#MeToo on the Canadian Prairies: Raising Awareness of Sexual Assaults and Mental Health in Women Abused by Intimate Partners
Abstract
Studies of intimate partner sexual assault (IPSA) and its effects on mental health are limited. This secondary data analysis examines IPSA, a history of child sexual abuse, depression, trauma, mental distress and quality of life in 665 Canadian women, 41% of whom had been sexually assaulted by intimate partners; 53% were sexually abused as children. Women who had experienced any IPSA had significantly higher scores on all Composite Abuse subscales (IPV), mental distress (SCL-10), and depression (CES-D-10). PTSD (PCL) was higher for women with both IPSA and CSA histories. Implications for advocates, clinicians, and researchers are presented.
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References
Agathis N. T., Payne C., Raphael J. L. (2018). A “#MeToo Movement” for children: Increasing awareness of sexual violence against children. Pediatrics, 142(2), e20180634.
Alaggia R., Wang S. (2020). “I never told anyone until the #metoo movement”: What can we learn from sexual abuse and sexual assault disclosures made through social media? Child Abuse & Neglect, 103(5).
Andresen E. M., Carter W. B., Malmgren J. A., Patrick D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D. American Journal of Preventive Medicine, 10(2), 77–84. https://doi.org/10.1016/S0749-3797(18)30622-6
Andrews F., Withey S. (1976). Social indicators of well-being: American’s perceptions of life quality. New York, NY: Plenum Press.
Bagwell-Gray M. E. (2021). Women’s experiences of sexual violence in intimate relationships: Applying a new taxonomy. Journal of Interpersonal Violence, 36(13–14), NP7813–NP839.
Bagwell-Gray M. E., Messing J. T., Baldwin-White A. (2015). Intimate partner sexual violence: A review of terms, definitions, and prevalence. Trauma, Violence & Abuse, 16(3), 316–335. https://doi.org/10.1177/1524838014557290
Ballan M. S., Burke Freyer M., Marti C. N., Perkel J., Webb J. A., Romanelli M. (2014). Looking beyond prevalence: A demographic profile of survivors of intimate partner violence with disabilities. Journal of Interpersonal Violence, 29(17), 3167–3179. https://doi.org/10.1177/0886260514534776
Ballan M. S., Freyer M. (2017). Trauma-informed social work practice with women with disabilities: Working with survivors of intimate partner violence. Advances in Social Work, 18(1), 131–144. https://doi.org/10.18060/21308
Barnes J. E., Noll J. G., Putnam F. W., Trickett P. T. (2009). Sexual and physical revictimization among victims of severe childhood sexual abuse. Child Abuse & Neglect, 33(7), 412–420.
Barrett K. A., O’Day B., Roche A., Lepidus Carlson B. (2009). Intimate partner violence, health status, and health care access among women with disabilities. Women’s Health Issues, 19(2), 94–100. https://doi.org/10.1016/j.whi.2008.10.005
Basile K. C. (1999). Rape by acquiescence: The ways in which women “give in” to unwanted sex with their husbands. Violence Against Women, 5(9), 1036–1058. https://doi.org/10.1177/1077801299005009004
Basile K. C. (2008). Histories of violent victimization among women who reported unwanted sex in marriages and intimate relationships: Findings from a qualitative study. Violence Against Women, 14(1), 29–52. https://doi.org/10.1177/1077801207311857
Bell M. E., Goodman L. A., Dutton M. A. (2007). The dynamics of staying and leaving: Implications for battered women’s emotional well-being and experiences of violence at the end of a year. Journal of Family Violence, 22(6), 413–438. https://doi.org/10.1007/s10896-007-9096-9
Bennice J. A., Resick P. A. (2003). Marital rape: History, research, and practice. Trauma, Violence & Abuse, 4(3), 228–246. https://doi.org/10.1177/1524838003004003003
Bennice J. A., Resick P. A., Mechanic M. B., Astin M. (2003). The relative effects of intimate partner physical and sexual violence on PTSD symptomatology. Violence & Victims, 18(1), 87–94. https://doi.org/10.1891/vivi.2003.18.1.87
Bergen R. K. (1995). Surviving wife rape: How women define and cope with the violence. Violence Against Women, 1(2), 117–138. https://doi.org/10.1177/1077801295001002002
Björgvinsson T., Kertz S. J., Bigda-Peyton J. S., McCoy K. L., Aderka I. M. (2013). Psychometric properties of the CES-D-10 in a psychiatric sample. Assessment, 20(4), 429–436. https://doi.org/10.1177/1073191113481998
Black D., Heyman R., Slep A. (2001). Risk factors for male-to-female partner sexual abuse. Aggression and Violent Behavior, 6(2–3), 269–280. https://doi.org/10.1016/S1359-1789(00)00026-4
Black M. C., Basile K. C., Breiding M. J., Smith S. G., Walters M. L., Merrick M. T., Chen J., Stevens M. R. (2011).The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 summary report. https://www.cdc.gov/violenceprevention/pdf/nisvs_report2010-a.pdf
Blanchard E. B., Jones-Alexander J., Buckley T. C., Forneris C. A. (1996). Psychometric properties of the PTSD checklist (PCL). Behaviour Research and Therapy, 34(8), 669–673. https://doi.org/10.1016/0005-7967(96)00033-2
Bonomi A. E., Anderson M. L., Rivara F. P., Thompson R. S. (2007). Health outcomes in women with physical and sexual intimate partner violence exposure. Journal of Women’s Health, 16(7), 987–997.
Boucher S., Lemelin J., McNicoll L. (2009). Marital rape and relational trauma. Sexologies, 18(2), 95–97. https://doi.org/10.1016/j.sexol.2009.01.005
Breiding M. J., Armour B. S. (2015). The association between disability and intimate partner violence in the United States. Annals of Epidemiology, 25(6), 455–457. https://doi.org/10.1016/j.annepidem.2015.03.017
Brownridge D. A. (2006). Partner violence against women with disabilities: Prevalence, risk, and explanations. Violence Against Women, 12(9), 805–822. https://doi.org/10.1177/1077801206292681
Campbell J. C. (1989). Women’s responses to sexual abuse in intimate relationships. Health Care for Women International, 10(4), 335–346.
Campbell J. C., Alford P. (1989). The dark consequences of marital rape. American Journal of Nursing, 89(7), 946–949. https://doi.org/10.2307/3426372
Campbell J. C., Soeken K. L. (1999). Forced sex and intimate partner violence: Effects on women’s risk and women’s health. Violence Against Women, 5(9), 1017–1035. https://doi.org/10.1177/1077801299005009003
Campbell J. C., Webster D. W., Glass N. (2009). The danger assessment: Validation of a lethality risk assessment instrument for intimate partner femicide. Journal of Interpersonal Violence, 24(4), 653–674. https://doi.org/10.1177/0886260508317180
Campbell R., Dworkin E., Cabral G. (2009). An ecological model of the impact of sexual assault on women’s mental health. Trauma, Violence, & Abuse, 10(3), 225–246.
Campbell R., Greeson M. R., Bybee D., Raja S. (2008). The co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner violence, and sexual harassment: A mediational model of posttraumatic stress disorder and physical health outcomes. Journal of Consulting and Clinical Psychology, 76(2), 194–207. https://doi.org/10.1037/0022-006x.76.2.194
Chen L. P., Murad M. H., Paras M. L., Colbenson K. M., Sattler A. L., Goranson E. N., Elamin M. B., Seime R. J., Shinozaki G., Prokop L. J., Zirakzadeh A. (2010). Sexual abuse and lifetime diagnosis of psychiatric disorders: Systematic review and meta-analysis. Mayo Clinic Proceedings, 85(7), 618–629. https://doi.org/10.4065/mcp.2009.0583
Cohen J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Erlbaum.
Cole J., Logan T. K., Shannon L. (2005). Intimate sexual victimization among women with protective orders: Types and associations of physical and mental health problems. Violence & Victims, 20(6), 695–716. https://doi.org/10.1891/088667005780927430
DeKeseredy W. S., Joseph C. (2006). Separation and/or divorce sexual assault in rural Ohio: Preliminary results of an exploratory study. Violence Against Women, 12(3), 301–311. https://doi.org/10.1177/1077801205277357
Du Mont J., Forte T. (2014). Intimate partner violence among women with mental health-related activity limitations: A Canadian population based study. BMC Public Health, 14(51).
Elias B., Mignone J., Hall M., Hong S. P., Hart L., Sareen J. (2012). Trauma and suicide behaviour histories among a Canadian Indigenous population: An empirical exploration of the potential role of Canada’s residential school system. Social Science & Medicine, 74(10), 1560–1569. https://doi.org/10.1016/j.socscimed.2012.01.026
Field A. (2009). Discovering statistics using SPSS (3rd ed.). Sage.
García-Moreno C., Pallitto C., Devries K., Stöckl H., Watts C., Abrahams N. (2013). Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. World Health Organization. Retrieved from Geneva, SW, http://apps.who.int/iris/bitstream/10665/85239/1/9789241564625_eng.pdf
Hahn J. W., McCormick M. C., Silverman J. G., Robinson E. B., Koenen K. C. (2014). Examining the impact of disability status on intimate partner violence victimization in a population sample. Journal of Interpersonal Violence, 29(17), 3063–3085. https://doi.org/10.1177/0886260514534527
Hegarty K., Bush R., Sheehan M. (2005). The composite abuse scale: Further development and assessment of reliability and validity of a multidimensional partner abuse measure in clinical settings. Violence and Victims, 20(5), 529–547. https://doi.org/10.1891/088667005780927548
Hegarty K., O’Doherty L., Taft A., Chondros P., Brown S., Valpied J., Astbury J., Taket A., Gold L., Feder G., Gunn J. (2013). Screening and counselling in the primary care setting for women who have experienced intimate partner violence (WEAVE): A cluster analysis. Lancet, 382(9888), 249–258.
Hegarty K., Tarzia L. (2019). Identification and management of domestic and sexual violence in primary care in the #MeToo Era: An update. Current Psychiatry Reports, 21(12).
Hillberg T., Hamilton-Giachritsis C., Dixon L. (2011). Review of meta-analyses on the association between child sexual abuse and adult mental health difficulties: A systematic approach. Trauma, Violence, & Abuse, 12(1), 38–45. https://doi.org/10.1177/1524838010386812
Honda T., Wynter K., Yokota J., Tran T., Ujiie Y., Niwa M., Ito, F., Kim, Y., Fisher, J., & Kamo T. (2018). Sexual violence as a key contributor to poor mental health among Japanese women subjected to intimate partner violence. Journal of Women’s Health, 27(5), 716–723.
Howard A., Riger S., Campbell R., Wasco S. (2003). Counseling services for battered women: A comparison of outcomes for physical and sexual survivors. Journal of Interpersonal Violence, 21(7), 193–208. https://doi.org/10.1177/0886260503253230
Huff S., Rappleyea D. L. (2020). Understanding and responding to victims of interpersonal sexual violence and sexual assault within committed relationships. American Journal of Family Therapy, 48(1), 107–125.
Jacobson N. S., Follette W. C., Revenstorf D. (1984). Psychotherapy outcome research: Methods for reporting variability and evaluating clinical significance. Behavior Therapy, 17(4), 308–311. https://doi.org/10.1016/S0005-7894(84)80002-7
Kennedy A. C., Prock A. K. (2018). “I still feel like I am not normal”: A review of the role of stigma and stigmatization among female survivors of child sexual abuse, sexual assault, and intimate partner violence. Trauma, Violence, & Abuse, 19(5), 512–527. https://doi.org/10.1177/1524838016673601
Koshan J. (2017). The criminalization of marital rape and law reform in Canada: A modest feminist success story in combatting marital rape myths. In M. Randall, J. Koshan, P. Nyaundi (Eds.), The right to say no: Marital rape and law reform in Canada, Ghana, Kenya and Malawi (pp. 257–298). Hart Publishing.
Koss M. P., Abbey A., Campbell R., Cook S., Norris J., Testa M., Ullman S., West C., Whyte J. (2007). Revising the SES: A collaborative process to improve assessment of sexual aggression and victimization. Psychology of Women Quarterly, 31(4), 357–370. https://doi.org/10.1111/j.1471-6402.2007.00385.x
Krebs C. P., Breiding M. J., Browne A., Warner T. (2011). The association between different types of intimate partner violence experienced by women. Journal of Family Violence, 26(6), 487–500.
Lacey K. K., McPherson M. D., Samuel P. S., Sears K. P., Head D. (2013). The impact of different types of intimate partner abuse on the mental and physical health of women in different ethnic groups. Journal of Interpersonal Violence, 28(2), 359–385. https://doi.org/10.1177/0886260512454743
Letourneau E. J., Brown D. S., Fang X., Hassan A., Mercy J. A. (2018). The economic burden of child sexual abuse in the United States. Child Abuse & Neglect, 79(4), 413–432.
Libesman T., McGlade H. (2016). Redress in response to institutional sexual abuse of Aboriginal children. Indigenous Law Bulletin, 8(17), 34–37. https://nfswc.org.au/wp-content/uploads/2018/06/Redress20Law20Bulletin- 15172962471.pdf
Logan T. K., Cole J., Shannon L. (2007). A mixed-methods examination of sexual coercion and degradation among women in violent relationships who do and do not report forced sex. Violence & Victims, 22(1), 71–94. https://doi.org/10.1891/vv-v22i1a005
Logan T. K., Walker R., Cole J. (2015). Silenced suffering: The need for a better understanding of partner sexual violence. Trauma, Violence, & Abuse, 16(2), 111–135. https://doi.org/10.1177/1524838013517560
Lundqvist G., Hansson K., Svedin C. G. (2009). Group therapy for women sexually abused as children: Social interaction, adjustment, and relationships before and after group therapy. Psychoanalytic Social Work, 16(2), 158–175. https://doi.org/10.1080/15228870903200335
Maas-Despain A., Todahl J. L. (2014). Rape, sexual violence, and acquiescence in intimate relationships: Screening, assessment, and clinical decision making. Journal of Feminist Family Therapy, 26(1), 28–49.
Macy R. J., Nurius P. S., Norris J. (2006). Responding in their best interests: Contextualizing women’s coping with acquaintance sexual aggression. Violence Against Women, 12(5), 478–500. https://doi.org/10.1177/1077801206288104
Marshall A. D., Holtzworth-Monroe A. (2002). Varying forms of husband sexual aggression: Predictors and subgroup differences. Journal of Family Psychology, 16(3), 286–296. https://doi.org/10.1037//0893-3200.16.3.286
McFarlane J., Malecha A., Watson K., Gist J., Batten E., Hall I., Smith S. (2005). Intimate partner sexual assault against women: Frequency, health consequences, and treatment outcomes. Obstetrics & Gynecology, 105(1), 99–108. https://doi.org/10.1097/01.AOG.0000146641.98665.b6
Moreau S., Boucher S., Hébert M., Lemelin J. (2015). Capturing sexual violence experiences among battered women using the revised sexual experiences survey and the revised conflict tactics scales. Archives of Sexual Behavior, 44(1), 223–231.
Müller J. M., Postert C., Beyer T., Furniss T., Achtergarde S. (2010). Comparison of eleven short versions of the symptom checklist 90-revised (SCL-90-R) for use in the assessment of general psychopathology. Journal of Psychopathology and Behavioral Assessment, 32(2), 246–254. https://doi.org/10.1007/s10862-009-9141-5
Murphy M. (2019). Introduction to “#MeToo Movement”. Journal of Feminist Family Therapy, 31(2–3), 63–65. https://doi.org/10.1080/08952833.2019.1637088
Nakyazze B., Österman K., Björkqvist K. (2020). Victimization from intimate partner rape in Uganda: Sex differences, psychological concomitants, and the effect of educational level. Medical Science and Discovery, 7(8), 603–610. https://doi.org/10.36472/msd.v7i8.410
Nguyen T., Attkisson C. D., Stegner B. L. (1983). Assessment of patient satisfaction: Development and refinement of a service evaluation questionnaire. Evaluation and Program Planning, 6(3), 299–313. https://doi.org/10.1016/0149-7189(83)90010-1
Pico-Alfonso M. A., Garcia-Linares M. I., Celda-Navarro N., Blasco-Ros C., Echeburúa E., Martinez M. (2006). The impact of physical, psychological, and sexual intimate male partner violence on women’s mental health: Depressive symptoms, posttraumatic stress disorder, state anxiety, and suicide. Journal of Women’s Health, 15(5), 599–611. https://doi.org/10.1089/jwh.2006.15.599
Potter L. C., Morris R., Hegarty K., Garcıa-Moreno C., Feder G. (2021). Categories and health impacts of intimate partner violence in the World Health Organization multi-country study on women’s health and domestic violence. International Journal of Epidemiology, 50(2), 652–666.
Radey M. (2010). Secondary data analysis studies. In B. Thyer (Ed.), The handbook of social work research methods (2nd ed., pp. 163–182). Sage.
Radloff L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.
Rea L. M., Parker R. A. (1992). Designing and conducting survey research. Jossey-Bass.
Riggs D. S., Kilpatrick D. G., Resnick H. S. (1992). Long-term psychological distress associated with marital rape and aggravated assault: A comparison to other crime victims. Journal of Family Violence, 7(4), 283–296. https://doi.org/10.1007/BF00994619
Russell D. E. H. (1990). Rape in marriage (expanded and rev. ed.). Indiana University Press.
Shields N., Hanneke C. (1992). Comparing the psychological impact of battering, marital rape and stranger rape. Clinical Sociology Review, 10(1), 151–169. http://digitalcommons.wayne.edu/csr/vol10/iss1/15
Sohal H., Eldridge S., Feder G. (2007). The sensitivity and specificity of four questions (HARK) to identify intimate partner violence: A diagnostic accuracy study in general practice. BMC Family Practice, 8(1).
Statistics Canada, S. (2011). Family violence in Canada: A statistical profile. (catalogue no. 85-224-X). Statistics Canada, http://www.statcan.gc.ca/pub/85-224-x/85-224-x2010000-eng.pdf
Straus M. A., Hamby S. L., Boney-McCoy S., Sugarman D. B. (1996). The revised conflict tactics scales (CTS2): Development and preliminary psychometrics data. Journal of Family Issues, 17(3), 283–316.
Sullivan C. M., Bybee D. (1999). Reducing violence using community-based advocacy for women with abusive partners. Journal of Consulting and Clinical Psychology, 67(1), 43–53. https://doi.org/10.1037/0022-006X.67.1.43
Symes L., Maddoux J., McFarlane J., Nava A., Gilroy H. (2014). Physical and sexual intimate partner violence, women’s health and children’s behavioural functioning: Entry analysis of a seven-year prospective study. Journal of Clinical Nursing, 23(10–20), 2909–2918.
Tarzia L., Thuraisingam S., Novy K., Valpied J., Quake R., Hegarty K. (2018). Exploring the relationships between sexual violence, mental health and perpetrator identity: A cross-sectional Australian primary care study. BMC Public Health, 18(1).
Temple J. R., Weston R., Rodriguez B. F., Marshall L. L. (2007). Differing effects of partner and nonpartner sexual assault on women’s mental health. Violence Against Women, 13(3), 285–297. https://doi.org/10.1177/1077801206297437
Tutty L. M., Radtke H. L., Ateah C., Ursel E. J., Thurston W. E., Hampton M., Nixon K. L. (2021). The complexities of intimate partner violence: Mental health, physical disabilities and child abuse history for White, Indigenous, and other visible minority Canadian women. Journal of Interpersonal Violence, 36(3–4), 1208–1232.
Tutty L. M., Radtke H. L., Thurston W. E., Ursel E. J., Nixon K. L., Hampton M., Ateah C. (2020). A longitudinal study of the well-being of Canadian women abused by intimate partners: A healing journey. Journal of Aggression, Maltreatment and Trauma.
Van Deinse T. B., Macy R. J., Cuddeback G. S., Allman A. J. (2019). Intimate partner violence and sexual assault among women with serious mental illness: A review of prevalence and risk factors. Journal of Social Work, 19(6), 789–828. https://doi.org/10.1177/1468017318766425
Wong J. Y. H., Choi E. P. H., Lo H. H. M., Wong W., Chio J. H. M., Choi A. W. M., Fong D. Y. T. (2019). Intimate partner sexual violence and mental health indicators among Chinese emerging adults. Journal of Interpersonal Violence.
Biographies
Leslie M. Tutty, PhD, is professor emerita with the Faculty of Social Work at the University of Calgary where she has taught courses in clinical social work methods and research. Over the past 30 years, her research has focused on policies, prevention programs, and services for intimate partner violence and child abuse including evaluations of shelters and support groups for abused women, treatment for adult and child victims of sexual abuse, and groups for men who abuse their partners.
Kendra L. Nixon, PhD, is an associate professor in the Faculty of Social Work, University of Manitoba. Her research interests include violence against women; mothering in the context of intimate partner violence; children's exposure to intimate partner violence; social and family policy, child protection; and feminist social work. She is currently the Director of the RESOLVE research network across the Canadian prairie provinces.
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Article first published online: September 25, 2021
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