Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Purpose: This study is a part of a National Institute of Justice mixed methods study conducted over a 2 year period. The purpose of the study was to examine how women, physically or sexually victimized as children or adults, utilized various coping skills, social supports, and support from agencies that impacted current levels of depression and PTSD. Methods: Structured interviews were conducted with an ethnically diverse sample of 423 women recruited from the women's correctional facility and from four communities across a Midwestern state. Interview questions were developed from a combination of existing and modified standardized instruments covering childhood and adult victimization experiences using the Childhood Maltreatment Interview Schedule, the Abusive Behavior Inventory, and the Sexual Experiences Survey. Other instruments include the Social Support Appraisal Scale, the Brief Cope Scale, the Self-Efficacy Scale, and revised questions on support for agencies from the National Comorbidity Scale. Outcome measures included the CES-D for depression and revised questions from the National Co-Morbidity Survey for PTSD. Results: The findings reveal that women who experienced physical child abuse, sexual child abuse, or rape report poorer rates of depression; these same women, along with those who experienced physical intimate partner violence (IPV), report poorer rates of PTSD. Childhood physical abuse has a stronger correlation with depression and PTSD than childhood sexual abuse; however, childhood sexual abuse is correlated with more adult outcomes than any other type of victimization. Women's reports of perceived social support and their sense of self-efficacy are also correlated with lower rates of depression and PTSD. Additionally, reports of using services are also correlated with better mental health outcomes, including domestic violence shelters, sexual assault providers, legal services, and subsidized housing. Finally, a series of multiple regression analyses were performed to predict one's level of depression and PTSD. The independent variables, including demographics, number of victimization experiences, disclosure, personal mediators (self-efficacy, coping skills, social support, and difficulty living on one's income), and service usage, were entered into the analyses to determine the relative contribution of predicting depression or PTSD. The results reveal that these multivariate models are fairly accurate in predicting depression (R²=.53) and PTSD (R²=.41). Only three of the independent variables were significant predictors of depression including the use of maladaptive coping strategies, social supports, and self-efficacy. The same three independent variables are also significant predictors of one's level of PTSD. Implications: Real prevention of depression and PTSD among survivors of abuse lies with early intervention strategies including interventions that enhance coping skills, self-efficacy, and social supports. Additionally, social workers should be trained on the importance of screening for multiple forms of victimization, especially childhood physical and sexual abuse as well as screening for current depression and PTSD. Finally, social workers should provide referrals to appropriate human service providers including providers offering shelter or sexual assault services.