Polyvictimization and Psychological Outcomes Among North Korean Refugee Women

BACKGROUND: North Korean refugee women are at risk of multiple violent victimizations throughout the migration phases. However, migration’s association with mental health outcomes has received little scholarly attention. This study examined North Korean refugee women’s exposure to polyvictimization—that is, exposure to both gender-based violence (GBV; e.g., sexual violence and forced sex work) and intimate partner violence (IPV)—and explored whether polyvictimization is associated with an increased risk of psychological symptoms.

METHODS: Data from a snowball sample of 212 North Korean refugee women were analyzed for this study. Polyvictimization was operationalized as No victimization (0), Only GBV (1), Only IPV (2), and Both GBV and IPV (3). The associations between polyvictimization and depression, suicidal ideation, suicide attempt, and alcohol use disorder were analyzed with multivariate analyses.

RESULTS: Results demonstrated that 46.2% experienced GBV in either North Korea or intermediary countries, and 30.9% were victims of IPV, from their current intimate partner in South Korea. Approximately 25% were victims of both GBV and IPV. Multivariate analyses revealed that GBV was the most critical factor for mental health outcomes. North Korean refugee women with only GBV or both GBV and IPV had significantly higher depression and suicidal ideation severity than those without any violence victimization. Risk of suicide attempt was also significantly higher among those with only GBV (OR = 16.52, p = .015) or both GBV and IPV (OR = 9.96, p = .048), than those without any violence victimization.

CONCLUSIONS AND IMPLICATIONS: North Korean refugee women are vulnerable to polyvictimization of GBV and IPV during and after migration. However, little is known about the association between polyvictimization and mental health outcomes among this population. To the best of our knowledge, the current study is the first to examine polyvictimization as a risk factor for greater psychological symptoms among North Korean refugee women. Findings of the present study demonstrated that almost 60% of the sample was victimized at least at once in their lives. Additionally, North Korean refugee women with both GBV and IPV victimization had higher levels of depressive symptoms and suicidal ideation severity than those without any violence victimization. Finally, past GBV victimization was a strong predictor for psychological symptoms, even in the absence of IPV victimization. Therefore, mental health clinicians should conduct comprehensive assessments of polyvictimization when completing mental health assessments with North Korean refugee women, and should especially consider past GBV victimization before entering South Korea as a strong risk factor for adverse psychological outcomes.