Social Reactions to IPV Disclosure and PTSD Symptom Severity: Assessing Avoidant Coping as a Mediator

Given the high prevalence rates of PTSD among IPV-victimized women (Golding, 1999), it is important for research to pinpoint specific factors that influence PTSD symptom severity in this population. Prior literature suggests that the types of social reactions women experience following IPV disclosure may be associated with their PTSD symptom severity (Edwards et al., 2015; Flicker et al., 2012; Levendosky et al., 2004). The goal of this study was to extend research by examining the potential mediating role of avoidant coping in this association. In the current study, IPV-victimized women who reported greater negative social reactions to IPV endorsed higher levels of avoidant coping and greater PTSD symptom severity. Moreover, avoidant coping was found to mediate the associations between negative social reactions to IPV disclosure and PTSD symptom severity, such that negative social reactions to IPV disclosure were related to higher levels of avoidant coping, which in turn predicted greater PTSD symptom severity. These findings provide further support for a link between negative social reactions to IPV disclosure and PTSD symptom severity, as well as underscore the underlying role of avoidant coping in this association.

One key finding was that avoidant coping was found to mediate the relation between negative social reactions to IPV disclosure and PTSD symptom severity. This result highlights avoidant coping as one potential target for prevention and intervention efforts aimed at reducing PTSD symptom severity among IPV-victimized women. Specifically, our findings suggest that treatments aimed at reducing avoidant coping, such as emotion regulation group therapy (Gratz, Tull, & Levy, 2014), which teaches women approach and distraction strategies to replace avoidant strategies, may attenuate the link between negative social reactions to IPV disclosure and PTSD symptom severity. It is also important that potential disclosure recipients be taught how to avoid negative reactions to victims’ disclosures of IPV. Indeed, the recently Supporting Survivors and Self (SSS) intervention was developed to teach informal supports how to respond in ways that are positive and not negative (Edwards & Ullman, 2016). Moreover, the SSS intervention teaches informal supports how to cope with their own distress in nonavoidant ways and how to model healthy, nonavoidant coping for victims who disclose to them. Research would benefit from examining whether other dimensions of negative (e.g., victim blame, treat differently) and positive (e.g., tangible aid/information support, emotional support, belief) social reactions to sexual assault disclosure (see Relyea & Ullman, 2015; Ullman, 2000) are relevant to IPV disclosure. Furthermore, although our findings suggest that negative social reactions to IPV disclosure are indirectly related to PTSD symptom severity through avoidant coping, the direct effect of negative social reactions to IPV disclosure on PTSD symptom severity remained significant. This suggests the need for future research that explores other relevant factors that may explain this association.

Although it may seem contradictory that positive reactions to IPV disclosure were not associated with lower levels of avoidant coping or reduced PTSD symptom severity, these findings are not entirely unexpected given mixed findings regarding the influence of positive social reactions to IPV on coping and PTSD symptom severity in the literature (Edwards et al., 2015; Flicker et al., 2012; Levendosky et al., 2004). There may be something qualitatively different about IPV-victimized women who receive more positive social reactions to IPV disclosure. For instance, IPV-victimized women who receive more positive social reactions to IPV disclosure may experience more severe and frequent IPV, and thus these positive reactions may have limited effect on their severity of PTSD symptoms. Indeed, it has been suggested that women who experience more severe assault may be more likely to disclosure this assault to formal and informal supports (Ullman & Peter-Hagene, 2014), and women who disclose assault are more likely to receive both negative and positive reactions from others (Ullman, 2010). Alternatively, Edwards et al. (2015) suggested that positive social reactions may be unrelated to PTSD symptom severity because victims who disclose IPV do so with the anticipation of receiving positive social reactions. Because positive reactions are expected, they may have little impact on PTSD symptom severity, whereas women who disclose experiences of IPV are likely not doing so in anticipation of negative or unhelpful social reactions, which could thus lead to more detrimental impacts than positive social reactions. Along these lines, Littleton (2010) suggested that negative social reactions may be more salient to poor victim adjustment than positive social reactions given that individuals tend to assign more weight to negative judgments and experiences than positive ones. Finally, it has been suggested that positive social reactions to IPV disclosure may be indirectly related to PTSD symptom severity through other factors. For instance, Ullman et al. (2014) found that positive social reactions to sexual assault disclosure predicted greater perceived control over recovery, which in turn was related to lower PTSD symptom severity. Thus, women’s perceptions about their ability to manage their recovery may be key to understanding how positive reactions to assault disclosure relate to PTSD symptom severity. Future research aimed at elucidating the role of perceived control over recovery (and other potential mediators) in the relation between positive reactions to IPV disclosure and PTSD symptom severity among IPV-victimized women is needed.

While this study contributes to the growing body of literature on social reactions to IPV disclosure and PTSD symptom severity, findings must be interpreted in light of its limitations. First, the cross-sectional and correlational nature of the data precludes determination of the precise nature and direction of the relations examined here. For instance, although stress and coping theory would suggest that the types of social reactions that women experience following IPV disclosure are associated with the coping methods they utilize to manage their IPV-related distress (Lazarus & Folkman, 1984), it is also possible that avoidant coping is a precurrsor, not an outcome, of social reactions to IPV disclosure (consistent with suggestions by Sullivan et al., 2010). For example, women who use avoidant coping strategies to manage their victimization may be seen as doing little to resolve their problems and thus be reacted to more negatively. Indeed, Sullivan et al. (2010) found that more severe physical and psychological IPV were related to greater avoidant coping, which in turn was related to greater negative social reactions to IPV disclosure, whereas more severe sexual IPV was related to greater social support coping, which in turn was related to greater positive social reactions to IPV disclosure. Prospective, longitudinal studies are needed to examine the precise nature and direction of the relations among social reactions to IPV disclosure, avoidant coping, and PTSD symptom severity. For instance, studies utilizing experience sampling methods may inform whether negative social reactions to IPV disclosure immediately precede or follow avoidant coping or whether this relation is reciprocal. Second, our study relied exclusively on women’s self-reports, which may be influenced by their willingness and ability to report accurately. Third, the sources to whom IPV-victimized women disclosed were not identified, and future studies might find it useful to differentiate between informal and formal sources of support to gain a more nuanced understanding of how social reaction to IPV disclosure impact IPV-victimized women so that the development of interventions can be more targeted. Fourth, the current study examined the role of one coping strategy—avoidant coping—in the relation between negative and positive social reactions to IPV disclosure and PTSD symptom severity given evidence for a robust association between avoidant coping and PTSD symptoms severity among IPV-victimized women (e.g., Arias & Pape, 1999; Flanagan et al., 2014; Krause et al., 2008; Lilly & Graham-Bermann, 2010). Future research is needed to examine the potential influence of other coping strategies (e.g., cognitive reappraisal, acceptance, social support, religious). Finally, although our focus on IPV-victimized women in an urban community may be considered a strength of this study, our findings cannot be assumed to generalize to other IPV populations (e.g., women in same-sex relationships or shelter settings, men). Given evidence to suggest that bidirectional aggression is the most common pattern of IPV (see Archer, 2000, for a meta-analytic review), it is likely that women—at times—disclosed both victimization and aggression to their social supports. However, very little is known about women’s disclosure of IPV perpetration (in general or in the context of their victimization in particular). It will be important for future studies to assess social reactions to women’s disclosure of IPV perpetration as well as examine whether social reactions to women’s disclosure of IPV perpetration relates to their avoidant coping and PTSD symptom severity. Investigations are also needed to explore the potential role of IPV revictimization on the relations examined here given evidence that women who experience more severe and frequent IPV are more likely to disclose (Sylaska & Edwards, 2014). Finally, we focused on women in heterosexual relationships because (a) the dynamics in homosexual and bisexual IPV-relationships are unique and contradict theories that have been developed in the context of heterosexual relationships (Johnson & Ferraro, 2000) and (b) for victims who are lesbian, gay, bisexual, trans, and queer (LGBTQ), social supports may also be reacting to the stigma of being LGBTQ, which would require specific attention in the design of the study. Future studies should examine the relations among social reactions to IPV, avoidant coping, and PTSD symptom severity among women who identify as LGBTQ.

Despite these limitations, findings of the present study extend previous research on the relation between social reactions to IPV disclosure and PTSD symptom severity. Specifically, results indicate that negative social reactions to IPV disclosure are associated with more severe PTSD symptoms, and that avoidant coping mediates this relation. These findings highlight the critical need for interventions that (a) integrate nonavoidant strategies for managing negative social reactions and (b) target victims’ informal and formal support networks to reduce the extent to which victims receive negative social reactions to IPV disclosures.