Istanbul University, Istanbul Medical Faculty, Forensic Medicine Department, Istanbul, Turkey.
Faculty of Social Sciences/Psychology, Tampere University, Kalevankatu 5, Linna 4krs, FIM-33014, Tampere, Finland.
Arch Womens Ment Health. 2020 Apr;23(2):155-166. doi: 10.1007/s00737-019-00960-w. Epub 2019 Apr 6.
Researchers agree that early marriage (EM) and adolescent pregnancy (AP) can form severe risks for women's somatic, mental, and reproductive health, as well as on educational and social status. Yet, less is known about factors that may moderate or mediate these associations. This study examined, first, retrospectively the impacts of EM and AP on self-reported mental and somatic health among multicultural group of women living in Eastern Anatolia, Turkey. Second task was to analyze whether and how the partner violence would mediate and/or moderate between EM and AP and mental health problems. The participants were 1569 women (16-72 years of age), who reported their age of being married, first pregnancy, and demographic characteristics. They described their mental health status through General Health Questionnaire (GHQ-28: depressive, anxiety, social dysfunction, and somatization symptoms) and symptoms of posttraumatic stress disorder (PTSD; DSM-5). Women's reports of somatic illnesses were classified according to WHO-ICD-10. The revised conflict tactics scale, short form was used as a proxy to partner violence. Women who gave birth at 13-19 years of age reported more anxiety and somatization symptoms than later delivered, and those married younger than 25 showed a higher level of depressive symptoms than later married. Both AP and EM formed a heightened risk for somatic illnesses. The partner violence functioned as a moderator; AP was associated with especially high levels of depressive and anxiety symptoms among women exposed to sexual coercion in their marriage. Non-significant mediation analysis indicates that partner violence did not explain the severe impacts of the AP and EM on women's mental health. Yet, the AP and EM were associated with heightened level of partner violence. Adolescent pregnancy forms a comprehensive mental health risk, and both AP and EM were risks for somatic illnesses, such as cardiovascular problems. The mental health risk of AP further intensified if women experienced sexual coercion in their partnership. Our fundamental work is to abolish these patriarchal phenomena.
研究人员一致认为，早婚（EM）和青少年怀孕（AP）会对女性的身体、心理和生殖健康以及教育和社会地位造成严重风险。然而，对于可能缓和或调解这些关联的因素知之甚少。本研究首先回顾性地研究了 EM 和 AP 对居住在土耳其东安纳托利亚的多元文化女性群体的自我报告的心理和身体健康的影响。其次，分析了伴侣暴力是否以及如何在 EM 和 AP 与心理健康问题之间进行调解和/或调节。参与者是 1569 名女性（16-72 岁），她们报告了结婚年龄、第一次怀孕和人口统计学特征。他们通过一般健康问卷（GHQ-28：抑郁、焦虑、社会功能障碍和躯体化症状）和创伤后应激障碍症状（DSM-5）描述了自己的心理健康状况。根据世界卫生组织国际疾病分类第 10 版（WHO-ICD-10）对女性的躯体疾病进行分类。修订后的冲突策略量表简表被用作伴侣暴力的代理。13-19 岁分娩的女性报告的焦虑和躯体化症状比晚产的女性多，25 岁以下结婚的女性比晚结婚的女性表现出更高水平的抑郁症状。AP 和 EM 都增加了患躯体疾病的风险。伴侣暴力起到了调节作用；在婚姻中受到性胁迫的女性中，AP 与抑郁和焦虑症状尤其高有关。非显著中介分析表明，伴侣暴力并不能解释 AP 和 EM 对女性心理健康的严重影响。然而，AP 和 EM 与更高水平的伴侣暴力有关。青少年怀孕构成了全面的心理健康风险，AP 和 EM 都会增加心血管问题等躯体疾病的风险。如果女性在伴侣关系中经历性胁迫，AP 的心理健康风险会进一步加剧。我们的根本工作是废除这些父权制现象。
