The sample consisted of 413 women drawn from community battered women’s programs. Demographic characteristics of the sample are summarized in . Participants averaged 34.5 years of age (SD = 8.1). The majority of participants were African American. The majority of women (70%) had at least one child under the age of 18 residing with them (SD = 1.5). Women received an average of 12.4 years of education (SD = 2.0), ranging from 4 to 19 years. Despite their relatively high educational attainment, the sample was impoverished in terms of income. Approximately one third of participants reported personal incomes of less than $5,000 annually. Demographic characteristics of the sample are listed in .
Demographic and Relationship Characteristics of Sample (N = 413)
In terms of participants’ relationships with their abusive partners, slightly more than one quarter (28.5%) were married, 11% were involved in dating relationships with their abusers, and 10.4% were separated or divorced from their perpetrators. Another 50.5% reported having had cohabitating relationships with their abusive partners, even though most were not living with their partners at the time of the assessment. Furthermore, 9.7% of the sample resided with their abusive partners, whereas the majority of participants reported living elsewhere. Nearly all participants (97.8%) identified their perpetrators as male. Participants’ abusive relationships averaged 6.9 years (SD = 6.5 years), ranging from 3 months to 32 years. The duration of abuse spanned nearly 5 years (M = 4.6 years, SD = 5.5), ranging from 7 days to 32 years. Relationship characteristics of the sample are summarized in .
Recruitment and Screening Criteria
Participants were recruited from residential and nonresidential community agencies serving battered women. Research staff made presentations to community agency staff during their regular staff meetings. Questions or concerns about the research goals and procedures were clarified at that time. Agency personnel apprised their clients of the research opportunity during the intake process. Agency clients were provided with a postcard briefly describing the study and listing confidential contact information for the study staff. A dedicated telephone line was established for purposes of participant recruitment.
Prospective participants contacted us and were screened for eligibility on the telephone. To recruit a sample of battered women who experienced recent, serial IPV, we used several screening criteria for potential participants: (a) length of relationship, (b) recency of violence, and (c) severity of violence. First, participants were required to have been in an intimate relationship, whether cohabiting or not, for a minimum of 3 months, effectively ruling out dating violence taking place within the context of casual dating relationships. Second, to improve reporting accuracy, we required that the most recent episode of violence occurred within the past 6 months. However, if the most recent episode occurred less than 2 weeks earlier, participants were scheduled so that there was at least 2 weeks between the most recent episode and the assessment. This designation was made so to reduce potential inflation of scores on symptom measures as a consequence of assault recency. Participants were assessed a minimum of 2 weeks following their last exposure to a violent incident to avoid artificially inflating PTSD scores based on very recent exposure to physical violence. The sample nonetheless was one with chronic exposure to repeat relationship abuse and violence.
Finally, to obtain a sample of women who experienced more than an occasional episode of relationship violence, we required that participants experience at least four incidents of minor violence or two episodes of severe violence (or some combination of four incidents of minor and/or severe violence) within the past year. Minor violence items were as follows: pushed, shoved, or grabbed you; slapped or hit you; threw things at you that could hurt; and twisted your arm or pulled your hair. Severe violence items were as follows: hit or punched you with a fist or with something that could hurt; caused you to have physical injuries; choked you; slammed you against a wall or threw you down stairs; kicked you or beat you up; threatened you with a weapon; used a weapon against you; forced you to have sex when you did not want to; caused you to fear for your life or the lives of your family members.
Participants who were ruled out of the study based on their telephone screening were given support, thanked for their time, and were provided with information about appropriate resources in the community. Sixty-seven women were screened out of the study for the following reasons: Seven women were with their partners for fewer than 3 months, 17 women reported fewer than the required number of episodes of physical violence, 38 women reported abuse that occurred more than 6 months ago (and for some women, the abuse ended many years ago), and 12 women declined to participate after completing the initial telephone screen. Twelve women were terminated from study participation for reasons including apparent psychosis, acute suicidality, drug or alcohol intoxication, or other factors potentially affecting the validity of the results. Another 14 women were dropped from the final data set due to suspected problems with the validity of their self-reported data (e.g., participant completed study measures much too quickly, response bias, or participant denied having experienced partner violence after having positively endorsed partner violence items on the telephone screen).
Participant literacy was assessed by having participants informally demonstrate their understanding of the consent process by having them paraphrase what they read. In the event that a participant had questionable literacy, the questions were read aloud to the participant by a trained female interviewer on the project.
The research was conducted at a university-based trauma center housing a community-based trauma clinic and research facilities. The center was located in an urban setting that was easily accessible by bus and an above-ground rail system that dropped passengers off very close to the setting, thus minimizing travel stress for participants.
Psychological Maltreatment of Women Inventory– Abbreviated Version (PMWI; Tolman, 1989, 1999)
The abbreviated 14-item version of the PMWI consists of two factor-derived subscales that measure dominance and isolation and emotional and verbal abuse. Evidence of reliability and validity are presented in Tolman (1999)
. The scale is a self-report measure, and each item is rated on a 5-point frequency scale, ranging from 1 = never
to 5 = very frequently
. Each subscale consists of 7 items. Coefficient alphas were .89 (dominance and isolation) and .91 (emotional and verbal) in the current study.
Revised Conflict Tactics Scale–2 (CTS-2; Straus, Hamby, Boney-McCoy, & Sugarman, 1996)
Two subscales of the revised CTS-2 were administered to assess the frequency and severity of physical assault (CTS-PA; 12 items) and injury (CTS-I; 6 items). Ratings are made in terms of frequency (0 = never, 1 = once in past year, 2 = twice in past year, 3 = 3 to 5 times in past year, 4 = 6 to 10 times in past year, 5 = 11 to 20 times in past year, 6 = more than 20 times in past year). The authors of the CTS-2 suggest creating a severity index by adding the midpoint for each item and creating a summed score for each subscale. The midpoint equals the rating for ratings of 0, 1, and 2 for items rated with those scores. Scores of 3 are recoded to 4, scores of 4 are recoded to 8, scores of 5 are recoded to 15, and scores of 6 are recoded to 25. Separate subscales assessing minor and severe violence were used. The Minor Violence subscale consisted of the five CTS-2 minor violence items and had a coefficient alpha of .87. The Severe Violence subscale contained the 7 CTS-2 severe violence items supplemented with two additional items assessing repeated and violent shaking and being hit on the head repeatedly. This subscale had a coefficient alpha of .86 in the current sample.
To assess sexual coercion, we used a modification of the CTS-2 items, by using two separate questions to assess (a) the use of threats or force to coerce oral or anal sex and (b) the use of threats or force to coerce vaginal intercourse. CTS-2 scoring was used. The alpha for the two items was .72.
The Stalking Behavior Checklist (SBC; Coleman, 1997)
The SBC is a 25-item inventory assessing a variety of unwanted harassing and pursuit-oriented behaviors. Each item was rated on a 6-point frequency scale, ranging from (0 = never
, 1 = once a month or less
, 2 = 2 to 3 times per month
, 3 = once or twice per week
, 4 = 3 to 6 times per week
, and 5 = once per day or more
). Participants rated each item for the period of time covering the 6 months preceding study participation. Two subscales, Harassing Behavior and Violent Behavior, comprise the SBC. The SBC was originally factor analyzed (Coleman, 1997
) resulting in two subscales, Violent Behavior with 12 items accounting for 34.7% of the variance, and Harassing Behavior with 13 items, accounting for 10.8% of the variance. The Violent Behavior subscale consists of items addressing overt acts of violence (e.g., broke into your home or car, violated a restraining order). The Harassing Behavior subscale consists of items reflecting nonviolent harassment, such as unwanted telephone calls, gifts or visits, and being followed. Only the Harassing Behavior items were included in the present analyses, because the Violent Behavior subscale shared too much overlap with measures of physical violence. Coefficient alpha for the Harassing Behavior subscale was .90 in the current sample.
The Standardized Battering Interview
This interview consists of a variety of structured questions assessing demographic and abusive relationship characteristics. Embedded in this structured interview were questions addressing various aspects of the abusive relationship, including: length of the battering, length of the abusive relationship, date of most recent episode of abuse, and time since leaving the relationship most recently. Participants were also queried about a range of minor and severe injuries. Each injury item is rated on a frequency scale. Six items assess minor injuries: (a) bruises to the head, face, or neck; (b) bruises to the rest of the body; (c) cuts on the head, face, neck; (d) cuts on the rest of the body; (e) burns to head, face, neck; and (f) burns to other parts of the body. These six items had a coefficient alpha of .73. Seven items assessing severe injuries were also included: (a) broken bones in the head, face, neck; (b) broken bones on other parts of the body; (c) dislocated bones on parts of the body other than head, face, neck; (d) loss of consciousness; (e) damaged teeth; (f) ruptured eardrum; and (g) damage to internal organs. Coefficient alpha for this subscale was .69. The low endorsement rate for this group of very severe injuries constrained the alpha level.
The Posttraumatic Diagnostic Scale (PDS; Foa, Cashman, Jaycox, & Perry, 1997)
The PDS is a 34-item measure of PTSD symptoms that can be used to compute a continuous severity score, severity scores for each of the three clusters of symptoms, and for making a formal diagnosis of PTSD. Seventeen items assess symptom frequency, rated for the past month using a 4-point scale (0 = not at all or only one time, 1 = once a week or less or once in a while, 2 = 2 to 4 times per week or half the time, 3 = five or more times a week or almost always). Coefficient alpha for the 17-point scale was .90 in this sample of battered women. The PDS has been found to possess excellent psychometric properties, including internal consistency, test-retest reliability, and convergent validity with other well-established measures of PTSD. Scores are interpreted according to severity: 10 or less = mild, 11 to 20 = moderate, 21 to 35 = moderate to severe, 36 and more = severe.
Beck Depression Inventory–Second Edition (BDI-II; Beck, Steer, & Brown, 1996)
The BDI-II is an updated version of its widely used predecessor, the BDI (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961
), which measures depressive symptoms. The BDI-II contains 21 items assessing depressive symptoms corresponding to the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition
(DSM-IV; American Psychiatric Association, 1994
) criteria for major depressive disorder. Items are rated on a 4-point severity scale. Coefficient alpha for the scale was .90 in the present sample. Total scores were obtained by summing the items, and scores can be clinically evaluated using the following cut score guidelines: 0 to 13 = minimal
, 14 to 19 = mild
, 20 to 28 = moderate
, 29 to 63 = severe
Participants who met study criteria and agreed to participate completed the study in two visits that typically occurred within several days of each other. On the initial day, women completed several symptom-based measures programmed onto a laptop computer to reduce the likelihood that symptom scores would be elevated as a consequence of discussing traumatic material. A trained female research assistant worked closely with the participant to demonstrate the laptop procedure. There were practice questions to ensure that the participant was using the computer correctly. The research assistant remained available for assistance throughout the procedure in case a participant encountered technical difficulties. Data from our own (Griffin, Resick, Waldrop, & Mechanic, 2003
) and other studies suggest that participants enjoy the use of computer-administered instruments, often preferring them to traditional paper-and-pencil versions.
Next, master’s or doctoral-trained female clinicians with extensive experience dealing with traumatized populations interviewed participants. Interview materials included participant exposure to partner abuse, injuries sustained, responses to abuse, and a number of other constructs not relevant to the current analyses. The second day consisted of additional self-report instruments that were programmed onto a laptop computer. Those measures are not relevant to the present article. Debriefings were conducted with participants following completion of all instruments. Participants were paid for their time.