Women's Experiences of Intimate Partner Violence, Economic Coercion, and Depressive Symptoms in Bangladesh

Abstract

Background: Prior studies of the association between intimate partner violence (IPV) and depressive symptoms have typically excluded economic coercion (EC), a common form of partner violence. We estimated associations of EC and other forms of IPV with depressive symptoms among women in Matlab, Bangladesh. Methods: Data were collected from cross-sectional surveys with married women 15-49 years. We examined relationships of EC, physical/psychological/sexual IPV, and depressive symptoms using structural equation models (SEM). Past-week depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Depression scale. Lifetime EC was assessed using a bi-dimensional, 36-item scale. Lifetime physical/sexual/psychological IPV was assessed with a 20-item scale. Covariates were age, age at marriage, and schooling; partner’s schooling; and household wealth. Findings: Among 929 women, 82·2% reported any past-week depressive symptoms. Lifetime experience of EC ranged from 41·9% (control over access to work, schooling, and training) to 50·0% (control over use/maintenance of economic resources), while any lifetime physical/psychological/sexual IPV was 89·5%. The standardized association of physical/psychological/sexual IPV with depressive symptoms, adjusted for covariates, was 0·350 (p < 0.0001, R2 = 0·143); when additionally adjusted for two EC measures, the association was attenuated (0.017, p = 0·817). Coercion involving the use and maintenance of economic resources had a significant, adjusted association with depressive symptoms (0·480, p < 0·001, R2 = 0·221). Interpretation: EC is prevalent and attenuates the association of physical/sexual/psychological IPV with depressive symptoms. Addressing EC with other forms of IPV may be necessary to reduce depressive symptoms in exposed women. Funding Statement: This study was supported by research grant 1R21HD093027 (PI Yount) from the Eunice Kennedy Shriver National Institute of Child Health and Development. Declaration of Interests: The authors have no conflicts of interest to report. Ethics Approval Statement: The Institutional Review Boards of Emory University (IRB00097428) and the International Centre for Diarrheal Diseases Research, Bangladesh (icddr,b) (PR17077) reviewed and approved the study protocol.