Social evils are inevitable in today's society because of tradition, cultural practices, and changing norms. Intimate partner violence and other forms of family are common in society and they negatively impact children and the victims. The Office of Juvenile Justice and Delinquency Prevention (OJJDP) asserts that increased exposure to violence can harm a minor’s physical, emotional, and psychological growth and development. Additionally, DeJonghe, Bogat, Levendosky, and von Eye (2008) acknowledge that domestic abuse and violence elevates risk for the development of post-traumatic stress disorder among partners. Consequently, intimate partner violence (IPV) and childhood maltreatment (CM) are a violation of fundamental human rights and public health challenges that needs to be addressed. The World Health Organization (WHO) asserts that women are the main victims of intimate partner violence in the world. The patriarchal nature of the society makes women vulnerable to gender-based violence and intimate partner violence compared to men; thus, likely to suffer from mental conditions such as post-traumatic stress disorder (PTSD).
Children Exposed to Violence
The nature and nurture debate plays a critical role in explaining the psychological and emotional growth of children. The debate involves whether human personality and behavior are shaped by a child's environment or an individual's genes. Proponents of the nurture theory in a minor's development and growth believe that parents and the environment where children grow influence their personality and behaviors. Based on the nurture approach, a child who grows in a violent family or environment is likely to become violent. A study conducted by the OJJDP on the impact of exposure to family violence among minors in the United States, including exposure to IPV confirmed that an increased number of children in the country are exposed to unacceptable rates of violence in their respective homes. According to the results of the survey, 11% of minors in the country experienced some form of family violence in 2010 (Mignone et al, 2017). Moreover, 6.6% of children in the United States are exposed to IPV and 26% have experienced at least one form of family violence in their lifetime. The statistics are worrying since children's exposure to IPV and other forms of family violence adversely impact their physical, psychological, and emotional growth (Mignone et al, 2017). Experts assert that exposure to violence can be distressing and lead to mental challenges among children. Consequently, children exposed to IPV and other forms of family violence are likely to exhibit a host of mental health illnesses and symptoms both during their childhood and later in life. Hamby, Finkelhor, Turner, and Ormrod (2011) acknowledge that the common mental challenges affecting children who have experienced IPV and other forms of family violence include anxiety, depression, and post-traumatic stress disorder. Furthermore, the study found the application of the nurture theory among children who have grown in hostile environments. Increased exposure to IPV as a minor is associated with offending as an adult (Hamby et al., 2011). Parents and other stakeholders should work on providing their children with conducive environments to curb mental challenges affecting children exposed to IPV and to limit the spread of IPV in future generations.
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Intimate Partner Violence Against Women
Patriarchial societies discriminate against women since they are considered to be the inferior gender. The social stereotypes are against women and contribute to their victimization. Furthermore, cultural practices make women vulnerable to IPV and other forms of domestic violence. According to the United Nations violence against women is considered to be an act of gender-based violence that can lead to sexual, physical, and mental harm. The United Nations define IPV as behavior by an ex-partner or intimate partner that leads to psychological, physical, and sexual harm. The international organization asserts that IPV includes sexual coercion, controlling behaviors, psychological abuse, and physical aggression against partners. IPV is considered to be a violation of women's human rights and a public health challenge. WHO acknowledges that 30% of women across the globe have experienced either IPV, physical violence, or non-partner sexual violence in their lifetime and the experience has adversely affected their psychological development. IPV is common among women from their teenage years to late adulthood. A study by the WHO asserts that 27% of women aged between 15 -49 years who have been in an intimate relationship have been subjected to different types of IPV and physical violence during their relationships. Stakeholders should combat IPV against women since it adversely affects their sexual, mental, physical, and reproductive health (Mignone et al, 2017). Governments should impose stringent laws as a measure of curbing IPV to deter people from attacking their partners since the practice is related to the increased risk of acquiring HIV/AIDS. Consequently, IPV has social and economic challenges for the victims. Women are the main victims of IPV since they are considered to be second-class citizens in patriarchal societies. The government and other stakeholders should protect women from violence by passing stringent laws that deter people from attacking them and having gender desks at the police stations to make it easy for women to report criminal activities (Mignone et al, 2017). The measures will help curb IPV and other forms of family violence that pose challenges to the public health sector and leads to adverse physical, psychological, economic, and social challenges for the victims.
Figure 1: Development of PTSD
Post-traumatic Stress Disorder among Women
Terrifying events are common in today’s society and people react differently to various types of trauma. The reaction to disasters and healing time depends on factors such as gender. PTSD is common among people who have experienced traumatic events in their lifetime. Experts define PTSD as a mental health condition that is triggered by terrifying events and can impact the victim's mental health throughout their lifetime because of constant flashbacks, nightmares, and anxiety caused by uncontrollable thoughts about the terrifying events. Olff (2017) asserts that gender plays a critical role in the management and healing process of people affected by PTSD since women have a two to three times higher risk of developing the condition compared to men. Furthermore, the lifetime prevalence of PTSD among men stands at 5 -6% while in women it is 10-12% (Olff, 2017). The difference in prevalence in PTSD among men and women is because of the varying brain and behavior in sex and gender. Consequently, some symptoms of PTSD are common in women compared to men.
IPV, children victimization and other forms of family violence are traumatic events that can lead to PTSD. Studies indicate that the common trauma for women that can result in PTSD is child sexual abuse and sexual assault – the two practices are related to gender-based violence that is common among women compared to men since they are considered to be inferior gender and social stereotypes encourage their abuse (Shields et al., 2020). During childhood, women are more likely to be neglected, abused, and experience domestic violence compared to men since they are considered second-class citizens in patriarchal societies and their rights are limited (Becker et al., 2010). Governments and societies should not discriminate based on sex or gender and women deserve equal protection under the law as a way of curbing IPV and the increasing rate of PTSD among women.
IPV is a major challenge that leads to significant costs to victims, society, and public healthcare systems across the globe. Statistics indicate that 20-64% of gender-based violence against women results from romantic partners. Moreover, a majority of women experiencing IPV (more than half of the victims) live with minors under the age of 12 years old. The study indicates that victims of IPV are women who are either raising children or pregnant (Mignone et al, 2017). Consequently, the increased IPV does not only affect the women who are violently abused by their partners or ex-partners but their children who live in hostile environments (Shields et al., 2020). According to the nurture theory, the children who are exposed to IPV are likely to emulate the traits and it will impact negatively on their physical and psychological growth. Societies are at risk of continued IPV since the children who grow in such hostile environments are likely to suffer from PTSD because of the trauma or emulate the practice and violently attack their partners in feature (Becker et al., 2010). When social evils such as IPV are passed from one generation to the other it promotes its continuation in society and contributes to increased cases of PTSD.
Mental wellness plays a critical role in the development of human beings. IPV adversely impacts the mental wellness of the victims and children who are exposed to such environments. As a result, IPV can be life-threatening to the victims since it leads to immune disorders, societal stigma, gastrointestinal challenges, sleep deprivation, and injuries that result in death (DeJonghe et al., 2008). Women who suffer from PTSD are likely to experience a conglomeration of other mental health challenges. According to DeJonghe and others (2008), people suffering from PTSD experiences at least one additional mental condition diagnosis such as anxiety, depression, psychological distress, and low self-esteem. Furthermore, the prevalence of PTSD among assaulted women ranges from 45-84% (DeJonghe et al., 2008). The correlation between different forms of IPV and PTSD has been proven. For example, experts believe that more forms of IPV experienced by victims lead to a greater number of the victim's PTSD symptoms (DeJonghe et al., 2008). Statistics indicate that pregnant women and those raising children are the highest victims of IPV. DeJonghe and others (2008) assert that somatic complaints, depressive, PTSD symptoms are higher among pregnant women with a history of sexual violence and IPV. The findings illustrate that the effects of IPV are dangerous and do not only affect the victims but can include unborn children. Consequently, fighting IPV can lead to a reduction in the infant mortality rate among women. Psychologically and physically abused women register higher rates of PTSD, anxiety, and depressive symptoms; thus, societies have a responsibility of shunning IPV since it negatively impacts the growth of any society. Women's mental health is crucial for the growth and development of any society. Curbing the rate of IPV will reduce the pressure on public health and lead to a healthy society that can undermine the growth of the infant mortality rate. PTSD is connected to suicidal thoughts and rates across the globe. Consequently, it is not only a violation of human rights but contributes to increased social evils.
The connection between IPV and PTSD
The existence of a close relationship between IPV victims and PTSD is a worrying trend that needs to be addressed. Contreras-Pezzotti, Arteaga-Medina, Fidel Latorre, Folino, and Campo-Arias (2010) acknowledge that women victims of IPV are at high risk for the development of PTSD compared to other women in the society. Moreover, women suffering from PTSD experience other co-morbid mental health challenges such as increased substance abuse and depression. Research indicates that neuroendocrine dysregulation plays a critical role in the development of PTSD among IPV victims. IPV has the potential of activating biological stress systems that have hypothalamic-pituitary-adrenal stress axis (HPA axis) as their predominant component, The HPA axis produces cortisol which enhances the stressful stimuli in IPV victims (Becker et al., 2010). When the cortisol levels increase they assist humans in coping with transient stressors through the alteration of metabolism and neural functions. However, the chronic activation of the cortisol levels for a prolonged period can lead to the damage of the physiological functions of humans (Becker et al., 2010). The other impact of the process includes psychological challenges (PTSD), lower immunity, and inflammatory problems in living organisms. Cortisol-induced alteration of the brain is connected to the emotional response that both minors and adults have during stressful events. The exposure of women to IPV can influence the functioning of their HPA axis. Consequently, there is a connection between increased cortisol levels with depression or PTSD among victims of IPV.
Risk Factors for the Development of PTSD
The severity of PTSD among victims of IPV is determined by the level of abuse or experience of abuse. Consequently, some factors enhance the likelihood of women developing PTSD because of exposure to IPV. Childhood victimization and abuse are among the leading risk of repeated victimization during adulthood among the victims. Moreover, childhood victimization is associated with an increase of adverse mental health challenges if a woman is victimized or engaged in IPV. DeJonghe and others (2008) note that depressive symptoms are associated with both sexual and physical abuse among women victims of IPV. The study further acknowledges that childhood exposure to IPV and other forms of family violence later affect the victims in their adulthood. DeJonghe and others (2008) assert that the nature of the abusive behavior plays a critical role in determining women's risk of PTSD since sexual abuse occurs in conjunction with other forms of IPV. The occurrence of such social evils leads to an increased risk for PTSD and other mental conditions associated with IPV and other types of family violence (Shields et al., 2020). For example, intimate partner or ex-partner rape is linked to mental conditions such as PTSD, suicidal ideation, and depression among the women victims (DeJonghe et al., 2008). The other risk factors are sexual assault and battering from ex-partners, intimate partners, and non-partners have proven to be a stronger predictor of PTSD among women. The third risk factor focus on the timing and exposure of victims to IPV and other types of family violence since the factors impact women's mental health. DeJonghe and others note that exposure to IPV during pregnancy or victims with a history of IPV from childhood adversely impacts women's mental health across various diagnostic categories. Consequently, the severe nature of PTSD and other mental health conditions among women can be determined by the number of intimate partners who have exposed them to IPV and the timing of the experience as they have varying impacts on women. The worst affected are women exposed to chronic IPV by their multiple partners in their vulnerable times such as when they are pregnant (DeJonghe et al., 2008). The next category of the worse affected victims are women exposed to IPV during their pregnancy or in the year before their pregnancy and still stay with their abusive partners (DeJonghe et al., 2008). IPV can lead victims to suffer from a conglomeration of mental health challenges. As a result, societies should shun IPV and stringent laws passed to contain the practice and hinder its continuation in society.
Symptoms of PTSD and Diagnostic Approach
The symptoms of PTSD among victims of IPV and other people who suffer from the condition are divided into three – intrusive, avoidance or numbing, and hyperarousal symptoms. During the intrusive symptom stage victims of the condition experience distressing recollection of the traumatic event through dreams, nightmares, and constant thinking of the situation. The other symptoms that occur in the first stage include a sense of reliving the event and enhanced distress on exposure to cues that are related to the traumatic event (Shields et al., 2020). According to the symptoms, the first stage is mainly concerned with thoughts and a sense of reliving the traumatic event. The second stage of the symptoms of PTSD focuses on the fight to avoid adverse thoughts about the traumatic event. Consequently, victims of PTSD will focus on avoiding conversations, thoughts, feelings, people, activities, and places that remind them of the traumatic events. Finally, the last stage involves sleep deprivation, enhanced startle response, outbursts of anger, and hypervigilance. When victims experience the symptoms they have to be screened for IPV and PTSD to help the healthcare professionals to determine a way of assisting them to overcome the condition (Shields et al., 2020). The screening process involves asking patients questions about their past and present lives to determine whether the condition is triggered by their past or present relationships. The process should be private and confidential to avoid victimization and stigmatization by the public (Becker et al., 2010). Victims of IPV can overcome PTSD and other mental conditions if they seek medical attention and follow the proper guideline in fighting the condition.
Overall, PTSD is common among women compared to men since they are the victims of the condition’s risk factors. The patriarchal nature of the society makes women vulnerable to IPV and other forms of family abuses compared to me who is considered to be the superior creature. Cultural practices in some underdeveloped and developing nations allow gender-based violence because of societal myths. However, IPV is a violation of the victim's fundamental human rights and has adverse social and economic effects on society. For example, children exposed to domestic violence are likely to practice IPV in the future since during their development they were exposed to a violent environment. According to the nurture theory, minors adopt behaviors and personalities that they experience in their environment when growing. Moreover, exposure to IPV negatively impacts the psychological development of children and it is a risk factor that can lead to PTSD and other mental conditions. WHO acknowledges that women are the leading victims of IPV in the world since most societies consider them to be second-class citizens. Sex and gender discrimination plays a critical role in the increased cases of violence and abuse against women in society. Consequently, sensitization is essential in informing the public on the importance of inclusivity and unity. IPV and other forms of family violence do not only affect the victims but adversely affect the unborn children and contribute to a high infant mortality rate in societies since some of the victims are pregnant women. Increased IPV leads to injuries and psychological challenges that may lead to mental health conditions such as depression, PTSD, and suicidal thoughts. Therefore, IPV has both social and economic impacts on the victims and societies. Curbing the practice will reduce the pressure exerted on public health facilities as it may undermine service delivery in hospitals. Fighting PTSD among women equals combating the rate of IPV ins society since it is the cause of the traumatic events. People exposed to such traumatic events should seek medical attention as a way of fighting and combating the adverse effects of mental conditions and PTSD in the world. Governments and other stakeholders have a responsibility of sensitizing the public on the adverse effects of IPV on women and children as a way of combating the practice and fighting the rise of mental conditions in society.
References
DeJonghe, E. S., Bogat, G. A., Levendosky, A. A., & von Eye, A. (2008). Women survivors of intimate partner violence and post-traumatic stress disorder: Prediction and prevention. Journal of postgraduate medicine , 54 (4), 294.
Hamby, S. L., Finkelhor, D., Turner, H., & Ormrod, R. (2011). Children's Exposure to Intimate Partner Violence and Other Family Violence. National survey of children’s exposure to violence .
Olff, M. (2017). Sex and gender differences in post-traumatic stress disorder: an update. European journal of psychotraumatology , 8 (sup4), 1351204.
Contreras-Pezzotti, L. M., Arteaga-Medina, J. E., Fidel Latorre, J., Folino, J. Ó., & Campo-Arias, A. (2010). Association between intimate partner violence and posttraumatic stress disorder: A case-control study. Revista Colombiana de Psiquiatría , 39 (1), 85-92.
Becker, K. D., Stuewig, J., & McCloskey, L. A. (2010). Traumatic stress symptoms of women exposed to different forms of childhood victimization and intimate partner violence. Journal of Interpersonal Violence , 25 (9), 1699-1715.
Shields, M., Tonmyr, L., Hovdestad, W. E., Gonzalez, A., & MacMillan, H. (2020). Exposure to family violence from childhood to adulthood. BMC public health , 20 (1), 1-15.
Mignone, T., Papagni, E., Mahadeo, M., Klostermann, K., & Jones, R. A. (2017). PTSD and intimate partner violence: Clinical considerations and treatment options. Journal of Addiction Medicine and Therapeutic Science , 3 (1), 001-006.
