health practice are discussed.

Highlights

International evidence shows that intimate partner violence (IPV) increases the risk of mental disorders [1]
Chiapas is Mexico’s poorest state, with 51% of the population living in rural areas, 76.2% of the population living in poverty educational lag; b) poor living standard–inadequate construction material of the dwelling, number of people per room–; c) insufficient or absence of access to household basic services; d) lack of access to health services; e) lack of security, and; f) lack of access to quality and nutritious food), 31.8% living in extreme poverty [27, 28], and almost half of children under five years old suffering from chronic malnutrition [29]
When analyzing the relationship between depression and anxiety symptoms and the typology of violence considering partner control, HC-IPV held a significant association with moderate-severe depression symptoms (RR 5.8, 95% CI: 1.29–24.10; p = .004) and a trend towards significance with moderate-severe anxiety symptoms, but MC-IPV did not

Summary

Introduction

International evidence shows that intimate partner violence (IPV) increases the risk of mental disorders [1]. Different IPV dynamics, such as those that entail partner’s controlling behaviors (CB), may have distinct effects on the mental health of victims and service providers may require different approaches to care. Sociologist Michael Johnson [2] uses the term intimate terrorism (IT) to describe the violence that a partner (a man 90% of the times) uses as a mean to control the victim. The term situational couple violence (SCV) refers to violence in the context of conflict, without the intention control one’s partner. The later types of IPV are often the ones addressed by health, social and legal services providers, disregarding the role that partner control has on women’s mental health, liberty, and autonomy [4]

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