Social norms and the association between intimate partner violence and depression in rural Bangladesh—a multilevel analysis

Precious Esie, Theresa L. Osypuk, Sidney R. Schuler, Lisa M. Bates

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Intimate partner violence (IPV) is highly prevalent globally and associated with adverse mental health outcomes among women. In IPV-endemic contexts like Bangladesh, previous research has found no association between low levels of IPV and depression. Although IPV and attitudes justifying IPV against women are highly prevalent in this context, nothing is known about how related contextual norms affect associations between individual-level IPV exposure and depression. The present study examines if village-level IPV norms, characterized using village-level (Level 2) prevalence of a) IPV-justifying attitudes (injunctive norms) and b) physical IPV (descriptive norms), modifies the individual-level (Level 1) associations between the severity of recent IPV and major depressive episode (MDE) among women in rural Bangladesh. Methods: Data were drawn from a nationally-representative sample consisting of 3290 women from 77 villages. Multilevel models tested cross-level interactions between village-level IPV norms and recently experienced individual-level IPV on the association with past 30-day MDE. Results: The prevalence of IPV was 44.4% (range: 9.6–76.2% across villages) and attitudes justifying IPV ranged from 1.6% to 49.8% across villages. The prevalence of MDE was 16.8%. The risk of MDE at low levels of IPV severity (versus none) was greater in villages with the least tolerant attitudes toward IPV compared to villages where IPV was more normative, e.g., interaction RR = 1.42 (95% CI: 0.64, 3.15) for low physical IPV frequency and injunctive norms. Conclusions: The association between IPV and depression may be modified by contextual-level IPV norms, whereby it is exacerbated in low-normative contexts.

Original languageEnglish (US)
JournalSocial Psychiatry and Psychiatric Epidemiology
Early online dateMar 9 2021
DOIs
StateE-pub ahead of print - Mar 9 2021

Bibliographical note

Funding Information:
This work was supported by the National Institute of Child Health and Development (1R01HD061630-01A1; PI: Schuler) and the National Institute of Mental Health (T32-MH1304348; Esie).

Publisher Copyright:
© 2021, Springer-Verlag GmbH, DE part of Springer Nature.

Keywords

  • Bangladesh
  • Depression
  • Intimate partner violence
  • Major depressive episode
  • Multilevel analysis

PubMed: MeSH publication types

  • Journal Article

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