Beyond violence exposure: gender-specific psychological responses to violence in Ecuador – a propensity score analysis

The consequences of violence differ depending on gender. This study explores the associations between exposure to violence and mental health outcomes in Ecuador, a country with high levels of violence yet limited research on its psychological effects. Using a nationally representative dataset and Propensity Score Matching (PSM) to reduce confounding bias, we examine gender-specific patterns of psychological outcomes. The analysis reveals that men exposed to violence are significantly more likely to display externalizing behaviors, including a near doubling of alcohol use (+93.6%) and heightened impulsivity, supporting theories of substance-based coping and behavioral dysregulation. In contrast, women exposed to violence show marked increases in internalizing symptoms, including depressive affect (+35.7%), perceived stress, and loneliness, reflecting emotion-focused coping strategies and affective vulnerability. While these findings support established gendered theories of violence, such as the selfmedication hypothesis and emotion-focused coping, they must be interpreted with caution. The associations observed reflect robust statistical links rather than definitive causal pathways. It remains possible that pre-existing psychological vulnerabilities or unmeasured third variables contribute to both the likelihood of experiencing violence and subsequent mental health outcomes. The results underscore the importance of gender-sensitive mental health interventions: substance use and impulsivity should be targeted among men, while women's care must be integrated with social and economic support systems. By focusing on a Latin American context, this study adds to global knowledge on the gendered psychological consequences of violence and highlights the need for longitudinal and interdisciplinary approaches.