Posttraumatic Stress Symptoms and Victimization Among Japanese American Women Authors: Mieko Yoshihama and Julie Horrocks, University of Michigan Published: Journal of Consulting and Clinical Psychology, V. 70 (1), 2002, 205-215. What is the scope of this study? This article looks at the relationship between intimate partner violence and symptoms of posttraumatic stress in Japanese American women, and it examines how "generational position", socio-demographic characteristics, prior victimizations and social support influence women's responses to intimate partner violence. The researchers hoped that their findings would help improve public policy and community services to a growing Asian immigrant population in the Los Angeles, California, area. What is "generational position"? "Generational position" refers to the length of time since immigration to the U.S. Through exploring participants' immigration histories researchers determined their "generational position." First generation Japanese Americans are those who immigrated to the U.S at age 13 or older; 2nd generation immigrated before age 13, or are U.S-born whose parents were born in Japan; 3rd generation are U.S-born, and their parents either immigrated to the U.S. before age 13 or were born in the U.S.; 4th generation are U.S. born to U.S. born parents, and their grandparents were born in the U.S. or immigrated here before age 13. How was this study conducted? Study participants came from Los Angeles County, California, where Japanese Americans comprise 15% of the local population. Using telephone listings, researchers contacted households with Japanese surnames, explained the purpose of the study and asked eligible female household members if they were interested in participating. Of the 407 households identified as having Japanese American women who fit criteria to be in the study, 211 (52%) participated. Criteria to be in the study were: female between age 18 and 49, Japanese descent born either in the U.S. or Japan, and had had an intimate heterosexual relationship. Only one eligible woman per household was allowed to participate in the study, and a random selection process chose between those eligible. Researchers interviewed study participants in person, in either English or Japanese. Behavior specific questions determined participants' lifetime experiences of intimate partner violence. Modified versions of standard measures assessed posttraumatic stress symptoms, and the kind and severity of violence. Researchers also explored participants' experiences of childhood abuse (physical and sexual), and victimization not involving intimate partners (i.e., property theft, hate crime, muggings, etc.), and gathered demographic data such as age, marital status, education, and immigration background. Because existing measures of social support were deemed unsuitable for a Japanese American population, researchers created a culturally appropriate measure that quantified social support and assessed participants' opinion of the quality of support. Findings Prevalence of intimate partner violence The majority of study participants had experienced some form of intimate partner violence in their lifetimes. Specifically, 75% reported emotional abuse. More than 50% reported physical abuse. For 14% of study participants the abuse had either caused injuries, caused them to fear for their lives, or both. 16% reported being raped by intimate partners History of child abuse or other victimization 13% of participants reported that they were physically abused as children. Of these, two (less than 1% of participants) had also been sexually abused. 94% of participants had experienced some form of criminal victimization in their lifetimes; 60% had experienced three or more such victimizations (i.e., muggings, burglaries, hate crimes, etc.). Generational position There were no significant differences between participants of different generational positions in their experiences of abuse, non-partner victimization or posttraumatic stress. Participants of different generational positions differed demographically and in their perception of social support: 1st and 3rd generation participants were older. 1st generation participants were most likely to be married or in committed relationships, and reported the smallest and least satisfying social support networks. More 1st generation participants had a high school diploma, or less, than other study participants, but educational differences were not as extreme at post-secondary educational levels. Posttraumatic stress Victimization was associated with posttraumatic symptoms regardless of the trauma or when it occurred (i.e., recently, or more than a year before the study). Participants who reported that they had been abused by intimate partners were much more likely to exhibit symptoms of posttraumatic stress than those who did not report intimate partner violence. Greater severity of intimate partner violence was associated with more symptoms. Age appeared to affect symptoms. That is, when symptomatic, younger (age 18-29) and older (age 40-49) participants had significantly more posttraumatic symptoms than participants in their 30's. Different symptoms of posttraumatic stress (i.e., re-experiencing, avoidance or hyper-arousal) were associated with different kinds of abuse. Re-experiencing: Study participants who sustained injuries from abuse by intimate partners, had been victimized by a non-intimate partner (e.g., burglary, mugging, etc.), or had been abused as a child reported proportionately higher re-experiencing symptoms. Multiple violations were associated with an equivalent increase in re-experiencing symptoms. Avoidance: This was the most frequently endorsed symptom. Violence, violation, and emotional abuse, unless committed by a non-intimate, were all strongly associated with symptoms of posttraumatic avoidance (i.e., emotional numbing, depressive or dissociative symptoms, actively suppressing thoughts and feelings, and avoiding reminders of the abuse). Arousal: Arousal was reported significantly more among study participants whose symptoms were related to child abuse. Social support and posttraumatic stress Posttraumatic symptoms of re-experiencing and avoidance were moderated by reports of satisfaction with social support when such symptoms were associated with childhood abuse. Satisfaction with social support and posttraumatic arousal symptoms from childhood abuse interacted in a manner that neutralized significance. In other words, childhood abuse increased the number of reported arousal symptoms, but each increment in reported satisfaction with social support decreased arousal symptoms. When posttraumatic re-experiencing and avoidance symptoms were not associated with childhood abuse, then satisfaction with social support had little moderating effect. Implications In a number of ways, the findings in this study agreed with findings from other studies about the effect of domestic violence on the psychological well being of women in the U.S. For example, more severe abuse predicted more severe posttraumatic stress, and there appears to be a cumulative effect (i.e., increased posttraumatic stress symptoms) with multiple experiences of trauma or abuse. There were several findings of concern. This study revealed that in this community sample of Japanese American women the number reporting intimate partner violence was disproportionate compared to women in the general population. In addition, the reported perception of poor social support among 1st generation Japanese American women, the strong association of physical with emotional abuse and emotional abuse with posttraumatic stress, and the persistence of posttraumatic stress symptoms over time suggested a need for certain services to immigrant populations, such as: Outreach programs to immigrant communities that ameliorate feelings of isolation and improve social support to new immigrants, seek to prevent abuse or victimization, offer help to those experiencing problems of domestic violence; Treatment programs that address the longer term consequences of abuse (i.e., persistent posttraumatic stress); Social policy and clinical strategies to address the detrimental effects of emotional abuse (i.e., legal remedies for emotional abuse). Reviewed by Priscilla Schulz, LCSW August 28, 2002 Center for Trauma Recovery University of Missouri - St. Louis

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