Abstract

Context: Dating violence is prevalent in romantic relationships between young adults, and may be linked with suicidal ideation and behavior in victims. However, the pattern of dating violence victimization, suicidality, and the relationship between dating violence victimization and suicidality could vary depending on gender.

Aims: To determine gender differences in the relationship between dating violence victimization and suicidality in young adults.

Settings and Design: Cross-sectional descriptive study of 118 students (66 Females, 52 Males) between the ages of 18-32 years at a College of Medicine in Lagos, Nigeria.

Methods and Material: Study instruments used include; the Dating Violence Questionnaire (DVQ), Suicide Behavior Questionnaire-Revised (SBQ-R), and a Socio-Demographic Questionnaire. Participants were chosen through the convenience sampling method.

Statistical Analysis: The Statistical Package for the Social Sciences Version-23 (SPSS version-23) was used to analyze the data.

Results: Females who had experienced victimization from their romantic partners in the form of emotional punishment (P=0.02), humiliation (P=0.01), sexual abuse (P=0.03), and gender-based abuse (P=0.01), had significantly higher levels of suicidality compared to males.

Conclusion: Gender has a major influence on the expression of suicidality in young adult victims of dating violence.

Keywords

Dating-Violence Victimization; Suicidality; Gender Difference; Youths

Key Message

Dating violence victimization is associated with increased suicide risk in youths, most especially, females. There is an urgent need for the creation of sustainable female youth empowerment and protection programs, and continued advocacy against all forms of dating violence among young adults.

Introduction

Intimate partner violence is a psycho-social construct that has been studied for decades, with the main focus of research mostly on married couples [1-3]. In some quarters, the probability that couples who are in the dating phase may also be dealing with violence at a similar, or possibly higher rate than their married counterparts, is being entertained [4]. In many climes, dating violence is quite prevalent among young persons, and contemporary research has demonstrated that Nigeria is no exception [5]. Dating violence may be deemed a cause for serious concern, not only because of its dire physical consequences but also due to its gradual resultant erosion of mental health in affected victims [6]. Dating Violence Victimization (DVV) may present in the form of physical, emotional, or sexual abuse, and has been linked to increased suicide risk [7,8].

Gender plays a role in the link between DVV and suicidality [9], this has been attributed to biological, social, and psychological disparities between males and females [10]. Notably, the pattern and impact of DVV may differ in males and females [11], this suggests that its relationship with suicide risk may not exactly be the same for both genders. However, there are limited reports from Nigeria concerning the relationship between gender, DVV, and suicide risk. Due to this, our study intends to address this research gap by exploring gender differences in the relationship between DVV and suicidality in young Nigerian adults. It is expected that our study findings may herald a greater advocacy for prevention programs against dating violence, thereby reducing the preponderance of DVV-related suicidality, and other psychopathology in Nigerian youth. Possibly, this could translate to scaling up mental health services for Nigerian youths suffering from dating violence-related mental health problems.

Materials and Methods

Ethics

All study procedures were in line with the 1964 Helsinki Declaration of 1975, and its later amendments in 2013 on human experimentation and research. Ethical approval was provided by the institutional research review board of the Lagos State University Teaching Hospital, Nigeria (LREC/06/10/2167). Also, verbal and written informed consent were obtained from the participants.

Study Design

This cross-sectional descriptive study was conducted between June 2023 and July 2023 on students of the Lagos State University College of Medicine, Nigeria. Inclusion criteria were; students aged 18 years and above, and those who gave consent. Exclusion criteria were; Class Year 1 students, and those who did not consent to participation. Convenience sampling method was deployed to select 118 participants who met the inclusion criteria.

Instruments

Socio-Demographic Questionnaire: Details such as age, gender, marital status, religion, family socio-economic status, and current relationship status, were collected from the participants.

Suicide Behavior Questionnaire-Revised (SBQ-R): The Suicide Behavior Questionnaire-Revised (SBQ-R) is a self-report questionnaire used to screen for suicidal ideation and behavior. It contains four items on suicidal behaviors and ideations over the past 12 months, suiciderelated communication, and self-reported likelihood of any future suicidal behavior.A total score of ≥7 indicates suicidality. The SBQ-R has an internal consistency of 0.93 [12].

Dating Violence Questionnaire (DVQ): The Dating Violence Questionnaire (DVQ) is a 42-item questionnaire that measures victimization in romantic relationships. It has eight subscales representing different domains of abuse, these include; gender-based abuse, sexual abuse, coercion, physical abuse, humiliation, detachment, emotional punishment, and instrumental violence. Total scores are obtained for each subscale, and higher scores indicate high levels of victimization. The DVQ has an internal consistency of 0.82 [13].

Procedure

The study purpose was explained to the participants, informed consent was obtained, and instruments were administered. Based on their response, participants identified as having psychopathology were referred to the psychiatry unit of the Lagos State University Teaching Hospital for further assessment and possible intervention.

Statistical Analysis

The Statistical Package for the Social Sciences Version-23 (SPSS version-23) by IBM was used to analyze the data. Means, standard deviations, frequencies, and percentages were used to characterize the data. A Two-Way between-groups Analysis of Variance (ANOVA) test and Post-hoc tests were used to examine the interaction between gender, DVV, and suicidality. All tests were two-tailed, and the level of significance was placed at P<0.05.

Results

Socio-demographic Characteristics

Most participants were female (56%), single (91%), and from middle-class homes (87%). The age range of the students was 18- 32 years, with most being less than 25 years of age (58%), and the mean age for males and females was 24.3 (±3) years, and 24(±3) years respectively. Close to two-thirds of females (59%), and 41% of males were presently in a romantic relationship. The experience of victimization was more among the females (61%) compared to males (39%), this difference was also statistically significant (X 2 =2.74, Df=1, P=0.03) (See Table 1).

Variable	Male Total N=52 N (%)	Female Total N=66 N (%)	Total Sample N=118
Marital Status Married  Single	4(40) 48(44)	6(60) 60(56)	10(9) 108(91)
Religion Islam Christian	18(42) 34(45)	25(58) 41(55)	43(36) 75(64)
Class Year 2 Year 3 Year 4 Year 5 Year 6	9(28) 13(59) 9(39) 13(65) 8(38)	23(72) 9(41) 14(61) 7(35) 13(62)	32(27) 22(18) 23(20) 20(17) 21(18)
Family Socio-economic Status Low Middle High	0(0) 47(46) 5(33)	0(0) 56(54) 10(67)	0(0) 15(12) 103(87)
Currently in relationship Yes No	29(41) 23(49)	42(59) 24(51)	71(60) 47(40)
Age (Years) <25 ≥25 Mean (SD)	31(46) 21(42) 24.3(3)	37(54) 29(58) 24(4)	68(58) 50(42) 24(3)
Experience of Dating Violence Victimization Yes No *(X2=2.74, Df=1, P=0.03)	32(39) 20(57)	51(61) 15(43)	35(30) 83(70)

Table 1: Gender by Sociodemographic Characteristics of the Sample.
N=Frequency, SD=Standard Deviation
*X2 = Chi-Square Value, Df=Degree of Freedom, P=Level of Significance

Relationship between Gender, DVV, and Suicidality

A Two-Way between-groups Analysis of Variance (ANOVA) test was performed to examine the interaction between gender and DVV to predict suicidality (Table 2). For DVV, participants were divided into 9 groups, viz-a-viz; 8 domains of abuse, and 1 group of those who had never experienced DVV (No DVV). The interaction effect between gender and DVV was statistically significant [F=0.58, df =8, P=0.03] (Table 2). Meaning, there was a significant gender difference in the relationship between DVV and suicidality.

Source	Type III Sum of Square	Df	Mean Square	F	P-Value	Partial Eta Square
Gender	21.6	1	21.6	1.05	0.22	0.01
DVV	620.6	8	77.6	3.78	0.01*	0.23
DVV*Gender	94.4	8	11.8	0.58	0.03*	0.04

Table 2: Two-Way Anova Test of Interaction between Gender and Dating Violence Victimization to Predict Suicidality.
*P<0.05, Df = Degree of Freedom
DVV=Dating Violence Victimization

Furthermore, there was a statistically significant main effect for DVV [F=3.78, df = 8, P=0.01] (Table 2). Bonferroni Post-hoc comparisons found significant differences in all the DVV groups except between; physical abuse and coercion (Mean difference=0.79, SE=2.06, P=1.00), physical abuse and humiliation (Mean difference=1.04, SE=2.07, P=0.78), No DVV and sexual abuse (Mean difference=0.12, SE=1.37, P=0.53), sexual abuse and emotional punishment (Mean difference=0.62, SE=1.77, P=1.00), humiliation and coercion (Mean difference=0.25, SE=2.27, P=0.64), and instrumental violence and detachment (Mean difference=0.11, SE=2.57, P=0.85).

A direct comparison of the suicidality scores between the males and females in each DVV group was also done (Table 3). There was no significant gender difference in suicidality scores for No DVV, coercion, detachment, instrumental violence, gender-based abuse, and physical abuse (Table 3). However, females who had experienced emotional punishment (P=0.02), humiliation (P=0.01), and sexual abuse (P=0.03) had significantly higher levels of suicidality compared to their male colleagues (Table 3).

Variable	Total Mean (SD)	Male Mean (SD)	Female Mean (SD)	T	Df	P-Value
No DVV	10(5)	8(5)	11.4(5)	0.39	33	0.70
Coercion	5.4(2)	5.4(1)	5.3(2)	2.94	6	0.15
Detachment	7.3(5)	5(1)	10(8)	1.71	12	0.58
Humiliation	6(2)	7(3)	5(1)	2.60	14	0.01*
Instrumental Violence	7.4(4)	7(6)	8(3)	1.34	6	0.18
Emotional Punishment	11.2(4)	14(4)	11(5)	2.60	10	0.02*
Gender-based abuse	13.4(4)	16(2)	13(4.4)	4.01	8	0.07
Sexual abuse	10(6)	8(5)	10.3(6)	1.78	2	0.03*
Physical abuse	5(2)	5(1)	5(2)	1.04	9	0.30

Table 3: Comparison of Suicidality Scores by Gender Across the Domains of Abuse.
*P<0.05, Df= Degree of Freedom

In summary, there was a stronger link between suicidality and DVV in female youths in comparison with male youths.

Discussion

Emotional punishment and humiliation are both forms of Psychological Violence (PV) and were associated with higher suicide risk in females than males. Our findings are in tandem with earlier studies which portray a strong connection between PV and suicidality in female victims [14-18].

Psychological violence is estimated to be the most common form of intimate partner violence [19-21]. It includes acts such as; frequent insults, belittling, constant humiliation, intimidation, or threats of harm [22]. Frequent exposure to PV may cause feelings of worthlessness, and hopelessness, which could lead to suicidality [23]. A possible reason for the stronger relationship between PV and suicidality in females than males is that PV could independently cause post-traumatic stress disorder, depression, and anxiety in victims, these are disorders commonly reported by females, and with increased propensity for suicidality [24-28]. It is also noteworthy that, social expectations for men and women vary remarkably, this factor, in combination with biological differences, may contribute to gender influence on suicide risk in the context of PV [9].

Female victims of sexual abuse reported higher suicidality compared to male victims. Comparable reports have been made in the past [29, 30]. Sexual abuse is any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts directed against a person's sexuality using coercion, by any person regardless of their relationship to the victim, if any [31]. Sexual abuse could be; nonconsensual sex, forced termination of pregnancy, forced contraception, or viewing of pornographic material [32-34].

Sexual abuse is a significant contextual factor of suicidal thoughts and suicidal behavior in females [35]. Considering that females tend to experience more sexual abuse than males [9,30,34], it is unsurprising that suicide risk is increased in them. Aside from this, sexual abuse has been linked to elevated rates of depression in females [36-38], knowing that suicidal ideas and behavior are likely symptoms of depression, this could contribute to over-reporting of suicidality in females.

Strengths and Limitations

Most Nigerian studies on dating violence in youths have focused more on the prevalence, and social risk factors of dating violence. However, our study is unique in being one of the few to examine gender differences in psychopathology in victims of dating violence. Also, as participant selection was based on a convenience sampling method, the extent to which these findings can be generalized to other youths is limited.

Clinical Implications

Female youths who are victims of dating violence would require frequent screening for suicidality and other forms of psychopathology at women’s mental health and wellness clinics. Hopefully, this would result in early mental health intervention, and avert DV-related mortality in affected females.

Policy Implications

There is a need for the institution of stiffer criminal penalties against perpetrators of dating violence, strengthened dating violence prevention programs, and accessible support networks for vulnerable youths across the nation.

Future Research Directions

Studies concerning the influence of coping strategies, cognitive appraisal, and resilience on the experience of dating violence victimization would be invaluable.

Conclusion

In youth victims, gender is a major determinant of suicide risk in the aftermath of dating violence. Concerted efforts should be made by both the public and private sector to curb the menace of dating violence, and of course, provide sufficient emotional support for youths who have been exposed to dating violence victimization.

Conflict of Interest

None

Funding

None.

Acknowledgement

The authors hereby thank all the participants for their time and cooperation during the study

Statement of Contribution

A.A.L: Conceptualization, Data acquisition, Data analysis, Manuscript preparation, Manuscript editing, Manuscript review

M.O.S: Conceptualization, Literature search, Data analysis, Manuscript editing, Manuscript review

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Article Information

Article Type: RESEARCH ARTICLE

Citation: Lebimoyo Azizat A, Sanni Mumtaz O (2024) Gender Differences in the Relationship between Dating-Violence Victimization and Suicidality in Youths. J Psychiatry Ment Health 9(1): dx.doi.org/10.16966/2474-7769.154

Copyright: © 2024 Azizat Lebimoy A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication history: 

Received date: 28 Dec, 2023

Accepted date: 24 Jan, 2024

Published date: 29 Jan, 2024