Objective
To understand the independent and interactive effects of childhood abuse history (CAH) and domestic violence (DV) on the mental health status of women in Japan.
Methods
A self-administered questionnaire survey was conducted among a sample of 340 women staying in 83 Mother-Child Homes in Japan to assess the women's CAH and DV experiences, along with their current mental health problems, including dissociated, depressed, and traumatic symptoms.
Results
Independent from DV, CAH, especially psychological abuse, had a significant impact on all of the women's mental health symptoms. DV was found to have an independent effect on traumatic symptoms. Weak interactive effects of CAH and DV were found on dissociated and traumatic symptoms. Among those women without CAH, DV was significantly associated with dissociated and traumatic symptoms; however, DV had no impact on dissociated and traumatic symptoms if CAH was present.
Conclusions
The findings suggest the significant impact of CAH on women's mental health problems, independent from DV. CAH and DV weakly interact on women's mental health.
Practice implications
In psychological therapy for battered women with mental health problems, if the cases were abused during childhood, it is recommended that therapy be focused on childhood abuse, especially if the client was psychologically abused. In addition, mental health care and welfare providers should be aware that the mental health problems of mothers without CAH might be exacerbated by DV; thus, appropriate resource allocation should be considered.
Child abuse is an emerging problem in Japan (Fujiwara, 2007). An estimated 35,000 children are abused annually, which is 1.54 cases per 1,000 children aged 0 through 17 years (Kobayashi, 2002). Previous studies have shown a link between child abuse history (CAH) and mental health consequences when the victim becomes an adult (Beitchman et al., 1992, Dykman et al., 1997, Horwitz et al., 2001, MacMillan et al., 2001, Reinherz et al., 2003, Widom, 1999 and Widom et al., 2007). It is also considered that the impact of child abuse on mental health problems varies by the type of abuse (i.e., physical abuse, sexual abuse, neglect, and psychological abuse) (Bensley, Van Eenwyk, & Wynkoop Simmons, 2003).
Domestic violence (DV) is another emerging issue in Japan. The estimated rate of DV is 14.3% among women by the age of 30 years (Yoshihama, Horrocks, & Kamano, 2007). A recent international study on DV showed that during the past 12 months, the prevalence rate of DV in Japan parallels those of Western countries (Garcia-Moreno, Jansen, Ellsberg, Heise, & Watts, 2006). In accordance with the increased recognition of DV in Japan, legislation to protect DV victims was enacted in the year 2000 (Domestic Violence Prevention Act [Law No. 31]) and amended in 2004 to include post-divorce partner violence. Numerous studies have reported that DV has a significant impact on mental health problems, especially depression and post-traumatic stress disorder (PTSD) (Bland and Orn, 1986, Campbell et al., 1997, Campbell, 2002, Cascardi et al., 1999, Gleason, 1993, Golding, 1999, Jaffe et al., 1986, Kaslow et al., 1998, McCauley et al., 1995, Ratner, 1993, Silva et al., 1997 and Thompson et al., 2000).
Previous studies have shown the link between CAH and DV; that is, women with CAH are more likely to be victims of DV (Bell and Chance-Hill, 1991, Bensley et al., 2003, Browne, 1993, Coid et al., 2001, Wingood and DiClemente, 1996 and Wyatt et al., 2000), because CAH violates expectations of relationships with loved ones (Wyatt et al., 2000). Thus, the reported association between DV and mental health problems might be confounded by CAH. However, few studies have investigated the independent effects of CAH and DV on women's mental health problems.
In addition, CAH and DV might generate interactive effects on the mental health of women. Previous studies have shown interactive effects between child abuse and DV on a child's mental health. Child abuse was associated with internalizing and externalizing problems and traumatic stress only when mothers reported higher levels of physical DV. This condition is not true for youths whose mothers did not experience DV (Kaslow & Thompson, 2008). However, few studies have investigated the interactive effects of CAH and DV on women's mental health.
Based on this previous research, it is hypothesized the following: (1) CAH and DV have independent associations with women's mental health problems and (2) CAH and DV have interactive effects on women's mental health problems; that is, women with CAH are more vulnerable to DV than women without CAH. The purpose of this study is to investigate the independent and interactive effects of CAH and DV on the mental health status of women in Japan.
