THE INTERACTION OF SEXISM AND HETEROSEXISM IN LESBIAN WOMEN’S EXPERIENCES WITH INTIMATE PARTNER VIOLENCE AND SUBSEQUENT POSTRAUMATIC REACTIONS A Dissertation Presented to The Graduate Faculty at the University of Akron In Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy Taylor L. Ceroni August, 2019 i THE INTERACTION OF SEXISM AND HETEROSEXISM IN LESBIAN WOMEN’S EXPERIENCES WITH INTIMATE PARTNER VIOLENCE AND SUBSEQUENT POSTRAUMATIC REACTIONS Taylor L. Ceroni Dissertation Approved: Accepted: ____________________ _______________________ Advisor Department Chair Dr. Dawn M. Johnson Dr. Paul E. Levy ____________________ _______________________ Committee Member Interim Dean of College Dr. Margo A. Gregor Dr. Linda M. Subich _____________________ _______________________ Committee Member Dean of the Graduate Dr. Ronald F. Levant School Dr. Chand Midha ____________________ Committee Member _______________________ Dr. Suzette L. Speight Date ____________________ Committee Member Dr. John F. Zipp ii Abstract Experiences of oppression and experiences of multiple oppressions have long been linked to psychological distress. Newer research has been conducted looking at the traumatic effects that oppression can have on mental health including PTSD symptom development. The experience of trauma in women and its links to PTSD have also long been studied but there has been no research to date to look at the experiences of lesbian women who experience IPV and how sexism and heterosexism may affect the development of PTSD symptoms. The current study added to the existing literature by exploring the additive and interactional roles that multiple oppressions play in individual’s lives. Specifically, the present study hypothesized additive effects and interactional effects between internalized sexism, internalized heterosexism, externalized sexism, and externalized heterosexism in predicting PTSD symptom severity. Additionally, it was predicted that a moderated moderation would exist, where the relationship between externalized oppression and PTSD symptom severity is moderated by internalized oppression with IPV severity moderating the relationship between internalized oppression and PTSD symptom severity. Participants were 209 lesbian women. Hierarchical regression analysis found support for externalized sexism as a unique predictor for PTSD symptom severity. Implications are discussed. Keywords: sexism, heterosexism, intimate partner violence, PTSD iii DEDICATION I dedicate this work to all sexual minority women. It is my hope that one day we can all love equally and find solidarity in our shared fight for liberation. iv ACKNOWLEDGEMENTS First and foremost, I wish to express my gratitude to Dr. Dawn Johnson, my graduate advisor and mentor. I can’t imagine that I would have been able to accomplish all of this without your endless support, wisdom, and guidance. Thank you, Dawn. My committee members, Drs Margo Gregor, Ronald Levant, Suzette Speight, and John Zipp, I am thankful for all the ways that you helped me to advance my thinking about this study. I would like to recognize the unequivocal support of my cohort members, Kathleen Alto, Maria Pappa, Sarah Sanders, and Rebecca Schlesinger. I am so grateful that you were all a part of this journey. Additionally, I would like to express my gratitude to my internship supervisors at the Southeast Louisiana Veterans Health Care system, Drs Julie Arseneau, Laurel Franklin, Michelle Hamilton, Amanda Raines, and Karen Slaton, your support and confidence in me has been invaluable to me completing this project. Thank you for giving me a home in New Orleans. To my internship cohort member, Chelsea Ennis, I wish to express my heartfelt appreciation for all of your support and friendship. Thank you for always knowing when to push me and when to distract me. To my longtime friend, Ashlee Fielding, there’s nothing I could accomplish without you, including this. Lastly, to my parents, thank you for always telling me that I could be anything I wanted, including a doctor one day. v TABLE OF CONTENTS Page LIST OF TABLES………………………………………………………………………iv LIST OF FIGURES……………………………………………………………………....x CHAPTER I. INTRODUCTION……………………………………………………………...1 II. A REVIEW OF THE LITERATURE…………………………………………20 Oppression as Trauma…………………………………………………………20 Sex-related Trauma, Sexism as Trauma, and Posttraumatic Reactions……..…28 Heterosexism, Heterosexism as Trauma, and Posttraumatic Reactions……….37 Intimate Partner Violence……………………………………………………...51 Theorizing Multiple Oppressions……………………………………………...53 Research Aims and Hypotheses..……………………………………………....72 III. RESEARCH METHODS……..………………………………………………..77 Participants……………………………………………………………………...77 Measures…………………………………………………………………..........79 Procedures……………………………………………………………………....96 Analytic Plan…………………………………………………………..………..97 IV. RESULTS……………………………………………………………………..105 Data Screening and Missing Data…………………………………………….105 Descriptive Statistics………………………………………………………….107 vi Hypothesis 1…………………………………………………………………..108 Hypothesis 2…………………………………………………………………..109 Hypothesis 3…………………………………………………………………..109 Hypothesis 4…………………………………………………………………..110 Hypothesis 5…………………………………………………………………..111 Hypothesis 6…………………………………………………………………..111 V. DISCUSSION…………………………………………………………………113 Hypothesis 1…………………………………………………………………..114 Hypothesis 2…………………………………………………………………..120 Hypothesis 3…………………………………………………………………..125 Hypothesis 4…………………………………………………………………..128 Hypothesis 5…………………………………………………………………..129 Hypothesis 6…………………………………………………………………..129 Clinical Implications…………………………………………………………..131 Implications for Counseling Psychology……………………………………...134 Strengths, Limitations and Future. Directions………………………………...136 Conclusions…………………………………………………………………...144 REFERENCES………………………………………………………………………....146 APPENDICES………………………………………………………………………….208 APPENDIX A. DEMOGRAPHIC QUESTIONNAIRE……………………………...208 APPENDIX B. PTSD CHECKLIST FOR THE DSM-5……………………………...209 APPENDIX C. THE SEVERITY OF VIOLENCE AGAINST WOMEN SCALE..…211 APPENDIX D. SCHEDULE OF SEXIST EVENTS….……………………………...213 vii APPENDIX E. THE HETEROSEXIST HARASSMENT, DISCRIMINATION, AND REJECTION SCALE………………………………………………………………….216 APPENDIX F. LESBIAN INTERNALIZED HOMOPHOBIA SCALE….………….218 APPENDIX G. THE INTERNALIZED MISOGYNY SCALE…………………...….221 APPENDIX H. INFORMED CONSENT…………………………………………….223 APPENDIX I. INSTITUTIONAL REVIEW BOARD APPROVAL FOR HUMAN SUBJECTS RESEARCH……………………………………………………………..224 viii LIST OF TABLES Table Page 1. Conceptual Interactions of Predictors…………………………………………195 2. Demographics……………………………...………………...…………….......196 3. Correlations Amongst Main Variables……….……..……….…………….......198 4. Descriptive Statistics for Main Variables……………………….………...…...199 5. Hierarchical Regressions – Hypothesis 1………………….……………...…...200 6. Hierarchical Regressions – Hypothesis 2…………………….……………......201 7. Hierarchical Regressions – Hypothesis 3……………………….……………..202 8. Hierarchical Regressions – Hypothesis 4………………….…………………..203 9. Moderated Moderators – Hypothesis 5……………….……………………….204 10. Moderated Moderators – Hypothesis 6……….…………….…………………205 ix LIST OF FIGURES Figure Page 1. Conceptual Model – Moderated Moderation of Sexism………………………206 2. Conceptual Model – Moderated Moderation of Heterosexism………………..207 x Chapter I INTRODUCTION Oppression is a pervasive and insidious daily occurrence for many individuals with minority statuses. Oppression has been defined in multiple ways over time with the common theme that there is a dominant group and a non-dominant group, with the dominant group keeping needed resources away from the non-dominant group (Bartky, 1990; Mar’i, 1988; Sidanius, 1993; Young, 1990). Bartky (1990) in particular, viewed oppression as not just the dominant group retaining control politically and economically but also psychologically. Bartky (1990) purported that oppression is not purely political or purely psychological but that the political and psychological nature of oppression are inherently linked. Oppression is inherently a state as well as a process of domination by a majority group but also, the insidious psychological control of subjugation of a marginalized group, who believe that they are less than the majority group, deserving of less resources, and ultimately deserving of the oppression they are experiencing (Bartky, 1990; Prilleltensky & Gonick, 1996). Thus, oppression can be defined as “a state of asymmetric power relations characterized by domination, subordination, and resistance, where the dominating persons or groups exercise their power by restricting access to material resources and by implanting in the subordinated persons or groups fear or self- 1 deprecating views about themselves” (Prilleltensky & Gonick, 1996, pp. 129-130). The current study aimed to better understand the additive and interactional perspectives in the experiences of sexism and heterosexism in lesbian women. Research on oppression has shown the links between the experience of oppression and negative mental health consequences, including but not limited to posttraumatic stress disorder (PTSD; Balsam, 2003; Bryant-Davis & Ocampo, 2005; Carter, 2007; Carter, Forsyth, Mazzula, & Williams, 2005; Neisen, 1993; Root,1992; Sanchez-Hucles, 1998; Szymanski & Balsam, 2011) and argue for a change in the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders (2013; DSM-5) in the diagnostic criteria for PTSD to include experiences of oppression. Less is known about how the traumatic experience of oppression, multiple