Posttraumatic stress disorder, childhood trauma and health behaviors in victims of intimate partner violence

Solange Costa Gomes, Eleonora Cunha Veiga Costa

Abstract


Intimate partner violence (IPV) is considered a serious public health problem and a significant risk factor for women’s health. In Portugal, studies focusing on the investigation of post-traumatic stress disorder (PTSD), childhood trauma, and health behaviors in victims of IPV are scarce. This research aimed to analyse the effects of childhood victimization and of IPV on PTSD symptoms and health behaviors in a sample of Portuguese women, including victims and non-victims of IPV (n=117). The participants’ ages ranged from 19 to 74 years (M=37.76; SD=14.85). Differences between women with and without IPV in childhood trauma, PTSD symptoms, and health behaviors were also examined. Results indicated that women who are victims of IPV experience higher levels of childhood abuse and PTSD symptoms and engage in fewer health behaviors compared to non-victimized women. Childhood physical and emotional abuse along with psychological aggression in adulthood are the strongest predictors of PTSD symptoms. Childhood sexual abuse and sexual coercion in adulthood contribute to a lower engagement in health behaviors. This study underscores the impact of IPV on mental health and highlights the need to design effective interventions that prevent future revictimization and promote healthy behaviors among victims.


Keywords


Intimate partner violence, Posttraumatic stress disorder, Child abuse, Health behaviors.

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References


American Psychiatric Association [APA]. (2014). Manual de diagnóstico e estatística das perturbações mentais [Diagnostic and statistical manual of mental disorders] (5th ed.). Climepsi.

Bandura, A. (1977). Social learning theory. Prentice-Hall.

Banks, D. E., Hahn, A. M., Goodrum, N. M., Bernard, D. L., Adams, Z. W., McCart, M. R., Chapman, J., Sheidow, A. J., de Arellano, M. A., & Danielson, C. K. (2022). Sexual risk behavior among adolescents seeking treatment for posttraumatic stress disorder: Exploring psychosocial & symptom correlates. Journal of Child and Adolescent Trauma, 15(1), 181-191. https://doi.org/10.1007/s40653-021-00378-6N

Berk-Clark, C., Secrest, S., Walls, J., Hallberg, E., Lustman, P. J., Schneider, F. D., & Scherrer, J. F. (2018). Association between posttraumatic stress disorder and lack of exercise, poor diet, obesity, and co-occuring smoking: A systematic review and meta-analysis. Health Psychology, 37(5), 407-416. https://doi.org/10.1037/hea0000593

Bernstein, D. P., Fink, L., Handelsman, K., Foote, J., Lovejoy, M., Wenzel, K., Sapareto, E., & Ruggiero, J. (1994). Internal reliability and validity of a new retrospective measure of child abuse and neglect. American Journal of Psychiatry, 151(8), 1132-1136. https://doi.org/10.1176/ajp.151.8.1132

Bernstein, D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., Stokes, J., Handelsman, L., Medrano, M., Desmond, D., & Zule, W. (2003). Development and validation of a brief screening version of the childhood trauma questionnaire. Child Abuse & Neglect, 27(2), 169-190. https://doi.org/10.1016/s0145-2134(02)00541-0

Bernstein, J., Milberg, W. P., McGlinchey, R. E., & Fortier, C. B. (2022). Associations between post-traumatic stress disorder symptoms and automobile driving behaviors: A review of the literature. Accident Analysis and Prevention, 170(1), 1-23. https://doi.org/10.1016/j.aap.2022.106648

Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The posttraumatic stress disorder checklist for DSM‐5 (PCL‐5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28(6), 489-498. https://doi.org/10.1002/jts.22059

Brown, S. J., Conway, L. J., Fitzpatrick, K. M., Hegarty, K., Mensah, F. K., Papadopoullos, S., Woolhouse, H., Giallo, R., & Gartland, D. (2020). Physical and mental health of women exposed to intimate partner violence in the 10 years after having their first child: An Australian prospective cohort study of first-time mothers. BMJ Open, 10(12), 1-11. https://doi.org/10.1136/bmjopen-2020-040891

Campbell, J. A., Walker, R. J., & Egede, L. E. (2016). Associations between adverse childhood experiences, high-risk behaviors, and morbidity in adulthood. American Journal of Preventive Medicine, 50(3), 344-352. https://doi.org/10.1016/j.amepre.2015.07.022

Carvalho, T. M. C., & Pinto-Gouveia, J. (2020). Portuguese version of the posttraumatic stress disorder checklist for DSM‐5 (PCL‐5): Comparison of latent models and other psychometric analyses. Journal of Clinical Psychology, 76(7), 1267-1282. https://doi.org/10.1002/jclp.22930

Centers for Disease Control and Prevention [CDC]. (2020). Preventing intimate partner violence. https://www.cdc.gov/violenceprevention/intimatepartnerviolence/fastfact.html

Costa, E. C. V., & Botelheiro, A. A. L. P. (2020). The impact of intimate partner violence on psychological well-being: Predictors of posttraumatic stress disorder and the mediating role of insecure attachment styles. European Journal of Trauma & Dissociation, 5(1), 1-10. https://doi.org/10.1016/j.ejtd.2020.100151

Costa, E. C. V., Guimarães, S., Ferreira, D., & Pereira, M. G. (2019). Resource loss moderates the association between child abuse and current PTSD symptoms among women in primary-care settings. Journal of Interpersonal Violence, 34(17), 3614-3636. https://doi.org/10.1177/0886260516670883

Costa, E. C. V., & McIntyre, T. M. (2006). Avaliação da eficácia relativa de duas intervenções psicoeducativas dirigidas à prevenção da SIDA e promoção da saúde em mulheres em risco para o VIH [Evaluation of the relative effectiveness of two psychoeducational interventions aimed at HIV prevention and health promotion in women at risk for HIV]. Universidade do Minho.

Cruz, D., Lichten, M., Berg, K., & George, P. (2022). Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment. Frontiers in Psychiatry, 13, 800687. https://doi.org/10.3389/fpsyt.2022.800687

Dias, A., Sales, L., Mooren, T., Mota-Cardoso, R., & Kleber, R. (2017). Child maltreatment, revictimization and post-traumatic stress disorder among adults in a community sample. International Journal of Clinical and Health Psychology, 17(2), 97-106. https://doi.org/10.1016/j.ijchp.2017.03.003

Dokkedahl, S., Kristensen, T. R., Murphy, S., & Elklit, A. (2021). The complex trauma of psychological violence: Cross-sectional findings from a cohort of four Danish women shelters. European Journal of Psychotraumatology, 12(1), 1-13. https://doi.org/10.1080/20008198.2020.1863580

Ferreira, F. M. P. B., Brito, I. S., & Santos, M. R. (2018). Health promotion programs in higher education: Integrative review of the literature. Revista Brasileira de Enfermagem, 71(4), 1714-1723. https://doi.org/10.1590/0034-7167-2016-0693

Field, A. (2009). Discovering statistics using SPSS. Sage.

Folayan, M. O., Zuñiga, R. A. A., Ellakany, P., Yousaf, M. A., Osamika, B. E., Virtanen, J. I., Gaffar, B., Lawal, F. B., Khalid, Z., Aly, N. M., Lusher, J., & Nguyen, A. L. (2024). Socio-economic factors associated with post-traumatic stress symptoms among adolescents and young people during the first wave of the COVID-19 pandemic. Scientific Reports, 14(1), 1-9. https://doi.org/10.1038/s41598-023-50333-8N

Galovski, T. E., Werner, K. B., Iverson, K. M., Kaplan, S., Fortier, C. B., Fonda, J. R., Currao, A., Salat, D., & McGlinchey, R. E. (2021). A multi-method approach to a comprehensive examination of the psychiatric and neurological consequences of intimate partner violence in women: A methodology protocol. Frontiers in Psychiatry, 12, 569335. https://doi.org/10.3389/fpsyt.2021.569335

Grassi-Oliveira, R., Stein, L. M., & Pezzi, J. C. (2006). Translation and content validation of the childhood trauma questionnaire into Portuguese language. Revista Saúde Pública, 40(2), 249-255. https://doi.org/10.1590/s0034-89102006000200010

Hailes, H. P., Yu, R., Danese, A., & Fazel, S. (2019). Long-term outcomes of childhood sexual abuse: An umbrella review. The Lancet Psychiatry, 6(10), 830-839. https://doi.org/10.1016/S2215-0366(19)30286-X

Herman, J. L. (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5(3), 377-391. https://doi.org/10.1002/jts.2490050305N

Hisasue, T., Kruse, M., Hietamäkihttps, J., Raitanen, J., Martikainen, V., Pirkola, S., & Rissanen, P. (2024). Health-relatedcosts of intimate partner violence: Using linked police and health registers. Journal of Interpersonal Violence, 39(8), 1596-1622. https://doi.org/10.1177/08862605231211932NN

Hoeboer, C., de Roos, C., van Son, G. E., Spinhoven, P., & Elzinga, B. (2021). The effect of parental emotional abuse on the severity and treatment of PTSD symptoms in children and adolescents. Child Abuse & Neglect, 111, 104775. https://doi.org/10.1016/j.rehab.2013.07.210N

Hoerster, K. D., Campbell, S., Dolan, M., Stappenbeck, C. A., Yard, S., Simpson, T., & Nelson, K. M. (2019). PTSD is associated with poor health behavior and greater body mass index through depression, increasing cardiovascular disease and diabetes risk among U.S. veterans. Preventive Medicine Reports, 15, 100930. https://doi.org/10.1016/j.pmedr.2019.100930N

Holmes, S. C., Johnson, N. L., Rojas-Ashe, E. E., Ceroni, T. L., Fedele, K. M., & Johnson, D. M. (2019). Prevalence and predictors of bidirectional violence in survivors of intimate partner violence residing at shelters. Journal of Interpersonal Violence, 34(16), 3492-3515. https://doi.org/10.1177/0886260516670183N

Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., Jones, L., & Dunne, M. P. (2017). The effect of multiple adverse childhood experiences on health: A systematic review and meta-analysis. The Lancet Public Health, 2(8), 356-366. https://doi.org/10.1016/S2468-2667(17)30118-4

Iverson, K. M., Vogt, D., Dichter, M. E., Carpenter, S. L., Kimerling, R., Street, A. E., & Gerber, M. R. (2015). Intimate partner violence and current mental health needs among female veterans. Journal of the American Board of Family Medicine, 28(6), 772-776. https://doi.org/10.3122/jabfm.2015.06.150154

Jaffe, A. E., Brockdorf, A. N., Messman, T. L., Gratz, K. L., & DiLillo, D. (2022). Is the risk for sexual revictimization Cumulative? A prospective examination. Women’s Health Issues, 33(2), 208-214. https://doi.org/10.1016/j.whi.2022.11.007N

Kiefer, R., Schick, M. R., Newberger, N. G., Ferguson, J. J., Raudales, A. M., Sullivan, T. P., & Weiss, N. H. (2023). Concordance of posttraumatic stress disorder symptoms assessed via retrospective report versus experience sampling methods in community women experiencing intimate partner violence. Journal of Interpersonal Violence, 39(3-4), 605-630. https://doi.org/10.1177/08862605231197737

Konstantopoulou, G., Hartoumpeki, K., & Mavroeidi, E. (2024). The relationship between intimate partner violence and PTSD in women survivors and the influence of risk Factors: A systematic literature review. British Journal of Multidisciplinary and Advanced Studies, 5(5), 44-58. https://doi.org/10.37745/bjmas.2022.04179

Lapierre, S. (2010). More responsibilities, less control: Understanding the challenges and difficulties involved in mothering in the context of domestic violence. British Journal of Social Work, 40(5), 1434-1451. https://doi.org/10.1093/bjsw/bcp080

Lauterbach, D., Bak, C., Reiland, S., Mason, S., Lute, M. R., & Earls, L. (2007). Quality of parental relationships among persons with a lifetime history of posttraumatic stress disorder. Journal of Traumatic Stress, 20(2), 161-172. https://doi.org/10.1002/jts.20194

Leen-Feldner, E. W., Feldner, M. T., Bunaciu, L., & Blumenthal, H. (2011). Associations between parental posttraumatic stress disorder and both offspring internalizing problems and parental aggression within the National Comorbidity Survey. Journal of Anxiety Disorders, 25(2), 169-175. https://doi.org/10.1016/j.janxdis.2010.08.017

Makaroun, L. K., Brignone, E., Rosland, A. M., & Dichter, M. E. (2020). Association of health conditions and health Service utilization with intimate partner violence identified via routine screening among middle-aged and older women. JAMA Network Open, 3(4), e203138. https://doi.org/10.1001/jamanetworkopen.

3138

María-Ríos, C. E., & Morrow, J. D. (2020). Mechanisms of shared vulnerability to post-traumatic stress Disorder and substance use disorders. Frontiers in Behavioral Neuroscience, 14(6), 34-54. https://doi.org/10.3389/fnbeh.2020.00006

Mehr, J. B., Bennett, E. R., Price, J. L., de Souza, N. L., Buckman, J. F., Wilde, E. A., Tate, D. F., Marshall, A. D., Dams-O’Connor, K., & Esopenko, C. (2023). Intimate partner violence, substance use, and health comorbidities among women: A narrative review. Frontiers in Psychology, 13, 1028375. https://doi.org/10.3389/fpsyg.2022.1028375

Miller, E., & McCaw, B. (2019). Intimate partner violence. The New England Journal of Medicine, 380(9), 850-857. https://doi.org/10.4324/9780429020612-37

Najavits, L. M., Clark, H. W., DiClemente, C. C., Potenza, M. N., Shaffer, H. J., Sorensen, J. L., Tull, M. T., Zweben, A., & Zweben, J. E. (2020). PTSD/substance use disorder comorbidity: Treatment options and public health needs. Current Treatment Options in Psychiatry, 7(4), 544-558. https://doi.org/10.1007/s40501-020-00234-8

Nemeroff, C. B. (2016). Paradise lost: The neurobiological and clinical consequences of child abuse and neglect. Neuron, 89(5), 892-909. https://doi.org/10.1016/j.neuron.2016.01.019

Ogden, S. N., Dichter, M. E., & Bazzi, A. R. (2022). Intimate partner violence as a predictor of substance use outcomes among women: A systematic review. Addictive Behaviors, 127(1), 2-19. https://doi.org/10.1016/j.addbeh.2021.107214

Pais-Ribeiro, J. (2005). Avaliação das intenções comportamentais relacionadas com a promoção e protecção da saúde e com a prevenção das doenças. Análise Psicológica, 22(2), 387-397. https://doi.org/10.14417/ap.199

Paiva, C. A., & Figueiredo, B. (2006). Versão portuguesa das “escalas de táticas de conflicto revisadas”: Estudo de validação. Psicologia: Teoria e Prática, 8(2), 14-39. https://editorarevistas.mackenzie.br/index.php/ptp/article/view/1045

Petersson, J., & Thunberg, S. (2022). Vulnerability factors among women victimized by intimate partner violence and the presence of children. Journal of Family Violence, 37(7), 1057-1069. https://doi.org/10.1007/s10896-021-00328-8

Pill, N., Day, A., & Mildred, H. (2017). Trauma responses to intimate partner violence: A review of current knowledge. Aggression and Violent Behavior, 34, 178-184. https://doi.org/10.1016/j.avb.2017.01.014

Pugliese, E., Visco-Comandini, F., Papa, C., Ciringione, L., Cornacchia, L., Gino, F., Cannito, L., Fadda, S., & Mancini, F. (2024). Understanding trauma in IPV: Distinguishing complex PTSD, PTSD, and BPD in victims and offenders. Brain Sciences, 14(9), 856. https://doi.org/10.3390/brainsci14090856

Roer, G. E., Solbakken, H. H., Abebe, D. S., Aaseth, J. O., Bolstad, I., & Lien, L. (2021). Inpatients experiences about the impact of traumatic stress on eating behaviors: An exploratory focus group study. Journal of Eating Disorders, 9(1), 1-12. https://doi.org/10.1186/s40337-021-00480-y

Stubbs, A., & Szoeke, C. (2021). The effect of intimate partner violence on the physical health and health-related behaviors of women: A systematic review of the Literature. Trauma, Violence, and Abuse, 23(4), 1157-1172. https://doi.org/10.1177/1524838020985541

Teixeira, C. M., Magalhães, T., Barrocas, J., Dinis-Oliveira, R. J., & Taveira-Gomes, T. (2022). Health outcomes in women victims of intimate partner violence: A 20-year real-world study. International Journal of Environmental Research and Public Health, 19(24), 1-12. https://doi.org/10.3390/ijerph192417035N

Thomas, E. A., Owens, G. P., & Keller, E. M. (2021). Relationships among non-interpersonal and interpersonal trauma types, posttraumatic stress, and posttraumatic growth. Journal of Clinical Psychology, 77(11), 2592-2608. https://doi.org/10.1002/jclp.23190

Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD checklist for DSM-5 (PCL-5). National Center for PTSD. https://doi.org/10.1037/t02622-000

Webster, E. M. (2022). The impact of adverse childhood experiences on health and development in young children. Global Pediatric Health, 9(23), 1-11. https://doi.org/10.1177/2333794X221078708

Weiss, N. H., Peasant, C., & Sullivan, T. P. (2017). Intimate partner violence and HIV-risk behaviors: Evaluating avoidant coping as a moderator. AIDS and Behavior, 21(8), 2233-2242. https://doi.org/10.1007/s10461-016-1588-2

White, S. J., Sin, J., Sweeney, A., Salisbury, T., Wahlich, C., Montesinos Guevara, C. M., Gillard, S., Brett, E., Allwright, L., Iqbal, N., Khan, A., Perot, C., Marks, J., & Mantovani, N. (2024). Global prevalence and mental health outcomes of intimate partner violence among women: A systematic review and meta-analysis. Trauma, Violence, and Abuse, 25(1), 494-511. https://doi.org/10.1177/15248380231155529

Widom, C. S. (1989). Child abuse, neglected, and adult behavior: Research design ans dinfdings on criminality, violence, and child abuse. American Journal of Orthopsychiatry, 59(3), 355-367. https://doi.org/10.3886/ICPSR09480

World Health Organization [WHO]. (2014). Global status report on violence prevention 2014. WHO. http://www.who.int/publications/i/item/9789241564793

World Health Organization [WHO]. (2018). Violence against women prevalence estimates, 2018. WHO. http://www.who.int/publications/i/item/9789240022256

Zwienenberg, M., Symphor, W., Peraud, W., & Décamps, G. (2024). Childhood trauma, PTSD/CPTSD and chronic pain: A systematic review. PLoS ONE, 19(8), 1-24. https://doi.org/10.1371/journal.pone.0309332




DOI: https://doi.org/10.14417/ap.2039

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