Risks go beyond the violence: Association between intimate partner violence, mental illness, and substance abuse among females admitted to a rural Level I trauma center.
BACKGROUND
Intimate partner violence (IPV) is a significant cause of intentional injury among women but remains underrecognized, and its relationship to other risk factors for all-cause injury remains poorly defined. This study aimed to assess IPV and its association with alcohol abuse, illicit substance use, selected mental illnesses, and other risk factors for injury.


METHODS
This is a cross-sectional study of prospectively collected data among adult females admitted to a rural, Level I trauma center. Well-validated instruments assessed IPV, substance abuse, and mental illness. Bivariate relationships were assessed with χ, odds ratios, and t test analyses.


RESULTS
Eighty-one women were enrolled; 51% reported lifetime IPV, and 31% reported past-year IPV. Both groups were significantly more likely to have a mental illness than those without a history of IPV. Those reporting lifetime IPV exposure were significantly more likely to report illicit substance use, and past-year IPV was associated with alcohol abuse (28% vs. 7.1%, p = 0.01). Participants reporting past-year IPV were significantly more likely to have a partner possessing a firearm (40% vs. 12.5%, p = 0.005).


CONCLUSIONS
The experience of lifetime and past-year IPV among women at a Level I, rural trauma center was high, and it was significantly associated with mental illness, substance abuse, and high-risk scenarios for intentional injury including firearm ownership by a significant other. These findings inform the potential value of IPV screening and intervention and suggest that IPV, mental illness, and substance abuse should be considered associated entities in prevention and recidivism reduction efforts in the female trauma population.


METHODS
Prognostic study, level II; therapeutic study, level III.
From the Division of General Surgery (A.B.H.), Department of Surgery, Medical University of South Carolina, Charleston; and Division of Trauma and Surgical Critical Care (E.T., B.W., M.B.), Department of General Surgery, The Brody School of Medicine at East Carolina University, Greenville, South Carolina.
Ashley B
AB
Hink
Eric
E
Toschlog
Brett
B
Waibel
Michael
M
Bard
D000328:Adult; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D000066511:Intimate Partner Violence / Q000523:psychology / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D020380:Needs Assessment; D016017:Odds Ratio; D010343:Patient Admission / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012424:Rural Population; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014481:United States; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology / Q000628:therapy