This longitudinal study explored changes in women's health after separation from an abusive partner by characterizing the trajectories of their mental health (depression and post-traumatic stress disorder [PTSD]) and physical health (chronic pain) over a 4-year period. We examined how the severity of intimate partner violence (IPV) affected these trajectories, controlling for selected baseline factors using 5 waves of data collected from a community sample of 309 English-speaking, Canadian women. IPV severity was measured using the Index of Spouse Abuse where women were asked to consider the entire period of their partner relationship up to present at wave 1 and to rate their IPV experiences in the previous 12 months at waves 2-5. Mental health was measured using established self-report measures of depression (CESD) and PTSD (Davidson Trauma Scale), while chronic pain was measured using the Chronic Pain Grade Scale. Trajectories were estimated using MLM techniques with severity of IPV and selected co-variates (time since separation, age, financial strain) included. Our results show that women's health improved significantly over time, although significant levels of depression, PTSD symptoms and disabling chronic pain remained at the end of wave 5. Regardless of time since separation, more severe IPV was associated with higher levels of depression, PTSD, and disabling chronic pain, with IPV having a stronger effect on these health outcomes over time, suggesting cumulative effects of IPV on health. The results of this study contribute to quantifying the continuing mental and physical health burdens experienced by women after separation from an abusive partner. Increased attention to the long-term effects of violence on women's health beyond the crisis of leaving is critically needed to strengthen health and social services and better support women's recovery and healing.

中文翻译：

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与虐待伴侣分开的女性的抑郁、创伤后压力和慢性疼痛的轨迹：纵向分析

这项纵向研究通过描述女性在 4 年期间的心理健康（抑郁和创伤后应激障碍 [PTSD]）和身体健康（慢性疼痛）的轨迹，探讨了与虐待伴侣分离后女性健康的变化。我们检查了亲密伴侣暴力 (IPV) 的严重程度如何影响这些轨迹，使用从 309 名讲英语的加拿大女性社区样本中收集的 5 波数据控制选定的基线因素。IPV 严重程度是使用配偶虐待指数衡量的，其中女性被要求考虑他们的伴侣关系的整个时期，直到出现在第 1 波，并在第 2-5 波评估他们在过去 12 个月中的 IPV 经历。使用既定的抑郁症自我报告测量 (CESD) 和 PTSD（戴维森创伤量表）测量心理健康，而使用慢性疼痛等级量表测量慢性疼痛。轨迹是使用 MLM 技术估计的，其中包括 IPV 的严重性和选定的协变量（自分离以来的时间、年龄、财务压力）。我们的结果表明，随着时间的推移，女性的健康状况显着改善，尽管在第 5 波结束时仍然存在显着水平的抑郁、PTSD 症状和致残性慢性疼痛。无论分离后的时间如何，更严重的 IPV 与更高水平的抑郁、PTSD、随着时间的推移，IPV 对这些健康结果产生更强的影响，表明 IPV 对健康的累积影响。这项研究的结果有助于量化女性在与虐待伴侣分离后所承受的持续身心健康负担。迫切需要更多地关注暴力对妇女离开危机后的健康的长期影响，以加强卫生和社会服务并更好地支持妇女的康复和康复。