SCOTTSDALE, ARIZ. — People who are emotionally and physically abused by their intimate partners develop more mental illness and substance abuse than those who are only physically abused, Susan Ditter, M.D., said at the annual meeting of the American Academy of Psychiatry and the Law.
“Emotional abuse is not well studied, [but] it precedes and predicts physical aggression in marriage,” said Dr. Ditter, a forensic psychiatry fellow at the University of Virginia, Charlottesville. “It can occur without physical abuse, but the converse is rare.”
She and her colleagues looked at data from the National Violence Against Women Survey, a random-digit-dial phone survey of households nationwide. The survey, conducted from November 1995 to May 1996, included responses from 8,000 men and 8,000 women, all aged 18 years and older. All respondents were either currently married, formerly married, or in a cohabiting heterosexual relationship.
Dr. Ditter and her associates distinguished between two subtypes of emotional abuse: verbal abuse, which involves verbal attacks and degrading behaviors, and power-and-control abuse, in which the victim is isolated and forced into traditional sex roles. They found that 25% of men and 27% of women had experienced verbal abuse, while 12% of men and 20% of women had experienced power-and-control abuse.
The risk of emotional abuse increased in low income, less educated, uninsured, unemployed, divorced, or single people, Dr. Ditter said. Widowed men were at higher risk for emotional abuse than widowed women.
The researchers also found that those who had experienced emotional abuse along with other types of intimate partner violence had more depression, serious mental illness, illicit drug use, and antidepressant treatment than those who experienced the violence without emotional abuse.
Overall, men were more likely to experience only emotional abuse than were women, while women experienced more power-and-control abuse along with other types of partner violence. Men who experienced only verbal abuse were much more likely to carry a gun for protection (adjusted relative risk, 4.77) than were women in that category (aRR, 0.22), Dr. Ditter said.
There were several limitations in the study, according to Dr. Ditter. She noted that it was a cross-sectional survey, so causation could not be assessed. In addition, the emotional abuse measures were not widely standardized for reliability and validity, and there were limited measures for mental health history and treatment.
Other studies support the harmfulness of emotional abuse. One study found that 6 months after leaving their partners, all of the 25 emotional abuse subjects studied had three sequelae of “battered woman's syndrome,” including trauma symptoms, low self-esteem, and a paradoxical attachment to the former partner. In another study, victims of even severe intimate partner violence reported psychological humiliation as their worst battering experience.