Khan Zara, Cheong Yuk F, Miedema Stephanie S, Naved Ruchira T, Yount Kathryn M
Hubert Department of Global Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.
Department of Psychology, Emory University, 36 Eagle Row, Suite 270, Atlanta, GA, 30322, USA.
SSM Popul Health. 2020 Aug 9;12:100641. doi: 10.1016/j.ssmph.2020.100641. eCollection 2020 Dec.
Prior studies of the association between intimate partner violence (IPV) and depressive symptoms have typically excluded economic coercion (EC), a prevalent form of IPV worldwide. Here, we used structural equation models (SEM) to estimate the association of EC with depressive symptoms, with and without adjustment for physical/psychological/sexual IPV, among women in rural Matlab, Bangladesh. Data were collected from cross-sectional surveys with married women 15-49 years, conducted between November 2018 and January 2019. Prior-week depressive symptoms were measured using the 10-item Centre for Epidemiologic Studies Depression short-form. Lifetime EC was assessed using a bi-dimensional, 36-item scale developed in Matlab. Lifetime physical/sexual/psychological IPV was assessed using the 20-item WHO Domestic Violence module. Covariates were age, age at marriage, and schooling; partner's schooling; and household wealth. Among 929 women, lifetime experience of EC ranged from 41.9% (control over access to work, schooling, and training) to 50.0% (control over use/maintenance of economic resources), while any lifetime physical/psychological/sexual IPV was 89.5%. Coercion involving the use and maintenance of economic resources had a significant, adjusted association with depressive symptoms (standardized coefficient = 0.491, p<0.001, R=0.221). The standardized association of any physical/psychological/sexual IPV with depressive symptoms, adjusted for covariates and cluster sampling, was 0.346 (p <0.001, R=0.143). When further adjusted for the two measures of EC, the association was attenuated and non-significant (0.049, p = 0.817). These findings suggest that EC is prevalent, significantly associated with depressive symptoms, and attenuates the association of other forms of IPV with depressive symptoms. Addressing EC with other forms of IPV may be necessary to reduce depressive symptoms in exposed women.
以往关于亲密伴侣暴力（IPV）与抑郁症状之间关联的研究通常排除了经济胁迫（EC），而经济胁迫是全球范围内一种普遍存在的亲密伴侣暴力形式。在此，我们使用结构方程模型（SEM）来估计在孟加拉国马特莱农村地区的女性中，经济胁迫与抑郁症状之间的关联，同时考虑了是否对身体/心理/性方面的亲密伴侣暴力进行调整。数据收集自2018年11月至2019年1月期间对15至49岁已婚女性进行的横断面调查。使用10项流行病学研究中心抑郁简表来测量前一周的抑郁症状。使用在马特莱开发的一个二维、36项量表来评估终生经济胁迫情况。使用20项世界卫生组织家庭暴力模块来评估终生身体/性/心理方面的亲密伴侣暴力情况。协变量包括年龄、结婚年龄、受教育程度；伴侣的受教育程度；以及家庭财富。在929名女性中，终生经历经济胁迫的比例从41.9%（控制工作、上学和培训的机会）到50.0%（控制经济资源的使用/维护）不等，而终生经历任何身体/心理/性方面亲密伴侣暴力的比例为89.5%。涉及经济资源使用和维护的胁迫与抑郁症状存在显著的、经调整后的关联（标准化系数 = 0.491，p<0.001，R = 0.221）。在对协变量和整群抽样进行调整后，任何身体/心理/性方面亲密伴侣暴力与抑郁症状的标准化关联为0.346（p <0.001，R = 0.143）。当进一步对两种经济胁迫测量指标进行调整后，该关联减弱且不显著（0.049，p = 0.817）。这些发现表明，经济胁迫很普遍，与抑郁症状显著相关，并减弱了其他形式的亲密伴侣暴力与抑郁症状之间的关联。解决经济胁迫以及其他形式的亲密伴侣暴力问题对于减轻受影响女性的抑郁症状可能是必要的。
