Dataset Information

Women's experiences of economic coercion and depressive symptoms in Matlab, Bangladesh.

ABSTRACT: Prior studies of the association between intimate partner violence (IPV) and depressive symptoms have typically excluded economic coercion (EC), a prevalent form of IPV worldwide. Here, we used structural equation models (SEM) to estimate the association of EC with depressive symptoms, with and without adjustment for physical/psychological/sexual IPV, among women in rural Matlab, Bangladesh. Data were collected from cross-sectional surveys with married women 15-49 years, conducted between November 2018 and January 2019. Prior-week depressive symptoms were measured using the 10-item Centre for Epidemiologic Studies Depression short-form. Lifetime EC was assessed using a bi-dimensional, 36-item scale developed in Matlab. Lifetime physical/sexual/psychological IPV was assessed using the 20-item WHO Domestic Violence module. Covariates were age, age at marriage, and schooling; partner's schooling; and household wealth. Among 929 women, lifetime experience of EC ranged from 41.9% (control over access to work, schooling, and training) to 50.0% (control over use/maintenance of economic resources), while any lifetime physical/psychological/sexual IPV was 89.5%. Coercion involving the use and maintenance of economic resources had a significant, adjusted association with depressive symptoms (standardized coefficient = 0.491, p<0.001, R²=0.221). The standardized association of any physical/psychological/sexual IPV with depressive symptoms, adjusted for covariates and cluster sampling, was 0.346 (p <0.001, R²=0.143). When further adjusted for the two measures of EC, the association was attenuated and non-significant (0.049, p = 0.817). These findings suggest that EC is prevalent, significantly associated with depressive symptoms, and attenuates the association of other forms of IPV with depressive symptoms. Addressing EC with other forms of IPV may be necessary to reduce depressive symptoms in exposed women.

SUBMITTER: Khan Z

PROVIDER: S-EPMC7714676 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Women's experiences of economic coercion and depressive symptoms in Matlab, Bangladesh.

Khan Zara Z Cheong Yuk F YF Miedema Stephanie S SS Naved Ruchira T RT Yount Kathryn M KM

SSM - population health 20200809

Prior studies of the association between intimate partner violence (IPV) and depressive symptoms have typically excluded economic coercion (EC), a prevalent form of IPV worldwide. Here, we used structural equation models (SEM) to estimate the association of EC with depressive symptoms, with and without adjustment for physical/psychological/sexual IPV, among women in rural Matlab, Bangladesh. Data were collected from cross-sectional surveys with married women 15-49 years, conducted between Novemb ...[more]

PMID: 33304983

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Project description:BackgroundReproductive coercion and abuse is a major public health issue, with significant effects on the health and well-being of women. Reproductive coercion and abuse includes any form of behaviour that intentionally controls another person's reproductive choices. The aim of this qualitative evidence synthesis is to explore women's experiences of reproductive coercion and abuse globally, to broaden understanding of the different ways reproductive coercion and abuse is perpetrated, perceived and experienced across settings and socio-cultural contexts.MethodWe searched Medline, CINAHL and Embase for eligible studies from inception to 25th February 2021. Primary studies with a qualitative study design that focused on the experiences and perceptions of women who have encountered reproductive coercion and abuse were eligible for inclusion. Titles and abstracts, and full texts were screened by independent reviewers. We extracted data from included studies using a form designed for this synthesis and assessed methodological limitations using CASP. We used Thomas and Harden's thematic analysis approach to analyse and synthesise the evidence, and the GRADE-CERQual approach to assess confidence in review findings.ResultsWe included 33 studies from twelve countries in South Asia, the Asia Pacific, North America, South America, Africa and Europe. Most studies used in-depth interviews and focus group discussions to discuss women's experiences of reproductive coercion and abuse. Reproductive coercion and abuse manifested in a range of behaviours including control of pregnancy outcome, pregnancy pressure or contraceptive sabotage. There were a range of reasons cited for reproductive coercion and abuse, including control of women, rigid gender roles, social inequalities and family pressure. Women's different responses to reproductive coercion and abuse included using covert contraception and feelings of distress, anger and trauma. Across contexts, perpetration and experiences of reproductive coercion and abuse were influenced by different factors including son preferences and social exclusion.ConclusionsWe reflect on the importance of socio-cultural factors in understanding the phenomenon of reproductive coercion and abuse and how it affects women, as well as how the mechanisms of power and control at both individual and societal levels work to perpetuate the incidence of reproductive coercion and abuse against women.

Project description:BackgroundPhysical intimate partner violence (IPV) risk looms large for younger women in Bangladesh. We are, however, yet to know the association between their intersectional social locations and IPV across communities. Drawing on intersectionality theory's tenet that interacting systems of power, oppressions, and privileges work together, we hypothesized that (1) younger, lower educated or poor women's physical IPV experiences will be exacerbated in disadvantaged communities; and conversely, (2) younger, higher educated or nonpoor women's physical IPV experiences will be ameliorated in advantaged communities.MethodsWe applied intercategorical intersectionality analyses using multilevel logistic regression models in 15,421 currently married women across 911 communities from a national, cross-sectional survey in 2015. To test the hypotheses, women's probabilities of currently experiencing physical IPV among intersectional social groups were compared. These comparisons were made, at first, within each type of disadvantaged (e.g., younger or poor) and advantaged (e.g., older or nonpoor) communities; and then, between different types of communities.ResultsWhile our specific hypotheses were not supported, we found significant within community differences, suggesting that younger, lower educated or poor women were bearing the brunt of IPV in almost every community (probabilities ranged from 34.0-37.1%). Younger, poor compared to older, nonpoor women had significantly higher IPV probabilities (the minimum difference = 12.7, 95% CI, 2.8, 22.6) in all communities. Similar trend was observed between younger, lower educated compared to older, higher educated women in all except communities that were poor. Interestingly, younger women's advantage of higher education and material resources compared to their lower educated or poor counterparts was observed only in advantaged communities. However, these within community differences did not vary between disadvantaged and advantaged communities (difference-in-differences ranged from - 0.9%, (95% CI, - 8.5, 6.7) to - 8.6%, (95% CI, - 17.6, 0.5).ConclusionsUsing intersectionality theory made visible the IPV precarity of younger, lower educated or poor women across communities. Future research might examine the structures and processes that put them at these precarious locations to ameliorate their socio-economic-educational inequalities and reduce IPV in all communities. For testing hypotheses using intersectionality theory, this study might advance scholarship on physical IPV in Bangladesh and quantitative intersectionality globally.

Project description:Small clinical studies suggest depression is associated with alterations in adiponectin and leptin, adipocyte-derived secretory proteins involved in metabolic regulation; however, longitudinal data on these association are lacking. This study examined cross-sectional and longitudinal associations of depressive symptoms and major depressive disorder (MDD) with adiponectin and leptin in healthy middle-aged women (mean (SD) age, 45.6 (2.5) years). Cross-sectional analyses included 575 women with baseline adipokine data; longitudinal analyses included 262 women with 2-4 adipokine measurements over 5 years. The 20-item Center for Epidemiologic Studies Depression scale (CES-D) was used to assess depressive symptoms; history of MDD was determined by the Structured Clinical Interview for DSM-IV. Adipokines were assayed from stored serum specimens; values were log-transformed for analyses. Linear and repeated measure random effects regression models evaluated associations of baseline CES-D scores with baseline adipokine concentrations and changes over time, respectively. Secondary analyses evaluated the relation of MDD history with adipokine concentrations. Mean (SD) baseline concentrations of adiponectin and leptin were 9.90 (4.92) μg/mL and 27.02 (20.06) ng/mL; both increased over time (p < .0001). CES-D scores were associated with lower adiponectin at baseline (per 1-SD: estimate=-0.04, SE=.02, p=.03) and over time (per 1-SD: estimate=-0.055, SE = .024, p=.02). Associations were unchanged in risk factor-adjusted models. Women with elevated CES-D scores (≥16) had 6.9% (95% CI: -1.1%, 14.3%; p = .089) lower median adiponectin at baseline and 11.5% (95% CI: 1.5%, 20.4%, p = .025) lower median adiponectin over time in adjusted models, compared to women with CES-D<16. Rate of change in adipokines did not vary by baseline depressive symptoms or MDD history. Depressive symptoms and MDD history were unrelated to leptin. In women at midlife, depressive symptoms are associated with lower adiponectin, a critical anti-inflammatory biomarker involved in metabolic and cardiovascular conditions.

Dataset Information

Women's experiences of economic coercion and depressive symptoms in Matlab, Bangladesh.

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Women's experiences of economic coercion and depressive symptoms in Matlab, Bangladesh.

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