Determinants and health sequelae of intimate partner violence and abuse in young adult relationships: a mixed methods study

亲密伴侣暴力和虐待（IPVA）是在亲密关系中对关系中的人造成身体、心理或性伤害的任何行为。IPVA侵犯人权，造成巨大的经济和社会代价，并日益被认为是一个重大的公共卫生问题。2016年的一项调查估计，380万英格兰和威尔士女性以及170万16-59岁的男性在生命的某个阶段经历过IPVA。6%的女性受访者和3%的男性受访者表示，仅在过去一年就有过IPVA的经历。研究表明，父母之间相互虐待的孩子，更有可能在自己的亲密成人关系中经历IPVA，并有长期的精神和身体健康问题，如抑郁、药物滥用和肥胖。但是，现有的研究规模很小，而且在诸如社会经济地位或童年受虐等重要因素方面没有很多信息。此外，大多数研究仅限于妇女（而不是男子），并侧重于IPVA的受害（而不是犯罪）。最后，大多数研究都是通过问卷调查来收集测量心理和身体健康的信息，而不是实际测量，这要准确得多。研究还表明，并非所有接触过IPVA的人，无论是父母还是自己的关系，都有精神和/或身体健康问题。但我们仍然不知道性别、童年虐待史，或者人们是否经历过IPVA的伤害、犯罪或两者兼而有之，这些因素是否会影响他们出现精神和身体健康问题的几率。这一点很重要，因为这方面的知识有助于确定可能从干预措施中获益最多的人群，以预防未来的健康问题。作为我们项目的一部分，我们计划使用我们已经收集的信息来调查这些问题，这些信息是雅芳父母和孩子纵向研究（ALSPAC）研究的一部分。ALSPAC于1990-1992年招募孕妇，在过去25年里一直跟踪她们及其子女，收集关于心理和身体健康以及经济和社会因素的各种措施的信息。这些孩子现在已经25岁了，最近参加了一项ALSPAC研究临床评估，其中包括对心理健康和心脏健康的详细评估。在22岁时，约3500名ALSPAC后代回答了一份关于亲密关系中身体、性和情感IPVA的发生、频率和影响以及父母之间IPVA的调查问卷。我们将利用这些信息以及收集到的25年来父母及其后代的详细信息，调查暴露于IPVA的年轻人的心理和身体健康状况，并确定问题风险特别高的群体。尽管这种类型的数据可能很详细，但它不能完全捕捉到IPVA的复杂和相互关联的影响，以及它对精神和心脏健康的意义。因此，我们还将对大约30名年轻人（18-22岁）进行访谈，以探索他们自己的IPVA经历，以及他们认为使自己的健康状况好转或恶化的因素。这两种类型的分析将相互补充，并提供前所未有的详细调查的原因和健康后果的IPVA的年轻人。

Intimate partner violence and abuse (IPVA) is any behaviour within an intimate relationship that causes physical, psychological, or sexual harm to those in the relationship. IPVA is a violation of human rights with enormous economic, and social costs, and is increasingly recognised as a major public health problem. A survey from 2016 estimated that 3.8 million English and Welsh women and 1.7 million men 16-59 years old have experienced IPVA at some point in their lives. Six percent of female and three percent of male respondents reported an experience of IPVA in the past year alone. Research has shown that children of parents who are abusive toward each other, are more likely to experience IPVA in their own intimate adult relationships, and have long-term mental and physical health problems such as depression, substance abuse and obesity. But existing studies have been small and have not had a lot of information on important factors such as socio-economic status or abuse in childhood. In addition, most studies have been restricted to women (not men) and have focused on IPVA victimisation (not perpetration). Finally, most studies have collected information on measures mental and physical health using questionnaires as opposed to actually measuring them, which is a lot more accurate. Research has also shown that not all people exposed to IPVA, either parental or in their own relationships, have mental and/or physical health problems. But we still don't know whether things like gender, a history of abuse in childhood, or whether people experienced IPVA victimization, perpetration or both affects their chances of mental and physical health problems. This is important because this knowledge can help to identify groups of people who may benefit most from interventions to prevent future health problems.As part of our project we plan to investigate these questions using information that we have already collected as part of the Avon Longitudinal Study of Parents and Children (ALSPAC) study. ALSPAC recruited pregnant women in 1990-1992 and has been following them and their children for the last 25 years, collecting information on a wide range of measures of mental and physical health, as well economic and social factors. The offspring are now 25 years-old and have recently participated in an ALSPAC study clinical assessment which included detailed assessment of mental health and heart health. At the age of 22, some 3,500 ALSPAC offspring answered a questionnaire about the occurrence, frequency and impact of physical, sexual and emotional IPVA in their intimate relationships as well as about IPVA between their parents. We will use this information together with the detailed information collected on both parents and their offspring over 25 years to investigate the mental and physical health of young adults exposed to IPVA and to identify groups who are at particularly high risk of problems. As detailed as it may be, this type of data cannot fully capture the complex and inter-related effects of IPVA and what it means for mental and heart health. We will therefore also conduct interviews with approximately 30 young adults (aged 18-22) to explore their own IPVA experiences, and the factors that they feel have made their own health better or worse. The two types of analyses will complement each other and provide an unprecedented detailed investigation of the causes and health consequences of IPVA in young adults.