OBJECTIVE: To assess how physical and/or sexual intimate partner violence (IPV), child abuse, and community violence relate to long-term
mental and physical problems; to examine the overlap between different forms of violence and the impact of experiencing multiple
forms of violence.
DESIGN: Cross-sectional survey.
SETTING: Three general internal medicine practices affiliated with an academic medical center.
PARTICIPANTS: English-speaking women aged 25 to 60.
MEASUREMENTS: Telephone or in-person interview and chart review.
RESULTS: One hundred seventy-four women completed interviews. A majority of participants experienced more than one form of violence.
In separate multivariate analyses, each form of violence was associated with depressive symptoms or with at least 6 chronic
physical symptoms, after adjustment for demographic factors and substance abuse. The degree of association with health outcomes
was similar for each form of violence (odds ratio [OR], 2.4 to 3.9; P<.003). The association with chronic physical symptoms remained significant for IPV (OR, 3.3; P<.002) and community violence (OR, 3.4; P<.003), even after adjustment for depression and posttraumatic stress disorder. There were dose-response relationships between
the number of forms of violence experienced and the odds of depressive symptoms and the odds of multiple chronic physical
symptoms.
CONCLUSIONS: Multiple types of victimizations may contribute to patients’ current mental health and physical problems. Research or clinical
protocols that only focus on one form of violence may underestimate the complexity of women’s experiences and needs.
Key words intimate partner violence - sexual assault - child abuse - depression - physical symptoms
Presented at the 26th annual meeting of the Society of General Internal Medicine, Vancouver, British Columbia, May 2003.
This work was funded by a grant from the Medical Research Foundation of Oregon (Pl: Nicolaidis).