Link between intimate partner violence or childhood sexual abuse and health problems stronger than we thought

The potential mental and physical health impacts of experiencing intimate partner violence or childhood sexual abuse are more extensive than previously thought, according to international research. The team compiled a list of previous studies on the links and  combined the results for re-analysis. They say intimate partner violence was associated with a 63% higher risk of major depressive disorder and 35% increased risk of maternal abortion and miscarriage. Childhood sexual abuse was linked to a 45% increased risk of alcohol use disorder and 35% increased risk of self-harm. The researchers say there is not currently enough research on this topic to fully evaluate many health risks that could potentially be exacerbated by abuse.

Journal/conference: Nature Medicine

Link to research (DOI): 10.1038/s41591-023-02629-5

Organisation/s: University of Washington, USA

Funder: Research reported in this publication was supported by the Bill and
Melinda Gates Foundation (award 66-7813 to E.G.). The funders of the
study had no role in study design, data collection, data analysis, data
interpretation, writing of the final report or the decision to publish.

Media release

From: Springer Nature

Health: Intimate partner violence and childhood sexual abuse associated with health effects (N&V)

Exposure to intimate partner violence or childhood sexual abuse is associated with wide-ranging physical and mental health effects, according to a systematic review and meta-analysis published in Nature Medicine. Although the findings suggest that the effects may be more extensive than previously thought, further research is needed.

Globally, one in three ever-partnered women have experienced intimate partner violence in their lifetime, and around 20% of young women and 10% of young men have experienced some form of childhood sexual abuse. However, research investigating health outcomes associated with intimate partner violence and childhood sexual abuse has been limited.

Searching through papers published from seven databases, Emmanuela Gakidou and colleagues identified the available literature on intimate partner violence and childhood sexual abuse and their associated health effects. They reviewed over 4,000 studies, of which 57 and 172 studies met the criteria for inclusion in relation to intimate partner violence and childhood sexual abuse, respectively. Using the burden of proof methodology (a meta-analytic approach for estimating a conservative measure of the elevated or reduced risk of a particular health outcome after exposure to a harmful or protective risk factor), they evaluated the strength of evidence connecting intimate partner violence and/or childhood sexual abuse to health outcomes, which were supported by at least three studies.

The authors found that exposures to intimate partner violence had a moderate association with an increased risk of major depressive disorders (63%) and an increased risk of maternal abortion and miscarriage (35%). Childhood sexual abuse was shown to be moderately associated with an increased risk of alcohol use and an increased risk of self-harm (45% and 35%, respectively). The authors indicate these findings are larger in magnitude and more extensive than previously suggested. They also identified additional potential health outcomes, including an association of maternal hypertensive disorders with intimate partner violence, during their initial literature review, but due to a scarcity of evidence, these could not be included in the meta-analysis.

The authors note that the studies are observational and cannot demonstrate causality and highlight that their findings are limited owing to the limited number of studies that explore these relationships. They suggest that their research demonstrates the wide-ranging health effects of intimate partner violence and childhood sexual abuse but emphasize the need for further research to strengthen the evidence base.

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