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J Nerv Ment Dis. Author manuscript; available in PMC 2022 January 01.
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Published in final edited form as:

J Nerv Ment Dis. 2021 January ; 209(1): 71–75. doi:10.1097/NMD.0000000000001255.

The Prevalence of Intimate Partner Violence and Association

with Depression in University Students: Results of a Cross-
sectional Study
Arif Musa, MS1, Alfonso J Valdez, PhD2, Jose L Aguilar, MD3, Kasim Pendi, BS4, Kate B
Wolitzky-Taylor, PhD5, Danny Lee, BS, BA6, Joshua Lee, BS6, David Safani, MD, MBA7
1School of Medicine, Wayne State University, Detroit, MI 48201, USA
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2Department of Sociology, University of California Irvine, Irvine, CA 92697, USA

3Department of Psychiatry, University of California Riverside, Riverside, CA 92521, USA
4School of Professional Studies, Southern California University of Health Sciences, Whittier, CA
90604, USA
5Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los
Angeles, CA 90095, USA
6School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA
7Department of Psychiatry and Human Behavior, University of California Irvine, Orange, CA
92868, USA
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Abstract
The purpose of this cross-sectional study was to determine the prevalence of IPV among university
students, investigate potential predictors of IPV in this population, and study the link between IPV
and depression. The survey included socio-demographic, relationship quality, and depression
related questions. From 498 respondents, prevalence of IPV was 4.8%, depression was 30.9%, and
suicidal ideation was 20.3%. After adjusting for co-variates and confounders, relationship
satisfaction (OR=0.201, 95% CI: 0.101 to 0.401, p<0.001) and jealousy (OR=0.270, 95% CI:
0.094 to 0.776, p=0.015) were significant predictors of IPV. Relationship satisfaction predicted
depressive disorders (OR=0.504, 95% CI: 0.365 to 0.698, p<0.001). IPV trended towards
predicting presence of a depressive disorder (OR=0.436, 95% CI: 0.170 to 1.113, p=0.083).
Relationship satisfaction and jealousy predicted IPV. Although IPV did not predict depression,
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poor relationship satisfaction increased odds of depression, implicating the influence of

relationship satisfaction on both IPV and depression.

Keywords
relationship satisfaction; intimate partner violence; depression; depressive disorder

Corresponding Author: Arif Musa at the Wayne State University School of Medicine, 320 E Canfield Ave, Detroit, MI 48201, USA.
Telephone: (313) 577-1450. gm3180@wayne.edu.
Disclosures: The authors declare no conflicts of interest.
 Musa et al. Page 2

Introduction
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Intimate partner violence (IPV) is of considerable concern in the university setting.

However, previous reports to document rates of physical abuse among intimate partners have
been limited by small sample sizes and conflicting results. Furthermore, several studies lack
data from male students or restricted data collection to undergraduate students. For example,
Lewis and Fremouw described intimate partner abuse in one of three college couples (Lewis
and Fremouw, 2001). By comparison, Kaukinen, Gover, & Hartman reported that 27% of
female college students experienced some form of dating violence (Kaukinen et al., 2012).
Studying rates of IPV among males and females, and among undergraduate and graduate
students, is necessary to lead grounded efforts to prevent and address IPV in the university
setting.

More than physical injury, IPV can also cause deterioration in mental health and even lead to
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the development of major psychopathology (Sugg et al., 2015). In fact, Lagdon, Armour, &
Stringer reported a significant association between IPV and both anxiety and depression in a
systematic review of the literature (Lagdon et al., 2014). Although, the relationship between
IPV and poor mental health outcomes has been previously documented, research in college
students has produced conflicting findings, been limited by small sample sizes, or lacked
data from male students (Sugg et al., 2015; Kamimura et al., 2016; Kamimura et al., 2016;
Garner and Sheridan, 2017; Christopher and Kisler, 2012). College students have high rates
of anxiety and depressive disorders as well as other mental disorders but often do not seek
treatment (Pendi et al., 2015; Eisenberg et al., 2007; Zivin et al., 2009). Therefore,
investigating the potential link between IPV and mental disorders among college/university
students is paramount in order to better understand the etiological factors associated with
psychopathology and spur efforts to screen for these problems on-campus.
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In order to address these issues, the study was designed with the following objectives: (1) to
establish the prevalence of IPV, depression and suicidal ideation in university students, (2)
identify potential predictors of IPV, and (3) study the link between IPV and depression in
this population.

Method
Institutional Review Board approval was obtained prior to conducting this study.
Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)
guidelines were used in the reporting of this study (Vandenbroucke et al., 2007).

The survey tool consisted of a socio-demographic and relationship quality questionnaires,

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Relationship Assessment Scale (RAS), Hurt-Insult-Threaten-Scream (HITS) Domestic

Violence Screening Tool, and Patient Health Questionnaire-9 (PHQ-9). Socio-demographic
items included questions about sex, age, sexual/affectional orientation, institution, student
type, student class, religious affiliation, ethnicity and/or race, parental household income,
relationship type, relationship status, and substance use. Relationship quality items included
questions about jealousy, flirting, cohabitation, sexual activity, and sexually explicit
electronic messaging.

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The Relationship Assessment Scale (RAS) was included as a global measure of relationship
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quality after previously demonstrating test-retest reliability and validity in the university
setting (Renshaw et al., 2010). HITS Domestic Violence Screening Tool, a highly-studied
questionnaire to measure IPV, was selected as a concise tool to measure intimate partner
violence (Shakil et al., 2005; Rabin et al., 2009). The scale was modified to include
additional items to capture past instances of IPV up to one year, such that individuals who
were not in a relationship at the time of participation could report previous experiences of
IPV. A total score ≥10 was considered positive for experience of IPV (Sherin et al., 1998).
Finally, the PHQ-9 scales have each demonstrated reliability and validity in numerous
settings and are widely accepted as screening tools of depression severity (Manea et al.,
2015). The PHQ-9 has been previously used to identify depression in undergraduate and
graduate students (Eisenberg et al., 2007). A cutoff PHQ-9 score ≥10 was used to detect
moderate to severe depression (Manea et al., 2015). Suicidal thoughts were identified by a
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score ≥1 on question 9 of the PHQ-9. The rationale for incorporating these standardized
scales into one questionnaire was based in part on the recommendation of the campus sexual
assault prevention and resource services team that was consulted for this study.

The survey was administered online to students at a large, public university in California
from September 30th, 2016 to January 30th, 2017. Recruitment began on June 1st 2016.
Participants were offered an opportunity to be entered into a lottery for an e-gift card. Only
full-time graduate or undergraduate students aged 18 years or older were eligible to
participate. Participants constituted a voluntary sample recruited indirectly via emails sent
by university faculty listed in the directory (n=1997). Data were not collected on whether
faculty chose to send electronic communications. Respondents were given an option for
participating in a lottery for an e-gift card.
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The survey was made available online via secure and encrypted online tool, Research
Electronic Data Capture (REDCap) (Harris et al., 2009). To calculate a suitable sample size
to assess IPV as a risk factor and predictor for depression, a power analysis was performed
with α set at 0.05 and power of 80%. Based on a conservative estimate of 20% for moderate
to severe depressive disorders in those who experienced IPV, a sample size of n=342 was
required to detect odds ratio (OR) of 2.0 predicted by IPV as modeled by logistic regression.

Responses with missing data were excluded. Potential respondents were given the
opportunity to end the survey at any time with the understanding that their partial data would
be excluded from analyses. Categorical socio-demographic and relationship quality items
with more than two response categories were dichotomized prior to further analysis and
sensitivity analyses were performed for all variables dichotomized this way. Age (18–20
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years vs 21 or older), sexual orientation (heterosexual vs non-heterosexual), class

(lowerclassmen including freshman and sophomore students vs upperclassmen including
junior, senior and students in their 5th year or later), religion (affiliated vs non-affiliated),
ethnicity (Asian, Caucasian), race (Hispanic vs non-Hispanic), parental income ($34,000
and below vs $35,000 and above), alcohol (use vs no use), tobacco (use vs no use),
marijuana (use vs no use), other drugs (use vs no use), relationship type (exclusive vs non-
exclusive or single), and relationship status (committed vs non-committed). Group
comparisons were made using Student’s t-test for continuous variables and chi-square for

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categorical variables. Variables that achieved statistical significance according to t-test were
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also incorporated as potential confounders into a binary logistic regression model. Logistic
regression models were used to identify potential predictors.

Analyses were carried out using Microsoft® Excel Version 15.11.2 for Mac (Microsoft,
Redmond, WA, USA) and IBM® SPSS® Version 22.0 for Mac (IBM, Chicago, IL, USA).

Results
Responses were collected from 687 participants. The university enrollment during the time
period of data collection was 33,467. There were 687 entries with 498 responses
incorporated into analyses, constituting 2.1% and 1.5% of total enrollment, respectively. Of
those, 498 (72.5%) had complete responses and were incorporated into further analyses. Due
to the recruitment strategy used for this study, the total number of students reached could not
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be determined, and a response rate could not be calculated. Descriptive information

regarding socio-demographic and relationship quality data are provided in Table 1 and Table
2, respectively.

Intimate partner violence was experienced by 5% of respondents (n=24), a depressive

disorder was experienced by 31% of respondents (n=154), and suicidal thoughts were
experienced by 20% of respondents (Table 3).

None of the socio-demographic variables were significantly associated with IPV. Among
relationship measures, only relationship satisfaction (OR=0.201, 95% CI: 0.101 to 0.401,
p<0.001) and jealousy (OR=0.270, 95% CI: 0.094 to 0.776, p=0.015) were significant
predictors of IPV. Relationship satisfaction was the sole significant predictor of depression
(OR=0.504, 95% CI: 0.365 to 0.698, p<0.001).
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Discussion
This study found the prevalence of IPV among university students to be 5%, a low
percentage when compared to previous studies. This discrepancy may be attributable to
differences in study settings, eras, and demographic characteristics. For example, rates of
physical violence have been reported to be lower in a four-year university compared to a
community college setting (Daley and Noland, 2001). Also, although Rouse, Breen, &
Howell found that physical abuse was experienced by 11% of college students, that study
was conducted nearly three decades ago (Rouse et al., 1998). More recently, Kaukinen,
Gover, & Hartman described victimization rates as high as 27%, but among female college
students only (Kaukinen et al., 2012). By comparison, the sample in this study consisted of
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both male and female students enrolled full-time at a four-year university. Further, the study
institution has an active office that provides campus-wide support, education, and training to
students to prevent or respond to acts of violence.

Intimate partner violence is likely underreported in this sample. There is a discrepancy

between reporting IPV and prevalence data from large-scale studies, which suggest that a
large percentage of cases of domestic violence go underreported (Garcia, 2004). In fact,
victims often underreport domestic abuse due to privacy concerns, fear of violence from the

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offender, and even a desire to protect the offender (Felson et al., 2002). In addition, because
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the HITS contains items addressing primarily physical and verbal abuse, the prevalence of
sexual violence, a component of IPV that may involve stalking, dating violence, or forced
sex, was not captured by this study. Furthermore, the students may have had concerns
regarding privacy as the survey link was forwarded to them by their professors. This is less
likely in light of the high rates of self-reported depressive disorders and suicidal ideation. In
addition, an incentive lottery was offered to increase response rate but may have degraded
data quality because respondents that receive incentive may be more likely to skip items,
rush, or answer items inaccurately (Laguilles et al., 2011; Barge and Gehlbach, 2011).
Kaukinen, Gover, & Hartman suggested that since many students engage in their first
romantic relationships during college, they may not perceive some forms of violence as
abnormal and/or may not have developed the appropriate communication skills to resolve
disputes encountered in their romantic relationships (Kaukinen et al., 2012; Kaukinen,
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2014). As a result, students may not have thought to report certain violent behaviors in this
survey.

Another major finding of this study was that nearly one-third of students (31%) endorsed
moderate-to-severe depression and one-fifth (20%) reported suicidal ideation during several
days over the previous two weeks. These results indicate an increasing burden of depression
compared to previous studies such as that of Eisenberg, Gollust, Golberstein, & Hefner,
which found the prevalence of depression to be 13.8% in undergraduate students and 11.3%
in graduate students (Eisenberg et al., 2007). It is likely that the reasons for this increase are
multi-factorial but may be in-part due to factors not measured in the study, such as increased
use of internet and television, sedentary lifestyle, and lack of sleep, which appear to be
pertinent to the current student population (Carli et al., 2014). It is also notable that the
increasing prevalence of depression in this population mirrors global trends (Pendi et al.,
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2016; Lépine and Briley, 2011). These findings underscore the need for effective depression
and suicide screening efforts in universities at the undergraduate and graduate levels.

In this study, severity of IPV did not differ significantly between males and females.
Although previous studies found that female students experienced more severe forms of
abuse, a recent study found that women experienced more minor injuries and men
experienced more severe injuries (Rouse et al., 1988; Amanor-Boadu et al., 2011; Cercone,
Beach, & Arias, 2005). Moreover, it has been suggested that relationship violence is often
perpetrated mutually (Kaukinen et al., 2012). Neither age nor sexual orientation was a
predictor of IPV according to this study. However, Porter & Williams described a significant
association between gay, lesbian, and bisexual students with physical and sexual abuse in
intimate relationships (Porter and Williams, 2011). The reason for this discrepancy may be
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due to differences in the sample. Porter & Williams studied college students from a private
university in the northeastern United States while this study was a survey of undergraduate
and graduate students from a large, public university in the southwest (Porter and Williams,
2011).

This study was the first to evaluate potential differences in IPV rates according to student
type (undergraduate or graduate) and class (lowerclassmen and upperclassmen), finding that
neither was a significant predictor of intimate partner abuse. Similarly, religious affiliation

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was not noted to affect experience of IPV in this sample of university students. Although it
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has been suggested that spirituality may reduce risk of victimization, there remains a paucity
of research identifying protective factors such as religiosity in terms of preventing domestic
violence (Kaukinen, 2014). Ethnicity or race was also not associated with increased
experience of physical violence in intimate relationships, a finding supported in-part by the
previous study by Porter & Williams, which did not identify a significant link between racial
or ethnic minorities and physical abuse (Porter and Williams, 2011). Parental household
income approximating the poverty level or below was the final socio-demographic predictor
not significantly associated with IPV among university students.

Neither relationship type nor relationship status was a significant predictor for experience of
IPV according to this study. While Kaukinen, Gover, & Hartman similarly reported few
differences in physical violence between casual and exclusive relationships among female
college students, this study supported those findings among a heterogeneous sample of both
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male and female students (Kaukinen et al., 2012). The majority of undergraduate and
graduate students in the study sample reported alcohol consumption and nearly 1/3 endorsed
marijuana use, but few indicated use of tobacco or other drugs. Alcohol, in particular, is a
classic predictor of relationship violence, but there are no longitudinal studies that describe
the effect of drug use on victimization in college students (Kaukinen, 2014). As a result, this
study suggests that neither use of alcohol, marijuana, nor other drugs was a predictor of IPV
in university students.

Notably, relationship satisfaction was linked to lower odds of IPV in this sample. Whether
addressing these relationship attributes through counseling may help to prevent IPV
constitutes one area for further study. Interestingly, jealousy was linked to lower odds of
IPV. While previous reports have linked jealousy to IPV (Hilberman and Munson, 1977;
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Rounsaville, 1978), the findings of the current study suggest that the inverse is true in the
university setting and that jealousy may be a protective factor. Why relationship jealousy
negatively predicted IPV in this sample remains an avenue for future research.

This study did not find a significant correlation between IPV and depression in university
students. Although the relationship between IPV and poor mental health outcomes has been
previously documented, previous studies in the college setting have indicated conflicting
findings (Sugg, 2015; Kamimura et al., 2016; Kamimura et al., 2016; Garner and Sheridan,
2017; Christopher and Kisler, 2012). For example, Kamimura, Nourian, Assasnik, &
Franchek-Roa found that Iranian college students that experienced IPV reported greater
depression severity (Kamimura et al., 2016). However, IPV was not significantly associated
with depression in Japanese, Singaporean, South Korean, and Taiwanese college students
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[6]. But American college women that suffered from physical abuse from an intimate
partner, experienced symptoms of both anxiety and depression (Christopher and Kisler,
2012). Also, among female college students with pre-existing disorders or disabilities,
victimization by an intimate partner was linked to exacerbation of depression (Bonomi et al.,
2017). In younger female students, depressive symptoms have been associated with an
increased risk of moderate to severe IPV, suggesting that addressing depressive symptoms in
adolescent women may help limit their experience of IPV (Lehrer et al., 2006). It has also
been suggested that cultural factors may mediate the relationship between IPV and

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depression, although the present study did not find the related factors of ethnicity or race to
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significantly affect rates of IPV or depression (White and Satyen, 2015).

Relationship satisfaction predicted lower odds of depression in this sample in line with
previous studies that have documented significant links between relationship satisfaction and
depression (Whitton and Whisman, 2010; Whitton and Kuryluk, 2012; Whitton and
Kuryluk, 2014). Moreover, Stavianopoulos noted that couples therapy to enhance
relationship satisfaction produced a statistically significant reduction in symptoms of
depression (Stavrianopoulos, 2015). These findings suggest utility in asking university
students about their relationships in the context of mental health screening. A post-hoc
analysis to determine the effects of relationship quality measures on suicidal ideation did not
demonstrate similar predictive value.

The findings of this study are moderated by certain limitations in the design and
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methodology. First, this study and the majority of studies performed to measure domestic
violence have utilized a cross-sectional study design, but more longitudinal studies are
necessary to accurately address the questions posed. Second, although this study obtained a
large sample size, convenience sampling may lead to a response bias toward students in a
relationship at the time of participation or experiencing hardship in their relationships. Given
that participants were asked to recall cases of abuse over a 12-month period, there is also
potential for recall bias. Third, although the HITS domestic violence screening tool has been
noted for its reliability and validity, it was not designed specifically to measure violence
among university students and did not include items to address sexual abuse or financial
abuse behaviors. Finally, given that the study sample may not completely reflect the total
student enrollment (e.g. nearly 78% of respondents were female), the generalizability of
these findings are limited.
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Conclusions
This study found the prevalence IPV to be 5% among university students, although this is
likely to be an underestimation. Prevalence of moderate to severe depressive disorders and
suicidal thoughts was 30% and 20%, respectively. Both relationship satisfaction and jealousy
were significant predictors of IPV, while only relationship satisfaction was a predictor of a
depressive disorder. Further research on interventions for IPV, depressive disorders, and
suicidal ideation in the university setting are needed.

Acknowledgements:
The authors thank Uma Rao, MD, for critical review of the manuscript, Mandy Mount, PhD, for survey
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development, and Eli Pascal, LSW, for survey development.

Conflicts of Interest and Sources of Funding: The authors report no conflicts of interest. This work was partially
supported by National Institutes of Health grant UL1 TR001414 from the National Center for Advancing
Translational Sciences. The content is solely the responsibility of the authors and does not necessarily represent the
official views of the NIH.

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References
Author Manuscript

Amanor-Boadu Y, Stith SM, Miller MS, Cook J, Allen L, Gorzek M (2011) Impact of dating violence
on male and female college students. Partner Abuse 2(3):323–343. 10.1891/1946-6560.2.3.323.
Barge S, Gehlbach H (2011) Using the theory of satisficing to evaluate the quality of survey data. Res
High Educ 53(2):182–200. doi: 10.1007/s11162-011-9251-2.
Bonomi A, Nichols E, Kammes R, Green T (2018) Sexual violence and intimate partner violence in
women with a mental health and/or behavior disability. J Womens Health (Larchmt) 27(3):359–368.
10.1089/jwh.2016.6279. [PubMed: 28504561]
Carli V, Hoven CW, Wasserman C, Chiesa F, Guffanti G, Sarchiapone M, Wasserman D (2014) A
newly identified group of adolescents at “invisible” risk for psychopathology and suicidal behavior:
findings from the SEYLE study. World Psychiatry 13(1):78–86. 10.1002/wps.20088. [PubMed:
24497256]
Cercone JJ, Beach SRH, Arias I (2005) The influence of individual and partner characteristics on the
perpetration of intimate partner violence in young adult relationships. Violence and Victims 20:
207–218. [PubMed: 16075667]
Author Manuscript

Christopher FS, Kisler TS (2012) College women’s experiences of intimate partner violence: exploring
mental health issues Journal of Women in Higher Education 5(2):166–183. 10.1515/
njawhe-2012-1116.
Daley EM, Noland VJ (2001) Intimate partner violence in college students: a cross-cultural
comparison. International Electronic Journal of Health Education 4:35–40.
Eisenberg D, Gollust SE, Golberstein E, Hefner JL (2007) Prevalence and correlates of depression,
anxiety, and suicidality among university students. American Journal of Orthopsychiatry 77:534–
542. 10.1037/0002-9432.77.4.534.
Felson RB, Messner SF, Hoskin A, Glenn D (2002) Reasons for reporting and not reporting domestic
violence to the police. Criminology 40(3):617–648.
Garcia E (2004) Unreported cases of domestic violence against women: towards an epidemiology of
social silence, tolerance, and inhibition. Journal of Epidemiology & Community Health 58(7):533.
10.1136/jech.2003.019604.
Garner AK, Sheridan DJ (2017). Influence of intimate partner violence and depression on
Author Manuscript

undergraduate nursing students: a literature review. Journal of Nursing Education 56(7):397–403.

10.3928/01484834-20170619-03.
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data
capture (REDCap) - a metadata-driven methodology and workflow process for providing
translational research informatics support. Journal of Biomedical Informatics 42(2):377–381.
10.1016/j.jbi.2008.08.010. [PubMed: 18929686]
Hilberman E, Munson K. (1977). Sixty battered women. Victimology 2(3–4):460–470.
Kamimura A, Nourian MM, Assasnik N, Franchek-Roa K (2016) Depression and intimate partner
violence among college students in Iran. Asian Journal of Psychiatry 23:51–55. 10.1016/
j.ajp.2016.07.014. [PubMed: 27969079]
Kamimura A, Nourian MM, Assasnik N, Franchek-Roa K (2016) Intimate partner violence—related
experiences and mental health among college students in Japan, Singapore, South Korea, and
Taiwan. International Journal of Social Psychiatry 62(2):262–270. 10.1177/0020764016629700.
Kaukinen C, Gover AR, Hartman JL (2012) College women’s experiences of dating violence in casual
and exclusive relationships. American Journal of Criminal Justice 37:146–162. 10.1007/
Author Manuscript

s12103-011-9113-7.
Kaukinen C (2014) Dating violence among college students: the risk and protective factors. Trauma
Violence Abuse 15(4):283–296. 10.1177/1524838014521321. [PubMed: 24499962]
Lagdon S, Armour C, Stringer M (2014) Adult experience of mental health outcomes as a result of
intimate partner violence victimization: a systematic review. European Journal of
Psychotramatology 5. 10.3402/ejpt.v5.24794.
Laguilles JS, Williams EA, Saunders DB (2011) Can lottery incentives boost web survey response
rates? Findings from four experiments. Research in Higher Education 52(5):537–553.

J Nerv Ment Dis. Author manuscript; available in PMC 2022 January 01.
 Musa et al. Page 9

Lehrer JA, Buka S, Gortmaker S, Shrier LA (2006) Depressive symptomatology as a predictor of

exposure to intimate partner violence among US female adolescents and young adults. Arch
Author Manuscript

Pediatr Adolesc Med 160(3):270–276. https://10.1001/archpedi.160.3.270. [PubMed: 16520446]

Lépine J-P, Briley M (2011) The increasing burden of depression. Neuropsychiatric Disease and
Treatment 7(Suppl 1):3–7. 10.2147/NDT.S19617. [PubMed: 21750622]
Lewis SF, Fremouw W (2001) Intimate partner violence: a critical review of the literature. Clinical
Psychology Review 21:105–127. [PubMed: 11148892]
Manea L, Gilbody S, McMillan D (2015) A diagnostic meta-analysis of the Patient Health
Questionnaire-9 (PHQ-9) algorithm scoring method as a screen for depression. General Hospital
Psychiatry 37:67–75. [PubMed: 25439733]
Pendi A, Ashraf J, Wolitzky-Taylor KB, Lee D, Sugar J, Pendi K, Lee J, Baron DA (2016) The
association between depression severity and stigmatized beliefs in undergraduate students at a
large metropolitan university: a cross-sectional study. Journal of Psychiatry and Mental Health
1(2). 10.16966/2474-7769.108.
Porter J, Williams LM (2011) Intimate violence among underrepresented groups on a college campus.
Journal of Interpersonal Violence 26(16):3210–3224. 10.1177/0886260510393011. [PubMed:
Author Manuscript

21362677]
Rabin RF, Jennings JM, Campbell JC, Bair-Merritt MH (2009) Intimate partner violence screening
tools. American Journal of Preventive Medicine 36(5):439–445.e4. 10.1016/j.amepre.2009.01.024.
[PubMed: 19362697]
Renshaw KD, McKnight P, Caska CM, Blais RK (2010) The utility of the relationship assessment
scale in multiple types of relationships. Journal of Social and Personal Relationships 28(4):435–
447. 10.1177/0265407510377850.
Rounsaville BJ (1978) Theories in marital violence: evidence from a study of battered women.
Victimology 3(1–2):11–31.
Rouse LP, Breen R, Howell M (1988) Abuse in intimate relationships: a comparison of married and
dating college students. Journal of Interpersonal Violence 3(4):414–429.
10.1177/088626088003004005.
Shakil A, Donald S, Sinacore JM, Krepcho M (2005) Validation of the HITS domestic violence
screening tool with males. Family Medicine 37(3):193–198. [PubMed: 15739135]
Author Manuscript

Sherin KM, Sinacore JM, Li X-Q, Zitter RE, Shakil A. (1998) HITS: A short domestic violence
screening tool for use in a family practice setting. Family Medicine 30(7):508–512. [PubMed:
9669164]
Stavrianopoulos K (2015) Enhancing relationship satisfaction among college student couples: an
emotionally focused therapy (EFT) approach. Journal of Couple & Relationship Therapy 14(1).
10.1080/15332691.2014.953656.
Sugg N (2015) Intimate partner violence prevalence, health consequences, and intervention. Medical
Clinics of North America 99(3):629–649. 10.1016/j.mcna.2015.01.012.
Vandenbroucke JP, von Elm E, Altman DG, Getzsche PC, Mulrow CD, Pocock SJ, …STROBE
Initiative (2014) Strengthening the reporting of observational studies in epidemiology (STROBE):
explanation and elaboration. International Journal of Surgery 12(12):1500–24. 10.1016/
j.ijsu.2014.07.014. [PubMed: 25046751]
White ME, Satyen L. Cross-cultural differences in intimate partner violence and depression: A
systematic review. Aggress Violent Behav 2015;24:120–30. 10.1016/j.avb.2015.05.005.
Whitton SW, Whisman MA (2010) Relationship satisfaction instability and depression. Journal of
Author Manuscript

Family Psychology 24(6):791–794. 10.1037/a0021734. [PubMed: 21171780]

Whitton SW, Kuryluk AD (2012) Relationship satisfaction and depressive symptoms in emerging
adults: cross-sectional associations and moderating effects of relationship characteristics. Journal
of Family Psychology 26(2):226–235. 10.1037/a0027267. [PubMed: 22329388]
Whitton SW, Kuryluk AD (2014) Associations between relationship quality and depressive symptoms
in same-sex couples. Journal of Family Psychology 28(4):571–576. 10.1037/fam0000011.
[PubMed: 25000131]

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Zivin K, Eisenberg D, Gollust SE, Golberstein E (2009) Persistence of mental health problems and
needs in a college student population. Journal of Affective Disorders 117(3):180–185. 10.1016/
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j.jad.2009.01.001. [PubMed: 19178949]

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Table 1.

Participant Socio-demographic Characteristics

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Category n (%) Category n (%)

Sex Ethnicity or race

Female 388 (77.9) Asian 188 (37.8)

Male 110 (22.1) Caucasian 115 (23.1)

Age (years) Hispanic 99 (19.9)

18–20 269 (54.0) Other 96 (19.3)

21 and above 229 (45.0) Household income

Sexual orientation Less than $34,999 148 (29.7)

Heterosexual 400 (80.3) More than $35,000 350 (70.3)

Non-heterosexual 98 (19.7) Alcohol use

Student type No 139 (27.9)

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Undergraduate 438 (88.0) Yes 359 (72.1)

Graduate 60 (12.0) Tobacco use

Student class No 431 (86.5)

Lowerclassmen 219 (44.0) Yes 67 (13.5)

Upperclassmen 279 (56.0) Marijuana use

Religion affiliation No 348 (69.9)

Affiliated 292 (58.6) Yes 150 (30.1)

Unaffiliated 206 (41.4) Other drug use

No 454 (91.2)

Yes 44 (8.8)
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Table 2.

Prevalence of Intimate Partner Violence, Depressive Disorders, and Suicidal Ideation

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Category n (%) Category n (%)

Intimate Partner Violence Suicidal ideation

No 24 (4.8) Not at all 397 (79.7)

Yes 474 (95.2) Several days 72 (14.5)

Depressive Disorders More than half the days 14 (2.8)

Minimal 206 (41.4) Nearly every day 15 (3.0)

Mild 138 (27.7)

Moderate 80 (16.1)

Moderately severe 46 (9.2)

Severe 28 (5.6)
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Table 3.

Participant Relationship Quality Characteristics

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Category n (%) Category n (%)

Relationship type Cohabitation

Single 198 (39.8) No 425 (85.3)

Exclusive 285 (57.2) Yes 73 (14.7)

Non-exclusive 15 (3.0) Sexual activity

Relationship status No 198 (39.8)

Single 185 (37.1) Yes 300 (60.2)

Dating 243 (48.8) Explicit messaging

Non-exclusive 15 (3.0) No 347 (69.7)

Jealousy Yes 151 (30.3)

No 385 (77.3)
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Yes 113 (22.7)

Worry of flirting

No 381 (76.5)

Yes 117 (23.5)

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