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Cited by 37Intimate Partner and Family ViolencePosttraumatic Stress Disorder ResearchChild Abuse and Trauma

Trauma exposure and IPV experienced by Afghan women: Analysis of the baseline of a randomised controlled trial

Open access
Jewkes, Rachel, Corboz, Julienne, Gibbs, Andrew·2018·PLOS ONE
DOI 10.1371/journal.pone.0201974PMC PMC6179202
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Abstract

BACKGROUND: Four decades of conflict has indelibly impacted the lives of Afghans, exposing many to different forms of trauma. The aim of this paper investigate a hypothesis that (mostly war related) trauma is a key driver of partner violence in Afghanistan. METHODS: 1,463 women aged 18-48 were recruited into a randomised controlled trial (RCT) to evaluate a women empowerment intervention in 8 villages of Kabul and Nangarhar provinces. The women were interviewed at baseline. The analysis uses multivariable logistic regression and structural equation modelling (SEM) to describe relationships between measures. RESULTS: 57.4% of women reported exposure to one of four types of trauma: 23.3% an armed attack, 39.4% had felt close to death, 10.6% witnessed a friend or family member being killed and 21.4% witnessed the death of a stranger or someone unknown. Trauma exposure was associated with being older, Pashtan, madrassa educated, and food insecure. Women who were trauma exposed were more likely to have ever experienced IPV, have hit their children in the last 4 weeks, and be hit by a sibling or relative of their husband or their mother-in-law in the last year. They held less patriarchal personal gender attitudes and perceived the community to be more patriarchal. The SEM showed that all pathways between trauma exposure and IPV were ultimately mediated by either (mostly mental) ill-health or quarrelling, but not both of these. There were multiple paths through which trauma exposure impacted women's past year experience of physical IPV. One was mediated by childhood trauma exposure and a latent variable for ill health. Other paths were mediated by women's education and personal gender attitudes and ill-health, or else by quarrelling. Trauma exposure was related to lower educational levels. Another path was mediated by less patriarchal personal gender attitudes and ill health. Community gender attitudes was a mediating variable on a path which was also mediated by ill health and another mediated by quarrelling. It was also a mediator on a path which included personal gender attitudes and ill-health. Food insecurity mediated another path with ill health. It was also connected to childhood trauma, community gender attitudes and educational level. CONCLUSION: Trauma exposure due to conflict will persist until the conflict ends but the impact on women can be ameliorated. This analysis suggests interventions to reduce women's exposure to IPV should focus on reducing poverty, changing social norms on gender, providing relationship skills to help reduce quarrelling and supporting women's mental health.

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  • Previous studies have highlighted higher rate of psychological disorder symptoms, including PTSD, among Afghan women compared to men.

    “Previous studies have also highlighted the higher rate of psychological disorder symptoms, including PTSD, among Afghan women compared to men (Jewkes et al., 2018; Paiman et al., 2019; Tomlinson et al., 2020; Kovess-Masfety et al., 2021).”

    From Traumatic Events, Post-Traumatic Stress Disorder, and Post-Traumatic Growth among University Students in Kabul City (2025) · cites this paper as Jewkes et al., 2018

    The Results report higher depressive and PTSD symptom scores among Afghan women with trauma exposure than among women without it. The paper does not compare women’s symptom rates with men’s, so it does not support the claimed gender difference. (LLM, conf=0.84)

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Authors
Jewkes, R., Corboz, J., & Gibbs, A.
Affiliations
South African Medical Research Council (ZA)
Corresponding author
Jewkes, Rachel
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2018-10-10
Volume
13
Issue
10
Pages
e0201974
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0201974
PMC
PMC6179202
OpenAlex
W2896335122
Cited by
36
References
35
Citations by year
2025: 5 · 2024: 2 · 2023: 7 · 2022: 8 · 2021: 5 · 2020: 4 · 2019: 2 · 2012: 3
FWCI
2.94
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • Department for International Development
  • South African Medical Research Council
Topics
  • Social Sciences › Health › Intimate Partner and Family Violence
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords
trauma exposure, intimate partner violence, war trauma, Afghan women, women's empowerment, gender attitudes, food insecurity, childhood trauma, mental illness, women's education, armed conflict, mediation pathways, Kabul, Nangarhar, Pashtun women
MeSH terms
Intimate Partner Violence, Adolescent, Adult, Afghanistan, Attitude, Family Characteristics, Female, Humans, Middle Aged, Power, Psychological, Risk Factors, Sexual Partners, Wounds and Injuries, Logistic Models, Spouses, Young Adult, Social Norms

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