Women's Appraisals of Intimate Partner Violence Stressfulness and Their Relationship to Depressive and Posttraumatic Stress Disorder Symptoms
Martinez-Torteya, Cecilia, Bogat, G. Anne, von Eye, Alexander, Levendosky, Alytia A., Davidson, William S., Violence and Victims
Intimate partner violence (IPV) increases risk for depressive and posttraumatic stress disorder (PTSD) symptoms. Most studies use a dose-response approach to examine the impact of IPV on mental health, but they often fail to explain mental health outcome specificity as well as to assess the impact of women's subjective appraisals. The present research examined women's IPV stressfulness appraisals and their psychological functioning (depressive and PTSD symptoms). Results indicate that IPV stressfulness appraisals are associated with depressive symptoms over and above frequency and severity of IPV. PTSD symptoms were associated with frequent and stressful IPV. Women who experienced highly frequent and highly stressful IPV were most likely to display comorbid depressive and PTSD symptoms. Results underscore the importance of women's subjective experiences and the heterogeneity of women's responses to IPV.
Keywords: domestic violence; intimate partner violence; stressfulness appraisals; mental health; PTSD; depression
Women who experience intimate partner violence (IPV; defined here as male violence toward a female romantic partner) have an increased risk of developing posttraumatic stress disorder (PTSD) symptoms (i.e., re-experiencing, avoidance, and /or hyperarousal) and depressive symptoms (e.g., sad mood, thoughts of worthlessness; Golding, 1999). However, women who experience IPV display heterogeneity in mental health outcomes (Stein & Kennedy, 2001). Many women develop only one type of symptom (e.g., depressive-only), others develop comorbid depressive and PTSD symptoms, whereas others remain relatively resilient (Bogat, von Eye, Leahy, & DeJonghe, 2006). Previous research has identified increased victimization as a risk factor for mental health problems (e.g., Sullivan, Meese, Swan, Mazure, & Snow, 2005), but more information is needed to elucidate the pathways that lead to specific symptom configurations. In addition, despite the influence of cognitive appraisals on depressive and PTSD symptoms (King, King, Gudanowski, & Vreven, 1995; Nurious et al., 2003), women's IPV stressfulness appraisals have not been explored. The present research examined women's IPV stressfulness appraisals to determine whether they were associated with their depressive and PTSD symptoms, as well as differentially linked to specific symptom configurations.
Perceptions are likely an essential determinant of a person's emotional and behavioral response to a stressor (Lazarus & Folkman, 1984; Monroe & Kelly, 1995), including the experience of IPV. According to transactional stress theory (Lazarus & Folkman, 1984), appraisals are the subjective interpretations that individuals assign to a potential stressor. Primary appraisals refer to the evaluation of the significance or relevance of a stimulus, whereas secondary appraisals refer to an evaluation of the individual's resources to manage effectively a potentially stressful situation (Lazarus & Folkman, 1984). A stress reaction is elicited when events are interpreted as salient to the individual's well-being and appraised as threatening, harmful, challenging, and/or surpassing the individual's resources. In the context of environmental stress, activation of the stress response can be adaptive; however, the individual's efforts to adapt to a chronically adverse psychosocial environment can result in the development of symptoms of depression and PTSD (McEwen, 2003, 2004).
Women's "subjective" appraisals of IPV have been rarely examined. However, a metaanalysis exploring psychological distress among victims with a variety of interpersonal trauma, including IPV, reported that subjective general and self-blame appraisals contributed twice as much to their psychological distress as "objective" factors, such as the victim's report of number of perpetrators, the duration of stressors, or weapon use (Weaver & Clum, 1995). …