Nursing Inquiry: Stress & Immune Response with Battering

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DESCRIPTION: (provided by applicant) Research with clinical- and population-based samples has shown that at least 60 percent of battered women experience posttraumatic stress disorder (PTSD). While changes in cortisol levels, immune status, and long-term health consequences associated with PTSD have been studied in several trauma survivor groups, there has been little such research with women in general, and battered women in particular. Additionally, there is a paucity of literature identifying specific predictors of PTSD symptoms in battered women. The purpose of this study is to examine the relationship between and among intimate partner violence, trauma history, PTSD symptomatology, cortisol levels, and immune status in battered women. The specific aims are to: 1) identify which empirical indicators of intimate partner violence (actual physical violence, emotional abuse, sexual violence, risk of homicide, threats of violence, and length of abusive relationship) are more predictive of PTSD symptoms in battered women; 2) examine the relative effects of childhood maltreatment and adult trauma history on PTSD symptoms in battered women; 3) examine childhood maltreatment as a moderator of PTSD symptoms in battered women; 4) describe immune status via leukocyte count, lymphocyte subset counts (CD4 cell, CD8 cell, B-cell, and natural killer cell), CD4:CD8 ratio, number of viral illnesses the past 6 months, and IgA levels in battered women; 5) examine the relationship between PTSD symptoms and salivary cortisol levels in battered women; and 6) examine the relationship between intimate partner violence, trauma history, PTSD symptoms, cortisol levels, and immune status in battered women. The theoretical interrelationships among the model constructs delineated in the specific aims will be examined in a sample of 135 battered women from shelters and the community. The soft modeling, or Least Variable Path Analysis with Partial Least Squares, approach to structural equation modeling and multiple regression will be used to test the specified relationships among the model constructs in the proposed model. The proposal also aims to enhance the development of the investigator as a nurse scientist with the advanced clinical and statistical skills needed to investigate the complex interrelationships between physiologic and psychosocial responses to intimate violence. The investigator?s long-term objectives are to develop, refine, and/or expand holistic interventions with the goal of delaying the onset and progression of disease in persons experiencing chronic stress as a result of violence or trauma.