A Prospective Analysis of Associations Between Changes in Mental Health and Men’s Perpetration of Intimate Partner Violence: Post-Hoc Analysis of Young Men Involved in the Stepping Stones and Creating Futures Trial

Men's poor mental health is increasingly recognised as a causal factor for their perpetration of intimate partner violence (IPV); however, the majority of studies are from high-income countries and cross-sectional. We conducted a secondary analysis of data collected as part of a randomised controlled trial, among young (ages 18-30 years) men, living in urban informal settlements in eThekwini Municipality, South Africa, to assess whether: (a) changes in depression symptoms, and (b) changes in post-traumatic stress (PTS) symptoms, were prospectively associated with IPV perpetration, after 2-years of follow-up. Among <i>N</i> = 505 men retained at endline, for depressive symptoms in adjusted models, men with consistently high symptoms (adjusted Odds Ratio [aOR] = 2.02, <i>p</i> = .002) and those with increasing symptoms (aOR = 2.80, <i>p</i> < .001) between the two time points were significantly more likely to report IPV perpetration at endline. Similarly, for PTS symptoms, those whose symptoms increased between the two time points were significantly more likely to perpetrate IPV (aOR = 1.95, <i>p</i> = .05). However, neither decrease in depressive symptoms nor in PTS symptoms between the two time points was associated with a significant reduction in IPV perpetration. This analysis suggests that interventions to reduce IPV perpetration should include a focus on preventing the onset of symptoms of poor mental health. It may be that alcohol is also intervening in this relationship, and this requires further research. The original clinical trial was pre-registered at clinicaltrials.gov (NCT03022370: https://clinicaltrials.gov/study/NCT03022370).