The relationship between interpersonal violence in adulthood and mental health: a longitudinal study based on the Northern Swedish Cohort 2023 Ziaei

Background

Longitudinal studies evaluating the negative effects of exposure to interpersonal violence in the adulthood on the mental health of both women and men are scarce. Using longitudinal data, we evaluated the relationship between the last year experience of violence and functional somatic and depressive symptoms at the ages of 30 and 43 among participants (n = 1006; 483 women and 523 men) in the Northern Swedish Cohort. Further, the relationship between cumulative exposure to violence over a decade and mental health symptoms among participants was evaluated.

Methods
Participants’ experience of interpersonal violence and symptoms of functional somatic and depressive symptoms were evaluated with standard questionnaires at the ages of 30 and 43. General linear models were used to evaluate the relationship between the experience of interpersonal violence and mental health symptoms among the participants. The interactions between gender and violence on functional somatic and depressive symptoms were evaluated separately, and models in which the interaction was significant, were split by gender.

Results
We found that the last year experience of violence at the age of 30 was related to current functional somatic symptoms among all participants and depressive symptoms only among men, (β Adj for the experience of any violence among men: 0.21; CI: 0.12–0.29; Vs. among women: 0.06; CI: -0.04-0.16, p for interaction = 0.02). At the age of 43, last year experience of violence was related to both functional somatic and depressive symptoms in both genders. Finally, a cumulative relationship between the experience of violence over time and mental health symptoms was observed in all participants.

Conclusions
Our findings revealed that while the relationship between the experience of interpersonal violence and mental health symptoms may differ among men and women and with age, the experience of violence can be negatively related to the mental health in both genders.

Open access, https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15525-x

 

"Functional somatic symptoms

Functional somatic symptoms (FSS) were operationalised by evaluating cardiopulmonary/autonomic, gastrointestinal, musculoskeletal, and general symptoms through 10 different questions (coded between 0 and 2), which were identical in all waves of data collection. Participants were asked if they had any symptoms of (headache or migraine; stomach-ache other than gastritis or gastric ulcer; nausea; backache, hip pain or sciatica; fatigue; breathlessness; dizziness; overstrain) during the last 12 months with the options of “No = 0”, “Yes light = 1” and “Yes Severe = 2”. Participants’ symptoms of palpitation were measured by the question “How often have you had nervous problems during the past 12 months, with the options of “Never = 0”, “Sometimes = 1”, and “Always = 2”. Additionally, participants’ symptoms of sleeplessness were measured through the question: ‘Have you had sleeping difficulties during the past 12 months’, with the response options of “Never = 0”, “Sometimes = 1” and “Often/Always = 2”. The FFS final score was captured as the mean of 10 items ranging from 0 to 2, with the higher mean indicating more symptoms. The Cronbach’s Alpha for FFS measurement was 0.70, 0.74, and 0.70 for the ages of 16, 30, and 43, respectively, indicating relatively good internal consistency."

"Depressive symptoms

Depressive symptoms were measured by six questions which were identical in all waves of data collections. The participants were asked if they had the following symptoms during the last 12 months: sleeping problems with four response options ranging from “Never = 0” to “all the time = 3”, poor appetite with three response options “No = 0”, “Yes moderate = 1”and “Yes severe = 2”, general tiredness (coded 0 to 2), feeling down and sad (coded 0 to 3), dejected about the future (coded 0 to 3) and concentration difficulties (coded 0 to 2). Response options ranging from 0 to 3 were recoded to 0 to 2 by combining the two middle response options. The final score was captured as the mean of six items ranging from 0 to 2, with the higher mean indicating more depressive symptoms. Cronbach’s Alpha for depressive symptoms measurement was 0.65, 0.67, and 0.76 for the ages of 16, 30, and 43. respectively, indicating relatively good internal consistency."

 

This article is a picture perfect example of why scientists and physicians, especially those working in public health, should be forced to take courses in humanities and social sciences. Chronically ill and disabled people are much more exposed to both interpersonal and societal violence than healthy people, even more so those with a psychiatric diagnosis or without a formal diagnosis, so it should not be surprising to find such an association but the authors did not address this point at all in the discussion section.

 

How will this research be used in future?

I can imagine the following scenario:

Someone who is known to have been exposed to violence or has been in the past or has been physically attacked themselves, will have doctors jumping to the conclusion that any physical symptoms are a result of mental health issues caused by that violence, not as a result of a physical disease.

So, is this yet another group that can be disbelieved and dismissed for ever more? I wonder how the armed forces are treated after they have been fighting in a war zone and have health difficulties at any point in their future?

 

If the care that Gulf War veterans have received is anything to go by, not well.

 

So even though the modern models of depression and anxiety are strictly psychosocial, they usually only ask about physiological symptoms, especially the most common medical symptoms, and this practice is getting more and more common. By the same approach, electricity could be defined as magical, and wow could you easily find so much magic. Even though it doesn't exist. That's what delusional models of reality do.

It's really weird seeing this last great pseudoscience just continue to be a target of mindless obsession despite being completely circular. We are likely to see nuclear fusion before we see mental healthcare grow out of this phase. This is basically equivalent to what medicine was overall 200 years ago, before the scientific revolution. The models of mental health may as well be the Humours, it's not as if there's a real difference, it's just that the fairy tales are slightly more elaborate and pseudoscientific.

It's well-known that most models are useless. And they keep making up the same model over and over again. It's always the same, it's just a model, it has no relation to reality. But the model is everything. Real life is of no importance compared to the model. It's borderline model worshipping.

This paper could be re-titled: Adding insult to injury, because you clearly haven't been injured enough already.