Learned helplessness (LH) may mediate the link between violence exposure and mental disorders in battered women. This study evaluated the contribution of LH to Posttraumatic Stress Disorder (PTSD) and major depression (MDD) in women with prolonged exposure to partner violence in 101 residents of shelters for battered women in Israel. DSM-IV axis-I disorders were assessed by a structured clinical interview. Self-report questionnaires evaluated exposure to violence, symptoms of PTSD and depression, LH, history of child abuse, SES and the extent of male-dominance and prejudice against women in the participants prior socialization background. LH significantly mediated the effect of violence on PTSD and depression symptoms. Male-dominated background contributed to LH. Thus, LH may increase the risk of mental disorders in battered women and should be addressed in interventions designed to reduce the burden of mental illness in this population.
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Aguilar, R. J., & Nightingale, N. N. (1994). The impact of specific battering experiences on the self esteem of abused women. Journal of Family Violence, 9(1), 35–45.
Arias, I., & Pape, K. T. (1999). Psychological abuse: Implications for adjustment and commitment to leave violent partners. Violence and Victims, 14, 55–67.
Astin, M. C., Ogland-Hand, S. M., Foy, D., & Coleman, E. M. (1995). Posttraumatic stress disorder and childhood abuse in battered women: Comparisons with maritally distressed women. Journal of Consulting and Clinical Psychology, 63, 308–312.
Ball, P. G., & Wyman, E. (1977–78). Battered wives and powerlessness: What can counselors do? Victimology, 2, 545–552.
Bean, J., & Moller, A. T. (2002). Posttraumatic stress and depressive symptomatology in a sample of battered women from South Africa. Psychological Reports, 9, 750–752.
Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck depression inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.
Beck, A. T., Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: The hopelessness scale. Journal of Consulting and Clinical Psychology, 42, 861–865.
Bennice, J., Resick, P., Mechanic, M., & Astin, M. (2003). The relative effects of intimate partner physical and sexual violence on post-traumatic stress disorder symptomatology. Violence and Victims, 18, 87–94.
Blake, D. D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., Klauminzer, G., Charney, D. S., et al. (1990). A clinician rating scale for assessing current and lifetime PTSD: The CAPS-1. Behavior Therapist, 13, 187–188.
Bleich, A., Gelkopf, M., & Solomon, Z. (2003). Exposure to terrorism, stress-related mental health symptoms, and coping behaviors among a nationally representative sample in Israel. JAMA, 290(5), 612–620.
Burns, M. O., & Seligman, M. E. (1991). Explanatory style, helplessness, and depression. In C. R. Snyder, & D. R., Forsyth et al. (Eds.), Handbook of social and clinical psychology: The health perspective (pp. 267–284). New York: Pergamon (Pergamon general psychology series).
Campbell, J. C. (1989). A test of two explanatory models of women’s responses to battering. Nursing Research, 38, 18–24.
Campbell, J. C. (2002). Health consequences of intimate partner violence. Lancet, 359, 1331–1336.
Cascardi, M., O’Leary, K. D., & Schlee, K. A. (1999). Co-occurrence and correlates of posttraumatic stress disorder and major depression in physically abused women. Journal of Family Violence, 14, 227–250.
Center for Health and Gender Equity (1999). Physical assault on women by an intimate male partner (Table 1). Population Reports Series L, 11 (4), Retrieved October 23,2004, from http://www.infoforhealth.org/pr/l11/l11tables.shtml#table_1. December.
Cheung, C. K., & Kwok, S. T. (1996). Male-dominated orientation as a determinant of hopelessness. Journal of Social Psychology, 136, 333–347.
Clements, C. M., & Sawhney, D. K. (2000). Coping with domestic violence: Control attributions, dysphoria, and hopelessness. Journal of Traumatic Stress, 13, 219–240.
Dion, K. L., & Giordano, C. (1990). Ethnicity and sex as correlates of depression symptoms in a Canadian university sample. International Journal of Social Psychiatry, 36(1), 30–41.
Duffy, J. D., & Malloy, P. F. (1994). Efficacy of buspirone in the treatment of posttraumatic stress disorder: An open trial. Annals of Clinical Psychiatry, 6, 33–37.
Dutton, M. A., Burghardt, K. J., Perrin, S. G., Chrestman, K. R., & Halle, P. M. (1994). Battered women’s cognitive schemata. Journal of Traumatic Stress, 7, 237–755.
Fallot, R. D., & Harris, M. (2002). The Trauma Recovery and Empowerment Model (TREM): Conceptual and practical issues in a group intervention for women. Community Mental Health Journal, 38(6), 475–485.
Falsetti, S. A., Resnick, H. S., Resick, P. A., & Kilpatrick, D. G. (1993). The modified PTSD symptom scale: A brief self-report measure of posttraumatic stress disorder. Behavioral Therapist 16, 161–162.
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1995). Structured clinical interview for DSM-IV axis-I disorders—Patient Edition (SCID-P)- version 2, New York State Psychiatric Institute, Biometrics Research, New York. Hebrew Version: Shalev A, Sahar T., and Abramovitz M. (1998). Department of Psychiatry, Hadassah University Hospital, Jerusalem, Israel.
Foa, E. B., Riggs, D. S., Dancu, C. V., & Rothbaum, B. O. (1993). Reliability and validity of a brief instrument for assessing posttraumatic stress disorder. Journal of Traumatic Stress, 6, 459–473.
Foa, E. B., Zinbarg, R., & Rothbaum, B. O. (1992). Uncontrollability and unpredictability in post traumatic stress disorder: An animal model. Psychological Bulletin, 112, 218–238.
Golding, J. M. (1999). Intimate partner violence as a risk factor for mental disorders: A meta-analysis. Journal of Family Violence, 14, 99–132.
Green, B. L. (1996). Trauma history questionnaire. In B. H. Stamm, & E. M. Varra (Eds.), Measurement of stress, trauma and adaptation (pp. 366–369). Lutherville: Sidran.
Haj-Yahia, M. (2000). Wife abuse and battering in the sociocultural context of Arab society. Family Process, 39, 237–255.
Hendricks-Matthews, M. (1982). The battered woman: Is she ready for help? J. Contemp. Soc. Work, 3, 131–137.
Hollingshead, A. B. (1957). Two factor index of social position. New Haven, CT: Yale.
Houskamp, B. M., & Foy, D. W. (1991). The assessment of posttraumatic stress disorder in battered women. Journal of Interpersonal Violence, 6, 367–375.
Jewkes, R., Levinb, J., & Penn-Kekanaa, L. (2002). Risk factors for domestic violence: Findings from a South African cross-sectional study. Social Science & Medicine, 55, 1603–1617.
John, R, Johnson, J. K., Kukreja, S., Found, M., & Lindow, S. W. (2004). Domestic violence: Prevalence and association with gynaecological symptoms. BJOG, 111(10), 1128–1132.
Kemp, A., Green, B. L., Hovanitz, C., & Rawlings, E. I. (1995). Incidence and correlates of posttraumatic stress disorder in battered women: Shelter and community samples. Journal of Interpersonal Violence, 10, 43–55.
Kemp, A., Rawlings, E. I., & Green, B. (1991). Post-Traumatic Stress Disorder (PTSD) in battered women: A shelter sample. Journal of Traumatic Stress, 4, 137–147.
Kessler, R. C., Molnar, B. E., Feurer, I. D., & Appelbaum, M. (2001). Patterns and mental health predictors of domestic violence in the United States: Results from the National Comorbidity Survey. International Journal of Law and Psychiatry, 24, 487–508.
Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–1060.
Koenig, M. A., Ahmed, S., Hossain, M. B., Khorshed, A. B. M., & Mozumder, A. (2003). Women’s status and domestic violence in rural Bangladesh: Individual and community level effects. Demography, 40, 269–288.
Kubany, E. S., McKenzie, W. F., Owens, J. A., Leisen, M. B., Kaplan, A. S., & Pavich, E. (1996). PTSD among women survivors of domestic violence in Hawaii. Hawaii Medical Journal, 55, 164–165.
Maziak, W., & Asfar, T. (2003) Physical abuse in low-income women in Aleppo, Syria. Health Care for Women International, 24(4), 313–326.
Mertin, P. M., & Philip, B. (2002). Incidence and correlates of posttrauma symptoms in children from backgrounds of domestic violence. Violence and Victims, 17, 555–567.
Miller, T. (1988). Advances in understanding the impact of stressful life events on health. Hospital & Community Psychiatry, 39, 615–622.
Miller, W. R., & Seligman, M. E. (1975). Depression and learned helplessness in man. Journal of Abnormal Psychology, 84, 228–238.
Noon, G. S. (1995). The relationship between locus of control and posttraumatic stress disorder (PTSD) in battered women. Thesis (Ph.D.)-United States International University.
Peled, E., Eisikovits, Z., Enosh, G., & Winstok, Z. (2000). Choice and empowerment for battered women who stay: Toward a constructivist model. Social Work, 45(1), 9–25.
Perrin, S., Van Hasselt, V. B., & Hersen, M. (1997). Validation of the Keane MMPI-PTSD Scale against DSM-III-R criteria in a sample of battered women. Violence and Victims, 12, 99–104.
Quinless, F. W., & Nelson, M. A. (1988). Development of a measure of learned helplessness. Nursing Research, 37, 11–15.
Saunders, D. G. (1994). Posttraumatic stress symptom profiles of battered women: A comparison of survivors in two settings. Violence and Victims, 9, 31–44.
Seligman, M. (1975). Helplessness: On depression, development and death. San Francisco: Freeman.
Shalev, A. Y., Freedman, S., Peri, T., Brandes, D., Sahar, T., Orr, S. P., et al. (1998). Prospective study of posttraumatic stress disorder and depression following trauma. American Journal of Psychiatry, 155, 630–637.
Silva, C., McFarlane, J., Soeken, K., Parker, B., & Reel, S. (1997). Symptoms of post-traumatic stress disorder in abused women in a primary care setting. Journal of Women’ s Health, 6, 543–652.
Stein, M. B., & Kennedy, C. (2001). Major depressive and post-traumatic stress disorder comorbidity in female victims of intimate partner violence. Journal of Affective Disorders, 66, 133–138.
Telner, J. I., & Singhal, R. L. (1984). Psychiatric progress: The learned helplessness model of depression. Journal of Psychiatric Research, 18, 207–215.
Tomes, E. K., Brown, A., Semenya, K., & Simpson, J. (1990). Depression in black women of low socioeconomic status: Psychosocial factors and nursing diagnosis. Journal of National Black Nurses’ Association, 4, 37–46.
Tuesca, R., & Borda, M. (2003). Marital violence in Barranquilla [Colombia]: Prevalence and risk factors [Article in Spanish]. Gac Sanit 17(4): 302–308. Abstract obtained from PubMed, PMID: 12975054.
Ullman, S. E., & Brecklin, L. R. (2002). Sexual assault history, PTSD, and mental health service seeking in a national sample of women. Journal of Community Psychology, 30, 261–279.
Vitanza, S., Vogel, L. C., & Marshall, L. L. (1995). Distress and symptoms of posttraumatic stress disorder in abused women. Violence and Victims, 10, 23–34.
Walker, L. E. (1996). Assessment of abusive spousal relationships. The battered woman syndrome. In F. W. Kaslow (ed.), Handbook of relational diagnosis and dysfunctional family patterns, Wiley series in couples and family dynamics and treatment (pp. 338–356). New York: Wiley.
Watson, C. G., Barnett, M., Nikunen, L., Schultz, C., Randolph, E. T., & Mendez, C. M. (1997). Lifetime prevalences of nine common psychiatric/personality disorders in female domestic abuse survivors. J. Nerv. Ment. Dis., 185, 645–647.
West, C. G., Fernandez, A., Hillard, J. R., Schoof, M., & Parks, J. (1990). Psychiatric disorders of abused women at a shelter. Psychiatric Quarterly, 61, 295–301.
Woods, S. J., & Isenberg, M. A. (2001). Adaptation as a mediator of intimate abuse and traumatic stress in battered women. Nursing Science Quarterly, 14, 215–221.
Yoshihama, M. (2002). Battered women’s coping strategies and psychological distress: Differences by immigration status. American Journal of Community Psychology, 30, 429–452.
This study was supported in part by the Women’s Health research grant and Paramedical research grant from Hadassah Women’s Zionist Organization of America, and by a scholarship to the first author from the Israel Foundation Trustees and The Hebrew University of Jerusalem.
We thank the women and staff at the shelters who took part in the study, and the shelters supervisory forum in the Israeli Ministry of Social Affairs for making this study possible.
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Bargai, N., Ben-Shakhar, G. & Shalev, A.Y. Posttraumatic Stress Disorder and Depression in Battered Women: The Mediating Role of Learned Helplessness. J Fam Viol 22, 267–275 (2007). https://doi.org/10.1007/s10896-007-9078-y
- Learned helplessness
- Battered women