{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:59:46Z","timestamp":1782845986358,"version":"3.54.5"},"reference-count":58,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Violence against women (VAW) is a major public health and human rights concern with profound mental health consequences. However, the association between specific VAW forms and mental health, particularly among left-behind women in rural China, remains unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to identify the associations of VAW with depression, anxiety, and comorbid symptoms and to explore the potential roles of resilience and social support.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The cross-sectional survey was conducted in Y City, Henan Province, China, in July 2023. A multistage stratified random sampling method was used to recruit left-behind women, resulting in a final sample of 1503 participants. Data on participants and their VAW were collected through a face-to-face questionnaire survey. The forms of VAW assessed were nonpartner violence (NPV) and intimate partner violence (IPV; including remote IPV). Depressive symptoms were evaluated using the 10-item Center for Epidemiological Studies Depression Scale, while anxiety symptoms were assessed with the Generalized Anxiety Disorder-7. The comorbid symptoms of depression and anxiety (CDA) were ascertained as the simultaneous presence of depressive and anxiety symptoms. A multivariable logistic regression model was used to estimate the odds ratio and 95% CIs. A 4-way decomposition analysis was conducted to test the mediation roles and interactions of resilience and social support between VAW and mental health outcomes. Population attributable fractions and pathway-specific population attributable fractions were calculated to estimate the burden of mental health outcomes attributable to VAW.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Lifetime VAW (adjusted odds ratio [aOR] 1.84, 95% CI 1.32\u20102.54) was associated with an increased risk of CDA. Women who were exposed to lifetime IPV (aOR 1.84, 95% CI 1.32\u20102.56), remote IPV (aOR 2.79, 95% CI 1.60\u20104.74), and NPV (aOR 2.63, 95% CI 1.58\u20104.26) had an increased likelihood of reporting CDA. Similar associations could also be found for depressive symptoms and anxiety symptoms. In the 4-way decomposition analysis for VAW and CDA, mediation effects of low resilience and social support were statistically significant (\n P<\/jats:italic>\n <.05), whereas none of the interactions reached significance (\n P<\/jats:italic>\n >.05). The pure mediation proportion was 28.2% for the low resilience and 18.6% for the social support between VAW and CDA. A total of 20.8% of CDA cases, 15.1% of depressive symptoms cases, and 22.7% of anxiety symptoms cases were attributable to VAW. Among these, low resilience accounted for 7.2% and low social support accounted for 4.7% of CDA cases as mediators.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Lifetime VAW, including IPV (and remote IPV) and NPV, shows significant associations with CDA and depressive and anxiety symptoms among rural left-behind women in China. The associations are partly mediated by low resilience and social support. Targeted strategies, including efforts to reduce violence against rural left-behind women, enhance their resilience and strengthen their social support networks, are urgently needed.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/72064","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T21:22:09Z","timestamp":1754601729000},"page":"e72064-e72064","source":"Crossref","is-referenced-by-count":2,"title":["Associations of Violence Against Women With Comorbid Symptoms of Depression and Anxiety Among Left-Behind Women in Rural China: Cross-Sectional Study"],"prefix":"10.2196","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6600-6343","authenticated-orcid":false,"given":"Leying","family":"Hou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4973-1463","authenticated-orcid":false,"given":"Zeyu","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8763-3569","authenticated-orcid":false,"given":"Weidi","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3457-1562","authenticated-orcid":false,"given":"Jiayao","family":"Ying","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4400-0577","authenticated-orcid":false,"given":"Jing","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8423-9576","authenticated-orcid":false,"given":"Shiyi","family":"Shan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8353-8855","authenticated-orcid":false,"given":"Wen","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0196-9759","authenticated-orcid":false,"given":"Peige","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Hugo G . 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