Applying the structural equation model approach to study the simultaneous relationship between women’s empowerment and mental disorder in Egypt

Zaky et al. BMC Women's Health (2024) 24:26 https://doi.org/10.1186/s12905-023-02863-6 BMC Women's Health Open Access RESEARCH Applying the structural equation model approach to study the simultaneous relationship between women’s empowerment and mental disorder in Egypt Hassan H.M. Zaky1,3, Dina M. Armanious2 and Maria A. Kalliny2* Abstract Purpose The main purpose of this paper is to examine whether women’s empowerment and mental disorder affect each other in a one-way or two-way simultaneous relationship. Accordingly, the study fills a gap in the literature since it is the first attempt to examine the simultaneous relationship between women’s empowerment and mental disorder in Egypt. To achieve this, the study aims to examine the most important dimensions of women’s empowerment and mental disorder that affect each other simultaneously, and the most important determinants affecting women’s empowerment and mental disorder. Design/methodology/approach The study depends on the cross-sectional data from the “Survey of Young People in Egypt” implemented in 2014. Married women aged 14–35 are included in the analysis (N = 3052). Recursive and nonrecursive structural equation models are used to examine the simultaneous relationship between women’s empowerment and mental disorder using AMOS, which stands for Analysis of Moment Structures (Version 22). Results Women’s education has a positive significant impact on women’s empowerment and mental health. Violence has a positive significant impact on mental disorder, while it has a negative impact on women’s empowerment. Sexual harassment has a negative impact on treatment with spouse dimension. Regarding the oneway relationship, the results show that the more empowered the woman, the better her mental health is. Considering the two-way simultaneous relationship, the findings show that there is a partial two-way simultaneous relationship. Conclusion There is a relationship between women’s empowerment and mental health, indicating that they affect each other simultaneously. Awareness of the importance of psychological counselling and treatment for mental disorders in women is needed. Keywords Empowerment, Psychiatric Illness, Latent variable modelling, Multivariate analysis *Correspondence: Maria A. Kalliny 1 Department of Psychology, School of Humanities and Social Sciences, The American University in Cairo, Cairo, Egypt 2 Present address: Department of Statistics, Faculty of Economics and Political Science, Cairo University, Cairo, Egypt 3 Social Research Center, The American University in Cairo, Cairo, Egypt © The Author(s) 2024. 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The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Zaky et al. BMC Women's Health (2024) 24:26 Background In recent years, women’s empowerment and mental disorder became an important aims of international development policies, and many donor agencies now include these topics in their development. This study aims to examine the relationship between women’s empowerment and mental disorder among youth women in Egypt. Poor global mental health, especially among young people, has gradually been recognized as a major public health issue [1, 2]. Accordingly, there is a declaration that said “there is no health without mental health” [3]. Therefore, the definition of health in the World Health Organization constitution reflected the importance of mental health by “not merely the absence of disease or infirmity”, but rather, “a state of complete physical, mental and social well-being” [4]. Mental health can be defined as “a state of well-being enabling individuals to realize their abilities, cope with the normal stresses of life, work productively and fruitfully, and make a contribution to their communities” [5]. The person becomes mentally disordered if he or she suffers from any defect in the definition of mental health. Mandal [6] defines women’s empowerment as ‘’an active, multidimensional process which enables women to realize their full identity and powers in all spheres of life’’. The significance of the study was highlighted in many points. Firstly, the study fills a gap in the literature in Egypt since it is the first attempt to examine the simultaneous relationship between women’s empowerment and mental disorder in Egypt. Secondly, the data depends on youth married women and two types of structural equation models, recursive and nonrecursive models, to achieve the study goals. Finally, the study constructs new indicators (dimensions) representing women’s empowerment and mental disorder depending on the “Survey of Young People in Egypt (SYPE 2014)”. Kermode et al. [7] studied the relationship between mental health and women’s empowerment in a qualitative manner, unlike our research. His study undertook a qualitative study on 32 women in rural Maharashtra in India. The key findings of this qualitative study show that women viewed the determinants of mental health and illness as mainly cultural and socioeconomic factors. Second, mental health was commonly conceptualized as an absence of stress, and the most identified stressors were conflicts with husbands and mothers-in-law, domestic violence and poverty. Finally, women’s mental health and empowerment were inextricably linked. Heim and Schaal [8] examine whether gender affects mental stress in Rwanda and apply nonrecursive structural equation modelling (SEM). The results show that gender is a significant predictor of mental stress. Page 2 of 13 The literature studies show that women’s empowerment dimensions could be measured by personal autonomy, household decision-making, economic domestic consultation and freedom of movement [9, 10]. Baig et al. [11] showed that the three dimensions of women’s empowerment, which are self-esteem, the power of decision-making and freedom of mobility, have a statistically positive significant impact on rural development, while control over resources was found to be insignificant. It also has been suggested that a high (...truncated)