Abstract

Intimate partner violence (IPV) is complicated, multifaceted, and can have very serious consequences for people, families and kids. This paper examines the psychological and social effects resulting from intimate partner violence (IPV) among married couples in the Khyber Pakhtunkhwa province of Pakistan, District Mansehra. A multi-stage sampling was performed with 384 participants, and the survey was conducted in Urdu and Hindko languages. This study explored the consequences, social and emotional, of intimate partner violence (IPV), utilizing structured Likert scales. The SPSS was used for the univariate and bivariate analyses. Chi square testing was used to determine the relationships between types of IPV and their effects. Results demonstrated a strong association between IPV and psychological and emotional damage and demonstrated the need for comprehensive therapies. These include awareness campaigns, gender equality initiatives, support services for survivors, legal reforms, economic empowerment and integrated healthcare interventions.

Key Words

Violence, Social, Emotional, Support, Gender

Introduction

Intimate partner violence (IPV) is a complex and multidimensional problem that affects people and communities all around the world. IPV includes sexual, psychological, physical and financial abuse, each having different effects on people’s wellbeing. Recent data from the Demographic Health Survey (NIP, 2013) show that 38% of women between 15 and 49 years old have experience IPD and sociological research points to the importance of studying the same from the perspective that global marriages and family patterns are being shifted (Goodman, 2020). Despite the current research on intimate partner violence (IPV) in Pakistan, existing research often has different definition and methodology, which results in widely varying prevalence numbers. Range is psychological abuse- 42%-84%; verbal abuse-31%-100%; physical abuse- 28%-35%; sexual abuse-1%-77% (Yon, 2017; Bottoms et al., 2016). Why don't we have consistent, reliable IPV data? Answer: these variations.

The Centers for Disease Control and Prevention (CDC) defines three main types of intimate partner violence (IPV): psychological abuse, physical abuse and sexual abuse. Physical violence is defined as using intentional force to cause physical injuries that can be immediate harm or long-lasting damage, such as striking, punching or strangulation, (Garcia-Moreno et al., 2006). Besides long-term concerns such as gastrointestinal disorders and problems of their reproductive systems, victims also experience bruises, fractures and constant aching during the signs (Devries et al., 2013; Beydoun et al., 2012). Physical abuse requires restrictive orders and other legal measures, in addition to counselling and shelters to protect victims’ safety and their well-being (Guedes et al., 2016).

Nonphysical methods of manipulating and emotionally abusing a partner (excluding physical abuse) include verbal threats, humiliation and manipulation (Stark, 2007). Psychological abuse doesn't show up physically, but it can leave you with acute emotional trauma, anxiety, hopelessness and complex post-traumatic stress disorder (CPTSD). (Coker, Kruger et al., 2002; Dutton, 2012) Specialized mental health support and public awareness campaigns are essential to address psychological abuse, raise the recognition of the symptomology and promote help seeking behavior (Tausig, 1999; Chang et al., 2018).

Forced sex or unwanted approach to sex are forms of sexual violence. Sexual violence is another very traumatizing part of IPV, which can be accompanied with bodily injury (instant) and also with sexual health problems such as STIs (World Health Organization, 2002). Survivors will also often experience severe emotional suffering and are at high risk for long term psychological outcomes, including PTSD and issues in future relationships (Campbell, 2002; Basile et al., 2016). Some effective approaches are that public awareness is raised on sexual assault and consenting relationships, specific support services are offered, and the laws protecting married couples against rape are affected Breiding et al., 2015).

Financial or economic abuse refers to controlling a partner's financial resources or imposing job restrictions so they can't support themselves financially — although it is less common. Some figurative ways of managing money, setting spending limits, and undermining job possibilities. Short term problems of abuse of this kind include and long-term ones include debt & financial instability. Survivors need financial education and legal protections to fight financial abuse (National Network to End Domestic Violence, 2021).

Technology is changing, and abuse of digital or cyberspace has become a serious problem. The meaning follows exploring how they keep an eye on what people are doing online, hacked into their accounts and tried to harass people with technology (Edwards et al., 2015). This abuse may lead to acute emotional anguish and long-term problems with personal and internet safety (Smith et al., 2017). To handle digital abuse, laws forbidding cyber bullying and educating the public on online safety and digital consent are essential (Patchin & Hinduja, 2016; Madden et al., 2013).

But reproductive coercion, one particularly sneaky kind of IPV, is when one partner’s reproductive decisions are manipulated. This includes, for instance, pressing a spouse to become pregnant or muching with contraceptives (Grace et al., 2016). Along with acute grief and anxiety, survivors may have unplanned pregnancies and problems with their reproductive systems (Miller et al. 2010). To combat reproductive coercion, there need to be legal protections of reproductive rights and assistance of medical professionals (McCauley et al., 2017).

Literature Review

IPV is closely related, along with more general phenomena of domestic violence which includes abuse in family and personal relationships beyond romantic relationships. Abuse of children, and other vulnerable household members, such as senior family members, is also considered domestic violence (García?Moreno et al, 2005). Research worldwide indicates that one in three women have ever suffered physical or sexual abuse from an intimate partner (World Health Organization, 2021). Social relationships are negatively affected, as well as the physical and mental health and financial stability, of victims of IPV and domestic violence (Campbell, 2002; Devries et al., 2013). These concerns require a multifaceted form of strategy that will include support services and legislative protections as well as public awareness campaigns.

This research is therefore required for an understanding of the particular social and cultural factors which lead to IPV in District Mansehra. These variables were investigated to develop regional prevention plans for IPV that work. Knowledge gained from this study will inform policies and procedures designed to reduce IPV and support survivors, given that IPV is increasing in Pakistan and, apart from changing family and marriage patterns, is becoming more common and is still a serious and growing problem globally (Goodman, 2020). Given the enormous impact that IPV has on society, IPV endangers societal fabric and family structures in that IPV is generally unreported and thus not appropriately addressed.

This investigation is based on the Social Ecological Model which is a framework commonly employed in intimate partner violence in research spanning the globe (Abeya et al., 2011). The Social Ecological Model surveys IPV across a diversity of levels ranging from public policy to environmental context, interpersonal interactions as well as characteristics of the individual (McLeroy et al., 1988). This all-encompassing approach stresses the concept of reciprocal causality, in other words, that individual behaviors both influence their larger social context and are shaped by it. A single attitude or behavior cannot be seen outside of these larger cultural and social contexts, as if it were simply an instance of that attitude or behavior into an intimate relationship. Addressing these interrelated layers through the model contribution assists in aiding the model to facilitate a rich understanding of IPV (Heise, 1998).




Theoretical Perspective 

Marxist analysis of IPV provides a singular vantage point in that, like other radical analyses, it does not concentrate on individual acts of violence in isolation. The viewpoint deals with how adverse financial dependency and economic inequality fomented by capitalism can contribute to IPV. While economic volatility and job insecurity can stress relationships, which can create aggressive behaviors (Ertürk, 2006). Secondly, the commodification of women’s labour, which lowers the worth of its unpaid domestic equivalent, perpetuates IPV by amplifying women’s financial dependence and exposure (Edin & Kefalas, 2005).

Finally, the Marxist theory focuses on how PVF is perpetuated by abusers wielding power and class hierarchy through the context of relationships based on economic domination. In fact, power relations can be worsened by economic inequality because when individuals are more affluent, they can exercise more influence and even the potential to engage in financial abuse (Ertürk, 2006). Regarding the perspective of this viewpoint, it concentrates on how the combination of patriarchal and economic systems preserve gendered violence and consequently reminds us that in creating the remedies to this issue, these structural elements need to be addressed (Chant, 2016).

From a feminist perspective, IPV is then viewed through the prism of gendered power relations and patriarchal standards. This method shows how conventional gender norms and economic control systems that maintain male domination sustain IPV. In patriarchal situations, men usually end up occupying very dominating roles, controlling resources and decision making which exacerbate intimate partner violence (IPV) (Dobash & Dobash, 1979; Yllo, 1983). Economic dominance of male partners also limits females’ freedom, gluing the two to one another, enforcing dependence and upholding power poles (Dutton & Goodman, 2005). According to this view, addressing IPV requires a challenge to society norms based in patriarchy to do so effectively.

Lastly, the Power and Control Wheel (PCW) theory was produced by the Domestic Abuse Intervention Project who provides a framework for understanding how abusers use tactics to maintain power. Based on the wheel, it identifies various strategies abused persons use to control partners, which include coercion, intimidation, isolation, emotional abuse, minimizing, male privilege, economic abuse, and physical assault (Johnson, 1995; Graham-Bermann & Hughes, 2003). This model isolated a number of aspects about the dynamics, of intimate partners violence, which is helpful in understanding how different abusers use their strategies to exert power and control towards their partners.

Research Method

The study was based on the positivist paradigm of social research; and used the quantitative methodology within which structured questionnaires were used to collect data and SPSS was used for analysis. Multistage sampling was used in the study and thus first Tehsil Mansehra was randomly selected, then five union councils and ten revenue villages were chosen out of them. Using the Sekaran table, the sample size was estimated and found as 384. Data were provided by both male and female respondents, and the surveys were also translated into Hindko and Urdu languages so that they were accessible and understandable to respondents. Structured questionnaires were used to evaluate different aspects of intimate partner abuse using Likert scales: responses were recorded from strongly agree to strongly disagree. Frequency distributions, and bivariate and multivariate analysis (e.g., Kendall's tau-b and chi-square tests) were used in the data analysis process to investigate the relationships of the variables. The chi-square test was quite useful when assessing the connections between independent and dependent variables. 

Results and Discussions

The data provides some significant insights based on multiple demographic parameters into Intimate Partner Violence (IPV). By gender distribution, there were more female respondents (51.6%) than male respondents (48.4%) which is in line with a global trend that shows that rates of IPV are significantly high among women. The bulk of responders (64.7%) are significantly older than 31 years old, suggesting that middle-aged people are more likely to encounter intimate partner violence. Data on respondents' marital status shows that the majority are married (87.2%) and that IPV is more common in this group than it is in the divorced (12.8%) group. 75.3% of respondents said they had been married for up to nine years, which indicates that shorter marriages may have a greater incidence of IPV. Regarding the profession of spouses, 55.5% are employed, highlighting the complex relationship between economic factors and IPV. Monthly household income data shows that 50.8% of respondents earn above 50,000 rupees, while 49.2% earn up to 50,000 rupees, suggesting that economic stressors can influence IPV risk. Finally, the place of residence indicates that 57.6% of respondents live in rural areas, reflecting the impact of geographical context on IPV dynamics. These findings underscore the multifaceted nature of IPV and the need for targeted prevention and intervention strategies considering socio-demographic, economic, and cultural factors.




 

Table 1

Demographic Background of the Respondents

Gender	Frequency	Percentage
Male	186	48.4
Female	198	51.6
Total	384	100.0
Age
Up to 30Y	137	35.7
31 and above	247	64.3
Total	384	100.0
Marital Status
Married	335	87.20
Divorced	49.0	12.8
Total.	384.0	100.00
Duration of Marriage
1-9y	289	75.3
10y and above	95	24.7
Total	384	100.0
No of Children
Zero child	125	32.6
One and above	259	67.4
Total	384	100.0
Type of Family
Nuclear	135	35.2
Joint	249	64.8
Total	384	100.0
Level of education
Illiterate	206	53.6
Educated	178	46.4
Total	384	100.0
Level of spouse education
Illiterate	220	57.3
Educated	164	42.7
Total	384	100.0
Employment status
Unemployed	174	45.3
Employed	210	54.7
Total	384	100.0
Profession of Spouse
Unemployed	171	44.5
Employed	213	55.5
Total	384	100.0
Monthly Household Income
upto 50000	189	49.2
50001 and above	195	50.8
Total	384	100.0
Place of residence
Rural	221	57.6
Urban	163	42.4
Total	384	100.0

 




The data highlights the prevalence of emotional and psychological abuse in intimate partner relationships, with respondents reporting significant negative behaviors from their partners. Many experienced being told they were "not good enough" (32.6% disagreed, 32.3% agreed), labeled as "ugly" (40.4% disagreed), and called "crazy" (41.9% favored). There were also reports of people being accused of laziness, with 27.1% agreeing. Some respondents faced threats of physical harm, with 42.4% disagreeing with the statement "Your partner told you they would kill you." Additionally, many reported emotional manipulation, such as partners becoming angry when challenged (37.8% strongly agreed) and threats to end the relationship (39.3% agreed). The findings highlight widespread emotional control, intimidation, and manipulation, underscoring the need for support and interventions to address intimate partner abuse.




 

Table 2

Emotional and Psychosocial Levels of Intimate Partner Violence

Statement	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree	Total
My partner tells me that I am not good enough	86 (22.4)	124 (32.3)	8 (2.1)	125 (32.6)	41 (10.7)	384 (100)
My partner tells me that I am ugly	59 (15.4)	70 (18.2)	39 (10.2)	155 (40.4)	61 (15.9)	384 (100)
My partner tells me that I am crazy	68 (17.7)	161 (41.9)	20 (5.2)	79 (20.6)	56 (14.6)	384 (100)
My partner tells me that I am lazy	71 (18.5)	104 (27.1)	58 (15.1)	83 (21.6)	68 (17.7)	384 (100)
My partner tells me that no one would ever want me	37 (9.6)	124 (32.3)	46 (12.0)	96 (25.2)	81 (21.1)	384 (100)
My partner tells me; he/she is going to kill you	19 (4.9)	59 (15.4)	72 (18.8)	164 (42.7)	70 (18.2)	384 (100)
My partner often irritates me while doing things I don’t like	135 (35.2)	121 (31.5)	0 (0)	80 (20.8)	48 (12.5)	384 (100)
My partner becomes very angry if I disagree with his/ her point of view	144 (37.5)	145 (37.8)	5 (1.3)	49 (12.8)	41 (10.7)	384 (100)
My partner does not consult me in decision-making	121 (31.5)	106 (27.6)	5 (1.3)	94 (24.5)	58 (15.1)	384 (100)
My partner often threatened me of quitting marital ties	34 (8.9)	151 (39.3)	31 (8.1)	119 (31.0)	49 (12.8)	384 (100)
Gave you angry stares or looks	131 (34.1)	157 (40.9)	1 (0.3)	61 (15.9)	34 (8.9)	384 (100)
My partner insults or shames me in front of others	90 (23.4)	114 (29.7)	0 (0)	117 (30.5)	63 (16.4)	384 (100)
My partner ignores me when I start to talk.	77 (20.1)	150 (39.1)	0 (0)	112 (29.2)	45 (11.7)	384 (100)

 




The data in Table 3 reveals the significant emotional and psychological toll of intimate partner violence (IPV) on respondents. A notable portion (23.7%) strongly agreed with the desire to quit their marital ties, while many felt inadequate as a partner (40.4% agreed, 32.3% strongly agreed). Additionally, 31.3% felt like a personal servant to their partner. Regret over marrying their current partner was expressed by a large group (33.6% strongly agreed they should not have married), and many would not marry the same partner again given the chance (34.1% strongly agreed). Trust and fear were major issues, with 30.7% lacking trust in their partner and 27.1% feeling constant fear. Life dissatisfaction and increased irritability were common, with 33.6% agreeing that life was not enjoyable and 45.6% agreeing they were easily irritated. These findings emphasize the psychological damage inflicted by IPV, including inadequacy, fear, mistrust, and overall dissatisfaction, underscoring the need for targeted support and intervention for those affected.




 

Table 3

Statement	Strongly Agreed	Agreed	Neutral	Disagreed	Strongly Disagreed	Total
Often, I think about quitting my marital ties	91 (23.7)	85 (22.1)	62 (16.1)	76 (19.8)	70 (18.2)	384 (100)
I feel that I am not a good partner	124 (32.3)	155 (40.4)	14 (3.6)	69 (18.0)	22 (5.7)	384 (100)
I feel that I am a personal servant of my partner	112 (29.2)	120 (31.3)	4 (1.0)	108 (28.1)	40 (10.4)	384 (100)
I think that I should never marry this partner	129 (33.6)	120 (31.3)	1 (0.3)	102 (26.6)	32 (8.3)	384 (100)
If I were given the chance to marry again, I would never marry this partner	131 (34.1)	92 (24.0)	0 (0)	99 (25.8)	62 (16.1)	384 (100)
I think I could find a better partner than this one	115 (29.9)	118 (30.7)	9 (2.3)	90 (23.4)	52 (13.5)	384 (100)
I am always afraid of my partner	103 (26.8)	104 (27.1)	28 (7.3)	97 (25.3)	52 (13.5)	384 (100)
I don’t trust my partner	49 (12.8	118 (30.7)	68 (17.7)	103 (26.8)	46 (12.0)	384 (100)
I think that my life is not enjoyable	62 (16.1)	129 (33.6)	31 (8.1)	115 (29.9)	47 (12.2)	384 (100)
I can be easily irritated over small things	46 (12.0)	175 (45.6)	5 (1.3)	109 (28.4)	49 (12.8)	384 (100)

 




Association between IPV and its impacts

Table 4 reveals significant associations between various forms of emotional or psychological abuse in intimate partner violence (IPV) and the emotional or psychological impacts on victims. The data shows a strong positive association between being told one is "not good enough" (?=0.991, P=0.000) and psychological distress, illustrating severe impacts on self-esteem and mental health. Insults regarding appearance, such as being called "ugly," were significantly associated (?=0.828, P=0.000) with emotional harm. Labeling a partner as "crazy" also had a high association (?=0.704, P=0.000), exacerbating feelings of anxiety and depression. The label "lazy" was significantly associated (?=0.667, P=0.000) with diminished self-worth. The data also shows that anger over disagreements (?=0.919, P=0.000) and exclusion from decision-making (?=0.893, P=0.000) significantly impact emotional well-being. These findings emphasize the extensive psychological harm caused by various forms of IPV and underscore the need for targeted interventions to address both the immediate and underlying issues of power and control in abusive relationships.




 

Table 4

Association between IPV and its Emotional or Psychological impacts

Independent variable (Sociological level of IPV)	Dependent variable	Statistics ?2 (P-Value) Gamma ?
My partner usually told me that I was not good enough	Emotional or Psychological Impacts of IPV	?2=243.392 (0.000) ?= .991
Told me that I was ugly		?2=134.793 (0.000) ?= .828
Told me that I was crazy		?2=172.490 (0.000) ?= .704
Your partner told you that you were lazy		?2=140.353 (0.000) ?= .667
Told me that no one would ever want me		?2=165.349 (0.000) ?= .803
Your partner told you; he/she is going to kill you		?2=90.789 (0.000) ? = .742
My partner often irritates me while doing things I don’t like		?2=219.419 (0.000) ? = .858
My partner becomes very angry if I disagree with his/ her point of view		?2=222.327 (0.000) ?= .919
My partner does not consult me in decision-making		?2=181.545 (0.000) ?= .893
My partner often threatened me of quitting marital ties		?2=217.600 (0.000) ?= .957
Gave you angry stares or looks		?2=185.887 (0.000) ?= .917
My partner insults or shames me in front of others		?2=194.288 (0.000) ?= .902
My partner ignores me when I start to talk.		?2=246.171 (0.000) ?= .942

Discussion

Approximately 35% of people worldwide experience intimate partner violence (IPV), which is disproportionately vulnerable to women. This is highlighted by the gender distribution of responders, which shows a slight female majority (World Health Organization, 2021). Age is a key factor; many responders were middle-aged, a group that frequently faces higher IPV risks because of constraints from society and family obligations (Capaldi et al., 2012). Among those who are married, marital status shows a high level of IPV, which has been attributed to social relativism, expectations and dependency on the grounds of economics (Cinoglu et al., 2023). Family type also appears to influence IPV; the extra pressures of living in a joint family arrangement are a factor (Amin et al, 2023). The reason education matters is because we've found that in terms of illiteracy, it is not the ability of a respondent or their spouses to address IPV adequately (Smith et al., 2023). Given the nearly equal divide in work status, these dynamics would also seem to indicate that economic variables matter in IPV dynamics even if employment itself does not typically have a lower risk of IPV (Garcia et al., 2023; Singh et al., 2024). Middle class and low-class households differ in the monthly household income, and the economic stress accounts for IPV risk (Gibbons et al., 2023). Lastly it should be noted that the respondents' overrepresentation in rural residence suggests that social and cultural variation between rural and urban settings contributes significantly to vari¬ance in IPV dynamics (Johnson et al., 2006).

These results also illustrate how the different types of intimate partner violence (IPV) affect victims psychologically and emotionally profoundly, proving that the victim’s wellbeing is being equally influenced by verbal and behavioral abuse. However, when couples receive negative feedback their mental and self-esteem get damaged and gives them a feeling of inadequacy and melancholy (Campbell et al., 2003). Insults about physical appearance cause similar amounts of psychological damage (O'Leary et al., 2007), leading to emotional hurt and promoting the feelings of guilt and doubting yourself. The assigning of a spouse the label of 'crazy' aggravates psychological pain aggravating the stigma attached to mental health problems and, therefore, worsens the symptoms of anxiety and sadness (Hartley et al., 2018). Consequently, equating one with something that is not like ‘lazy’ erodes a partner's confidence, and a sense of confidence if you will, and sets negative feedback loops of guilt, and self-blame on the path (Lawrence, Kafetsios and Blundell, 2019). The point is that when someone tells the spouse no one would want them, or threatens to kill them, or get angry out of frustration over their behavior, they are causing significant emotional damage. These actions can have some serious psychological effects including PTSD, sadness and anxiety. They also instill feelings of rejection, fear and powerlessness (Whiting & Simmons, 2014). Opting for resentment towards a spouse for having contrary viewpoints or for not being involved in the decision making just adds to the sense of helplessness this individual is already feeling and decreasing of self-worth (Babcock et al., 2004). Threats of relationship separation and impending public humiliation in addition to exacerbating emotions of uncertainty, dread, and low self-esteem can create doubt about the victims confidence and likelihood of validation (Johnson, et al 2005).

Furthermore, intimate partner violence (IPV) has emotional and psychological effects on different demographic characteristics which are discussed in the study too. Emotional abuse perpetuates cycles of manipulation and psychological injury including degrading self–esteem and coercive control. It also causes severe discomfort – being felt as dissatisfaction, sorrow, and trauma (Capaldi et al., 2012), it indeed has a very negative impact both on women and men, but men more often report greater consequences than women (to women) (Breiding et al., 2014), and these effects depend on the age, when aging, those over 31 are suffering more strongly from the difficulties of the emotional kind (Johnson & Leone, 2005), the degree of suffering from the IPV is determined by the marital status and length of marriage: suffering is stronger for married people and people in shorter marriages (Johnson & Leone, 2005), the existence or absence of the children as well as other features of the family structure, such as nuclear house vs joint family house, play a great role (Bates, 2016), the educational and professional level of the respondents and their spouses are also important factors – respondents who do not have sufficient literacy and the respondents’ spouses who do not work and do not have a job – are suffering more from the emotional part (Yoshihama et al., 2009), finally, as compared to the urban inhabitants, rural Released today, these results demonstrate the complexity of the effects of IPV and the importance of targeting interventions to meet the multiple needs of survivors.

Conclusions

This study concludes that intimate partner violence exists in many subtler forms in district Manshera of the Khyber Pakhtunkhwa of Pakistan. The study reveals that instances of IPV are negatively affecting the general well-being, life quality emotional, and mental health of couples across respondents of various demographic characteristics. In addition, the study explores socio?cultural facets of sustaining intimate partner violence (IPV), emphasizing the need to eliminate systemic oppressive legacies and promote gender equity through preventative and remedial measures. For instance, policy and practice must consider the differing needs and experiences of many different demographic groups, for example, based on gender, age, marital status, family structure, educational level, employment position, and income. Second, an assessment of current IPV regulations and programs to identify gaps in their regulation and effectiveness, and guide future decisions is also required. This dissertation advocates for tactics that attack the root causes and consequences of IPV because safer, more supportive, and egalitarian societies are found in our advocacy efforts. It carries important policy and practice implications as well. The findings of this thesis provide important information about the field of IPV research.

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