Synergistic Effects of Psychological Intimate Partner Violence Exposure and Gender Discrimination on Postnatal Mental Health Trajectories

Abstract

While the literature examining physical intimate partner violence (IPV) is extensive, the impact of psychological IPV on mental health during highrisk times such as the period following childbirth is not well understood. The current study examined associations between psychological IPV and the course and severity of women's postnatal mental health symptoms (depression, anxiety, and trauma symptoms). Both main effects of psychological IPV exposure and possible exacerbation by broader social victimization (i.e., gender discrimination) were considered. Participants were 76 mothers from a larger longitudinal study, who completed selfreport measures of IPV, gender discrimination, and affective symptoms at 3, 6, 12, and 18 months postnatal. Hierarchical linear modeling revealed a main effect of psychological IPV on the course of trauma symptoms only. As hypothesized, gender discrimination moderated the effect of psychological

Intimate Partner Violence and Perinatal Post-Traumatic Stress and Depression Symptoms: A Systematic Review of Findings in Longitudinal Studies

“…Several studies reported positive associations between IPV and depression in the antenatal period (Flanagan et al, 2015;Paulson & Miller-Graff, 2019), postpartum period (Adynski et al, 2019;Agrawal et al, 2014;Escriba-Aguir et al, 2013;Jackson et al, 2015;Kita et al, 2019;McMahon et al, 2011;Valentine et al, 2011), or both (Flach et al, 2011;Ogbonnaya et al, 2013;Tiwari et al, 2008;Velonis et al, 2017;Woolhouse et al, 2012) even after adjusting for demographics, perinatal, or mental health factors. Five studies, however, found null associations between IPV (i.e., lifetime ¼ 3, recent ¼ 1, perinatal ¼ 1) and postpartum depression after adjusting for factors like childhood abuse and/or mental health (Dawson et al, 2019;Dennis & Vigod, 2013;Gaillard et al, 2014;Katon et al, 2014;Malta et al, 2012).…”

“…In the multilevel analyses, perinatal psychological IPV was not related to initial levels of postpartum mental health symptoms, nor the course of depression. It was, however, associated with a declining trajectory in PTSS (Dawson et al, 2019). Researchers also found that the effect of psychological IPV on mental health was moderated by gender discrimination, such that IPV predicted elevated depression and PTSS among women reporting high levels of gender discrimination.…”

“…Perinatal IPV and depression. Four studies, from the United States and South Africa, examined the role of perinatal IPV in the course of depression, either across the entire perinatal period (Peltzer et al, 2018;Tsai et al, 2016) or the postpartum period (Dawson et al, 2019;Okafor et al, 2018;Velonis et al, 2017). These studies differed in analytic techniques and definitions of IPV.…”

“…Longitudinal studies should assess IPV subtypes to determine whether specific profiles of IPV exposure confer differential risk for perinatal mental health difficulties. Many studies examined the unique contribution of different types of IPV on perinatal mental health, but they almost exclusively focused on perinatal depression (excluding Dawson et al, 2019). There was no consistent pattern in terms of which types of IPV represented the greatest risk, which is likely due to variation in definitions of subtypes of IPV and the inconsistent manner in which studies classified IPV exposure when using the same assessment tool.…”

“…Further, no review has examined how these associations might vary by type of IPV exposure. This represents an opportunity given that trajectories of IPV and perinatal mental health have attracted burgeoning interest in recent years (Dawson et al, 2019; Tho Tran et al, 2018; Tsai et al, 2016, as examples).…”