title: Trajectories for women who disclose intimate partner violence in health care settings: the key role of abuse severity.
abstract: OBJECTIVE
  To examine the role of abuse severity in predicting women's trajectories in mental and physical health and psychological quality of life during the 18 months following abuse identification in a health care setting.
  
  
  METHODS
  The present analysis used growth curve modeling in a sample of 411 women positive for abuse on the Composite Abuse Scale.
  
  
  RESULTS
  A high proportion of women experienced severe combined abuse (SCA; 55 % at baseline and 29 % at 18 months). On average, there was an improvement in depressive symptoms and psychological quality of life over time. Controlling for sociodemographic characteristics, women scoring positive versus negative for SCA experienced increased depressive symptoms and decreased quality of life; however, exposure to severe abuse did not affect the rate of change over time in these outcomes. Severe abuse was not associated with physical health.
  
  
  CONCLUSIONS
  There is an important association between abuse severity and women's health and well-being over time. Understanding the role of different abuse experiences, risk and protective factors, and trajectories can assist in more accurate identification and appropriate care provision for women exposed to IPV.
authors.affiliation: Faculty of Information and Media Studies, Western University, North Campus Building, Rm 240, 1151 Richmond St., London, ON, N6A 5B7, Canada. nwathen@uwo.ca.|Centre for Research and Education on Violence Against Women and Children, Western University, London, ON, Canada. nwathen@uwo.ca.
authors.forename: C Nadine
authors.identifier: http://orcid.org/0000-0003-2646-2919
authors.initials: CN
authors.lastname: Wathen
authors.affiliation: Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.
authors.forename: Masako
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Faculty of Information and Media Studies, Western University, North Campus Building, Rm 240, 1151 Richmond St., London, ON, N6A 5B7, Canada.|Centre for Research and Education on Violence Against Women and Children, Western University, London, ON, Canada.
authors.forename: Jennifer C D
authors.initials: JC
authors.lastname: MacGregor
authors.affiliation: Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ferro
authors.affiliation: Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: McKee
authors.affiliation: Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Boyle
authors.affiliation: School of Nursing, Western University, London, ON, Canada.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Ford-Gilboe
authors.affiliation: Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.
authors.forename: Harriet L
authors.initials: HL
authors.lastname: MacMillan
mesh_terms: D000293:Adolescent; D000328:Adult; D019548:Crime Victims / Q000523:psychology*; D005260:Female; D006268:Health Facilities; D006801:Humans; D000066511:Intimate Partner Violence; D008875:Middle Aged; D011788:Quality of Life; D012650:Self Disclosure; D057566:Self Report; D015599:Trauma Severity Indices; D016387:Women's Health; D055815:Young Adult
keywords: Abuse severity; Depression; Intimate partner violence; Life quality; Physical health