How does a person’s disability severity affect their risk of IPV? This study in the Disability & Health Journal looks at the risk of IPV among mothers. It focuses on rural Pakistan as a case study.
This plain language summary is part of a new series sharing highlights from the Disability and Health Journal.
Why was this study done?
Disabled people are more likely to experience violence or aggression from someone they’re in a relationship with. This kind of abusive dynamic is called intimate partner violence (IPV). A lot of research on disability and IPV is done as a snapshot in time showing experiences across a population. A lot of that research often considers disability as something a person either has or doesn’t have. This study takes a different approach, and looks at disability from a functional perspective. It also looks at experiences of IPV over longer periods of time. This is a case study from South Asia. This region has unique different cultural norms and resources for people with disabilities.
How was this study done?
This study studied people in rural Pakistan who took a maternal depression screener. Mothers of 3-6 year olds were included if they were screened at least twice in the years after giving birth. These 869 mothers were screened after giving birth. This study looked for a connection between disability severity and IPV. Better IPV prevention work will be possible with better research.
IPV experiences were measured with another survey. This survey asked mothers if they had experienced any of the following IPV events in the last year:
- Being belittled or humiliated by your husband
- Having belongings destroyed
- Being slapped
- Having something thrown at you
- Being pushed
- Being choked or burned
- Being forced to have sex
- Being forced to do something sexual that was humiliating
Interviewers made sure to ask these questions in a safe environment. Family members were not present, including the husband. People could skip questions on request. All interviewers were female. These questions were asked again 1, 2, 3, and 6 years after the initial screening.
What did this study show?
In this low-income, rural South Asian context, mothers with disabilities are at a high risk of IPV. More severe disabilities led to higher risk of all types of IPV. This includes psychological, physical, and sexual forms of IPV.
There are a few factors that might increase the risk of IPV for women with disabilities:
- Arranged marriage may often pair women with disabilities with abusive partners.
- Women with more severe disabilities often have less educational attainment. This can be due to their disability, or the lack of accessible schooling options. These women may have less autonomy or control in their marriage. Ensuring education access can protect against violence later in life.
- The main occupation of the women studied is housework, childrearing, and subsistence farming. In low-resource areas, this work is demanding. Difficulty completing these tasks can increase stress and violence in the household.
- Divorce in Pakistan is rare. Women with disabilities might be more isolated from social supports.
IPV prevention is especially important for women with disabilities. To empower women and reduce IPV, they need:
- Resources for accommodations
- mental health and social supports
- education
Educational programs from women in community health worker roles could help other women experiencing IPV. Other education around mental health could help people with psychiatric disabilities to get support.
Learn more about this study
More research is being done on the impacts of disability in recent years. These can be social, psychological, and interpersonal impacts. The World Health Organization has a definition of disability that says:
- Disability comes from the interaction between a person and their environment.
- Health conditions like cerebral palsy, Down syndrome, and depression are disabilities.
- Factors that affect a person’s daily life can include: accessibility of transportation and public buildings; availability of social supports; and social attitudes.
Disabilities can be caused by many different health conditions. These can be physical, intellectual, psychiatric, or cognitive. They can change over time. The impact of a disability depends on the social context a person lives in. The social environment can directly impact a person’s daily functioning. The severity of a disability depends on a lot of social and environmental factors. These factors can really affect a person’s health status. About 1 in 6 people worldwide have disabilities. People with disabilities have higher rates of depression, physical illness, and early death. Disability severity varies by country. Lower-resourced countries often have more people with severe disabilities. These countries often underfund accommodations for people with disabilities. This can make the experience of disability harder to navigate. People with disabilities tend to be more marginalized in society. There are often fewer opportunities for work, education, transportation, and community involvement. Women and girls with disabilities are even more likely to be harmed by violence. This includes from their intimate partners.
About IPV, Disability and Motherhood
Intimate partner violence (IPV) is harm that happens in an intimate relationship. This harm can be physical, sexual, or psychological. It can include physical aggression, sexual coercion, psychological abuse, and controlling behavior. This kind of harm happens a lot to people with disabilities. Around the world, 1 in 4 women experience physical or sexual IPV during their life. For women with disabilities, the number is 1 in 2. Even after the abuse ends, the effects of IPV can have longer-term effects. These can affect a person’s mental and physical health.
There is a link between disability and greater risk of IPV. However, a lot of that research only looks at a single point in time. Research was lacking on how the risk of IPV changes over time for a person with a disability. For example, people with more severe disabilities might have higher risks of IPV. Alternatively, IPV could increase the risk of severe disability. It’s important to understand the relationship between these two factors over time. Some studies show that IPV causes harmful health affects which can cause disability. IPV can also make symptoms more challenging for a person with a disability. More research is needed on how much disability severity predicts IPV. This research is especially lacking from low and middle-income countries.
IPV and disability are important factors to study in mothers. Some disabilities can be caused from complications during birth that last for years. These can be physical, psychiatric, or cognitive. For women with disabilities, motherhood can increase the severity of their disability. There are many physical and cognitive demands in raising a child. Household stress also increases when parenting young children. This can make IPV worse.
Disability Severity and IPV in South Asia
Disability severity and IPV can be affected by many factors. A lot of existing research focuses on high-income countries. This study looks at IPV in Pakistan. There are fewer resources for people with disabilities there. People lack accessible education, buildings, transportation, and healthcare. Access to income and employment is also hard to find, especially in rural areas. In rural Pakistan, IPV is more accepted, happening in 45% of households. The global average for IPV is 27%. Where arranged marriages are common there can be a greater risk of IPV. It can be harder to find a partner for a daughter with a disability who is safe. Even without an arranged marriage, people with disabilities may be more likely to choose an abusive partner. That might happen for a few reasons. It can be harder to recognize signs of abuse. Abusive partners might also seek out more vulnerable partners. Women with disabilities can struggle to complete the expected demands of marriage. This work can include housework, raising children, and farming. Stress in the household can increase IPV. Social isolation is also more commonly experienced by women with disabilities. This can increase their risk of IPV too. Stigma and the lack of accessible transit can be barriers to social support.
Strengths and limitations of the study
Strengths
- The design of this study allowed the researchers to look at how disability severity and IPV change over time.
- The focus on severity was helpful, rather than using disability diagnosis. Many people do not label themselves as disabled. This is especially true in contexts where psychiatric disabilities go undiagnosed.
Limitations
- Overall, the level of disability in the sample was low.
- This study focused on married women with children in rural households. This leaves out a lot of key disabilities groups, including: unmarried people; people without children; and those living in institutions.
- This study focused on a rural part of Pakistan. Its findings might not apply to other countries or even other regions of Pakistan.
- People may underreport disability and IPV.
- This study only looks at violence committed by the husband. People with disabilities can also experience abuse by other caregivers or loved ones.
- Depression may have an impact on both disability and IPV. Its effect may be hard to measure.
- This study doesn’t look at different types of disability in relationship to IPV.
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