Effects of Resource Loss and Coping on PTSD and

Transcription

1 Acknowledgements Effects of Resource Loss and Coping on PTSD and Depression in IPV Survivors Rachel Kendra & Michelle Lilly Northern Illinois University Michelle Lilly & Kathryn Bell Christine Valdez, Andrew Sherrill, Sarah Ramsey, Phylice Lim, Melissa London, MC Mercer, & Nicole Wyngarden Undergraduate RAs Holly Orcutt, Julie Crouch, & CSFVSA PTSD in IPV Survivors Depression in IPV Survivors High prevalence of PTSD in IPV survivors In meta-analysis, prevalence rate of 64% among battered women (Golding, 1999; Jones et al., 2001) Weighted OR = % of IPV victims had moderate-to-severe PTSD symptoms (Coker & Weston, 2005) High prevalence of depression in IPV survivors In meta-analysis, prevalence rate of 48% among battered women (Golding, 1999) Weighted OR = % of battered women were moderately to severely depressed (Campbell et al., 1997) Physical IPV predicted depression (Campbell et al., 1997) 1

2 Symptoms in IPV Survivors Conservation of Resources Theory Though research has established the link between IPV and psychological distress, still examining why some women do not develop posttrauma psychopathology p Among the many factors that have received attention are: The extent to which resources and access to resources are diminished in the face of trauma Efforts to cope with trauma Resources: anything people value or that allows people to protect what they value Objects (e.g., house) Personal characteristics (e.g., self-esteem) esteem) Conditions (e.g., marriage) Energies (e.g., credit) Any event that results in loss of resources can lead to psychological stress Resource Loss and PTSD Resource Loss and Depression Downward-spiraling, bidirectional relationship Longitudinal research Demonstrated with variety of traumatized populations After controlling for related variables (Littleton et al., 2011; Schumm et al., 2005; Zwiebach et al., 2010) Resource loss is also associated with current and future depression Longitudinal research Resource loss partially mediated relationship between trauma and depression (Banou et al., 2009; Hobfoll et al., 2006) After controlling for related variables (Hobfoll et al., 2006; Schumm et al., 2005) 2

3 Resource Loss in IPV Survivors Johnson et al. (2008) IPV can result in resource loss in many areas Access to resources protected women from re-abuse (Sullivan & Bybee, 1999) Resources partially mediated relationship between IPV severity and mental health (Ford- Gilboe et al., 2009) Within-woman perceived difficulty obtaining resources fully mediated relationship between change in psychological abuse and change in depression over time (Beeble et al., 2010) 177 battered women in shelters PTSD partially mediated relationship between IPV severity and resource loss Suggests PTSD may be mechanism through which IPV severity affects resource loss in battered women Did not control for other variables, other than shelter stay length Coping Literature has shown that coping is related to post-traumatic symptomatology Greater overall psychological distress has been linked to more efforts to cope, leading to a positive relationship between the use of more coping strategies and greater PTSD and depression symptoms Individuals will engage in many coping strategies until distress has remitted Coping The relationship between coping and post-trauma symptomatology may be amplified when an individual is also confronted with significant loss of resources Trying to actively cope while still losing resources can lead to even greater psychological distress Arata (2000) proposed a bidirectional relationship between resource loss and coping in predicting PTSD Thus far, only one study of resource loss has included coping 3

4 Arata et al. (2000) Current Study 125 commercial fishers 6 years after oil spill Both resource loss and avoidant coping predicted PTSD and depression Proposed bidirectional relationship between resource loss and coping However, did not test their interrelationship or interactive effects Research investigating impact of resource loss on psychological symptoms in IPV victims is scarce First study to examine effects of both resource loss and coping on psychological symptoms in IPV victims Controlling for trauma history Given its relationship with study variables Based on previous research Hypotheses Participants As Arata (2000) proposed, there will be a positive relationship between coping and resource loss After controlling for trauma history, Coping and resource loss will have positive main effects on PTSD and depression Will coping and resource loss interact to predict PTSD and depression? 111 community and shelter women who reported physical IPV victimization in past 6 months Mean age = (SD = 9.90) 90) Single/Unmarried = 54.1% 4

5 Demographics Ethnicity Percentage African-American 58.7% Caucasian 28.4% Biracial 8.3% Hispanic 2.7% Other 1.8% Shelter Yes 28.4% No 71.6% Work Yes 24.5% No 75.5% Measures Ways of Coping Checklist (WOC; Vitaliano et al., 1985) Emotion-focused coping Conversation of Resources Evaluation (CORE; Hobfoll & Lilly, 1993) Actual material loss Posttraumatic Diagnostic Scale (PDS; Foa, 1995) Symptom severity Symptom Checklist-90-Revised (SCL-90-R; Derogatis, 1994) Depression subscale Procedure Results: Preliminary Analyses Recruited through flyers and newspaper advertisements Surveys administered individually by RAs or PIs Monetary compensation Research with COR typically includes demographic variables in analysis (e.g., Freedy et al., 1994; Hobfoll et al., 2006; Littleton et al., 2011; Sattler et al., 2006; Schumm et al., 2005) No relationships between demographic and study variables Not included in analyses 5

6 Results: Descriptives α M SD Min/Max Coping / 2.50 Resource Loss / 3.16 PTSD / Depression / 3.60 Trauma / Poss. Range Results: Traumatic Events Event % N Physical IPV 90.4% 94 Sudden or unexpected death of loved one 81.6% 84 Saw or heard family violence 54.8% 57 Miscarriage 48.1% 50 Loved one survived life-threatening illness 47.1% 49 Someone threatened to kill you 47.1% 49 Stalked 47.1% 49 CPA 41.3% 43 CSA by someone 5+ years older 35.0% 36 Saw stranger attack or beat someone up 32.7% 34 Results: Correlations Results: PTSD Symptoms 1. Coping Resource Loss PTSD.37**.28** Depression.50**.27**.55** Trauma.40**.23*.52**.44** 1.00 **p <.01. *p <.05. Step Adj. R 2 Variable B 1.26 Trauma history 6.81* 2.30 Trauma history 5.45* Coping 2.48* Resource loss Trauma history 5.09* Coping 2.73* Resource loss 1.64 Coping x resource loss 1.76 *p <.05 6

7 Results: Depression Symptoms Step Adj R 2 Variable B 1.17 Trauma history 0.39* 2.31 Trauma history 0.24* Coping 0.33* Resource loss Trauma history 0.25* Coping 0.32* Resource loss 0.12 Coping x resource loss Conclusions Both trauma history and emotion-focused coping were associated with PTSD and depressive symptoms Resource loss had no main or interactive effects on PTSD and depressive symptoms First study with IPV survivors to control for trauma history May be better accounted for by trauma history *p <.05 What s next? Limitations Run analyses with larger sample Examine additional variables IPV severity (Beeble et al., 2010; Ford-Gilboe et al., 2009) Additional analyses Psychological symptoms predicting resource loss (Johnson et al., 2009) Different resources Different statistics Small sample size Cross-sectional study Temporal/directional relationship between variables is unknown Focus on physical IPV victims Other studies suggest relationship between psychological IPV, resource loss, and psychological symptoms (Beeble et al., 2010) Scoring error in TLEQ 7

8 Implications and Future Directions Importance of trauma history and coping skills in PTSD and depressive symptoms Treatment with clients with PTSD and depression should assess/address trauma history and coping skills Longitudinal research to determine directional relationships Test effects of different types of resource loss 8