Martie P. Thompson

Social Support Protects against the Negative Effects of Partner Violence on Mental Health

OBJECTIVES Social support for abused women may reduce the impact of abuse on mental health, yet few studies have addressed this issue. We wish to determine associations between intimate partner violence (IPV) and mental health outcomes and to assess the protective role of abuse disclosure and support on mental health among abused women. METHODS A cross-sectional survey was conducted of 1152 women, ages 18-65, recruited from family practice clinics from 1997 through 1999. They were screened for IPV during a brief in-clinic interview, and physical and mental health status was assessed in a follow-up interview. RESULTS IPV, defined as sexual, physical, or psychological abuse, was associated with poor perceived mental and physical health, substance abuse, symptoms of posttraumatic stress disorder (PTSD), current depression, anxiety, and suicide ideation/actions. Among women experiencing IPV and controlling for IPV frequency, higher social support scores were associated with a significantly reduced risk of poor perceived mental health (adjusted relative risk [aRR] 0.5, 95% confidence interval [CI] 0.3, 0.6) and physical health (aRR 0.6, 95% CI 0.5, 0.8), anxiety (aRR 0.3, 95% CI 0.2, 0.4), current depression (aRR 0.6, 95% CI 0.5, 0.8), PTSD symptoms (aRR 0.5, 95% CI 0.4, 0.8), and suicide attempts (aRR 0.6, 95% CI 0.4, 0.9). CONCLUSIONS Healthcare providers can be instrumental in identifying IPV and helping women develop skills, resources, and support networks to address IPV. Physicians, family, or friends may provide needed social support.

Childhood victimization and subsequent adult revictimization assessed in a nationally representative sample of women and men.

The purpose of this study was to identify whether experiences of childhood physical and/or sexual victimization would increase women’s and men’s risk for victimization in adulthood by different perpetrators (any perpetrator regardless of the relationship to the victim; intimate partner perpetrator; non-intimate perpetrator) using a nationally representative sample. Results of hierarchical logistic regression analyses indicated that childhood victimization increased the risk for adulthood victimization by any perpetrator for men and women, and by an intimate partner for women but not men. Female and male victims of physical and/or sexual child abuse are at higher risk for adult victimization by non-intimate perpetrators. These results suggest the appropriateness of interventions among adults or young adults who have been victims of child abuse, to prevent any future victimization in adulthood. To guide the development of such prevention programs, research is needed to identify factors that affect the probability of adulthood victimization among child abuse victims.

Children's Attributional Style Questionnaire—Revised: Psychometric Examination

This study examines the psychometric properties of the Childrens Attributional Style Questionnaire—Revised (CASQ-R; N. J. Kaslow & S. Nolen-Hoeksema, 1991), a 24-item shortened measure derived from the 48-item CASQ designed to assess childrens causal explanations for positive and negative events. The data for this study come from 1,086 children, 9 to 12 yean* old, with equal representation of boys and girls and African American and Caucasian children. Approximately one half (n = 475) of the youths also completed the CASQ-R 6 months later. Results revealed that although the CASQ-R was somewhat less reliable than the original CASQ, with moderate internal consistency reliability and fair test-retesl reliability, it demonstrated equivalent criterion-related validity with self-reported depressive symptoms. Psychometric properties of the CASQ-R showed some variation by race, such that the overall composite demonstrated better internal consistency and criterion-related validity among Caucasian youths than among African American youths.

Gender differences in long-term health consequences of physical abuse of children: data from a nationally representative survey

OBJECTIVES This study investigated the effects of physical abuse in childhood on health problems in adulthood and assessed gender differences in these associations. METHODS We used data from 8000 men and 8000 women who were interviewed in the National Violence Against Women Survey. We used multivariate logistic regression to test for main and interactive effects and conducted post hoc probing of significant moderational effects. RESULTS Men were more likely than women to have experienced physical abuse during childhood. Whereas abuse had negative consequences for both boys and girls, it was generally more detrimental for girls. CONCLUSIONS Findings suggest the need to consider gender differences and long-term adverse health consequences in the development of intervention strategies to address physical abuse in childhood.

Factors That Mediate and Moderate the Link Between Partner Abuse and Suicidal Behavior in African American Women

Findings from a study comparing partner abuse in African American women suicide attempters (n = 148) and nonattempters (n = 137) revealed higher rates of physical and nonphysical partner abuse among attempters than their demographically similar nonsuicidal counterparts. The partner abuse--suicidal behavior link was mediated by psychological distress, hopelessness, and drug use and moderated by social support. Results also revealed that nonphysical partner abuse accounted for unique variance in the prediction of suicide attempt status beyond that attributable to childhood maltreatment. Implications of the findings for assessing both suicidal and abused women are discussed, and recommendations for preventive interventions for women at risk for suicidal behavior are provided.

Partner violence, social support, and distress among inner-city African American women

This study examined the role of social support in the partner violence–psychological distress relation in a sample of African American women seeking medical care at a large, urban hospital (n = 138). Results from bivariate correlational analyses revealed that partner violence was related to lower perceived social support and greater psychological distress, and lower social support was related to more distress. Furthermore, findings based on path analysis indicated that low levels of social support helped account for battered womens increased distress. Findings point to the need for service providers to screen for partner violence in nontraditional sites, such as hospital emergency rooms, and to address the role of social support resources in preventive interventions with African American battered women.

The Roles of Victim and Perpetrator Alcohol Use in Intimate Partner Violence Outcomes

Alcohol use increases the risk of intimate partner violence (IPV), yet little research has examined its role in victimization outcomes (e.g., physical injury, police reporting). This study examined the roles of perpetrator and victim incident-specific alcohol use in IPV outcomes. The sample included 501 men and 1,756 women who had experienced an IPV physical assault. Logistic regression analyses showed that after controlling for relevant covariates, women whose partners had been drinking were significantly more likely to be injured than were women whose partners had not been drinking. A woman’s own alcohol use was unrelated to victimization outcomes. Men were significantly more likely to report the incident if their partners had been drinking but were marginally less likely to report if they had been drinking. Findings suggest that perpetrators’ incident-specific alcohol use is important in understanding which victims are most likely to be injured and report the incident to the police.

Attitudinal Acceptance of Intimate Partner Violence among U.S. Adults

Attitudinal acceptance of intimate partner violence (IPV) is an important correlate of violent behavior. This study examined acceptance of IPV using data collected from a nationally representative telephone survey of 5,238 adults. Multivariable logistic regression analyses were used to test for associations between sociodemographic characteristics, exposure to violence, question order, and acceptance of hitting a spouse or boyfriend/girlfriend under specific circumstances. Depending on the circumstance examined, acceptance of IPV was significantly higher among participants who were male and younger than 35; were non-White; were divorced, separated, or had never married; had not completed high school; had a low household income; or were victims of violence within the past 12 months. Participants were more accepting of women hitting men; they also were consistent’; more likely to report tolerance of IPV if they were asked first about women hitting men rather than men hitting women. Reports of IPV tolerance need to be interpreted within the context of the survey. Efforts to change IPV attitudes can be tailored to specific IPV circumstances and subgroups, and these efforts should emphasize that the use of physical violence is unacceptable to both genders.

Age differences in the psychological consequences of Hurricane Hugo

At 12, 18, and 24 months after Hurricane Hugo, 831 adults were interviewed regarding their disaster-related stressors and present psychological state. The studys purposes were to assess whether age influenced ones vulnerability to postdisaster stress and to evaluate four different perspectives on disaster recovery that have been previously used to explain age differences. Regression analyses demonstrated that disaster exposure had substantial and pervasive psychological effects. The analyses also revealed a curvilinear interaction between disaster exposure and age. Younger people exhibited the most distress in the absence of disaster, but middle-aged people did so in its presence. Differential exposure, resources, and inoculation all failed to explain these differences, however, the burden perspective had considerable explanatory power.

RISK FACTORS FOR SUICIDE ATTEMPTS AMONG AFRICAN AMERICAN WOMEN

The aim of this study was to examine psychological and interpersonal risk factors for suicidal behavior in low income, African American women; 285 African American women who reported being in a relationship with a partner in the past year were studied, 148 presented to the hospital following a suicide attempt, and 137 presented for general medical care. Cases were compared to controls with respect to psychological symptoms, alcohol and drug abuse, family violence (intimate partner abuse, childhood trauma), relationship discord, and social support. Psychological risk factors for suicide attempts at the univariate level included psychological distress [Crude Odds Ratio (COR) = 6.5], post traumatic stress disorder (PTSD) symptoms (COR = 3.8), hopelessness (COR = 7.7), and drug abuse (COR = 4.2). Interpersonal risk factors at the univariate level included relationship discord (COR = 4.0), physical partner abuse (COR = 2.5), nonphysical partner abuse (COR = 2.8), childhood maltreatment (COR = 3.2), and low levels of social support (COR = 2.6). A multivariate logistic regression model identified four variables that were strongly and independently associated with an increased risk for suicide attempts: psychological distress, hopelessness, drug abuse, and relationship discord. The model predicted suicide attempt status correctly 77% of the time. The results reveal that African American women who report high levels of psychological distress, hopelessness, drug use, and relationship discord should be assessed carefully for suicidal ideation and referred for appropriate mental health care. Depression and Anxiety 12:13–20, 2000.