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Intimate partner violence (IPV), sexual assault (SA), and childhood abuse (CA) are common forms of violence experienced by women across the globe at alarming rates. These rates of violence carry a heavy financial burden with estimated life-time costs in the United States being $3.6 trillion for IPV, $124 billion for CA, and $1.2 trillion for SA (Peterson et al., 2018; Fang et al., 2012; Peterson et al., 2017). Current literature has displayed that violence which results in symptoms of post-traumatic stress disorder is linked to long-term negative health impacts (Felitti et al., 1998; Lupien et al., 2009; Mechanic et al., 2008; Jaquier et al., 2013). While a great deal of literature exists in regards to rates, costs, and health impacts of different forms of violence, little research has been done concerning factors that may alleviate some of the negative, life-time effects of interpersonal violence. In an effort to fill in this gap in literature, the current study analyzes stress, social support, and health behaviors as potential mediators that better explain the relation between violence and current health-related quality of life (HR-QOL).
For the purpose of this study, violence was defined as IPV, CA, and SA. The variable health-related quality of life was used to measure perceived negative physical and mental health outcomes. A secondary data analysis was conducted to address the following research questions: 1) Does violence (recent or past experiences) increase the rate of current, poor perceptions of HR-QOL? 2) Does stress, social support, and/or health behaviors explain associations between violence and current HR-QOL?
Data was analyzed from 12,594 participants, 50.1% of which reported experiencing at least one form of violence and 19.9% experiencing multiple forms. Results showed that all three types of violence (IPV, SA, and CA) were associated with higher rates of poor current mental and physical HR-QOL and those who reported experiencing multiple forms also had high rates of poorer mental and physical HR-QOL. To address the first research question, those currently experiencing any form of violence had higher rates of poor mental and physical HR-QOL. The second research question was addressed by conducting multiple mediation models. When all mediation variables were included (stress, social support, and health behaviors) partial mediation was observed. Current stress was the most important mediator as it accounted for the most change in the association between violence and HR-QOL.
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