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This is to certify that the

thesis entitled

DOES SOCIAL SUPPORT MODERATE STRESS APPRAISAL
FOR.WOMEN IN ABUSIVE RELATIONSHIPS?

presented by

Sally A. Theran

has been accepted towards fulﬁllment
of the requirements for

M.A. Psychology

degree in

 

 

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12/10/99

 

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DOES SOCIAL SUPPORT MODERATE STRESS APPRAISAL
FOR WOMEN IN ABUSIVE RELATIONSHIPS?

By

Sally A. Theran

A THESIS
Submitted to
Michigan State University
in partial fulﬁllment of the requirements
for the degree of
MASTER OF ARTS
Department of Psychology

1999

ABSTRACT

DOES SOCIAL SUPPORT MODERATE STRESS APPRAISAL
FOR WOMEN IN ABUSIVE RELATIONSHIPS?

By

Sally A. Theran

Previous research on domestic violence has neglected the relationship between
stress appraisal and social support. This study examined social support as a moderator of
the relationship between abuse and stress appraisal. The current study was part of a larger
project that interviewed 399 women, of whom 206 had been physically and
psychologically abused in the six months prior to the interview. Results indicated that the
experience of psychological abuse resulted in more stress appraisal than did physical
abuse. In addition, while social support did not buffer the effects of abuse, a main effect

was found.

ACKNOWLEDGEMENTS

I owe many thanks to my advisor, Anne Bogat, who thoughtﬁilly guided me
during the process of writing my thesis. She was compassionate, knowledgeable, and a
source of constant encouragement; I could not have asked for a better advisor. I also
appreciate the help and guidance of my thesis committee members, Bill Davidson and
Cris Sullivan. In addition, John’s commitment, support, and love were an integral part of
this process. Finally, I would like thank my friends and family, both near and far, for

their support.

iii

TABLE OF CONTENTS

LIST OF TABLES ........................................................................................................ vi-vii
INTRODUCTION ................................................................................................................ 1
Domestic Violence ................................................................................................... 1

Stress Appraisal ....................................................................................................... 8

Social Support ........................................................................................................ 11
Rationale ................................................................................................................ 17

The relationship between stress and social support. .................................. 18

The relationship between social support and domestic violence. .............. 19

Hypotheses ............................................................................................................. 1 9
METHOD .......................................................................................................................... 21
Participants ............................................................................................................. 2 1
Measures ................................................................................................................ 22
Physical Abuse ........................................................................................... 22

Psychological Abuse .................................................................................. 23

Social Support ............................................................................................ 24

Stress .......................................................................................................... 24

Procedure ............................................................................................................... 25
RESULTS .......................................................................................................................... 27
Preliminary Analyses ............................................................................................. 27

Test of the Hypotheses ........................................................................................... 31
DISCUSSION .................................................................................................................... 34
Limitations ............................................................................................................. 38
Directions for Future Research .............................................................................. 43

iv

APPENDICES ................................................................................................................... 45

Appendix A: The Conﬂict Tactics Scale, Modiﬁed .............................................. 45
Appendix B: The Index of Psychological Abuse Scale ......................................... 47
Appendix C: The Adult Social Support Questionnaire .......................................... 49
Appendix D: The Life Event Checklist .................................................................. 52
Appendix E: The Informed Consent Form ............................................................ 58
Appendix F: Tables ................................................................................................ 60
REFERENCES .................................................................................................................. 80

Table I:

Table II:

Table III:

Table IV:

Table V:

Table VI:

Table VII:

Table VIH:

Table IX:

Table X:

Table XI:

Table XII:

Table XIII:

Table XIV:

LIST OF TABLES

Abuse Status of Participants ........................................................................ 61

Descriptive Statistics for Demographics of
Abused Women versus Non-Abused Women ............................................. 62

Pearson Product Moment Correlations for Variables:
Abused Women only ................................................................................... 63

Descriptive Statistics for Abused Women only ........................................... 64

Pearson Product Moment Correlations for Variables:
Non-Abused Women only ........................................................................... 65

Descriptive Statistics for Non-Abused Women only .................................. 66

Pearson Product Moment Correlations for Variables:
All Women in the Sample ........................................................................... 67

Descriptive Statistics for All Women in the Sample ................................... 68

Most Endorsed Types of Physical Abuse and Most Frequently
Occurring Types of Physical Abuse for Abused Women ............................ 69

Most Endorsed Types of Psychological Abuse and Most Frequently
Occurring Types of Psychological Abuse for Abused Women ................... 70

Most Endorsed Types of Psychological Abuse and Most Frequently
Occurring Types of Psychological Abuse for Non-Abused Women ........... 71

Most Endorsed Life Events and Most Stressful Life Events
for Abused Women ..................................................................................... 72

Most Endorsed Life Events and Most Stressful Life Events
for Non-Abused Women ............................................................................. 73

Summary of Hierarchical Regression Analysis for

Frequency of Psychological Abuse and Social Support
Predicting Stress Appraisal .......................................................................... 74

vi

Table XV:

Table XVI:

Table XVII:

Table XV 1H:

Table XIX:

Controlling for Demographics: Summary of Hierarchical Regression
Analysis for Frequency of Psychological Abuse and Social Support
Predicting Stress Appraisal .......................................................................... 75

Summary of Hierarchical Regression Analysis for Frequency of Physical
Abuse and Social Support Predicting Stress Appraisal ............................... 76

Controlling for Demographics: Summary of Hierarchical Regression
Analysis for Frequency of Physical Abuse and Social Support
Predicting Stress Appraisal .......................................................................... 77

Summary of Hierarchical Regression Analysis for Severity of Physical
Abuse and Social Support Predicting Stress Appraisal ............................... 78

Controlling for Demographics: Summary of Hierarchical Regression

Analysis for Severity of Physical Abuse and Social Support
Predicting Stress Appraisal .......................................................................... 79

vii

INTRODUCTION

The goal of this study was to test the effects of social support in the lives of
women in abusive relationships. Speciﬁcally, this study examined social support as a
moderator of the relationship between abuse, a stressor, and amount of stress appraisal.
Social support was comprised of several domains that included social companionship,
advice and information, practical assistance, emotional support, and ﬁnancial support.
Abuse was deﬁned as physical, psychological, and sexual abuse.

The present study attempted to determine whether socioemotional types of social
support, such as companionship and emotional support, can reduce the amount of stress
appraisal. Abusive relationships are associated with multiple negative consequences, so
if social support reduces the amount of stress appraisal, social support can drastically
affect the amount of stress experienced, and secondarily, the amount of psychological and
physical distress experienced as a result of the abuse.

Domestic Violence

Recently, researchers have focused on the issue of domestic violence. Domestic
violence continues to be a pervasive social and public health problem; estimates indicate
that between 21 and 34 percent of all women will experience some kind of abuse from an
intimate partner during their lifetime (Koss, 1990), and the current incidence rate ranges
from 5 to 25 percent of women, depending on the methodology used (Campbell &
Lewandowski, 1997).

Consequences of an abusive relationship involve physical injuries, physical health
problems, and emotional and psychological symptoms. Injuries from an abusive

relationship may involve pain, broken bones, facial trauma, and tendon or ligament

injuries (Campbell & Lewandowski, 1997). In addition, it is possible that hearing, vision,
and concentration problems may be the result of undiagnosed neurological damage
(Campbell & Lewandowski, 1997). One study (Sullivan, Tan, Basta, Rumptz, &
Davidson, 1992) found that the three most common injuries experienced by women, six
months before entering a shelter, were cuts or bruises (87%), soreness without bruises
(84%), and strains or sprains (40%). In addition, a notable percentage of women
experienced more severe injuries, such as broken bones (21%), internal injuries (13%),
pregnancy problems or miscan'iage (10%), and dislocations of bones (10%).

Physical abuse is highly correlated with physical health problems (Hilberman &
Munson, 1977; Rodriguez, 1989; Warshaw, 1997). One study found that 97% of a
sample of women in abusive relationships had at least one physical or psychological
symptom stemming from the effects of the abuse and associated stress; these symptoms
were reactions to the abuse, rather than injuries (F ollingstad, Brennan, Hause, & Polek,
1991). In addition, women experienced a signiﬁcant increase in physical health once
abuse ended. Research also demonstrates that women in abusive relationships report
signiﬁcantly higher levels of somatic complaints than women not in abusive relationships
(J affe, Wolfe, Wilson, & Zak, 1986). Therefore, it is clear that women in abusive
relationships suffer not only from injuries, but also from long-term physical health
problems such as back and limb problems, insomnia, pelvic pain, migraine headaches,
sleep problems, and stomach aches (Eby, Campbell, Sullivan, & Davidson, 1995;
Follingstad, Brennan et al., 1991; Hilberrnan & Munson, 1977; Jaffe et al., 1986).

Initially, research focused on traits of the individual woman that made her more

vulnerable to abuse (Goodstein & Page, 1981); this victim-blaming approach later

changed to a focus on the psychological consequences of physical abuse (Campbell,
Sullivan, & Davidson, 1995; Tutty, Bidgood, & Rothery, 1993). Researchers noted that
psychological problems that women experienced were a r_egi_lt of the abuse, rather than
defective characteristics of women that were the cause of the abuse (Gelles & HarrOp,
1989; Holtzworth-Munroe, Smutzler, & Sandin, 1997). Psychological symptoms are as
prevalent as physical symptoms in abused women; women in abusive relationships tend
to be more depressed, have increased anxiety, and increased suicide attempts (Campbell
& Lewandowski, 1997; Campbell et al., 1995; Gelles & Harrop, 1989; Hilbennan &
Munson, 1977; J affe et al., 1986; Mitchell & Hodson, 1983; Sato & Heiby, 1992).

One study examined a sample of women in a battered women’s shelter and
conducted follow-up interviews with the women upon shelter exit (Campbell et al.,
1995). The researchers found that rates of depression signiﬁcantly decreased over time.
At shelter exit, 83% of the women had at least mild depression; six months later, only
59% of the women had at least mild depression. The rates of depression decreased even
more for women who were no longer in the abusive relationship. Furthermore, it was
found that feelings of powerlessness, experience of abuse, and decreased social support
contributed to the depression, and that the scores on these variables at the 10-week
follow-up point predicted levels of depression at the 6-month time period. Thus, abuse
can engender psychological problems, such as depression and powerlessness, that damage
women’s feelings of control, and may serve as barriers to leaving the abusive
relationship.

One shortcoming of studies that have examined the impact of physical abuse on

psychological well-being is that, with the exception of Gelles and Harrop’s (1989) study,

all of the researchers cited above recruited their participants from domestic violence
shelters. These participants are not representative samples of the abused population at
large (Kemp, Green, Hovanitz, & Rawlings, 1995), and are more likely to have ﬁnancial
problems (Sullivan & Rumptz, 1994). It is also possible that shelter participants could
have more or less psychological problems stemming ﬁom the abusive relationship (Gelles
& Harrop, 1989).

One of the studies that did use a general population sample (Gelles & Harrop,
1989) surveyed a randomly selected national sample, and found that women who reported
experiencing violence and abuse were signiﬁcantly more likely to report symptoms of
moderate or severe psychological distress. They deﬁned moderate psychological distress
as headaches, nervousness or stress, and feelings of sadness and depression. Severe
psychological distress included being overwhelmed by difﬁculties, feeling worthless and
hopeless, not being able to cope, and feeling that nothing was worthwhile. In addition,
the participants’ income was negatively related to moderate and severe distress; thus,
women with higher income were less likely to report experiencing moderate and severe
psychological distress. However, this study had several disadvantages; because it was a
cross-sectional design, it was impossible to determine if the psychological distress
preceded experiences with violence or was a consequence of the experiences. Given
Campbell et al.’s (1995) study, it is likely that the psychological distress was largely a
consequence of the abusive relationship, because distress decreased substantially after
leaving the shelter. A second shortcoming of Gelles and Harrop’s (1989) study is that

they did not use a control group.

The psychological symptoms resulting from physical abuse sometimes ﬁt DSM-
lV criteria for Posttraumatic Stress Disorder (PTSD). Some research has documented
that women in abusive relationships suffer from PTSD (Astin, Lawrence, & F oy, 1993;

F ollingstad, Neckerman, & Vormbrock, 1988). As deﬁned by the DSM-IV, PTSD
involves experiencing or witnessing a threatening event, a response involving fear, re-
experiencing the event (including nightmares or psychological distress at symbols that
resemble the event), avoidance of stimuli associated with the trauma, and persistent
symptoms of increased arousal (e. g., sleep disturbances and concentration difﬁculties).
Rates of PTSD in women in abusive relationships range from 33% to 85%, depending on
the sample used, and the protocol used to measure PTSD (Astin et al., 1993). However,
the most frequently experienced psychological responses to an abusive relationship, such
as depression and stress-related physical symptoms, are not related to PTSD (Woods &
Campbell, 1993). In addition, researchers often assess PTSD when women are still
experiencing violence and/or threats from their partner, making it impossible to
adequately assess PTSD. This indicates that PTSD is not the most complete explanation
for women’s reactions to abusive relationships.

While the effects of physical abuse have been widely researched in the last ﬁfteen
years, researchers have only begun to examine the effects of emotional abuse. Emotional
abuse also has serious psychological consequences (Campbell & Lewandowski, 1997). In
fact, Marshall posited that psychological abuse is more damaging than all but the most
severe violence (Marshall, 1993, as cited in Ellington & Marshall, 1997). Indeed, in a
study comparing three groups of women, with psychological abuse only, psychological

abuse with moderate violence, and psychological abuse with severe violence, there were

few differences among the groups, and the only differences existed between the ﬁrst two
groups and the third (Ellington & Marshall, 1997).

According to Follingstad, Rutledge, Berg, Hause, & Polek’s (1990) study, the
only evidence for the negative consequences of psychological abuse has been anecdotal.
The anecdotal evidence indicates that psychological abuse can have devastating effects,
because it is more painful, and damages self-esteem. Psychological abuse is used as a
means of wielding power; it serves to control the woman, diminish her self-esteem, and
keep her with the abuser. A qualitative study by Lempert (1996) indicates the importance
of examining psychological as well as physical abuse. One woman said,

“The verbal attack was much more abusive [than the physical attack], I thought,

much more, much more devastating... a physical attack is just physical. It’s your

body. Whereas a verbal attack, you know, they get into you, the person, and um,
it’s more emotional and psychological. I mean my face healed. But the stuff he

did to my mind, it hasn’t even healed to this day and it’s been, you know, I’ve

been separated from him for over a year now” (p. 285).

F ollingstad et al.’s (1990) study sought to clarify the prevalence and effects of
psychological abuse. Their sample consisted of 234 women with some history of
physical abuse who were recruited from a variety of sources, including shelters and
newspaper ads. F ollingstad and her colleagues assessed six types of emotional abuse:
threats of abuse, ridicule, jealousy, threats to change marital status, restriction/social
isolation, and damage to joint property. Follingstad and her colleagues found that 99% of
women experienced emotional abuse. The most frequently experienced form of
psychological abuse was restriction/social isolation (74.4%). Jealousy (67.6%) and

ridicule (64.5%) were also common. Women rated ridicule (45.7%) as the worst type of

emotional abuse, followed by threats (14.9%), jealousy (12.2%) and restriction/social

isolation (10.4%). Psychological abuse is very detrimental to women in abusive
relationships; 72% of the participants indicated that emotional abuse had a more severe
impact on them than physical abuse. However, one signiﬁcant flaw of this study is that
the participants only rated the emotional abuse as to the direction of the impact on their
lives: negative, neutral, or positive effect. Thus, the study lacks a richer understanding of
the effects of psychological abuse on psychological well-being, and how the
consequences of psychological abuse differ from those of physical abuse.

According to Follingstad et a1. (1990), isolation is considered a form of
psychological abuse; it was the most commonly experienced form of emotional abuse,
and has harmful repercussions on a woman’s independence. Other studies indicate as
well that women in abusive situations can become extremely socially isolated (Forte,
Franks, Forte, & Rigsby, 1996; Hilbennan & Munson, 1977; Holiman & Schilt, 1991;
Rynerson & Fishel, 1993). Women in abusive relationships have less social support than
controls (Barnett, Martinez, & Keyson, 1996). One study (Forte et al., 1996) found that
25% of their sample had not been involved in any social activities in the previous month.
Another study found similar results; 42% of couples in an abusive relationship had a
social activity less than once a month, and 63% of couples had no outside activities
(Rynerson & F ishel, 1993). In terms of their personal relationships, when asked to
indicate the number of people that they could be with when they wanted to have fun or
with whom they could discuss personal problems, 61% of women in abusive relationships
reported that they had one or less person available (Mitchell & Hodson, 1983).

It has been hypothesized that friends and family may feel discomfort with the

abuser’s behavior, and thus tend to avoid the abuser, and by association, the woman being

abused (Dutton, Hohnecker, Halle, & Burghardt, 1994). In addition, discomfort with the
issue of domestic violence may cause ﬁiends and families to try to minimize the situation,
which might increase the woman’s experience of isolation and frustration (Mitchell &
Hodson, 1983). However, as previously noted, all of the research on psychological abuse
used domestic violence shelter samples, with the exception of Follingstad et al.’s (1990)
study, which used a mixed sample. It is possible that women in shelters have less access
to social support than a community sample, who have other means of refuge besides
shelters. Thus, domestic violence has many harmful repercussions for women’s lives,
and may engender large amounts of stress appraisal.

Stress Appraisal

Domestic violence acts as a chronic stressor in women’s lives (Woods &
Campbell, 1993). It enacts the double bind of increasing the level of stress in a woman’s
life, while decreasing personal and social resources for dealing with stress (Mitchell &
Hodson, 1983). In addition, abuse is a stressor that threatens a woman’s physical and
psychological well-being (Carlson, 1997). Women in abusive relationships experience a
great deal of stress; one study found that 68% of women in a shelter perceived themselves
to be under a great deal of stress (Rodriguez, 1989).

Traditionally, stress has been deﬁned as the response of the body to demands
placed upon it (Spacapan, 1988). Assessment of stress has involved the existence of
speciﬁc life stressors in a person’s life. However, the existence of an objective stressor is
less important than how stress is appraised, and stress is therefore more subjective than

objective (Aldwin & Revenson, 1987). Within the reahn of stress research, the

psychological literature has focused on individuals’ subjective evaluations of speciﬁc life
events or circumstances (Cohen, Kessler, & Underwood Gordon, 1995).

Current stress theory focuses on the cognitive process of appraisal, which pertains
to the evaluation of stressors and their dimensions. According to Lazarus and F olkrnan’s
(1984) model of stress, stress is deﬁned as the aspect of the person-environment
relationship in which the person perceives something as depleting, or exceeding,
resources and endangering physical and psychological well-being. Thus, this concept
involves a cognitive appraisal of the stressor, because the individual has to evaluate an
incident regarding its implications for physical and psychological well-being. Therefore,
the subjective meaning of the event, rather than the mere existence of the event itself, is
important.

Cognitive appraisal has two steps. The ﬁrst step, primary appraisal, involves
assessing whether or not an event is stressful. Stressful appraisals include harm or loss,
threat, and challenge. Women in abusive relationships are likely to decide that the abuse
is stressful, because an abusive relationship is likely to have aspects of harm or loss,
threat, and challenge. The second step, secondary appraisal, is an evaluative process in
which the person evaluates their resources, and determines how to respond or how to
cope (Cohen et al., 1995). Again, women in abusive relationships are likely to consider
different ways of handling the abusive relationship, and their options will be affected by
their personal resources, including social support.

Thus, there are several steps in the stress process. First, the event occurs,

followed by primary appraisal and then secondary appraisal. Next comes the stress

reaction, which can be manifested in physiological responses or psychological response.
This process results in an increased risk of psychiatric and physical diseases.

Stress has serious health-related consequences. A strong association between
stress and physical and psychological illness exists (Gottlieb, 1985). Physically, stress
has been linked to health problems such as headaches, heart disease, heartburn, backache,
childhood leukemia, heart attack, stroke, and respiratory illness (Gottlieb, 1985; Quick,
Horn, & Quick, 1987). Psychologically, stress has been related to problems such as
burnout, depression, schizophrenia, sexual dysfunction, and sleep disturbances (Gottlieb,
1985; Quick et al., 1987). As described earlier, women in abusive relationships
frequently suffer from such illnesses, both physical and psychological, that are
uncorrelated with the actual physical injuries inﬂicted by their abuser.

There is a positive pattern between stress and social support; as stress increases,
so does the likelihood that the individual will utilize social support resources (Carveth &
Gottlieb, 1979). Conversely, social support may affect functioning by reducing
subjective appraisal of the stressfulness of a negative life event or strain (Kessler, Price,
& Wortman, 1985; Mitchell, Billings, & Moos, 1982). Although certain life events are
almost universally experienced as stressful (e. g., death of a spouse), the impact of such
events are still dependent upon the individual’s appraisal of the event, and her ability to
cope with it. Social support can inﬂuence the appraised stressfulness of such an event
(Cohen et al., 1995). Thus, social support, or the inﬂuence of signiﬁcant persons, affects

the appraisal of stress (Follingstad, Brennan et al., 1991).

10

Social Support

Social support has been deﬁned in numerous ways. Primarily, social support is
the assmnption that others can be relied upon for advice, information, understanding,
guidance, and support (Buunk & Hoorens, 1992). In addition, social support refers to
receiving support from others once stress occurs (Gottlieb, 1983). Both of these
deﬁnitions of support assume the preventive role of support against the negative effects of
stress. Social support can also be viewed as a commodity that is provided by a variety of
social relationships (Veiel, 1985).

In coping with stress, social support has been associated with better physical and
psychological health (Cohen & Wills, 1985; F lannery & Wieman, 1989; Kessler &
McLeod, 1985). Social support can act as a protective factor against stress appraisal, as
well as the physical and psychological health problems caused by stress. Social support _
can be perceived as a resistance resource against illness, including stress-related illness
(Quick et al., 1987). Because women in abusive relationships are typically socially
isolated, social support can help ameliorate their isolation. In addition, positive social
support from friends and family might inﬂuence a woman in an abusive relationship to
seek social services or other help (Bowker, 1984).

However, it is essential that social support be positive; one study found that
family members were the most frequently cited source of informal support, and that
family members were rated as at least fairly helpful in 80% of the abusive incidents
(Bowker, 1984). The author noted that negative social support can cause women in
abusive relationships to blame themselves, or become less likely to seek help (Bowker,

1984). Women who did not share their abuse history gave reasons such as it being a

ll

private matter, and being embarrassed (Mahlstedt & Keeny, 1993). Therefore, for women
who are more reluctant to share their abuse, covertly blaming them will have serious
consequences. In addition, if social support is either inadequate or judgmental, it could
increase the woman’s feelings of guilt and stigmatization. The quality of the social
support matters; empathic responses from women’s friends were positively correlated
with self-esteem, while avoidance responses from friends were negatively correlated with
self-esteem (Mitchell & Hodson, 1983).

Cohen and Wills (1985) provide a thorough examination of the two processes
through which social support has a beneﬁcial effect on psychological well-being. The
main effect model maintains that social support has a beneﬁcial effect regardless of the
level of stress; the buffering hypothesis suggests that social support buffers and protects
from the negative effects of stressful life events only under high levels of stress
(DeKeseredy, 1988). In other words, the buffering model suggests that social support
protects the individual ﬁ'om negative health outcomes, rather than enhancing health, as in
the main effect model (Gottlieb, 1987).

The main effect theory of social support has been veriﬁed in numerous research
studies (Bell, Leroy, & Stephenson, 1982; Duckitt & Broll, 1982; Mitchell et al., 1982).
An additional study that veriﬁed the main effect model (Kemp et al., 1995) with a
domestic violence sample used a shelter sample that is not representative of the general
population. The buffering model has also been veriﬁed by many research studies
(Aldwin & Revenson, 1987; Cohen & Hobennan, 1983; Dutton et al., 1994; Flannery &
Wieman, 1989; Mitchell & Hodson, 1986). Of the previous studies mentioned that

corroborate the buffering model, the two that used a domestic violence sample used non-

12

representative samples. Dutton and her colleagues (1994) compared women in abusive
relationships to a forensic sample of women in abusive relationships who killed their
spouses. The second study (Mitchell & Hodson, 1986) used a small shelter sample.
Thus, there is a need for research on social support with a domestic violence sample that
is more representative of the general domestic violence population.

Cohen and Wills (1985) hypothesize that in the buffering model, social support
can mitigate stress at two different points in the stress continuum. The stress continuum
begins with a potentially stressful event that leads to illness and/or disturbance in
psychological well-being. Social support may come into play following the potential
stressful event, when the appraisal process is occurring. In this manner, the individual
suffering from stress will perceive that the social support will provide necessary resources
that will redeﬁne the situation, or help cope with the situation, and prevent the event from
becoming as potentially stressful (Spacapan, 1988). Thus, the perception of social
support, and available resources, results in the appraisal of reduced stress (F elsten &
Wilcox, 1992). The second point at which social support might intercede is following the
point where the event is appraised as stressful, but before the pathological response.
Thus, social support might affect the impending pathological response by reducing stress,
allowing for reevaluation of the situation, or providing a solution to the problem at hand.

To understand how social support affects the stress continuum, it is necessary to
discuss the salient aspects of social support. Social support is deﬁned as the qualitative
aspects of a social network (Israel & Antonucci, 1987), while social networks are deﬁned
as the structure of the social support system. Research has shown that qualitative aspects

of social support are better predictors of psychological well-being, and better buffers, than

13

quantitative aspects of social support (Cohen & Hoberrnan, 1983; Israel & Antonucci,
1987; Kemp et al., 1995; Wilcox, 1981). One study found that satisfaction with social
support was independent of the size of the social network (Tan, Basta, Sullivan, &
Davidson, 1995). Of the aforementioned studies, the two that examined the role of social
support in a domestic violence population both used shelter samples (Israel & Antonucci,
1987; Tan et al., 1995).

Researchers have suggested that it is more important to examine perceived social
support, as opposed to m social support (Buunk & Hoorens, 1992; Power, 1988).
Receiving social support or help from others does not always lead to feeling supported
(Rook, 1984). Wethington and Kessler (1986) noted that there were two interpretations
of the stress-buffering hypothesis: that the perception of support availability is an accurate
representation of actual network responses to the stressful situation, or that perception of
support availability inﬂuences beliefs by modifying appraisals of the situation. They
found stress-buffering for perceived support, not received support, and concluded that
perceived support is more signiﬁcant than received support in predicting adjustment in
response to stressful life events. Wethington and Kessler (1986) noted that the perception
of being supported can in itself promote health, regardless of the accuracy of that
perception. In addition, the perception of being supported is not always determined by
the resources of the social network.

Domains of social support include companionship, advice and information,
practical assistance, emotional support, and ﬁnancial support. Social companionship, or
belongingness, is spending time with others in an informal way and being part of a social

network; this fulﬁlls a need for afﬁliation and contact (Cohen & Wills, 1985; Dutton et

14

al., 1994; F lannery & Wieman, 1989; Wellrnan & Wortley, 1990). Advice and
information is when guidance and problem solving support are provided (Wills, 1985).
Practical assistance involves giving services, such as child care (Wellman & Wortley,
1990; Wills, 1985). Emotional support involves behavior that reﬂects empathy and
understanding (Bailey, Wolfe, & Wolfe, 1994). Finally, ﬁnancial support involves
having someone to loan or give large amounts of money (Wellman & Wortley, 1990).
Different kinds of social support have different mechanisms for decreasing stress.
Research indicates that socioemotional types of social support (i.e., social companionship
and emotional support) are more effective in reducing depressive symptoms than more
tangible means of social support, such as practical assistance or ﬁnancial support (Cohen
& Hobennan, 1983; Israel & Antonucci, 1987; Tutty et al., 1993). A study examining the
social support networks of cancer patients found that socioemotional was the most
important type of social support (Taylor & Dakof, 1988). Research examining the
efﬁcacy of support groups for women in abusive relationships evaluated the effects of
four different types of social support: tangible, appraisal, belonging, and total social
support (Tutty et al., 1993). They found that, following the conclusion of the group,
belonging support was the only type of support which improved signiﬁcantly (Tutty et al.,
1993). Thus, support groups are likely to affect women’s sense of a supportive social
system and afﬁliation, but are unable to affect perceptions of more tangible resources. In
addition, one study found that affective, or emotional support, was a predictor of
psychological well-being, while instrumental/practical assistance was unrelated to
psychological well-being (Israel & Antonucci, 1987). Possibly, stressful experiences

elicit coping requirements that are best met by socioemotional types of support. While

15

tangible support emphasizes the availability of external resources, socioemotional types
of support emphasize the recipient’s internal feelings, and how she is viewed by others
(Cohen & McKay, 1984). In addition, several studies deﬁned social support in a multi-
dimensional manner with various domains as described above, but failed to report
differential ﬁndings for these domains in their results and discussion sections (F lannery &
Wieman, 1989; Koeske & Koeske, 1990).

For women who are in abusive relationships, it is likely that while they will need
external resources to leave the abuser, it is also probable that because the abuse will have
adversely affected psychological functioning, socioemotional support could be more
effective in ameliorating their stress and depression. One study found that women who
had been in abusive relationships expressed a greater need for understanding and
emotional support than any other type of support (Mahlstedt & Keeny, 1993). Another
study found that women expressed a need for socioemotional support from their friends,
because the interpersonal support allowed them to increase their self-conﬁdence, which
was a precursor for leaving the abuser (Bowker, 1984). In addition, social
companionship, or feelings of belonging, would be very important for someone in an
abusive relationship because intimate relationships could help lessen the social isolation
experienced during the relationship.

Tangible support is most effective when the offer of help is viewed by the
recipient as appropriate (Cohen & McKay, 1984). Cohen and Wills (1985) postulated
that the buffering model was most effective when the coping needs were met by the type
of social support offered. One study found that the most effective type of social support

was understanding and emotional support (Mahlstedt & Keeny, 1993). Participants

16

indicated that while they ultimately might be interested in advice, it was more important
that people listen to them ﬁrst, and that they made their own autonomous decisions. This
study examined the ﬁve different domains listed above in relation to the interaction
between abuse and stress.

Rationale

The relationship between stress appraisal and social support has been scarcely
examined (Bailey et al., 1994), and the relationship between stress appraisal, social
support, and domestic violence has never been studied. Because domestic violence
engenders stress, social support could interact to ameliorate the effects of the abuse,
lessen stress appraisal, and thus reduce the psychological and physical health
repercussions. In this manner, social support acts as a preventative mechanism to
diminish the effects of stress. Examining social support in this context would lead to
more effective interventions for women in abusive relationships, such as increasing social
support for women at risk of abuse, or women who have already experienced abuse and
are remaining with their partners. Thus, if these women have increased access to social
support, they are more likely to be empowered to leave the abusive situation, which will
likely serve to lessen the intensity of the stress appraisal, thus reducing the possibilities of
psychological and physical health problems.

In addition, most of the domestic violence studies have examined women in
shelters; it is unlikely that these results can be generalized to all women affected by
domestic violence. Women who utilize shelters are more likely to be affected by external
circumstances such as poverty. Thus, the stress experienced from the abusive situation

might be confounded by external variables. The use of a middle-income population, as

17

well as a low-income population, avoids such problems, as does the use of alternate
recruiting methods.

The relationshim between stress and social support. When a stressful event occurs,
the immediate response is stress appraisal, followed by the response to the stress, which is
sometimes pathological. As described above, researchers have typically examined what
factors intercede between the stress appraisal and the pathological response to the stress
to diminish the impact of the stress. However, if the relationship between the traumatic
event and stress appraisal was determined, and what factors interact to diminish stress
appraisal, this would be a more proactive way to reduce pathological reactions. While
previous researchers have scarcely examined this approach, their results do indicate that
social support can act as a buffer against the stress appraisal (Bailey et al., 1994; F elsten,
1991; Felsten & Wilcox, 1992). Speciﬁcally, satisfaction with social support affected the
appraisal of a stressful situation and the total amount of stress experienced (F elsten,
1991). In addition, this was only found with persons who experienced many stressors.
This study hypothesizes that social support is a moderator between abuse and stress
appraisal.

In addition, the buffering model of social support, which as explained above,
protects health, will be examined. In this study, the stress appraisal of women in abusive
relationships will be moderated by their level of socioemotional social support. Thus, it
will be demonstrated that the effects of social support are dependent upon the level of
abuse, the stressor. Because women who are abused are more likely to have high stress
appraisal, social support will only be effective in reducing stress appraisal for women

under high levels of stress.

18

The relationship between social support amd domestic violence. Studies have
shown that as stress increases, increased levels of social support are associated with a
decrease in tension and psychological symptoms (Cohen & Hoberman, 1983; Gottlieb,
1987). In a domestic violence sample, research has shown that abuse increases the
experience of stress, while it decreases personal and social resources for dealing with
stress. Women themselves indicate a great need for social support. One study found that
79% of women exiting a shelter mentioned social support as an aspect of their lives that
they wanted to work on (Sullivan et al., 1992). In samples of women in abusive
relationships, social support has been negatively correlated with depression and other
negative psychological outcomes (Campbell et al., 1995; Mitchell & Hodson, 1986; Tan
et al., 1995). However, all of the studies examining social support and stress in a
domestic violence sample examined the interaction of stress and social support at the
second point in Cohen & Wills (1985) model; no studies to date have examined the
relationship between abuse and stress appraisal with social support as the moderator.
W

The study examined the role of social support as a moderator between abuse and
stress appraisal. Three hundred and ninety-nine women, half of whom had been in an
abusive relationship in the previous six months, were interviewed. The following
hypotheses were tested:
1. Women who are abused, regardless of the type of abuse, will report more stress

appraisal in their lives than women who have not been in an abusive relationship

in the last six months. A one-way ANOVA will be used to test this hypothesis.

19

For abused women, psychological abuse will result in more stress appraisal than
physical abuse. A ; test of difference will compare the correlation between
physical abuse and stress appraisal to the correlation between psychological abuse
and stress appraisal.

Social support will moderate the relationship between abuse and stress appraisal

for frequency of psychological abuse, frequency of physical abuse, and severity of

physical abuse; this will corroborate the buffering model of social support. Three
multiple regression analyses will be used to test this hypothesis; a signiﬁcant
interaction between social support and abuse will indicate that social support
functions as a moderator.

A. Since psychological abuse will result in more stress appraisal than physical
abuse, the buffering effect of social support will be stronger for psychological
abuse than for physical abuse. This will be tested by comparing the beta
weights for stress appraisal in the two different equations for psychological

abuse and physical abuse.

20

METHOD

Participants

As part of a larger research project, 399 women were recruited to participate in the
current study. The larger research project, the Women’s Health Study, examined the
effects of various life circumstances on women’s psychological well-being. The primary
method of recruitment was through newspaper advertisements. Four different
advertisements were placed simultaneously in three local newspapers from August 1996
to June 1997. Each of the advertisements was designed to recruit a speciﬁc proﬁle
(middle income women who had been physically abused in the past six months by an
intimate partner, low income women who had been physically abused in the past six
months by an intimate partner, middle income women who had not been abused in the
past six months, and low income women who had not been abused in the past six months)
for each wave of recruitment. Women called the Women’s Health Study ofﬁce, where
they were screened for eligibility, which was determined by the desired participant
proﬁle, as determined by the current recruitment wave. Once women were determined to
be eligible, an interview was scheduled.

Over half of the women in the study identiﬁed themselves as White/Caucasian
(70%), with 17% identifying themselves as Black/African-American, 6% multiple
ethnicity, 5% Hispanic/Latina, 1% Asian-Paciﬁc, and 1% Native American. The average
age of women in the study was 34 years old with a range of 37 years; the minimum age
was 17 and the maximum age was 54. The majority of women (81%) had at least some
high school education; 69% of women were currently employed, and 85% had been

employed in the last six months. The average monthly income ranged from O to $8,667;

21

the mean monthly income was $2,042 and the median income was $1500. This monthly
income supported a mean number of 2.81 people, with a range of 1 - 9 people. More than
half (53%) of the women interviewed had been abused by an intimate partner in the last
six months.

Measures

Physical abuse. Physical abuse was conceptualized as any incident in which the
woman was physically harmed by an intimate partner/ex-partner or spouse/ex—spouse.
The relationship was considered intimate if the participant indicated that the partner was
at least a boyfriend or a girlfriend. Physical abuse was assessed by a modiﬁed version of
Straus’ (1979) Conﬂict Tactics Scale (CTS), which contains 13 items (See Appendix A
for a copy of this measure). The modiﬁed scale eliminated the verbal abuse items and
separated composite items (i.e., partitioned a question asking about pushing, grabbing, or
shoving into two distinct items). Participants rated the frequency of the physical abuse on
a six-point scale ranging from 1 = “Never” to 6 = “More than four times a week.” The
frequency of abuse scale score was created by taking the mean score across the items.
The coefﬁcient alpha for this scale was .92, and the corrected item-total correlations
ranged from .25 to .80.

In addition to the frequency of physical abuse, a measurement of the severity of
physical abuse was also computed. The coding method for severity followed Sullivan
and Bybee’s (1999) method. Item scores from the CTS were recoded into severity scores,
using a four-point scale where “0” indicated no physical abuse, “1” indicated moderate
abuse only (tore clothing, pushed/ grabbed, threw something at, slapped) at any frequency,

“2” indicated low frequency (less than once a month) of severe abuse (kicked/hit with

22

ﬁst, hit or tried to hit with something, drove recklessly, beat up, choked, tied up, raped,
threatened with gun or knife, used gun or knife), and “3” indicated high frequency (more
than once a month) of severe abuse (as previously described). Because only one person
fell into the high frequency of moderate abuse, the “moderate” abuse categories were
collapsed and undifferentiated by frequency. Also, before scaling, the burn item from the
CTS was dropped from the severity scale due to infrequency of response.

Psychologicalpbuse. Psychological abuse was conceptualized as any act in which

 

the participant was emotionally hurt or harmed by an intimate partner/ex-partner or
spouse/ex-spouse. The experience of psychological abuse was measured with a shortened
version of the 33-item Index of Psychological Abuse (IPA) scale (Sullivan et al., 1992)
(See Appendix B for a copy of this measure). The scale contained 20 items asking
women to rate how often, in the past six months, they had been harassed, controlled,
ridiculed, and criticized by an intimate partner. Participants rated their experiences of
psychological abuse on a 4-point scale that ranged from 1 = “Never” to 4 = “Often.” The
scale score was calculated as the mean frequency with which participants experienced the
different forms of psychological abuse. The coefﬁcient alpha for this scale was .93, and
the corrected item-total correlations ranged from .43 to .76.

The present researcher attempted to categorize the different items on the IPA into
a severity score comparable to the physical abuse severity score previously calculated.
Three researchers involved in the domestic violence ﬁeld sorted the items into moderate
or severe abuse categories. However, the interrater reliability was only 69%. In order to
obtain better interrater reliability, twelve residents of the Council Against Domestic

Assault, a local shelter, categorized the items. The interrater reliability of these women

23

was 39%. Thus, it was determined that these items are fairly subjective, context-
dependent, and it was not possible to reliably categorize their severity.

Social Support. The social support scale used was a modiﬁed version of Bogat,

 

Chin, Sabbath and Schwartz’s (1983) scale, the Adult’s Social Support Questionnaire
(See Appendix C for a copy of this measure). The scale contained eleven items that
measured the participant’s amount and quality of social support in ﬁve different areas.
These domains of social support included: companionship, advice and information,
practical assistance, emotional support, and ﬁnancial assistance. Participants rated their
feelings about the quantity and quality of social support that they receive ﬁ'om friends and
family on a seven-point scale ranging from 1 = “Extremely Pleased” to 7 = “Terrible.”
The scale score for social support was obtained by averaging the quantity and quality
scores across the ﬁve domains. In addition, there is one question about overall social
support. A factor analysis supported the use of one social support scale score. The
coefﬁcient alpha for the social support scale score was .90. The corrected item-total
correlations ranged ﬁom .55 to .77.

Sm. The stress scale used was the Life Event Checklist (Reischl, Eby, &
Ramanathan, 1992) (See Appendix D for a copy of this measure). This 50—item list
involves varying dimensions of stressful life events: intimate relationships, family,
ﬁnances, work, school, and legal issues. Participants were asked if the stressful event
occurred within the past six months, and then indicated, on a ﬁve-point scale ranging
from 1 = “Not at all Stressful” to 5 = “Extremely Stressful,” how stressful it was for
them. The scale score equals the mean stressfulness rating across endorsed items. The

coefﬁcient alpha for this scale, .77, was expected to be moderately low since the various

24

stressful life events in a person’s life need not be related. The corrected item-total
correlations ranged from -.02 to .53.
Procedure

The interviewers were undergraduate females who either received college credit
or an hourly wage for their participation. The interviewers were involved in a 10-week
training course that used reading and discussion assignments related to women’s health
and interview skills. Interviewers were further trained through role plays and mock
interviews. The interviewers were graded according to the quality of the interviews, and
received weekly feedback reports on their performance level. Interviewers were allowed
to do interviews once they had achieved 95% reliability on a mock interview with project
staff. Interrater reliability was also calculated after approximately every tenth interview
by having a second interviewer listen to the audiotaped interview and completing the
interview protocol. Interrrater reliability ranged from .91 to .97, and averaged .94.

Interviewers met the participant at either her home or at the American Red Cross.
The interviewer explained the procedure, and reminded the participant that the interview
was completely conﬁdential, no identifying information would be attached to the
interview, and that she could decline to do any part of the interview without penalty.
After the participant signed an informed consent form (see Appendix E), the interviewer
administered the oral part of the interview. This part of the interview lasted 60 minutes to
4.5 hours (mean = 90 minutes). Next, the participant completed the written self-

administered section of the interview. Upon completing the second part of the interview,

25

the participant was paid $30.00 for her participation. All participants received a

Women’s Health Project business card and a sheet detailing community resources.

26

RESULTS

This study utilized a large sample size (n = 399) for most of the analyses; thus,
conservative signiﬁcance levels were used (i.e., p < .05).

Preliminary Analyses

For several of the hypotheses, women were separated into “abused” or “non-
abused” categories. Women were considered abused if they had endorsed at least one
item from both the CTS and IPA scales (see Table I). A total of 206 women were in the
abused category, and 193 women were in the non-abused category.

Abused and non-abused women differed on several demographic variables (see
Table 11). The overall distribution of ethnic background for abused women and non-
abused women was signiﬁcantly different, 12(6, N = 399) = 16.43. Abused women were
more likely to be African-American and Latina than the non-abused women. Abused
women were signiﬁcantly younger than the non-abused women [E(1,397) = 12.85],
although the age difference was less than three years. The educational level of abused
and non-abused women also differed, x2(7, N = 399) = 83.02. Abused women were less
likely to have a bachelor’s degree than the non-abused women. Abused women were less
likely to be employed in the last six months, and less likely to be currently employed
M2, bl = 399) = 4.37 and x20, n = 399) = 13.24, respectively].

Overall, the marital status of abused and non-abused women was signiﬁcantly
different , x2(8, N = 399) = 44.22. Abused women were less likely to be married and
living with their spouse or divorced from a spouse; they were more likely to be separated
from a spouse, living with a girl/boyfriend, or not living with a girl/boyfriend (see Table
H). Abused women had signiﬁcantly less monthly income than non-abused women

27

[E(1,397) = 60.13]; this was a difference of approximately $1,171 per month. Abused
and non-abused women both supported the same average number of persons (M = 2.81),
and their average number of children was not signiﬁcantly different (M = 1.92 and M =
1.68, respectively). Finally, although both abused women and non-abused women
experienced psychological abuse, abused women had a signiﬁcantly higher frequency of
psychological abuse than non-abused women [M = 2.28 and M = 1.41 , respectively;
E(1,332)= 222.43].

To determine whether abused and non-abused women differed in their satisfaction
with social support, a one-way analysis of variance was conducted with abuse status as
the independent variable and social support as the dependent variable. Results were
signiﬁcant [E(1,395) = 36.01], indicating that abused women (M = 3.46) were
signiﬁcantly more dissatisﬁed with their social support than were non-abused women (M
= 2.78). Higher scores indicate greater dissatisfaction with the quantity and quality of
social support. In addition, 11 was .29, which according to Cohen (1988) is between a
medium and large effect size.

For the abused women in the sample, frequency of psychological abuse had
signiﬁcant positive correlations with frequency of physical abuse (r = .61), amount of
stress appraisal (r = .26), and social support (r = .16). These were all signiﬁcant at p <
.05. Frequency of physical abuse was signiﬁcantly correlated with frequency of
psychological abuse, as stated above, and was also signiﬁcantly correlated with amount of
stress appraisal (g = .22). Amount of stress appraisal was signiﬁcantly correlated with

social support (r = .23) at p < .05 (see Tables HI and IV).

28

For the non-abused women in the sample, frequency of psychological abuse was
signiﬁcantly correlated with all of the other variables. Frequency of physical abuse was
not applicable, since no women experiencing physical abuse were classiﬁed as non-
abused. Amount of stress appraisal was signiﬁcantly correlated with frequency of
psychological abuse, as described above, and with social support (r = .16) (see Tables V
and VI).

Preliminary analyses on all of the women in the study revealed several signiﬁcant
relationships between variables. Frequency of psychological abuse, amount of stress
appraisal, and social support were all positively correlated with each other, with
correlations ranging from .22 to .61. These correlations were all signiﬁcant at p < .05.
Frequency of physical abuse was only signiﬁcantly correlated with frequency of
psychological abuse (r = .61) and amount of stress appraisal (r = .22). These were both
signiﬁcant at p < .05 (see Tables VII and VIII).

For abused women, the most frequently endorsed type of physical abuse was
“pushed or shoved you,” the second was “grabbed you,” and the third was “threw
something at you” The most ﬁequently occurring type of physical abuse was “grabbed
you,” the second was “drove recklessly, so that you felt scared or endangered,” and the
third was “pushed or shoved you” (see Table IX).

When severity of physical abuse was calculated, 13 women had experienced
moderate physical abuse, 88 women experienced low frequency of severe physical abuse,
and 105 experienced high frequency of severe physical abuse.

For abused women, the most frequently endorsed type of psychological abuse was

“tried to control your activities,” the second and third were “ignored or made light of your

29

anger” and “lied to you or deliberately misled you,” and the fourth was “called you
names.” The most frequently occurring types of psychological abuse were “lied to you or
deliberately misled you,” and “tried to control your money,” the third was “tried to
control your activities,” and the fourth was “called you names” (see Table X).

For non-abused women, the most frequently endorsed type of psychological abuse
was “ignored or made light of your anger,” the second was “criticized your family or
ﬁiends to you,” and the third was “lied to you or deliberately misled you. ” The most
frequently occurring type of psychological abuse was “discouraged your contact with
family or friends,” the second was “tried to force you to leave your home,” and the third
and fourth were “threatened to hurt your family or friends” and “threatened to commit
suicide when he/she was angry with you” (see Table XI).

For abused women, the most frequently endorsed life event was “increased
arguments with spouse or partner, ”the second was “had less money than usual, ” and the
third was “separated or ended long-term committed relationship.” The most stressful life
event, on average, was “victim of a violent crime or serious assault,” the second was
“arrested or convicted of a serious crime,” and the third was “serious illness or injuries”
(see Table XII). It should be noted that the most stressﬁrl life event was “death of a
partner or spouse” with a mean stressfulness rating of 5.00. However, since only one
participant endorsed this item, it does not represent the overall sample.

For non-abused women, the most frequently endorsed life event was “had less
money than usual,” the second was “started a new job or experienced a change in current
job,” and the third was “serious illness or injuries happen to other family members.” The

most stressful life event, on average, was “victim of a violent crime or serious assault,”

30

the second was “learned her partner or spouse was unfaithful,” and the third was
“children taken away or threatened with having children removed from the home” (see
Table XIII). It should be noted that the most stressful life events, on average, were
“miscarriage or stillbirth” and “arrested or convicted of a serious crime” with mean
stressfulness ratings of 5.00. However, since only three participants endorsed the former
item, and one endorsed the latter item, they do not represent the overall sample.

Test of the Hypotheses

To test the ﬁrst hypothesis, that women who were abused, regardless of the type
of abuse, would report more stress appraisal in their lives than women who have not been
in an abusive relationship in the last six months, a one-way analysis of variance was
conducted with abuse status as the independent variable and stress appraisal as the
dependent variable. Results were signiﬁcant [E (1,395) = 30.55], indicating that abused
women (M = 3.68) reported more stress appraisal than did non-abused women (M =
3.26). In addition, r] was .27, which according to Cohen (1988) is between a medium and
large effect size.

To test the second hypothesis, that for abused women, the experience of
psychological abuse would result in more stress appraisal than physical abuse, a ; test of
difference was completed. This involved comparing the correlation between physical
abuse and stress appraisal (g = .22) to the correlation between psychological abuse and
stress appraisal (r = .33). The z score was -2.04, outside the critical value of :1: 1.96.

When the correlation coefﬁcients were translated into Fisher’s Z, q = .224 — .343 =

31

-.119, which according to Cohen (1992) is a small effect. Thus, there was a signiﬁcant
difference in predicting stress appraisal from physical abuse versus psychological abuse,
and psychological abuse was a better predictor of stress appraisal.

To test the third hypothesis, that social support would moderate the relationship
between abuse and stress appraisal for frequency of psychological abuse, frequency of
physical abuse, and severity of physical abuse, three different multiple regression analyses
were used. In addition, since there were signiﬁcant demographic differences between the
abused and non-abused women, these regression analyses were all controlled for race,
income, and education level.

The ﬁrst multiple regression analysis used frequency of psychological abuse and
social support as the independent variables, stress appraisal as the dependent variable, and
the product of psychological abuse and social support as the interaction term (see Table
XIV). Findings revealed no buffering effect. However, there was a signiﬁcant main
effect for social support (AB: = .03, AB = 13.14) The second multiple regression analysis
used the same variables as the ﬁrst, and controlled for demographics. While a buffering
effect was not found, there was a signiﬁcant main effect for social support (AL2 = .03, AF
= 11.22) (see Table XV).

The third multiple regression analysis used frequency of physical abuse and social
support as the independent variables, stress appraisal as the dependent variable, and the
product of physical abuse and social support as the interaction term (see Table XVH).
Findings revealed no buffering effect. However, there was a signiﬁcant main effect for
social support (Ag2 = .03, A}: = 14.67) The fourth multiple regression analysis used the
same variables as the third, and controlled for demographics. While a buffering effect

32

was not found, there was a signiﬁcant main effect for social support (AR_2 = .03, AP =
13.09) (see Table XVH).

The ﬁfth multiple regression analysis used severity of physical abuse and social
support as the independent variables, stress appraisal as the dependent variable, and the
product of physical abuse and social support as the interaction term (see Table XVIII).
Findings revealed no buffering effect. However, there was a signiﬁcant main effect for
social support (A_R_2 = .03, AP = 14.00) The sixth multiple regression analysis used the
same variables as the ﬁfth, and controlled for demographics. While a buffering effect
was not found, there was a signiﬁcant main effect for social support (AK2 = .03, AE =

12.44) (see Table XIX).

33

DISCUSSION

The present study had two main purposes. The ﬁrst was to examine the role of
social support as a moderator between abuse and stress appraisal. As previously stated,
the relationship between abuse and stress appraisal, with social support as a moderator,
had never been examined prior to this study. Because abuse engenders stress, it was
hypothesized that social support would act as a moderator to reduce levels of stress
appraisal for women experiencing high levels of abuse.

The second purpose of this study was to examine the role of physical abuse versus
psychological abuse as contributors to stress appraisal. It was hypothesized that
psychological abuse would result in more stress appraisal than would physical abuse,
because research demonstrates that psychological abuse often has more negative
repercussions than does physical abuse (Campbell & Lewandowski, 1997; Follingstad et
aL,1990)

The current study has a unique sample, demographically, in that the women were
recruited from the community, and represented a middle-income sample. Thus, the
results from this study are generalizable to the community, and to the general population.

Very few studies on domestic violence have included community populations. In
addition, not all of these studies reported the demographic characteristics of their
participants (Gelles & Harrop, 1989); if they did, they only reported the racial
composition of their samples, as opposed to including other demographic variables. The
abused women in the current sample are more likely to be Aﬁican-American or Latina

than the women in other community studies (Follingstad et al., 1990; Kemp et al., 1995).

34

Participants from shelters are less likely to be representative of the population at
large; they are likely to over-represent the Aﬁican-American population and to have
lower incomes. This is evident when comparing the demographics of the abused women
from the current study to the participants in shelter sample studies. In this study, 22.8%
of the abused women were African-American, compared to approximately 44% of
participants from shelter studies (Mitchell & Hodson, 1983; Sullivan, Campbell,
Angelique, Eby, & Davidson, 1994).

Women in abusive relationships from the current study had higher incomes than
women in shelter studies; women in the current study had an average monthly income of
$1,476 versus $1,179 and $983 in other studies (Jaffe et al., 1986; Sullivan et al., 1994).
In addition, women in abusive relationships from the current study had a much lower
unemployment rate of 25.7% versus 82% of women in a shelter study (Sullivan et al.,
1994). Women in the current study were more educated than women in shelter studies;
28.6% of women in the current study had a high school diploma or less versus one study
which found that 65% of a shelter sample had a high school diploma or less (Mitchell &
Hodson, 1983).

Thus, this study adds to the current literature by focusing on a population that has
been previously neglected due to the difﬁculty in recruitment. Despite the limited means
of recruiting, and the mostly Caucasian sample, this study has a population that is more
representative of the general population than previous studies, and that has an income that

is above poverty level.

35

It is important that networks of social support consist of support other than friends
and family. Using data from the current study, Sutherland (1999)1 noted that women
could rely on friends and family for general types of support, but when they asked for
help related to the partner’s violence, they were less likely to receive the type of support
that they needed. Some support would be provided on a conditional basis or in a
judgmental fashion, which is not helpful or supportive to the woman. This is consistent
with research that demonstrates that social support is not always positive (Cohen & Wills,
1985), and that the source of social support must be considered (Taylor & Dakof, 1988).
Negative social support can cause women in abusive relationships to be less likely to seek
help (Bowker, 1984), or if the social support is judgmental, it can cause women to feel
more guilt and stigrnatization.

Interestingly, while women in abusive relationships reported more stress appraisal
in their lives than women not in abusive relationships, frequency of psychological abuse,
frequency of physical abuse, and severity of physical abuse did not differentially affect
their stress appraisals. That is, women with higher levels of satisfaction with social
support had less stress appraisal than women with lower levels of satisfaction with social
support, regardless of the level of abuse experienced. Thus, the hypothesized buffering
model of social support was not supported. Rather, the direct effects model of social
support, which stipulates that social support is helpful regardless of the level of abuse,
was supported for social support. This has been corroborated in previous research studies

(Aneshensel & Stone, 1982; Bell et al., 1982; Kemp et al., 1995; Koeske & Koeske,

 

1 Due to Sutherland’s (1999) age restrictions, her dataset was comprised of 397 women.

36

1990; Power, 1988), and with researchers who have found consistent support for direct
effects (Mitchell et al., 1982). One researcher noted that despite the “inherent
attractiveness of the buffering model” (Terry, 1989, p. 170), it was likely that social
support had direct effects on well-being.

Interestingly, results from another study that utilized the same dataset as the
current study indicated that social support did not moderate the effects of stress on
psychological well-being (Sutherland, 1999). Instead, she found that social support had a
direct effect upon psychological well-being. This result is relevant to the second stage of
Cohen and Wills’ (1985) stress continuum.

Other researchers have found direct effects for practical support (e. g., Cohen &
Hoberman, 1983; Powers, 1988), while researchers have consistently found buffering
effects for socioemotional support (Israel & Antonucci, 1987). However, it is essential to
note that all of the above research used psychological well-being as an outcome measure,
as opposed to stress appraisal.

As indicated earlier, there has been little research assessing the effects of social
support on stress appraisal (Mitchell et al., 1982; F elsten, 1991). The one study to
examine this process found buffering effects for social support on stress appraisal
(F elsten, 1991). However, because Felsten used male undergraduates for his participants,
it is difﬁcult to generalize results to women in abusive relationships from his study. In
addition, Felsten did not use standardized measures of social support or stress appraisal,
and did not assess different domains of social support as has been customary in social
support research. Thus, due to his restricted sample and unstandardized measures, it is

difﬁcult to compare results from Felsten’s study with the results from the current study.

37

 

 

It is also interesting that psychological abuse had a stronger relationship with
stress appraisal than did physical abuse, although this was a small effect. This is
corroborated by researchers who have suggested that psychological abuse is at least as
important as physical abuse in affecting women’s levels of functioning (Rollstin & Kern,
1998). Abusive relationships vary dramatically in terms of levels of psychological and
physical abuse (Follingstad, Laughlin, Polek, Rutledge, & Hause, 1991). In the current
study, women in abusive relationships experienced greater frequency of psychological
abuse than of physical abuse. Interestingly, of the 193 women who were recruited for not
having been physically abused in the six months prior to the interview, 66% sustained
psychological abuse. This speaks to the pervasiveness of psychological abuse in
relationships.

The distinction between the effects of psychological abuse and physical abuse is
important for understanding the differential experiences that women have in abusive
relationships. Psychological abuse and physical abuse often co-occur, as was
demonstrated in the current study. However, this study demonstrated that psychological
abuse and physical abuse affect stress appraisal in different ways. Other researchers have
found that psychological and physical abuse are different phenomena (e. g., Stets, 1990).
Limitations

One limitation of this study is the different demographic backgrounds of the
women in abusive relationships versus the women in non-abusive relationships.
Although this study is unusual in utilizing a non-shelter sample, which can thus be more
generalized to the population at large, it would have been optimal, statistically, had the

participants been better matched according to their backgrounds. However, given that

38

national statistics indicate that women of all races are equally likely to be at risk for
domestic violence, and that studies that utilize shelter populations over-represent
minorities, the current study is an improvement on past studies partners (Bachman, 1994;
Bachman & Saltzman, 1995).

In addition, national statistics indicate that women with lower education and
family income levels were more likely to be victimized by intimate partners than women
who had graduated from college and had higher family incomes (Bachman, 1994;
Bachman & Saltzman, 1995). Thus, while the abused women in the current study may
not perfectly match the non-abused women in this study, they are reﬂective of the
national proﬁles of women in abusive relationships.

This study employed a cross-sectional design. While this design is convenient for
many reasons (e. g., time, money), it is optimal to utilize a longitudinal or prospective
design. A longitudinal study would allow the study of the effects of social support upon
stress appraisal over a period of time, and allow the researcher to examine how changing
resources in a woman’s life affect her stress level and differing social support levels. In
addition, one researcher suggested that there is a greater likelihood for confounding
between stress and resource measures in a cross-sectional study (Terry, 1989), and thus
such a design results in a less accurate test for stress-buffering effects of social support.

Both the current study and Felsten’s (1991) study examined stress appraisal by
asking the participants to rate the stressfulness of major and minor life situations.
However, while the questionnaire used in the current study has the advantage of listing
many possible life situations that may relevant to a woman in an abusive situation, it may

serve to both minimize her experiences when faced with a long list of life crises that have

39

not happened to her, and overwhelm her when presented with a long list of life crises that
have occurred in the last six months.

An alternate method of stress appraisal is the Perceived Stress Scale (PSS) which
measures the degree to which situations in one’s life are perceived as stressful (Cohen,
Karnarck, & Mennelstein, 1983). This scale involves rating how often the participant felt
a certain way in the last month, e. g., “how often have you been upset because of
something that happened unexpectedly,” and “how often have you felt difﬁculties were
piling up so high that you could not overcome them.” This scale has been validated
(Cohen & Williamson, 1988) and a shorter 10-item version has been used in other studies
to assess the degree to which life situations are perceived as stressful (Cohen, Tyrrell, &
Smith, 1993). A review chapter on stress appraisal and its measurement cited the PSS as
the only empirically validated measure of stress appraisal (Monroe & Kelley, 1995).

It is also debatable if the concept of stress appraisal as an outcome measure is
conducive to a buffering model of social support. Perhaps stress appraisal is not robust
enough of an outcome measure to be able to be differentiated by women’s abuse levels.
Or, perhaps the concept of social support buffering the effects of abuse on stress appraisal
is infeasible. In the timeline and continuum proposed, social support would intercede at
the point of crisis to lessen stress appraisal for abused women. While satisfaction with
socioemotional and ﬁnancial social support did lessen stress appraisal for all women, in
the buffering model, the social support would intercede following the abusive event, to
affect stress appraisal. Perhaps it is this part of the stress-social support model that is

faulty.

40

Another limitation of this study is the social support instrument used. The
majority of the social support research has found more than one factor of social support
(e.g., Cohen & Hoberman, 1983; Israel & Antonucci, 1987). One possible reason for this
measure having one factor of social support is that the different domains overlapped. It is
likely that practical assistance could tap into the same resources as ﬁnancial support, and
that emotional support and social companionship are similar constructs as well. Other
measures (e. g., Cohen & Hoberrnan’s ISEL) have more clearly differentiated domains of
social support.

It seems likely that the relevance of social support is based upon need. Research
does indicate that social support functions best when the type of social support meets the
coping requirements (Cohen & Hoberman, 1983). In addition, women in abusive
relationships had signiﬁcantly less income than women not in abusive relationships, and
perhaps these women have differing needs for social support.

In order to help women in abusive relationships, researchers need to determine
what kind of social support can help the most. Research has found that women in abusive
relationships have speciﬁc needs. One study on the effectiveness of social service
programs for women in abusive relationships found that direct ﬁnancial aid and modeling
were useful to women, and were essential aspects of an effective social service program
(Donato & Bowker, 1984). These researchers also noted that direct aid and modeling
were not available in traditional service agencies. Thus, specifying the social support
needs of women in abusive relationship can provide better care.

The conceptualization of psychological abuse is difﬁcult, and it is unfortunate that

the severity of psychological abuse could not be determined for this sample. However, it

41

is worth noting that, in general, the conceptualization of psychological abuse is difﬁcult.
It is very subjective to measure the severity of an item from the Index of Psychological
Abuse, such as “left somewhere with no way to get home” when the rater is unaware
where the woman was left, how far from home she was, and if she had the resources to
get home. This can be contrasted to an item from the Conﬂict Tactics scale, such as
“slapped you with an open hand” which is less subjective and context-dependent. In fact,
the difﬁculty in parsing out severity for the items on the IPA is indicative of the very
nature of psychological abuse: it is difﬁcult to understand, comprehend, and categorize.
In part, this is why psychological abuse is so detrimental to women’s well-being.

There is perhaps only one other researcher (Marshall, 1992) who has attempted to
examine the severity of psychological abuse. Marshall criticized the creators of the
Conﬂict Tactics Scale for determining the severity of the items themselves, as opposed to
piloting the items with a large sample. Marshall argues that psychological abuse is very
complex, and in a series of studies that surveyed both college undergraduates and
members of the community, determined that there are nine factors of violence, three of
which are psychological. These nine factors are: threats of mild, moderate, and serious
violence, actual mild, minor, moderate, and serious violence, and sexual violence.
Marshall’s deﬁnition of psychological abuse is exemplary in that she acknowledges that
psychological abuse may be very subtle, and may target perceptions, thoughts, and
feelings that undermine a woman’s sense of self (Marshall, 1996). Her inclusive
deﬁnition of psychological abuse goes beyond the concept of overt, observable actions

used by other researchers (e. g., Stets, 1990). Marshall’s study addresses the issue of

42

measuring severity, in that she proves that rather than suggesting that the severity of
psychological abuse cannot be measured, it takes a large representative sample to do so.
Directions for Future Research

Future research should continue to address the validity and reliability of stress
appraisal as an outcome with social support as moderator. While the results of this study
did not support the hypothesis of social support as moderator of abuse on stress appraisal,
future research should continue to examine the social support-stress appraisal
relationship. This is only the second study that has examined such a relationship; thus,
researchers need to look at this relationship with various factors in addition to abuse, and
with diverse populations.

The ﬁndings that women in abusive relationships had signiﬁcantly less social
support than women not in abusive relationships, and that social support reduced stress
appraisal, indicate that more research needs to investigate what exactly about social
support is important, and how social support is utilized. Future research should examine
the existence of different domains of social support. In addition, it would be helpful to
have a social support measure that is more speciﬁc for women in abusive relationships.
In addition, it would be helpful to consider the source of social support, and how that
affects satisfaction with various types of social support. Research has found that the
helpfulness of speciﬁc types of social support varies with the source; for example, while
emotional support was helpful regardless of the source, information and advice were
helpful ﬁ'om caregivers, but not from family or friends (Taylor & Dakof, 198 8).

As previously described, Marshall’s (1992) Violence Against Women Scale is an

excellent ﬁrst step toward understanding the various dimensions of psychological abuse

43

and the implications of severity of psychological abuse. However, the effects of
psychological abuse on women still needs to be explored. This study determined that
psychological abuse was more of a contributor to stress appraisal than was physical
abuse. This highlights the importance of psychological abuse in a relationship, and
emphasizes the fact that while psychological abuse is a prevalent factor in abusive
relationships, we still do not understand how psychological abuse and physical abuse

differentially affect women.

44

Appendices

Appendix A: The Conﬂict Tactics Scale, Modiﬁed

45

Now I have a list of different types of violence women have experienced from their ex—
partners (or current partners, as applicable). I wonder if you could tell me, as best as you
can remember, how many times in the last six months did any of the
following things to you:

NEVER ............................................ 1
ONCE A MONTH OR LESS .......... 2
2 OR 3 TIMES A MONTH .............. 3
ONCE OR TWICE A WEEK .......... 4
3 OR 4 TIMES A WEEK ................. 5
MORE THAN 4 TIMES A WEEK..6
(not applicable) ................................ 8
(refused to answer) ........................... 9

A. How often did he/she break your glasses or tear your clothing ...................

B. Pushed or shoved you ..................................................................................

C. Grabbed you .................................................................................................

D. Slapped you with an open hand ...................................................................

E. Hit you with a ﬁst .........................................................................................

F. Kicked you ...................................................................................................

G. Threw something at you ...............................................................................

H. Aside from throwing, how often did he/she hit you with an object .............

I. Tried to hit you with an object .....................................................................

J. Drove recklessly, so that you felt scared or endangered ..............................

K. Choked you ..................................................................................................

L. Burned you ...................................................................................................

M. Tied you up or physically restrained you in some way ................................

N. Beat you up ..................................................................................................

O. Forced any sexual activity you didn’t want to happen .................................

P. Threatened you with a gun or knife .............................................................

Q. Used a gun or knife against you ...................................................................

46

Appendix B: The Index of tholopigal Abuse Scale

47

I have a list of some things some people due to annoy or hurt their ex (or current)
partners. These are emotional kinds of things that can happen in any relationship. Could
you tell me how often in the last six months did any of these things to annoy or
hurt you?

1 = NEVER

2 = RARELY

3 = SOMETIMES

4 = OFTEN

8 = not applicable

9 = (refused to answer)

A. How often has he/she accused you of having or

wanting other sexual relationships ...............................................................
B. Told you about other sexual relationships he/she wanted or was having

in order to hurt you .......................................................................................
C. Tried to control your money ........................................................................
D. Tried to control your activities .....................................................................
E. Lied to you or deliberately misled you .........................................................
F. Called you names .........................................................................................
G. Ignored or made light of your anger .............................................................
H. Ridiculed or criticized you in public ............................................................
I. Criticized your family or ﬁiends to you .......................................................
J. Harassed your family or friends in some way ..............................................
K. Discouraged your contact with family or friends .........................................
L. Threatened to hurt your family or ﬁiends ....................................................
M. Used threats to try and have sex with you ....................................................
N. Broken or destroyed something important to you ........................................
O. Abused or threatened to abuse pets to hurt you ...........................................
P. Punished or deprived the children when he/she was angry with you ...........
Q. Threatened to take the children away from you ...........................................
R. Left you somewhere with no way to get home ............................................
S. Threatened to end the relationship if you didn’t do what he/she wanted .....
T. Tired to force you to leave your home .........................................................
U. Threatened to commit suicide when he/she was angry with you .................

48

Appendix C: The Adult Social Support Questionnaire

49

Now I’m going to ask you some questions about how you feel about the kind of support
and how you feel about the amount of support that you get from ﬁiends and family.

 

1 = EXTREMELY PLEASED

2 = PLEASED

3 = MOSTLY SATISFIED

4 = EQUALLY SATISFIED AND DISSATISFIED
5 = MOSTLY DISSATISFIED

6 = UNHAPPY

7 = TERRIBLE

9 = refused to answer

The ﬁrst couple of questions have to do with companionship.
In general, how do you feel about the amount of companionship that you have?
In general, how do you feel about the quality of companionship that you have?

Okay, thanks. Now I’m going to ask you about a different kind of help that you may
receive ﬁom others called “advice and information.” This means being able to count on
folks to provide you with advice and information about personal matters, such as
problems with your children, spouse, or dealing with a personal situation. It can also be
getting advice and information about resources, such as ﬁnding a job or a place to stay,
where to ﬁnd furniture and or other material goods, and things like that.

In general, how do you feel about the amount of

advice and information that you receive? ................................................................
In general, how do you feel about the quality of

advice and information that you receive? ................................................................
The next couple of questions have to do with another type of support called “practical
assistance,” for example, people you can count on to help you get things or do things.
These are peOple that you can count on to be dependable when you need help, or that you
can count on to do a favor for you, like take you someplace you need to go, watch your
kids, loan or give you small amounts of money or something you need.

In general, how do you feel about the amount of
practical assistance that you receive? .......................................................................
In general, how do you feel about the quality of
practical assistance that you receive? .......................................................................

50

1 = EXTREMELY PLEASED

2 = PLEASED

3 = MOSTLY SATISFIED

4 = EQUALLY SATISFIED AND DISSATISFIED
5 = MOSTLY DISSATISFIED

6 = UNHAPPY

7 = TERRIBLE

9 = refused to answer

Now I’d like to ask you about the “emotional support” that you receive. This can mean
being able to count on someone to listen to you when you want to talk about something
personal, or feeling that there are people in your life who really care about you.

In general, how do you feel about the amount of
emotional support that you receive? ........................................................................
In general, how do you feel about the quality of
emotional support that you receive? ........................................................................

This last group of questions have to do with the “ﬁnancial assistance” you may receive or
have available to you. This can mean being able to count on someone to loan or give you
large amounts of money when you need it. For example, this would be people who could
help you pay monthly bills if you were to lose part or all of your income.

In general, how do you feel about the amount of
ﬁnancial assistance that is available to you? ............................................................

Sometimes, people may provide ﬁnancial assistance when you need it, and they do it in a
way that makes you feel good. Other times, people may provide ﬁnancial assistance in a
way that makes you feel inadequate or bad. In general, how do you feel about the quality
or appropriateness of ﬁnancial assistance that is available to you? .........................

51

Appendix D: The Life Event Checklist

52

Now, I’d like to ask you about different events that may have happened to you in the last
six months. Sometimes our current stress level can inﬂuence the way we think and feel
about an event that happened a while ago. To help you remember how you felt Mtge
time the event occurred, I’d like you to tell me when it occurred. Then, thinking back to
that date, tell me how upsetting or stressful the event was for you. These are the answers
I’d like you to use. Again, some of these may not apply to you, but to be consistent, we
need to ask them of everyone. If they do not apply to you, please let me know.

 

1 = NOT AT ALL STRESSFUL

2 = A LITTLE STRESSFUL

3 = MODERATELY STRESSFUL
4 = VERY STRESSFUL

5 = EXTREMELY STRESSFUL

8 = not applicable

STRESS
MO/YR RATING

I’d like to start with a few questions about your serious

relationships. In the last six months have you:

A. Started a serious dating relationship? ...................................... /
B. Ended a serious dating relationship? ....................................... /

C. Married or started a long-term
committed relationship? .......................................................... /

D. Separated or ended a long—temr

committed relationship? .......................................................... _/_
E. Reconciled a martial or romantic relationship? ....................... ___/__
F. Had increased arguments with your spouse or partner? .......... ___/_
G. Moved to a new town or neighborhood? ................................. __/_

H. Learned that your partner or spouse
was unfaithful to you (i.e., was having an affair)? .................. /

53

1 = NOT AT ALL STRESSFUL

2 = A LITTLE STRESSFUL

3 = MODERATELY STRESSFUL
4 = VERY STRESSFUL

5 = EXTREMELY STRESSFUL

8 = not applicable

STRESS
MO/Y R RATING

In the last six months have you:
I. Had an affair? .......................................................................... /
J. Had a serious argument with a friend or neighbor? ................ /
K. Started any kind of classes at school?

This includes adult learning, community education,

community college, etc. ........................................................... /

L. Stopped attending school? ....................................................... /

M. Started a new job or
experienced a big change in your current job? ........................ /

N. Has your spouse or partner started a new job
or experienced a big change in their current job? .................... /

0. Been ﬁred or laid off from your job? ...................................... _/_
P. Has your partner or spouse been ﬁred, laid off,

or quit their job? ...................................................................... _/_
Q. Had new troubles with your boss or other people at work? _/_
R. Retired? ................................................................................... _/_
S. Had your partner or spouse retire? .......................................... __/_
T. Quit your job? .......................................................................... __/_

54

1 = NOT AT ALL STRESSFUL

2 = A LITTLE STRESSFUL

3 = MODERATELY STRESSFU L
4 = VERY STRESSFUL

5 = EXTREMELY STRESSF UL

8 = not applicable

STRESS
MO/YR RATING

Okay, let’s talk a bit about your family.
In the last six months have you:
U. Had or adopted a child? ........................................................... /

V. Had trouble with your partner’s
or spouse’s family members? .................................................. /

W. Had trouble with one of your family members

(not your partner or spouse)? ................................................... _/_
X. Had a new person move into your home? .............................. _/__
Y. Had any serious illness or injuries? ........................................ _/_

Z. Had any serious illness or injuries
happen to your partner or spouse? .......................................... /

AA. Had any serious illness or injuries
happen to your partner or spouse? .......................................... /

BB. Had any serious illness or injuries
happen to any other family members? .................................... /

55

1 = NOT AT ALL STRESSFUL

2 = A LITTLE STRESSFUL

3 = MODERATELY STRESSFUL
4 = VERY STRESSFUL

5 = EXTREMELY STRESSFUL

8 = not applicable

STRESS
MO/YR RATING

In the last six months have you:

CC. Had a miscarriage or stillbirth? ............................................... _/_
DD. Found out that you’re unable to have children? ...................... __/_
EE. Started menopause? ................................................................. _/_
FF. Had any sexual difﬁculties? .................................................... _/_
GG. Experienced the death of a child? ............................................ _/_
HH. Experienced the death of a partner or spouse? ........................ _/___
11. Experienced the death of another close family member? ....... _/_
JJ. Experienced the death of a close friend? ................................. _/_

KK. Experienced the death of a pet? ............................................... /

These next questions have to do with your ﬁnances.
In the last six months have you:

 

 

 

LL. Had less money than usual? .................................................... _/_
MM. Taken on a major purchase? ................................................... /
NN. Started receiving public assistance? ....................................... /
00. Had your utilities shutoff? ..................................................... /
PP. Been without phone service? .................................................. /

 

56

l = NOT AT ALL STRESSFUL

2 = A LITTLE STRESSFUL

3 = MODERATELY STRESSFUL
4 = VERY STRESSFUL

5 = EXTREMELY STRESSFUL

8 = not applicable

STRESS
MO/Y R RATING

Finally, let’s talk about your legal status.
In the last six months have you:

QQ. Been involved in a lawsuit or any legal action? ...................... /

RR. Had your driver’s license taken away by the police or court?. /

 

 

 

 

SS. Been a victim of violent crime or theft? .................................. /
TT. Been a victim of violent crime, such as rape or assault? ........ /
UU. Been arrested or convicted of a serious crime? ...................... /
VV. Received a jail sentence or probation? ................................... /
WW. Been released from jail? ......................................................... /

 

XX. Had your children taken away from you
or been threatened with having your children
removed from your home? ..................................................... /

57

Appendix E: The Informed Consent Form

58

PARTICIPANT AGREEMENT
MSU WOMEN’S HEALTH PROJECT

The Women’s Health Project is a research study conducted through Michigan

State University designed to better understand the different aspects of women’s physical
and emotional health. You will be interviewed one time, for which you will be paid
$30.00. It is expected that the interview will take approximately two hours. We feel it is
important to know exactly what you are agreeing to, so it is outlined below:

1.

My involvement in this research study has been fully explained to me and I am
volunteering to participate. I realize that I may discontinue my participation at
any time without penalty.

I agree to be interviewed by the Women’s Health Project. I understand that I will
be paid $30.00 for completing the interview. I understand that I will be asked
questions about the social support I receive, abuse experienced (if applicable), and
my physical health, including questions about drug and alcohol use and at-risk
sexual behavior. I understand I may choose not to answers certain questions
without penalty.

I understand that any information I provide to anyone involved with the Women’s
Health Project will be held in the strictest confidence and that my anonymity will
be protected. I understand this to mean that anyone involved with the project may
not disclose my participation in the project in any way.

I understand that I may receive results of this project, if I desire, after its
completion by calling or writing the Women’s Health Project (whose business
I’ve received).

OPTIONAL:

5.

I agree to have the interview tape recorded to ensure accuracy of information. I
understand that I can request that the tape recording be stopped at any time. I also
understand that this cassette tape will be held in the strictest of conﬁdence, that
my name or any identifying information will not be recorded or marked on the
tape, and that it will be destroyed after completion of the research study.

YES _ NO _

 

 

 

Participant Signature Project Staff Date

59

Appendix F: Tables

60

Table I

Abuse Status of Participants

 

 

Abuse Status
Abused Women Non-Abused Women
Physical abuse Psychological abuse Physical abuse Psychological abuse
N 206 206 O 128
% of total 52% 52% - 32%

Total N = 399

Note: A total of 206 women experienced physical abuse, and a total of 334 women
experienced psychological abuse.

61

Table II

Descriptive Statistics for Demographics of Abused Women versus Non—Abused Women

 

Abused Women Non-Abused Women

 

 

 

 

 

 

 

 

 

 

Ethnic Background*

African-American 22.8% 10.4%

Caucasian 62.1% 78.8%

Latina 6.8% 3.1%

Asian-Paciﬁc 1.0% 1.0%

Native-American 0.5% 1 .0%

Other 6.8% 5.7%
Age*

Mean age 32.89 35.64
Educational Level*

High School graduate or less 28.6% 8.8%

Some college/trade school 61.6% 46.7%

Bachelor’s degree 6.8% 30.1%

Post-Bachelor’s degree 2.9% 13.5%
Employed in last six months*

Yes 81.1% 88.6%
Currently employed“

Yes 74.3% 89.5%
Marital Status*

Married, living together 17.5% 38.9%

Married, separated 13.6% 4.1%

Divorce 12.6% 18.1%

Girl/boyﬁiend living together 15.0% 6.2%

Girl/boyﬁiend not living together 16.5% 10.9%

Dating not girl/boyfriend 4.4% 3.6%

Not currently dating anyone 15.5% 16.6%

Other 4.9% 1.5%
Income*

Mean monthly income $1,476 $2,647

Median monthly income $1,200 $2,400
People supported by income

Average number of people 2.81 2.81
Number of children

Average number of children 1.92 1.68
Psychological Abuse*

Mean frequency of psych. abuse 2.28 1.41

 

*p<.05

62

Table HI

mson Product Moment Correlations for Variables; Abused Women only

 

 

Variables 2 3 4

1. Frequency of Psychological Abuse .61 * .26* .16*
2. Frequency of Physical Abuse — .22* .07
3. Amount of Stress Appraisal - .23*

4. Social Support

*p<.05

63

Table IV

Descriptive Statistics for Abused Women only

 

 

Variables Minimum Maximum Mean SD

1. Frequency of Psychological Abuse 1.18 3.79 2.28 .56
2. Frequency of Physical Abuse 1.06 5.18 1.80 .72
3. Amount of Stress Appraisal 2.00 5.00 3.68 .66
4. Social Support 1.00 6.60 3.46 1.20

 

64

Table V

Pguson Product Moment Correlations for Variables: Non-Abused Women only

 

 

Variables 2 3 4
1. Frequency of Psychological Abuse - .19* .41 "‘
2. Frequency of Physical Abuse - - -
3. Amount of Stress Appraisal - .l6*

4. Social Support

 

*p<.05

65

Table VI

Descriptive Statistics for Non-Abused Women only

 

 

Variables Minimum Maximum Mean SD.

1. Frequency of Psychological Abuse 1.05 3.35 1.41 .44
2. Frequency of Physical Abuse - - - -

3. Amount of Stress Appraisal 1.00 5.00 3.26 .82
4. Social Support 1.00 6.30 2.77 1.04

 

66

Wt ..

Table VII

Pearson Product Moment Correlations for Variables: All Women in the Sample

 

 

Variables 2 3 4

1. Frequency of Psychological Abuse .61 * .33* .35*
2. Frequency of Physical Abuse - .22* .07
3. Amount of Stress Appraisal - .26*

4. Social Support -

*p<.05

67

Table VIII

Descriptive Statistics for All Women in the Sample

 

 

Variables Minimum Maximum Mean SD

1. Frequency of Psychological Abuse 1.05 3.79 1.95 .67
2. Frequency of Physical Abuse 1.06 5.18 1.80 .72
3. Amount of Stress Appraisal 1.00 5.00 3.48 .77
4. Social Support 1.00 6.60 3.13 1.18

 

68

q

. 1-
v
r

Table IX

Most Endorsed Types of Physical Abuse and Most Freqpently Occurring Types of
Physical Abuse for Abused Women

 

 

 

 

 

 

 

 

 

 

 

Pushed or shoved you 93%
Grabbed you 88%
Threw something at you 61%
Grabbed you 3.12
Drove recklessly 3.07
Pushed or shoved you 3.00

 

 

 

69

Table X

Most Endorsed Types of Psychological Abuse and Most Frequently Occurring Types of
Psychological Abuse for Abused Women

 

 

 

 

 

 

 

 

 

 

 

 

 

Tried to control activities 93%
Ignored or made light of your anger 92%
Lied to you or deliberately misled you 92%
Called you names 91%
Lied to you or deliberately misled you 3.44
Tried to control your money 3.44
Tried to control activities 3.43
Called you names 3.41

 

 

 

7O

Table XI

Most Endorsed Types of Psychological Abuse and Most Frequently Occurring Types of
PsMchological Abuse for Non-Abused Women

 

 

 

 

 

 

 

 

 

 

 

 

Ignored or made light of your anger 52%
Criticized your family or ﬁiends to you 44%
Lied to you or deliberately misled you 31%
Discouraged contact with family or friends 3.13
Tried to force you to leave your home 3.11
Threatened to hurt your family or friends 3.00
Threatened to commit suicide when he was angry with you 3.00

 

 

 

71

Table XII

Most Endorsed Life Events and Most Stressful Life Events for Abused Women

 

 

 

 

 

 

 

 

 

 

 

Increased arguments with partner 72%
Had less money than usual 68%
Separated or ended long-term relationship 57%
Victim of a violent crime/serious assault. (54%) 4.71
Arrested or convicted of a serious crime (9%) 4.67
Serious illness or injuries (33%) 4.56

 

 

 

72

Table XHI

Most Endorsed Life Events and Most Stressful Life Events for Non-Abused Women

 

 

 

 

 

 

 

 

 

 

 

Had less money than usual 52%
Started a new job or experienced a change in current job 45%
Serious illness or injuries to family members 30%
Victim of a violent crime/serious assault (3%L 4.60
Learned partner/spouse was unfaithfull5%) 4.30
Children taken away or been threatened with having 4.17
children removed from the home (3%)

 

 

 

73

Table XIV

Summary of Hierarchical Regression Analysis for Frequency of Psychologiczg Abuse and
Social Support Predicting Stress Appraisal (N = 395)

 

 

 

Variables a SE B 13 AK
Frequency of Psychological Abuse .24 .04 .30* .09*
Social Support .12 .03 .18* .03*
Psych. Abuse x Social Support .00 .03 -.02 .00

*p < .05

74

Table XV

Controlling for Demographics: Summary of Hierarchical Regression Analysis for
Frequency of Psychological Abuse and Social Support Predicting Stress Appraisal (N =

 

 

 

 

 

 

325)
Variables B SL153 13 AK
Race, Income, and Education Level .04*
Race .00 .03 .01
Income .00 .00 -. 10
Education Level -.01 .03 -.14*
Frequency of Psychological Abuse .22 .04 .27* .06*
Social Support .11 .03 .17* .O3*
Psych. Abuse x Social Support .00 .03 .OO .00
*p < .05

75

Table XVI

Summary of Hierarchical Regression Analysis for Frequency of Physical Abuse arﬁ
Social Support Predicting Stress Appraisal (N = 3m

 

 

 

Variables E SE B 13 AK
Frequency of Physical Abuse .22 .04 .30* .09*
Social Support . 12 .03 . 19* .03*
Physical Abuse x Social Support .00 .03 -.O7 .00

*p < .05

76

Table XVII

Controlling for Demoggaphics: Summary of Hiermchicﬂemession Analysis for
Frequency of Physical Abuse and Social Support Predicting Stress Apprwl (N = 395)

 

 

 

 

 

 

Variables B SE_B B AK
Race, Income, and Education Level .04*
Race .00 .03 .01
Income .00 .00 -.10
Education Level -.01 .03 -.14*
Frequency of Physical Abuse .20 .04 .27* .06*
Social Support . 12 .03 .24* .03*
Physical Abuse x Social Support .00 .03 -.06 .00
* p < .05

77

Table XVIII

Summary of Hierarchical Regression Analysis for Severity of Physical Abuse 2&1 Social
Support Predicting Stress Appraisal (N = 395)

 

 

 

Variables 3 SE B 13 AK
Severity of Physical Abuse .13 .02 .30* .09*
Social Support . 12 .03 . 19* .03*
Physical Abuse x Social Support .00 .02 -.07 .00

*p < .05

78

Table XIX

Controlling for Demographics: Summary of Hierarchical Regression Analysis for
Severity of Physical Abuse and Social Support Predicting Stress Appraisal (N = 395)

 

 

 

 

 

Variables 13 _EB 13 AK
Race, Income, and Education Level .04*
Race .00 .03 .01
Income .00 .00 -.10
Education Level -.01 .03 -. 14*
Severity of Physical Abuse .1 1 .02 .26* .05*
Social Support .01 .02 .22* .03*
*p < .05

79

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