Understanding Overlapping Forms of Violence Within International Social Work: Unique Effects of Political and Domestic Violence Among Women in Palestine

Purpose: While findings consistently demonstrate the global mental health implications of both political violence and domestic violence, these problems are conventionally analyzed in exclusivity. Recently, however, scholarship has demonstrated connections between political violence and domestic violence; two international studies found that men who have experienced political violence are more likely to perpetrate domestic violence (Clark, et al., 2010; Gupta, et al., 2009). However, less is known about how political and domestic violence co-exist for the women who might experience them, and how each type of violence may pose unique risks to women’s mental health. Using survey data from adult women in Palestine, this study explores the relationships between domestic violence and political violence and tests their independent relationships to mental health.

Methods: This study is part of an IRB-approved collaborative research project between a US researcher and the Palestinian Medical Relief Society (PMRS). Surveys were collected from Palestinian women recruited from healthcare clinics and universities within eight districts in the West Bank (N=122). Staff used a prepared script that explained the study, its voluntary nature, and the potential benefits and risks. Two measures of political violence were used: a lifetime measure (a=.745) and a measure of experiences in the past month (a=.809). Domestic violence was measured with a 12-item scale that asked about aggression from the husband towards the wife within the past 12 months, adapted by Haj-Yahia (2008) from an earlier measure that had been used with similar populations (a=.834). Mental health outcome measures included: (1) Post-Traumatic Stress Disorder symptoms, assessed with the 4-item Primary Care PTSD screen (PC-PTSD; a=.854); (2) distress, assessed with a 10-item scale (Kessler’s-10, a=.889), which is extensively used in the US, Canada, and globally, by organizations like the WHO (Kessler et al., 2002); and (3) the Mental Health (MH) subscale of the SF-12, which is widely used to assess health, including within Arab populations (Al Sayah, 2012; Sabbah, 2003), and was highly correlated with distress= -.583, p=.000 and PTSD=-.351, p=.000. Higher MH scores indicate better mental health. After examining basic correlations, a series of regression models tested the relative contributions of political violence and domestic violence on each mental health outcome. Separate models were used for lifetime and past-month political violence.

Results: Domestic violence was significantly correlated with lifetime political violence (r=.416, p=.000). After controlling for domestic violence, both lifetime and past month political violence were independently correlated with PTSD (b=.308, p=.015; b=.344, p=.002). After controlling for lifetime political violence, domestic violence was independently associated with distress and mental health (b=.313, p=.014; b=-.251, p=.020). Both past-month political violence and domestic violence independently correlated to distress, after controlling for the other form of violence (although political violence only approached statistical significance: b=.198, p=.078; b=.262, p=.021).

Implications: Findings demonstrate that distinct forms of violence exposure might be associated with specific mental health symptomology. Results illustrate the need to assess for both political violence and domestic violence when considering international social work interventions related to violence.