Abstract
Objective
Although many women are affected by intimate partner violence (IPV) across the life span, rates of help seeking for IPV-related concerns are low. The current project examined predictors of personal and professional resource use in a sample of female IPV survivors, with the purpose of identifying engagement strategies for IPV services and resources. The study is notable for is concurrent examination of demographic variables, abuse characteristics, beliefs about cause of violence, beliefs about helpfulness of resources, coping style, and PTSD symptoms as predictors of resource use.
Method
Interviews and self-report measures were completed by 372 women recruited from community agencies. The average age was 34.41 years (SD = 8.09), and sixty-six percent of the sample was African-American, followed by 28% Caucasian, 1.4% Latino, and 1.4% Native American.
Results
Results indicated that professional help seeking was significantly related to psychological aggression, age, controllability of cause of violence, engaged coping, helpfulness of resource, and PTSD severity (p<.001), and that personal resource use was related to relationship length, stability of cause of violence, disengaged coping, and helpfulness of resource (p<.001).
Conclusions
These findings point to the importance of cognitions and coping style in the decision to seek help for IPV. In particular, beliefs about the helpfulness of potential resources as well as beliefs about the controllability and stability of the violence appear to be important targets for increasing engagement of IPV survivors in available services.
Keywords: Professional Help, Personal Resources, Intimate Partner Violence, Theory of Planned Behavior
Over the course of the lifespan, approximately 20% of women will experience intimate partner violence (IPV; Tjaden & Thoennes, 2000). Population data suggest that women are at significantly higher risk for IPV than are men, and that they are also significantly more likely to be injured or killed by partner assault (Bureau of Justice Statistics, 2012). Although rates of IPV are high, rates of help seeking for this issue are relatively quite low. Research has suggested that between half and three quarters of female survivors in the US never report violence to the police, and that only about 40% of survivors seek medical or psychological care. Studies from other countries have demonstrated even lower rates of help seeking; for example, a study in Turkey demonstrated that only 8% of female IPV survivors used any formal help-seeking resource (Ergocmen, Yuksel-Kaptanoglu, & Jansen, 2013).
Within the broader range of possible help-seeking behaviors, resource use is typically divided into two more specific categories: 1) use of professional/formal resources, such as the police or medical providers, and 2) use of personal/informal resources such as one's internal strengths and talking with family and friends. Most survivors of IPV tend to rely more heavily on and prefer the use of personal resources, in part due to increased barriers to professional resources (e.g. Simmons, Farrar, Frazer, & Thompson, 2011). Many barriers to any type of help seeking for IPV have been identified, including fear of retribution, shame about IPV, desire to protect one's partner, privacy issues, and cultural prohibitions against seeking outside assistance (Fugate, Landis, Riordan, Naureckas, & Engel, 2005; Montalvo-Liendo, 2009). However, IPV survivors identify additional barriers to using professional help, such as mistrust of professional resources, perceived lack of resources, perception of the abuse as “not serious enough,” and concerns about more serious consequences for their partners, such as legal charges (Fugate, Landis, Riordan, Naureckas, & Engel, 2005; Paranjape, Tucker, McKenzie-Mack, Thompson, & Kaslow, 2007). These beliefs lead to a discrepancy in rates of use of personal vs. professional resources. For example, in a study of married IPV survivors in Canada, 69% of women had talked to family and friends, but only 22% had reported concerns to police, 24% had used a social service agency and 38% had used a healthcare provider. Notably, women who have used shelters are more likely to have used other forms of help seeking than women who have not used a shelter (Moe, 2007).
The current study sought to examine predictors of help-seeking behavior in a sample of help-seeking female IPV survivors, with the goal of identifying potential engagement strategies to overcome the many barriers faced by this population. Previous literature has suggested that women are more likely to seek help if they are of a minority racial status and have greater impairment in mental health and overall functioning (Hampton & Gelles, 1994; Klopper, Schweinle, Ractcliffe, & Elhai, 2014). Although income level also appears to be an important factor in help seeking, the findings in this domain are mixed. On one hand, it has been suggested that women with higher income and resources seek help less frequently than do lower-income women, but on the other hand, it has also been suggested that economic instability is a major barrier to help seeking (Barnett, 2000; Kaukinen, Meyer, & Akers, 2013). Several studies have examined predictors of professional help seeking specifically (e.g. Hegarty et al., 2013), and found that IPV survivors' use of formal help seeking sources is related to severity and frequency of abuse (Goodman, Dutton, Weinfurt, & Cook, 2003; Hegarty et al., 2013), in addition to functional impairment and the demographic variables described above (e.g. Nurius, Macy, Nwabuzor, & Holt, 2011). Fewer studies have examined predictors of personal or informal help seeking. Although common wisdom seems to suggest that women use personal resources prior to attempting to use professional resources, empirical research suggests that use of personal resources is also related to increased severity and duration of abuse (Barrett & St. Pierre, 2011; Sylaska & Edwards, 2014).
As discussed, previous research has examined the role of demographic variables, abuse characteristics, and mental health in the use of formal and informal resources for IPV. Research has also examined cognitive and coping strategies used in response to violence; however, relatively little attention has been given to survivors' cognitive and coping responses to violence as they specifically relate to help-seeking behaviors. One theory has proposed that women who cope actively and believe that they have appropriate assistance will choose to take steps to leave an abusive relationship (Gondolf & Fisher, 1988). Several studies have supported this theory, showing that women use a variety of coping techniques, both engaged and disengaged, and that behavioral coping leads to increased self-esteem (Lewis et al., 2006; Mitchell & Hodson, 1983). Results of one study of female IPV survivors who had a protection order has suggested that problem-focused coping is related to increased overall help seeking (Shannon, Logan, Cole, & Medley, 2006). Another model of help seeking, the theory of planned behavior (Ajzen, 1991), suggests that the choice to act is largely determined by one's beliefs about the effectiveness of the potential behavior as well as one's beliefs about her ability to complete behavioral change. Several studies have suggested that self-efficacy beliefs are related to increased self-change and empowerment (Goodman et al., 2014; Song, 2012). Limited recent research has begun to include the role of beliefs in relation to help seeking, and has found preliminary evidence that positive attitudes about seeking treatment are related to treatment seeking in IPV survivors (Klopper, Schweinle, Ractcliffe, & Elhai, 2014; Sylaska & Edwards, 2014).
The current study sought to obtain a more comprehensive understanding of predictors of help seeking in female IPV survivors. Based on previous literature, it was hypothesized that use of professional help seeking would be related to demographic variables, such as age, income, and race; abuse characteristics, including length of abusive relationship and level of psychological and physical aggression; and beliefs about and response to help seeking and relationship violence, including PTSD severity, coping style, and thoughts about cause of violence and helpfulness of potential resources. Because limited information was available regarding suggested predictors of use of personal resources, prediction of personal resources was exploratory, and each category of variable listed above was examined. Given the differential rates of personal vs. professional help seeking, it was further hypothesized that there might be distinct predictors for each type of behavior. Consequently, prediction of each type of behavior was modeled separately.
Methods
Participants and Recruitment
The sample consisted of 372 female survivors of IPV who were recruited from community support programs. A majority of the sample was African-American (66%), followed by Caucasian (28%), Latino (1.4%), and Native American (1.4%). The average age of participants was 34.41 years (SD = 8.09), and the average level of education was a high school degree. The average length of participants' current relationships was 6.80 years (SD = 6.44 years), the average length of abuse was 4.58 years (SD =5.42 years), and approximately half of the sample were cohabitating but unmarried. About 85% of the sample reported a personal income of $20,000 or less.
Participants were recruited from residential and nonresidential community agencies for victims of IPV. Information about the study was shared with agency staff members, who in turn discussed the opportunity with their clients. Women were eligible for the study if they were in an intimate relationship that had lasted at least 3 months, during which there had been episodes of violence within the past 6 months, but no more recently than 2 weeks prior. To ensure that the sample consisted of women who had experienced more than occasional past violence, participants were required to have experienced 4 episodes of minor violence (e.g. arm twisting, slapping), 2 episodes of major violence (e.g. hitting with a fist, choking), or some combination of 4 events within the past year. Sixty-seven women were screened out based on these requirements as well as for suicidal intent, psychotic behavior, intoxication, or concerns about validity of responding. Everyone who participated in a screening was provided with a list of community resources.
Procedure
The study was conducted at the Center for Trauma Recovery at the University of Missouri – St. Louis (UMSL), and was approved by the UMSL IRB. Participants were invited to the research offices for two visits typically scheduled within several days of each other. On the first day, participants completed informed consent, symptom-based measures, and trauma history interviews. Symptom-based measures were completed on a laptop computer, and female Masters or Doctoral-level clinicians conducted interviews. On the second day, participants completed additional self-report measures on a laptop, and were debriefed and encouraged to discuss any way in which the assessment process had affected them. Participants were paid $60 for their time. If they were unable to come to the center and were living in a shelter, the researchers went to the shelter to administer the instruments and interviews.
Measures
Causal Dimension Scale (CDS; Russell, 1982)
The CDS is an 11-item self-report assessment of perception of locus of causality (internal/external), stability of causality (stable/unstable), and controllability of causality (changeable/unchangeable) in the case of IPV. Items were rated on a 7-point likert scale on each dimension (e.g. 1 (stable over time) to 7 (variable over time)), where higher scores indicated higher levels of agreement with the construct. The three-factor structure of the measure was supported by factor analysis, and the measure demonstrated adequate reliability (Russell, 1982).
Conflict Tactics Scale – 2 (CTS-2; Straus, Hamby, Boney-McCoy, & Sugarman, 1996)
The CTS-2 is a 33-item self-report measure of frequency of physical, psychological, and sexual aggression as well as injury resulting from violence. Items are rated on a scale from 1 (never), 2 (twice in the past year)…6 (more than 20 times in the past year), and scores were summed. In the current study, only the physical and psychological subscales were examined, due to relatively low incidence of sexual aggression and injury in this sample, as well as lack of correlation between sexual violence/injury and outcomes in this sample.
Coping Strategies Inventory (CSI; Tobin, Holroyd, Reynolds, & Wigal, 1989)
The CSI is a 72-item self-report assessment of individuals' coping strategies. Use of each type of strategy in response to IPV was rated on a scale from 1 (not at all) to 5 (very much), and scores were summed. The CSI has been measured in eight subscales representing specific types of coping strategies (e.g. problem-solving, social support) and has also been represented by a two-factor structure reflective of general engagement vs. disengagement strategies. The latter was used in this study. The engagement coping subscale reflects approach coping strategies such as cognitive restructuring and problem-solving, and the disengagement subscale reflects avoidant coping such as wishful thinking and social withdrawal. The CSI has demonstrated criterion and construct validity, and alphas for the subscales typically range from .71 -.94 (Tobin et al., 1989).
Posttraumatic Diagnostic Scale (PDS; Foa, Cashman, Jaycox, & Perry, 1997)
The PDS is a 34-item measure of PTSD symptoms based on the DSM-IV criteria. Items reflecting PTSD symptoms are rated on a scale from 0 (not at all or only one time) to 3 (five or more times a week or almost always) and are summed into a total PTSD score. The overall scale has been shown to have strong internal consistency and is highly correlated with other measures of PTSD.
Help-Seeking Measure
As a part of the Standardized Battering Trauma Interview (see Resick et al., 1988), respondents indicated their past use of several help- seeking strategies that were categorized into professional and personal resource categories. Scores for total use of resources were calculated by summing responses to these items. They were also asked to rate how helpful the strategies were likely to be if used in the future on a 9-point scale ranging from 1 (not at all likely to be helpful) to 9 (totally likely to be helpful). These items were averaged to reflect a mean helpfulness score. Professional resources included use of a hotline/therapist/counselor, the police, an order of protection, a shelter, seeking medical care, or consulting with a clergy/minister/rabbi. Personal resources included use of talking to friend/relative, going to a temporary place, using inner resources, trying to make partner stop, and trying to prevent future violence.
Results
Data were analyzed using IBM SPSS Statistics Version 22. Descriptive statistics and correlations among study variables are presented in Table 1. Data were first examined to determine rates of help seeking in the overall sample. In terms of professional help seeking, 59% of women had called a hotline, 73% had contacted the police, 49% had obtained an order of protection, 64% had gone to a shelter,52% had visited a health care provider, and 34% had consulted a religious leader. In terms of use of personal resources, 72% had spoken to a friend or family member, 65% had found temporary housing on their own, 72% had relied on inner resources, 78% had independently tried to make their partner stop, and 82% had independently tried to prevent future violence.
Table 1. Descriptive statistics and correlations with outcome variables.
| M | SD | 1. Professional | 2. Personal | |
|---|---|---|---|---|
| 1. Use of Professional Resources | 3.78 | 1.44 | -- | .19*** |
| 2. Use of Personal Resources | 4.20 | .98 | -- | |
| Age | 34.47 | 8.14 | .11* | .09 |
| Personal Income | -- | -.06 | -.01 | |
| Race | -- | -.05 | -.11* | |
| Relationship Length | 6.8 | 6.4 | .05 | .11* |
| Psychological Aggression (CTS-2) | 106.39 | 48.09 | .18** | .06 |
| Physical Aggression (CTS-2) | 85.16 | 71.07 | .11* | .01 |
| PTSD Severity (PDS) | 28.92 | 10.87 | .14* | .02 |
| Helpfulness of Resource | 5.59 | 1.55 | .16** | .19*** |
| Disengagement Coping (CSI) | 109.03 | 24.57 | -.01 | -.13* |
| Engagement Coping (CSI) | 110.60 | 25.56 | .13* | .09 |
| Locus of Causality (CDS) | 15.75 | 4.53 | -.09 | -.03 |
| Controllability of Cause (CDS) | 10.35 | 4.62 | -.20*** | -.08 |
| Stability of Cause (CDS) | 16.63 | 5.29 | -.01 | -.19*** |
Note:
p < .05,
p <.01,
p < .001.
A multiple regression model predicting use of professional resources was created, including demographic variables, abuse characteristics, beliefs about cause of violence, beliefs about helpfulness of resources, coping style, and PTSD symptoms as independent variables. The overall model was significant, F(13,319) = 4.25, p<.001, but many variables did not contribute significantly to the model. Thus, the model was respecified using only significant variables, and this model was significant, F(6,329) = 9.06, p<.001. Psychological aggression, age, controllability of cause, engaged coping, helpfulness of resource, and PTSD severity contributed significantly to the model (See Table 2).
Table 2. Multiple Regression Models Predicting Use of Professional Resources.
| Model 1 | Model 2 (Respecified) | |||
|---|---|---|---|---|
|
| ||||
| ΔR2 | β | ΔR2 | β | |
| Step 1 | .05** | .04* | ||
| Psych Aggression | .15* | .17** | ||
| Physical Aggression | .00 | |||
| Relationship Length | .01 | |||
| Race | -.03 | |||
| Personal Income | -.07 | |||
| Age | .12* | .13* | ||
| Step 2 | .10*** | .10*** | ||
| Psych Aggression | .14* | .15** | ||
| Physical Aggression | .02 | |||
| Relationship Length | .02 | |||
| Race | -.01 | |||
| Personal Income | -.06 | |||
| Age | .11∧ | .12* | ||
| Locus of Causality | .00 | |||
| Stability of Causality | -.01 | |||
| Controllability of Causality | -.23*** | -.23*** | ||
| Disengagement Coping | -.05 | |||
| Engagement Coping | .11* | .11* | ||
| Helpfulness of Resource | .15** | .16** | ||
| PTSD Severity | .12* | .11* | ||
| Total R2 | .15*** | .14*** | ||
Note: N = 333
p < .10,
p < .05,
p <.01,
p < .001.
A second multiple regression was created predicting use of personal resources, and also including demographic variables, abuse characteristics, beliefs about cause of violence, beliefs about helpfulness of resources, coping style, and PTSD symptoms as independent variables. The overall model was significant, F(13,319) = 3.95, p<.001, but again, several of the independent variables were not significantly related. The model was respecified and was significant, F(5,335) = 8.86, p<.001, and relationship length, stability of cause, disengaged coping, and helpfulness of resource were significant predictors (See Table 3).
Table 3. Multiple Regression Models Predicting Use of Personal Resources.
| Model 1 | Model 2 (Respecified) | |||
|---|---|---|---|---|
|
| ||||
| ΔR2 | β | ΔR2 | β | |
| Step 1 | .03 | .01* | ||
| Psych Aggression | .04 | |||
| Physical Aggression | .01 | |||
| Relationship Length | .09 | .11* | ||
| Race | -.09 | |||
| Personal Income | -.02 | |||
| Age | .04 | |||
| Step 2 | .11*** | .11*** | ||
| Psych Aggression | .06 | |||
| Physical Aggression | .06 | |||
| Relationship Length | .11∧ | .14** | ||
| Race | -.09 | |||
| Personal Income | .03 | |||
| Age | .04 | |||
| Locus of Causality | .02 | |||
| Stability of Causality | -.23*** | -.22*** | ||
| Controllability of Causality | -.04 | |||
| Disengagement Coping | -.13* | -.11* | ||
| Engagement Coping | .10∧ | .08 | ||
| Helpfulness of Resource | .20** | .19** | ||
| PTSD Severity | .00 | |||
| Total R2 | .14*** | .12*** | ||
Note: N = 333
p < .10,
p < .05,
p <.01,
p < .001.
Discussion
The main study hypotheses were that a) personal and professional help seeking by IPV survivors would be predicted by a combination of demographic variables, abuse characteristics, beliefs about cause of violence, beliefs about helpfulness of resources, coping style, and PTSD symptoms, and that b) given strongly differential rates of personal vs. professional help seeking, that predictors of use of each type of resource might be distinct. Results indicated that increased use of professional help seeking was related to increased psychological trauma, older age, belief that the cause of the violence is not controllable, higher level of engagement coping, more belief that resources will be helpful, and increased PTSD symptom severity. Increased use of personal resources were related to longer relationship length, belief that the cause of the violence is not stable, more belief that the resources will be helpful, and lower level of disengagement coping.
The relationship between help seeking and severity of abuse has been well established in past studies (e.g. Barrett & St. Pierre, 2011; Hegarty et al., 2013), and this finding was reflected in the current study with regard to formal resource use. However, it is surprising that personal resource use was not related to either abuse characteristics or PTSD. This finding may be due to overall high levels of personal resource use that limited variability (70-80% of women had used most personal resources), or may reflect the relative importance of cognitive variables in personal resource use (i.e. a woman's evaluation of how stable the violence is may be a more influential predictor then the perceived severity). Alternately, the lack of association between violence and personal resource use may be explained by relationship length. While relationship length was not related to professional resource use, it was related to personal resource use, suggesting that longer time in an abusive relationship, rather than an increase in severity, is related to informal help seeking. Both findings underscore the importance of early intervention in this population. In particular, reaching out to women to offer and encourage professional resource use prior to abuse reaching the threshold of being perceived as “severe enough” could reduce duration and severity of abusive relationships in the long term.
Interestingly, coping styles were also different by type of help seeking. While professional help seeking was related to increased active engagement coping, personal resource use was related to lower levels of disengaged coping. In the current study, engagement and disengagement coping showed a small but significant positive correlation (r=.14, p=.004). These results seem to suggest that engagement and disengagement coping are orthogonal constructs that function distinctly in different help-seeking contexts, rather than as two ends of a continuum of behaviors. It appears that utilizing personal resources prevents survivors from using avoidance strategies, but is not necessarily related to taking action, while utilizing professional resources is related to an increase in active coping behaviors. This finding suggests that it may be useful to encourage family and friends of survivors to suggest more active and professional strategies to attempt to connect women to more services. Also, it is possible that professional resource use could result in a domino effect of other active coping behaviors. Although beyond the scope of the current data, this would be an interesting topic for further research.
The results of this study indicate the importance of cognitive appraisals in the decision to seek help for IPV. Notably, the only variable that was related to the prediction of both personal and professional resources use was belief about the helpfulness of the resource. This finding suggests that cognitive appraisal of the resource is key in any type of help seeking, and that increasing perceived availability and credibility of available resources may be a critical intervention point to increase use of survivor resources. For professional resources, this might be accomplished through increased targeted marketing as well as increased screening and provision of information and referrals at regular medical appointments. In a previous qualitative study of female IPV survivors, women reported that improved community awareness, focused marketing, and facilitation of comfort with services would be key strategies that might help them to feel more confident to reach out for help (Simmons, Farrar, Frazer, & Thompson, 2011). The findings from this qualitative study as well as the current study also suggest that it is important to increase the perceived helpfulness of more informal sources of support such as family and friends. This issue might be best approached at the public health level by continuing to create and disseminate violence prevention and awareness efforts such as bystander interventions (e.g. Palm Reed, Hines, Armstrong, & Cameron, 2014).
Further, professional resource use was related to belief that controllability of the cause of violence is low, but personal resource use was related to belief that the stability of the cause of violence is low. Women who use personal resources might have a self-statement like, “This isn't permanent, I can handle it” whereas women who use professional help might have the thought, “This is out of my control. I need help.”Given the relatively low rates of professional help seeking in this population, it appears that cognitive restructuring regarding the likely occurrence and nature of future abuse might be an important target for intervention.
The current findings suggest that reaching out to women earlier and with information relevant to adapting key cognitions may be helpful in increasing help-seeking behavior in IPV survivors. Assisting survivors in challenging beliefs about the controllability and stability of the violent relationship, as well as inspiring confidence in available resources, both personal and professional, appear to be important steps in building motivation to utilize resources for IPV survivors. Although change in support for IPV survivors will likely need to occur at the individual level, as the majority of survivors turn to family and friends, this level of change will likely require national-level public health initiatives to disseminate information and engagement strategies intended to adjust beliefs and stigma around abuse survivors.
It is important to consider that the current study was completed in a population of women who had reached out to at least one community agency, and had thus engaged in at least minor levels of professional help seeking. As compared to other studies, women in this sample had relatively high rates of some forms of professional help seeking, in addition to typically high rates of use of personal resources. Although it is necessary to examine help seeking in women who have engaged in this set of behaviors, it is also valuable to understand the process of help seeking, and barriers to help seeking, in women who have not utilized professional resources. Women who have not sought professional help may have different coping strategies, key cognitions, or patterns of informal resource use. Additionally, this study looked at help seeking behaviors in aggregated groups of personal vs. professional resource use, rather than looking at each type of help-seeking individually. Although the current results shed light on these broader categorizations of behaviors, each individual behavior may have distinct predictors. Further, the current results accounted for 12-15% of the variance in help-seeking behavior in female IPV survivors. Although this is comparable to relatively similar studies that have been able to account for 12-25% of the variance in help seeking (in a Canadian population-based sample; Barrett & St. Pierre, 2011), considerable work remains to be done to fully understand the process of help seeking in IPV situations.
Acknowledgments
This research was supported by NIH Grant R01 MH55542-01A2 to the second author.
Contributor Information
CJ Eubanks Fleming, Duke University Medical Center, Department of Psychiatry and Behavioral Sciences.
Patricia A. Resick, Duke University Medical Center, Department of Psychiatry and Behavioral Sciences.
References
- Ajzen I. The theory of planned behavior. Organizational Behavior and Human Decision Processes. 1991;50:179–211. doi:0749-5978/91. [Google Scholar]
- Barnett OW. Why battered women do not leave, part 1: External inhibiting factors within society. Trauma, Violence, and Abuse. 2000;1:343–372. doi: 10.1177/1524838000001004003. [DOI] [Google Scholar]
- Barrett BJ, St Pierre M. Variations in women's help seeking in response to intimate partner violence: Findings from a Canadian population-based study. Violence Against Women. 2011;17(1):47–70. doi: 10.1177/1077801210394273. [DOI] [PubMed] [Google Scholar]
- Bureau of Justice Statistics, U.S. Department of Justice. Intimate Partner Violence, 1993-2010. NCJ Report No 239203. 2012 Retrieved from: http://www.bjs.gov/content/pub/pdf/ipv9310.pdf.
- Ergocmen BA, Yuksel-Kaptanoglu I, Jansen AFM. Intimate partner violence and the relation between help-seeking behavior and the severity and frequency of physical violence among women in Turkey. Violence Against Women. 2013;19(9):1151–1174. doi: 10.1177/1077801213498474. [DOI] [PubMed] [Google Scholar]
- Foa EB, Cashman L, Jaycox L, Perry K. The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale. Psychological Assessment. 1997;9(4):445–451. doi: 10.1037/1040-3590.9.4.445. [DOI] [Google Scholar]
- Fugate M, Landis L, Riordan K, Naureckas S, Engel B. Barriers to domestic violence help seeking: Implications for intervention. Violence Against Women. 2005;11:290–310. doi: 10.1177/1077801204271959. [DOI] [PubMed] [Google Scholar]
- Gondolf EW, Fisher ER. Battered women as survivors An alternative to treating learned helplessness. Toronto: Lexington Books; 1988. [Google Scholar]
- Goodman LA, Bennett Cattaneo L, Thomas K, Woulfe J, Chong SK, Fels Smyth K. Advancing Domestic Violence Program Evaluation: Development and Validation of the Measure of Victim Empowerment Related to Safety (MOVERS) Psychology of Violence. 2014 Nov 10; Advance online publication. http://dx.doi.org/10.1037/a0038318.
- Goodman L, Dutton MA, Weinfurt K, Cook S. The Intimate Partner Violence Strategies Index: Development and application. Violence Against Women. 2003;9(2):163–186. doi: 10.1177/1077801202239004. [DOI] [Google Scholar]
- Hampton RL, Gelles RJ. Violence toward Black women in a nationally representative sample of Black families. Journal of Comparative Family Studies. 1994;51:105–119. [Google Scholar]
- Hegarty KL, O'Doherty LJ, Chondros P, Valpied J, Taft AJ, Astbury J, Brown SJ, Gold L, Taket A, Feder GS, Gunn JM. Effect of type and severity of intimate partner violence on women's health and service use: Findings from a primary care trial of women afraid of their partners. Journal of Interpersonal Violence. 2013;28(2):273–294. doi: 10.1177/0886260512454722. [DOI] [PubMed] [Google Scholar]
- Kaukinen CE, Meyer S, Akers C. Status compatibility and help-seeking behaviors among female intimate partner violence victims. Journal of Interpersonal Violence. 2013;28(3):577–601. doi: 10.1177/0886260512455516. [DOI] [PubMed] [Google Scholar]
- Klopper JJ, Schweinle W, Ractliffe KC, Elhai JD. Predictors of mental healthcare use among domestic violence survivors in shelters. Psychological Services. 2014;11(2):134–140. doi: 10.1037/a0034960. [DOI] [PubMed] [Google Scholar]
- Lewis CS, Griffing S, Chu M, Jospitre T, Sage RE, Madry L, Primm BJ. Coping and Violence Exposure as Predictors of Psychological Functioning in Domestic Violence Survivors. Violence Against Women. 2006;12(4):340–354. doi: 10.1177/1077801206287285. [DOI] [PubMed] [Google Scholar]
- Mitchell RE, Hodson CA. Coping with domestic violence: Social support and psychological health among battered women. American Journal of Community Psychology. 1983;11:629–654. doi: 10.1007/BF00896600. [DOI] [PubMed] [Google Scholar]
- Moe AM. Silenced voices and structured survival: Battered women's help seeking. Violence Against Women. 2007;13(7):676–699. doi: 10.1177/1077801207302041. [DOI] [PubMed] [Google Scholar]
- Montalvo-Liendo N. Cross-cultural factors in disclosure of intimate partner violence: An integrated review. Journal of Advanced Nursing. 2009;65:20–34. doi: 10.1111/j.1365-2648.2008.04850.x. [DOI] [PubMed] [Google Scholar]
- Nurius PS, Macy RJ, Nwabuzor I, Holt VL. Intimate partner survivors' help-seeking and protection efforts: A person-oriented analysis. Journal of Interpersonal Violence. 2011;26(3):539–566. doi: 10.1177/0886260510363422. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Palm Reed KM, Hines DA, Armstrong JL, Cameron AY. Experimental evaluation of a bystander prevention program for sexual assault and dating violence. Psychology of Violence. 2014 doi: 10.1037/a0037557. [DOI] [Google Scholar]
- Paranjape A, Tucker A, Mckenzie-Mack L, Thompson N, Kaslow N. Family violence and associated help-seeking behavior among older-African American women. Patient Education and Counseling. 2007;68:167–172. doi: 10.1016/j.pec.2007.05.019. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Resick PA, Jordan CG, Girelli SA, Hutter CK, Marhoeder-Dvorak S. A comparative outcome study of behavioral group therapy for sexual assault victims. Behavior Therapy. 1988;19:385–401. [Google Scholar]
- Russell D. The Causal Dimension Scale: A measure of how individuals perceive causes. Journal of Personality and Social Psychology. 1982;6:1137–1145. [Google Scholar]
- Shannon L, Logan TK, Cole J, Medley K. Help-Seeking and Coping Strategies for Intimate Partner Violence in Rural and Urban Women. Violence And Victims. 2006;21(2):167–181. doi: 10.1891/vivi.21.2.167. [DOI] [PubMed] [Google Scholar]
- Simmons CA, Farrar M, Frazer K, Thompson MJ. From the voices of women: Facilitating survivor access to IPV Services. Violence Against Women. 2011;17(10):1226–1243. doi: 10.1177/1077801211424476. [DOI] [PubMed] [Google Scholar]
- Song L. Service utilization, perceived changes of self, and life satisfaction among women who experienced intimate partner abuse: The mediation effect of empowerment. Journal Of Interpersonal Violence. 2012;27(6):1112–1136. doi: 10.1177/0886260511424495. [DOI] [PubMed] [Google Scholar]
- Straus MA, Hamby SL, Boney-McCoy S, Sugarman DB. The revised conflict tactics scale (CTS2) Journal of Family Issues. 1996;17:283–316. doi: 10.1177/019251396017003001. [DOI] [Google Scholar]
- Sylaska KM, Edwards KM. Disclosure of intimate partner violence to informal social support network members: A review of the literature. Trauma, Violence, and Abuse. 2014;15(1):3–21. doi: 10.1177/1524838013496335. [DOI] [PubMed] [Google Scholar]
- Tjaden P, Thoennes N. Full report of the prevalence, incidence, and consequences of violence against women: Findings from the National Violence Against Women Survey (NCJ183781) Washington, DC: U.S. Department of Justice, National Institute of Justice; 2000. [Google Scholar]
- Tobin DL, Holroyd KA, Reynolds RV, Wigal JK. The hierarchical factor structure of the Coping Strategies Inventory. Cognitive Therapy and Research. 1989;13:343–361. doi: 10.1007/BF011734. [DOI] [Google Scholar]