Posttraumatic Stress Symptom Disease Research Paper

Abstract

This paper will discuss the relationship that is found between Intimate Partner Violence and Post Traumatic Stress Disorder, how IPV leads to PTSD; what factors leads the development of IPV to a more severe condition of PTSD which affects the mental well being of the victim in this situation, it will further go ahead to explain what these syndromes are and what group of the population are highly infected with it. It will enlighten those who find themselves in this situation what they can do and for those who haven’t what are the risk factors involved with IPV; this will be covered in the recommendation segment.

Table of contents

• Abstract.
• Introduction
• Purpose of the study
• Objectives of the study
• Literature review
• Definition of IPV
• Rates and Types of IPV
• Domestic violence
• Dynamics of an Abusive Relationship (Based On Domestic Violence)
• Effects of domestic violence- a common breeding place of IPV
• Post traumatic stress disorder as a consequence of intimate partner violence.
• Why Does IPV Result To Post Traumatic Stress Disorder?
• Risk Factors for the Development of Post Traumatic Stress Disorder
• Protective Factors for the Development of Post Traumatic Stress Disorder
• Statistics on IPV
• Ipv prevention
• Recommendations
• Treatment of Post Traumatic Stress Disorder
• Key Recommendations on Advanced Ipv That Has Developed To PTSD
• Conclusion
• References

Introduction

The key symptoms of Intimate Partner Violence are the main causes of PTSD and may comprise of signs such as individuals affected exhibiting easy exhaustion, restlessness, poor concentration, being temperamental and sleep disorders.

Purpose of the study

The main purpose of this research paper is that of highlighting how Intimate Partner Violence leads to Post Traumatic Stress Disorder. And what can be done to stop this developments that pose health risk to the victim while in the long run increasing the cost of health care to the victim.

Objectives of the study

The main objectives are defining and understanding what IPV is, classify the types of IPV experienced by the population, describe the rates and types of IPV, why does IPV develop to PTSD their relationship, what factors can be taken to account to prevent the escalation of IPV to PTSD, the risk factors associated with PTSD in relation to IPV treatment of PTSD in relation to IPV, then we will look into the statistics that have been carried out in regard to IPV, how IPV can be prevented and the recommendations on the way to follow when taking steps to prevent IPV in the dating scene and in the long term relationship such as marriages. The paper also includes major research projects that have been coined to solve the mysteries associated with IPV and PTSD.

Literature review

Definition of IPV

Intimate partner violence is a type of abuse that is experienced between two people in a close relationship. The term intimate tends to mean present and former spouses either in dating or in steady relationships, in steady it comprises of marriage couples and long term relationship. Ipv is experienced by the victim in a sparse of one incidence of violence that is left uncontained to a series of battements that prove to be detrimental to the assailant. Ipv can be defined into three segmented behaviors

Physical abuse, this is where by a partner takes to beating, kicking, hitting and burning the other partner, this is the act of causing physical harm to a partner

Sexual abuse, this is termed in a situation where by the partner is forced to do sexual acts that are not within their consents. Emotional abuse takes place in the form of one partner emotional stability is threatened by her/his sense of self worth being down played this can be effected by stalking, name calling, intimidation or being secluded not to see friends or relatives. Mostly the abuse starts with the emotional side of it, the victim is misused emotional after which it progresses to physical and sexual assault. Though, several types of IPV can take place simultaneously, in one incidence, such as in the case of domestic violence.

Rates and Types of IPV

Intimate partner violence is a serious problem that results to high cost in terms of health care contracted to deal with the after effects of Ipv. According to Rennison (1993-2001) this puts weight to the established health care system of a nation and makes it a heavy burden to the society. Theonnes(2000) almost 20% – 65% of all violence experienced by women is from romantic partners and according to Theonnes(2000) more than half the woman exposed to IPV live with children under the ages of twelve.

Surprisingly according to Fantuzo and colleagues most women who are at a greater risk of being exposed to IPV and experiencing its brunt are women who are pregnant and those who are raising children. From Gazmarian and colleagues, he says that not only do women suffer negatively but also their unborn child develops some kind of stress. Morland (2008) in our study in the next paragraph we will single out a form of Ipv in form of domestic violence that encompasses physical, emotional and sexual abuse all in one before we look at the factors that promote IPV to develop to PTSD. This will enable us to understand the core problem and foundation of IPV in relation to PTSD it will also give us a clear picture on how the three types of abuse play into our lives on a daily course.

Domestic violence

Domestic violence can be defined as the use of threat to instill fear1, harm or controlling behavior. Domestic violence is the most prominent example of IPV, in that it compromises the three types of IPV form that is the emotional, physical, and sexual abuse. Take for instance a case where by the husband comes home drunk and demands to have sex with the spouse, while the spouse doubts his faith fullness she refuses to have sex with him. This will result to physical abuse, which will define to beatings as he forces himself into her, she gets the other end of emotional abuse when she is subjected to forced sexual intercourse , sexual abuse comes along with the act itself.

Research based in the above problem of battering have concluded that the following characteristics are prone in identifying a batterer; a person who in the past has been exposed to violent situations, a person who uses threats and violence to get what he wants, a person who vents his anger through breaking objects around the home, people who are always forceful in getting their own way during arguments.

When a partner becomes jealous and over protective, when he is too controlling, when he takes quick steps in establishing a new relationship, when they resolve to accuse and blame others for their misfortunes, when they become cruel to children and animals and lastly when a partner has abrupt mood swings these are indications of potential harm full situation in other terms they are warning signs. (Harway, Hansen1994).

Dynamics of an Abusive Relationship (Based On Domestic Violence)

Dynamics of domestic violence will be measured according to the relationship between the batterer and the victim. According to Hattendorf and Tollerud (1997) the first step in the violence cycle is the tension building stage, this increases as time elapses, the second stage is the eruption stage, this consist of when the victim gets severe beatings, the final stage is the honey moon stage this consists of the batterer seeming apologetic and sorry to the victim, promising not to repeat only for the cycle to take course all over again. The honey moon stage gives the victim hope that the batterer will change thus the victim continues to stay out in the relationship.

The concept of traumatic bonding according to Dutton and Painter (1981) has been used to define the dynamics found in domestic violence relationships. During the cycle of the violence between the two people involved an emotional bonding develops, this occurs due to the imbalances of power between the victim and perpetrator, this happens due to the treatment of the victim which varies from one time being good to another being bad. As the abuser gains more power, the victim feel worse this makes the victim to become more dependent to the abuser. The second factor in traumatic bonding is the fact by which the abuser becomes unpredictable; sometimes the abuser showers the victims with gifts and attention. The abuser gets the notion that the abuse has ended while it waiting to happen.

The third approach is by the use of the concepts of, approach and avoidance. According to Barnett (2001) this can be discussed through the mixture of pros (love and financial support) and cons (fear, and humiliation). The abuser will want to hide on the pros side of the relationship avoiding the real cons. The struggle to leave the relationship becomes a hurdle to the victim.

Effects of domestic violence- a common breeding place of IPV

It has both long term and short term effects to the victim. The effects can take a physical or a psychological route and times affect the people who are around such environments especially children. The physical effects of the victim are varied, they come as lacerations, bruises, broken bones, abdominal pains and gastrointestinal complaints, virginal and urinary tract infections and even worse they can have HIV transmission.

According to Bohn and Holz (1996) victims may experience pregnancy complications which correlate to miscarriage, low birth weight for the child and or death of the fetus. Psychological effects, these consist of depression, this accounts almost 60 % of all battered women tend to become depressed. The above can lead to suicidal attempts according to Barnett (2000) African American woman are more susceptible to committing suicide at the percentage of 450 compared to the white women who stands at 25%.

Along with stress victims are exposed to developing PTSD, whose main symptoms are those of experiencing flashbacks of the traumatic events, intrusive imagery, nightmares, anxiety and emotional numbness as for mentioned insomnia and hyper vigilance are also experienced. There is a significant connection between domestic violence as a breeding ground of IPV and the subsequent development of PTSD. In a research carried out by Vitanza, Vogel and Marshall (1995), they rook a sample of study regarding 93 women who were in stressful relationships, they based their study on the psychological abuse and severity of the violence, the deduction they got was that there is a correlation between the IPV incidence and PTSD.

Mertin and Mohr (2000) again interviewed Australian women at rescue shelters and they deducted that 46% of the 100 women met the criteria of being diagnosed with PTSD symptoms. When it comes to domestic violence the children too can develop PTSD symptoms this they experience through anxiety, withdrawal and aggression, this they get when they are exposed to the violence being meted to their parents. The most aggravating problem in this situation is the carrying forward of the experience (long term side effects), meaning that the child in adult hood can experience the same and won’t budge because they think it’s right and normal

How Are These Effects Treated?

For a battered woman the treatment option favors psychological treatment, according to Hattendorf and Tollerud (1997) they recommend the use of feminist therapy approach. The primary focus that the above responds to is the empowerment of the victim, though at the beginning of the therapy session the safety of the victim especially if the victim is still in the abusive relationship. The assessor of the victim should assess the situation by wanting to know the character of the abuser is he under the influence of drugs does he mistreat animals, does he poses weapons and also asses the level of rage of the batterer.

According to Harways and Hansen (1994) the presence of the aforementioned factors should help in gauging the potential of lethality of the batterer. Through this a safety plan can be devised in the wellness of the victim, a strategy like having an exit plan on hand that should consist of a safety kit that should contain money, clothing, car keys and copies of important documents. The above should include a prior arrangement with a shelter home or a friend’s house, this should be done without the consent of the abuser. After the safety and lethality have been covered then the therapists should cover long term goals pertaining to the victim.

According to Hattendorf and Tollerud (1997) victims can be empowered by them regain their independence and regaining their social support like friends and relatives whom the victims had been cut off from. The children in these households too need their own therapeutic treatment to hamper them from long tern effects. All in all additional treatment for depression and PTSD symptoms should be administered to the victims.

The only problem that is left in domestic violence treatment is how to combat the issue of breaking the cycle which repetitive intimate terrorism in other terms, according to Harway, and Hansen (1994). The victims should have their own personal therapy session’s couple therapy should be discouraged as long as the violence is still on course. Each member of the relationship should be encouraged to visit a therapist individually and separately until they come to the point of acceptance.

The relationship between PTSD and IPV

IPV can be termed as life threatening to women according to 6 it can result to injuries, immune disorders, and insomnia and digestive tract problems. It also makes the woman prone to mental instability, which include depression, low self esteem or self worth, psychological distress and post traumatic stress disorder this is according to Cascardi and Houskamp. According to Vitanza and Bogat PTSD is defined as a syndrome that includes the experiencing of avoidance and emotional numbing and hyper arousal symptoms that tend to occur in some individual as an aftermath of particular events that can be termed traumatic. All women in their life time tend to experience some form of Ipv or PTSD which are associated with multiple mental health problems.

According to Pardoning, in a survey taken whose main aim was that of examining prevalence of PTSD in a sample of young Germans ranging from the age of 14-24 years old indicated that most persons of at least 88% who met the criteria of experiencing ptsd had connection with other mood and anxiety disorders, agoraphobia and they had some dependency to substance use which they used after the traumatic experience.

According to varma (2007) and Pico Alphonso (2006) when PTSD is chronic it tends to become co morbid with depression more than half the time. According to 8 the prevalence rate of PTSD in women who are battered is high it takes the range of 46- 85 %. According to varma (2007) and Pico Alphonso (2006) they argue that the high the number of Ipv experiences (physical, emotional and sexual) the greater the number of PTSD symptoms experienced by a woman.

According to Basile (2004) in a research carried out found out that PTSD levels, depressive levels and somatic complaints were higher in women who were pregnant, this research was carried out in an Indian hospital it concluded that women who reported of having had a history of Ipv and sexual coercion compared to those who didn’t. According to varma (2007) and Pico Alphonso (2006) in another study both physically and psychologically abused women displayed higher rates of PTSD, depressive, and anxiety symptoms as well as having thoughts of suicide when compared to none abused controls.

Why Does IPV Result To Post Traumatic Stress Disorder?

Studies indicate that IPV is a stressor that activates the hypothalamic-pituitary-adrenal stress axis which then is activated to produce cortisol, the levels of cortisol increases with the increase in the level of stress thus it helps the system to be able to cope with transient stressors by altering metabolism and neural function. Chronic activation of this system can lead in the poisoning of the neurons known as neurotoxin.

According to Mc Ewen (2005) and Mirescu (2006) recent studies have concluded that these cortisol induced brain changes are related to the emotional responses that adults and children have to stress full conditions. According to Inslicht (2006) cortisol levels are a determinant factor when it comes to PTSD levels, or depression within IPV affected samples. Although it not conclusive to argue that those who experience high levels of cortisol are less exposed to PTSD.

According to Miller (2007) describes how characteristics of a stressor that is threat to physical integrity affect cortisol secretion for example when a victim is exposed to threat to life the level of cortisol production is high, although for most people the hypo-pituitary axis levels increases with subjected distress, but for those who have ptsd symptoms was negatively related to cortisol levels.

Causes of PTSD

According to Sandberg (1999) PTSD that occurs in childhood due to childhood abuses matures into the adult hood stage, this is done through repeated victimization in adult hood. The above factor increases the chances of adult victimization.

Child hood abuse increases the chances of a woman experiencing negative mental health in case of victimization. Koopmans and colleagues (2005) found out that depressive symptoms are strongly associated with child hood physical and sexual abuse among women who were IPV victims. Lewis and colleagues (2007) found out that child hood emotional abuse correlates the relationship between child hood exposure to family violence and PTSD which results to Ipv in adult hood. Thus in conclusion it means a woman becomes susceptible to Ipv if she had an abused childhood.

The second reason according to Weaver (2007) rape with a non partner or with partner increases the chance of experiencing PTSD and this implies to sexual assault. Sexual aggression by a partner is a stronger activator to PTSD symptoms, meaning it affects the victim more in a mental way other than physical aspect of it. In conclusion according to Taft (2007) and Pico Alphonso et al, found that for IPV and PTSD to be experienced in their highest form could produce increased levels of depression and suicidal attempts from victims of sexual abuse.

The third cause is that of duration of the IPV for example when a woman is pregnant and gets the IPV exposure her mental health is affected, according Bogat (2003) the number of partners and the timing of this exposure had varying effects. When both partners experience IPV at the same times the outcomes are devastating. The second worse out comes is experienced with pregnant women who experienced IPV with their current partners.

Measures for the prevention of PTSD

Social support systems have proved to be an effective way of helping women experiencing IPV not to contract PTSD thus their mental health is not affected. Otherwise tangible social support moderates the relationship between IPV and PTSD symptoms according to Martin and Hassle brooks’ (2001) found out that social support enhanced the capacity of resilience among incarcerated women with the history of victimization.

The repeatedly act of severe abuse of a person by his partner can be termed as intimate terrorism according to Leone et al (2007) people who sought help from such relationships compared to situational couple violence, the former ones were more likely to sought help other than the later. In the factor of personal characteristics in resilient women with Ipv comes into play when the victim exercises self control, commitment, being goal oriented, increase levels of adaptability and practice high levels of self esteem, having high social skills and being humorous will contribute to high levels of mental well being of the victim experiencing Ipv.

According to Martin and Hassle brooks’ (2001) when the victim creates a positive mechanism in which he combats with the symptoms of IPV he tends to escalate to experiencing PTSD symptoms. Reverie et al (2007) found out that among low income earners, especially African American women, would rather commit suicide rather than combat the abusers meaning that they tend to accommodate the abusers. Specific cognitive styles have been associated with resilience of Ipv, for instance Calveat et al, (2007) concluded that cognitive schemes of rejection and disconnection created a link of violence and depression. For the survivors of child hood abuse, PTSD symptoms were persistent this is because of the negative emotions that they experienced.

Statistics on IPV

It is estimated by Callie Marie Rennison and Sarah Welchans who are staticians that in 1998 about 1 million violent crimes were committed against persons by their current and former spouses and boyfriends or girl friends, about 86% of violence in partners in intimate relationships 900,000 of the incidences were meted on women. Intimate partner violence made up 23% of violent crimes against women this is between 1993 and 1998 in comparison violence against men was only at 2.5%. Although according to statistics the rate of violence against women decreased in 1998 with a percentage of 9% compared to 1993.

Most women from 1976 have been murdered due to staying in relationship that experienced IPVS most of this households also housed children who are under the age of twelve. Meaning this children will grow up in a dysfunctional homes will tend to appreciate violence because this is what the learnt as they grew up in their households. Another observance is that as modernization creeps in our back yards then sophistication also grows with the kind of IPV that women experience.

Women are the ones who suffer most worldwide under the Ipv scenario they are the victims of this ostracized notion of violence where women are gagged and have no say in the relationships. According to the US department of justice office of justice programs they recorded two thousand murders of victims of IPV. Intimate partner victimization has increased on households that are rental, thus living in an owned residential area curtailed the IPV prevalence this can be attributed to the stress levels when it comes to financial problem s in couples.

In the rural areas IPV is higher women in this settings are more prevalent to go through IPV without realizing this can be attributed to the illiteracy level and inflexibility in behavior change about the dating scene. The urban women are more aware of their rights and know how to detect violence thus they aren’t prone to IPV as compared to the rural folks. The above can be termed as the reverse when the gender setting takes place.

By this I mean the men at the urban centers are highly prone to experience IPV than their rural counterparts but the rate is not significantly realized this is because the number of men being subjected to IPV is almost negligent it stands at a mere 2.5% compared to women which is at 23%. Most of these victims of IPV in the US report these crimes to the police, according to statistics carried out in 1993 and 1998 about half of them did report, 54% of women and 46% of the men population. Although traditions seem to keep some segments down, from reporting these incidences because according to statistics the reports were varying when it came to the different ethnic groupings.

In the black race 68% of the women fraternity reported these crimes as compared to the men at 42%, white men at 45%, women 52%, Hispanics women were at a high of 66%. Apparently these reports were higher on the female side not until 1997 when men too started reporting. In conclusion most people don’t report to the police due to fear of victimization by their assailant or they deemed Ipv to be a personal matter that needed cover from the public. All the statistics used are based from the United States of America, justice department.

Ipv prevention

The efforts of prevention measures of IPV should be started during adolescence stage through open discussions and knowledge dispersion. Cornelius and Resseguie (2007) reviewed current intervention programmes for adolescence dating violence. Although these programmes are affected the implementation part is elusive when it comes to behavioral changes, and dating violence.

For instance Foshee (2000)and colleagues coined out a dating program to meet out violence in the dating scene, this was done with the consideration of ninth and eighth graders, its main focus was that of behavioral norms, gender stereotypes, and conflict resolution styles not to add cognitive therapy for those who seeked for help, this was for those who were in the dating scene after a year of follow up the authors deducted that there were no vital step when it came to behavioral changes, in beliefs and attitude towards dating relationships. In conclusion more research is needed to ascertain effective preventive measures to be used in curbing Ipv from the grass roots that is from when people start dating i.e. The adolescence stage

The ultimate solution of Ipv is finding an avenue to walk away from the situation by accepting that there is a form of abuse in the prevailing relationship. The victim should stop protecting the assailant by deeming his actions as normal, this can be evidenced mostly in developed relationship such as marriages where by the husband gets drunk on a daily basis and at the end of the day abuses the wife verbally and forces himself into her sexually. A woman in such a relationship should not let it to develop into intimate terrorism nature but should curtail the repetition by walking out before something worse happens to her and her children. By practicing pretence to the whole scene it gives the assailant more power over the victimized person thus manipulating them in each front.

Recommendations

As mentioned above women should become more enlightened in order to escape experiencing IPV. According to the centers for disease control prevention and the national center for injury prevention and control the strategy is that of being able to prevent IPV before it happens because as discussed it can develop to ptsd which is detrimental to ones mental health, thus factors that promote healthy dating relationship should be promoted from the societal stage, and these strategies should be focused and instilled on young people as the start dating, this will arm those who may fall victim of IPV because of the knowledge that have accrued they will know when it gets out of hand from being loving to being possessive, they will be able to detect the danger sign and run before it gets too late.

Traditionally women have grouped themselves to address IPV this they have done through setting up of hot lines and shelters for battered women and rapped girls and mothers. The whole society should be involved in mentoring the youths when it comes to the dating scene, guidance from the adults should be subjected while it’s still early, adults can change the norms of dating as they are currently perceived. In order to prevent IPV the community has to be informed what is IPV and where it is found, through centre and development care program data is collected and research is done to prevent IPV in the community.

From different ethnic settings adults should find a way of deeming old traditions that seem to favor the prevalence of IPV in relationships, in some communities they term women beatings as a lesson and that each man is priced when he beats his wife such sentiments should be eradicated by young men of such communities, by being taught on how to treat their women. The police force should implement ways through which victims will find it easy to report such incidence that they deem too personal while they need attention.

For instance the police system should have a private office that deals with such complaints and all procedures like medical checkup points should be integrated in the system. The comfort ability of these victims should be considered for them to lose the fear of their assailants coming back after them. Women at the rural areas should be exposed to their rights within a relationship this doesn’t include being battered and being raped, this will make them know how to observe control measures and identification measures on the onset of Ipv

Treatment of Post Traumatic Stress Disorder

Effort to combat trauma symptoms have been successful, among adults their psychotherapy treatments of PTSD has so far been very effective. Medical treatment is helpful, for instance selective serotonin reuptake inhibitors have effectively treated PTSD. Albucher (2002)

New treatments are being evolved for effective treatment of PTSD, for example the use of cognitive processing therapy, this therapy was made to specifically help people from sexual abuse especially rape, though it has been applied to other forms of abuse. Narratives are used and are read aloud to enable the victims to shed their inhibitions of anger, guilt and depression.

Bryant (1999) apparently symptoms in acute stress disorder are more alike to the ones found in PTSD though they only last for about four weeks prior to the traumatic events then they tend to escalate. About 80% of victims experiencing acute stress disorder will develop into PTSD, according to Harvey (1998) using cognitive therapy on people who have experienced motor accidents and industrial accidents on a six week therapy will prevent them from developing chronic ptsd at six months and four years after the event, according to Bryant(2003) the above hasn’t been tested to women experiencing IPV, thus it offers a fertile ground in which this women can profit from research being carried out to see even if them they can benefit from it.

However not all preventive treatments for PTSD are effective, in recent articles on psychological issues it has been suggested that open discussion about the critical incidence may actually increase or maintain the symptoms. Rose and colleagues (2003)

Key Recommendations on Advanced Ipv That Has Developed To PTSD

Victims should be advised to visit health centers for effective medication and counseling services. To avoid the victims from such adverse effects such experiencing low level of self esteem which can lead to alienation of the victim pouring over to suicidal attempts, bad eating disorders which include anorexia(the lack of eating food), obesity(the act of over eating), some experience sexual dysfunctional problems such as being frigid.

Research should be taken seriously in order to combat PTSD syndromes this will make therapy treatment to be more effective, pharmacology and medical treatment should also be delegated in the strongest form. This will help victims not to sink into deep alleys of insanity brought about by imbalances of their mental state. In conclusion according to this papers discussion it seems fit to label IPV as a national disaster that needs numerous and vigorous campaigns.

This will promote public sensitization on awareness of their rights. The population will be well armed with information regarding their safety in relationships and limits that should be maintained. By doing this it will make partners feel better about themselves thus making them better people who can function well within the relationships and not assuming the roles of being mere parts of the relationships but core members of the relationship.

Conclusion

From the above discussion it’s evident that women exposed to Ipv are candidates to experience even worst exposure of PTSD. The effects of Ipv are profound on their victims by saying that their childhood experiences are the greatest factors that will determine whether the woman is resilient or not to contract PTSD symptoms. As doctors handle the issue of IPV they should keep in mind the people around the victims especially the children and families.

Though they are chances that some factors can reduce the chances of women with IPV to experience PTSD, as aforementioned above through a well established support system that embraces the victims and makes them open up, this will decrease the chances of IVP growing into PTSD thus her mental health will be safeguarded. All in all, with all the research that is being conducted on ways of effectively treating Ipv and PTSD then we have hope, as we continue using therapies, pharmacological and psychological treatments that are available.

For the effective prevention measures of not experiencing Ipv which could develop to PTSD then everyone in the society is obligated to take responsibility in participating in public awareness programs that promote the disabling of IPV in relationship. Non governmental and governmental organization should chip in research of identifying the weak areas found in the knowledge of Ipv symptoms that can lead to a more serious disease PTSD. Preventive measures are well beyond curative procedures, when looked at the perspective of financial cost, damage accumulated and wasted lives.

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