Adverse mental health outcomes associated with emotional abuse in young rural South African women: a cross-sectional study

• Type of Material: Article
• Authors: Ruxana Jina, University of the Witwatersrand; Rachel Jewkes, University of Witwatersrand; Susie Hoffman, Columbia University; Kristen L. Dunkle, Emory University; Mzikazi Nduna, University of the Witwatersrand; Nwabisa J. Shai, Medical Research Council
• Language: English
• Date: 2012-03
• Publisher: SAGE Publications (UK and US)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © The Author(s) 2012
• Final Published Version (URL): http://jiv.sagepub.com/content/27/5/862
• Title of Journal or Parent Work: Journal of Interpersonal Violence
• ISSN: 0886-2605
• Volume: 27
• Issue: 5
• Start Page: 862
• End Page: 880
• Grant/Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the National Institute of Mental Health (Grant Nos. MH 64882-01, MH 64882-04S1A1, and 1R03MH085599) and the South African Medical Research Council. Ruxana Jina was supported by the Columbia University-Southern African Fogarty AIDS International Training and Research Program (AITRP) funded by the Fogarty International Center, National Institutes of Health (Grant No. D43TW000231). Susie Hoffman is supported in part by a center grant from the National Institute of Mental Health to The HIV Center for Clinical and Behavioral Studies (Grant No. P30 MH43520), (Anke A Ehrhardt, Principal Investigator).
• Keywords: Inter-personal violence; mental health; women; suicide
• Research Categories: Psychology, Behavioral; Health Sciences, Mental Health; Health Sciences, Public Health

Abstract

There is a lack of data on the prevalence of emotional abuse in youth. The aim of this study was thus to estimate the prevalence of emotional abuse in intimate partnerships among young women in rural South Africa and to measure the association between lifetime experience of emotional abuse (with and without the combined experience of physical and/or sexual abuse) and adverse health outcomes. Between 2002 and 2003, young women from 70 villages were recruited to participate in the cluster randomized controlled trial of an HIV behavioural intervention, Stepping Stones. Data was obtained through the administration of a questionnaire at baseline. Of the 1293 women who had ever been partnered, 189 (14.6%) had experienced only emotional abuse in their lifetimes. Three hundred and sixty-six women (28.3%) experienced emotional abuse with physical and/or sexual abuse in their lifetimes, and one hundred and forty-four women (11.1%) experienced physical and/or sexual abuse without emotional abuse. Hazardous drinking was associated with the experience of physical and/or sexual abuse, with (OR 6.0, 95% CI 1.0 – 36.6) and without emotional abuse (OR 5.8, 95% CI 1.1 – 29.4). Illicit drug use (OR 5.6, 95% CI 2.4 – 12.6), having depressive symptoms (OR 2.9, 95% CI 1.2 – 4.2), having psychological distress (OR 1.9, 95% CI 1.4 – 2.6), and suicidality (OR 79.0, 95% CI 17.3 – 359.6) was associated with the experience of emotional abuse with physical and/or sexual abuse. Suicidality was also strongly associated with having experienced emotional abuse alone (OR 79.5, 95% CI 16.7 – 377.4). This study showed that emotionally abused young women had a greater risk of suicidality than those experiencing no abuse and that the combined experience of emotional with physical and/or sexual abuse was strongly associated with poor mental health outcomes.