Marital control, domestic violence justification, and mental health: a study of married women in Bangladesh

Marital control and culturally accepted justifications of domestic violence are pervasive forms of gendered power imbalances that undermine women’s autonomy and significantly contribute to adverse mental health outcomes. These factors are critical yet often overlooked in patriarchal settings like Bangladesh, where the interpersonal dynamics within marital households pose a substantial health burden, with long-lasting effects on the well-being of women. Despite this, national-scale studies remain scarce. This study examines how attitudes toward domestic violence and socioeconomic contexts influence anxiety and depression among married women in Bangladesh, leveraging data from the 2022 Bangladesh Demographic and Health Survey (BDHS). Anxiety and depression were assessed using the Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) scales. Descriptive statistics, one-way ANOVA, binary logistic regression, and stepwise multiple regression were employed to identify predictors. Results indicate that 26.9% and 29.2% of married women experienced mild-to-severe anxiety and depression, respectively, with 4.5% reporting moderate-to-severe anxiety and 1.3% moderate-to-severe depression. Justified domestic violence was significantly associated with higher odds of moderate to severe anxiety and depression. Women who believed wife-beating was acceptable in situations such as going out without informing the husband (p < 0.001), neglecting children (p < 0.001), arguing (p < 0.001), refusing sex (p < 0.001), or burning food were more likely to suffer from anxiety and depression. Stepwise regression identified terminated pregnancy as the strongest predictor of both anxiety (R2 = 0.071, p < 0.001) and depression (R2 = 0.069, p < 0.001). Socioeconomic factors, such as education and continuing education after marriage, also significantly influenced outcomes. The findings underscore the high prevalence of mental health issues among Bangladeshi married women, shaped significantly by socioeconomic conditions and normalization of gender-based violence. These findings highlight the urgent need for culturally sensitive interventions addressing familial pressures and gender-based violence. Future research should employ longitudinal designs to explore causal pathways and incorporate additional determinants, such as social support and coping mechanisms, to inform comprehensive mental health policies in low-resource settings.