Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Doctor of Philosophy

Program

Nursing

Supervisor

Marilyn Ford-Gilboe

Abstract

Background: Despite the growth in research on intimate partner violence (IPV) as a chronic stressor, including studies on the negative mental health impacts of IPV, limited attention has been given to understanding the stress process in terms of the direct impact of IPV on mental health and the simultaneous mediating effects of social support (emotional or practical assistance from one’s network) and mastery (a sense of personal control) on the relationship between IPV and mental health [Depression symptoms and Post-traumatic stress disorder (PTSD) symptoms]. These mechanisms are also poorly understood in the context of the concurrent effects of age, mothering, education, and intimate partner status.

Purposes: This dissertation examined the direct impact of IPV on mental health (Depression symptoms and PTSD symptoms) and the mechanisms that explain the relationship between severity of IPV and women’s mental health at a specific point in time, with a particular focus on testing whether and how social support and mastery mediated this relationship, in the context of selected conditions of women’s lives. The specific purposes were: (i) to examine whether mastery and social support mediate the effects of IPV severity on mental health and (ii) to identify which aspects of the social context of women’s lives account for variations in the mechanisms between IPV and mental health.

Methods: Drawing on feminist intersectionality, a secondary analysis was conducted using data from a sample of 462 women with histories of recent IPV (i.e., past 6 months) and who participated in the iCAN plan 4 safety trial. Participants completed online surveys comprised of standard self-report measures for each study variable: IPV severity (Composite Abuse Scale), Depression (Center for Epidemiologic Studies Depression Scale), PTSD (PTSD checklist, Civilian Version), Mastery (Pearlin’s Mastery Scale) and Social Support (Medical Outcomes Study Social Support Survey). Structural equation modeling techniques were used to examine the mediating effects of both social support and mastery on the relationships between IPV severity on both depression and PTSD symptoms, while examining the effects of selected covariates capturing conditions of women’s lives (e.g., education, age, whether living with partner and mothering a minor child) on the direct and indirect effects of IPV on mental health.

Results: The four key results are: (1) there was overall support for both direct and indirect effects in the model although direct effects were stronger; these results suggest strong relationship between severity of IPV and mental health problems even in the presence of mediators; (2) mastery but not social support mediated the relationship between IPV and mental health (for both outcomes: depression and PTSD symptoms), supporting nonconcurrent mediating effects of social support and mastery on the relationship between IPV and mental health, as opposed to the simultaneous mediating effects of these resources proposed in the Stress Process Model; (3) mothering reduced the negative effects of IPV on mental health, and although this effect was weak, it was stronger for depression than for PTSD; thus, mothering may offer some protection against the negative effect of IPV on depression and PTSD symptoms; (4) based on a subgroup analyses conducted with women who were and were not mothering dependent children, different mechanisms may explain the impact of IPV on mental health for women based on mothering status: social support mediated the relationship between IPV and mental health in women who identified as mothers of dependent children, while mastery mediated this relationship in women who did not identify as mothers of dependent children.

Conclusions: The dissertation study produced new evidence that mastery mediates the relationship between severity of IPV and women’s mental health. If mastery is eroded by IPV, efforts to help women regain control could also help strengthen women’s health. Further, mothering is an important context for understanding the varied impacts of IPV on mental health. This reinforces the importance of taking an intersectional perspective and attempting to unpack the complexity of the mechanisms that explain the pathways between IPV, resources and mental health in ways that account for women’s differing realities.

Summary for Lay Audience

Informed by the Stress Process Model and Feminist Intersectional lens, the dissertation advances knowledge of the negative mental health impacts of intimate partner violence on Canadian women by offering novel insights about the role of mastery in mediating the relationship between IPV and mental health and the potential role of mothering (a key social location/condition) in protecting against these negative impacts in ways that needs to be more fully explored to promote holistic intervention against intimate partner violence.

The dissertation also underscores the complexity and variation in women’s experiences of violence and the mechanisms that explain the impacts of IPV on mental health based on women’s mothering status. For women who identified as mothering dependent children, social support was the means through which intimate partner violence reduced mental health. But for women who identified as not mothering dependent children, mastery was the means through which intimate partner reduced mental health.

These findings point to the value of intersectional lens in research and in developing programs and policies that prioritize women’s choice and control, and are responsive to their varied needs and contexts, as a pathway to better mental health.

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