Original article| Volume 22, ISSUE 5, e491-e500, September 2012

Factors That Contribute or Impede the Physical Health Recovery of Women Exposed to Intimate Partner Violence: A Longitudinal Study



      Several cross-sectional studies have demonstrated the negative impact that intimate partner violence (IPV) has on the physical health of women. However, longitudinal studies are needed to establish the time course of this effect. This study assessed the physical health course of female IPV victims and established the factors that enhance or impede their recovery.


      Women (n = 91) who participated in a previous cross-sectional study (T-1) and were either victims of physical/psychological IPV (n = 33) or psychological IPV (n = 23) were evaluated 3 years later (T-2). A control group of women (n = 35) was included for comparison. Structured interviews provided information regarding IPV characteristics, physical health, and lifestyle.


      Physical symptoms decreased over time for both groups of abused women. Factors that contributed to this improvement were perception of social support and the cessation of physical IPV. Factors that impaired recovery included cohabitation with the aggressor, victimization experiences at T-2, negative perceptions of life events, and continuing psychological IPV.


      This study shows that physical health improvement is possible in female victims of IPV, but that continuing psychological IPV hinders recovery. Additional longitudinal studies are needed to investigate the factors that best predict health recovery in female IPV victims to design effective intervention programs.
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        • Beeble M.L.
        • Bybee D.
        • Sullivan C.M.
        • Adams A.E.
        Main, mediating, and moderating effects of social support on the well-being of survivors of intimate partner violence across 2 years.
        Journal of Consulting and Clinical Psychology. 2009; 77: 718-729
        • Bellón Saameño J.A.
        • Delgado Sanchez A.
        • Luna del Castillo J.D.
        • Lardelli Claret P.
        Validity and reliability of the Duke-UNC-11 questionnaire of functional social support [Validez y fiabilidad del cuestionario de apoyo social functional Duke-UNC-11].
        Atencion Primaria/Sociedad Española De Medicina De Familia y Comunitaria. 1996; 18: 153-156
        • Bergman B.
        • Brismar B.
        A 5-year follow-up study of 117 battered women.
        American Journal of Public Health. 1991; 81: 1486-1489
        • Blasco-Ros C.
        • Sanchez-Lorente S.
        • Martínez M.
        Recovery from depressive symptoms, state anxiety and post-traumatic stress disorder in women exposed to physical and psychological, but not to psychological intimate partner violence alone: A longitudinal study.
        BMC Psychiatry. 2010; 10: 98
        • Bonomi A.E.
        • Anderson M.L.
        • Reid R.J.
        • Rivara F.P.
        • Carrell D.
        • Thompson R.S.
        Medical and psychosocial diagnoses in women with a history of intimate partner violence.
        Archives of Internal Medicine. 2009; 169: 1692-1697
        • Broadhead W.E.
        • Gehlbach S.H.
        • de Gruy F.V.
        • Kaplan B.H.
        The Duke-UNC functional social support questionnaire. Measurement of social support in family medicine patients.
        Medical Care. 1988; 26: 709-723
        • Bybee D.I.
        • Sullivan C.M.
        The process through which an advocacy intervention resulted in positive change for battered women over time.
        American Journal of Community Psychology. 2002; 30: 103-132
        • Bybee D.
        • Sullivan C.M.
        Predicting re-victimization of battered women 3 years after exiting a shelter program.
        American Journal of Community Psychology. 2005; 36: 85-96
        • Campbell J.C.
        Health consequences of intimate partner violence.
        Lancet. 2002; 359: 1331-1336
        • Campbell J.C.
        • Soeken K.L.
        Women’s responses to battering over time: An analysis of change.
        Journal of Interpersonal Violence. 1999; 14: 21-40
        • Campbell R.
        • Sullivan C.M.
        • Davidson W.S.
        Women who use domestic violence shelters: Changes in depression over time.
        Psychology of Women Quarterly. 1995; 19: 237-255
        • Campbell J.
        • Jones A.S.
        • Dienemann J.
        • Kub J.
        • Schollenberger J.
        • O'Campo P.
        • et al.
        Intimate partner violence and physical health consequences.
        Archives of Internal Medicine. 2002; 162: 1157-1163
        • Chang J.C.
        • Dado D.
        • Hawker L.
        • Cluss P.A.
        • Buranosky R.
        • Slagel L.
        • et al.
        Understanding turning points in intimate partner violence: Factors and circumstances leading women victims toward change.
        Journal of Women's Health. 2010; 19: 251-259
        • Coker A.L.
        • Reeder C.E.
        • Fadden M.K.
        • Smith P.H.
        Physical partner violence and Medicaid utilization and expenditures.
        Public Health Reports. 2004; 119: 557-567
        • Coker A.L.
        • Smith P.H.
        • Bethea L.
        • King M.R.
        • McKeown R.E.
        Physical health consequences of physical and psychological intimate partner violence.
        Archives of Family Medicine. 2000; 9: 451-457
        • Coker A.L.
        • Smith P.H.
        • Thompson M.P.
        • McKeown R.E.
        • Bethea L.
        • Davis K.E.
        Social support protects against the negative effects of partner violence on mental health.
        Journal of Women's Health. 2002; 11: 465-476
        • Ellsberg M.
        • Jansen H.A.
        • Heise L.
        • Watts C.H.
        • Garcia-Moreno C.
        • WHO Multi-country Study on Women's Health and Domestic Violence against Women Study Team
        Intimate partner violence and women's physical and mental health in the WHO multi-country study on women's health and domestic violence: An observational study.
        Lancet. 2008; 371: 1165-1172
        • Escribà-Agüir V.
        • Ruiz-Pérez I.
        • Montero-Pinar M.I.
        • Vives-Cases C.
        • Plazaola-Castaño J.
        • Martín-Baena D.
        • et al.
        Partner violence and psychological well-being: Buffer or indirect effect of social support.
        Psychosomatic Medicine. 2010; 72: 383-389
        • Follingstad D.R.
        The impact of psychological aggression on women's mental health and behavior: The status of the field.
        Trauma, Violence & Abuse. 2009; 10: 271-289
        • Ford-Gilboe M.
        • Wuest J.
        • Varcoe C.
        • Davies L.
        • Merritt-Gray M.
        • Campbell J.
        • et al.
        Modelling the effects of intimate partner violence and access to resources on women's health in the early years after leaving an abusive partner.
        Social Science & Medicine. 2009; 68: 1021-1029
        • Gao W.
        • Paterson J.
        • Abbott M.
        • Carter S.
        • Iusitini L.
        • McDonald-Sundborn G.
        Impact of current and past intimate partner violence on maternal mental health and behaviour at 2 years after childbirth: Evidence from the pacific islands families study.
        The Australian and New Zealand Journal of Psychiatry. 2010; 44: 174-182
        • García-Linares M.I.
        • Sánchez-Lorente S.
        • Coe C.L.
        • Martínez M.
        Intimate male partner violence impairs immune control over herpes simplex virus type 1 in physically and psychologically abused women.
        Psychosomatic Medicine. 2004; 66: 965-972
        • García-Linares M.I.
        • Pico-Alfonso M.A.
        • Sánchez-Lorente S.
        • Savall-Rodríguez F.
        • Celda-Navarro N.
        • Blasco-Ros C.
        • et al.
        Assessing physical, sexual, and psychological violence perpetrated by intimate male partners toward women: A Spanish cross-sectional study.
        Violence and Victims. 2005; 20: 99-123
        • Garcia-Moreno C.
        • Jansen H.A.F.M.
        • Ellsberg M.
        • Heise L.
        • Watts C.
        WHO multi-country study on women’s health and domestic violence against women: Initial results on prevalence, health outcomes, and women’s responses.
        World Health Organization, Geneva2005
        • Gerber M.R.
        • Wittenberg E.
        • Ganz M.L.
        • Williams C.M.
        • McCloskey L.A.
        Intimate partner violence exposure and change in women's physical symptoms over time.
        Journal of General Internal Medicine. 2008; 23: 64-69
      1. Instituto Nacional de Calidad y Evaluacion (2000). Sistema estatal d e indicadores de la educación.

        • Jordan C.E.
        • Campbell R.
        • Follingstad D.
        Violence and women's mental health: The impact of physical, sexual, and psychological aggression.
        Annual Review of Clinical Psychology. 2010; 6: 607-628
        • Katz J.
        • Arias I.
        Psychological abuse and depressive symptoms in dating women: Do different types of abuse have differential effects?.
        Journal of Family Violence. 1999; 14: 281-295
        • Kelly U.
        Intimate partner violence, physical health, posttraumatic stress disorder, depression, and quality of life in Latinas.
        Western Journal of Emergency Medicine. 2010; 11: 247-251
        • Kernic M.A.
        • Wolf M.E.
        • Holt V.L.
        Rates and relative risk of hospital admission among women in violent intimate partner relationships.
        American Journal of Public Health. 2000; 90: 1412-1420
        • Krug E.G.
        • Dahlberg L.L.
        • Mercy J.A.
        • Zwi A.B.
        • Lozano R.
        World report on violence and health.
        World Health Organization, Geneva2002 (Accessed November 9, 2012, from:)
        • Lamy C.
        • Dubois F.
        • Jaafari N.
        • Carl T.
        • Gaillard P.
        • Camus V.
        • et al.
        Clinical and psychopathological profile of women victims of psychological partner violence [Profil clinique et psychopathologique des femmes victimes de violences conjugales psychologiques].
        Revue d'Epidemiologie et de Sante Publique. 2009; 57: 267-274
        • Leung T.W.
        • Leung W.C.
        • Ng E.H.
        • Ho P.C.
        Quality of life of victims of intimate partner violence.
        International Journal of Gynaecology and Obstetrics. 2005; 90: 258-262
        • Linton S.J.
        A prospective study of the effects of sexual or physical abuse on back pain.
        Pain. 2002; 96: 347-351
        • Lo Fo Wong S.
        • Wester F.
        • Mol S.
        • Romkens R.
        • Lagro-Janssen T.
        Utilisation of health care by women who have suffered abuse: A descriptive study on medical records in family practice.
        British Journal of General Practice. 2007; 57: 396-400
        • Lown E.A.
        • Vega W.A.
        Intimate partner violence and health: Self-assessed health, chronic health, and somatic symptoms among Mexican American women.
        Psychosomatic Medicine. 2001; 63: 352-360
        • Martínez M.
        • García-Linares M.I.
        • Picó-Alfonso M.A.
        Women victims of domestic violence: Consequences for their health and the role of the health system.
        in: Klein R. Walln B. Conflict, gender and violence. Studien-Verlag, Vienna2004: 53-71
        • Martínez M.
        • Sánchez-Lorente S.
        • Blasco-Ros C.
        Violencia de pareja y salud integral de las mujeres: Deterioro y recuperación.
        in: López Zafra E. Violencia contra las mujeres: Descripción e intervención biopsicosocial. Universidad de Jaén Servicio de publicaciones, Jaén2010: 229-254
        • Mburia-Mwalili A.
        • Clements-Nolle K.
        • Lee W.
        • Shadley M.
        • Wei Y.
        Intimate partner violence and depression in a population-based sample of women: Can social support help?.
        Journal of Interpersonal Violence. 2010; 25: 2258-2278
        • Mertin P.
        • Mohr P.B.
        A follow-up study of posttraumatic stress disorder, anxiety, and depression in Australian victims of domestic violence.
        Violence and Victims. 2001; 16: 645-654
        • Picó-Alfonso M.A.
        Psychological intimate partner violence: The major predictor of posttraumatic stress disorder in abused women.
        Neuroscience and Biobehavioral Reviews. 2005; 29: 181-193
        • Picó-Alfonso M.A.
        • Echeburúa E.
        • Martínez M.
        Personality disorder symptoms as a result of chronic intimate male partner violence.
        Journal of Family Violence. 2008; 23: 577-588
        • Picó-Alfonso M.A.
        • Garcia-Linares M.I.
        • Celda-Navarro N.
        • Herbert J.
        • Martinez M.
        Changes in cortisol and dehydroepiandrosterone in women victims of physical and psychological intimate partner violence.
        Biological Psychiatry. 2004; 56: 233-240
        • Picó-Alfonso M.A.
        • Garcia-Linares I.M.
        • Celda-Navarro N.
        • Blasco-Ros C.
        • Echeburúa E.
        • Martinez M.
        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. 2006; 15: 599-611
        • Plichta S.B.
        Intimate partner violence and physical health consequences: Policy and practice implications.
        Journal of Interpersonal Violence. 2004; 19: 1296-1323
        • Plichta S.B.
        • Abraham C.
        Violence and gynecologic health in women <50 years old.
        American Journal of Obstetrics and Gynecology. 1996; 174: 903-907
        • Rivara F.P.
        • Anderson M.L.
        • Fishman P.
        • Bonomi A.E.
        • Reid R.J.
        • Carrell D.
        • et al.
        Healthcare utilization and costs for women with a history of intimate partner violence.
        American Journal of Preventive Medicine. 2007; 32: 89-96
        • Ruiz-Perez I.
        • Plazaola-Castano J.
        • Del Rio-Lozano M.
        Physical health consequences of intimate partner violence in Spanish women.
        European Journal of Public Health. 2007; 17: 437-443
        • Sánchez-Lorente S.
        • Blasco-Ros C.
        • Coe C.L.
        • Martinez M.
        Recovery of immune control over herpes simplex virus type 1 in female victims of intimate partner violence.
        Psychosomatic Medicine. 2010; 72: 97-106
        • Schei B.
        • Guthrie J.R.
        • Dennerstein L.
        • Alford S.
        Intimate partner violence and health outcomes in mid-life women: A population-based cohort study.
        Archives of Women's Mental Health. 2006; 9: 317-324
        • Staggs S.L.
        • Long S.M.
        • Mason G.E.
        • Krishnan S.
        • Riger S.
        Intimate partner violence, social support, and employment in the post-welfare reform era.
        Journal of Interpersonal Violence. 2007; 22: 345-367
        • Stene L.E.
        • Dyb G.
        • Jacobsen G.W.
        • Schei B.
        Psychotropic drug use among women exposed to intimate partner violence: A population-based study.
        Scandinavian Journal of Public Health. 2010; 38: 88-95
        • Sutherland C.
        • Bybee D.
        • Sullivan C.
        The long-term effects of battering on women's health.
        Women's Health. 1998; 4: 41-70
        • Taft A.J.
        • Small R.
        • Hegarty K.L.
        • Watson L.F.
        • Gold L.
        • Lumley J.A.
        Mothers' Advocates in the community (MOSAIC): Non-professional mentor support to reduce intimate partner violence and depression in mothers: A cluster randomised trial in primary care.
        BMC Public Health. 2011; 11: 178
        • Vives-Cases C.
        • Ruiz-Cantero M.T.
        • Escribà-Agüir V.
        • Miralles J.J.
        The effect of intimate partner violence and other forms of violence against women on health.
        Journal of Public Health. 2011; 33: 15-21
        • Vung N.D.
        • Ostergren P.O.
        • Krantz G.
        Intimate partner violence against women, health effects and health care seeking in rural Vietnam.
        European Journal of Public Health. 2009; 19: 178-182


      Segunda Sánchez-Lorente is psychologist and criminologist, with a PhD in Neurosciences from the University of Valencia. Her research interests are the consequences of intimate partner violence on women's health. At the present, she works as educational referent in a school–foundation for unprivileged children.


      Concepcion Blasco-Ros is a psychologist with a PhD in Neurosciences from the University of Valencia. Her research interests are related to the consequences of intimate partner violence on women's health, mainly mental health and the impact on the endocrine system. She has worked as psychotherapist.


      Manuela Martinez, MD, PhD, is Professor and Head of the Department of Psychobiology at the University of Valencia. Her research interests include both sides of violence: The aggressor and the victim, especially the biological contribution to violence and its impact on the victims.