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Stressful life events, intimate partner violence, and perceived stress in the postpartum period: longitudinal findings in rural Pakistan

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Abstract

Purpose

While the association between intimate partner violence (IPV) and stress is well documented, the directionality of this relationship is unclear. We use an adjusted longitudinal study design to better understand if stressful life events in the home precipitate or exacerbate intimate partner violence (IPV) and if experiences of IPV, in turn, increase levels of perceived stress.

Methods

Longitudinal data were collected among married women in rural Pakistan at 12 and 24 months postpartum (N = 815). Adjusted Poisson and linear regression models were used to examine stressful life events, past year IPV and severity (number and frequency of violent acts), and perceived stress (Cohen Perceived Stress Scale).

Results

At 12 months postpartum, the prevalence of past year physical, psychological, and sexual IPV was 8.5%, 25.7%, and 25.1%, respectively, with 42.6% experiencing any IPV. After adjustment, stressful life events were associated with a subsequent increased likelihood of all IPV types and increased severity of all but physical IPV. Any past year IPV (versus none) and greater IPV severity were associated with 3.43 (95% CI 2.33–4.52) and 2.57 (95% CI 1.87–3.27) point subsequent increases in perceived stress. Physical, psychological, and sexual IPV and their respective severities were all independently associated with increased perceived stress.

Conclusions

Among postpartum women in Pakistan, stressful life events increase the likelihood of IPV and, in turn, experiences of IPV increase stress levels. Support to families undergoing stressful circumstances may be critical to reducing women’s IPV exposure and resulting elevated stress.

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Data availability statement

Data are available upon reasonable request from PI Maselko. Data are not publicly available due to ongoing data collection; however, data will be released when the Bachpan cohort study is completed.

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Funding

The Bachpan cohort was established by funding through the Human Development Research Foundation and leveraging the research study funded by the National Institute of Mental Health (U19MH95687) and National Institute of Child Health and Development (R01 HD075875; PI: Maselko). This analysis was supported in part by training grants from the National Institute of Child Health and Development [T32 HD52468; T32 HD091058].

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Authors and Affiliations

  1. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA

    Sarah C. Haight, Esther O. Chung & Joanna Maselko

  2. Duke Global Health Institute, Duke University, Durham, NC, USA

    John A. Gallis

  3. Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA

    John A. Gallis

  4. Carolina Population Center, North Carolina, Chapel Hill, NC, USA

    Esther O. Chung, Allison Frost & Joanna Maselko

  5. Department of Economics, The University of Melbourne, Melbourne, VIC, Australia

    Victoria Baranov

  6. Global Institute of Human Development, Shifa Tameer-E-Millat University, Islamabad, Pakistan

    Amina Bibi & Siham Sikander

  7. Human Development Research Foundation, Islamabad, Pakistan

    Amina Bibi

  8. Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA

    Ashley Hagaman

  9. Center for Methods in Implementation and Prevention Science, Yale School of Public Health, New Haven, CT, USA

    Ashley Hagaman

  10. Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK

    Siham Sikander

  11. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY, USA

    Lisa M. Bates

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  1. Sarah C. Haight
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Correspondence to Sarah C. Haight.

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The authors have no relevant financial or non-financial interests to disclose.

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This study was approved by institutional review boards at the Human Development Research Foundation, the University of North Carolina at Chapel Hill and Duke University. Written informed consent (or witnessed consent, if the participant was illiterate) was obtained from mothers before study participation.

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Table 6 Description of analytical measures and specific items
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6.

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Haight, S.C., Gallis, J.A., Chung, E.O. et al. Stressful life events, intimate partner violence, and perceived stress in the postpartum period: longitudinal findings in rural Pakistan. Soc Psychiatry Psychiatr Epidemiol 57, 2193–2205 (2022). https://doi.org/10.1007/s00127-022-02354-3

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