Maternal domestic violence linked with depressive disorders in adolescents, Indian study finds

A new multi-site study from India has revealed troubling associations between maternal experiences of domestic violence (DV) and adolescent mental health outcomes. Conducted across seven urban and rural locations, this large-scale analysis is the first of its kind in the Indian context to show significant links between maternal abuse -- psychological, physical or sexual -- and increased rates of anxiety and depression among adolescents.
The study analysed responses from 2,784 adolescent-mother pairs, focusing on the connections between maternal DV and adolescent mental disorders such as anxiety and depression. The results suggest that maternal exposure to DV particularly physical abuse is significantly associated with higher rates of mental health disorders in children, even after adjusting for factors such as site, gender and education status.
The study published in the journal PLOS One, draws on secondary analysis of data from the Consortium on Vulnerability to Externalising Disorders and Addictions (cVEDA). Data collection was carried out through private face-to-face interviews conducted by trained research staff, including psychologists and health professionals certified in nursing or related fields. Each mother-child pair was interviewed at their respective study site in a confidential setting.
During this process, adolescents were directly administered the Standard of Living Index–Modified (SDI-M), Wealth Index, and MINI-Kid, all in the presence of their mothers. In contrast, the Domestic Violence questionnaire -- based on the Indian Family Violence and Control Scale (IFVCS) was administered privately to mothers. The Adverse Childhood Experiences–International Questionnaire (ACE-IQ) was administered directly and privately to the adolescent participants. All instruments were translated into the appropriate regional languages and administered in the participant's primary language .
Health risks and cultural implications of maternal violence
The most significant association identified was between maternal physical abuse and adolescent depressive disorders, suggesting that trauma in the household has ripple effects on children. According to the study's principal investigator, Amritha Gourisankar, resident physician, Internal Medicine-Paediatrics , University of Minnesota, this may reflect the longer duration or severity of abuse. 'There is evidence to show that physical abuse is a later manifestation of domestic violence -- those experiencing physical abuse have often experienced psychological abuse before as well,' she noted. 'The presence of physical abuse may suggest a progression or length of time of the abuse that may drive the association with adolescent depressive disorders.'
The findings also highlight the importance of recognising non-visible forms of violence. Psychological abuse, often harder to detect, was still significantly linked to anxiety and depression among adolescents. 'These experiences in homes are being observed and absorbed by children,' Dr. Gourisankar said. 'Knowing the prevalence of domestic violence and its impact can lead to earlier conversations with children, improved screening in schools, and more informal supports in communities.'
Unlike standard Western surveys, the IFVCS included context-specific references such as dowry-related threats and restrictions on visiting one's natal home, making the experience of abuse more recognisable and reportable. 'By asking the questions in a culturally relevant way, we're able to get more accurate responses,' Dr. Gourisankar explained. 'People may recognise the violence they're experiencing that they otherwise might not have.'
. 'In our region, domestic violence often involves extended family members-- not just the husband. In many cases, the in-laws join in the abuse, leaving women with no refuge -- neither in their marital homes nor at their natal homes, where returning is seen as taboo,' said R.K. Lenin Singh, professor and former head, department of psychiatry, Regional Institute of Medical Sciences, Imphal, Manipur, and co-author of the study. The resulting trauma for women is often silently endured, but its effects are not: 'Adolescents, who begin to understand the household dynamics, are caught in this pain, confused and helpless, unable to intervene or escape,' he added.
In such contexts, the mental health burden is compounded by social and familial expectations, including stigma around leaving a marriage, the absence of a male child, or infertility -- all of which can exacerbate domestic tensions. 'These are not common drivers of domestic violence in many Western countries,' Dr. Singh noted, 'but they are crucial to understand in our settings if we are to develop meaningful mental health interventions.'
Call for trauma- informed systems rooted in empathy
The implications of this research go beyond epidemiological significance -- they call for trauma-informed interventions in schools, communities, and healthcare systems. Dr. Gourisankar emphasises the critical role of frontline workers such as ASHA workers, teachers, and paediatricians. 'Healthcare systems -- particularly those embedded in communities -- need more support in recognising trauma symptoms in children,' she said. 'This includes changes in mood and behaviour, withdrawal or aggression. Trainings led by psychologists can empower community-level workers to act as early responders.'
Dr. Singh reinforced this point: 'In our communities, ASHA workers know the ground realities. They see what doctors and teachers often don't -- because it's taboo to talk about abuse, especially within families. If equipped with the right tools, ASHAs could play a transformative role in recognising and addressing mental health concerns in adolescents stemming from domestic violence,' he said.
While national programmes on school mental health exist, Dr. Singh expressed concern about the gap in implementation in many northeastern states. 'Most schools in Manipur don't have even a part-time counsellor. Yet, we are seeing increasing rates of mental health issues in students, from anxiety and exam stress to ADHD. Without basic screening and support systems in place, these children are left to cope alone.'
Interestingly, while the study accounted for household structure (joint vs. nuclear families), this variable did not significantly affect the associations between maternal DV and adolescent mental health. Still, the researchers argued that future qualitative investigations into in-law dynamics may offer deeper insights into how extended family structures shape domestic violence experiences.
Study limitations and the need for further research
The genesis of this work lies in the cVEDA project, a large-scale research initiative focused on the role of environment -- including genetics, pollution, and domestic violence -- on the mental health of children and adolescents. 'Our site at RIMS in Imphal was part of one of the largest adolescent mental health cohorts in India,' Dr. Singh said. 'Although funding gaps briefly stalled the project, we are now continuing under a modified initiative, PARAM. More than 30 papers have been published across journals from this data, exploring everything from genetic vulnerabilities to the role of parental substance abuse.'
The study however, is not without limitations. One key concern is the potential for participant fatigue, given the length of the four-hour survey battery, which may have affected response reliability.
Also, the study was unable to control for all potential confounders known to influence adolescent mental health, such as family history of mental illness or parental substance use, due to the limitations of the parent dataset. Future research using longitudinal designs, qualitative approaches and focused exploration of intergenerational trauma, in-law dynamics and cultural stigmas can offer a more nuanced understanding of how domestic violence shapes adolescent mental health in Indian contexts.
'Understanding how domestic violence is experienced in India, and how it affects the mental health of adolescents, allows us to design better tools, support systems, and prevention strategies,' Dr. Gourisankar said. In a country where one in three women experience domestic violence, and youth mental health challenges are rising, this research urges families, schools, and systems to listen more carefully -- and respond more holistically --to the children caught in the silence of abuse.

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