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Disordered eating among African American and African Caribbean women: The influence of intimate partner violence, depression, and PTSD
– Reported, May 24, 2013
IPV, consisting of physical, sexual, and psychological abuse by an intimate partner, remains a pervasive epidemic in the United States, where between nearly one in three women has experienced violence from a partner in their lifetime. IPV occurs in both opposite- and same-sex relationships, with 11% of women in same-sex relationships reporting IPV perpetrated by their female partner.
When abuse is considered in conjunction with DE, young women experiencing dating violence and partner rape are up to 5 times more likely to have DE behaviors . Adult women experiencing IPV are also at increased risk for various eating disorders, when compared to their non-abused counterparts .Women experiencing abuse are more likely to experience depression and post-traumatic stress disorder (PTSD) than women reporting no abuse.
Considering depressive symptoms, PTSD, severity of physical and sexual violence, and severe risk for lethality from violence among women experiencing abuse, only depressive symptoms remained an independent risk factor DE. The relationship between risk for lethality and DE was fully mediated by the presence of depressive symptoms. It stands to reason that depression is the most important driver of DE, given that women in serious danger in an IPV relationship often become depressed and this in turn influences DE. Even so, given the direct association of IPV with DE in the full sample analysis, a relationship of IPV and DE remains that is not explained by increased depressive symptomatology from potential lethality. Again, additional research especially prospective studies with more precise measures of DE are needed, particularly measures of anorexia nervosa, binge eating and bulimia and analyses by ethnicity of patterns of disordered eating.
Treatment for DE, PTSD and/or depression clearly also needs to address IPV from the onset, so that women can be helped to be safer as they obtain interventions for other co-occurring problems. Health care professionals functioning under the belief that eating disorders occur less frequently among women of African heritage than among women of other ethnic groups could be less likely to detect them in these women, contributing to disparities in care and treatment. African American and African Caribbean women are less likely to have access to and utilize mental health services designed to treat eating disorders, making it imperative that culturally competent practitioners with preparation and training to recognize and treat eating disorders in ethnically-diverse patient populations are available in primary care and public health settings. Appropriate training and health policy interventions could help achieve optimal and equitable care for eating disorders across all ethnic groups in the United States.
CREDITS.
Marguerite B. Lucea, Ph.D, MPH, RN,1 Lucine Francis, BSN, RN,1 Bushra Sabri, Ph.D., LMSW, ACSW,1 Jacquelyn C. Campbell, Ph.D., RN, FAAN,1 and Doris W. Campbell, PhD, ARNP, FAAN2
http://www.ncbi.nlm.nih.gov/
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