Emotional abuse may raise risk of mental illness.(Clinical Rounds)

SCOTTSDALE, ARIZ. -- People who are emotionally and physically abused by their intimate partners develop more mental illness and substance abuse problems than those who are only physically abused, Susan Ditter, M.D., said at the annual meeting of the American Academy of Psychiatry and the Law.

"Emotional abuse is not well studied, [but] it precedes and predicts physical aggression in marriage," said Dr. Ditter, a forensic psychiatry fellow at the University of Virginia, Charlottesville. "It can occur without physical abuse, but the converse is rare."

She and her colleagues looked at data from the National Violence Against Women Survey, a random-digit-dial phone survey of households nationwide. The survey, conducted from November 1995 to May 1996, included responses from 8,000 men and 8,000 women, all aged 18 years and older. All respondents were either currently married, formerly married, or in a cohabiting heterosexual relationship. Respondents who were involved in same-sex relationships were excluded.

Dr. Ditter and her associates distinguished between two subtypes of emotional abuse: verbal abuse, which involves verbal attacks and degrading behaviors, and power-and-control abuse, in which the victim is isolated and forced into traditional sex roles. They found that 25% of men and 27% of women had experienced verbal abuse, while 12% of men and 20% of women had experienced power-and-control abuse.

The risk of emotional abuse increased in people who were low income, less educated, uninsured, unemployed, ...