Violence Against Women Can Take Lifelong Toll: Study

Women who've suffered from gender-based violence are more likely to develop anxiety disorders or other mental woes, experience physical and mental disabilities, and have worse quality of life than other women, new research shows.

Gender-based violence includes rape and other forms of sexual assault, intimate-partner violence (such as spouse abuse) and stalking.

Risks for these long-term problems rose with the intensity of abuse. For example, women who'd experienced three or four types of gender-based violence had 10 times the odds of developing an anxiety disorder than women who haven't experienced such violence, the study found. The odds of a woman who'd been subjected to such violence developing a substance abuse problem were almost six times higher than for a woman who hasn't experienced gender-based violence.

"Gender-based violence is a public health problem and occurs to many women. Women need to recognize that the social and psychological problems they are experiencing may be related to their past or current exposure to violence and not pass these reactions off to other causes," said the study's lead author, Susan Rees, a senior research fellow at the University of New South Wales in Sydney, Australia.

Results of the study are published in the Aug. 3 issue of the Journal of the American Medical Association.

In the United States, more than 20 percent of women have experienced intimate-partner violence, stalking or both. A full 17 percent have reported rape or attempted rape, according to background information in the study.

The data for Rees' study came from a national survey done in Australia on mental health and well-being. The survey included over 4,400 women between the ages of 16 and 85 years old.

In that group, 1,218 women (27 percent) reported experiencing at least one form of gender-based violence, while 139 had been exposed to three or more forms of gender-based violence.

The average age that women were first raped was 13 years old and 12 years old for sexual assault. The average age that women were beaten by a partner or stalked was 22 years old.

The more violence a woman was exposed to, the greater her risk of developing mental illnesses, according to the study.

For example, about 15 percent of women who had been subjected to one form of gender-based violence experienced post-traumatic stress disorder (PTSD). But, if women were subjected to three or more forms of gender-based violence, that number jumped to more than 56 percent, the investigators found.

Suicide rates were significantly higher for women who'd experienced gender-based violence. The average rate of attempted suicide was 1.6 percent for all women in the study, but it was 6.6 percent for women who'd experienced one form of violence, and 34.7 percent for women exposed to three or more types of violence.

Rates of physical and mental disabilities were also much higher for women who had experienced gender-based violence. These women also tended to report an impaired quality of life.

Even though the study team had expected the findings, "the extent and strength of the associations we found was surprising and very concerning," Rees said.

She noted that "the nature of gender-based violence is particularly insidious because it occurs in the very situations where the victim/survivor usually expects to enjoy conditions of safety, security and love, particularly the home."

Furthermore, this type of aggression "often occurs repeatedly, unlike other traumas such as exposure to natural disasters, so you get a compounding effect. Gender-based violence is unfortunately still largely considered a personal and private matter, making help-seeking very difficult for many women, so they rarely received the support trauma survivors need to assist recovery," Rees noted.

One U.S. expert said the findings need to be heeded closely.

"This study really demonstrated the extent of gender-based violence and the long-term consequences of violence against women," said Andrea Gielen, director of the Center for Injury Research and Policy at the Johns Hopkins Bloomberg School of Public Health in Baltimore. "There are huge implications for health services; this is not just a one-time treatment in the ER for a broken bone. People who treat women for any health-related issues need to think about the extent that such violence can affect women," Gielen said.

Gielen added that in the United States, a measure of help is on the way. The federal government on Monday adopted recommendations from the Institute of Medicine on preventive services for women's health, and one new rule is that health care insurers must cover the cost of screening and counseling for domestic violence.

"Any woman is who experiencing gender-based violence needs to realize that there are things she can do, there are hotlines she can call, there are resources available," Gielen said. "Talking about the experience with an informed and supportive health professional is a good thing to do to move on."