Angelite Nurses

SEATTLE, May 19 -- Domestic violence against men is common, though often under-reported, and may damage mental health, a retrospective cohort study showed.

In a survey of 420 men, 28.8% had been the victim of either physical or psychological abuse during their adult lifetime, Robert Reid, M.D, Ph.D., of the Group Health Cooperative Center for Health Studies here, and colleagues reported in the June issue of the American Journal of Preventive Medicine.

In a similar study, the group found the prevalence to be 44% among women.
Action Points

* Explain to interested patients that this study found that domestic violence -- either physical or psychological -- affects about 30% of men during their lifetime.

Men 55 and older who had been abused had lower mental health scores and were more likely to be depressed than older men who had not been abused, the researchers found.

And men younger than 55 who had been subjected to physical or psychological abuse reported more difficulty in functioning socially.

"The findings … suggest that the failure of healthcare personnel to ask about and acknowledge men's experiences of [intimate partner violence] may be shortsighted," the researchers said.

"Asking men about [intimate partner violence] may open a conversational space about abuse -- perhaps bi-directional in nature -- that may be occurring in their relationships," they said.

Future research, the researchers said, is needed to determine effectiveness of various interventions.

Dr. Reid said that this study should not overshadow the effects of abuse against women.

"This study doesn't downplay or mitigate the experience that women have with domestic violence. It's common for women, and health consequences -- including death -- can be devastating," he said. "But violence appears to go in many directions, directed against children, against women, and, in some cases, men."

The researchers conducted a telephone survey of 420 adult men (mean age 53.8, 86.1% white) who were insured by Group Health for at least three years.

They were asked about past episodes of intimate partner violence using the Behavioral Risk Factor Surveillance Survey.

Health was assessed using the Short Form-36 version 2, the Center for Epidemiological Studies Depression Scale, and the National Institute of Mental Health Presence of Symptoms Survey.

A total of 18.4% of the participants reported being a victim of childhood physical or sexual abuse and 14.5% had witnessed intimate partner violence.

Overall, 4.6% of the participants had been abused in the past year by an intimate partner and 10.4% had been a victim of violence in the past five years.

Those younger than 55 were more likely than older men to have been abused in the past five years (14.2% versus 5.3%) and to have been subjected to physical violence at any time (8.8% versus 1.1%) (P<0.01 for both).

Most of the men said they had been a victim of intimate partner violence more than once -- 68.1% for those reporting physical abuse and 92.4% for those who had been abused psychologically.

Physical violence generally lasted less than a year but psychological abuse persisted longer.

Among men younger than 55, 82% said they were a victim of non-physical abuse for a year or longer. The figure for older participants was 72.5%.

Those 55 and older who had been physically abused at any time had lower mean scores out of 100 for mental health (-5.86), vitality (-3.48), and a summary of the mental component of the assessment (-4.70) compared with older men who had not been a victim of physical abuse. These changes were statistically and clinically significant, Dr. Reid said.

Participants younger than 55 who had been abused had lower scores for social functioning whether the abuse had been physical (-2.53) or psychological (-2.51).

Older participants who had been abused physically were 2.8 times more likely to have depressive symptoms (prevalence ratio 2.80, 95% CI 1.23 to 6.34) and 3.14 times more likely to be severely depressed (PR 3.14, 95% CI 1.06 to 9.32) than those who were not abused.

Older participants who were victims of non-physical abuse were 2.61 times more likely to have depressive symptoms (PR 2.61, 95% CI 1.28 to 5.34).

Intimate partner violence did not have any significant effects on physical health, in contrast to the effects on women.

The authors said that the results may not be generalizable to uninsured or more diverse populations.

Also, they said, the study had a low response rate and the small sample size precluded the assessment of a direct connection between abuse and health outcomes.

They also pointed out that "because the men were asked to remember events that may have occurred long ago, the findings may underrepresent the occurrence of events in the distant past. As such, the estimates of lifetime

prevalence may be biased downward for older men compared to younger men, and may explain the lower reported lifetime prevalence found for older men."

Finally, the participants were not asked about reciprocal violence, as the study was focused on the consequences for male victims.

The study was supported by a grant from the Agency for Healthcare Research and Quality and by the Group Health Cooperative Center for Health Studies. Dr. Reid and one of his co-authors received salary support from the Group Health Permanente medical group.

Primary source: American Journal of Preventive Medicine
Source reference:
Reid R, et al "Intimate partner violence among men: prevalence, chronicity, and health effects" Am J Prev Med 2008; DOI: 10.1016/j.amepre.2008.01.029.