Intimate partner violence and its association with substance use disorder : a qualitative study

Date
2023-12
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Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY: Intimate partner violence (IPV) is a serious public health and social problem affecting a large proportion of women in both developed and developing countries. South Africa has one of the highest prevalence rates of IPV compared to other countries, with significant negative effects on the well-being and mental health of the victims. IPV has been significantly associated with substance use disorder (SUD) and victims of IPV are significantly more prone to abuse multiple substances. There is a lack of rich narrative information within a South African context with regards to women’s experiences of IPV and SUD. My aim was to qualitatively investigate the experiences and challenges of women present with both SUD and IPV. Twelve participants with ages ranging between 18 and 43, in an inpatient unit offering rehabilitation services, were interviewed using a semi-structured interview and several questionnaires to assess type, severity and history of IPV and SUD; to identify risk factors such as mental health symptoms and childhood abuse. After transcription of audiotaped interviews, thematic analysis was used to derive from participants’ narratives three primary themes: i) Substance abuse and relationship development, ii) The relationship became abusive, and iii) Becoming sober and leaving the relationship. Under each primary theme, four subthemes were identified. A history of abuse and mental health problems contributed to increased vulnerability in these participants. Mental health consequences of IPV were mostly undiagnosed and participants identified symptoms of depression, anxiety, and trauma. IPV often went untreated as the primary treatment was for SUD. These findings describe the complexity of IPV and SUD in women within treatment centres as well as the escalation and severity of these two problems when they occur simultaneously. This study adds to the limited literature on South African women’s daily experiences of living with both IPV and SUD. Participants’ narratives provide valuable information that provide a foundation for future investigations among larger populations of women with IPV and SUD; to determine their unique experiences, difficulties and needs for targeted treatment.
AFRIKAANSE OPSOMMING: Intiemepaargeweld (IPV) is ‘n ernstige openbare gesondheids- en maatskaplike probleem wat ‘n groot aantal vroue in beide ontwikkelde en ontwikkelende lande raak. Suid-Afrika het een van die hoogste voorkomssyfers van IPV in vergelyking met ander lande, met beduidende negatiewe uitwerking op die welstand en geestesgesondheid van die slagoffers. IPV is in ‘n groot mate geassosieer met substansgebruiksteuring (SUD) en slagoffers van IPV is aansienlik meer geneig om veelvuldige substanse te misbruik. Daar is ‘n gebrek aan ryk narratiewe inligting binne ‘n Suid-Afrikaanse konteks met betrekking tot vroue se ervarings van IPV en SUD. My doel was om die ervarings en uitdagings van vroue met beide SUD en IPV, kwalitatief te ondersoek. ‘n Semi-gestruktureerde onderhoud is met twaalf deelnemers met ouderdomme wat wissel tussen 19 en 43 jaar, in ‘n binnepasient-eenheid wat rehabilitasiedienste aanbied, gevoer. ‘n Aantal vraelyste is gebruik om die tipe, erns en geskiedenis van IPV en SUD te assesseer, en om die risikofaktore soos geestesgesondheidsimptome en mishandeling as kind te identifiseer. Na transkripsie van oudioband-onderhoude van deelnemers se vertellings is tematiese analise gebruik om drie primere temas af te lei: 1) Middelmisbruik en verhoudingsontwikkeling, ii) Die verhouding het beledigend geword en iii) Nugter-wording en verlating van die verhouding. Onder elke primere tema is vier subtemas geidentifiseer. ‘n Geskiedenis van mishandeling en geestesgesondheidsprobleme het bygedra tot verhoogde kwesbaarheid by hierdie deelnemers. Geestesgesondheidsgevolge van IPV was meestal ongediagnoseer en deelnemers het simptome van depressie, angs en trauma gerapporteer. IPV het dikwels onaangespreek gegaan aangesien die primere behandeling op SUD gefokus was. Hierdie bevindinge beskryf die kompleksiteit van IPV en SUD by vroue in behandelingsentrums sowel as die toename en erns van hierdie twee probleme wanneer hulle gelyktydig voorkom. Hierdie studie dra by tot die beperkte literatuur oor vroue se daaglikse ervarings van lewe met beide IPV en SUD. Deelnemers se narratiewe verskaf waardevolle inligting wat ‘n grondslag bied vir toekomstige ondersoeke onder groter groepe vroue met IPV en SUD om hul unieke ervarings, probleme en behoeftes vir geteikende behandeling te bepaal.
Description
Thesis (MA)--Stellenbosch University, 2023.
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