Association Between Intimate Partner Violence and Suicidal Ideation Among Female and Male Adults in South Korea: A Nationally Representative Longitudinal Study

Abstract

This study sought to assess the prevalence of intimate partner violence (IPV) victimization and to examine the sex-stratified associations between IPV and suicidal ideation in South Korea. This study used nationally representative longitudinal survey data from 2011 to 2020 of the Korean Welfare Panel Study of 9732 married adults at baseline. Participants were annually asked about IPV experiences of verbal abuse, physical threat, or physical assault over the past year in 2011–2019. Suicidal ideation in the past year was assessed in the following year 2012–2020 of IPV experiences. Using multilevel logistic regression models, we examined the associations between IPV and suicidal ideation among married adults. The prevalence of verbal abuse, physical threat, and physical assault was respectively 19.8%, 3.0%, and 1.4% in females (n = 5056); and 18.8%, 2.7%, and 1.0% in males (n = 4676). After adjusting for potential confounders (e.g., lifetime suicidal ideation and random effects of individuals and households) in the same year when participants had IPV experiences, all types of IPV experiences were statistically associated with suicidal ideation in the following year among both females and males, except for physical threat among males. We found a statistically significant association between physical threat and suicidal ideation among females (adjusted odds ratio: 2.22, 95% confidence interval: 1.62, 3.04), whereas no association was observed among males. Our findings suggest that public health interventions related to suicidal behaviors that can be attributable to experiencing IPV are necessary among both females and males in South Korea.

Keywords

intimate partner violence domestic violence suicide suicidal ideation gender patriarchy South Korea

Introduction

The definition of intimate partner violence (IPV) is “physical violence, sexual violence, stalking, and psychological aggression (including coercive tactics) by a current or former intimate partner” (Breiding et al., 2015). Intimate partner violence may negatively affect a victim’s health and quality of life. Previous literature has indicated that IPV is related to adverse mental health outcomes, including depressive symptoms, anxiety, post-traumatic stress disorder, and sleep disorder (Bacchus et al., 2018; Devries et al., 2013; Dillon et al., 2013; Randle & Graham, 2011).

Particularly, several systematic reviews reported that the experience of IPV is associated with suicidal behaviors including suicidal ideation and suicide attempts (Bacchus et al., 2018; Devries et al., 2013; Lagdon et al., 2014; McLaughlin et al., 2012; ). For instance, a longitudinal study of 1750 married females in India found that IPV increased the risk of suicide attempts in the following 12 months (Chowdhary & Patel, 2008). Moreover, a study of females and males in Spain also demonstrated that participants who experienced violence from their partners reported higher levels of suicidal ideation compared to those who did not experience such violence (Ruiz-Perez et al., 2018).

However, the aforementioned studies had several limitations. First, the associations between IPV and suicidal behaviors were consistent among females, but not males (Devries et al., 2013). For example, a cross-sectional study of 4459 males in the United States (US) observed a significant association between IPV and suicide attempts (Schneider et al., 2009). However, a cross-sectional study of 1119 males, using US National Comorbidity Survey Replication data, found that the relationship of IPV experience to suicidal ideation was not statistically significant (Afifi et al., 2009). Also, the experience of IPV in post-genocide Rwanda was not associated with suicide risk for males (Umubyeyi et al., 2014). Considering these inconsistent findings in previous studies, more studies in men, as well as women, are needed.

Given that IPV is a physical or psychological trauma event that can adversely affect the mental health of both females and males (World Health Organization, 2013), it is necessary to further investigate the impact of IPV on suicidal behaviors among both females and males (Coker et al., 2002). Gender inequality can be a determinant of health. The World Health Organization has declared that harmful and unequal gender norms, roles, and unequal power relations that privilege men over women should be addressed in public health (World Health Organization, 2011). Feminist theory is the most well-known framework of IPV, which explains that sexism and gender inequality stemming from patriarchy are the main causes of IPV and adversely affect health (Dobash & Dobash, 1977; Walker, 1979; Yllö & Bograd, 1988). The theory states that patriarchy could harm men as well as women by dictating the gender role norms of men (George & Stith, 2014). However, empirical research relevant to this issue is lacking in men.

Second, most of the previous studies had a cross-sectional design, and thus cannot provide information about temporal order between IPV and suicidal behaviors (Afifi et al., 2009; Park et al., 2017; Ruiz-Perez et al., 2018; Schneider et al., 2009; Umubyeyi et al., 2014). A systematic review of empirical research reported that people with poor mental health indicators are at significantly increased risk of violent victimization (Khalifeh & Dean, 2010). To provide temporality on the association between IPV and suicidal behaviors, therefore, more studies using longitudinal datasets are needed.

In South Korea (hereafter Korea), according to the Korean government’s domestic violence report published in 2019, 28.9% of females and 26.0% of males have experienced any physical, sexual, economic, or emotional violence or control (Korean Ministry of Gender Equality and Family, 2019). A previous study of 4659 married Korean females reported a significant relationship between IPV victimization and suicidal ideation (Park et al., 2017). However, the aforementioned study was a cross-sectional design, and male samples were not included (Park et al., 2017).

Accordingly, this study used a nationally representative longitudinal dataset to examine the prevalence of IPV and suicidal ideation and to identify the association between experiences of IPV and suicidal ideation among both married females and males in Korea. In addition, this study further assessed whether this association differs by sex.

Methods

Dataset and Study Population

This study analyzed data from the Korea Welfare Panel Study (KOWEPS), which is a nationally representative longitudinal survey. The KOWEPS was launched by the Korean Institute of Social and Health Affairs with the Social Welfare Research Institute of Seoul National University. Survey data were collected through person-to-person interviews by visiting each household. In 2006 (1^st wave), 18,856 participants from 7072 households residing in Korea participated. In 2012 (7^th wave), 1800 new households were added to replenish participants who were lost to follow-up during 2006–2011. Data from 2006 through 2020 of KOWEPS have been publicly released from the website (www.koweps.re.kr). The follow-up rate was 54.65% of the original households in 2020.

Our analysis included participants from 2011 to 2020 of the KOWEPS because measurements of lifetime suicidal ideation and past-year suicidal ideation were included in 2011 and 2012 for the first time, respectively. We found 25,733 participants in 8329 households who met the eligibility criteria for married adults at the time of the survey. Among them, participants who did not respond to three IPV questions (n = 13,666), participants who have any missing information in covariates (n = 1603), lifetime suicidal ideation variable (n = 1670), and suicidal ideation over the past year (n = 661) were excluded. The overall sample size was 9732 participants (52.0% females and 48.0% males) in 4757 households at baseline. Because each participant has a different year of first participation in the analysis, each participant’s baseline is different. A total of 63,756 observations (52.8% females and 47.3% males) nested in 9732 participants were used in the main analysis.

To measure the occurrence of suicidal ideation in the following year of IPV experience, information about suicidal ideation was collected the following year, that is, 2012–2020, after the IPV experiences reported in 2011–2019. For example, if IPV as the exposure variable was measured in 2011, suicidal ideation as the outcome variable was measured in 2012 (Figure 1).

Figure 1.

Flow-chart of study population selection from the Korean Welfare Panel Study 2011–2020 (6th – 15th waves).

Measures

Intimate partner violence

Experiences of IPV were measured using three questions, “In the past year, has your partner: (a) made insulting, malicious remarks about you? (b) threatened to hit or use physical violence like throwing things? or (c) used physical assault against you?” Responses were defined respectively as (a) verbal abuse, (b) physical threat, and (c) physical assault. For each of these questions, respondents could answer with an ordinal scale as follows: (1) not experienced, (2) 1–2 times, (3) 3–5 times, (4) more than 6 times, (5) not applicable (e.g., bereavement, divorce, or unmarried). Respondents who answered, “not applicable,” were excluded from the study population. This study categorized responses of IPV (1) as “not experienced,” and (2) to (4) as “experienced.” If any of the three violent scenarios had been experienced, we classified them as having experienced any IPV. The reference group for each type of IPV was a group that had not experienced any IPV. Intimate partner violence was measured in 2011–2019 (6^th–14^th wave). Intimate partner violence was measured one year before suicidal ideation which is an outcome variable, to give a time lag of 1-year.

Suicidal ideation

Suicidal ideation was measured by the question “Have you ever seriously considered dying by suicide during the past year?” with the response options “yes” or “no.” Suicidal ideation over the past year was measured in 2012–2020, the following year when the respondent reported IPV experience (2011–2019). For instance, if IPV experience was measured in 2011, information on suicidal ideation was obtained in 2012.

Covariates

Age was classified as 19–29, 30–39, 40–49, 50–59, 60–69, and ≥70 years old. The residential area was divided into urban and rural areas. Educational level was classified into four categories: junior high or less, high school graduate, college graduate, and university graduate or more. Employment status was classified into seven categories: permanent employment, precarious employment, business owner, self-employed, unpaid family worker, unemployed, and economically inactive. An equalized household income which was calculated by dividing the sum of annual household income by the square root of the number of household members was classified as a quartile. A dummy variable that indicates the year (2011–2019) each participant entered the analysis and was used to adjust for potential confounding over time. Covariates were measured in 2011–2019, the same year as the IPV, which is the exposure variable.

Lifetime suicidal ideation was also included in the analyses with the following yes/no question: “Have you ever seriously considered dying by suicide in your lifetime?” Lifetime suicidal ideation was assessed when participants first entered the analysis of this study. For example, if participants first participated in the survey in 2011, their lifetime suicidal ideation was assessed in 2011 only and then past-year suicidal ideation was annually measured every year thereafter. We combined the lifetime suicidal ideation with past-year suicidal ideation up to the year used in the study.

Data Analysis

Chi-square tests were used to compare the distribution of past-year suicidal ideation, verbal abuse, physical threat, and physical assault across covariates in the baseline that participants first enrolled in the analysis. Since we used the hierarchical structure dataset that repeatedly measures individuals nested in a household, two kinds of correlations could occur: (1) clustering among individuals from the same household, and (2) autocorrelation due to the within-subject correlation of responses on dependent variables when using a repeated measures longitudinal dataset. Multiple multilevel logistic regression models (Merlo et al., 2006; Wong & Mason, 1985) were fitted to examine the association between IPV experience and suicidal ideation in the following year of IPV among married females and males after adjusting for potential confounders (i.e., age, residential area, educational level, employment status, household income, year, lifetime suicidal ideation, and random effect of individuals and households). Data are reported as odds ratio (OR) with 95% confidence interval (CI). All analyses were performed using STATA/MP version 16.0 (Stata Corp, College Station, TX, USA).

Results

Table 1 presents the prevalence of past-year suicidal ideation, verbal abuse, physical threat, and physical assault for each covariate at baseline. Among 9732 Korean married adults at baseline included in our analysis, the overall prevalence was 2.9% for suicidal ideation, 19.3% for verbal abuse, 2.9% for physical threat, and 1.2% for physical assault. Experience of suicidal ideation appeared to be more common among participants with older age, lower education level, those who were unemployed, and participants with lower income, compared to their respective counterparts. Furthermore, 10.9% of participants with lifetime suicidal ideation had suicidal ideation over the past year. All types of IPV were significantly different by age, employment status, household income, and lifetime suicidal ideation, but not by sex. Specifically, all three types of IPV were frequent among those who were 40–49 years old, were precarious employees or, business owners had a lower household income, and reported lifetime suicidal ideation.

Table 1.

Distribution of the Study Population and Prevalence of Suicidal Ideation, Verbal Abuse, Physical Threat, and Physical Assault by Key Covariates Among Female and Male Adults in South Korea, at Baseline.

	Distribution	Experience of suicidal ideation over the past year^a		Experience of IPV over the past year^b
	Distribution	Experience of suicidal ideation over the past year^a		Verbal abuse		Physical threat		Physical assault
	N (%)	N (%)	P-value^c	N (%)	P-value^c	N (%)	P-value^c	N (%)	P-value^c
Total	9732 (100.0)	283 (2.9)		1881 (19.3)		277 (2.9)		118 (1.2)
Sex			0.293		0.222		0.387		0.072
Female	5056 (52.0)	160 (3.2)		1001 (19.8)		151 (3.0)		71 (1.4)
Male	4676 (48.1)	131 (2.8)		880 (18.8)		126 (2.7)		47 (1.0)
Age (years)			<0.001		<0.001		0.002		0.002
19–29	482 (5.0)	10 (2.1)		89 (18.5)		18 (3.7)		9 (1.9)
30–39	2071 (21.3)	33 (1.6)		403 (19.5)		63 (3.0)		19 (0.9)
40–49	1910 (19.6)	53 (2.8)		434 (22.7)		76 (4.0)		39 (2.0)
50–59	1718 (17.7)	49 (2.9)		367 (21.4)		47 (2.7)		21 (1.2)
60–69	1821 (18.7)	73 (4.0)		337 (18.5)		40 (2.2)		19 (1.0)
≥70	1730 (17.8)	73 (4.2)		251 (14.5)		33 (1.9)		11 (0.6)
Residential area			0.571		0.005		0.664		0.118
Urban	7662 (78.7)	233 (3.0)		1436 (18.7)		221 (2.9)		86 (1.1)
Rural	2070 (21.3)	58 (2.8)		445 (21.5)		56 (2.7)		32 (1.6)
Educational level			<0.001		<0.001		0.037		0.204
Junior high school or less	3969 (40.8)	171 (4.3)		773 (19.5)		121 (3.1)		54 (1.4)
High school graduate	3196 (32.8)	83 (2.6)		678 (21.2)		103 (3.2)		43 (1.4)
College graduate	777 (8.0)	8 (1.0)		146 (18.8)		19 (2.5)		7 (0.9)
University graduate or more	1790 (18.4)	29 (1.6)		284 (15.9)		34 (1.9)		14 (0.8)
Employment status			<0.001		<0.001		0.001		0.005
Permanent employment	2063 (21.2)	20 (1.0)		345 (16.7)		47 (2.3)		16 (0.8)
Precarious employment	1807 (18.6)	59 (3.3)		419 (23.2)		71 (3.9)		36 (2.0)
Business owner	201 (2.1)	3 (1.5)		48 (23.9)		8 (4.0)		4 (2.0)
Self-employed	1493 (15.3)	39 (2.6)		301 (20.2)		33 (2.2)		14 (0.9)
Unpaid family worker	736 (7.6)	22 (3.0)		132 (17.9)		8 (1.1)		3 (0.4)
Unemployed	75 (0.8)	4 (5.3)		13 (17.3)		1 (1.3)		1 (1.3)
Economically inactive	3357 (34.5)	144 (4.3)		623 (18.6)		109 (3.3)		44 (1.3)
Household income			<0.001		<0.001		0.001		0.005
Less than 1Q	2082 (21.4)	112 (5.4)		424 (20.4)		72 (3.5)		32 (1.5)
1Q–2Q	2584 (26.6)	84 (3.3)		574 (22.2)		93 (3.6)		43 (1.7)
2Q–3Q	2730 (28.1)	56 (2.1)		507 (18.6)		65 (2.4)		27 (1.0)
Greater than 3Q	2336 (24.0)	39 (1.7)		376 (16.1)		47 (2.0)		16 (0.7)
Lifetime suicidal ideation			<0.001		<0.001		<0.001		<0.001
Not experienced	8646 (88.8)	173 (2.0)		1522 (17.6)		192 (2.2)		70 (0.8)
Experienced	1086 (11.2)	118 (10.9)		359 (33.1)		85 (7.8)		48 (4.4)

Note. IPV = intimate partner violence.

^a Suicidal ideation over the past year was measured in the following year (2012–2020) when the respondent reported IPV experience (2011–2019). For example, if a participant experienced IPV in 2019, suicidal ideation was measured in 2020.

^b Experiences of IPV over the past year were measured in 2011–2019. The first report of IPV experience was taken as the ‘baseline’ for the individual, such that each respondent had a different baseline.

^c p-value were calculated using the chi-square test, comparing the prevalence of suicidal ideation and the experience of IPV across the different groups at baseline.

After adjusting for potential confounders including random effects of individual and household, the sex-stratified associations between experiences of IPV and suicidal ideation among female and male adults were shown in Table 2. We found statistically significant associations of suicidal ideation with any IPV, verbal abuse, and physical assault in both females and males, but not with physical threat. In female participants, any IPV (adjusted odds ratio [aOR]: 1.68, 95% CI: 1.44, 1.97), verbal abuse (aOR: 1.68, 95% CI: 1.44, 1.97), physical threat (aOR: 2.24, 95% CI: 1.63, 3.07), and physical assault (aOR: 2.56, 95% CI: 1.66, 3.96) were significantly associated with suicidal ideation. Any IPV (aOR: 1.56, 95% CI: 1.29, 1.89), verbal abuse (aOR: 1.56, 95% CI: 1.29, 1.89), and physical assault (aOR: 2.57, 95% CI: 1.38, 4.76) were significantly associated with suicidal ideation among male participants, whereas there was no association between physical threat and suicidal ideation.

Table 2.

Association Between Experiences of IPV and Suicidal Ideation Among Female and Male Adults in South Korea.

Experience of IPV	Female		Male
Experience of IPV	aOR	95% CI	aOR	95% CI
Any IPV
not experienced^a	1	reference	1	reference
experienced	1.68***	(1.44, 1.97)	1.56***	(1.29, 1.89)
Verbal abuse
not experienced^a	1	reference	1	reference
experienced	1.68***	(1.44, 1.97)	1.56***	(1.29, 1.89)
Physical threat
not experienced^a	1	reference	1	reference
experienced	2.24***	(1.63, 3.07)	1.55	(0.97, 2.48)
Physical assault
not experienced^a	1	reference	1	reference
experienced	2.56***	(1.66, 3.96)	2.57**	(1.38, 4.76)

Note. IPV = intimate partner violence.

**p< 0.01; ***p< 0.001

Adjusted for demographic variables (i.e., age and residential area), socioeconomic status variables (i.e., household income, educational level, and employment status), lifetime suicidal ideation, year, and random effect of household members and households.

^a The reference group is those who have never experienced any IPV. For example, participants who experienced physical threat or physical assault, but not verbal abuse were excluded from the analysis about verbal abuse. The same exclusion was applied to the analysis of physical threat or physical assault.

Discussion

Using a nationally representative longitudinal dataset, this study found that 19.8%, 3.0%, and 1.4% in females (n = 5056); and 18.8%, 2.7%, and 1.0% in males (n = 4676) reported verbal abuse, physical threat, and physical assault during the past year, respectively. Our findings are consistent with a previous study that showed females and males had similar IPV prevalence (Archer, 2000; Holtzworth-Munroe, 2005; Lagdon et al., 2014). After adjusting for potential confounders, we found that experiences of any IPV, verbal abuse, and physical assault within the past year were significantly associated with suicidal ideation over the past year in the following year of IPV experience among Korean married adult females and males. Furthermore, the physical threat was also associated with suicidal ideation in female adults, but not male adults. These results are consistent with most previous studies reporting that IPV may aggravate suicidal behaviors (Afifi et al., 2009; Ruiz-Perez et al., 2018; Schneider et al., 2009; Umubyeyi et al., 2014).

Traumatic and psychological stress reactions are considered to be the mechanisms that explain why IPV as a physical or psychological trauma event may cause subsequent suicidal behaviors including suicidal ideation and suicide attempt among both females and males. Physical injury after experiencing IPV causes musculoskeletal, soft tissue, and genital trauma which can worsen mental health (World Health Organization, 2013). Psychological stress can lead to the inability to avoid violent situations as well as fear and isolation, which can contribute to worse mental health outcomes, including suicidal behaviors (Devries et al., 2013; World Health Organization, 2013).

The findings from existing studies examining the association between IPV and suicidal behaviors in males are controversial (Afifi et al., 2009; Ruiz-Perez et al., 2018; Schneider et al., 2009; Umubyeyi et al., 2014). In the current study, males who have experienced IPV were more likely to have suicidal ideation, compared to males without such experience. For males, there may be other additional specific pathways that become stressors along with traumatic and psychological stress reactions. The situations in which men are perceived as violating the norms of masculinity by being assaulted by their woman spouses can be another potential social stressor affecting their mental health. Generally, masculine gender norms mean being tough, brave, aggressive, engaged in some risk-taking behaviors, and not caring for one’s body (Courtenay, 2000; Sen et al., 2007; Vogel et al., 2011). When men become victims of women’s aggression, it can be seen as violating the norms of masculinity (Scarduzio et al., 2017). Moreover, in men, dominant masculine norms aggravate self-stigma and make it difficult to seek help (Vogel et al., 2011). When men who are assaulted seek help, they may not receive the help they need (Jina et al., 2020) because there has been a lack of domestic violence support services for men (Bates, 2020; Brooks et al., 2020). Also, men may be suspected of being liars or even perpetrators of IPV when seeking help after experiencing violence (Dutton & White, 2013). The feminist theory explains that sexism and gender inequality caused by patriarchy was responsible for IPV and explain poor health status due to IPV (Dobash & Dobash, 1977; Walker, 1979; Yllö & Bograd, 1988). The theory suggests that the harmful masculinity of dominating or exercising power over women can harm not only women but also men (George & Stith, 2014; Sen et al., 2007). In particular, this explanation can be emphasized in Korea, where patriarchal social traditions (Brown, 2014) and the Confucian ideology of man’s superiority (Soh, 1993) are highly prevalent.

Although this study only included married adults as the study population using a secondary dataset, findings from this study may have some implications for people who are not married. Unmarried people also reported violence victimization from their intimate partners (Ackard et al., 2003). One of the features of intimate partner abuse is fear, entrapment, and feelings of inability to escape from violent situations, which could contribute to increased adverse mental health outcomes (Devries et al., 2013). Marriage relationships make it difficult to separate from each other because married people are more likely to live together or be legally bound, which can lead to lasting reactions to traumatic events. Dating relationships without cohabitation are less likely to be chronically exposed to IPV (Devries et al., 2013), but cohabiting dating relationships may not be much different from marriage. Furthermore, since our findings were based among females and males who were in legal marriage in South Korea where same-sex marriage is not yet legally recognized, interpretation of our findings needs to be cautious when applying these findings to couples other than in heterosexual relationships. Therefore, it is necessary to add questions asking sexual orientation in the nationally representative survey in Korea to investigate IPV experiences in non-heterosexual relationships.

This study found that both female and male victims who experienced IPV by their spouses were more likely to have suicidal ideation than those who never experienced IPV. Since harmful masculinity leads to the exercise of power or dominance over women, which could harm men as well as women (Sen et al., 2007), the fundamental way to break the link between IPV and suicidal ideation could be based on institutional interventions aimed at changing the social structure that emphasizes gender norms. In addition, compared to women, men have less experience in seeking help from domestic violence counseling centers or shelters for victims of spousal violence in Korea (Korean Ministry of Gender Equality and Family, 2019). In particular, the support system for victims of violence in Korea is designed mainly for women, making it difficult for men to receive support due to low awareness of institutions, and there are few emergency shelters or protective facilities for men (Lee et al., 2017). Intimate partner violence is a crime that violates individual safety and human rights, and it is necessary to create an environment that victims can receive appropriate protection and support, regardless of gender.

Limitations and Strengths

This study had a few limitations. First, because the experiences of IPV and suicidal ideation were assessed through in-person interviews, underestimation may have occurred due to concerns over negative perceptions by the interviewer. The sensitive nature of the topic can be a social barrier to obtaining accurate data (Breiding et al., 2015). Also, considering the relatively high rate of missing data among study participants including suicidal ideation over the past year (n = 11,207) and lifetime suicidal ideation (n = 10,847), there could be a possibility of selection bias. For example, those who had severe suicidal behaviors might refuse the relevant questions to avoid reporting their suicidality, which could influence the estimate of the association between IPV and suicidal ideation. Lastly, another potential selection bias may have existed. For instance, participants with severe violent experiences may not have participated in the follow-up survey.

This study also had notable strengths. First, this study included a large study population of married male and female adults from nationally representative datasets of Korea, which makes this study have adequate statistical power. Second, this study may be less vulnerable to potential reverse causation because it used a longitudinal dataset and adjusted lifetime suicidal ideation. Lifetime suicidal ideation is an important confounder that could influence future suicidal behaviors and health status. People with chronic mental disorders are not only at increased risk of all forms of IPV but are also more likely to suffer poor mental health such as suicide attempts (Khalifeh et al., 2015; Ruiz-Perez et al., 2018). However, our study established a temporal order for IPV and suicidal ideation.

Conclusions

Using a nationally representative longitudinal survey, the current study has documented IPV experiences in both females and males, considering that most of the previous studies only focused on females. We also found statistically significant associations between IPV and suicidal ideation in both females and males, after adjusting for potential confounders including lifetime suicidal ideation. Our findings suggest that IPV should be prevented, and interventions related to poor mental health that can occur after experiencing IPV are necessary among both females and males.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs

Ranyeong Kim

Jooyoung Park

Author Biographies

Ranyeong Kim, BA, is a PhD candidate of the Department of Public Health Sciences at Korea University. She received a bachelor’s degree in philosophy and psychology and certified youth counselor in South Korea. Her research focuses on the social determinants of health and investigating the health impact of violence and discrimination.

Jaehong Yoon received his PhD degree in Public Health Sciences from Korea University. His research focuses on the application of advanced methods to public health.

Ji-Hwan Kim received his PhD degree in Public Health Sciences from Korea University. His research focuses on the workers' health and its determinant including discrimination, violence, job insecurity, and presenteeism.

Hyemin Lee, MPH, PhD, received her doctoral degree in health policy and management from Korea University in 2022. Her research interests include health disparities and social determinants of health among sexual and gender minority populations. Since 2014, she has joined the Rainbow Connection Project, a series of studies on the health of sexual and gender minority individuals in South Korea.

Jooyoung Park, PhD, is a leading researcher in the Jeju Institute of Public Health and Health Policy. Her research identifies health disparity among marginalized populations such as precarious workers and sexual minorities. She is concerned to investigate how people’s health may deteriorate while unemployed or bullied in their school or workplace as well as improve policy development for health equity.

Seung-Sup Kim MD, MPH, ScD is an associate professor in the Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University and a visiting scientist in the Department of Social and Behavioral Sciences at the Harvard T. H. Chan School of Public Health. His research focuses on occupational safety and health among the vulnerable working population in South Korea.

References

Ackard

D. M.

Neumark-Sztainer

Hannan

(2003). Dating violence among a nationally representative sample of adolescent girls and boys: associations with behavioral and mental health. The Journal of Gender-specific Medicine, 6(3), 39–48.

Afifi

T. O.

MacMillan

Cox

B. J.

Asmundson

G. J.

Stein

M. B.

Sareen

(2009). Mental health correlates of intimate partner violence in marital relationships in a nationally representative sample of males and females. Journal of Interpersonal Violence, 24(8), 1398–1417. https://doi.org/10.1177/0886260508322192

Archer

(2000). Sex differences in aggression between heterosexual partners: a meta-analytic review. Psychological Bulletin, 126(5), 651–680. https://doi.org/10.1037/0033-2909.126.5.651

Bacchus

L. J.

Ranganathan

Watts

Devries

(2018). Recent intimate partner violence against women and health: a systematic review and meta-analysis of cohort studies. BMJ Open, 8(7), e019995. https://doi.org/10.1136/bmjopen-2017-019995

Bates

E. A.

(2020). “No one would ever believe me”: An exploration of the impact of intimate partner violence victimization on men. Psychology of Men & Masculinities, 21(4), 497–507. https://doi.org/10.1037/men0000206

Breiding

M. J.

Basile

K. C.

Smith

S. G.

Black

M. C.

Mahendra

R. R.

(2015). Intimate partner violence surveillance: Uniform definitions and recommended data elements. Version 2.0. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

Brooks

Martin

Broda

Poudrier

(2020). “How many silences are there?” Men’s experience of victimization in intimate partner relationships. Journal of Interpersonal Violence, 35(23–24), 5390–5413. https://doi.org/10.1177/0886260517719905

Brown

(2014). Factors related to domestic violence in Asia: The conflict between culture and patriarchy. Journal of Human Behavior in the Social Environment, 24(7), 828–837. https://doi.org/10.1080/10911359.2014.884962

Chowdhary

Patel

(2008). The effect of spousal violence on women’s health: findings from the Stree Arogya Shodh in Goa, India. Journal of Postgraduate Medicine, 54(4), 306–312. https://doi.org/10.4103/0022-3859.43514

10.

Coker

A. L.

Davis

K. E.

Arias

Desai

Sanderson

Brandt

H. M.

Smith

P. H.

(2002). Physical and mental health effects of intimate partner violence for men and women. American Journal of Preventive Medicine, 23(4), 260–268. https://doi.org/10.1016/s0749-3797(02)00514-7

11.

Courtenay

W. H.

(2000). Constructions of masculinity and their influence on men’s well-being: A theory of gender and health. Social Science & Medicine, 50(10), 1385–1401. https://doi.org/10.1016/s0277-9536(99)00390-1

12.

Devries

K. M.

Mak

J. Y.

Bacchus

L. J.

Child

J. C.

Falder

Petzold

Astbury

Watts

C. H.

(2013). Intimate partner violence and incident depressive symptoms and suicide attempts: A systematic review of longitudinal studies. Plos Medicine, 10(5), e1001439. https://doi.org/10.1371/journal.pmed.1001439

13.

Dillon

Hussain

Loxton

Rahman

(2013). Mental and physical health and intimate partner violence against women: A review of the literature. International Journal of Family Medicine, 2013(5), 313909. https://doi.org/10.1155/2013/313909

14.

Dobash

R. E.

Dobash

R. P.

(1977). Wives: The appropriate victims of marital violence. Victimology, 2(3–4), 426–442.

15.

Dutton

D. G.

White

K. R.

(2013). Male victims of domestic violence. New Male Studies: An International Journal, 2(1), 5–17. https://www.newmalestudies.com/OJS/index.php/nms/article/view/59

16.

George

Stith

S. M.

(2014). An updated feminist view of intimate partner violence. Family Process, 53(2), 179–193. https://doi.org/10.1111/famp.12073

17.

Holtzworth-Munroe

(2005). Male versus female intimate partner violence: Putting controversial findings into context. Journal of Marriage and Family, 67(5), 1120–1125. https://doi.org/10.1111/j.1741-3737.2005.00203.x

18.

Jina

Machisa

Labuschagne

Vetten

Loots

Jewkes

(2020). Unspoken victims: A national study of male rape incidents and police investigations in South Africa. The South African Medical Journal, 110(9), 926–931. https://doi.org/10.7196/SAMJ.2020.v110i9.14525

19.

Khalifeh

Dean

(2010). Gender and violence against people with severe mental illness. International Review of Psychiatry, 22(5), 535–546. https://doi.org/10.3109/09540261.2010.506185

20.

Khalifeh

Oram

Trevillion

Johnson

Howard

L. M.

(2015). Recent intimate partner violence among people with chronic mental illness: findings from a national cross-sectional survey. The British Journal of Psychiatry, 207(3), 207–212. https://doi.org/10.1192/bjp.bp.114.144899

21.

Korean Ministry of Gender Equality and Family (2019). The domestic violence survey in 2019. Ministry of Gender Equality and Family.

22.

Lagdon

Armour

Stringer

(2014). Adult experience of mental health outcomes as a result of intimate partner violence victimisation: A systematic review. European Journal of Psychotraumatology, 5(1), 24794. https://doi.org/10.3402/ejpt.v5.24794

23.

Lee

M. J.

Jung

S. Y.

Yang

H. L.

(2017). Sexual violence and domestic violence male victims support status and policy task. Korean Women's Development Institute.

24.

McLaughlin

O'Carroll

R. E.

O’Connor

R. C.

(2012). Intimate partner abuse and suicidality: A systematic review. Clinical Psychology Review, 32(8), 677–689. https://doi.org/10.1016/j.cpr.2012.08.002

25.

Merlo

Chaix

Ohlsson

Beckman

Johnell

Hjerpe

Råstam

Larsen

(2006). A brief conceptual tutorial of multilevel analysis in social epidemiology: Using measures of clustering in multilevel logistic regression to investigate contextual phenomena. Journal of Epidemiology & Community Health, 60(4), 290–297. https://doi.org/10.1136/jech.2004.029454

26.

Park

G. R.

Park

E. J.

Jun

Kim

N. S.

(2017). Association between intimate partner violence and mental health among Korean married women. Public Health, 152, 86–94. https://doi.org/10.1016/j.puhe.2017.07.023

27.

Randle

A. A.

Graham

C. A.

(2011). A review of the evidence on the effects of intimate partner violence on men. Psychology of Men & Masculinity, 12(2), 97–111. https://doi.org/10.1037/a0021944

28.

Ruiz-Perez

Rodriguez-Barranco

Cervilla

J. A.

Ricci-Cabello

(2018). Intimate partner violence and mental disorders: Co-occurrence and gender differences in a large cross-sectional population based study in Spain. Journal of Affective Disorders, 229, 69–78. https://doi.org/10.1016/j.jad.2017.12.032

29.

Scarduzio

J. A.

Carlyle

K. E.

Harris

K. L.

Savage

M. W.

(2017). “Maybe she was provoked” exploring gender stereotypes about male and female perpetrators of intimate partner violence. Violence Against Women, 23(1), 89–113. https://doi.org/10.1177/1077801216636240

30.

Schneider

Burnette

M. L.

Ilgen

M. A.

Timko

(2009). Prevalence and correlates of intimate partner violence victimization among men and women entering substance use disorder treatment. Violence and Victims, 24(6), 744–756. https://doi.org/10.1891/0886-6708.24.6.744

31.

Sen

Östlin

George

(2007). ‘Unequal, unfair, ineffective and inefficient. Gender inequity in health: Why it exists and how we can change it,’ final report to the WHO commission on social determinants of health. World Health Organization. Women and Gender Equality Network.

32.

Soh

C. H. S.

(1993). Sexual equality, male superiority, and Korean women in politics: Changing gender relations in a “patriarchal democracy”. Sex Roles, 28(1), 73–90. https://doi.org/10.1007/bf00289748

33.

Umubyeyi

Mogren

Ntaganira

Krantz

(2014). Intimate partner violence and its contribution to mental disorders in men and women in the post genocide Rwanda: findings from a population based study. BMC Psychiatry, 14(1), 315. https://doi.org/10.1186/s12888-014-0315-7

34.

Vogel

D. L.

Heimerdinger-Edwards

S. R.

Hammer

J. H.

Hubbard

(2011). “Boys don't cry”: Examination of the links between endorsement of masculine norms, self-stigma, and help-seeking attitudes for men from diverse backgrounds. Journal of Counseling Psychology, 58(3), 368–382. https://doi.org/10.1037/a0023688

35.

Walker

L. E.

(1979). The battered woman. Harper & Row.

36.

Wong

G. Y.

Mason

W. M.

(1985). The hierarchical logistic regression model for multilevel analysis. Journal of the American Statistical Association, 80(391), 513–524. https://doi.org/10.1080/01621459.1985.10478148

37.

World Health Organization (2011). Gender mainstreaming for health managers: A practical approach. : World Health Organization.

38.

World Health Organization (2013). Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. : WHO, Sexual and Reproductive Health and Research team.

39.

Yllö

Bograd

M. E.

(1988). Feminist perspectives on wife abuse. Paper presented at the national conference for family violence researchers. 2nd, 1984.