Paediatrics (RCH) - Theses

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Author: Fitzpatrick, Kelly Marie × End date: 2021 × Start date: 2020 × Subject: Mental Health ×

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    Types and Patterns of Intimate Partner Violence and Health Outcomes for Women
    Fitzpatrick, Kelly Marie ( 2021)
    Intimate partner violence (IPV) can include physical, sexual, and emotional abuse. Despite increasing recognition that women experience different types of IPV, the majority of research has focussed on physical or sexual IPV. There are very few longitudinal studies that have aimed to capture women’s experiences of multiple types of IPV, and little is known about the health outcomes associated with different types and combinations of abuse. A small number of studies have suggested that emotional IPV may precede other types of IPV, however it remains unclear whether there are distinct patterns in women’s experiences of different types of IPV over time. Drawing on data from a prospective pregnancy cohort of 1507 first time mothers, the overall aim of this research was to explore women’s exposure to different types and patterns of intimate partner violence in the first ten years of motherhood and identify health outcomes associated with these experiences. Important conceptual and measurement issues were identified in the existing literature, including the widespread segregation of emotional, physical and/or sexual IPV. In Study 1, emotional IPV alone was found to be the most common type of IPV experienced in the first 12 months postpartum, followed by combined (physical and emotional) IPV, and physical IPV alone. Women experiencing IPV were more likely to report poor health, with the strongest associations observed between experiences of combined IPV and mental health problems. Experiences of emotional IPV alone were also associated with physical and mental health problems in the first year postpartum. Study 2 demonstrated that experiences of IPV reported in the first year postpartum commonly persisted in later motherhood. Emotional IPV alone remained the most prevalent type of IPV across the first ten years of motherhood, followed by combined IPV. Associations between past year IPV and women’s mental and physical health in the tenth year of motherhood reflected findings from Study 1, with the largest effect sizes observed for combined IPV. Women who reported prior emotional IPV alone or prior combined IPV (during the first four years of motherhood but not at ten years) also reported poor health in the tenth year of motherhood. Finally, in Study 3, a novel technique for visualising data, showed that there was considerable variability in women’s experiences of IPV over the first ten years of motherhood. The prevalence of IPV remained consistent across the first ten years of motherhood. Women who reported combined IPV were more likely to report IPV at multiple time-points during this period. Maternal sociodemographic characteristics in early pregnancy (e.g., younger age, unemployment, lower income or education) were associated with an increased risk of IPV at all three time points. Overall, the findings presented in this thesis show that while there is variability in women’s experiences of IPV, there are substantial health problems associated with both types of IPV. There is a need for better understanding and recognition of the complexity and chronicity of these experiences, and the harm associated with different types of IPV, to strengthen responses and support for women who experience IPV.