Terri L. Weaver

A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims.

The purpose of this study was to compare cognitive-processing therapy (CPT) with prolonged exposure and a minimal attention condition (MA) for the treatment of posttraumatic stress disorder (PTSD) and depression. One hundred seventy-one female rape victims were randomized into 1 of the 3 conditions, and 121 completed treatment. Participants were assessed with the Clinician-Administered PTSD Scale, the PTSD Symptom Scale, the Structured Clinical Interview for DSM–IV, the Beck Depression Inventory, and the Trauma-Related Guilt Inventory. Independent assessments were made at pretreatment, posttreatment, and 3 and 9 months posttreatment. Analyses indicated that both treatments were highly efficacious and superior to MA. The 2 therapies had similar results except that CPT produced better scores on 2 of 4 guilt subscales.

Mental Health Consequences of Intimate Partner Abuse A Multidimensional Assessment of Four Different Forms of Abuse

Battered women are exposed to multiple forms of intimate partner abuse. This article explores the independent contributions of physical violence, sexual coercion, psychological abuse, and stalking on symptoms of posttraumatic stress disorder (PTSD) and depression among a sample of 413 severely battered, help-seeking women. The authors test the unique effects of psychological abuse and stalking on mental health outcomes, after controlling for physical violence, injuries, and sexual coercion. Mean scores for the sample fall into the moderate to severe range for PTSD and within the moderate category for depression scores. Hierarchical regressions test the unique effects of stalking and psychological abuse, after controlling for physical violence, injuries, and sexual coercion. Psychological abuse and stalking contribute uniquely to the prediction of PTSD and depression symptoms, even after controlling for the effects of physical violence, injuries, and sexual coercion. Results highlight the importance of examining multiple dimensions of intimate partner abuse.

Psychological distress associated with interpersonal violence: A meta-analysis

Abstract The present meta-analytic review examined the relationship between interpersonal violence and psychological distress, utilizing 50 published or prepublication empirical studies. Studies were included in the review if they quantified psychological distress following childhood sexual or physical abuse, rape, criminal assault, or partner (domestic) physical abuse or rape. The overall effect size, though heterogeneous, was clinically and practically significant, demonstrating empirically that interpersonal violence has deleterious effects on psychological functioning. Within victimized groups, specific objective and subjective stressor-related factors were examined for the magnitude of their effect on resulting psychological distress. Subjective factors, such as general appraisal, self-blame, and perceived life threat, contributed twice as much to the magnitude of psychological distess as did objective factors, such as physical injury, force, and use of a weapon. Generally, psychological distress in the domains of intra- and interpersonal functioning emerged as theoretically and clinically important avenues for further research.

Intimate partner violence and stalking behavior: exploration of patterns and correlates in a sample of acutely battered women.

The aims of this study were to provide descriptive data on stalking in a sample of acutely battered women and to assess the interrelationship between constructs of emotional abuse, physical violence, and stalking in battered women. We recruited a sample of 114 battered women from shelters, agencies, and from the community at large. Results support the growing consensus that violent and harassing stalking behaviors occur with alarming frequency among physically battered women, both while they are in the relationship and after they leave their abusive partners. Emotional and psychological abuse emerged as strong predictors of within- and postrelationship stalking, and contributed a unique variance to women’s fears of future serious harm or death, even after the effects of physical violence were controlled. The length of time a woman was out of the violent relationship was the strongest predictor of postseparation stalking, with increased stalking found with greater time out of the relationship. Results suggest the need to further study the heterogeneity of stalking and to clarify its relationship to constructs of emotional and physical abuse in diverse samples that include stalked but nonbattered women, as women exposed to emotional abuse, and dating violence.

The impact of severe stalking experienced by acutely battered women: an examination of violence, psychological symptoms and strategic responding

Stalking has been relatively understudied compared to other dimensions of intimate partner violence. The purpose of this article was to examine concurrent and subsequent intimate partner abuse, strategic responses and symptomatic consequences of severe stalking experienced by battered women. Thirty-five battered women classified as “relentlessly stalked” and 31 infrequently stalked battered women were compared. Compared to infrequently stalked battered women, relentlessly stalked battered women reported: (a) more severe concurrent physical violence, sexual assault and emotional abuse: (b) increased post-separation assault and stalking; (c) increased rates of depression and PTSD; and (d) more extensive use of strategic responses to abuse. Results underscore the scope and magnitude of stalking faced by battered women and have implications for assessment and intervention strategies.

Economic Education for Battered Women: An Evaluation of Outcomes

Economic education programs that are intended to improve financial literacy have gained significant attention in recent years as one strategy for promoting social and economic development, especially among poor and disadvantaged groups. The aims of such programs are to increase awareness of financial choices, opportunities, and consequences. The role that poverty and financial matters play in intimate partner violence has also received increasing attention among advocates for victims of domestic violence. This study examined the financial literacy outcomes of an economic education program that was created specifically for battered women using a quasi-experimental design. The findings indicate limited gains in financial knowledge and significant improvements in financial self-efficacy and highlight the need for further research.

Adapting cognitive processing therapy for child sexual abuse survivors

With the advent of managed care, there is an increasing need for short-term, empirically based treatments. This article presents a cognitive behavioral therapy protocol for the treatment of adult survivors of childhood sexual abuse, Cognitive Processing Therapy for Sexual Abuse (CPT-SA). Based on information processing, developmental and self-trauma theories, this 26-session model combines group and individual therapy over a 17-week period. Clients are asked to write about the trauma, and explore adaptive, schema congruent, and discrepant beliefs that developed during and after the abuse. Focus is placed on beliefs related to safety, trust, power/control, self-esteem, and intimacy, with individual modules for each of these areas. Initial pilot data (N = 15), clinical implications, and two client case studies are also discussed.

Mediators of Suicidal Ideation Within a Sheltered Sample of Raped and Battered Women

The relationship between suicide attempts and the experience of intimate partner physical violence has been examined in recent literature. The present study extended this literature by examining the relationship between intimate partner rape and suicidal ideation in a sheltered sample of battered women. Fifty women were recruited from a regional shelter setting for battered women in a Midwestern city in the United States. Fifty-eight percent had experienced intimate partner rape. Morethan one-third of the sample confirmed experiencing suicidal ideation at least “some of the time” within the past week. Experiencing intimate partner rape was significantly associated with suicidal ideation and symptoms of post-traumatic stress disorder (PTSD) and depression. Tests of mediation revealed that both PTSD and depressive symptoms mediated the relationship between intimate partner rape and suicidal ideation.

Sex differences in physiological and affective responses to stress in remitted depression.

Major depressive disorder (MDD) is associated with alterations in stress physiology. Severe melancholic depression is characterized by hypercortisolism, but community dwelling mildly depressed individuals and those with remitted MDD have shown reduced or normal reactivity to stress. There are also pronounced sex differences both in the incidence of MDD and in stress reactivity. To explore the relationships among depression history, sex differences, and stress, we examined stress reactivity in people with and without a history of MDD. Twenty-two participants with remitted MDD (12 men and 10 women) and 36 never depressed comparison participants (22 men and 14 women) participated in the study. Cortisol and alpha-amylase (sAA) were sampled from saliva before, 10 min after, and 30 min after the Trier Social Stress Test (TSST). Participants filled out the Positive Affect Negative Affect Schedule (PANAS) before and after they underwent the TSST. Women with remitted MDD showed reduced cortisol response to the TSST compared with the never MDD women, while men with remitted MDD showed comparable cortisol reactivity to the never depressed men. The groups did not differ on sAA reactivity to stress. The remitted MDD group (overall and men and women separately) reported greater negative affect both before and after stress compared to the never depressed group. Women from both groups reported greater post-stress negative affect than men. In contrast, men from both groups reported higher positive affect before and after stress than women. Given that the sex difference findings were not dependent on depression history, self-reported affective differences in response to stress may predate depressive symptoms and contribute to sex differences in depression incidence.

Development and Preliminary Psychometric Evaluation of the Domestic Violence-Related Financial Issues Scale (DV-FI)

Intimate partner violence (IPV) occurs at disproportionate rates within impoverished groups of women and can include economic abuse as a form of psychological maltreatment. The current study developed a comprehensive assessment of the unique financial issues facing female victims of IPV using a sheltered sample (N = 113). An exploratory factor analysis (principal-axis factoring with varimax rotation) was conducted on 24 items of the newly developed Domestic Violence—Related Financial Issues Scale. Preliminary results supported five extracted factors, which accounted for approximately 53% of the total common variance in the womens responses. Psychometric properties of the instrument are presented.