WITHDRAWN: Syndemic Predictors of Intimate Partner Violence Victimization Risk across Eight Years

Background and Purpose. Intimate partner violence (IPV) victimization is a pervasive public health problem with severe long-term physical and mental health consequences (Bonomi et al., 2006; Smith et al., 2018; Spencer et al., 2019). Empirical work has yet to be able to clearly delineate the core mechanisms that confer risk for IPV victimization in women (Spencer et al., 2019; Stith et al., 2004). Yet, this is an area of urgent need as current treatments for IPV victimization have shown limited effectiveness at reducing future victimization, especially over several years (Eckhardt et al., 2013), highlighting how current mechanisms of risk targeted through these intervention programs are lacking precision for sustained IPV mitigation over time. Trauma exposure, mental health, and sociodemographic factors have been identified as likely contributors to IPV victimization (Spencer et al., 2019; Stith et al., 2004), yet limited research has concurrently examined these factors as overlapping epidemics or syndemic predictors of risk (Singer, Bulled, Ostrach, & Mendenhall, 2017). The aim of this study is to identify the contributions of the syndemic factors of trauma exposure, mental health, and sociodemographics to IPV victimization in order to inform novel targets of intervention to improve the precision of current treatments.

Method. This study follows women with children (N = 118) across eight years to identify the trauma exposure (IPV re-engagement and cumulative trauma), mental health (posttraumatic stress and depressive symptoms), and sociodemographic factors (income and age) that contribute to IPV victimization using a longitudinal OLS regression. Participants completed three clinical interviews: at baseline, 6-8 months after enrollment, and 8-years after enrollment.

Results. Higher levels of posttraumatic stress (PTS) symptoms were associated with initially greater IPV victimization. However, across time women with higher PTS symptoms decreased more quickly in the amount of IPV victimization than those with lower PTS symptoms. Follow-up analyses revealed that higher levels of PTS arousal and re-experiencing were each associated with initially higher levels of IPV victimization. However, over time women with high levels of PTS arousal decreased more quickly in the amount of IPV victimization than those with low levels of PTS arousal. This was not the case for re-experiencing: higher levels of PTS re-experiencing started off and remained associated with higher levels of IPV victimization across time. Women’s age was inversely related to IPV victimization over time only when accounting for the PTS symptom domains. Time alone, IPV re-engagement, cumulative trauma, total depressive symptoms, and monthly income were not significantly associated with IPV victimization across time.

Conclusions and Implications. This study provides a novel examination of women’s trauma exposure, mental health, and sociodemographic factors as potential syndemic factors for IPV victimization using prospective methodology with eight-year longitudinal data. Findings suggest that PTS symptoms are the salient risk factor for IPV victimization but that that collapsing PTS symptoms into an overall construct may be too imprecise to identify key mechanisms of IPV victimization. Specifically, intervention efforts should prioritize addressing re-experiencing symptoms to mitigate future IPV victimization.