Research ArticleOriginal Research

Psychosocial Effects of Physical and Verbal Abuse in Postmenopausal Women

Charles P. Mouton, Rebecca J. Rodabough, Susan L. D. Rovi, Robert G. Brzyski and David A. Katerndahl
The Annals of Family Medicine May 2010, 8 (3) 206-213; DOI: https://doi.org/10.1370/afm.1095

Article Figures & Data

Tables

  • Table 1.

    Characteristics of Baseline Sample by Baseline Psychosocial Scores

    VariableN (%)Depressive SymptomatologyaMean (SD)MCS ScorebMean (SD)Social Support ConstructcMean (SD)Social Strain ConstructdMean (SD)Optimism ConstructeMean (SD)
    GED = general equivalency diploma; MCS = mental component summary of the RAND 36-Item Health Survey 1.0.
    a Scores range from 0 to 18, with higher scores indicating greater depressive symptomatology.
    b Scores range from 0 to 100 with higher scores indicating better mental health.
    c Scores range from 9 to 45, with higher scores indicating greater social support.
    d Scores range from 4 to 20, with higher scores indicating greater social strain.
    e Scores range from 6 to 30, with higher scores indicating greater optimism about the future.
    All93,676 (100)2.4 (2.6)53.0 (8.5)35.9 (7.9)6.5 (2.5)23.3 (3.5)
    Abuse
        No abuse82,636 (88.2)2.2 (2.4)53.7 (8.0)36.5 (7.6)6.3 (2.4)23.4 (3.4)
        Physical abuse only225 (0.2)3.8 (3.4)49.1 (11.0)33.2 (8.6)7.5 (3.0)21.8 (3.8)
        Verbal abuse only9,239 (9.9)3.8 (3.3)48.3 (10.3)31.9 (8.4)8.2 (2.8)22.2 (3.8)
        Physical and verbal abuse925 (1.0)5.2 (4.0)45.6 (11.5)29.6 (9.4)8.9 (3.4)21.4 (3.9)
    Age, y
        ≤5826,284 (28.1)2.6 (2.9)51.5 (9.1)36.2 (7.7)7.0 (2.7)23.3 (3.7)
        59–6423,771 (25.4)2.3 (2.5)53.2 (8.3)36.3 (7.7)6.6 (2.5)23.3 (3.5)
        65–6920,847 (22.3)2.2 (2.4)53.8 (8.0)35.9 (7.8)6.3 (2.4)23.3 (3.4)
        70–7415,655 (16.7)2.3 (2.4)54.0 (8.1)35.3 (8.1)6.1 (2.3)23.2 (3.3)
        >747,119 (7.6)2.3 (2.3)54.2 (8.2)34.7 (8.4)5.9 (2.3)23.0 (3.3)
    Ethnicity
        American Indian/Alaskan Native422 (0.5)3.4 (3.5)51.3 (9.9)33.1 (9.4)7.2 (3.1)22.3 (3.6)
        Asian/Pacific Islander2,671 (2.9)1.8 (2.2)54.0 (7.6)35.6 (7.7)6.3 (2.6)22.1 (3.1)
        Black/African American7,639 (8.2)2.6 (2.9)52.1 (9.3)34.5 (8.4)7.4 (3.1)23.1 (3.5)
        Hispanic/Latino3,623 (3.9)3.5 (3.4)50.6 (10.0)33.3 (9.3)7.4 (3.1)22.1 (3.6)
        White78,013 (83.3)2.3 (2.5)53.2 (8.3)36.2 (7.7)6.4 (2.4)23.4 (3.5)
        Unknown1,308 (1.4)2.6 (2.8)52.4 (9.0)34.3 (8.6)6.9 (2.7)22.5 (3.6)
    Education
        0–8 y1,560 (1.7)3.7 (3.4)49.3 (10.0)32.3 (9.7)7.6 (3.3)20.9 (3.4)
        Some high school, high school diploma/GED18,409 (19.8)2.7 (2.8)52.3 (9.0)35.7 (8.2)6.6 (2.7)22.3 (3.4)
        School after high school33,933 (36.5)2.5 (2.6)53.0 (8.7)35.6 (8.0)6.6 (2.6)23.2 (3.4)
        College graduate or higher39,002 (42.0)2.1 (2.4)53.6 (7.9)36.4 (7.4)6.3 (2.4)23.9 (3.4)
    Family income
        <$20,00014,016 (16.2)3.1 (3.1)51.2 (9.9)32.4 (9.0)7.0 (2.9)22.1 (3.6)
        $20,000–$34,99920,226 (23.3)2.5 (2.6)52.9 (8.7)34.9 (8.0)6.5 (2.6)22.9 (3.5)
        $35,000–$49,99917,429 (20.1)2.3 (2.5)53.3 (8.3)36.1 (7.5)6.4 (2.4)23.4 (3.4)
        $50,000–$74,99917,486 (20.2)2.1 (2.4)53.5 (8.0)37.2 (7.1)6.4 (2.4)23.7 (3.4)
        ≥$75,00017,608 (20.3)2.0 (2.2)53.9 (7.5)38.4 (6.5)6.3 (2.3)24.2 (3.3)
    Marital status
        Never married4,390 (4.7)2.4 (2.6)52.8 (8.7)32.9 (8.2)6.6 (2.6)22.9 (3.6)
        Divorced/separated14,727 (15.8)2.8 (2.9)51.6 (9.6)32.4 (8.4)6.8 (2.7)23.1 (3.8)
        Widowed16,290 (17.5)2.6 (2.7)52.9 (8.7)33.0 (8.3)6.3 (2.5)22.9 (3.5)
        Presently married57,805 (62.0)2.2 (2.4)53.5 (8.1)37.9 (6.9)6.5 (2.5)23.4 (3.4)
    Smoking
        Never smoked47,023 (50.9)2.3 (2.5)53.3 (8.3)36.2 (7.8)6.4 (2.5)23.3 (3.5)
        Past smoker39,514 (42.8)2.4 (2.5)53.1 (8.4)35.9 (7.8)6.5 (2.5)23.3 (3.5)
        Current smoker5,791 (6.3)2.9 (3.0)50.7 (9.9)34.1 (8.6)7.1 (2.9)22.6 (3.7)
    Alcohol intake
        Nondrinker10,477 (11.3)2.4 (2.7)53.3 (8.6)35.6 (8.4)6.5 (2.7)22.8 (3.5)
        Past drinker17,555 (18.9)2.7 (2.8)52.2 (9.2)34.8 (8.4)6.9 (2.8)22.8 (3.6)
        <1 Drink per week29,461 (31.7)2.4 (2.6)52.9 (8.5)35.7 (7.8)6.5 (2.5)23.2 (3.4)
        ≤7 Drinks per week23,842 (25.6)2.2 (2.4)53.4 (8.1)36.7 (7.3)6.3 (2.4)23.6 (3.4)
        >7 Drinks per week11,709 (12.6)2.2 (2.3)53.8 (7.8)37.0 (7.3)6.2 (2.3)23.8 (3.4)
    Living alone
        No68,307 (73.5)2.3 (2.5)53.2 (8.3)37.2 (7.3)6.5 (2.5)23.3 (3.4)
        Yes24,603 (26.5)2.6 (2.8)52.5 (9.0)32.3 (8.3)6.4 (2.5)23.1 (3.6)
  • Table 2.

    Associations of Changes in Mental Health with New Reports of Physical and Verbal Abuse at Year 3

    Depressive SymptomatologyaMCS Scorea
    AbuseMean (SD)P ValuebMean (SD)P Valueb
    MCS = mental component summary, from the RAND 36-Item Health Survey 1.0.
    Note: The cohort for this analysis is women who reported no abuse exposure at baseline.
    a The values for depressive symptomatology and the MCS score represent a change in score from baseline. Negative values represent a decline in score.
    b P values from simple linear regression models with 3 indicators for categories of abuse; reference level is no abuse.
    No abuse (n = 75,376)0.09 (2.6)–0.51 (8.35)–
    Physical abuse only (n = 136)0.43 (3.3).14−1.34 (11.2).016
    Verbal abuse only (n = 6,133)0.65 (3.3)<.001−1.26 (10.4)<.001
    Physical and verbal abuse (n = 483)0.77 (3.9)<.001−1.82 (11.7)<.001
  • Table 3.

    Multivariate Analysis of Variance Showing the Association of Change in Mental Health at Year 3 and Incident Abuse, Controlling for Baseline Psychosocial Characteristics

    Change in No. of Depressive Symptoms at 3-Year Follow-upChange in MCS Score at 3-Year Follow-up
    CharacteristicParameter Estimate (95% CI)Parameter Estimate (95% CI)OverallP Value
    CI=confidence interval; MCS = mental component summary, from the RAND 36-Item Health Survey 1.0.
    Abuse
    Incident abuse (vs no abuse)
        Physical abuse only (n = 136)0.20 (−0.21 to 0.60)−1.12 (−2.45 to 0.21).006
        Verbal abuse only (n = 6,133)0.18 (0.11 to 0.24)−0.55 (−0.75 to −0.34)<.001
        Physical and verbal abuse (n = 483)0.15 (−0.05 to 0.36)−0.44 (−1.11 to −0.22)<.001
    Baseline psychosocial characteristics
    Depressive symptoms−0.20 (−0.23 to −0.16)<.001
        MCS score0.06 (0.05 to 0.06)<.001
        Social support−0.01 (−0.01 to −0.01)0.05 (0.04 to 0.06)<.001
        Social strain0.07 (0.06 to 0.08)−0.24 (−0.27 to −0.22)<.001
        Optimism−0.04 (−0.05 to −0.04)0.16 (0.14 to 0.18)<.001
    Demographic characteristics
    Age, years (vs 50–58 years)
        59–64−0.08 (−0.13 to −0.03)0.59 (0.44 to 0.74)<.001
        65–69−0.07 (−0.12 to −0.02)0.61 (0.45 to 0.77)<.001
        70–790.01 (−0.05 to 0.06)0.41 (0.23 to 0.60)<.001
    Race (vs non-Hispanic Whites)
        American Indian−0.05 (−0.13 to 0.03)0.10 (−0.16 to 0.36)<.001
        Asian/Pacific Islander0.22 (0.11 to 0.33)−0.24 (−0.61 to 0.13)<.001
        African American0.19 (−0.11 to 0.49)−0.29 (−1.29 to 0.71).005
        Hispanic American−0.36 (−0.46 to −0.25)−0.08 (−0.42 to 0.27)<.001
        Unknown0.24 (0.08 to 0.40)−0.44 (−0.96 to 0.09)<.001
    Education (vs college graduate)
        High school diploma or less0.06 (0.01 to 0.12)0.27 (0.08 to 0.46)<.001
        Some college/technical school0.08 (0.04 to 0.13)0.07 (−0.08 to 0.22)<.001
    Income (vs $75,000+)
        <$20,0000.22 (0.14 to 0.29)−0.67 (−0.92 to −0.42)<.001
        $20,000–$34,9990.13 (0.07 to 0.19)−0.52 (−0.72 to −0.32)<.001
        $35,000–$49,9990.07 (0.01 to 0.13)−0.16 (−0.35 to 0.03)<.001
        $50,000–$74,9990.03 (−0.02 to 0.09)−0.12 (−0.30 to 0.06)<.001
    Marital status (vs presently married)
        Never married−0.11 (−0.20 to −0.01)0.32 (0.00 to 0.64)<.001
        Divorced−0.06 (−0.13 to 0.01)0.13 (−0.10 to 0.37)<.001
        Widowed−0.22 (−0.29 to −0.15)0.99 (0.75 to 1.22)<.001
    Smoking status (vs never smoked)
        Past smoker0.06 (0.02 to 0.10)−0.05 (−0.17 to 0.08)<.001
        Current smoker0.22 (0.14 to 0.30)−1.06 (−1.32 to −0.80)<.001
    Alcohol use (vs past or never drank)
        <1 Drink per week−0.04 (−0.90 to 0.01)0.07 (−0.08 to 0.23)<.001
        ≥1 Drink per week−0.04 (−0.09 to 0.00)0.04 (−0.12 to 0.19)<.001
    How much does your religion comfort you (vs little/none)
        A great deal−0.03 (−0.07 to 0.01)0.12 (−0.01 to 0.25)<.001
    Living alone (vs no)
        Yes−0.06 (−0.12 to 0.00)0.25 (0.04 to 0.46).005

Additional Files

  • The Article in Brief

    Psychosocial Effects of Physical and Verbal Abuse in Postmenopausal Women

    Charles P. Mouton , and colleagues

    Background Although researchers have examined the physical effects of abuse on older women, there has been little research into the psychological effects of abuse. This study examines the psychological effects of physical and verbal abuse on older women.

    What This Study Found Older women who have been exposed to abuse have worse mental health than nonabused women. In this study, abused women had more symptoms of depression, greater social strain, and lower optimism. Exposure to verbal abuse only, without physical abuse, had greater psychological effects than physical abuse alone.

    Implications

    • Detecting and alleviating abusive situations may have significant beneficial effects on the mental health and quality of life of older women.
    • Clinicians should consider possible exposure to abuse in older female patients with depression.
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