Towards Intentional Relational Well-Being: Syndemic Contributions of Mental Health, Trauma Exposure, and Sociodemographic Factors to Risk for Intimate Partner Violence Victimization

Abstract

Treatments for reducing intimate partner violence (IPV) victimization have shown limited effectiveness, raising questions about the appropriateness of the mechanisms of risk targeted through these interventions. Yet, limited empirical work has delineated said mechanism of risk. A comprehensive understanding of these mechanisms is required to effectively mitigate future victimization. The aim of this dissertation is to contribute empirical evidence regarding modifiable factors that a person can address to change their intimate relationship trajectories and work towards intentional relational well-being. This research utilizes a syndemics framework to identify the trauma exposure, mental health, and sociodemographic contributors to IPV victimization risk across three independent studies.

Study one follows women across eight years to identify the risk factors for the total amount of IPV victimization experienced. 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. Higher levels of PTS arousal and reexperiencing were 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 reexperiencing: higher levels of PTS reexperiencing started off and remained associated with higher levels of IPV victimization across time. Age was inversely related to IPV victimization only when accounting for the PTS symptom domains. Findings suggest that collapsing PTS symptoms into an overall construct may be too imprecise to identify key mechanisms of IPV victimization risk. Intervention efforts should prioritize addressing reexperiencing symptoms as a pathway to limiting future IPV victimization.

Study two follows women over eight years to delineate the risk factors for IPV re-engagement (number of violent partners). More psychological but less sexual IPV was associated with greater re-engagement. A greater number of PTS reexperiencing symptoms were associated with less re-engagement. Lower levels of positive affect and higher somatic symptoms (depressive symptoms) were associated with higher re-engagement. Higher income and lower housing instability were associated with more re-engagement. Findings suggest that it is not what happened that creates risk for re-engagement, but rather how women are doing following traumatic experiences.

Study three examines the role trauma exposure and mental health on the odds of experiencing IPV victimization in emerging adults. Non-partner violence victimization was not associated with IPV victimization, nor were anxiety or marijuana use alone. However, IPV aggression, alcohol consumption, and identification as female were associated with IPV victimization. Findings suggested a synergistic relationship between IPV aggression and alcohol use and alcohol and marijuana use on IPV victimization. At low levels of IPV aggression (1-3 acts in the prior six months), alcohol use was associated with increased IPV victimization risk, but this did not hold for four acts or more. Here, IPV victimization risk remained high across all levels of alcohol consumption. Furthermore, those who did not use marijuana had significantly higher IPV victimization risk as alcohol use increased. This was not true of those who did use marijuana as IPV victimization risk did not increase as alcohol use increased. Findings suggest that alcohol use is an important but insufficient predictor of IPV victimization alone and needs to be considered in tandem with other indicators of risk.