Paper
Friday, July 15, 2005
The Relationship of Marginality, Abuse, and Health Outcomes in Women
Anne Floyd Koci, PhD, APRN-BC, Byrdine F. Lewis School of Nursing, Georgia State University, Atlanta, GA, USA, Ora Strickland, RN, PhD, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA, and David Cantor, PhD, Psychological Sciences Institute ((PSI), Duluth, GA, USA.
| Learning Objective #1: Identify the relationship among abuse, marginality, and health outcomes of anxiety and depression in women ages 18-45 |
| Learning Objective #2: Understand the impact abuse has on the long-term health of women ages 18-45 |
Violence in the form of physical and/or sexual abuse presents a significant public health problem with adverse effects on women's health. A wide range of emotional and behavioral sequelae has been linked with abuse. Such sequelae increase a woman's vulnerability to future adverse health outcomes. The majority of abuse research has been done with clinical samples, yet little data exists regarding the relationship of abuse and marginality. Purpose: To examine the relationship between marginality, abuse (physical and/or sexual abuse), and health outcomes of anxiety and/or depression. Research is deficient regarding marginality, abuse and health outcomes. Methods: A secondary analysis of 568 healthy women from the community who had participated in a study of PMS. Women with chronic diseases, diagnosed physical or psychological problems, and who were on birth control pills were excluded. Childhood, adolescent and adult abuse history data were obtained. All participants completed a Minnesota Multiphasic Personality Inventory. Descriptive statistics, hierarchical regression analyses, analysis of covariance and Pearson and Spearman correlations were computed. Findings: Physical, sexual and total abuse across the lifespan significantly predicted marginality, anxiety and depression. Marginality, anxiety and depression had significant positive correlations with physical and sexual abuse across the lifespan. Women without a history of physical and/or sexual abuse had significantly lower adjusted mean marginality, anxiety and depression scores than abused women. Race/ethnicity was not significantly associated with anxiety or depression. Comorbidity of anxiety and depression was noted in 9% of the sample. Sexual abuse significantly predicted comorbidity of anxiety and depression. Discussion: Abuse was shown to be a strong predictor of marginality, anxiety and depression in this study. The health impact of abuse was shown to have long-term biobehavioral consequences. (Original PMS study funded by NIH Grant No. R01-NR02705, Ora Strickland, Principal Investigator)