Psychological treatments for depression among women experiencing intimate partner violence: findings from a randomized controlled trial for behavioral activation in Goa, India
Date
2019-07-30
Journal Title
Journal ISSN
Volume Title
Publisher
Archives of Women's Mental Health
Abstract
Intimate partner violence (IPV) strongly predicts depression, but it is unknown if women experiencing IPV can benefit from
depression treatments in contexts where depression and IPVare prevalent. This study explored whether women experiencing IPV
in Goa, India, can benefit from the Healthy Activity Program (HAP), a culturally adapted behavioral activation treatment,
compared with enhanced usual care (EUC). Cross-sectional and longitudinal analyses were performed on data from a clinical
trial. Measures assessed at baseline and 3 and 12 months included depressive symptoms. Measures assessed at 3 and 12 months
included activation and IPV. Independent t tests were conducted to assess if participants experiencing IPV had higher depressive
symptoms and lower activation at 3 and 12 months; hierarchical linear regression was conducted to determine if 3-month IPV
predicted 12-month depressive symptoms across trial arms (Hypothesis 1). Hierarchical linear regression was then conducted to
examine if the relationship between 3-month activation and 12-month depressive symptoms was moderated by 3-month IPV
within each trial arm (Hypothesis 2). As expected, participants experiencing IPV had significantly lower activation levels and
higher depressive symptoms compared with participants who did not experience IPV at 3 and 12 months in cross-sectional
analyses. Similarly, IPVendorsed at 3 months significantly predicted depressive symptoms at 12 months. However, activation
was significantly associated with less severe depressive symptoms at 12 months, irrespective of IPVendorsement among HAP
participants. For EUC participants, IPV remained the only significant predictor of depressive symptoms at 12 months. Results
suggest that women experiencing IPV can still benefit from behavioral activation.
Description
Research Article
Keywords
Depression, Intimate partner violence, Behavioral activation, India, LMIC