Comorbidity Between Abuse of an Adult and DSM-III-R Mental Disorders: Evidence From an Epidemiological Study

Abstract

Objective-To report the prevalence, risk and implications of comorbidity between partner violence and psychiatric disorders.Method-Data were obtained from a representative birth cohort of 941 young adults using the Conflicts Tactics Scales and Diagnostic Interview Schedule.Results-Half of those involved in partner violence had a psychiatric disorder; one-third of those with a psychiatric disorder were involved in partner violence. Individuals involved in severe partner violence had elevated rates of a wide spectrum of disorders. Conclusions-Mental health clinicians may treat victims and perpetrators before injury occurs.Studies of partner violence reveal that 35-50% of young adults are involved in some level of physical abuse (1). Accordingly, the mental health field has made partner violence a "focus of clinical attention" with its creation of the category "Physical Abuse of Adult" in the DSM-IV. Acknowledging that partner violence may represent a clinical condition raises the possibility that abusive relationships may co-occur with other clinical disorders (i.e., comorbidity). This study aimed to estimate the base rates of psychiatric disorders among women who are victims and men who are perpetrators of partner violence because these persons are most frequently treated in mental health facilities.Previous studies found that women victims of partner violence have an increased incidence of depression, anxiety, personality disorders, schizophrenia, and drug and alcohol abuse and that men perpetrators of partner violence have an increased incidence of depression, personality disorders, and drug and alcohol abuse (2-7). However, these studies relied on samples from shelters (2,4), medical settings (3), treatment programs (5,6,7) and correctional facilities (5). Such samples are biased by factors associated with treatment seeking or adjudication. Therefore, epidemiological studies such as this one are needed to identify rates and patterns of comorbidity in the age segment of the general population that is at greatest risk for partner violence (8). Such knowledge can inform theory about relations MethodParticipants were members of the Dunedin Multidisciplinary Health and Development Study, a representative birth cohort (N=1037; 52% males, 48% females) studied since birth in 1972-73. We report data gathered at age 21, when 92% of the living study members provided data about their intimate relationships and mental health. Sample, design, and data are described extensively elsewhere (9,10,11,12).Partner violence in the previous 12 months was measured using the Conflict Tactics Scales (CTS) (13). We examined Any Physical Violence, which referred to any of three minor or six severe violent behaviours in the CTS (minor: throw object at partner, push/grab/shove partner, slap partner; severe: kick/bite/hit with fist, hit with object, beat up, choke/strangle, threaten with a knife/gun, use a knife/gun) and Severe Physical Violence, which referred to any of the six severe violent behaviours in the CTS.The Diagnostic I...

Mental Health of Victims of Intimate Partner Violence: Results From a National Epidemiologic Survey

“…Intimate partner violence is associated not only with an increased risk of posttraumatic stress disorder, major depressive disorder and substance use disorders, as previously reported (5, 6), but also with bipolar disorder, panic disorder, and generalized anxiety disorder. Previous research indicates that a history of child physical and sexual abuse increase the prevalence of several disorders in adulthood (15).…”

“…Furthermore, intimate partner violence is associated with depression, posttraumatic stress disorder, and substance abuse (5, 6). The National Comorbidity Survey (NCS) reported that 17.4% and 18.4% of women and men respectively were victims of intimate partner violence during the course of their current marriage or cohabitation (7).…”

Patients' Advice to Physicians About Intervening in Family Conflict

“…[1][2][3][4][5] Women who are victims of intimate partner violence make up 34% to 46% of adult female patients in primary care practices. [6][7][8][9] Although nearly all physicians believe identifi cation and management of family violence is important, 10,11 in practice routine screening is uncommon.…”

Intimate Partner Violence and Comorbid Mental Health Conditions Among Urban Male Patients

“…6,7 Substance abuse and mental health problems have been found to be major cofactors in IPV, [8][9][10] and there is reason to believe that interventions aimed at reducing violent behavior will be only marginally effective if co-occurring mental health and substance abuse problems are ignored. [11][12][13][14][15] Recent research targeting substance use along with IPV behavior is promising. [16][17][18] The US Preventative Service Task Forces ranked the evidence in favor of routine screening for family violence as inconclusive and raised concerns for possible harm from retaliatory IPV after disclosure.…”