"Teen dating", partner violence and mental health issues in COVID era

Intimate partner violence is described as physical violence, sexual violence, stalking, or psychological aggression by a current or former intimate partner. It is estimated to be in more than 30% women especially young women. Marianna Mazza et al. explain the factors associated with intimate partner violence and consequences of exposure of children to parental domestic violence in their recent review published in World Journal of Psychiatry, along with possible intensification of violence against women with the spread of coronavirus disease 2019 pandemic and subsequent lockdown.

Exposure to violence contributes to the genesis of, and exacerbates, mental health conditions, and existing mental health problems increase vulnerability to partner violence, and creates a loop that imprisons victims and perpetuates the abuse. It is linked with both physical health problems, as well as with mental health consequences like depression, anxiety, posttraumatic stress disorder, eating disorders, suicidal behavior, alcohol or drug abuse, sexual problems etc.

Emotional violence is the most common form of intimate partner violence across all continents worldwide. Factors associated with intimate partner violence originate from multiple levels: Individual, relationship, community, and societal level.

Subjects who are at greater risk of experiencing intimate partner violence more likely come from a lower education background and poorer socioeconomic status (with difficulty of access to resources and greater acceptance towards violence).

Exposure of children:

The presence of intimate partner violence often compromises a child's attachment to primary caregivers, which results in an additional risk factor for social, emotional, and psychological impairment. These younger children have not completely strengthened the cognitive ability to discern between intimate partner violence as a threat to caregiver or to the self.

The larger the number of adverse childhood experiences, the higher the odds of worst physical and mental health outcomes, including heart disease, stroke, asthma, diabetes, and mental distress

Teen dating violence:

Adolescence is a critical developmental period characterized by puberty, progressive autonomy from parents and family, changes in social relationships, and often the beginning of romantic relationships.

Six forms of teen dating violence have been assessed:

1. Threatening behaviours,

2. Verbal/emotional abuse,

3. Relational abuse,

4. Physical abuse,

5. Sexual abuse,

6. Stalking.

Victims of teen dating violence may develop adverse health outcomes such as increased sexual risk behaviors, suicidality, unhealthy behaviors (e.g., lack of physical activity and negative weight-controlling behaviors), inauspicious mental health outcomes, substance use, injuries, victimization, and death.

Violence during COVID-19 pandemic:

COVID-19 has had a dreadful impact on society and women are forced to take on additional risks as they are already disadvantaged and vulnerable, especially in rural and remote settings.

During the institutional lockdown, victims of domestic violence were required to remain closed with partners and without help or support: In such scenario there is a great chance that abusive situations can further aggravate, with a possible increase of domestic homicides or murder-suicides or deviant behaviors towards children. Psychological distress linked with the pandemic itself, arising in response to fears about personal and familial infection as well as the sequelae of social distancing and quarantine measures, add worry about possible consequences of intimate partner violence during this global pandemic.

While, referral rates to mental health and psychology services have declined, despite a likely increase in psychological distress, victimization, and mental illness. programs are necessary to provide funding sources to guarantee telephone or remote counseling services or psychological assistance hotlines to manage and attempt to prevent crisis situations.

Interventions that can be done:

1. Clinical routine screening for indicators of intimate partner violence.

2. Prenatal assessment and counselling for pregnant women suspected or known to be exposed to violence and home-visitation programs.

3. Culturally tailored specific approach for immigrant women victims of violence.

4. Intervention techniques to reduce violence among offenders

5. Implementation of research aimed to develop additional strategies for addressing interpersonal violence.

6. During COVID-19 pandemic, enhancement of telephone or remote counseling services or psychological assistance hotlines to manage crisis situations.

7. Specific programs for prevention of domestic violence with a particular attention on healthy child and adolescent development.

Source: World J Psychiatr 2021 June 19; 11(6): 201-264