|Year : 2020 | Volume
| Issue : 2 | Page : 65-70
Coping, resilience, and hopefulness among women survivors of Intimate Partner Violence (IPV)
KS Shilpa1, LN Suman2
1 PhD Scholar, Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
2 Professor, Trauma Recovery Clinic, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
|Date of Submission||02-Sep-2020|
|Date of Acceptance||28-Oct-2020|
|Date of Web Publication||14-Jan-2021|
Ms. K S Shilpa
Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka
Source of Support: None, Conflict of Interest: None
Context: Intimate partner violence (IPV) is the most common form of violence experienced by women. This can take the form of physical, sexual, financial, and emotional violence. The short-term as well as long-term consequences of IPV are significant.
Aims: To examine trauma-specific coping self-efficacy, resilience, and hopefulness following IPV among women in short stay shelter homes.
Settings and Design: The sample consisted of 30 women aged between 19 and 56 years from three shelter homes in Bengaluru, India.
Materials and Methods: A sociodemographic data sheet along with four scales, Kessler's Psychological Distress Scale (K-10), Trauma Coping Self-Efficacy (CSE) Scale (CSE-T), Connor–Davidson Resilience Scale, and Adult Hope Scale (AHS), were administered to the participants of the study.
Statistical Analysis Used: The data were analyzed using descriptive and inferential statistics to describe the sample and examine the interrelationships among the variables.
Results: There was a significant negative relationship (r = −0.489) between level of distress and trauma CSE. A significant positive relationship (r = 0.524) was found between trauma CSE and resilience. There were also significant positive relationships (r = 0.618) among trauma CSE and goal-directed determination and pathways (AHS agency and pathways).
Conclusions: The study helps in understanding the risk for psychopathology among these women as well as in indicating measures to be taken in devising psychosocial interventions for women who have experienced IPV. The details of the study and its implications are discussed.
Keywords: Intimate partner violence, shelter homes, trauma, women
|How to cite this article:|
Shilpa K S, Suman L N. Coping, resilience, and hopefulness among women survivors of Intimate Partner Violence (IPV). Arch Ment Health 2020;21:65-70
|How to cite this URL:|
Shilpa K S, Suman L N. Coping, resilience, and hopefulness among women survivors of Intimate Partner Violence (IPV). Arch Ment Health [serial online] 2020 [cited 2021 May 17];21:65-70. Available from: https://www.amhonline.org/text.asp?2020/21/2/65/306868
| Introduction|| |
Intimate partner violence (IPV) is the most common form of violence experienced by women. This can take the form of physical, emotional, sexual, and financial violence. An intimate partner is a person with whom an individual has a close personal relationship characterized by emotional connectedness, constant physical contact, sexual behavior, identity as a couple, and information and understanding about each other's lives. The global prevalence of physical and sexual IPV among women is 30%. In India, the prevalence rate of physical and sexual IPV is 29%. There are significant short-term and long-term physical and mental health consequences that women experience due to IPV. Trauma being the key consequence of IPV, women with experience of IPV are thrice more likely to meet the criteria for posttraumatic stress disorder (PTSD), which is often linked with depression. While women worldwide continue to suffer, it is important to note that women are inflicted with violence mostly within their families and by people close to them. To escape such dire consequences, women who experience IPV seek shelter in transitory homes. Shelter homes for women provide refuge and undertake rehabilitation of women who are homeless and are at high risk of violence, assault, and human trafficking., In this context, it is crucial to understand how women cope and bounce back despite experiences such as IPV. The aim of the present study was to examine trauma-specific coping self-efficacy (CSE), resilience, and hopefulness among women with experiences of IPV.
| Materials and Methods|| |
The Ethics Committee of the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India, has approved the study related protocol. Written informed consent was obtained from all the participants before the assessment and interviews. The participants understand that their names and initials will not be published and due efforts will be made to conceal their identity.
Aim and objectives
The aim of the study was to examine trauma-specific CSE, resilience, and hopefulness for IPV among women in short stay shelter homes. The objectives of the study are as follows:
- To assess psychological distress among the women
- To examine trauma CSE among the women
- To assess resilience among the women
- To assess hopefulness among the women
- To examine the relationships among the above variables.
The sample consisted of 30 women with experience of IPV from three different shelter homes in Bengaluru, India. The mean age of the sample was 32.43 years (standard deviation [SD] = 10.6).
Inclusion and exclusion
The inclusion criteria for the study included women who were above 18 years of age with experience of IPV. The women were required to provide written informed consent. Women with psychosis and those who were unable to provide informed consent due to psychopathology were excluded from the study.
The following tools were used for the purpose of this study:
- Sociodemographic data sheet (SDS)
- Part A: SDS was used to obtain details of the women such as name, age, educational qualification, socioeconomic level, duration of marriage, employment history, religion, spoken languages, and details about family members
- Part B: In this section, details about the spouse were obtained
- Part C: In this section, details about the children were obtained.
- Semistructured interview schedule (SSIS): Part A: The SSIS was developed by the investigator for obtaining information about the following: nature of IPV, reasons for the violence, severity of the violence, and perceived danger from the spouse as well as disclosure of IPV to others
- Kessler's Psychological Distress Scale (K-10): This scale was developed by Kessler and Mroczek in 2002 for screening populations on psychological distress. The scale consists of 10 questions on nonspecific psychological distress regarding the level of anxiety and depressive symptoms a person may have experienced in the most recent 4-week period. The values of the kappa and weighted kappa scores ranged from 0.42 to 0.74, indicating that K10 is a moderately reliable instrument
- Trauma CSE Scale (CSE-T): This scale was developed by Benight et al. This scale assesses general trauma-related CSE perceptions. The scale is used to understand the posttraumatic recovery process. The internal consistency for the 9-item version of the CSE-T indicated good reliability of 0.72
- Connor–Davidson Resilience Scale (CD-RISC-10): The CD-RISC was developed by Connor and Davidson as a brief self-rated assessment to help quantify resilience and as a clinical measure to assess treatment response. It comprises 10 items, each rated on a five-point scale, with higher scores reflecting greater resilience. Internal consistency of the 10-item CD-RISC was evaluated by calculating Cronbach's alpha. The alpha value of 0.85 indicated good reliability
- Adult Hope Scale (AHS): This scale was developed based on the Snyder's cognitive model of hope, which he defined as “a positive motivational state that is based on an interactively derived sense of successful (a) agency (goal-directed energy), and (b) pathways (planning to meet goals).” The AHS consists of 12 items, where four of the items measure pathways thinking, four measure agency thinking, and four items are fillers. The internal reliability of the total scale ranged from 0.74 to 0.84.
Description of the settings
The places selected for the study included semi-government organizations that have a shelter home for homeless women. They are connected with Mahila Sahaya Vani, a helpline for distressed women run by the government. The organizations have wide network with the legal system and the police department. They have around 20 staff members, which includes the counsellors, social workers, and a warden. The women are admitted into the shelter and their decision to leave their homes can either be voluntary or involuntary. They cater to individuals by providing them with several services such as accommodation, education, vocational training, sports, and rehabilitation. The organizations also enable livelihood opportunities to women with disabilities and women in distress through its services.
The study was part of MPhil Clinical Psychology dissertation. It had two parts: quantitative and qualitative. The present study reports the results obtained on the quantitative measures. Permission to carry out the study was obtained from the Department Ethics Sub-Committee and the Institutional Ethics Committee of NIMHANS. Then, the managements of the shelters were contacted and the aim of the study was discussed with them. After obtaining permission from the managements, the participants in the shelters were met and explained about the nature of the study. Written informed consent was obtained individually from all the participants who agreed to be a part of the study. Privacy and confidentiality of the participants during the assessments were ensured.
The assessments with all the participants were conducted in a private setting in a room that was reserved for the researcher. The duration for conducting the assessments ranged from 45 to 60 min per participant. While interviewing the women, it was found that most of them had emotional breakdowns, which had to be dealt with by offering space for ventilation and giving them breaks in between to feel better. All the participants were debriefed and offered a brief supportive intervention of a single session of duration ranging from 30 to 45 min.
The data were analyzed using descriptive statistics such as frequencies, mean, and SD for examining the sociodemographic profile of the subjects and their partners. In addition, inferential statistics such as correlation was carried out to examine the interrelationships among the variables.
| Results|| |
The sociodemographic profile of the participants is presented in [Table 1]. The mean age of the sample was 32.43 years, indicating that it is mainly young adults who take refuge in shelters as they come from dangerous situations. The age of the participants ranged from 19 years to 56 years. The duration of marriage ranged from 6 months to 30 years, indicating that IPV was a common phenomenon whether the women were married recently or for several years. More than half of the participants, that is 16 (53.3%) women, were educated up to secondary level, making it difficult for them to get jobs and become financially independent. The women cited financial dependence to be one of the main reasons to stay with their abusive spouses. Despite low education being a hinderance, more than half, that is 18 (60%) of the women, were employed in semiskilled jobs such as garments factory, textile factory, weaving, and domestic help. Poor education along with inadequate skill set made it difficult for the women to live independently. The women came from both rural and urban backgrounds, indicating that IPV is common in both kinds of domicile.
The duration of IPV experienced by the women ranged from 0.5 years to 30 years with the mean duration of 8.59 years. More than half the participants, that is 18 (60%), experienced IPV on a daily basis. This reveals that IPV is a common phenomenon in the households of these women and most often happens on a daily basis. On the different kinds of violence that is perpetuated against women, 29 (96.7%) women reported physical and emotional IPV. Sexual and financial IPV were lesser reported, with 9 (30%) of them reporting sexual violence and 19 (63.3%) reporting financial violence. Women usually experienced a combination of the types of IPV, with more than three-fourths of them experiencing overlap of physical and emotional forms of IPV.
Results from the quantitative measures
On K-10, the mean for the sample on psychological distress was 26.40 and the SD was 7.58 [Table 2]. Based on K-10, 7 (23.3%) women were likely to have severe distress, 12 (40%) were likely to have moderate distress, 5 (16.7%) were likely to have mild distress and 6 (20%) were likely to be well. These findings indicate that majority of the women with experiences of IPV experienced moderate-to-severe distress.
On CSE-T, the mean of the sample on the scale was 50.3 and SD was 10.57 [Table 2]. Higher scores reflect better trauma CSE. On CSE-T, 20 (67%) of the women were found to have high self-efficacy, while 10 (33%) were found to have low self-efficacy. These findings of the study indicate that majority of the women are capable in managing the internal and external posttraumatic recovery demands.
On CD-RISC, the mean of the scores of the sample on the scale was 28.20 and SD was 9.78 [Table 2]. The percentage of women who scored low on resilience was 14 (46.6%), intermediate was 10 (33.3%), and high resilience was 6 (20%). Although the findings on this scale indicate that majority of the women fall into the low resilience category, it can be seen that 51% of the women fall into the intermediate (moderate)-to-high resilience range, indicating that more than half the women reported being resilient despite their current circumstances and experiences.
On AHS, the total mean of the sample was 49.93, while that of the agency and pathway subscales were 24.67 and 25.27, respectively. On AHS (agency subscale), 22 (73.3%) of the women reported high agency, indicating that they had good goal-directed determinism. On the AHS (pathway subscale), 19 (63.3%) of the women reported high pathway, indicating that they were able to plan and think of different ways to meet the goals. These findings indicate that these women are hopeful about their future and in achieving their goals.
Intercorrelations among the quantitative measures
The intercorrelations between variables were calculated using Spearman's Rho [Table 3].
The results show a significant negative relationship (r = −0.489) between level of distress (K10) and trauma CSE-T. This reveals that when the distress is high among these women, adaptive coping is compromised and vice versa. A significant positive relationship (r = 0.524) was found between trauma CSE-T and resilience (CD-RISC), indicating that when women evaluate themselves positively with regard to coping from IPV experiences, they report higher levels of resilience. There is a significant positive relationship (r = 0.618) between trauma CSE-T and goal-directed determination (AHS-agency). Trauma-related self-efficacy had a positive relationship (r = 0.671) with planning of ways to meet goals (AHS-pathway) as well as a positive relationship (r = 0.705) with overall hope (AHS total). This reveals that when women report adaptive coping despite their IPV experiences, they are able to plan ahead to meet their goals and are also able to bounce back indicating resilience. They are able to plan ahead and find strategies to achieve the goals. Goal-directed determination (AHS-agency) had a significant positive relationship with resilience (CD-RISC, r = 0.644), planning of ways to meet goals (AHS pathway, r = 0.522), and overall hope (AHS total, r = 0.634). These findings indicate that when women have the resources to meet goals, their resilience and planning for future are adequate.
| Discussion|| |
The aim of this study was to examine trauma-specific CSE, resilience, and hopefulness for IPV among women in short stay shelter homes. The main findings from the current study indicate that women show self-efficacy with respect to coping from IPV-related trauma. They also reported being resilient and hopeful with regard to their future goals.
Psychological distress is a common consequence of IPV. These findings can be supported by previous literature that highlights negative consequences of IPV on the individual's psychological well-being. Studies have explored the relationship between IPV and psychological distress in young adults. The findings from the study indicate that frequency of sustained psychological violence, but not physical violence, was positively associated with distress. Review of papers from 2006 to 2012 conducted to examine the link between IPV and poor mental and physical health outcomes. The women who participated in the current study also reported physical consequences such as chronic pains and injuries. Women who experience IPV often experience depressive and trauma-related symptoms. A meta-analysis was conducted to examine the cooccurrence of IPV and depression outcomes in women. Majority of the studies reviewed reveal that there is moderate-to-strong positive associations between IPV and depression. The review also indicates increased risk for severe depressive symptoms and postpartum depression among women exposed to IPV when compared to nonexposed women.
Coping from trauma is a crucial aspect that needs to be studied in women who undergo traumatic experiences. The results in the current study indicate that most women reflect adaptive coping in the context of trauma experienced due to IPV. A study conducted to examine CSE and psychological distress after IPV found that lower CSE particular to recovery demands was closely associated with IPV and would also report more severe symptoms of depression and PTSD. Another study focused exploring the experiences of mothers who had left an abusive relationship. This study also aimed to understand how women described coping and looking after their children during IPV, both during an abusive relationship and after leaving. Each participant in this study described how the contextual factors influenced whether they coped with IPV by seeking support from others, changing the way they thought, or changing their behavior. While examining the factors associated with stay-leave decision-making in women with experiences of IPV, a study found that psychological variables such as self-efficacy and coping varied based on the relationship status of the women with their partners. Studies have emphasized on the importance of evaluating domestic violence CSE in incarcerated women who had recent experiences of partner violence. CSE was found to be a protective factor against PTSD symptoms.
While risk factors for violence against women are studied widely, little is known about the resilience among these women. A study conducted to assess protective factors associated with resilience of women exposed to IPV found that spirituality, greater social support, and less violent relationships predicted higher resilience. Couple of other studies conducted in this area also have similar findings with regard to social support fostering resilience in these women., A qualitative study that aimed to understand resilience among women with IPV experiences found that all the women had overcome the difficulties due to the IPV and had moved on in their lives. The interviews also revealed certain childhood themes such as independence, trust, boundaries, and insight, which could have helped in the development of resilience in adulthood.
Another important aspect to consider while understanding the process of recovery is the hopefulness for the future. A study was conducted to examine hope as a mediator of the association between IPV and suicidal risk in college students. However, results indicated that hope agency, but not hope pathways, mediated the link between IPV and suicidal risk in the women. Importantly, the associations of IPV with both depression and suicide ideation became nonsignificant once hope was included in the prediction model. Another study conducted to examine the relationship between hope, self-efficacy, and life satisfaction among survivors of IPV indicated that hope was associated with strong variance in life satisfaction over self-efficacy. The overall results are consistent with hope being a unique variable important to psychological well-being among IPV survivors.
| Conclusions|| |
The current study focused on trauma CSE, resilience, and hopefulness showed by the women. High incidence of physical and emotional abuse among majority of the women was found. Significant number of women reported moderate distress due to IPV. More than half of the women showed higher levels of trauma-related coping. However, half of the women reported having lower levels of resilience to overcome distress. Distress was found to be significant among these women, indicating the need for trauma informed care in shelter homes. Interventions that focus on overcoming barriers to resilience and coping can be planned based on the findings of this study. Interventions can be planned with the couple/family if the women decide to go back to their spouse. Longitudinal studies with bigger sample size can be conducted on this population to get a better understanding of the recovery process after leaving the shelter home.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Devries K, Watts C, Yoshihama M, Kiss L, Schraiber LB, Deyessa N, et al
. Violence against women is strongly associated with suicide attempts: Evidence from the WHO multi-country study on women's health and domestic violence against women. Soc Sci Med 2011;73:79-86.
Waldrop AE, Resick PA. Coping among adult female victims of domestic violence. J Fam Violence 2004;19:291-302.
Khan M, Kapoor S, Cooraswamy R. Domestic violence against women and girls. Innocent Dig 2000;6:1-30.
Sekar K. Psychosocial care for women in shelter homes: A training manual. UNODC, Regional Office for South Asia Publication, New Delhi. 2011.
Anderson KM, Renner LM, Danis FS. Recovery: Resilience and growth in the aftermath of domestic violence. Violence Against Women 2012;18:1279-99.
Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, et al
. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 2002;32:959-76.
Benight CC, Shoji K, James LE, Waldrep EE, Delahanty DL, Cieslak R. Trauma coping self-efficacy: A context-specific self-efficacy measure for traumatic stress. Psychol Trauma 2015;7:591-9.
Connor KM, Davidson JR. Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety 2003;18:76-82.
Snyder CR, Harris C, Anderson JR, Holleran SA, Irving LM, Sigmon ST, et al
. The will and the ways: Development and validation of an individual-differences measure of hope. J Pers Soc Psychol 1991;60:570-85.
Fortin I, Guay S, Lavoie V, Boisvert J, Beaudry M. Intimate partner violence and psychological distress among young couples: Analysis of the moderating effect of social support. J Fam Violence 2011;27:63-73.
Dillon G, Hussain R, Loxton D, Rahman S. Mental and physical health and intimate partner violence against women: A review of the literature. Int J Family Med 2013;2013:1-15.
Beydoun HA, Beydoun MA, Kaufman JS, Lo B, Zonderman AB. Intimate partner violence against adult women and its association with major depressive disorder, depressive symptoms and postpartum depression: A systematic review and meta-analysis. Soc Sci Med 2012;75:959-75.
Lambert JE, Benight CC, Wong T, Johnson LE. Cognitive bias in the interpretation of physiological sensations, coping self-efficacy, and psychological distress after intimate partner violence. Psychol Trauma 2013;5:494.
Jones A, Vetere A. 'You just deal with it. You have to when you've got a child': A narrative analysis of mothers' accounts of how they coped, both during an abusive relationship and after leaving. Clin Child Psychol Psychiatry 2016;22:74-89.
Lerner CF, Kennedy LT. Stay Leave decision making in battered women: Trauma, coping and self-efficacy. Cogn Ther Res 2000;24:215-32.
DeCou CR, Lynch SM, Cole TT, Kaplan SP. Coping self-efficacy moderates the association between severity of partner violence and PTSD symptoms among incarcerated women. J Trauma Stress 2015;28:465-8.
Howell KH, Thurston IB, Schwartz LE, Jamison LE, Hasselle AJ. Protective factors associated with resilience in women exposed to intimate partner violence. Psychol Violence 2018;8:438-47.
Gopal N, Nunlall R. Interrogating the resilience of women affected by violence. Agenda 2017;31:63-73.
Hyland DL. “Constructing Safer Lives: Women who Display Resilience in Responding to Intimate-Partner Violence (IPV)”. Counselor Education Master's Theses. 171; 2014. Available from: https://digitalcommons.brockport.edu/edc_theses/171
. [Last accessed on 2017 Sep 12].
Muyan M, Chang EC. Hope as a mediator of the link between intimate partner violence and suicidal risk in Turkish women: Further evidence for the role of hope agency. J Interpers Violence 2019;34:4620-37.
Munos RT, Hellman CM, Brunk KL. The relationship between hope and life satisfaction among survivors of intimate partner violence: The enhancing effect of self-efficacy. Appl Res Qual Life 2016;12:981-95.
[Table 1], [Table 2], [Table 3]