Psychological sequelae of battered women residing in rural community shelters

Presty, Sharon Katharine, Department of Psychology, University of Virginia
Wilson, Melvin, Department of Psychology, University of Virginia
Emery, Robert, Department of Psychology, University of Virginia
Patterson, Charlotte, Department of Psychology, University of Virginia
Macciocchi, Stephen N., Department of Physical Medicine and Rehabilitation, University of Virginia

Partner violence is serious health concern leading to debilitating physical injury in women. Significant psychological sequelae are associated with battering, however, only recent investigations have begun to delineate the different types of psychological distress. The diagnosis of Posttraumatic Stress Disorder (PTSD) has been useful in characterizing the symptoms associated with victims of severe trauma. The DSM-IV criteria for PTSD include reexperiencing trauma, avoidance responses, and heightened arousal. Given the characteristics shared between battered women and other victims of violent crime, it was predicted that battered women develop primary features of PTSD. The second hypothesis was that other women would meet DSM-IV criteria for Acute Stress Disorder (ASD). Exploratory analyses were also performed to examine relationships between the frequency and severity of abuse and diagnostic categories. The results confirmed the two hypotheses. First, 65.6% of the sample was PTSD-positive, with 5% meeting criteria for ASD. Other anxiety disorders accounted for 13.1%. The prevalence rate of Major Disorder (MDD) was 70.5%. The comorbidity of depression with PTSD was 84.6%. Physical abuse significantly predicted PTSD development, explaining 11.40% of the total variance. Verbal abuse significantly predicted MDD. Dissociation was predicted by both verbal and physical abuse.

Exploratory cluster analysis revealed three typologies of battered women. Cluster 1 reflected young, poorly educated women, who experienced the greatest physical abuse. They had. the highest levels of PTSD, moderate depression, and the poorest level of functioning. Cluster 2 women were the oldest, had the most children, and had the longest relationship duration. They experienced more verbal than physical abuse, and had the highest degree of depression, with modest PTSD severity. Cluster 3 reflected the youngest, most educated group, with the least number of children, and shortest relationship duration. They experienced the lowest levels of verbal and physical abuse, with significant but low levels of PTSD, and depression.

Battered women demonstrate primary PTSD symptoms, as well as secondary features of PTSD (major depression and dissociation), suggesting that the PTSD model explains the pattern of psychological sequelae exhibited by battered women. The results of cluster analysis suggest that battered women are not homogeneous and differential treatment strategies may be necessary.

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PHD (Doctor of Philosophy)
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