This paper is a critique of the article “ Experiences of Domestic Violence and Mental Disorders: A Systematic Review and Meta-Analysis.” The writers of this study are Sian Orem, Gene Feder, Kylee Trevelyan and Louise Howard. The writers are associated with a department of women’s health at King’s College, UK. Feder is working with School of community medicine at Bristol University. The writers are a part of policy formulation of the World Health Organization as well. This study was published on 26th December, 2012 in PLOS One.
The major purpose of the research is to elucidate the relationship between the experiences of domestic violence and mental disorders. The researcher holds the view that domestic violence is a health problem occurring globally. The mental health is a major element in this violence. The lives of many fall prey to this menace. The women are more prone to the domestic violence. 15 to 71 percent of women come across the domestic violence of differing natures throughout their life span. The leading cause in the rising trend of this violence is the mental illness. The women are more exposed to the violent activities than the men. The growing trend is due to the declining mental health of the individuals. The people are becoming targets of the victim also developmental and cognitive problems. These people visit health facilities on a more frequent basis. This trend is not prevalent in people getting less or no exposure of domestic violence. Moreover, it is also stated that the span of this menace is not limited to women only. Men also get the victims, however, their percentage is less. It is also not possible to measure the extent of domestic violence. However, the researchers claim that is related with the cognitive health of the individual. The ones suffering from more violence are mentally ill. There stands a positive relationship between these variables (Trevillion, Oram, Feder, & Howard, 2012)
The reasons of the domestic violence and the consequences are a lot. Therefore, these things are little known. This study suggests that the domestic violence affects the mental health and therefore favors its recurrence. The ones becoming victims also show aggressive behaviors and propagate the act of violence through their own acts. The effect on the behavior is a measure of the exposure to the violent activities. In this way, the mental health suffers deterioration as well. These conditions hold true for the both genders. The mental disorders are recognized with the domestic violence, according to the researcher. The main objective of the research and review is to estimate the probability and occurrence of being a victim of domestic violence by diagnostic group and sex. The study has its focus on the relationship of domestic violence to the mental health and stability (Drake & Simper, 2002).
The literature suggests that mental conditions have found to be responsible for the domestic violence. The mental health and disorders increase the risk of domestic violence. Those with the illness and disorders are more prone to the violence. The depression also leads to the victimization of violence. The people having less mental stability are more prone to become the victims. The research merely focused on the report on various mental disorders without their diagnostic classification. No previous study or research touched upon violent victimization of people with mental disorders. The research did not review much literature as the dimension of research is completely new and aimed at systematic analysis. The study evaluates the present literature and identifies the major loophole that there is no critical appraise study quality and no report conducted specifically on men who are facing domestic violence. The focus largely is on the women. This study ignores the family unit and its effects in relation to the domestic violence.
Men and women with some kind of mental health disorder or disability are more likely to experience domestic violence than the rest of the population. This is the crux of the research set forth by this team of researchers. The previous studies largely focused on depression as the mental diagnostics but this research is the first one to ever consider a wide range of mental health problems in both the males and the female victims of domestic violence (Drake & Simper, 2002).
Disorders like obsessive compulsive disorder, eating disorders, common mental health problems, schizophrenia and bipolar disorder also led to a higher risk of domestic violence as compared to those people who were not suffering from any kind of mental disease. Both men and women had the same relationship evident however women were found to be more commonly targeted for repeated domestic violence.
The study was designed as a systematic review of the data collected. The sources of the data were 18 biomedical and social sciences databases, journals and references which were tracked from included or referred articles. The recommendations of the experts and reviews on victimization have been consulted and studied. The samples included men and women more than 16 years of age and observational study is used to report the occurrence or probability of victimization in the two sexes. Certified diagnostic measures of various mental disorders are observed. Data is collected and results presented data of experiences of individuals experiencing partner violence which include physical, sexual and psychological in comparison to the mental disorders in both the men and women. (Trevillion, Oram, Feder, & Howard, 2012)
Forty one studies were carried out which concluded that there is a higher risk of domestic violence in women with depressive disorders (OR 2. 77 (95% CI 1. 96–3. 92), then the anxiety disorders (OR 4. 08 (95% CI 2. 39–6. 97) and Post Traumatic Stress Disorder (OR 7. 34 95% CI 4. 50–11. 98) as compared to those women who were free from any sort of mental disorder. There was not much data for other mental disorders and samples could not be accessed by the researchers. This is a drawback in the overall study as it limits the findings of the research to only three types of mental disorders. Individual study results, however showed that women and men with any medical disorder were all at higher probability while there was a higher occurrence in women than men (Drake & Simper, 2002).
The selection process of study was carried out in any efficient manner by the researchers which yielded 29, 707 references from the literature. 28, 584 were excluded after the abstract screening. The remaining 1123 references which met the criteria for inclusion were also further reduced. 59 were not located, 41 were included in the review and 28 were from the different electronic database, 5 were from citation tracking. There were four from an older systematic review and also three expert sources were there too. There were six non English papers too according to the results of data finding but they were wisely not included in the study. Meta- analysis was used to collect the estimate of occurrence and probability of victimization in the study. The research performed random effects Meta-analysis which derived clear estimates of results. (Trevillion, Oram, Feder, & Howard, 2012)
The inclusive search strategy was used which followed MOOSE and PRISMA guidelines of reporting. Estimates of the occurrence and probability of domestic violence are examined across all mental disorders and separate analysis is provided for each sex. The relation between mental disorders and victimization is established using the empirical data and findings through diagnostic study of the sample population. DerSimonian-Laird random effects odds, results and estimates were calculated along with a 95% confidence interval for both the entire lifetime and the recent year of digestive violence occurring only with the people suffering from some sort of mental disorder. These were compared with those not suffering from mental disorder. Separate odds ratios for both men and women were derived and it was not possible to include studies for which data was not found, in the meta- analysis. The addition of low quality studies or their exclusion of the individual studies did not have any impact on the estimate or the findings. There were small number of studies in each of the meta-analysis which did not make it possible to investigate and find the sources of heterogeneity in the analysis; STATA 11 was used to conduct all the analysis.
The research could have been improved with more data and a larger sample for each diagnostic medical disorder. The factors such as individual life experiences, substance uses and behavioral attitudes were ignored. Contribution of such factors on the prevalence of domestic violence is not observed or found in this research. Since this research is new dimensional, considering the aspect of victimization of men with mental disorders, lack of primary researches and studies have resulted in lack of literature for review, and data collection. The study describes that men and women with existing mental disorders are a higher risk of facing domestic violence. The major objectives of this systematic review and research are to estimate the prevalence of victimization in men and women who have some sort of mental disorders (Drake & Simper, 2002).
More effort and data is needed to develop the study further and examine the relationship between domestic violence and mental disorders. While the study is authentic, well planned, evaluated and paves way to new dimensions for further research, its methods of data collections needs to be re-considered. Such a method must be acquired which will not ignore the other factors which act along with mental state of mind of the people in determining the probability of domestic violence. Without this it is highly unlikely to evaluate and judge the potential meaningfulness of the study. The conclusion and the language which is observed and seen throughout the article suggest that mental disorder occurred before the abuse. It suggests that the abuse was not what leads to mental illness but the mental disorder which leads the abuse. A problem with the research is that the abusers and the individuals responsible for the violent acts are not considered at all. Further research is required is to improve this hypothesis. The article is pretty damaging for the victims of domestic violence as the reports of the study suggest how mental disorder attracts and invites violence. This kind of judgment acknowledges the abuser and makes the victim appear deserving of the violence perhaps.
Several times the article has mentioned “ relationship violence” which terms the relationships as violent and abusive and not the individuals demonstrating violent behaviors. Mentally instable individuals, who are suffering from any of the mental ailments like depression, stress, Post traumatic stress disorder etc., cannot be precede victimization to domestic violence.
The researchers or the social scientists conducting the research gather data that is practical and factual, and falls under the conceptual idea of pure science. Information is gathered and developed to predict and understand a phenomena- domestic violence. The research methodology was based on both qualitative and quantitative data while the collection of data was entirely first hand and primary. Over all the results are valid and the research is constructed in a systematic manner considering the lack of primary sources available. Apart from the seemingly questionable hypothesis, findings of the research and the analysis are well conducted. However major changes like increase in samples, consideration of other factors involved in domestic violence, behaviors of the individuals responsible for the violence and the ones suffering from domestic violence are all required to be taken in regard.
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Trevillion, K., Oram, S., Feder, G., & Howard, L. M. (2012). Experiences of domestic violence and mental disorders: a systematic review and meta-analysis. PLoS One, 7(12), e51740.
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