The Trauma and Mental Health Impacts of Coercive Control: A Systematic Review and Meta-Analysis
Abstract
Background
Objectives of the Present Study
Method
Registration and Protocols
Literature Search Strategy
Inclusion Criteria
Quality Assessment
Data Extraction and Coding
Data Analyses
Results
Search Results
Description of Studies
Study | Country | Study Type | Recruitment | Sample | Age Range (M; SD) | Type | IPV Measures | Mental Health Constructs and Measures | |||
---|---|---|---|---|---|---|---|---|---|---|---|
Coercive control | Psychological | Physical/sexual | Constructs | Measures | |||||||
*Ahmad et al. (2018) | Malaysia | CS | Com: Post-natal health care facilities | 5,727 w | ≥18 | CC | WHOMCS-CC items | WHOMCS | WHOMCS | Postnatal depression | EPDS (Malaysian) |
Alexander et al. (2019) | USA | CS | Com: Community support services | 188 w | 18–24 (21.3; 2.2) | RC | 10-items (Miller et al., 2010) | PTSD, depression | PCPTSD, CESD-SF | ||
*Anderson (2008) | USA | CS 2nd | Com: NVAWS national survey | 4,575 w | 18–88 | CC | NVAWS-CC items | PTSD, depression | IES (adapted), NVAWS 8 depression items | ||
Anderson et al. (2017) | USA | CS | Com: HIV clinic | 67 w | 18–45 | RC | 10-items (Miller et al., 2010) | PTSD, depression | PCL-C, CESD | ||
Basile et al. (2004) | USA | CS—2nd | NVAWS: IPV subgroup | 380 w | <18 (40) | ST | NVAWS-ST Items |
NVAWS verbal abuse + CC |
CTS | PTSD | IES (adapted) |
*Beck et al. (2011) | USA | CS | IPV survivors—university research clinic | 63 w | 18–64 (36.75; 11.62) | CC | PMWI-DI | PMWI-EV | Interview devised by authors | PTSD | CAPS for DSM-IV |
*Broughton and Ford-Gilboe (2017) | Canada | LO—2nd | IPV—subsample from WHES | 157 w | 20–64 (40.6; 9.6) | CC | WEB | Depression | CESD | ||
*BubriskiMcKenzie and Jasinski (2013) | USA | CS 2nd | Com: IPV sample CWHRS | 705 w | ≥18 Bl: (31.07; 9.46) His: (29.08; 7.79 |
CC | CWHRS Power and Control Scale | CTS2 | PTSD, Depression | PSS-I CWHRS-based on MOS | |
Coker et al. (2002) | USA | CS—2nd | Com: NVAWS national survey | 6,790 w 7,122 m | 18–65 | CC | NVAWS-CC items | NVAWS-verbal abuse | CTS | Depression Drug and Alcohol Use | SF-36 NVAWS Drug and Alcohol items |
*Damra and Abujilban (2021) | Jordan | CS | Com: hospital gynecology/obstetric service | 300 w | 18–49 (32; 6.4) | CC | WHOMCS-CC items | WHOMCS | WHOMCS | Depression | BDI for Jordanian culture |
*Dokkedahl et al. (2021) | Denmark | CS | Shelter | 147 w | ≥18 (34.6; 10.1) | CC | PMWI-DI | PMWI-EV | CTS2 | PTSD | ITQ, HTQ, TSC-26 |
*Dutton and Painter (1993) | Canada | LO | IPV—shelters, support programs | 75 w | ≥18 (31.4) | PMWI-DI | PMWI-EV | CTS | PTSD | TSC-33 | |
Dutton et al. (1999) | USA | CS | DV support service | 149 w | 18–58 (30) | CC | PMWI-DI | PMWI-EV | CTS2 | PTSD, Depression | PSS-SR, CESD |
*Emery et al. (2019) | South Korea | CS | Com | 462 w | ≥18 | CC | NVAWS-CC items | Alcohol Use | CAGE | ||
Fleming et al. (2012) | USA | CS | Com | 192 w | ≥18 (55.04; 3.92) | ST | NVAWS-ST items | CTS2 | CTS2 | PTSD | PCL-C |
*Gibbs et al. (2018) | South Africa | CS | Com | 677 w | 18–30 (23.7) | EA | WHOMCS-CC | WHOMCS | Depression Suicidal Ideation | CESD SI: 1-item |
|
Gou et al. (2019) | Canada | LO | Com | 98 w 98 m |
≥18 w: (29.98; 5.49) m: (32.03; 5.51) | CC | PMWI-DI | CTS2 | CESD | ||
Grace et al. (2020) | USA | CS | University students | 354 w | ≥18 (20.88; 2.31) | CC, RC | 2 RC questions CAS |
CAS | CAS | Depression Drug and Alcohol Use |
CESD-R MFDAQ |
*Groves et al. (2012) | South Africa | CS | Com: HIV | 1,500 w | ≥18 (27.29; 5.36) | CC | SRPS | adapted WHOMCS |
adapted WHOMCS |
Depression, Anxiety | HSCL-25 |
Hardesty et al. (2019) | USA | LO | Com: mothers who filed for divorce | 135 w | 20.83–53.92 (35.22; 7.02) | CC | PMWI-DI | CTS2 | PTSD, Depression |
PCL-C-SF CESD-SF |
|
Hayes and Kopp (2020) | USA | CS—2nd | Com: National NISVS | 7,433 w 6266 m |
≥18 | CC RC | Number of CC, RC past year | Number of psych. IPV past year | Number of physical IPV past year | Mental Health | Self-rated |
*Hazen et al. (2008) | USA | CS | Com: Healthcare service users | 282 w | 18–45 (27.74; 7.12) | CC | PMWI-DI-SF | PMWI-EV-SF | CTS2 | Depression, Anxiety | BSI |
*Hedin and Janson (1999) | Sweden | CS | Com: Antenatal clinics | 207 w | 18–35 (29.5, 4.5) | CC | PMWI-DI | PMWI-EV | SVAWS | PTSD, Anxiety | TSC-33 STAI |
*Hines and Douglas (2011) | USA | CS | IPV support services (help-seeking group), Com |
822 m (302 IPV 520 com) | 18–59 IT: (40.49; 8.97) Com: (43.68; 10.88) |
CC | PMWI-DI | CTS2 | CTS2 | PTSD | PCL-C |
*Hines and Douglas (2012) | USA | CS | IPV services (help-seeking group), Com | 822 m (302 IPV 520 Com) |
18–59 help-seek. (40.49; 8.97) Com: (43.68; 10.88) |
CC | PMWI-DI | CTS2 | CTS2 | Drug and Alcohol Use | NWS Alcohol and Drug Use scale |
*Hines and Douglas (2018) | USA | CS | IPV support services (help-seeking group), Com |
2,212 m (611 IPV, 1601 Com) |
18–59 IPV: (43.89; 9.18), Com: (41.77; 11.35) |
CC | PMWI-DI | CTS2 | CTS2 | PTSD, Depression | PCL-C, CESD |
*Ireland et al. (2017) | Australia | CS | Com: LGBTI | 287 LGBTI w and m | ≥18 (34.8; 11.2) | CC | MMEA (extended 44 items) | MMEA (extended 44 items) |
MMEA (extended 44 items) |
PTSD, Depression, Anxiety | PCL-C-SF, HAD |
*Johnson and Leone (2005) | USA | CS—2nd | Com: NVAWS national survey |
4,967 w (81 IT) |
18–97 (44.55; 13.89) | CC | NVAWS-CC items | 12-items adapted from CTS | PTSD, Depression | IES (adapted), 8-items depression scale (based on SF-36) | |
Johnson et al. (2014) | USA | CS—2nd | Com: NVAWS national survey | 7,782 w 6,908 m |
18–97 (46.91; 15.67) | CC | 12-items CC-Scale like PMWI | 12-items adapted from CTS | Depression | 8-items depression scale (based on SF-36) | |
*Jones (2020) | USA | CS | Prison | 337 w | 18–65 | CC | based on CCMIPV | PTSD | PCL-C | ||
*Jones et al. (2005) | USA | CS | DV services, medical and com | 172 w | 18–40 | CC | PMWI-DI-SF | PMWI-EV-SF, SOSPS | PTSD, Depression, Anxiety | PSDSWB BDI, BAI | |
*Kapiga et al. (2017) | Tanzania | CS | Com | 1,021 w | 19–70 | CC, EA | WHOMCS-CC, EA items | WHOMCS | WHOMCS | Mental Health | SRQ-20 |
*Lawrence et al. (2009) | USA | LO | Com: married couples | 103 w 103 m |
18–55 w: (25; 4.3) m: (26.4; 4.7) | CC | MMEA-RE | MMEA-total | Depression, Anxiety | BDI-II, BAI | |
*Leone (2011) | USA | CS 2nd | CWHRS abused women subsample | 369 w | ≥18 (31; 9.62) | CC | PCS | PTSD, Depression, Suicidality |
PSS-I, MOS-4 items SI + SA combined 1item | ||
*Levine and Fritz (2016) | Canada | CS | Shelter | 51 w | 19–58 (37) | CC | CBS-R | CTS2 | PTSD, Depression | PCL-C, BDI-II |
|
*Lovestad et al. (2017) | Sweden | CS | Com: population sample | 573 w | 18–65 (42.7: 13.01) | CC | CBS-isolating control | WHOMCS | WHOMCS | Depression | self-report of 5 DSMIV indicators |
*Ludermir et al. (2010) | Brazil | CS | Com: pregnant women from a family health program | 1,045 w | 18–49 | CC | WHOMCS-CC | WHOMCS | WHOMCS | Postnatal Depression | EPDS |
*Ludermir et al. (2010) | Brazil | CS | Com: pregnant women from a family health program | 1,045 w | 18–49 | CC | WHOMCS-CC | WHOMCS | WHOMCS | Postnatal Depression | EPDS |
Ludermir et al. (2014) | Brazil | CS | Com: pregnant women from a family health program | 1,120 w | 18–49 | CC | WHOMCS-CC | WHOMCS | WHOMCS | Mental Health | SRQ-20 |
McCauley et al. (2014) | Cote d'Ivoire | CS | Com | 953 w | ≥18, (37.4) | RC | Based on Miller et al. (2010) | PTSD | HTQ | ||
Mechanic et al. (2000) | USA | CS | DV support services | 114 w | 19–59 (35; 7.9) | (CC) ST |
SBC (PMWI-DI) | PMWI-EV | CTS2 | PTSD, Depression | PDS, BDI-II |
*Mechanic et al. (2008) | USA | CS | DV support services | 413 w | 18–62 (34.5; 8.1) | CC, ST | PMWI-DI, SBC | PMWI-EV | PTSD, Depression | PDS, BDI-II | |
Mutiso et al. (2020) | Kenya | CS | Com: Healthcare services | 5,448 w 2,862 m |
18–60+ | CC | WHOMCS-CC items |
WHOMCS | WHOMCS | Mental Health | MINI Plus |
Newton (2021) | USA | CS | Com | 69 w | ≥18 (54.53; 3.19) | CC | PMWI-DI-SF | PMWI-DI-SF | CTS2 | PTSD—peritraumatic emotions | CAPS for DSM-IV |
*Nielsen et al. (2016) | USA | CS | Com: Coparenting | 147 w | 20–54 (35.2) | CC | PMWI-DI-SF | PMWI-EV-SF | CTS2 | PTSD, Depression | PCL, CESD-SF |
*Norwood and Murphy (2012) | USA | CS 2nd | DV support services | 216 w | 18–70 (34.0, 10.1) | CC | MMEA-RE | MMEA-total | CTS2 | PTSD | PCL-C-IPV |
*Nnawulezi and Murphy (2019) | USA | CS | DV support services (archival data) | 228 w | 18–70 (34.23; 10.09) | CC | MMEA-RE | MMEA-total | CTS2 | PTSD | PCL-C-IPV |
*Ogunbajo et al. (2020) | Nigeria |
CS |
Com |
389 m |
≥18 |
CC |
IPV-GBM monitoring controlling |
IPV-GBM |
IPV-GBM |
Depression, Suicidality, Anxiety |
CESD SI-1-item, SA-1-item GAD-7 |
Peltzer et al. (2013) | South Africa | CS | IPV survivors who obtained a protective order | 268 w | 18–62 (28.8; 8.0) | ST | SVS, 10 items from HARASS |
SVAWS | SVAWS | PTSD, Depression Alcohol Use | PCL-C, CESD AUDIT-C |
*Petra (2020) | USA | CS | Com | 222 w | 24–63 (33) | CC | MASIC-CC subscale | WAST | Depression, Anxiety | DASS-21 | |
*Pickover et al. (2017) | USA | CS | IPV survivors, mental health research clinic | 284 w | ≥18 (37.84; 12.08) | CC | PMWI-DI-SF | PMWI-EV-SF | CTS2 | PTSD, Anxiety | LEC, IPV-related DSMIV-TR, ADIS-IV |
Postmus et al. (2012) | USA | LO | Com | 2,305 w | ≥18 (25.8; 6.1) |
EA | Any EA in year 1 | Any psych. IPV in year 1 |
Any physic. IPV in year 1 |
Depression | CIDI-SF |
Prospero (2008) | USA | CS | University students | 609 (361 w, 248 m) |
≥18 (21.44; 4.58) | CC | CBS-R | CTS2 | CTS2 | Mental Health | SQ |
Prospero (2009) | USA | CS | University students | 573 (332 w, 241 m) |
≥18 (21.4; 4.37) |
CC | CBS-R | CTS2 | CTS2 | Mental Health | SQ |
*Prospero and Kim (2009a) | USA | CS | University students | 560 (325 w, 235 m) |
≥18 (21.4; 4.37) |
CC, EA | CBS-R | CTS2 | CTS2 | Depression, Anxiety | SQ |
Prospero and Kim (2009b) | USA | CS | University students | 676 (419 w, 257 m) |
≥18 (21.6; 4.66) |
CC, EA | CBS-R | CTS2 | CTS2 | Mental Health | SQ |
*Reich et al. (2015) | USA | CS | IPV survivors—mixed recruitment | 105 w | ≥18 (36.94;12.68) | CC | PMWI-DI-SF | PMWI-EV-SF | CTS2 | PTSD | CAPS for DSM-IV |
*Sackett and Saunders (1999) | USA | CS | DV support services | 60 w | ≥18 (34.7; 9.1) | CC | PPA-JC |
PPA | Depression, Anxiety | BDI 6-item Anxiety Scale |
|
Sauber and O'Brien (2020) | USA | CS | DV support services, community | 147 w | ≥18 (34.7; 9.1) |
EA | SEA-12 | ABI | ABI | PTSD, Depression | PCL-C, CESD |
Strauss et al. (2019) | USA | CS | University students | 357 (290 w, 67 m) |
18–25 (18.64; 1.13) | ST | 32-item validated ST measure | Alcohol and Drug Use | AUDIT DUDIT | ||
*Street and Arias (2001) | USA | CS | Shelter | 63 w | 19–64 (32) | CC | PMWI-DI | PMWI-EV | CTS | PTSD, Depression | CMS, SCL-90-R |
Stylianou (2018) | USA, Puerto Rico | LO | DV support services | 457 w | ≥18 (36; 9.15) |
EA | SEA-12 | ABI-R | ABI-R | Depression | CESD |
*Taft et al. (2005) | USA | LO | Partners of IPV perpetrator group program participants | 96 w | 18–59 (34.0; 8.6) | CC | MMEA-RE | MMEA-total | CTS | PTSD | DIS for DSM-III |
*Tiwari et al. (2015) | Hong Kong | CS | DV support services | 613 w | ≥20 | CC | CBS-R (Chinese) | C-AAS | PTSD, Depression | PCL-C (Chinese) BDI-II (Chinese) | |
Voth Schrag et al. (2019) | USA | CS | University students | 435 w | ≥18 (27; 9.9) | EA | SEA-12 | ABI-R | PTSD, Depression |
PCL-5 LEC-5, CESD-SF |
|
*Weaver and Etzel (2003) | USA | CS | DV support services | 62 w | ≥18 (34; 8.4) | CC | PMWI-DI-SF | PMWI-EV-SF | CTS2 | PTSD, Depression * | PDS, BDI-II |
Wolf et al. (2018) | Denmark | CS | ST support services, groups | 196 w | 27–70 (40.82; 6.93) | ST | SBC | PMWI | PTSD | HTQ, TSC-33 | |
*Wolford-Clevenger et al. (2017) | USA | CS | University students | 208 (107 w, 101 m) |
18–29 (19.61; 11.09) | CC | MMEA-RE | MMEA | CTS2 | Depression, Suicidal Ideation | PDSQ |
*Wolford-Clevenger and Smith (2017) | USA | CS | Shelter | 134 w | 19–67 (32.50; 8.21) | CC | CIPRS | CTS2 (modified) | PTSD, Depression, Suicidal Ideation and Attempts | PCL-C, DASS-21 SI: MSSI SA: L-SASI |
Coercive Control Measures
Mental Health Measures
Quality Assessment
Meta-Analyses
Association | Studies k | Effect Sizes k | r | 95% CI | I2 (%) | ||||
---|---|---|---|---|---|---|---|---|---|
Total | Women | Men | Both | Range | Mean | ||||
PTSD | |||||||||
Coercive control | 30 | 31 | 28 | 2 | 1 | −.08 to .56 | .32* | [.28, .37] | 71.77* |
Psychological IPV | 19 | 19 | 17 | 1 | 1 | −.15 to .64 | .34* | [.25, .42] | 88.48* |
Depression | |||||||||
Coercive control | 35 | 38 | 31 | 3 | 4 | −.09 to .59 | .27* | [.22, .31] | 87.20* |
Psychological IPV | 18 | 19 | 15 | 2 | 2 | −.08 to .60 | .33* | [.26, .40] | 85.45* |
Coercive Control, PTSD, and Depression
Subgroup analyses
Psychological IPV, PTSD, and Depression
Publication Bias
Discussion
Limitations
Conclusion
• Coercive control exposure was moderately associated with PTSD and depression symptom severity • The strength of these associations was comparable to those involving measures of broader psychological IPV The strength of these associations was comparable to those for physical IPV found in previous meta-analyses |
Implications
Implications for Clinical Practice
Implications for Research
Implications for Policy and Legislation
Implications for Clinical Practice • Coercive control exposure is linked to PTSD and depression, suggesting long-term mental health implications that require mental health support • Trauma-informed interventions are needed to support long-term recovery • A stronger link between coercive control and PTSD in domestic violence service/shelter settings suggests a need to include short-term trauma-informed mental health care in crisis response services • Clinicians need to be trained and supported so that they can provide effective short- and long-term care. Implications for Research • Coercive control is difficult to capture in most commonly used psychometric measures and more comprehensive measures of coercive control need to be used in primary studies • Research into the development of more specific coercive control measures is needed • Qualitative research approaches may be well suited to address the nuances in behaviors, such as verbal threats, to determine if they occur within the context of situational couple violence or coercive control. • There is lack of empirical studies that have investigated the relationship between coercive control and CPTSD, and more research is needed • More research in developing countries is needed • More research with gender diverse samples is needed Implications for Policy and Legislation • The mental health impacts of coercive control need to be considered in policies and legislations surrounding the criminalization of coercive control Funding for trauma-informed mental health care that supports the long-term recovery of those who have been exposed to coercive control is needed |
Declaration of Conflicting Interests
Funding
ORCID iD
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