Religious and spiritual factors in intimate partner violence have received increasing attention. But are such factors related to outcomes in violent relationships? The purpose of this study was to assess the relative impact of spiritual symptoms and religious coping on attitudinal/behavioral and clinical outcomes among women in violent relationships.
Methods
Adult women with a recent history of husband-to-wife physical abuse were recruited from six primary care clinics. Once enrolled, 200 subjects completed a baseline interview and daily assessment of level of violence, using the Interactive Verbal Response for 12 weeks. At the completion of the study, contact with each participant was attempted to determine whether she had either sought professional help or left the relationship. Three religious/spiritual variables were assessed at baseline—number of visits to a religious/spiritual counselor, religious coping, and severity of spiritual symptoms. Stepped multiple linear regression was used to explain factor-analyzed outcomes (coping and appraisals, hope and support, symptomatology, functional status, readiness for change, and medical utilization), adjusting for demographic, marital, childhood, mental health, and violence variables.
Results
After controlling for duration, severity and dynamics of violence, the use of spiritual resources, and the level of spiritual symptoms were associated with most attitudinal/behavioral and clinical outcomes, while religious coping was only associated with staying in the relationship.
Conclusions
Religious and spiritual factors were associated with most outcomes. Spiritual symptoms had a consistently negative effect on outcomes while use of spiritual resources had variable effects. Religious coping was only associated with refraining from leaving the relationship.
HotalingGTSugarmanDB. Analysis of risk markers in husband to wife violence: the current state of knowledge. Violence Vict1986; 1: 101–123.
2.
KaterndahlDAObregonML. Exploration of the spiritual and psychosocial variables associated with husband-to-wife abuse and its effect on women in abusive relationships. Int J Psychiatry Med2007; 37: 113–128.
3.
VakiliMNadrianHFathipoorM. Prevalence and determinants of intimate partner violence against women in Kazeroon, Islamic Republic of Iran. Violence Vict2010; 25: 116–127.
4.
HeinrichHA. Relationship of religion to beliefs about physical punishment and physical abuse. Dissert Abstr Intl: Section B: Sci Eng2009; 70: 7210.
5.
Pournaghash-TehraniSEhsanHBGholamiS. Assessment of the role of religious tendency in domestic violence. Psychol Rep2009; 105: 675–684.
6.
AntaiDEAntaiJB. Attitudes of women toward intimate partner violence. Rural Remote Health2008; 8: 996.
7.
RodriguezCMHendersonRC. Who spares the rod?Child Abuse Negl2010; 34: 84–94.
8.
JacksonDS. Examination of social risk factors for wife abuse in the Dominican Republic. Fam Ther2008; 35: 1–22.
BrinkerhoffMBGrandinELupriE. Religious involvement and spousal violence. J Sci Study Relig1992; 31: 15–31.
11.
EllisonCGAndersonKL. Religious involvement and domestic violence among U.S. couples. J Sci Study Relig2001; 40: 269–286.
12.
EllisonCGBartkowskiJPAndersonKL. Are there religious variations in domestic violence?J Fam Issues1999; 20: 87–113.
13.
SeballoYB. Religion as a protective factor in resilience. Dissert Abstr Intl: Section B: Sci Eng2012; 73: 654.
14.
BerkelLAVandiverBJBahnerAD. Gender role attitudes, religion, and spirituality as predictors of domestic violence attitudes in white college students. J College Student Dev2004; 45: 119–133.
15.
FowlerDNRountreeMA. Exploring the meaning and role of spirituality for women survivors of intimate partner abuse. J Pastoral Care Counsel2010; 64: 1–13.
16.
ReilandSLauterbachD. Effects of trauma and religiosity on self-esteem. Psychol Rep2008; 102: 779–790.
17.
JesseDESwansonMS. Risks and resources associated with antepartum risk for depression among rural southern women. Nurs Res2007; 56: 378–386.
18.
DervicKGrunebaumMFBurkeAK. Protective factors against suicidal behavior in depressed adults reporting childhood abuse. J Nerv Ment Dis2006; 194: 971–974.
19.
ConwayK. Coping with the stress of medical problems among black and white elderly. Int J Aging Hum Dev1985; 21: 39–48.
20.
KoenigHGGeorgeLKSieglerIC. Use of religion and other emotion-regulating coping strategies among older adults. Gerontologist1998; 28: 303–310.
21.
WebbMWhitmerKJ. Abuse history, world assumptions and religious problem solving. J Sci Study Relig2001; 40: 445–453.
22.
ReinertDFSmithCE. Childhood sexual abuse and female spiritual development. Couns Values1997; 41: 235–245.
23.
RyanPL. An exploration of the spirituality of fifty women who survived childhood violence. J Transpersonal Psychol1998; 30: 87–102.
StrausMGellesRSteinmetzS. Behind closed doors, New York, NY: Anchor Books, 1980.
26.
KaterndahlDARealiniJP. Use of health care services by persons with panic symptoms. Psychiatr Serv1997; 48: 1027–1032.
27.
CarverCSScheierMFWeintraubJK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol1989; 56: 267–283.
28.
KaterndahlDOyiriaruD. Assessing the biopsychosociospiritual model in primary care. Int J Psychiatry Med2007; 37: 393–414.
29.
HerthKA. An abbreviated instrument to measure hope. J Adv Nurs1992; 17: 1251–1259.
30.
VitalianoPP. Manual for appraisal dimension scale and revised ways of coping checklist, Seattle: Department of Psychiatry, University of Washington, 1985.
31.
Duke University. Duke social support and stress scale, Durham: Duke University, 1986.
32.
BrownJBAdamsME. Patients as reliable reporters of medical care process. Med Care1992; 30: 400–411.
33.
WareJEJrSherbourneCD. The MOS 36-item short form health survey (SF-36), I. Conceptual framework and item selection. Med Care1992; 30: 473–483.
34.
ProchaskaJODiClementeCCToward a comprehensive model of change. In: MillerWRHeatherN (eds). Treating addictive behaviors, New York, NY: Plenum Press, 1986.
35.
GlasgowREOryMGKlesgesLM. Practical and relevant self-report measures of patient health behaviors for primary care research. Ann Fam Med2005; 3: 73–81.
36.
HegglerRKantzHSchreiberT. Practical implementation of nonlinear time series methods: the TISEAN package. Chaos1999; 9: 413.
37.
KreindlerDMLumsdenCJ. Effects of the irregular sample and missing data in time series analysis. Nonlinear Dyn Psychol Life Sci2006; 10: 187–214.
38.
KreindlerDMLumsdenCJ. Effects of irregular sampling and missing data on largest Lyapunov exponents. Nonlinear Dyn Psychol Life Sci2007; 11: 401–412.
ZivJLempelA. Compression of individual sequences via variable-rate coding. IEEE Trans Inf Theory1978; 24: 75.
41.
PincusSM. Approximate entropy as a measure of irregularity for psychiatric serial metrics. Bipolar Disord2006; 8: 430–440.
42.
WolfASwiftJBSwinneyHL. Determining Lyapunov exponents from a time series. Physica1985; 16D: 285–317.
43.
YeraganiVKPohlRMallavarapuM. Approximate entropy of symptoms of mood. Bipolar Disord2003; 5: 279–286.
44.
GeversEPincusSMRobinsonICAF. Differential orderliness of the GH release process in castrate male and female rats. Am J Physiol1998; 274: R437–R444.
45.
PincusSMHartmanMLRoelfsemaF. Hormone pulsatility discrimination via coarse and short-time sampling. Am J Physiol1999; 277: E948–E957.
46.
ZhangXSZhuYSThakorNV. Detecting ventricular tachycardia and fibrillation by complexity measure. IEEE Trans Biomed Eng1999; 46: 548–555.
47.
HollingsheadARedlichF. Social class and mental illness, New York, NY: John Wiley & Sons, 1958.
48.
BechoJBurgeSKKaterndahlDA. Serendipitous intervention: qualitative findings from the study of dynamic patterns of husband-to-wife abuse. J Fam Violence2013; 28: 243–251.
49.
KaterndahlDA. Impact of spiritual symptoms and their interactions on health services and life satisfaction. Ann Fam Med2008; 6: 412–420.
50.
KaterndahlDBurgeSFerrerR. Do violence dynamics matter?J Eval Clin Pract2014; 20: 719–727.
51.
TaylorLL. Relationship between religion, spirituality and intimate partner violence. Dissert Abstr Intl: Section B: Sci Eng2012; 72: 7114.
WatlingtonCGMurphyCM. Roles of religion and spirituality among African American survivors of domestic violence. J Clin Psychol2006; 62: 837–857.
54.
PylesL. Complexities of the religious response to domestic violence. Affilia: J Women Soc Work2007; 22: 281–291.
55.
ValinDA. Do you hear their cries?Dissert Abstr Intl: Section B: Sci Eng2007; 67: 3854.
56.
RichardsonB. Christian clergy response to intimate partner violence. Dissert Abstr Intl: Section B: Sci Eng2008; 69: 1404.
57.
LevittHMWareK. Anything with two heads is a monster. Violence Against Women2006; 12: 1169–1190.
58.
BehnkeAOAmesNHancockTU. What would you do?J Interpers Violence2012; 27: 1259–1275.
59.
CopelLC. Lived experience of women in abusive relationships who sought spiritual guidance. Issues Ment Health Nurs2008; 29: 115–130.
60.
BowlandS. Process theology’s relevance for older survivors of domestic violence. J Pastoral Care Counsel2011; 65: 1–9.
61.
FowlerDNFaulknerMLearmanJ. Influence of spirituality on service utilization and satisfaction for women residing in a domestic violence shelter. Violence Against Women2011; 17: 1244–1259.
62.
TingL. Out of Africa. Health Care Women Int2010; 31: 345–364.
63.
GatobuAK. Towards an interpretive understanding of survivors of domestic violence. Dissert Abstr Intl: Section B: Sci Eng2007; 67: 4706.
64.
AhrensCEAbelingSAhmadS. Spirituality and well-being. J Interpers Violence2010; 25: 1242–1263.
65.
BradleyRSchwartzACKaslowNJ. Posttraumatic stress disorder symptoms among low-income, African American women with a history of intimate partner violence and suicidal behaviors. J Trauma Stress2005; 18: 685–696.
66.
GallTL. Spirituality and coping with life stress among adult survivors of childhood sexual abuse. Child Abuse Negl2006; 30: 829–844.
67.
ArnetteNCMascaroNSantanaMC. Enhancing spiritual well-being among suicidal African American female survivors of intimate partner violence. J Clin Psychol2007; 63: 909–924.
68.
Hassouneh-PhillipsD. Strength and vulnerability. Issues Ment Health Nurs2003; 24: 681–694.
69.
NashSTHesterbergL. Biblical framings of and responses to spousal violence in the narratives of abused Christian women. Violence Against Women2009; 15: 340–361.
70.
EllisonCGTrinitapoliJAAndersonKL. Race/ethnicity, religious involvement, and domestic violence. Violence Against Women2007; 13: 1094–1112.
71.
El-KhouryMYDuttonMAGoodmanLA. Ethnic differences in battered women’s formal help-seeking strategies. Cultur Divers Ethnic Minor Psychol2004; 10: 383–393.
72.
ParanjapeATuckerAMcKenzie-MackL. Family violence and associated help-seeking among older African American women. Patient Educ Couns2007; 68: 167–172.
