# Presentation: 694080

## Child Abuse, Intimate Partner Violence and Mental Disorders

## Malcoe, L. H., Duran, B. M., & Montgomery, J. M. (2004). Socioeconomic disparities in intimate 

- Malcoe, L. H., Duran, B. M., & Montgomery, J. M. (2004). Socioeconomic disparities in intimate
- partner violence against Native American women: a cross-sectional study. *BMC Med, 2*(1), 20.

## Malcoe, L. H., Duran, B. M., & Montgomery, J. M. (2004). Socioeconomic disparities in intimate 

- Malcoe, L. H., Duran, B. M., & Montgomery, J. M. (2004). Socioeconomic disparities in intimate
- partner violence against Native American women: a cross-sectional study. *BMC Med, 2*(1), 20.

## Malcoe, L. H., Duran, B. M., & Montgomery, J. M. (2004). Socioeconomic disparities in intimate 

- Malcoe, L. H., Duran, B. M., & Montgomery, J. M. (2004). Socioeconomic disparities in intimate
- partner violence against Native American women: a cross-sectional study. *BMC Med, 2*(1), 20.

## Prevalence Ratios for Past Year Mental Disorders by   CAN, and IPV Variables N=234

|  
 CA and IPV | 
N (%) | Any Substance Abuse/Dep | 
PTSD
  |  |  | 
Any Anxiety Disorder |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- |
| Maximum Level of 
Childhood Abuse |  |  |  |  |  |  |  |  |
|      None to Minimal | 74 (32) | 1.0 |  |  | 1.0 |  |  | 1.0 |
|      Low to Moderate | 72 (31) | 1.9 (0.8, 4.5) |  |  | 2.1 (0.6, 6.5) |  |  | 1.5 (1.03, 2.2) |
|      Severe | 88 (37) | 1.9 (0.8, 4.4)
 |  |  | 4.6 (1.7, 12.8) |  |  | 2.0 (1.4, 2.8) |
| Maximum Level of 
Past  Year IPV |  |  |  |  |  |  |  |  |
|      None | 86 (37) | 1.0 |  | 1.0 |  |  | 1.0 |  |
|      Minor | 85 (36) | 0.9 (0.4, 2.0) |  | 1.6 (0.6, 3.9) |  |  | 1.4 (1.03, 2.0) |  |
|      Severe | 63 (27) | 1.5 (0.7, 7.1) |  | 3.1 (1.4, 7.1) |  |  | 1.5 (1.1, 2.1) |  |

## Prevalence Ratios for Past Year Mental Disorders by   CAN, and IPV Variables N=234

|  
 CA and IPV | 
N (%) | 
Mood Disorder | 
Any Disorder | 
2+ Disorders |
| --- | --- | --- | --- | --- |
| Maximum Level of 
Childhood Abuse |  |  |  |  |
|      None to Minimal | 74 (32) | 1.0 | 1.0 | 1.0 |
|      Low to Moderate | 72 (31) | 1.8 (0.9, 3.9) | 1.5 (1.1, 2.1) | 2.3 (1.1, 4.7) |
|      Severe | 88 (37) | 2.7 (1.4, 5.4) | 2.0 (1.5, 2.7) | 2.8 (1.4, 5.5) |
| Maximum Level 
of Past  Year IPV |  |  |  |  |
|      None | 86 (37) | 1.0 | 1.0 | 1.0 |
|      Minor | 85 (36) | 1.3 (0.7, 2.4) | 1.3 (1.04, 1.8) | 1.5 (0.9, 2.6) |
|      Severe | 63 (27) | 1.5 (0.8, 2.6) | 1.5 (1.1, 1.9)) | 1.6 (0.9, 2.9) |

## Prevalence Ratios for Past Year Mental Disorders by Single “Abuse/Violence” Variable

|  Childhood Abuse and Past Year IPV | N | Mood Disorder | Any Disorder | 2+ Disorders |
| --- | --- | --- | --- | --- |
| Neither | 34 | 1.0 | 1.0 | 1.0 |
| Childhood Abuse Only | 52 | 1.4 (0.5, 3.8) | 2.4 (1.3, 4.4) | 2.8 (0.9, 9.2) |
| Past Year IPV only | 40 | 0.7 (0.2, 2.3) | 2.0 (1.1, 3.7) | 1.7 (0.5, 6.3) |
| Both | 105 | 2.1 (0.9, 5.0) | 2.8 (1.6, 5.0) | 3.9 (1.3, 11.8) |

## Cultural Identification

| Cultural Identification | Number  | Percent |
| --- | --- | --- |
| Indian way |  |  |
|      Not at All | 45 | 19 |
|      A Little | 48 | 20 |
|      Some | 64 | 27 |
|      A Lot | 78 | 33 |
| White/American Way |  |  |
|      Not at All | 52 | 22 |
|      A Little | 49 | 21 |
|      Some | 65 | 28 |
|      A Lot | 69 | 29 |
| Bi-Cultural |  |  |
|      Not at All | 41 | 17 |
|      A Little | 60 | 25 |
|      Some | 52 | 22 |
|      A Lot | 82 | 35 |

**39**%

**33**%

**42**%

## Utilization of Traditional Healing Services

| Have you seen a medicine person for physical health, drug or alcohol or mental health problem? | 
Number | 
Percent |
| --- | --- | --- |
|      Never | 106 | 45 |
|       Yes-not past year | 52 | 22 |
|       Yes-past year | 77 | 33 |

## Conclusions

## Native American Women in Primary Care

- Have very high rates of exposure to child maltreatment
- CAN is a general risk factor for mental disorders
- CAN is a specific risk factor for PTSD
- Community and policy level interventions are warranted

## Source: Broken Promises: Evaluating the Native American Health Care System. (Draft)(2004). 

*Source: Broken Promises: Evaluating the Native** **American Health Care System*. (Draft)(2004).
- Washington DC: US Commission on Civil Rights: Office of the General Counsel.

## Slide 14

## Slide 15