Intimate partner violence is a major health problem for women; some of the most common symptoms of violence are depression, psychological distress, and sleep disturbances. In this parallel randomized controlled trial, which took place in Athens-Greece, abused women were randomly assigned to undergo either an 8-week stress management program (n = 16; relaxation breathing and progressive muscle relaxation, twice a day counseling) or standard shelter services (n = 18). Self-reported validated measures were used to evaluate perceived stress, health locus of control, depression, and ways of coping. In participants in the intervention group, perceived stress was significantly decreased after 8 weeks of relaxation, showing a medium effect of 0.45, but no significant results were noted for sleeping hours, health locus of control, depression, and ways of coping. These results reveal the need to develop interventions for this vulnerable population and future studies should incorporate more objective laboratory outcomes.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed). Washington, DC: Author.
Andreou, E., Alexopoulos, E. C., Lionis, C., Varvogli, L., Gnardellis, C., Chrousos, G. P., & Darviri, C. (2011). Perceived stress scale: reliability and validity study in Greece. International Journal of Environmental Research and Public Health, 8(8), 3287–3298.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.
Bergman, B., & Brismar, B. (1991). Suicide attempts by battered wives. Acta Psychiatrica Scandinavica, 83, 1486–1489.
Caetano, R., & Cunradi, C. (2003). Intimate partner violence and depression among whites, blacks and Hispanics. Annals of Epidemiology, 13(10), 661–665.
Caetano, R., Cunradi, C., Schafer, J., & Clark, C. (2000). Intimate partner violence and drinking among white, black and Hispanic couples in the US. Journal of Substance Abuse Treatment, 11, 123–138.
Campbell, C. J. (2002). Health consequences of intimate partner violence. The Lancet, 359(9314), 1331–1336.
Campbell, J., & Lewandowski, L. (1997). Mental and physical health effects of intimate partner violence on women and children. Psychiatric Clinics of North America, 20(2), 353–374.
Campbell, J. C., Kub, J., Belknap, R. A., & Templin, T. (1997). Predictors of depression in battered women. Violence Against Women, 3, 271–293.
Carlson, C., & Hoyle, R. (1993). Efficacy of abbreviated progressive muscle relaxation training: a quantitative review of behavioral medicine research. Journal of Consulting and Clinical Psychology, 61, 1059–1067.
Cascardi, M., & O’Leary, K. D. (1992). Depressive symptomatology, self-esteem, and self-blame in battered women. Journal of Family Violence, 7, 249–259.
Cohen, S., Mermelstein, K., & Kamarck, T. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.
Coker, A., Smith, P., Bethea, L., King, M., & McKeown, R. (2000). Physical health consequences of physical and psychological intimate partner violence. Archives of Family Medicine, 9, 451–457.
Constantino, R., Kim, Y., & Crane, P. A. (2005). Effects of a social support intervention on health outcomes in residents of a domestic violence shelter: a pilot study. Issues in Mental Health Nursing, 26, 575–590.
Cooke, H. (2013). Progressive Muscle Relaxation. CAM-CANCER, Complementary and Alternative Medicine for Cancer.
Council, D. V. A. (1998). Preventing domestic violence: A blueprint for the 21st century. Sacramento: California Department of Health Services.
Crespo, M., & Arinero, M. (2010). Assessment of the efficacy of a psychological treatment for women victims of violence by their intimate male partner. The Spanish Journal of Psychology, 13(2), 849–863.
Dahlberg, L., Krug, E., Mercy, J., & Zwi, A. (2002). World report on violence and health. Geneva: World Health Organization.
Donias, S., & Demertzis, I. (1983). Validation of the beck depression inventory [in Greek]. In G. Varfis (Ed.), 10th Hellenic congress of neurology and psychiatry, Thessaloniki (pp. 486–492). Thessaloniki: University Studio Press.
Dutton, M. A., Haywood, Y., & El-Bayoumi, G. (1992). Impact of violence on women’s health. In S. J. Gallant, G. P. Keita, & R. Royak-Schaler (Eds.), Health care for women: Psychological, social and behavioral influences. Washington: American Psychological Association.
Dutton, M., Green, B., Kaltman, S., Roesch, D., Zeffiro, T., & Krause, E. (2006). Intimate partner violence, PTSD and adverse health outcomes. Journal of Interpersonal Violence, 21, 955–968.
Eby, K. K., Campbell, J. C., Sullivan, C. M., & Davidson, W. S., II. (1995). Health effects ofexperiences of sexual violence for women with abusive partners. Health Care for Women International, 16, 563–567.
Farrell, M. L. (1996). Healing: a qualitative study of women recovering from abusive relationships with men. Perspectives in Psychiatric Care, 32(3), 23–32.
Ferris, L. E. (2007). Intimate partner violence. British Medical Journal, 334(7596), 706–707.
Franzblau, S. H., Smith, M., Echevarria, S., & Van Cantfort, T. E. (2006). Take a breath, break the silence: the effects of yogic breathing and testimony about battering on feelings of self-efficacy in battered women. International Journal of Yoga Therapy, 16, 49–57.
General Secretariat for Gender Equality. (2012). Combating domestic violence. Ministry of Interior: General Secretariat for Gender Equality.
Golding, J. M. (1999). Intimate partner violence as a risk factor for mental disorders: a meta-analysis. Journal of Family Violence, 14, 99–132.
Gunter, J. (2007). Intimate partner violence. Obstetrics and Gynecology Clinics of North America, 34(3), 367–388.
Harvard Health Publications. (2006). Relaxation techniques: Breath control helps quell errant stress response. Harvard Health Publications, Harvard Medical School.
Hernández-Ruiz, E. (2005). Effects of music therapy on the anxiety levels and sleep patterns of abused women in shelters. Journal of Music Therapy, 42(2), 140–158.
Hyman, K. (2001). Impact of emergency department intimate partner violence (IPV) advocacy: A longitudinal, randomized trial [PhD thesis]. University of Pittsburgh, Pittsburgh, PA.
Jacobson, E. (1938). Progressive relaxation. Chicago: University of Chicago Press.
Jerath, R., Edry, J.W., Barnes, V. A., & Jerath, V. (2006). Physiology of long pranayamic breathing.
Karademas, E. C. (1998). The adjustment in Greek of a scale measuring the coping strategies of stressful situations. Psychology, 5(3), 260–273.
Karademas, E. C. (2009). Effects of exposure to the suffering of unknown persons on health-related cognitions, and the role of mood. Health (London, England), 13(5), 491–504.
Kim, S., & Kim, H. (2005a). Effects of a relaxation breathing exercise on anxiety, depression and leukocyte in hemopoietic stem cell transplantation patients. Cancer Nursing, 28(1), 79–83.
Kim, S., & Kim, H. (2005b). Effects of a relaxation breathing exercise on fatigue in hemopoietic stem cell transplantation patients. Journal of Clinical Nursing, 14(1), 51–55.
Kubany, E., Hill, E., & Owens, J. (2003). Cocnitive trauma therapy for battered women with PTSD: preliminary findings. Journal of Traumatic Stress, 16(1), 81–91.
Lazarus, R. S., & Folkman, S. (1984). Coping and adaptation. In W. D. Gentry (Ed.), Handbook of behavioral medicine. New York: The Guilford Press.
Leroi, A. M., Duval, C., Roussignol, C., Berkelmans, I., Peninque, P., & Denis, P. (1996). Boifeedback for anismus in 15 sexually abused women. International Journal of Colorectal Disease, 11(4), 187–190.
McCallie, S. M., Blum, M. C., & Hood, J. C. (2008). Progressive muscle relaxation. Journal of Human Behavior in the Social Environment, 13(3), 51–66.
McFarlane, J., Campbell, J. C., Sharps, P., & Watson, K. (2002a). Abuse during pregnancy and femicide: urgent implications for women’s health. Obstetrics and Gynecology, 100(1), 27–36.
McFarlane, J., Malecha, A., Gist, J., Watson, K., Batten, E., Hall, I., & Smith, S. (2002b). An intervention to increase safety behaviors of abused women: results of a randomized clinical trial. Nursing Research, 51(6), 347–354.
McFarlane, J., Groff, J. Y., O’Brien, J. A., & Watson, K. (2006). Secondary prevention of intimate partner violence. a randomized controlled trial. Nursing Research, 55(1), 52–61.
McKinney, J., & Wang, J. F. (1997). Battered women’s perceptions of loss and health. Holistic Nursing Practice, 11(2), 50–59.
Mechanic, M., Weaver, T., & Resick, P. (2008). Mental health consequences of intimate partner abuse: a multidimensional assessment of four different forms of abuse. Violence Against Women, 14, 634–654.
Molassiotis, A., Yung, H., Yam, B., Chan, F., & Mok, T. (2002). The effectiveness of progressive muscle relaxation training in managing chemotherapy- induced nausea and vomiting in Chinese breast cancer patients: a randomized controlled trial. Supportive Care in Cancer, 10(3), 237–246.
Pawlow, L. A., & Jones, G. E. (2005). The impact of abbreviated progressive muscle relaxation on salivary cortisol and salivary immunoglobulin A (sIgA). Applied Psychophysiology and Biofeedback, 30(4), 375–387.
Pico-Alfonso, M., Garcia-Linares, M., Celda-Navarro, N., Blasco-Ros, C., Echeburúa, E., & Martinez, M. (2006). The impact of physical, psychological, and sexual intimate male partner violence on Women’s mental health: depressive symptoms, posttraumatic stress disorder, state anxiety, and suicide. Journal of Women’s Health, 15(5), 599–611.
Reed, L. G., & Enright, D. R. (2006). The effects of forgiveness therapy on depression, anxiety and posttraumatic stress for women after spousal emotional abuse. Journal of Consulting and Clinical Psychology, 74(5), 920–928.
Schei, B., & Bakketeig, L. S. (1989). Gynaecological impact of sexual and physical abuse by spouse: a study of a random sample of Norwegian women. British Journal of Obstetrics and Gynaecology, 96(12), 1379–1383.
Sullivan, C. M., Bybee, D. I., & Allen, N. E. (2002). Findings from a community-based program for battered women and their children. Journal of Interpersonal Violence, 17, 915–936.
Sutherland, A. C., Bybee, I. D., & Sullivan, C. M. (2002). Beyond bruises and broken bones: the joint effects of stress and injuries on battered Women’s health. American Journal of Community Psychology, 30(5), 609–636.
Taylor, W., Magnussen, L., & Amundson, M. J. (2001). The lived experience of battered women. Violence Against Women, 7(5), 563–585.
Tiwari, A., Fong, D. Y., Wong, J. Y., Yuen, K. H., Yuk, H., Pang, P., & Bullock, L. (2012). Safety-promoting behaviors of community-dwelling abused Chinese women after an advocacy intervention: a randomized controlled trial. International Journal of Nursing Studies, 49, 645–655.
Trimpey, M. L. (1989). Self-esteem and anxiety: Key issues in an abused Woman’s support group. Issues in Mental Health Nursing, 10(3–4), 297–308.
Wallston, K. A., Wallston, B. S., & DeVellis, R. (1978). Development of the multidimensional health locus of control scale. Health Education Monographs, 6, 160–170.
WHO. (2011). Intimate partner and sexual violence against women. World Health Organization, Media Centre: http://www.who.int/mediacentre/factsheets/fs239/en/.
Williams, J., Teasdale, J., Segal, Z., & Soulsby, J. (2000). Mindfulness-based cognitive therapy reduces overgeneral autobiographical memory in formerly depressed patients. Journal of Abnormal Psychology, 109(1), 150–155.
George P. Chrousos and Christina Darviri contributed equally to this work.
Rights and permissions
About this article
Cite this article
Michalopoulou, E., Tzamalouka, G., Chrousos, G.P. et al. Stress Management and Intimate Partner Violence: A Randomized Controlled Trial. J Fam Viol 30, 795–802 (2015). https://doi.org/10.1007/s10896-015-9740-8
- Domestic abuse