The complex trauma of psychological violence: cross-sectional findings from a Cohort of four Danish Women Shelters

Dissociative Symptoms in Women with Histories of Intimate Partner Victimization: A Focus on Coercive Control

Identifying and contrasting different patterns of intimate partner violence (IPV) (e.g. situational couple violence, coercive controlling violence) is useful for understanding IPV and its connections with health. Applying this approach to dissociation may be fruitful, given theoretical perspectives that predict a specific connection between coercive controlling violence and dissociative symptoms. To address this, community women with divorce histories (N = 188) completed measures to identify patterns of IPV victimization in prior relationships (no direct violence, situational couple violence, coercive controlling violence), and to quantify recent dissociative symptoms and number of depressed days, for comparison. Contrary to predictions, the predicted odds of recent dissociative symptoms did not differ between women who experienced situational couple violence versus coercive controlling violence. However, the latter group had greater odds of recent dissociative symptoms, but not depressed days, compared to women with no histories of direct violence. Further, a continuous measure of coercive control was uniquely associated with increased odds of dissociative symptoms. This study provides preliminary empirical support for a connection between coercive controlling violence and dissociative symptoms, compared to women without histories of direct violence. This deserves further attention given the strong theoretical rationale for this link, and the importance of dissociation for mental health.

Intimate Partner Sexual Violence: An Exploratory Study on Sexual Victimization Profiles Among Survivors of Intimate Partner Violence in France

Intimate partner sexual violence (IPSV) is a common form of intimate partner violence (IPV). This study aimed to (a) identify a typology of intimate partner sexual victimization among French women victims of IPV on the basis of the frequency of various forms of sexual violence and (b) evaluate whether these profiles differ in several clinical characteristics. A total of 93 women consulting a specialized hospital service were recruited. Cluster analyses suggested four profiles: highly frequent rapes (5.4%), predominant sexual coercion (20.4%), medium frequency of all forms (20.4%), and low frequency of all forms (19.4%). Further person-centered research focusing on IPSV is warranted.

Healthcare and legal systems responses to coercive control: an embodied performance of one woman's experience

This paper uses a drama-based method to illustrate the responses of healthcare and legal systems to women experiencing coercive control. This approach involved writing a play using the first-person narrative voice of a victim-survivor. We presented the play at the Stop Domestic Violence Conference (Gold Coast, Australia) in 2021. The central character, 'Kate', provided an embodied performance that enabled the conference participants to see, feel and understand experiences of coercive control from a personal perspective. We followed the trajectory of coercive control from the beginning of an intimate relationship to the time of separation. We showed how the process of coercive control escalates from love bombing, reproductive coercion, isolation, and technology-facilitated abuse until a point of police intervention. As Kate told her story, the conference audience witnessed the barriers and challenges faced by survivors of coercive control, and the emotional, financial, and psychological impacts that are intensified in geographically remote environments. They watched Kate navigate health and other systems meant to help women experiencing domestic and family violence, but that ultimately failed to deliver. Finally, the drama-based approach allowed us to present a feminist embodiment of coercive control and an innovative method for communicating inter-disciplinary research findings on domestic abuse.

Intimate partner violence and its correlates in middle-aged and older adults during the COVID-19 pandemic: A multi-country secondary analysis

Intimate partner violence (IPV) may have been exacerbated during the COVID-19 pandemic. Middle-aged and older adults, ages 45 years or older, are at higher risk of COVID-19 mortality and social isolation. However, most studies on IPV during the pandemic do not focus on this important subpopulation. Informed by the social-ecological theory, this study examines individual, household, community, and country-level correlates of IPV among middle-aged and older adults in multiple countries using a cross-sectional online survey. Data from 2867 participants aged 45 or older in the International Sexual Health and Reproductive Health (I-SHARE) survey from July 2020 to February 2021 were described using univariate analysis. IPV was defined using four validated WHO measures. Individual characteristics included self-isolation and food security. At the country-level, we examined social distancing stringency. Logistic regression models with a random intercept for country were conducted to explore IPV correlates among 1730 eligible individuals from 20 countries with complete data. Most participants were heterosexual (2469/2867), cisgender (2531/2867) females (1589/2867) between the ages of 45-54 (1539/2867). 12.1% (346/2867) of participants experienced IPV during social distancing measures. After adjustment, participants who self-isolated experienced 1.4 (95% CI 1.0, 2.0, p = 0.04) times the odds of IPV compared to those who had not isolated. Those who reported an increase in food insecurity compared to pre-pandemic experienced 2.2 times the odds (95% CI 1.6, 3.0, p<0.0001) of IPV compared to those who did not report increased food insecurity. People in countries with more stringent social distancing policies were less likely to experience IPV compared to people in countries with lower levels of stringency (aOR = 0.6, 95% CI 0.4, 0.9, p = 0.04). IPV was common among middle-aged and older adults during the COVID-19 pandemic. Our data suggest the need for further crisis management and social protection measures for middle-aged and older adults who have intersecting vulnerabilities to IPV to mitigate COVID-19 impact.

Exposure to Psychological Intimate Partner Violence: Resilience to Depression is Related to Social Support and Learned Resourcefulness

Psychological violence is the most common form of intimate partner violence (IPV). Psychological IPV places women at significant risk for depressive symptoms. Accordingly, this study examined the moderator role of perceived social support and learned resourcefulness (LR) as personal resources in the relationship between psychological IPV and depression. This cross-sectional study was performed via an online survey platform. A total of 168 Turkish women, with a mean age of 33.8, completed a set of measurement tools. Data were assessed using linear regression and two-way and three-way interactions in moderated multiple regression analyses. The results of the study showed that as expected psychological IPV was directly associated with depression (β = .268, p < .001). To explore the moderator roles, two separate two-way interactions were conducted, and results demonstrated that neither social support nor LR separately moderated the relationship between psychological IPV and depression. However, there was a significant three-way interaction: togetherness of perceived social support with LR moderated the relationship between psychological IPV and depression (β = -.388, p < .05). More specifically, if women exposed to psychological IPV have high perceived social support and high LR, they are less likely to report depressive symptoms. This finding highlights the positive effect of the combination of personal resources on depression linked to psychological IPV's detrimental effects. The findings were discussed in the light of the relevant literature. Interventions focusing on strengthening social support and fostering LR skills may promote the psychological well-being of women exposed to psychological IPV.

The Trauma and Mental Health Impacts of Coercive Control: A Systematic Review and Meta-Analysis

Coercive control is an under researched type of intimate partner violence (IPV). The aims of this review were to (a) synthesize all available evidence regarding associations with coercive control and mental health outcomes including post-traumatic stress disorder (PTSD), complex PTSD, and depression; and (b) compare these with associations involving broader categories of psychological IPV. Primary studies which measured associations of coercive control with PTSD, complex PTSD, depression, or other mental health symptoms, were identified via a systematic search of electronic databases (PsycINFO, Medline, CINAHL, Scopus). Eligible studies involved observational designs and reported associations between coercive control and mental health outcomes, among participants who were at least 18 years old. Studies were published in peer-reviewed journals and English language. Random-effects meta-analyses were used to synthesize correlational data from eligible studies. The search identified 68 studies while data from 45 studies could be included in the meta-analyses. These indicated moderate associations involving coercive control and PTSD (r = .32; 95% confidence interval [.28, .37]) and depression (r = .27; [.22, .31]). These associations were comparable to those involving psychological IPV and PTSD (r = .34; [.25, .42]) and depression (r = .33; [.26, .40]). Only one study reported on the relationship between coercive control and complex PTSD and meta-analyses could not be performed. This review indicated that coercive control exposure is moderately associated with both PTSD and depression. This highlights that mental health care is needed for those exposed to coercive control, including trauma-informed psychological interventions.

Suicidal ideation and psychological dating violence victimization-A short report

As the second leading cause of death among Americans aged 10 to 34, suicide is a serious public health concern. One potential predictor of suicidality is dating violence (DV) victimization, such as any physical, psychological, or sexual abuse by a current or former intimate partner. However, little longitudinal data exists on the relationship between suicidal ideation and DV. To address this gap in knowledge, we leverage data from two years of our longitudinal study Dating It Safe. Specifically, we examine whether physical and psychological DV victimization is associated with subsequent suicidal ideation in our ethnically diverse sample of young adults (n = 678; mean age = 25 at Wave 9; 63.6% female). While physical DV victimization was not linked to suicidal ideation over time, psychological DV victimization was (χ2 = 7.28, p = 0.007 for females; χ2 = 4.87, p = 0.027 for males). That psychological abuse was potentially as or more impactful than physical violence is consistent with the broader literature on the deleterious impacts of psychological violence, as well as the limited longitudinal literature looking at DV and suicidality specifically. These findings reinforce the notion that psychological abuse is as consequential as physical violence in the long-term, has unique impacts on mental health, and points to the need for both suicide and violence intervention programs to address this form of dating violence victimization.

Predicting Depression Among Spouses of Ex-POWs: The Contribution of Exposure to Violence, Trauma, and Stress Through the Life Cycle

The current longitudinal study focused on predicting depression among spouses of former Israeli war veterans (combat veterans or ex-prisoners of war [ex-POWs]). The research examined the direct and moderating role of secondary trauma related to their husbands' war-related experiences, stress related to being exposed to intimate partner violence in their relationship, being a second-generation Holocaust (SGH) survivor, and the effects of additional stressful life events (SLEs) since the end of the war. Wives of ex-POWs and combat veterans (N = 129) participated in two time measurements. Spouses of ex-POWs were found to be at higher risk of depression and psychological violence. Psychological violence was a risk factor for depression. The three-way interaction among psychological violence, being a SGH survivor, and experiencing SLEs was significant. In addition, experiencing earlier stressful events had a protective effect. The findings suggest that the association between early exposure and additive exposure through life is a complex iteration of factors and does not necessarily follow the vulnerability perspective.

Risk Factors for Sexual Revictimization and Dating Violence in Young Adults with a History of Child Sexual Abuse

Interpersonal revictimization, through sexual violence and psychological or physical dating violence, is one of the many consequences of childhood sexual abuse (CSA). This study examined how childhood maltreatment, sociodemographic characteristics, mental health, relational factors, and community factors are associated with 1) sexual revictimization 2) psychological dating violence victimization, and 3) physical dating violence victimization in a sample of young adults reporting a history of CSA. A sample of 190 young adults (18-25 y.o.) with self-reported experiences of CSA completed an online survey measuring childhood maltreatment (e.g. neglect, physical abuse, witness to domestic violence), sociodemographic characteristics (e.g. material deprivation, education), mental health (dissociation, posttraumatic stress symptoms), relational factors (e.g. insecure attachment style), and community factors (e.g. neighborhood disadvantage). Hierarchical logistic regressions indicated that once all risk factors were entered in the models, PTSD was positively associated with psychological dating violence, while dissociation was positively associated with physical dating violence. Physical abuse in childhood was positively associated with sexual revictimization. The present study shows the importance of simultaneously considering the impact of multiple characteristics surrounding CSA survivors when evaluating risks of revictimization. Additionally, it highlights the importance of providing CSA survivors with adequate mental health support for trauma-related disorders, as it may be crucial to prevent revictimization.

Can Women Shelters Help Reduce Symptoms of PTSD and C-PTSD? Trajectories of PTSD Symptom Development Following Partner- and Family-Related Violence

BACKGROUND

To protect women from Intimate partner violence (IPV), women's shelters should not only provide emergency safety from IPV exposure, but also prolonged support that empowers women to build a life free from violence. The present study aims to investigate individual symptom development in association with residency at a women's shelter.

METHOD

Data were collected at four different timepoints, that is, enrolment (T1, N = 150), 3-months residency (T2, = 110), 6-months residency (T3, N = 68) and after relocation (T4, N = 63). Women were included from four Danish women's shelters. The International Trauma Questionnaire (ITQ) was applied to test for post-traumatic stress disorder (PTSD) and Complex-PTSD (C-PTSD) at all timepoints. A paired sample t-test was used to test the mean symptom development, and a Latent Class Growth Analysis (LCGA) was applied to test for different classes of PTSD-trajectories. Logistic regression was applied to predict class membership from shelter-related variables and symptom severity, that is, length of residency, psychological counselling, revictimization and key symptoms of C-PTSD.

RESULTS

The prevalence of PTSD (31%) and C-PTSD (37.9%) was high at enrolment. Although t-tests suggested a significant decline in symptoms at follow-up, the LCGA revealed different classes of symptom development. The two-class model was found to be the best representation of data with low-symptom- and high-symptom profiles, respectively. Overall, the largest decline in symptoms occurred within the first 3 months of residency. Revictimization was high and was further found to predict class membership. However, when included in a multiple regression only symptom severity predicted the high-symptoms profile class.

DISCUSSION

Psychological treatment focussing on PTSD and C-PTSD is important for the women's future well-being and safety. Reports on revictimization was alarmingly high, which emphasises a continuing need to protect women from psychological violence within the shelters. These findings should be replicated in larger samples before we can draw any conclusion.

Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment

Children exposed to adverse childhood experiences (ACEs) and pervasive interpersonal traumas may go on to develop PTSD and, in most cases, will further undergo a significant shift in their developmental trajectory. This paper examines contemporary research on Developmental Trauma (DT), which is inextricably linked to disruptions in social cognition, physiological and behavioral regulation, and parent-child attachments. Developmental trauma associated with early experiences of abuse or neglect leads to multi-faceted and longstanding consequences and underscores critical periods of development, complex stress-mediated adaptations, and multilevel, trans-theoretical influences in the diagnostic formulation and treatment of traumatized children, adolescents, and adults. Psychological and medical correlates of Developmental Trauma Disorder are considered, and directions for future research are discussed.

Complex PTSD in survivors of intimate partner violence: risk factors related to symptoms and diagnoses

BACKGROUND

In 2018, the World Health Organization proposed a new diagnosis entitled Complex Posttraumatic Stress Disorder (CPTSD) in the ICD-11. It is a diagnosis that encompasses the classic symptoms of PTSD, along with symptoms of disturbances in self-organization (DSO). Although this disorder has been studied in several countries and populations, research on the population of women survivors of intimate partner violence (IPV) is scarce.

OBJECTIVES

1) To analyse the prevalence of CPTSD and PTSD according to ICD-11 criteria; 2) To analyse the associations between CPTSD symptomatology and severity of violence, level of fear, resilience and strategies of emotion regulation; 3) To analyse which risk factors (severity of violence, level of fear, resilience and strategies of emotion regulation) may differ between female survivors with CPTSD or PTSD.

METHOD

162 women IPV survivors who completed a socio-demographic and violence-related interview, as well as questionnaires to assess PTSD and CPTSD, severity of violence, resilience and emotion regulation strategies.

RESULTS

The results showed a higher prevalence of CPTSD (39.50%), compared to PTSD (17.90%). Moreover, a high level of fear was related to re-experiencing in the here and now, avoidance, current sense of threat and disturbances in relationships. Low levels of resilience and maladaptive emotion regulation strategies such as expressive suppression were related to affective dysregulation, negative self-concept and disturbances in relationships. Finally, the results showed that maladaptive emotion regulation strategies differentiated between meeting CPTSD and PTSD criteria in women survivors of IPV.

CONCLUSION

The findings of this study indicated that CPTSD was twice as prevalent as PTSD within the sample. Moreover, maladaptive emotion regulation strategy as expressive suppression was the main variable related to experiencing CPTSD, in contrast to PTSD. These findings may have important implications for the design of specific treatments aimed at women survivors of IPV, who also suffer CPTSD.