Patterns of Intimate Partner Violence Victimization and Health Outcomes

Background: Survivors of intimate partner violence (IPV) suffer numerous negative consequences, including health problems. The literature on IPV and health outcomes demonstrated that the more frequent and severe is IPV, the worse is the survivors’ health. However, previous studies are limited due to small samples, focusing on a single perpetrator (e.g., measuring what happened with relation to the most recent intimate partner), and overlooking potentially cumulative effects of multiple victimization by multiple perpetrators and/or multiple types of IPV (e.g., physical violence by one perpetrator, and both psychological and sexual assaults by another perpetrator). This study fills this gap by using one of the biggest, and the most recent, national data, addressing those limitations of the literature, and examining health outcomes of a variety of different patterns of IPV victimization.

Method: This study used the National Intimate Partner and Sexual Violence Survey that collected data in 2010 in the U.S. (Black et al., 2011). The study sample included 8,587 survivors who reported one or more perpetrators. We developed a typology of perpetrators, including those who perpetrated only psychological aggression and those who perpetrated physical, psychological, and sexual violence altogether (details reported elsewhere). A hierarchical cluster analysis was first conducted to create the pattern of victimization based on this perpetrator typology. Survivors were classified into five groups: (1) victimized mainly by perpetrators of psychological aggression (n=938, 12%), (2) less severe physical violence (n=2,218, 25%), (3) stalking (n=1,017, 12%), (4) multiple types of violence (n=1,755, 20%), (5) coercive control (n=2,659, 32%). Complex sample logistic regression analyses were conducted to examine if the pattern of victimization was associated with various health problems, such as headache, chronic pain, and difficulty sleeping. Self-rated physical and mental health status were also measured. Controlled were survivors’ gender, age, race, income, education, birthplace (US born vs. not), and sexual orientation.

Result: Of all survivors, 21% had headache, 23% chronic pain, 31% difficulty sleeping, 21% poor physical health, and 13% poor mental health. Health problems varied significantly depending on the pattern of victimization. Compared to the survivors of psychological aggression, those of multiple types of violence were more likely to report headache (exp(β)=1.74), chronic pain (exp(β)=1.71), difficulty sleeping (exp(β)=1.92), poor physical health (exp(β)=0.68), and poor mental health (exp(β)=0.54). Low income, low education, and being females were associated with more headache, chronic pain, and difficulty sleeping, and also associated with poor mental health.

Conclusions and Implications: Findings suggest that different victimization experiences are associated with various health problems and self-rated physical and mental health. Empirical evidence from this study can help better assess possible health risks of IPV survivors based on their victimization patterns, taking multiple perpetrations into account. Knowledge of what accounts for distinctive IPV survivor subgroups and how they are associated with certain health outcomes can lead to providing them with effective health interventions. Future research is needed to examine how survivors’ characteristics, such as income and gender, interact with different patterns of victimization, potentially resulting in a range of different health outcomes.