Predictors of Posttraumatic Stress Disorder and Depression among Low-Income Women Exposed to Perinatal Intimate Partner Violence
Date
2015
Authors
Kastello, Jennifer C.
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Abstract
Women exposed to intimate partner violence (IPV) during pregnancy are at increased risk for compromised mental health. There is evidence that trauma, both violent and non-violent events, are associated with the development of posttraumatic stress disorder (PTSD) and depression. Routine assessment for conditions such as depression and IPV is recommended for women of reproductive age, but the current health care environment impedes the ability of clinicians to complete recommended screenings for every patient. The purpose of this cross-sectional study was to examine trauma, IPV type and IPV severity as predictors of posttraumatic stress disorder and depression among low-income women who experienced intimate partner violence during pregnancy. A secondary purpose was to examine the validity of a brief screening measure of self-rated mental health (SRMH) to identify PTSD and depression in comparison to previously established mental health assessment measures. The baseline data of 239 low-income pregnant women who experienced recent IPV was analyzed to address the study objectives. Univariate and bivariate analyses were used to describe the sample and identify relationships among the major study variables. Regression models were developed to further explore these relationships to identify predictors of PTSD and depression. Calculation of validity coefficients and receiver operating characteristic (ROC) analyses were conducted to determine the ability of SRMH to identify depression and PTSD among these women. PTSD was identified in 40% of the women, while 41% had high risk for depression. Age was the only predictor of PTSD development, with women more likely to develop PTSD as they aged. Women who experienced severe psychological IPV were more likely to have high risk for depression than those exposed to severe sexual or physical IPV. The SRMH item demonstrated moderate validity and accuracy in its ability to detect high risk for depression, suggesting it may be a useful way to increase screening and identification of women at risk for depression and who may benefit from a more comprehensive mental health assessment. These results suggest that current mental health screening measures should be expanded to routinely assess trauma, as well as IPV, to increase early identification and treatment of women most at risk for depression and PTSD. The current clinical climate may not be conducive to completing the recommended routine screenings for each patient. The present study findings indicate that single item measures may be useful, but further research is needed to establish a valid measure of mental health that is quick and efficient in a busy clinical setting.
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Keywords
Mental health, Nursing, Depression, Intimate partner violence, Perinatal, Pregnancy, PTSD