Assari Shervin
Center for Research on Ethnicity, Culture and Health, University of Michigan, Ann Arbor, Michigan, USA.
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
Int J Epidemiol Res. 2017 Fall;4(4):232-239. doi: 10.15171/ijer.2017.09.
Although major depressive disorder (MDD) also increases the risk of Intimate Partner Violence (IPV) perpetration, poor mental health has been mostly conceptualized as a consequence of IPV victimization rather than a risk factor for IPV perpetration. Poor impulse control is another IPV risk factor. Building on a risk / risk framework, this study investigates additive and multiplicative effects of male partners' MDD and poor impulse control on physical IPV victimization reported by female partner.
This national longitudinal study followed a random sample of 2,500 male and female cohabiting partners for two years in United States. Data came from the Fragile Families and Child Wellbeing Study (FFCWS). Male partner's MDD was the independent variable. Baseline socio-demographic factors (age, relation status, education level, income, and minority status) and Generalized Anxiety Disorder (GAD), and Alcohol Use Disorder (AUD) were covariates. Outcome was female partner's physical IPV victimization measured at baseline and two years later. Male partner's impulse control was the moderator. tested independent effects of MDD and impulse control on physical IPV. used multi-group structural equation model to test the effect of MDD in those with low and poor impulse control. All participants provided written consent and SPSS and AMOS were used for data analysis.
In that tested additive effects of SES, GAD, AUD, MDD, and poor impulse control did not show main effects of MDD or impulse control on an increase in perpetration of physical IPV over two years. showed that MDD predicts an increase in perpetration of physical IPV of men with poor impulse control, but not men with high impulse control.
Based on the findings, poor impulse control and MDD have synergistic effects on IPV committed by men. Given the synergistic effects of psychological determinants of IPV, there is a need for prevention of IPV in male partners who have multiple risk factors such as MDD and poor impulse control. Self-regulation trainings of depressed men with poor impulse control may reduce IPV risk among men.
尽管重度抑郁症（MDD）也会增加亲密伴侣暴力行为（IPV）的风险，但心理健康不佳大多被视为亲密伴侣暴力受害的后果，而非亲密伴侣暴力行为的风险因素。冲动控制能力差是亲密伴侣暴力行为的另一个风险因素。基于风险/风险框架，本研究调查男性伴侣的重度抑郁症和冲动控制能力差对女性伴侣报告的身体亲密伴侣暴力受害情况的累加效应和相乘效应。
这项全国性纵向研究在美国对2500对同居伴侣（男女各半）进行了为期两年的随机抽样跟踪调查。数据来自脆弱家庭与儿童福利研究（FFCWS）。男性伴侣的重度抑郁症是自变量。基线社会人口学因素（年龄、关系状况、教育水平、收入和少数族裔身份）、广泛性焦虑障碍（GAD）和酒精使用障碍（AUD）为协变量。结果变量是在基线和两年后测量的女性伴侣的身体亲密伴侣暴力受害情况。男性伴侣的冲动控制能力是调节变量。测试了重度抑郁症和冲动控制能力对身体亲密伴侣暴力行为的独立影响。使用多组结构方程模型测试重度抑郁症在冲动控制能力低和差的人群中的影响。所有参与者均提供了书面知情同意书，数据分析使用SPSS和AMOS软件。
在测试社会经济地位、广泛性焦虑障碍、酒精使用障碍、重度抑郁症和冲动控制能力差的累加效应的研究中，未显示重度抑郁症或冲动控制能力对两年内身体亲密伴侣暴力行为增加的主要影响。研究表明，重度抑郁症预示着冲动控制能力差的男性身体亲密伴侣暴力行为会增加，但冲动控制能力高的男性则不会。
基于研究结果，冲动控制能力差和重度抑郁症对男性实施的亲密伴侣暴力行为具有协同效应。鉴于亲密伴侣暴力行为心理决定因素的协同效应，有必要对具有多种风险因素（如重度抑郁症和冲动控制能力差）的男性伴侣进行亲密伴侣暴力行为的预防。对冲动控制能力差的抑郁症男性进行自我调节训练可能会降低男性中的亲密伴侣暴力行为风险。
