Patterns of Intimate Partner Violence Victimization and Survivors' Health

Background: Survivors of intimate partner violence (IPV) suffer from numerous negative consequences, including health problems. The literature demonstrates that the more frequent and severe IPV is, the worse the survivors’ health is, which relationship is moderated by gender and race. 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). The current study fills this gap in the literature by using one of the biggest and the most recent national data to examine the health outcomes of various different patterns of IPV victimization, with a particular emphasis on the gender and race effects. 

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, identifying six types, such as Molesters, Downers, Predators, Manipulators, Bullies, and Stalkers. Structural equation modeling was used to examine the impacts of diverse perpetrators on survivor’s health outcomes including headache, chronic pain, difficulty sleeping, and self-rated physical and mental health status. In addition, direct and indirect impacts of gender, race, and the interaction between gender and race of the survivors on health outcomes were examined. Controlled were survivors’ race, income, education, birthplace (US born vs. not), and sexual orientation. 

Result: Survivors victimized by Predators, who perpetrated all types of IPV including physical, psychological, and sexual violence, suffered from many negative health outcomes. Survivors of Predators, compared to those of other types of perpetrators, were more likely to have a headache (exp(β)=0.17), chronic pain (exp(β)=0.18), difficulty sleeping (exp(β)=0.19), and lower perceived mental health (exp(β)=0.20) and physical health status (exp(β)=0.15). Survivors of Molesters, who perpetrated mainly sexual violence, were more likely to have chronic pain (exp(β)=0.05). Gender and Race affected these relationships. Although female survivors in general were more likely to have a headache (exp(β)=0.26) than male counterparts, African American females were less likely to have a headache than African American males (exp(β)=-0.07). Hispanic survivors were more likely to have lower self-rated physical health status (exp(β)=0.12) than White counterparts.  

Conclusions and Implications: Our findings signify the importance of social workers and health-care providers considering the types of IPV perpetration as well as gender and race of the survivors as a dynamic set of contexts that may define their health outcomes of IPV. By taking such elements into account, the helping professionals can better understand and assess survivors’ IPV experiences and needs, especially in treating health and mental health issues resulted from IPV and coordinating appropriate services. Moreover, building on the present study, future research should examine through what mechanisms the various IPV perpetration types, gender, and race shape the survivors’ health and mental health experiences.