Spousal Physical Violence and Women’s Psychological Distress in the Middle Ganga Plain, India: The Moderating Role of Husband’s Migration

ABSTRACT Spousal physical violence remains a major public health concern in India, contributing substantially to women’s psychological distress. In the Middle Ganga Plain, which includes rural areas of Uttar Pradesh and Bihar, patriarchal norms and widespread male out-migration may intensify this burden. This study investigates the association between spousal physical violence and nonspecific psychological distress (NPD) among married women using Propensity Score Matching (PSM) and examines whether the husband’s migration status modifies this relationship. Using data from 2701 married women (aged 15–49) in the Middle Ganga Plain project, NPD was measured using the Self-Reporting Questionnaire-20, and experiences of spousal physical violence were self-reported. Women exposed to spousal violence were more than twice as likely to report NPD (32%) as those unexposed (15%), and this association remained significant after PSM (average exposure effect = 0.165, p: < 0.001). Multivariable logistic regression further showed that women experiencing both spousal violence and husband’s migration had the highest predicted probability of distress (22.9%) compared with 18.5% among those exposed to violence but whose husbands had not migrated. These findings highlight the compounded psychological vulnerability of women in migration-affected households and the need for integrated interventions addressing both violence and mental health.