Adverse Childhood Experiences and Psychological, Sexual, and Physical Forms of Intimate Partner Violence in Nepal

Objective: To examine the prevalence of adverse childhood experiences (ACEs) and intimate partner violence (IPV) among married couples in Nepal as well as the relationships among ACEs, IPV (psychological, sexual, physical), and psychological distress. Method: The sample comprised the control group (N = 720) of a cluster randomized intervention trial among married women in Nepal. Interviewers assessed ACEs, IPV, quality of life, self-efficacy, and depressive symptoms among participants. Times 2 and 3 were conducted 12 and 28 months after baseline, respectively. Results: At baseline, 24% of women reported a history of ACEs. Across time points, married Nepali women most frequently reported psychological IPV (28%-37%). Greater ACEs and IPV scores were related to less quality of life, less self-efficacy, and more depressive symptoms, |rs| = .10-.78, ps < .025. The largest bivariate correlation existed between women's self-reported experiences of psychological and physical violence, r = .78, p < .001. Across time points, structural equation modeling (comparative fit index = .93, standardized root-mean-square residual = .05; adequate fit with physical violence removed) demonstrated that psychological violence was the most consistent statistical consequent when women's ACEs served as an antecedent; married Nepali men's ACEs were related to women's later experiences of psychological and sexual IPV, although not significantly related to psychological distress. Conclusions: Although limitations in generalizability must be considered, these findings extend Western-focused trauma literature by examining ACEs and IPV in Nepal, a historically underrepresented country in this inquiry. Assessing childhood trauma history inclusive of psychological trauma across genders has research and clinical implications, including prevention efforts.