Intimate Partner Violence, Trauma and Decision Making Resources

Lerner, C., Kennedy, L. (2000). Stay-leave decision making in battered women: Trauma, coping and self-efficacy. Cognitive Therapy and Research, 24(2), 215- 232.

As many as 80% of women who experience domestic violence meet the diagnostic criteria for Post Traumatic Stress Disorder. The traumatic process has an effect on the victim’s cognitive processes and functioning including cognitive appraisals, cognitive schemas, symptom expression, and resolution as well as behavioral action.

Passive and avoidant coping strategies, seen as adaptive responses to danger, may have negative effects on decision making ability.

The time period 6 months after leaving the relationship was found to be particularly vulnerable for deciding to return. This was seen as the most psychologically intense and vulnerable time: the victim has low confidence about the initial decision to leave, demand on coping resources is high and trauma symptoms such as sleep problems, depression and dissociation are high.

Kyspin-Exner, I., Lueger-Schuster, B., Moser, E., Robinson, S. Posttraumatic Stress Disorder (PTSD) and Decision-Making - Neural Correlates and Possible Therapeutic Effects. Downloaded 6/1/10 from http://brl.psy.univie.ac.at/research/decisions/

Decision-making is a complex process that requires identifying alternatives, evaluating their probability and estimating their consequences. Numerous studies have shown that this process can be biased by background moods and emotions of the deciding individual. However, delaying decisions until one is cool and collected is not possible in some pathological states with affects being altered in the long term. This is the case in posttraumatic stress disorder (PTSD). Its symptoms include disturbances of attention, memory, cognition, and impaired problem-solving - all components of efficient decision-making. PTSD patients also exhibit altered brain activation in regions involved in decision-making, the anterior cingulate (ACC), orbitofrontal and dorsolateral prefrontal cortices. Thus, decision-making is likely to be impaired in PTSD. Ortiz, Maria. (2008). Healing the Trauma of Post Traumatic Stress Disorder in Battered Women. PowerPoint Presentation. Relationship Training Institute. Downloaded on 6/1/10 from www.RTIprojects.org.

Power of Non-negative Thinking: . The importance of being rational - Try not to make major decisions in high emotional states - Decisions that lead to relief from negative feelings (i.e., guilt) are usually not logical - Sample of logic in many battered women: “I feel sorry for him. He misses me. He’s falling apart. He says he will never do it again. Maybe I should go back and give him another chance.” - More effective to ask: “What is in my best interest? What if he hits me again in front of the children?” - CONCLUSION: Decision driven by emotional impulses are never in your best interest.

When Self-Advocacy is Lacking: . Placing other people’s wants ahead of your own . Unassertiveness and tolerance of disrespect . Decision making is based on beliefs of obligation (“supposed to,” “should,” “have to”) . Inability to deal with hostility . Negative self talk

Kubany, E., Hill, E., Owens, J. (2003). Cognitive trauma therapy for battered women with PTSD. Journal of Traumatic Stress, 16(1), 81-91.

Cognitive Trauma Therapy for battered Women (CTT-BW) modules covered in the latter sessions focus on self-advocacy and empowerment and include (a) training in how to differentiate between assertive and aggressive speech and how to be assertive in response to verbal aggression, (b) how to identify potential perpetrators, (c) how to respond to telephone and face-to-face harassment by former partners, and (d) psycho-education on self-advocacy strategies in five areas of functioning (e.g., getting personal needs satisfied as a top priority; decision making that promotes self-interests; standing up for one’s rights).