Post-Traumatic Relationship Syndrome Studies

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Table of Contents

Introduction
Methods Section
Participants
Manipulations
Dependent Measures
Procedures
Predictions
References

Introduction

Intimate partner violence has a damaging impact on interpersonal relationships. Female victims of physical, emotional, or sexual assault perpetrated by an intimate partner usually suffer prolonged trauma and generalized anxiety whenever they encounter actions or conditions reminiscent of the abuse. Domestic violence not only affects the recipient’s physical and mental health, but it also disorients them socially in the long term. Post-traumatic relationship syndrome (PTRS), a novel trauma-based syndrome, affects victims of sexual, physical, and emotional violence committed by a close partner (Vandervoort & Rokach, 2006). It resembles Posttraumatic Stress Disorder (PSTD) in terms of emotional reactions and recurrent memories, but does not elicit avoidance symptoms associated with PSTD.

Past studies have examined various aspects of trauma resulting from intimate partner abuse and its impact on relationships. One rationale for characterizing PTRS as a distinctive trauma-based syndrome is that clients manifest symptoms that are different from those of PSTD (Vandervoort & Rokach, 2006). This means that PSTD treatment approaches that involve emotion-focused coping cannot work for PTRS, as they evoke the traumatic memories (Orzeck, 2008).). A second rationale relates to cases where some posttraumatic illnesses do not fit within the definition of PSTD. This means that some posttraumatic disorder clients may exhibit symptoms that do not meet the PSTD criteria. In addition, PTRS, unlike PSTD, involves ‘interpersonal traumatic stressors’, which have long-term effects on victims (The Neurotypical Site, 2011). Thus, PSTR has adverse effects on clients because it occurs within the context of intimate relationships.

PSTR manifests itself as intense fear, recurring experiences (intrusive symptoms), arousal symptoms, and relational symptoms (Orzeck, 2008). These symptoms affect the victims’ psychosocial functioning in subsequent interpersonal relationships. Pico-Alfonso, Echeburua, and Martinez (2008) examined the personality disorders in female victims of domestic abuse. They predicted that female victims of intimate partner violence would exhibit a range of personality disorder symptoms because such abuses are more traumatic compared to those perpetrated by non-intimate individuals. The study compared physical and emotional abuse victims (experimental group) and non-abused females (control group). The findings indicated that the abused women were more “schizoid, avoidant, and paranoid” than non-abused ones, after controlling for childhood assault (Pico-Alfonso, Echeburua, & Martinez, 2008, p. 587). These findings imply that counselors should assess female victims for the symptoms of PD before subjecting them to treatment. The writer will extend this study by examining how the PD symptoms identified affect the female victims’ subsequent intimate relationships.

A comparable study by Blasco-Ros, Sanchez-Lorente & Martinez (2010) correlated the effects of physical and psychological abuse on women victims. The researchers used a cross-sectional study of women victims of intimate partner violence to assess symptoms such as anxiety and depression, which are characteristic of PTRS. The results indicated psychological abuse affected the mental health of the victims who displayed more “depressive, anxiety, and PSTD symptoms” than those subjected to physical abuse by an intimate partner (Orzeck, 2008, p. 12). Moreover, female exposed to psychological abuse showed no recovery from these symptoms. In the writer’s view, this finding implies that PTRS has long-term effects on victims’ social and psychological functioning. The proposed study will examine how PTRS affects a victim’s perception of intimate relationships.

Studies have also explored the correlation between intimate partner violence and internalization of the experiences. Miller and Resick (2007) examined how female survivors internalize sexual violence perpetrated by intimate male partners. The study found that ‘internalizers’ display depressive symptoms, a higher rate of schizoid and avoidance. In contrast, ‘externalizers’ show PD and substance abuse symptoms. The study illustrates how internalizing and externalizing tendencies affect the survivors’ psychopathology. In the writer’s view, internalizing subtypes are likely to perceive intimate relationships negatively compared to externalizing persons because they exhibit depressive symptoms and a low temperament. On their part, Monson, Gradus, La Bash, Griffen, and Resick (2009) examined how wives with PSTD symptoms adjust to intimate relationship and their interaction with their husbands. The study found a negative correlation between the wives’ PSTD symptoms and interaction with their husbands following a disastrous event. This implies that disasters cause relational symptoms such as mistrust and fear, which affect interpersonal interactions.

Becker, Stuewig, and McCloskey (2010) compared the traumatic stress symptoms in women exposed to childhood abuse and domestic violence perpetrated by a male partner. The study relied on the victims’ accounts to predict how exposure to child abuse leads to PSTD in adulthood. The findings indicate that intimate partner violence exacerbates the effects of childhood abuse and PSTD symptoms. The results imply that abuse within intimate relationships increases the trauma for women who suffered abuse in childhood. In the writer’s view, intimate partner abuse escalates arousal symptoms in victims resulting in intense PSTD. In this respect, the writer’s hypothesis is that intimate male violence re-traumatizes female survivors of childhood abuse more than it affects those who were abused as children. In the writer’s view, comparing victims of male partner violence who were abused in childhood with those who were not will reveal traumatic experiences in childhood causes PSTD symptoms in adulthood.

A meta-analysis by Taft, Watkins, Stafford, Street, and Monson (2011) examined the correlation between intimate relationship challenges and PSTD. The review revealed that PSTD is strongly associated with physical and psychological abuse within intimate relationships. This shows that people displaying PSTD symptoms are likely to encounter relationship challenges with their partners. In this view, the survivors would exhibit negativism and skepticism towards subsequent intimate relationships. In addition, mistrust and fear, which are associated with PTRS, will hamper their ability to form stable intimate relationships.

Another review by Lamber, Engh, Hasbun, and Holzer (2012), which examined the effect of PSTD on the quality of intimate relationships, found a stronger association between PSTD symptoms and interpersonal relationships. This implies that people exposed to PTRS stressors can have difficulties forming and sustaining quality intimate relationships. The proposed study will examine how individuals with PTRS differ from those who have never experienced relationship trauma in the way they make attributions or interpretations about their partners’ behaviors. Among the variables that the study will examine are relationship quality, childhood influences, and personality characteristics.

Methods Section

The study will involve an experimental approach to test the hypothesis that individuals with PTRS differ from those who have never experienced relationship trauma in partner attributions. It will involve experimental (female victims of partner abuse) and control groups (non-abused women).

Participants

The participants of the proposed study will involve two different groups: adult survivors of intimate male partner abuse (suffering with PTRS) and non-abused female subjects. A preliminary survey (questionnaires) will be conducted to separate abused women from the non-abused ones based on self-reports of domestic violence. The idea is to compare how the women in the two distinct groups attribute or interpret their partners’ behaviors. A convenient sample of 16 women will be drawn through snowballing from an institution offering counseling services to female victims of violence perpetrated by a domestic partner. The center must be located in communities that have a high rate of domestic violence against women. This will help the researcher recruit a representative sample that would ensure data saturation.

Victims of past intimate partner abuse display PTRS symptoms, including arousal, ‘intrusive’, and relational symptoms that may affect the way they perceive their present partners’ behavior (Orzeck, 2008). Only women who have experienced physical, psychological, or sexual abuse from their male partners will participate. Women who meet these inclusion criteria will form the experimental group. Their responses and personality attributes will be compared with that of the control group to reveal differences in interpretation of intimate relationships.

The control subjects will be recruited from the same counseling institution. The organization offers counseling services to women victims of abusive relationships. Only members that have never been in a relationship with a violent partner will be recruited. The subjects will be conveniently sampled into the control group. In total, 12 participants who have never experienced any form of physical, sexual, psychological violence will form the control group.

Manipulations

As aforementioned, PTRS presents symptoms similar to those of PSTD. In this view, it is important to conduct a proper assessment in order to diagnose a client correctly. PTRS clients do not display long-term avoidance and inhibited responsiveness as PSTD patients do. In the proposed study, the experimental subjects will be assessed for both PSTD and PTRS. Female survivors exhibiting all PSTD symptoms, but not avoidant behavior will be included in the study because such symptoms are characteristic of an anxiety disorder. Moreover, since the experimental group will comprise of survivors of intimate partner violence, a person exhibiting a few PSTD symptoms will likely have PTRS.

Besides adjusting the PTRS diagnosis, the writer will also manipulate the sampling criteria to recruit a sufficient sample that can allow conclusions to be made on this topic. The study population for the proposed research will be adult females who have had an intimate male partner at any point in their lives. The writer chose to examine women and not men because they usually endure more victimization and injury in most cultures than men do. The writer will also extend the spectrum of violence to include financial and spiritual abuse in addition to the physical, mental, and sexual assault described in most studies. This will ensure that victims of less common forms of violence are included in the sample. In addition, subjects who have experienced traumatic experiences in their childhood or who have been victims of disasters will be included. The idea here is to control for confounding effects associated with abusive childhood. Similarly, the study will recruit participants with or without depression or eating disorders indicative of PSTD.

Dependent Measures

The writer will measure two dependent variables, namely, intimate partner violence, behavior/personality attributions. Exposure to intimate male violence can predispose a female victim to PTRS and subsequently affect how she perceives her partner’s behavior. The study will measure different forms of abuse committed by a male partner, including physical, emotional, sexual, and financial abuse. The participants will be required to indicate the frequency of the abuse to facilitate the determination of its severity. Physical violence variables will include slaps and other bodily harm. On the other hand, sexual violence will encompass forced sex, pornography, and threats, among others. Verbal abuse and threats will indicate psychological violence. On the other hand, economic sabotage or refusal to pay for bills will indicate financial violence.

Personality measures will indicate how abused and non-abused females perceive or interpret their partners’ behavior in intimate relationships. This will also be an indication of the prevalence of PTRS among abused and non-abused female participants. A higher score in this variable will indicate severe PTRS while a lower score will reflect the absence of the disorder. The personality variables that the study will measure include antisocial, aggressive, and avoidant attributes, among others. The dependent measures will be compared with independent variables such as age, marital status, and educational level to reveal intra-group differences.

Procedures

The participants will be sampled from a community-based counseling agency. Information will be posted on the agency’s notice board requesting abused and non-abused women to participate. Those who will agree to participate will fill complete a consent form prior to participation. The next step will involve collecting the demographic data of the participants, including their relationship status, age, race/ethnicity, academic level, and number of kids. They will also complete a trauma inventory form to determine whether they are suffering from PTRS symptoms resulting from an abusive marriage. Those exhibiting these symptoms will be included in the study. On the other hand, participants who have never been in an abusive relationship, but meet the inclusion criteria will be recruited into the control group.

Data collection will involve the interviewing method. The interview session will last about one hour for each participant. However, this period will be increased or reduced depending on whether the participant is willing to discuss the traumatic events in detail. The writer will conduct face-to-face interviews in a confidential room within the organization. The interviews will be scheduled to occur immediately after the counseling session to preserve their confidentiality. Each interview will start with a clear explanation regarding the study’s aim, procedure, and the expected outcome. The idea here is to build a good relationship with the participant and allay fears surrounding information confidentiality.

The writer will ask a leading question and specific questions to probe the respondent’s answers. However, the respondents will be at liberty to terminate the interview at any time. Each interview will cover issues related to trauma symptoms, effect on interpersonal relationships, and coping methods. Their responses will be recorded using an audiotape for future transcription and analysis. The researcher will conduct follow-up interviews in case a participant’s response is unclear or ambiguous. Data transcription and coding will reveal the common themes in the participants’ responses. The themes from the experimental group (abused participants) will be compared with those of the control group to determine the differences in attributions or interpretations of ‘partner behavior’ between the two categories.

The study will use a trauma inventory instrument to assess the participants’ personality disorders. The instrument will measure trauma symptoms in both groups of participants. It will give information to validate or reject the participants’ self-reports of trauma occasioned by abusive experiences in the hands of their intimate partners. The instrument usually contains 100 items on posttraumatic disorders (Orzeck, 2008). Each is rated using the Likert scale indicating the frequency or severity of the symptom. The tool is a standardized instrument that gives reliable results to validate the presence of trauma in the participants.

Predictions

Comparisons between the abused and non-abused women will reveal how they interpret their partners’ behaviors. It is expected that the experimental group (abused women) will exhibit personality variables reminiscent of PTRS. They will score highly on personality attributes such as avoidance, schizoid, and paranoia, among others. The mean values for these attributes will be higher in the experimental group than the control group. Women in the experimental group will also exhibit mistrust, fear, and social isolation, which are the relational symptoms of PTRS. There will also be statistically significant differences in attributes such as self-defeating and negativism between the two groups. Generally, abused women will score high on these variables because of the trauma associated with psychological violence.

The results will give insights into the effect of intimate partner abuse on relationship quality. Abused women will exhibit PTRS symptoms, such as mistrust and fear, towards their current partners, which affects the quality of intimate relationships. Research shows that a counseling approach that emphasizes on “emotion-focused coping” can exacerbate trauma in PTRS clients (Orzeck, 2008, p. 16). By examining the victim’s interpretation of ‘partner behavior’, the proposed study will reveal the factors that trigger persistent trauma in survivors of intimate partner abuse. In addition, the study will reveal the strategies abused women use to cope with the trauma. The findings will have implications for psychosocial counseling and support for abuse victims, especially on how to protect clients from traumatizing experiences.

References

Becker, D., Stuewig, J. & McCloskey, L. (2010). Traumatic stress symptoms of women exposed to different forms of intimate partner violence and childhood victimization. Journal of Interpersonal Violence, 25, 1699-1715.

Blasco-Ros, C., Sanchez-Lorente, S. & Martinez, M. (2010). Recovery from depressive symptoms, state anxiety and post-traumatic stress disorder in women exposed to physical and psychological, but not to psychological intimate partner violence alone: a longitudinal study. BMC Psychiatry, 10, 98-107.

Lambert, J., Engh, R., Hasbun, A. & Holzer, J. (2012). Impact of posttraumatic stress disorder on the relationship quality and psychological distress of intimate partners: a meta-analytic review. Journal of Family Psychology, 26(5), 729-737.

Miller, M. M., & Resick, P. A. (2007). Internalizing and externalizing subtypes in female sexual assault survivors: Implications for the understanding of complex PTSD. Behavior Therapy, 38, 58–71.

Monson, C. M., Gradus, J. L., La Bash, H. A. J., Griffen, M. G., & Resick, P. A. (2009). The role of couples interacting world assumptions and relationship adjustment in women’s postdisaster PTSD symptoms. Journal of Traumatic Stress, 22, 276–281.

Orzeck, T. (2008). Relationship Trauma: A Grounded Theory Investigation of Women’s Traumatically Abusive Intimate Relationship Processes. Alberta: University of Calgary.

Pico-Alfonso, A., Echeburua, E. & Martinez, M. (2008). Personality disorder symptoms in women as a result of chronic intimate male partner violence. Journal of Family Violence, 23, 577–588.

Taft, C. T., Watkins, L. E., Stafford, J., Street, A. E., & Monson, C. M. (2011). Posttraumatic stress disorder and intimate relationship problems: A meta-analysis. Journal of Consulting and Clinical Psychology, 79, 22–33

The Neurotypical Site. (2011). Post-traumatic Relationship Syndrome. Web.

Vandervoort, D. & Rokach, A. (2006). Posttraumatic Relationship Syndrome: A Case Illustration. Clinical Case Studies, 5, 231-245.

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