In both men and women, psychiatric disorders in late adolescence appear to
predict involvement in clinically significant partner abuse during early
adulthood, according to a report in the May American Journal of
Longitudinal study of a birth cohort found that both men and women who
became involved in clinical partner abuse between the ages of 24 and 26 had
significantly higher rates of certain psychiatric disorders at age 18 than
those who did not become involved in partner abuse.
Among women, those disorders included major depressive disorders and
marijuana abuse; among men, they included major depressive episodes, marijuana
dependence, alcohol dependence, and any anxiety disorder, according to the
The study also found that partner abuse predicts an increase in psychiatric
disorders— especially depression, marijuana dependence, and
posttraumatic stress disorder—but only for women. For men, mental
disorders following partner abuse appear to reflect their history of mental
disorder in adolescence.
"This is the first time, to our knowledge, that a study has been able
to untangle the temporal link between partner violence and mental disorder, by
looking at changes within individuals over time," said lead author
Miriam K. Ehrensaft, PhD. "That is, we measured psychiatric disorders
before and after the abuse. Other studies have measured both at the same time,
making it hard to determine which came first."
She is with the Division of Child Psychiatry at Columbia University College
of Physicians and Surgeons.
Ehrensaft told Psychiatric News that the differential finding
regarding the aftereffects of partner abuse for men and women is evidence of
real gender differences in the mental health effects of partner abuse,
particularly among women of child-bearing age.
"What's important is that this gender difference in mental health
effects emerged even though both men and women in our partner abuse group said
they had been victimized by their partner at the same high rates,"
In the study, a cohort from the Dunedin Multidisciplinary Health and
Development Study was followed prospectively. Adolescent mental health
disorders were diagnosed at age 18. The researchers then identified
individuals involved in nonabusive relationships versus those who were
involved in clinically abusive relationships between the ages of 24 and 26. (A
clinically abusive relationship was defined as resulting in injury and/or
official intervention.) Finally, mental disorders were assessed again at age
The results showed that both men and women with mental disorders in
adolescence were at greater risk of becoming involved in abusive adult
relationships. But when the researchers controlled for earlier psychiatric
disorder, only women experienced an increased risk for psychiatric morbidity
after partner abuse.
Ehrensaft said she believes psychiatrists should routinely include a few
questions about current or recent partner abuse in evaluations of young women.
Such questions could ask about specific acts, such as hitting, kicking, or
pushing, and about consequences, including injuries or legal intervention.
"Partner abuse may be an important part of the etiology of a woman's
presenting problem and is usually not spontaneously disclosed,"
Ehrensaft told Psychiatric News.
She said clinicians should familiarize themselves with available local
resources and be prepared to refer patients. "Our findings highlight the
importance of integrating partner violence into psychiatric research and
clinical training," she said.
"Is Domestic Violence Followed by an Increased Risk of
Psychiatric Disorders Among Women But Not Among Men? A Longitudinal Cohort
Study" is posted at<http://ajp.psychiatryonline.org/cgi/content/full/163/5/885>.▪