Department of Population Health Sciences, Centre for Academic Primary Care, University of Bristol, Bristol, UK.
Department of General Practice, University of Melbourne, Carlton, VIC, Australia.
Int J Epidemiol. 2021 May 17;50(2):652-662. doi: 10.1093/ije/dyaa220.
Intimate partner violence (IPV) damages health and is costly to families and society. Individuals experience different forms and combinations of IPV; better understanding of the respective health effects of these can help develop differentiated responses. This study explores the associations of different categories of IPV on women's mental and physical health.
Using data from the World Health Organization (WHO) Multi-Country Study on Women's Health and Domestic Violence, multilevel mixed effects logistic regression modelling was used to analyse associations between categories of abuse (physical IPV alone, psychological IPV alone, sexual IPV alone, combined physical and psychological IPV, and combined sexual with psychological and/or physical IPV) with measures of physical and mental health, including self-reported symptoms, suicidal thoughts and attempts, and nights in hospital.
Countries varied in prevalence of different categories of IPV. All categories of IPV were associated with poorer health outcomes; the two combined abuse categories were the most damaging. The most common category was combined abuse involving sexual IPV, which was associated with the poorest health [attempted suicide: odds ratio (OR): 10.78, 95% confidence interval (CI) 8.37-13.89, thoughts of suicide: 8.47, 7.03-10.02, memory loss: 2.93, 2.41-3.56]. Combined psychological and physical IPV was associated with the next poorest outcomes (attempted suicide: 5.67, 4.23-7.60, thoughts of suicide: 4.41, 3.63-5.37, memory loss: 2.33, 1.88-2.87-).
Understanding the prevalence and health impact of different forms and categories of IPV is crucial to risk assessment, tailoring responses to individuals and planning services. Previous analyses that focused on singular forms of IPV likely underestimated the more harmful impacts of combined forms of abuse.
亲密伴侣暴力（IPV）会损害健康，给家庭和社会带来沉重负担。个体所经历的 IPV 形式和组合各有不同；深入了解这些不同形式的各自健康影响有助于制定有针对性的应对措施。本研究旨在探讨不同类型的 IPV 对女性身心健康的关联。
本研究使用世界卫生组织（WHO）多国家妇女健康和家庭暴力研究的数据，采用多级混合效应逻辑回归模型分析了虐待行为（单独的身体 IPV、单独的心理 IPV、单独的性 IPV、身体和心理联合 IPV、性与心理和/或身体联合 IPV）类别与身心健康指标（包括自报告症状、自杀意念和尝试以及住院夜数）之间的关联。
各国 IPV 的不同类别流行率存在差异。所有类别的 IPV 均与较差的健康结果相关联；两种联合虐待类别最具破坏性。最常见的类别是涉及性 IPV 的联合虐待，与最差的健康状况相关联[自杀未遂：比值比（OR）：10.78，95%置信区间（CI）：8.37-13.89，自杀意念：8.47，7.03-10.02，记忆力丧失：2.93，2.41-3.56]。联合心理和身体 IPV 与下一个较差的结果相关联（自杀未遂：5.67，4.23-7.60，自杀意念：4.41，3.63-5.37，记忆力丧失：2.33，1.88-2.87）。
了解不同形式和类别的 IPV 的流行率和健康影响对于风险评估、针对个体的应对措施和服务规划至关重要。以前侧重于单一形式 IPV 的分析可能低估了联合虐待形式的更有害影响。
