Rees Susan, Mohsin Mohammed, Tay Alvin Kuowei, Steel Zachary, Tam Natalino, da Costa Zelia, Soares Cesarina, Tol Wietse, Eapen Valsamma, Dadds Mark, Silove Derrick
Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.
St John of God Hospital, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.
Glob Ment Health (Camb). 2018 Jul 3;5:e23. doi: 10.1017/gmh.2018.16. eCollection 2018.
A key issue in need of empirical exploration in the post-conflict and refugee mental health field is whether exposure to torture plays a role in generating risk of intimate partner violence (IPV), and whether this pathway is mediated by the mental health effects of torture-related trauma. In examining this question, it is important to assess the impact of socio-economic hardship which may be greater amongst survivors of torture in low-income countries.
The study data were obtained from a cohort of 870 women (recruited from antenatal clinics) and their male partners in Dili district, Timor-Leste. We conducted bivariate and path analysis to test for associations of men's age, socioeconomic status, torture exposure, and mental disturbance, with IPV (the latter reported by women).
The path analysis indicated positive paths from a younger age, torture exposure, and lower socio-economic status amongst men leading to mental disturbance. Mental disturbance, in turn, led to IPV. In addition, younger age, lower socio-economic status, torture exposure, and mental disturbance were directly associated with IPV.
Our data provide the first systematic evidence of an association between torture and IPV in a low-income, post-conflict country, confirming that low socio-economic status, partly related to being a torture survivor, adds to the risk. The high prevalence of IPV in this context suggests that other structural factors, such as persisting patriarchal attitudes, contribute to the risk of IPV. Early detection and prevention programs may assist in reducing the risk of IPV in families in which men have experienced torture.
冲突后及难民心理健康领域中一个需要实证探索的关键问题是,遭受酷刑是否会增加亲密伴侣暴力(IPV)的风险,以及这条途径是否由与酷刑相关创伤的心理健康影响所介导。在研究这个问题时,评估社会经济困境的影响很重要,因为在低收入国家,酷刑幸存者可能面临更大的社会经济困境。
研究数据来自东帝汶帝力地区的870名女性(从产前诊所招募)及其男性伴侣组成的队列。我们进行了双变量分析和路径分析,以检验男性的年龄、社会经济地位、遭受酷刑情况和精神障碍与亲密伴侣暴力(由女性报告)之间的关联。
路径分析表明,男性年龄较小、遭受酷刑以及社会经济地位较低会导致精神障碍,而精神障碍又会导致亲密伴侣暴力。此外,年龄较小、社会经济地位较低、遭受酷刑和精神障碍与亲密伴侣暴力直接相关。
我们的数据首次提供了低收入冲突后国家中酷刑与亲密伴侣暴力之间关联的系统证据,证实社会经济地位较低(部分与成为酷刑幸存者有关)会增加风险。在这种情况下,亲密伴侣暴力的高发生率表明,其他结构性因素,如持续存在的男尊女卑态度,也会增加亲密伴侣暴力的风险。早期发现和预防项目可能有助于降低男性遭受过酷刑的家庭中亲密伴侣暴力的风险。