PTSD, Cortisol, Immune Function with Battering Over Time

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DESCRIPTION (provided by applicant): The devastating physical and emotional effects associated with intimate partner violence (IPV) affect nearly 1.2 million women in the United States yearly. The first assault is only the beginning of the terror, injuries, and desperation that can continue through a woman's life. Knowledge regarding the dynamic interplay among the physiological and psychological factors affecting the health of women who have experienced violence and trauma is limited, particularly as it relates to repeated traumatic experiences. Most studies of trauma survivor groups are conducted cross-sectionally, yielding much information, but this methodology provides only a single observation in time. Little is known in nursing or other disciplines about how the impact of IPV might affect health over time. The purpose of this study is to examine relationships among IPV, childhood maltreatment, resilience, and posttraumatic stress disorder (PTSD) on health outcomes, including self-report physical health, diurnal adrenocortical hormones, and immune function in 156 battered women from shelters and the community over 24-months. A predictive-explanatory design will be employed to test a model of these relationships and address three research objectives: 1) to test the cross-sectional fit of the model and identify possible mediating and moderating paths, 2) to longitudinally examine patterns of relationships among diurnal adrenocortical hormones, immune function and PTSD, and 3) to longitudinally test the fit of the full model. Structural equation modeling (SEM) will be used to model the cross-sectional and longitudinal relationships between model constructs and growth curve modeling will be used to examine trajectories of change in PTSD, diurnal adrenocortical hormones, and immune function over 24-months. Exploratory analyses will be used to identify predictors of individual patterns of change. This study will increase knowledge regarding the relationships between psychosocial and physiologic responses to trauma and their impact on women's health over time. Findings will provide a theoretical foundation upon which to develop nursing interventions directed towards the prevention and reduction of long-term physical and mental health consequences of IPV.