Abstract

A key issue in need of empirical exploration in the post-conflict and refugee mental health field is whether exposure to torture plays a role in generating risk of intimate partner violence (IPV), and whether this pathway is mediated by the mental health effects of torture-related trauma. In examining this question, it is important to assess the impact of socio-economic hardship which may be greater amongst survivors of torture in low-income countries. The study data were obtained from a cohort of 870 women (recruited from antenatal clinics) and their male partners in Dili district, Timor-Leste. We conducted bivariate and path analysis to test for associations of men's age, socioeconomic status, torture exposure, and mental disturbance, with IPV (the latter reported by women). The path analysis indicated positive paths from a younger age, torture exposure, and lower socio-economic status amongst men leading to mental disturbance. Mental disturbance, in turn, led to IPV. In addition, younger age, lower socio-economic status, torture exposure, and mental disturbance were directly associated with IPV. Our data provide the first systematic evidence of an association between torture and IPV in a low-income, post-conflict country, confirming that low socio-economic status, partly related to being a torture survivor, adds to the risk. The high prevalence of IPV in this context suggests that other structural factors, such as persisting patriarchal attitudes, contribute to the risk of IPV. Early detection and prevention programs may assist in reducing the risk of IPV in families in which men have experienced torture.

Highlights

  • Clinicians working with refugees and other conflict-affected populations have noted that intimate partner violence (IPV) may be a risk in families of torture survivors, yet there are no systematic data corroborating that observation (Rees & Pease, 2006; Gupta et al, 2009)

  • A systematic review and meta-regression of studies amongst refugee and other populations exposed to persecution confirmed that torture is the most potent of all the traumas of mass conflict in generating post-traumatic stress disorder (PTSD) (Steel et al, 2009)

  • We evaluated model fit according to the conventional suite of indicators including a non-significant chi-square test; Comparative Fit Index (CFI) >0.90; the Tucker-Lewis Index (TLI) >0.90; the root mean square error of approximation (RMSEA)

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Summary

Introduction

A key issue in need of empirical exploration in the post-conflict and refugee mental health field is whether exposure to torture plays a role in generating risk of intimate partner violence (IPV), and whether this pathway is mediated by the mental health effects of torture-related trauma. In examining this question, it is important to assess the impact of socio-economic hardship which may be greater amongst survivors of torture in low-income countries

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