Abstract
Objective This study examined whether socioeconomic status moderated the association between intimate partner violence (IPV) and postpartum depression among a community-based sample of women. Defining the role of poverty in the risk of postpartum depression for IPV victims enables prioritization of health promotion efforts to maximize the effectiveness of existing maternal-infant resources. Methods This cross-sectional telephone-survey study interviewed 301 postpartum women 2 months after delivery, screening them for IPV and depression [using Edinburgh Postnatal Depression Scale (EPDS)]. Socioeconomic status was defined by insurance (Medicaid-paid-delivery or not). This analysis controlled for the following covariates, collected through interview and medical-record review: demographics, obstetric history, prenatal health and additional psychosocial risk factors. After adjusting for significant covariates, multiple linear regression was conducted to test whether socioeconomic status confounded or moderated IPV’s relationship with EPDS-score. Results Ten percent of participants screened positive for postpartum depression, 21.3 % screened positive for current or previous adult emotional or physical abuse by a partner, and 32.2 % met poverty criteria. IPV and poverty were positively associated with each other (χ2 (1) = 11.76, p < .001) and with EPDS score (IPV: beta 3.2 (CI 2.0, 4.5) p < .001, poverty: beta 1.3 (CI 0.2, 2.4) p = .017). In the multiple linear regression, IPV remained significantly associated, but poverty did not (IPV: adjusted beta 3.1 (CI 1.8, 4.3) p < .001, poverty: adjusted beta 0.8 (CI −0.3, 1.9) p = .141), and no statistically significant interaction between IPV and poverty was found. Conclusions Study findings illustrated that IPV was strongly associated with postpartum depression, outweighing the influence of socioeconomic status upon depression for postpartum women.
Similar content being viewed by others
References
Adams, A. E., Sullivan, C. M., Bybee, D., & Greeson, M. R. (2008). Development of the scale of economic abuse. Violence Against Women, 14(5), 563.
Aguinis, H., & Stone-Romero, E. F. (1997). Methodological artifacts in moderated multiple regression and their effects on statistical power. Journal of Applied Psychology, 82(1), 192.
Aneshensel, C. S. (2015). Sociological inquiry into mental health: The legacy of Leonard I. Pearlin. Journal of Health and Social Behavior, 56(2), 166.
Badile, K. C., Hettz, M. F., & Back, S. E. (2007). Intimate partner violence and sexual violence victimization assessment instruments for use in healthcare settings: Version 1. Atlanta, GA: Centers for Disease Control and Preventions.
Bassuk, E., Dawson, R., & Huntington, N. (2006). Intimate partner violence in extremely poor women: Longitudinal patterns and risk markers. Journal of Family Violence, 21, 387.
Beydoun, H. A., Beydoun, M. A., Kaufman, J. S., & Zondeman, A. B. (2012). Intimate partner violence against adult women and its association with major depressive disorder, depressive symptoms and postpartum depression: A systematic review and meta-analysis. Social Science and Medicine, 75(6), 959. doi:10.1016/j.socscimed.2012.04.025.
Black, M. C., Basile, K. C., Breiding, M. J., Smith, S. G., Walters, M. L., Merrick, M. T., et al. (2011). The national intimate partner and sexual violence survey (NISVS): 2010 summary report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
Bonomi, A. E., Anderson, M. L., Reid, R. J., Rivara, F. P., Carrell, D., & Thompson, R. S. (2009). Medical and psychosocial diagnoses in women with a history of intimate partner violence. Archives of Internal Medicine, 169(18), 1692.
Bybee, D., & Sullivan, C. M. (2005). Predicting re-victimization of battered women 3 years after exiting a shelter program. American Journal of Community Psychology, 36(1/2), 85.
Campbell, J., & Sullivan, C. (1994). Relationship status of battered women over time. Journal of Family Violence, 9, 99.
Centers for Disease Control and Prevention. (2008). Prevalence of self-reported postpartum depressive symptoms—17 states, 2004–2005. Federal Information & News Dispatch, Inc.
Coker, A. L., Smith, P. H., Bethea, L., King, M. R., & McKeown, R. E. (2000). Physical health consequences of physical and psychological intimate partner violence. Archives of Family Medicine, 9(5), 451–457.
Colman, I., & Ataullahjan, A. (2010). Life course perspectives on the epidemiology of depression. Canadian Journal of Psychiatry, 55(10), 622.
Cox, J. L., Chapman, G., Murray, L., & Cooper, P. (1996). Validation of the edinburgh postnatal depression scale (EPDS) in non-postnatal women. Journal of Affective Disorders, 39(3), 185.
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item edinburgh postnatal depression scale. British Journal of Psychiatry, 150, 782.
Dennerstein, L., Astbury, J., & Morse, C. (1993). Psychosocial and mental health aspects of women’s health. (No. WHO/FHE/MNH/93.1). Geneva, Switzerland: World Health Organization.
Dichter, M. E., & Rhodes, K. V. (2011). Intimate partner violence survivors’ unmet social service needs. Journal of Social Service Research, 37, 481.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14(4), 245.
Fox, G. L., & Benson, M. L. (2006). Household and neighborhood contexts of intimate partner violence. Public Health Reports, 121, 419.
Gaynes, B. N., Gavin, N., Meltzer-Brody, S., Lohr, K. N., Swinson, T., Gartlehner, G., et al. (2005). Perinatal depression: Prevalence, screening accuracy, and screening outcomes. Evidence Report/Technology Assessment No. 119. Prepared by the RTI-University of North Carolina Evidence Based Practice Center. AHRQ Publication No. 05-E006-2. Rockville, MD: Agency for Healthcare Research and Quality.
Gilroy, H., Nava, A., Maddoux, J., McFarlane, J., Symes, L., Koci, A., & Fredland, N. (2014). Poverty, partner abuse, and women’s mental health: New knowledge for better practice. Journal of Social Service Research. doi:10.1080/01488376.2014.972010.
Golding, J. M. (1999). Intimate partner violence as a risk factor for mental disorders: A meta-analysis. Journal of Family Violence, 14(2), 99.
Goodman, S. H., & Gotlib, I. H. (1999). A risk for psychopathology in the children of depressed mothers: A developmental model for understanding mechanisms of transmission. Psychological Review, 106(3), 458.
Goodman, L. A., Smyth, K. F., Borges, A. M., & Singer, R. (2009). When crises collide: How intimate partner violence and poverty intersect to shape women’s mental health and coping? Trauma, Violence, & Abuse, 10(4), 306–329. doi:10.1177/1524838009339754.
Haas, J. S., Jackson, R. A., Fuentes-Afflick, E., Stewart, A. L., Dean, M. L., Brawarsky, P., & Escobar, G. J. (2005). Changes in the health status of women during and after pregnancy. Journal of General Internal Medicine, 20(1), 45–51. doi:10.1111/j.1525-1497.2004.40097.x.
Hasin, D. S., Goodwin, R. D., Stinson, F. S., & Grant, B. F. (2005). Epidemiology of major depressive disorder: Results from the national epidemiologic survey on alcoholism and related conditions. Archives of General Psychiatry, 62(10), 1097.
Herman, D. R., Harrison, G. G., Afifi, A. A., & Jenks, E. (2008). Effect of a targeted subsidy on intake of fruits and vegetables among low-income women in the special supplemental nutrition program for women, infants and children. American Journal of Public Health, 98(1), 98.
Kendall-Tackett, K. A. (2007). Violence against women and the perinatal period: The impact of lifetime violence and abuse on pregnancy, postpartum, and breastfeeding. Trauma, Violence, & Abuse, 8(3), 344–353. doi:10.1177/1524838007304406.
Kennedy, N., Abbott, R., & Paykel, E. S. (2004). Longitudinal syndromal and sub-syndromal symptoms after severe depression: 10-year follow-up study. British Journal of Psychiatry, 184, 330.
Kernic, M. A., Holt, V. L., Stoner, J. A., Wolf, M. E., & Rivara, F. P. (2003). Resolution of depression among victims of intimate partner violence: Is cessation of violence enough? Violence and Victims, 18(2), 115.
Kessler, R. C. (2003). Epidemiology of women and depression. Journal of Affective Disorders, 74(1), 5.
Kessler, R. C., Angermeyer, M., Anthony, J. C., DeGraaf, R., Demyttenaere, K., Gasquet, I., & Ustun, T. B. (2007). Lifetime prevalence and age-of-onset distributions of mental disorders in the world health organization’s world mental health survey initiative. World Psychiatry, 6, 168.
Kornfeld, B. D., Bair-Merritt, M. H., Frosch, E., & Solomon, B. S. (2012). Postpartum depression and intimate partner violence in urban mothers: Co-occurrence and child healthcare utilization. The Journal of Pediatrics, 161(2), 348. doi:10.1016/j.jpeds.2012.01.047.
Kothari, C. L. (2012). Kalamazoo healthy babies-healthy start evaluation: Representativeness of mothers’ mind matters study sample. (Program Evaluation). Kalamazoo, MI:
Levendosky, A. A., Bogat, G. A., & Huth-Bocks, A. C. (2011). The influence of domestic violence on the development of the attachment relationship between mother and young child. Psychoanalytic Psychology, 28(4), 512. doi:10.1037/a0024561.
Liepman, M. R., Kothari, C. L., & Tareen, R. S. (2010). Mother’s mind matters: Recognizing and treating perinatal mood disorders. Houston, TX: Postpartum Support International.
Lindhorst, T., & Beadness, B. (2011). The long arc of recovery: Characterizing intimate partner violence and its psychosocial effects across 17 years. Violence Against Women, 17, 480.
Lyon, E. (2000). Welfare, poverty, and abused women: New research and its implications (building comprehensive solutions to domestic violence no. 10). Harrisburg, PA: Pennsylvania Coalition Against Domestic Violence, National Resource Center on Domestic Violence.
MacMillan, R., & Kruttschnitt, C. (2005). Patterns of violence against women: Risk factors and consequences (Document # (208346th ed.). Washington, DC: U.S. Department of Justice.
Marcus, S., Lopez, J. F., McDonough, S., MacKenzie, M. J., Flynn, H., Neal, C. R., & Vazquez, D. M. (2011). Depressive symptoms during pregnancy: Impact on neuroendocrine and neonatal outcomes. Infant Behavior and Development, 34(1), 26.
Martin, J. A., Hamilton, B. E., Ventura, S. J., Osterman, M. J. K., Kirmeyer, S., Mathews, T. J., et al. (2011). Births: Final data for 2009. (No. volume 60, number 1). Atlanta, GA: Centers for Disease Control and Prevention.
Martin, J. A., Hamilton, B. E., Ventura, S. J., Osterman, M., Wilson, E. C., & Mathews, R. J. (2012). Births: Final data for 2010. National Vital Statistics Reports (No. volume 61, number 1). Hyattsville, MD: National Center for Health Statistics.
Medicaid Program. (2005). General information, technical summary: Medicaid coverage for pregnant women. New York: U.S. Department of Health and Human Services.
Moe, A. M., & Bell, M. P. (2004). Abject economics: The effects of battering and violence on women’s work and employability. Violence Against Women, 10, 29.
Oakes, J. M., & Rossi, P. H. (2003). The measurement of SES in health research: Current practice and steps toward a new approach. Social Science and Medicine, 56, 769.
O’Hara, M. W., Neunaber, D. J., & Zekoski, E. M. (1984). Prospective study of postpartum depression: Prevalence, course, and predictive factors. Journal of Abnormal Psychology, 93(2), 158–171. doi:10.1037/0021-843X.93.2.158.
Papachristou, E., Frangou, S., & Reichenberg, A. (2013). Expanding conceptual frameworks: Life course risk modeling for mental disorders. Psychiatry Research, 206(2), 140.
Pausell, D., Avellar, S., Martin, S., & DelGrosso, P. (2010). Home visiting evidence of effectiveness review: Executive summary. U.S. Department of Health and Human Services, Washington D.C.: Office of Planning, Research and Evaluation, Administration for Children and Families.
Pearlin, L. I., Megaghan, E. G., Lieberman, M. A., & Mullan, J. T. (1981). The stress process. Journal of Health and Social Behavior, 22(4), 337.
Quinlivan, J. A., & Evans, S. F. (2005). Impact of domestic violence and drug abuse in pregnancy on maternal attachment and infant temperament in teenage mothers in the setting of best clinical practice. Archives of Women’s Mental Health, 8(3), 191. doi:10.1007/s00737-005-0079-7.
Rhodes, K. V., Lauderdale, D. S., He, T., Howes, D. S., & Levinson, W. (2002). “Between me and the computer”: Increased detection of intimate partner violence using a computer questionnaire. Annals of Emergency Medicine, 40, 476.
Riger, S., Raja, S., & Camacho, J. (2002). The radiating impact of intimate partner violence. Journal of Interpersonal Violence, 17, 184.
Salzman, L. E., Johnson, C. H., Gilbert, B. C., & Goodwin, M. M. (2003). Physical abuse around the time of pregnancy: An examination of prevalence and risk factors in 16 states. Maternal and Child Health Journal, 7(1), 31.
Segre, L. S., O’Hara, M. W., Arndt, S., & Stuart, S. (2007). The prevalence of postpartum depression: The relative significance of three social status indices. Social Psychiatry and Psychiatric Epidemiology, 42, 316.
Silverman, J. G., Decker, M. R., Reed, E., & Raj, A. (2006). Intimate partner violence victimization prior to and during pregnancy among women residing in 26 U.S. states: Associations with maternal and neonatal health. American Journal of Obstetrics and Gynecology, 195(1), 140.
Silverman, J. G., McCauley, H. L., Decker, M. R., Miller, E., Reed, E., & Raj, A. (2011). Coercive forms of sexual risk and associated violence perpetrated by male partners of female adolescents. Perspectives on Sexual and Reproductive Health, 1, 60.
Sutherland, C., Bybee, D., & Sullivan, C. (1998). The long-term effects of battering on women’s health. Women’s Health, 4(1), 41.
Taillieu, T. L., & Brownridge, D. A. (2010). Violence against pregnant women: Prevalence, patterns, risk factors, theories, and directions for future research. Aggression and Violent Behavior, 15(1), 14.
Turney, K., & Carlson, M. J. (2011). Multipartnered fertility and depression among fragile families. Journal of Marriage and the Family, 73(3), 570.
World Health Organization. (2000). Women’s mental health: An evidence based review. (No. WHO/MSD/MDP/00.1). Geneva, Switzerland: World Health Organization.
Wu, Q., Chen, H., & Xu, X. (2012). Violence as a risk factor for postpartum depression in mothers: A meta-analysis. Archives of Women’s Mental Health, 15, 107.
Yonkers, K. A., Ramin, S. M., Rush, A. J., Navarrete, C. A., Carmody, T., March, D., & Leveno, K. J. (2001). Onset and persistence of postpartum depression in an inner-city maternal health clinic system. American Journal of Psychiatry, 158(11), 1856.
Zelkowitz, P., & Milet, T. H. (2001). The course of postpartum psychiatric disorders in women and their partners. Journal of Nervous and Mental Disease, 189(9), 575. doi:10.1097/00005053-200109000-00002.
Zuckerman, B., Amaro, H., Bauchner, H., & Cabral, H. (1989). Depressive symptoms during pregnancy: Relationship to poor health behaviors. American Journal of Obstetrics and Gynecology, 160, 1107.
Acknowledgments
The authors would like to thank the women who participated for their generosity of time and spirit. This project received funding from the Blue Cross Blue Shield of Michigan Foundation and the Kalamazoo Community Foundation, Liepman Family Fund.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kothari, C.L., Liepman, M.R., Shama Tareen, R. et al. Intimate Partner Violence Associated with Postpartum Depression, Regardless of Socioeconomic Status. Matern Child Health J 20, 1237–1246 (2016). https://doi.org/10.1007/s10995-016-1925-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-016-1925-0