Gender moderates the association between posttraumatic stress disorder and mutual intimate partner violence in an emergency department sample

Abstract

Introduction: Patients in emergency departments (EDs) constitute a diverse population with multiple health-related risk factors, many of which are associated with intimate partner violence (IPV). This paper examines the interaction effect of depression, posttraumatic stress disorder (PTSD), impulsivity, drug use, adverse childhood experiences (ACEs), at-risk drinking, and having a hazardous drinker partner with gender on mutual physical IPV in an urban ED sample.

Methods: Research assistants surveyed 1037 married, cohabiting, or partnered patients in face-to-face interviews (87% response rate) regarding IPV exposure, alcohol and drug use, psychological distress, ACEs, and other sociodemographic features. IPV was measured with the Revised Conflict Tactics Scale. Interaction effects were examined in multinomial and logistic models.

Results: Results showed a significant interaction of gender and PTSD (odds ratio [OR] 3.06, 95% CI 1.21-7.23, p < 0.05) for mutual IPV. Regarding main effects, there were also statistically significant positive associations between mutual physical IPV and at-risk drinking (OR 1.73, 95% CI 1.07-2.77, p < 0.05), having a hazardous drinker partner (OR 2.19, 95% CI 1.35-3.55, p < 0.01), illicit drug use (OR 2.09, 95% CI 1.18-3.71, p < 0.01), ACEs (OR 1.23, 95% CI 1.06-1.42, p < 0.01), days of cannabis use past in the 12 months (OR 1.003, 95% CI 1.002-1.005, p < 0.001), and impulsivity (OR 2.04, 95% CI 1.29-3.22, p < 0.01).

Conclusions: IPV risk assessment in EDs will be more effective if implemented with attention to patients' gender and the presence of various and diverse other risk factors, especially PTSD.