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Intimate Partner Violence, Psychological Distress, and Suicidality: A Path Model Using Data from African American Women Seeking Care in an Urban Emergency Department

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Abstract

Intimate partner violence (IPV) and suicidal behavior are major public health problems in the African American community. This study investigated whether or not IPV and suicidal ideation are correlated in urban African American women, and if the IPV–suicidal ideation link is explained by symptoms of depression and posttraumatic stress disorder (PTSD). With 323 abused African American females, path analysis revealed that: (1) IPV → depressive symptoms → suicidal ideation, and (2) IPV → PTSD symptoms → depressive symptoms → suicidal ideation. When evaluating abused women, depressive and PTSD symptoms and suicidal thoughts must be assessed. Interventions for reducing suicidal behavior in abused, low income African American women should reduce symptoms of depression and PTSD.

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Acknowledgment

This investigation was supported by CDCC R-49 Grant 4230113, “Safety and efficacy of IPV screening for victimization and perpetration.” (Houry—PI, Kaslow—Co-Investigator).

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Leiner, A.S., Compton, M.T., Houry, D. et al. Intimate Partner Violence, Psychological Distress, and Suicidality: A Path Model Using Data from African American Women Seeking Care in an Urban Emergency Department. J Fam Viol 23, 473–481 (2008). https://doi.org/10.1007/s10896-008-9174-7

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