Michelle M. Lilly

Intimate partner violence and PTSD: The moderating role of emotion-focused coping

Intimate partner violence (IPV) affects millions of women every year, often resulting in posttraumatic stress disorder (PTSD). The strength of the relationship between IPV and PTSD has been shown to be affected by factors such as the amount of violence exposure and the style of coping in which the individual engages. For example, emotion-focused coping has been shown to be strongly related to IPV exposure and the expression of PTSD symptoms. This topic was explored in IPV survivors, with the finding that more frequent use of emotion-focused coping was associated with both higher violence exposure and heightened PTSD symptoms. Regression analyses revealed that emotion-focused coping moderated the relationship between IPV exposure and PTSD symptoms. More specifically, the results suggest that while individuals low on emotion-focused coping had fewer PTSD symptoms than women who frequently used emotion-focused coping, these individuals reported higher PTSD symptoms in the presence of frequent violence exposure. For individuals who frequently engaged in emotion-focused coping, violence exposure was less strongly associated with symptoms of PTSD.

Traumatic Events and Maternal Education as Predictors of Verbal Ability for Preschool Children Exposed to Intimate Partner Violence (IPV)

Despite research on the effects of intimate partner violence (IPV) on children, little is known about its impact on cognitive development. In this study, 87 preschool-aged children and their mothers exposed to IPV within the last two years participated in interviews to ascertain verbal ability, history of violence, and exposure to trauma. When compared to a national sample of 1,700 same-age children not evaluated for exposure to traumatic events, children exposed to IPV scored significantly lower on verbal ability, as assessed with standardized measures. In order to understand variation in verbal ability, multiple regression models were tested. Both prior exposure to traumatic events and the level of mother’s education were significant predictors of verbal ability. However, level of education mediated the relationship between traumatic events and the child’s verbal ability.

Mediators and Moderators of Change in Adjustment Following Intervention for Children Exposed to Intimate Partner Violence

Children aged 6 to 12 who were exposed to intimate partner violence (IPV) within the last year participated in an intervention program found to be successful in reducing their internalizing and externalizing behavior problems. However, little is known about factors that may contribute to this efficacy. Both fixed and modifiable risk factors that predicted change in children’s adjustment after the intervention were identified and tested. There was a significant relationship between the extent of exposure to IPV, gender, change in mothers’ mental health, and change in child adjustment. Among fixed factors, length of exposure to violence was found to moderate the relationship between the amount of the child’s and mother’s participation in the intervention and change in child adjustment, specifically internalizing behavioral problems. Among the modifiable risk factors, change in mother’s mental health, specifically symptoms of posttraumatic stress, was found to mediate the relationship between the amount of intervention participation and change in child adjustment. These findings can be used to inform and enhance evidence-based clinical services for children exposed to IPV.

The Mediating Effect of World Assumptions on the Relationship Between Trauma Exposure and Depression

The association between trauma exposure and mental health-related challenges such as depression are well documented in the research literature. The assumptive world theory was used to explore this relationship in 97 female survivors of intimate partner violence (IPV). Participants completed self-report questionnaires that assessed trauma history, world assumptions, and depression severity. Regression analyses revealed that diminished world assumptions mediate the relationship between trauma exposure and depression severity. As predicted, this relationship held for interpersonal forms of trauma, whereas noninterpersonal forms of trauma were related neither to diminished world assumption nor to depression severity. This suggests that our conceptual system of relating to the world, our core beliefs that comprise our assumptive world, may be challenged in the face of human-induced trauma, increasing our risk for developing adverse psychological outcomes such as depression.

Duty‐related trauma exposure in 911 telecommunicators: Considering the risk for posttraumatic stress

Peritraumatic distress may increase the risk for posttraumatic stress disorder (PTSD) in police officers. Much less is known about emotional reactions and PTSD symptomatology in 911 telecommunicators. The current study assessed duty-related exposure to potentially traumatic calls, peritraumatic distress, and PTSD symptomatology in a cross-sectional, convenience sample of 171 telecommunicators. Results showed that telecommunicators reported high levels of peritraumatic distress and a moderate, positive relationship was found between peritraumatic distress and PTSD symptom severity (r = .34). The results suggest that 911 telecommunicators are exposed to duty-related trauma that may lead to the development of PTSD, and that direct, physical exposure to trauma may not be necessary to increase risk for PTSD in this population.

Shared Pathogeneses of Posttrauma Pathologies: Attachment, Emotion Regulation, and Cognitions

OBJECTIVE To demonstrate how intrapersonal functioning variables related to attachment, cognition, and emotion are implicated in mental health outcomes for two samples of interpersonal trauma survivors, including undergraduates and women from the community. METHOD Two samples of survivors of interpersonal trauma were included: undergraduates (n = 290, 60% female) and intimate partner violence survivors from the community (n = 114). Participants completed self-report measures that assessed psychopathology, emotion dysregulation, attachment processes, and cognitions about the world, self, and others. RESULTS Emotion dysregulation was strongly linked to symptoms of depression, posttraumatic stress disorder, and somatization in both samples. Cognitions also accounted for unique variance in predicting symptoms of depression and somatization in both samples. CONCLUSIONS Results suggest that disruption in the ability to regulate emotions is the most consistent predictor of mental health in survivors of interpersonal trauma, followed by cognitions regarding the world, self, and others. Treatment implications are discussed.

Fostering Social Competence in Preschool Children Exposed to Intimate Partner Violence: Evaluating the Preschool Kids' Club Intervention

This study assessed whether participation in an intervention program enhanced social competence in 113 preschool-aged children who were exposed to intimate partner violence. Change in competence was evaluated from baseline to approximately five weeks postbaseline and compared preschool children who did and did not receive intervention services. Protective factors, such as exposure to less severe violence, were identified that predicted change in competence scores. Results indicated that children with the highest social competence pre-intervention exhibited a significant increase in their postintervention scores, if they participated in the program. The extent of this change was predicted by a higher preintervention score and exposure to less severe violence. This study indicates that even short-term intervention could result in meaningful change in key aspects of child functioning.

Self-Worth as a Mediator Between Attachment and Posttraumatic Stress in Interpersonal Trauma

It is well documented that most trauma survivors recover from adversity and only a number of them go on to develop posttraumatic stress disorder (PTSD). In addition, survivors of interpersonal trauma (IPT) appear to be at heightened risk for developing PTSD in comparison to survivors of noninterpersonal trauma (NIPT). Despite a robust association between IPT exposure and attachment disruptions, there is a dearth of research examining the role of attachment-related processes implicated in predicting PTSD. Using a sample of college undergraduates exposed to IPT and NIPT, this study explores the mediating effect of self-worth in the relationship between attachment and PTSD. It is hypothesized that insecure attachment will be related to posttraumatic symptomatology via a reduced sense of self-worth in IPT survivors but not in NIPT survivors. Mediation analyses provide support for this hypothesis, suggesting the importance of considering negative cognitions about the self in therapeutic interventions, particularly those offered to IPT survivors.

Posttraumatic growth in survivors of intimate partner violence: an assumptive world process.

Adverse consequences of intimate partner violence (IPV) are well documented, whereas less research has explored positive changes. Recent efforts indicate that survivors report posttraumatic growth (PTG), but the schema reconstruction hypothesis by which this is achieved is in need of further investigation. One model of PTG suggests that growth is triggered by trauma(s) that challenges an individual’s assumptive world. This threat promotes cognitive processing and schema reconstruction that fosters a sense of meaning and value in one’s life. As schema change is posited as the main cognitive antecedent of PTG, a longitudinal assessment of world assumptions was used to examine whether assumption change predicts PTG in IPV survivors. Results indicate that world assumptions became more positive 1 year after an initial interview but only for women who had not been revictimized in the year between study assessments. Furthermore, positive world assumption change was associated with greater PTG scores. Implications for intervention and research are discussed.

The Contributions of Interpersonal Trauma Exposure and World Assumptions to Predicting Dissociation in Undergraduates

This study examines the relationship between world assumptions and trauma history in predicting symptoms of dissociation. It was proposed that cognitions related to the safety and benevolence of the world, as well as self-worth, would be related to the presence of dissociative symptoms, the latter of which were theorized to defend against threats to ones sense of safety, meaningfulness, and self-worth. Undergraduates from a midwestern university completed the Multiscale Dissociation Inventory, World Assumptions Scale, and Traumatic Life Events Questionnaire. Consistent with the hypotheses, world assumptions were related to the extent of trauma exposure and interpersonal trauma exposure in the sample but were not significantly related to non-interpersonal trauma exposure. World assumptions acted as a significant partial mediator of the relationship between trauma exposure and dissociation, and this relationship held when interpersonal trauma exposure specifically was considered. The factor structures of dissociation and world assumptions were also examined using principal component analysis, with the benevolence and self-worth factors of the World Assumptions Scale showing the strongest relationships with trauma exposure and dissociation. Clinical implications are discussed.