3 RESULTS 3.1 Study selection
3.5 Health outcomes observed in victims of IPV during COVID-19 epidemic
Sediri and colleauges (2020) found that significantly higher rates of anxiety, depression and stress levels as well as higher vulnerability to Facebook addiction were associated with IPV. Gresham and colleauges (2021) reported a direct positive association between IPV and physical and mental health. IPV victimisation during COVID-19 was also associated with higher rates of substance use and movement outside the home. An increase of substance use was also reported by Gosangi and colleauges (2021) and Tadesse and colleauges (2020).
4 DISCUSSION
The aim of the present review was to assess the prevalence and incidence of IPV victimization during the COVID-19 epidemic, risk factors associated with it and potential associations of IPV with health outcomes of the victimization during the epidemic. Out of 691 identified papers, seven were included in the present review based on pre-established criteria.
The results indicate that the prevalence of IPV during epidemic ranged from 14.8% to 45.29%, with emotional IPV being the most common. These numbers are consistent with previous estimations of IPV prevalence before COVID-19 epidemic (Dicola & Spaar, 2016; WHO, 2021); however, the issue of underreporting must be taken into consideration. Indeed Vives-Cases and colleauges (2021) have noted that there have been a decrease in number of official complaints and POs issued during COVID-19. Yet they have also found a more than 45% increase in number of calls made to the telephone-service for IPV information. Furthermore, although there were less patients treated for the any type of IPV at the emergency department, the number of serious injuries was substantially higher (Gosangi et al., 2021). This suggests underreporting of IPV and thus, the aforementioned prevalence of IPV during COVID-19 should not be taken at face value due to underreporting. One possible explanation why victims of IPV would underreport is fear of retribution, embarrassment or failure to recognise the experiences as IPV (Birdsey & Snowball, 2013; Loxton et al., 2019). Secondly, victims might not have known the agencies at their disposal and therefore did not know where to seek help, or were unable to access those services due to COVID-19 measurement of social distancing (Kaukinen, 2020). Moreover, COVID-19 measurements (e.g. stay at home orders, loss of employment, police curfew) have created conditions that often resulted in victims being in the same household with the perpetrator for prolonged periods of time cut from their support system. Thus, it is possible that the victims’ opportunities to report or seek help for their abuse were greatly hindered (Buttell &
Ferreira, 2020; WHO, 2020).
In the present systematic review, the following risk factors for IPV were identified: lower education of the victim and perpetrator, unemployment, living in a rural area, living in a community that tolerates IPV, substance abuse, history of IPV and lower family income (Gosangi et al., 2021; Rayhan & Akter, 2021; Sediri et al., 2020; Tadesse et al., 2020; Vives-Cases et al., 2021; Walsh et al., 2021). Similar risk factors have been identified by previous research (e.g. Capaldi et al., 2012; Dutton & Goodman, 2005; Fagen et al., 2011; Jenkins & Phillips, 2008; Kim et al., 2008).
What is more, reduction of income during COVID-19 was found to increase the risk for IPV victimisation by 9.16 times (Rayhan & Akter, 2021). External relational stressors (e.g. loss of employment, reduction in income) can enhance the likelihood of relational conflict, which in turn presents higher risk for more severe IPV (Capaldi et al., 2012). This was confirmed also by one of the studies included in the present review, which found a direct positive association between the IPV and COVID-19 related stressors, such as financial anxiety, social disconnection, perceived stress and impact (Gresham et al., 2021). Therefore, it appears that during COVID-19 epidemic the likelihood of IPV victimisation was increased by additional stressors steaming from the imposed governmental measurements aiming to secure public health.
Expectedly, studies exploring the effects of IPV during COVID-19 on health outcomes (physical and mental health) have found increased levels of depression and anxiety symptoms, higher levels of stress, greater vulnerability to Facebook addiction, substance use and poorer self-reported general health (Gresham et al., 2021; Sediri et al., 2020). This again is consistent with the previous research (Coker et al., 2002; Lagdon et al., 2014; Mason & O’Rinn, 2014).
Although the present review was made according to established review standard there are some limitations.
Authors of the studies took very different approaches to exploring IPV during COVID-19. On the one hand, it gives us a wide overview of the outcomes from different perspectives – e.g. victims self-report, official records and health records. On the other hand, it prevents comparability of the results and consequently limits the results’
applicability due to cofounding effects of cultural differences. Another limitation is small number of studies included, which does not allow addressing the potential cofounding effects such as cultural differences and different governmental approaches to preventing the spread of COVID-19 on the results. However, at present there is a limited amount of empirical studies exploring the field of IPV during COVID-19, which would provide a better insight of the subject studied. Furthermore, none of the studies combined different sources of information for assessing the prevalence of IPV during COVID-19 – e.g. official records and self-reports by the victims.
Future research should focus on conducting well-designed empirical studies using validated measures, so that the results can be compared to previous studies of IPV. Multiple sources of information should be used to establish the prevalence of IPV and reasons for not seeking help or reporting the IPV during the epidemic should be explored as well.
5 CONCLUSION
The COVID-19 epidemic and consequential measurements imposed by the government have created conditions that greatly increase the risk for IPV victimisation, yet make it difficult for the victims to report it. Thus, the government and authorities should be conscious of the fact that official reports probably do not reflect a realistic picture of the magnitude of IPV issue during (and before) COVID-19 epidemic. More focus should be given to ensure awareness of different programs and channels that are at disposal for IPV victims. Furthermore, they should strive to cultivate a society with zero tolerance for IPV with sense of responsibility to report any suspicion or witnessing of IPV.
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