Jessica K. Salwen

The predictive utility of psychological aggression for intimate partner violence

Although psychological aggression has been identified as a risk factor for physical aggression, the prevalence of psychological aggression is much higher than that of physical aggression. To further understand the relationship between psychological and physical aggression, the level of psychological aggression at which physical aggression becomes more likely was evaluated. A representative sample of 268 men and 299 women responded anonymously to a self-report measure of aggression (revised Conflict Tactics Scale [CTS-2]) at baseline, and then 1 year later. Using both cross-sectional and longitudinal analyses, this study evaluated the level of psychological aggression that is necessary before it is likely that one will be physically aggressive. When one was at the 80th percentile of psychological aggression, there was a 70% probability that a man would be physically aggressive and 85% probability that a woman would be physically aggressive. Longitudinally, when one was at the 80th percentile of psychological aggression at Time 1, there was a 40% probability that a man would be physically aggressive and 45% probability that a woman would be physically aggressive at Time 2. CTS-2 psychological decile scores are provided along with the probability of physical aggression to assist clinicians in interpreting client scores. Implications for research and couples therapy are discussed.

Childhood abuse, adult interpersonal abuse, and depression in individuals with extreme obesity.

This study sought to examine (a) a mediational model of childhood abuse, adult interpersonal abuse, and depressive symptoms and (b) the impact of weight-related teasing on rates and correlates of childhood abuse. Charts of 187 extremely obese individuals seeking psychological clearance for bariatric (weight-loss) surgery were retrospectively examined. Among the participants, 61% reported a history of childhood abuse, 30.5% reported adult interpersonal abuse, and 15% reported clinically significant depressive symptoms. Initially, the relationship between childhood abuse and current depressive symptoms was significant (p<.001). However, the introduction of adult interpersonal abuse as a mediator in the model reduced the magnitude of its significance (Sobels test p=.01). The associations between childhood abuse and adult interpersonal abuse and between adult interpersonal abuse and depressive symptoms were significant (p<.001 and p=.002, respectively), and the model showed a good fit across multiple indices. Finally, weight-related teasing was a significant moderator in the relationship between childhood and adult interpersonal abuse. Bariatric surgery patients report elevated rates of childhood abuse that are comparable to rates in psychiatric populations (e.g., eating disorders, depression), and higher than those in community samples and other medical populations. The relationship between child abuse and depressive symptomatology may be partially explained by the presence of adult interpersonal abuse; additionally, the relationship between childhood and adult interpersonal abuse was stronger for those who did not endure weight-related teasing than for those who did.

Weight-related abuse: perceived emotional impact and the effect on disordered eating

The purpose of this article was to evaluate theories that (1) weight-related abuse (WRA) plays a unique role in the development of disordered eating, above and beyond general childhood verbal abuse and weight-related teasing, and (2) the perceived emotional impact of WRA mediates the relationship between WRA and current disordered eating. Self-report questionnaires on childhood trauma, weight-related teasing, WRA, and current eating behaviors were administered to a total of 383 undergraduate students. In initial regressions, WRA significantly predicted binge eating, emotional eating, night eating, and unhealthy weight control. WRA continued to significantly predict all 4 forms of disordered eating following the introduction of measures of weight-related teasing and childhood verbal abuse into the regression. Latent variable analysis confirmed that perceived emotional impact of WRA mediated the relationship between WRA and disordered eating, and tests for indirect effects yielded a significant indirect effect of WRA on disordered eating through perceived emotional impact. In sum, WRA is a unique construct and the content of childhood or adolescent maltreatment is important in determining eventual psychopathology outcomes. These findings support the necessity of incorporating information on developmental history and cognitive factors into assessment and treatment of individuals with disordered eating.

A mediational model of obesity related disordered eating: The roles of childhood emotional abuse and self-perception

The extant literature indicates negative self-perceptions are a risk factor for disordered eating (DE) and DE is a risk factor for overweight and obesity. While childhood emotional abuse (EA) is often linked to DE and obesity, it is typically not included in comprehensive models of these health problems. Further investigation of interactions among EA, self-perception, and DE is needed to refine treatments for overweight, obesity, and DE. This study evaluated a model of DE and weight difficulties in which negative self-perception mediate the relationship between EA and DE, and DE predicts body mass index (BMI) in a population of emerging adults. Further, this study investigated the utility of history of EA for prediction of DE and classification of individuals with and without DE. Self-report questionnaires on childhood trauma, psychopathology, and eating behaviors were administered to 598 undergraduate students. Latent variable analysis confirmed the hypothesized model. Recursive partitioning determined that individuals reporting a high level of EA likely meet criteria for night eating syndrome (NES) or binge eating disorder (BED), and history of EA has a moderate to high level of specificity as a predictor of BED and NES. These findings confirm the necessity of evaluating EA and DE in emerging adults with weight difficulties, and the importance of assessing self-perception and DE in individuals with a history of EA. Future studies should investigate the utility of addressing EA and self-perception in interventions for DE and obesity and to determine whether these findings can be generalized to a clinical population.

Adjustment Problems and Maladaptive Relational Style: A Mediational Model of Sexual Coercion in Intimate Relationships

Four hundred and fifty-three married or cohabitating couples participated in the current study. A meditational model of men’s perpetration of sexual coercion within an intimate relationship was examined based on past theories and known correlates of rape and sexual coercion. The latent constructs of adjustment problems and maladaptive relational style were examined. Adjustment problem variables included perceived stress, perceived low social support, and marital discord. Maladaptive relational style variables included psychological aggression, dominance, and jealousy. Sexual coercion was a combined measure of men’s reported perpetration and women’s reported victimization. As hypothesized, adjustment problems significantly predicted sexual coercion. Within the meditational model, adjustment problems were significantly correlated with maladaptive relational style, and maladaptive relational style significantly predicted sexual coercion. Once maladaptive relational style was introduced as a mediator, adjustment problems no longer significantly predicted sexual coercion. Implications for treatment, limitations, and future research are discussed.

The Weight-Related Abuse Questionnaire (WRAQ): Reliability, validity, and clinical utility.

Weight-related teasing (WRT)/stigmatization may be distinct from teasing and general abuse and may differentially impact adult outcomes. As WRT increases in severity so do depression and disordered eating. Currently, there are no validated measures designed to assess abuse specific to weight. Thus, we developed the Weight-Related Abuse Questionnaire (WRAQ) and validated it in young adult and clinically obese populations. The WRAQ was administered to 3 samples of participants: 292 undergraduate students, 382 undergraduate students, and 59 individuals seeking bariatric surgery. Concurrent validity was assessed via measures of WRT and general childhood abuse. Convergent validity was assessed with measures of depression and disordered eating. Study 1 data were used to further develop the structure of the WRAQ. Study 2 indicated that the WRAQ had excellent psychometric properties (based on factor analyses and reliability/scale consistency analysis) and strong concurrent and convergent validity, supporting the validity of the questionnaire. 6-month test-retest reliability was also good. In Study 3 responses on the WRAQ converged well with interview responses, showed good psychometric properties, and showed moderate correlations with measures of childhood abuse and psychopathology. The WRAQ has strong psychometric properties and is strongly associated with measures of current psychopathology. Additionally, it fills a gap in the assessment literature and may be a beneficial tool for determining which individuals are at increased risk for psychopathology.

Childhood verbal abuse: a risk factor for depression in pre-bariatric surgery psychological evaluations.

The present study evaluated the importance of multimodal assessment of childhood verbal abuse (CVA) in pre-bariatric surgery psychological evaluations, and the role of CVA as a predictor of depression. Data from the psychological evaluations of 184 pre-bariatric surgery patients were retrospectively examined. Using two self-report measures and an interview-based screen, 52.2 % of participants reported experiencing some form of CVA; conversely, assessments of CVA based on only one measure yielded significantly lower prevalence rates. Endorsement of CVA on multiple measures was associated with more severe depressive symptomatology and greater likelihood of mood disorder diagnosis. Based on these data, a self-report measure and interview-based screen for CVA should be included in pre-bariatric psychological evaluations; either of these assessments may be conducted via a single-item screen. Lastly, patients who endorse CVA on multiple measures should be monitored closely for symptoms of depression post-surgery.

Predictors of suicidality in bariatric surgery candidates

Risk for suicidality (current or past suicidal ideation or attempt) increases after bariatric surgery; however, there is a paucity of research investigating suicidality predictors in this population. This study involved a retrospective chart review of individuals seeking psychological clearance for bariatric surgery. In total, 32 participants (15.8%) were classified as reporting suicidality. These participants endorsed greater depressive symptomatology and hopelessness, and hopelessness and mood disorder diagnosis each uniquely predicted whether or not a patient was classified as reporting suicidality. The findings within suggest that increased attention to the relationship among these variables may improve methods for identification of high-risk patients. Implications for clinical practiced are discussed.

Sexual coercion and psychological aggression victimization: unique constructs and predictors of depression

Sexual coercion of women is a common problem in couples that is often conceptualized as a facet of sexual assault or as a form of psychological aggression. Because psychological aggression is consistently linked to depressive symptoms, the researchers evaluated the unique contribution of sexual coercion victimization in the prediction of depressive symptoms beyond the variance explained by psychological aggression victimization. Sample 1 consisted of women living with a partner for at least a year and parenting a young child, whereas Sample 2 consisted of undergraduate students in relationships of at least 6 months. Overall, 27.4% of the women in Sample 1 and 22.8% of the women in Sample 2 reported experiencing sexual coercion victimization. Across both samples, depressive symptoms and psychological aggression victimization were significantly greater in women who experienced sexual coercion victimization. In addition, sexual coercion victimization and psychological aggression victimization each contributed significantly and uniquely to the prediction of depressive symptoms. Thus, although related to psychological aggression victimization, sexual coercion in an intimate relationship is a distinct construct. Implications for assessment, prevention, and couple therapy are discussed.

The roles of body mass index and jealousy in women's perpetration of sexual coercion

Although a substantial body of research exists on men’s perpetration of sexual coercion, research on women’s perpetration is limited. The authors evaluated a model of women’s sexual coercion perpetration in 448 couples. Women with greater body mass indexes (BMIs) were more likely to perpetrate sexual coercion against an intimate partner. Couple weight status (women with higher BMIs than their partners) moderated the relationship between partners’ BMI differences and women’s jealousy. Furthermore, women’s jealousy mediated the relationship between partners’ BMI differences and women’s sexual coercion. These findings show that BMIs impact sexual and relationship quality and suggest that the literature on men’s sexual coercion perpetration may also apply to women’s perpetration. Limitations, implications for couple therapy, and future research are discussed.