Marilyn Ford-Gilboe

Abuse‐Related Injury and Symptoms of Posttraumatic Stress Disorder as Mechanisms of Chronic Pain in Survivors of Intimate Partner Violence

OBJECTIVE To examine the role of abuse-related injury and posttraumatic stress disorder (PTSD) symptom severity in mediating the effects of assaultive intimate partner violence (IPV) severity, psychological IPV severity, and child abuse severity on chronic pain severity in women survivors of IPV. METHODS Using data collected from a community sample of 309 women survivors of IPV, structural equation modeling was used to test a theoretical model of the relationships among the key variables. RESULTS The theoretical model accounted for almost 38% of the variance in chronic pain severity. PTSD symptom severity was a significant mediator of the relationships of both child abuse severity (beta = 0.13) and assaultive IPV severity (beta = 0.06) with chronic pain severity. Lifetime abuse-related injury was also a significant mediator of the relationships between both child abuse severity (beta = 0.05) and assaultive IPV severity (beta = 0.06) and chronic pain severity. Child abuse severity made the largest significant contribution to the model (beta = 0.35). Assaultive IPV severity had a significant indirect effect (beta = 0.12) on chronic pain severity while psychological IPV severity had a significant direct effect (beta = 0.20). CONCLUSIONS Management of chronic pain in IPV survivors requires attention to symptoms of PTSD, abuse-related injury, and lifetime experiences of violence. Ensuring that acute pain from injury is adequately treated and followed over time may reduce the extent of chronic pain in abused women. The results also support the importance of routine assessment for IPV and child abuse.

Attributing Selected Costs to Intimate Partner Violence in a Sample of Women Who Have Left Abusive Partners: A Social Determinants of Health Approach

Cet article rend compte d’une étude qui nous a permis d’évaluer certains coûts associés à la violence conjugale au sein d’un échantillon de 309 femmes qui avaient quitté leur conjoint abuseur depuis 20 mois en moyenne. Nous estimons ces coûts – c’est-à-dire les dépenses publiques et privées associées à la violence conjugale – à 13 162,39

Pathways of Chronic Pain in Survivors of Intimate Partner Violence

par femme en moyenne. Si l’on considère l’ensemble des femmes canadiennes de 19 à 65 ans ayant un conjoint abuseur, les coûts associés à la violence conjugale se chiffrent donc à 6,9 milliards de dollars, et à 3,1 milliards si l’on considère les femmes victimes de violence conjugale au cours des trois dernières années. Ces résultats indiquent que la violence conjugale implique des coûts qui persistent longtemps après la séparation des conjoints. Il est donc important, en matière de politiques de lutte contre la violence conjugale, que les décideurs tiennent compte du fait que la séparation ne met pas un terme à cette violence.

Leaving ≠ Moving Housing Patterns of Women Who Have Left an Abusive Partner

OBJECTIVE To examine the roles of lifetime abuse-related injury, posttraumatic stress disorder (PTSD) symptom severity, and depressive symptom severity in mediating the effects of severity of assaultive intimate partner violence (IPV), psychological IPV, and child abuse on chronic pain severity in women survivors of IPV. METHODS Structural equation modeling of data from a community sample of 309 women survivors of IPV was used to test partial and full theoretical models of the relationships among the variables of interest. RESULTS The full model had good fit and accounted for 40.2% of the variance in chronic pain severity. Abuse-related injury, PTSD symptom severity, and depressive symptom severity significantly mediated the relationship between child abuse severity and chronic pain severity, but only abuse-related injury significantly mediated the relationship between assaultive IPV severity and chronic pain severity. Psychological IPV severity was the only abuse variable with significant direct effects on chronic pain severity but had no significant indirect effects. CONCLUSIONS These findings can inform clinical care of women with chronic pain in all areas of healthcare delivery by reinforcing the importance of assessing for a history of child abuse and IPV. Moreover, they highlight the relevance of routinely assessing for abuse-related injury and PTSD and depressive symptom severity when working with women who report chronic pain.

Adolescent mothers: resilience, family health work and health-promoting practices

Access to safe and affordable housing is a key concern for women leaving abusive partners. Yet little is known about women’s housing patterns around leaving. In this community sample, approximately equal numbers of women did not move, moved once, and moved two or more times during the transition period around leaving. Overall, moving patterns were associated with housing type and suitability, economic circumstances, and severity of violence. This study calls into question the tendency to equate leaving with moving, draws attention to the different housing patterns after leaving, and highlights the need to tailor housing supports to diverse women.