1. How does psychological abuse affect battered women's commitment to leave abusive partners?
2. How do symptoms of posttraumatic stress disorder (PTSD) affect battered women's intentions to leave abusive partners?
3. How do coping strategies and sense of control in response to abuse affect the development of PTSD symptoms?
   

How was the study conducted?
Sixty-eight women residing at emergency women's shelters participated in the study; approximately half the study participants were white and half were of minority backgrounds. Within two weeks of their arrival at the shelter, study participants completed self-report surveys on psychological and physical abuse experiences, coping styles and psychological well being including the presence of PTSD symptoms. Researchers distinguished between "emotion-focused" and "problem-focused" styles of coping based on subjects' responses on the Ways of Coping Checklist-Revised (Folkman & Lazarus, 1985; Forsythe & Compas, 1987). After study participants wrote brief narratives about the most recent episode of abuse they had experienced, they were asked to rate on a scale of 1 to 7 their sense of control over the violence and the likelihood they would leave their abusive partners. Statistical techniques were applied to analyze participants' responses.

What are the study's findings?
Eighty-eight percent of study participants had PTSD symptom scores at or above clinical levels. (At two weeks post-trauma, study participants could not be diagnosed with PTSD because the diagnosis requires symptom persistence for at least one month post-trauma.) Measures also revealed that study participants had survived frequent episodes of psychological and severe physical abuse. They equally used emotion- and problem-focused coping. Most felt they had little control over the violence and expressed strong resolve to leave their abusive partners.

Significant results were found regarding the effects of psychological abuse, PTSD symptoms and coping styles on women's resolve to leave abusive partners.

1. Psychological abuse predicted both PTSD symptoms and intent to leave abusive partners, even after statistically controlling for the effects of physical abuse.
2. The PTSD symptoms determined the effects of abuse on victims' intent to leave their abusers. Subjects with low levels of PTSD symptoms expressed resolve to leave abusive partners, but those with high levels of PTSD symptoms had less resolve to leave despite the severity of the abuse.
3. Coping style predicted psychological problems. Study participants who preferred emotion-focused coping were more likely to have PTSD symptoms.
   

What are the study's implications?

1. Battered women are at risk for developing PTSD, and PTSD symptoms increase battered women's risk of continued abuse. Screening and appropriate interventions for PTSD are called for among domestic violence survivors.
2. Clinicians who serve battered women should be aware that PTSD symptoms could disable them from leaving the abusive relationship.
3. Before victims can consider leaving abusive partners and becoming self-sufficient they may first need services that restore their sense of psychological well being.
4. Deficits in coping skills in combination with psychological distress can interfere with a battered woman's ability to succeed at recreating a life without violence.
5. Protective, supportive environments such as shelters are needed.
6. Shelter stays longer than 30 days may be necessary to allow time for women to receive treatment that gives them mental and emotional strength to address the problems caused by domestic violence.

Reviewed by Priscilla Schulz, October 1999