Stephanie J. Woods

PTSD is Associated With an Excess of Inflammatory Immune Activities

PURPOSE. Post-traumatic stress disorder (PTSD) is associated with inflammatory-related medical conditions. This review examines studies of immune function in individuals with PTSD to determine if excessive inflammation is associated with PTSD. CONCLUSIONS. Current studies suggest an excess of inflammatory actions of the immune system in individuals with chronic PTSD. High levels of inflammatory cytokines have also been linked to PTSD vulnerability in traumatized individuals. There is also evidence that excessive inflammation is in part due to insufficient regulation by cortisol. PRACTICE IMPLICATIONS. An excess of inflammatory immune activity may contribute to health declines in individuals with PTSD, and treating PTSD symptoms may reduce these risks.

Prevalence and patterns of posttraumatic stress disorder in abused and postabused women

This study examined the prevalence and patterns of posttraumatic stress disorder (PTSD) symptomatology in abused and postabused women. A convenience sample of 160 abused, postabused, and nonabused women completed measures related to physical and emotional abuse by an intimate partner, risk of homicide, and PTSD. Results indicated that PTSD symptoms were present in both the abused and postabused women and were positively correlated with the severity of abuse and risk of homicide that the women experienced. The postabused women were out of the abusive relationship an average of nine years, yet continued to experience PTSD symptoms.

Intimate Partner Violence and Post-Traumatic Stress Disorder Symptoms in Women What We Know and Need to Know

This article presents a review of knowledge regarding post-traumatic stress disorder (PTSD) in women experiencing intimate partner violence. Knowledge related to the prevalence and predictors of PTSD in battered women, the association between PTSD and physical health, and the emerging science regarding PTSD and physiological and immune parameters is addressed. Primary recommendations for future research includes the need for longitudinal and intervention research that incorporates a range of psychosocial and physiologic health outcomes.

Physical Health and Posttraumatic Stress Disorder Symptoms in Women Experiencing Intimate Partner Violence

This correlational-predictive study addresses the associations between intimate partner violence (IPV) and physical health and posttraumatic stress disorder (PTSD) symptoms, including: 1) detailed physical health symptoms reported and health care sought by women in intimate abusive relationships, 2) relationships between physical health symptoms, IPV, and PTSD, and 3) unique predictors of physical health symptoms. An ethnically diverse sample of 157 abused women was recruited from crisis shelters and the community. The women averaged almost 34 years of age and had been in the abusive relationship for slightly more than 5 years. The women experienced physical health symptoms falling into 4 groups: neuromuscular, stress, sleep, and gynecologic symptoms. Women experiencing more severe IPV reported more physical health and PTSD symptomatology. PTSD avoidance and threats of violence or risk of homicide uniquely predicted physical health. More than 75% of the women had sought treatment from a health care professional in the previous 9 months. Implications for practice are discussed.

Assessing salivary C-reactive protein: longitudinal associations with systemic inflammation and cardiovascular disease risk in women exposed to intimate partner violence.

This study evaluated individual differences in levels of C-reactive protein (CRP) measured in saliva, cross-sectionally and prospectively, in relation to systemic inflammation and risk for cardiovascular disease (CVD). Plasma and saliva samples, later assayed for CRP, were collected multiple times from an ethnically diverse group of women seeking help from domestic violence crisis shelters-agencies (N=107; mean age at study start=34 years). Plasma and saliva CRP levels were moderately associated cross-sectionally and across two years. There were indications that saliva CRP levels were, on average, higher in the morning than evening. Higher levels of saliva and plasma CRP were associated with a higher body mass index, but did not differ between women who did and did not smoke. Salivary CRP reliably discriminated between high and low levels of plasma CRP, using a clinically relevant cutoff point of 3mg/L, recommended by the American Heart Association. Results build upon an emerging literature suggesting that under specific conditions levels of CRP in saliva may reflect low-grade inflammation and have the potential to serve as a screen for CVD risk status.

Predicting immune status in women from PTSD and childhood and adult violence.

This study uses a predictive exploratory design to test the relationships between and among childhood maltreatment, intimate partner violence (IPV), posttraumatic stress disorder (PTSD) symptoms, and immune status in abused women. A convenience sample of 126 abused women and 12 nonabused women matched for age and race/ethnicity were recruited. The womans current smoking habit, history of childhood maltreatment, experience of IPV, and PTSD symptoms predicted immune status. This prediction occurs through both direct and indirect pathways from IPV to immune status and from IPV to immune status through PTSD.

Trauma and its Aftermath for Commercially Sexually Exploited Women as Told by Front-Line Service Providers

Commercial sexual exploitation of women and girls through forced prostitution and sex-trafficking is a human rights and public health issue, with survivors facing complex mental health problems from trauma and violence. An international and domestic problem, the average age of recruitment into sex-trafficking is between 11 and 14 years old. Given its secrecy and brutality, such exploitation remains difficult to study, which results in a lack of knowledge related to trauma and how best to develop specific services that effectively engage and meet the unique needs of survivors. This qualitative research, using thematic analysis, explored the stories of trauma and its aftermath for commercially sexually exploited women as told by front-line service providers. Three themes emerged regarding the experience of sex-trafficking and its outcomes—Pimp Enculturation, Aftermath, and Healing the Wound—along with seven subthemes. These have important implications for all service and healthcare providers.

Posttraumatic stress in battered women: does the diagnosis fit?

Posttraumatic stress disorder (PTSD) has been recommended as an appropriate psychiatric diagnosis for battered women. The criteria for the diagnosis are reviewed along with research that supports its application in battering situations. Definitional, diagnostic, research, and treatment issues using the diagnosis with abused women also are discussed, including recommendations for future investigations and clinical application.

Subjective sleep quality in women experiencing intimate partner violence: Contributions of situational, psychological, and physiological factors†

This study, guided by an adaptation of the theory of unpleasant symptoms, examined the complex relationships of childhood maltreatment, intimate partner violence (IPV), posttraumatic stress disorder (PTSD), depression, and physical health symptoms with global sleep quality and disruptive nighttime behaviors. Data were analyzed using covariance structure analysis. A convenience sample of 157 women currently experiencing IPV was recruited from crisis shelters and community agencies. Findings provide empirical support that women concurrently experiencing PTSD, depression, and stress-related physical health symptoms demonstrated poor global sleep quality and frequent disruptive nighttime behaviors. Posttraumatic stress disorder and stress health symptoms functioned as mediators of childhood maltreatment and IPV effects on both global sleep quality and disruptive nighttime behaviors, but depression did not.

Normative Beliefs Regarding the Maintenance of Intimate Relationships Among Abused and Nonabused Women

This study examined the normative beliefs regarding how women act in maintaining intimate relationships. A convenience sample of 53 abused and 52 nonabused women completed self-report measures related to physical and emotional abuse by an intimate partner (Index of Spouse Abuse), normative beliefs regarding relationships (Silencing the Self), and their self-esteem (Rosenberg Self-Esteem). Results indicated that abused and nonabused women with low self-esteem tended to have higher levels of belief in societal norms and gender-specific socializations regarding how women should maintain relationships. Abused women exhibited significantly higher levels of externalized self-perception, self-sacrifice, silence, and disconnection in intimate relationships when compared to nonabused women.