Mental and Physical Health Changes Following an Abusive Intimate Relationship: A Systematic Review of Longitudinal Studies

Abstract

Longitudinal studies are critical to understanding health changes following trauma. The present systematic review adopted a longitudinal perspective on intimate partner abuse (IPA) by examining characteristics and findings of studies that followed persons who recently left an abusive relationship or who were at a point where they might leave and reported on health over time. Web of Science, EBSCO, Published International Literature on Traumatic Stress, and PubMed databases were searched using combinations of terms reflecting IPA, longitudinal study design, and health outcomes. Quantitative studies that recruited adults or adolescents, had multiple time points, used a health indicator as an outcome, and where IPA was a predictor, independent variable, or inclusion criterion were included. These methods yielded 36 studies from 20 unique samples. The following domains were coded for each article: citation, demographics, risk of bias, sample setting, design, follow-up, relationship and IPA characteristics, outcomes, and analytic focus. Results showed that all samples were female, and most were help-seeking. Depression, post-traumatic stress, and physical symptoms decreased over time, while quality of life increased in most studies. Changes in anxiety symptoms over time were less consistent. Ongoing IPA and social support were the most consistent predictors of health changes over time, showing relations with indicators of poorer or better health, respectively. There was preliminary evidence that decreases in emotional and physical symptoms plateaued within 9 months of the baseline assessment. Sampling, study design, measurement, and analysis are considered, and recommendations for future research are provided.

Trajectories of Depression, Post-Traumatic Stress, and Chronic Pain Among Women Who Have Separated From an Abusive Partner: A Longitudinal Analysis

“…Our findings suggest that the severity of abuse to which a woman is exposed predicts her mental and physical health and long-term recovery regardless of the length of time since separating from her abusive partner, and source of abuse (former partner or new partners). These results are consistent with an emerging body of longitudinal research on women’s mental health after separation from an abusive partner, including 2 studies on physical health ( Patton et al, 2022 ). More severe IPV was associated with poorer mental health (greater symptoms of depression and PTSD), and more severe chronic pain, with IPV having a stronger impact on these health outcomes over time.…”

“…Our hypothesis that the severity of IPV (past and ongoing) would predict health outcomes over time is based on an understanding that IPV is a common experience in the life course of women with cumulative effects on health, and that separation from an abusive partner does not equate with cessation of violence. Consistent with Patton et al’s (2022) review, accounting for the severity of past and ongoing IPV is particularly salient in predicting changes in women’s health post-separation.…”

“…In a recent systematic review of changes in women’s health after separation from an abusive partner, Patton et al (2022) noted the primacy given to mental health in this research largely (84%) conducted in the United States (US) with women who were accessing services (32 of 36 studies). Their results identified a consistent reduction in depression (9 studies) and post-traumatic stress (5 studies) over time after separation, and emerging evidence of improvement in general physical symptoms (4 studies); no studies focused on chronic pain.…”

“…In a cross-sectional analysis of women who had separated from an abusive partner, women’s personal, social, and economic resources mediated the relationship between severity of IPV and women’s mental and physical health, such that more severe abuse eroded women’s resources, with negative effects on their health ( Ford-Gilboe et al, 2009 ). In Patton et al’s (2022) review, social support consistently predicted improvements in women’s health trajectories (5 studies) and access to economic resources predicted improvement in depression (2 studies); results were inconclusive for post-traumatic stress (2 studies) and change was not examined in relation to physical health. From an equity perspective, studies that unpack the complex relationships among IPV, health and varied social and economic conditions could lead to more nuanced understanding of women’s continued risks and inform more tailored and appropriate interventions.…”

Structural and construct validity of the Quality of Life Scale among Canadian women with histories of intimate partner violence

“…The consequences of IPV include more than visible physical injuries, but often extend to long-term effects on women's mental and physical health, relationships, living conditions, finances, and safety for themselves and for their families. 19,[68][69][70] The ability to measure different aspects of women's life quality has the potential to yield more comprehensive and appropriate assessment, while enhancing understanding about the differential impacts of IPV on the many different facets of women's lives. Both Sullivan's QOL Scale and the WHOQOL measures tap a broad number of domains; as previously noted, each scale has evidence supporting its reliability and validity and has been used in studies of women experiencing IPV.…”