“You Always End up Feeling Like You’re Some Hypochondriac”: Intimate Partner Violence Survivors’ Experiences Addressing Depression and Pain

  • Christina Nicolaidis
  • Jessica Gregg
  • Hilary Galian
  • Bentson McFarland
  • MaryAnn Curry
  • Martha Gerrity
Original Article

Abstract

Objective

Little is known regarding how providers should use information about intimate partner violence (IPV) to care for depressed patients. Our objective was to explore what depressed IPV survivors believe about the relationship between abuse, mental health, and physical symptoms and to elicit their recommendations for addressing depression.

Design

Focus group study.

Patients/Participants

Adult, English-speaking, female, Internal Medicine clinic patients with depressive symptoms and a history of IPV.

Interventions

Thematic analysis using an inductive approach (consistent with grounded theory), at a semantic level, with an essentialist paradigm.

Measurements and Main Results

Twenty three women participated in 5 focus groups. Although selected because of their depression, participants often felt their greatest concerns were physical. They acknowledged that their abuse history, depression, and physical complaints compound each other. They appreciated the need for health care workers to know about their depression and IPV history to get a “full picture” of their health, but they were often hesitant to discuss such issues with providers because of their fear that such information would make providers think their symptoms were “all in their head” or would encourage providers to discount their pain. Participants discussed difficulties related to trust and control in relationships with providers and gave recommendations as to how providers can earn their trust.

Conclusions

Understanding a patient’s IPV history may allow providers to develop a better therapeutic relationship. To treat depression adequately, it is important for providers to reassure patients that they believe their physical symptoms; to communicate respect for patients’ intelligence, experience, and complexity; and to share control.

KEY WORDS

intimate partner violence depression pain physical symptoms qualitative research physician–patient relationship 

Supplementary material

11606_2008_606_MOESM1_ESM.doc (36 kb)
ESM 1(DOC 35.5 KB)

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Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • Christina Nicolaidis
    • 1
    • 2
  • Jessica Gregg
    • 1
  • Hilary Galian
    • 1
  • Bentson McFarland
    • 2
    • 3
  • MaryAnn Curry
    • 4
  • Martha Gerrity
    • 1
    • 5
  1. 1.Division of General Internal Medicine, Department of MedicineOregon Health & Science UniversityPortlandUSA
  2. 2.Department of Public Health & Preventive MedicineOregon Health & Science UniversityPortlandUSA
  3. 3.Department of PsychiatryOregon Health & Science UniversityPortlandUSA
  4. 4.School of NursingOregon Health & Science UniversityPortlandUSA
  5. 5.Portland Veterans Administration Medical CenterPortlandUSA

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