Psychological Abuse in Intimate Relationships Increases Intensity of PTSD Symptoms

The most common forms of intimate partner violence (IPV) are sexual violence, sexual coercion, psychological abuse and physical abuse and each causes significant psychological problems. “Many victims of intimate partner violence (IPV) experience negative mental health outcomes including anxiety problems, substance abuse, depression, and suicidal ideation,” said Amber Norwood and Christopher Murphy of the University of Maryland. “Most notable are high rates of posttraumatic stress disorder (PTSD), with prevalence estimates ranging from 33% to 84%.” Yet in a relationship, not all four behaviors predict PTSD, according to a recent study conducted by Norwood and Murphy. The team theorized that because research suggests that intimate partner rape causes extreme psychological trauma, that sexual violence would be the strongest predictor of PTSD in IPV.  In order to confirm their theory, the researchers interviewed 216 women who were in abusive relationships and asked them about the frequency and types of abuse that they experienced.

The results of the study revealed similar findings to previous research, with some exceptions. “As predicted, the rate of PTSD diagnosis was higher in both the sexual coercion (56.8%) and sexual violence (63.2%) groups when compared to the no sexual abuse group (32.3%),” said the researchers. But they were surprised by some of their findings, such as the fact that psychological abuse increased PTSD symptoms much more significantly than physical violence. Overall, exposure to sexual violence and sexual coercion together did increase the presence of PTSD. But when taken as separate factors, only sexual coercion was directly linked to increased PTSD symptoms. “Though not hypothesized, the finding that sexual coercion (which resembles psychological abuse) is more predictive of PTSD symptoms than sexual violence (which resembles physical abuse), appears to be consistent with the overall finding that psychological abuse had the most consistent unique associations with PTSD. When all four abuse variables—physical abuse, psychological abuse, sexual coercion, and sexual violence—were examined together, only psychological abuse remained a significant unique predictor of PTSD symptoms.”

Norwood, A., & Murphy, C. (2011, August 22). What Forms of Abuse Correlate With PTSD Symptoms in Partners of Men Being Treated for Intimate Partner Violence?. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. doi: 10.1037/a0025232

© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • TAJ


    September 3rd, 2011 at 1:05 PM

    Yeah that happens when someone you love the most hurts you the most

  • D'Andrea


    September 4th, 2011 at 10:40 AM

    It is no surprise that when you have encountered some form of sexual abuse that you would suffer more from the repercussions and healing than others. This has to be especially hard when it is committed by someone that you love and who you thought loved you. The pain, no matter the particular situation has to be hard, but to face this by someone that you know? Even worse.

  • Freddie


    September 4th, 2011 at 11:51 AM

    surprised to see that psychological hurt has a bigger influence than physical abuse.true that what hurts our heart is more painful than what hurts our body.

  • Hollis


    September 5th, 2011 at 12:59 PM

    Curious that it takes until NOW to realize that this can be a major life hazard? I mean, come on! This is serious stuff happening in someone’s life and you cannot possibly tell me that we are going to be surprised at this finding!

  • KH


    September 5th, 2011 at 1:12 PM

    So hurt from a loved one can spark PTSD? Is that not like when we are hurt by a loved one it’s like we encounter a tragedy,a major loss in our subconscious?

  • Olivia


    September 6th, 2011 at 3:59 PM

    any ideas on why psychological abuse seems the be the better indicator of future PTSD symptoms? I would have thought for sure that it would be physical abuse.

  • Una Radcliffe

    Una Radcliffe

    September 6th, 2011 at 4:16 PM

    Here’s a study for you. Women who are in an abusive relationship have higher confidence and a superior quality of life when their abuser gets sentenced to 20 years in prison for a laundry list of offenses against them and their children.

    Okay so there wasn’t any such study. I made that up. So many studies really just turn up the rational expected outcome in the end, don’t they? I think that makes them a bit pointless. I don’t need a study to tell me what I figured out for myself there would be accurate. It’s sheer logic.

  • v.h.


    September 6th, 2011 at 10:10 PM

    We have counselors for rape victims, which is good.
    Nonetheless, those women and indeed every woman needs more safeguards to prevent rape in the first place. Why aren’t rapists locked up for life or chemically castrated? Our justice system obviously is not working as well as we wish it would, given the number that re-offend.

    There is such a heavy burden on the victim to prove it. I don’t know of any other crime where the victim of a serious crime can be treated subtly and not so subtly as if they are the one at fault.

  • Andrew C.

    Andrew C.

    September 7th, 2011 at 12:00 AM

    Seeing your partner being abusive and inconsiderate towards you can be quite a devastating thing for someone.And to compare it to or even equate it to trauma would not be wrong.

    After all,it may seem different from trauma(like surviving an accident or seeing a loved one die) to an observer but in the mind it evokes the same kind of fear and response. Domestic violence is a major roadblock to civility.

  • Reece Mason

    Reece Mason

    September 7th, 2011 at 9:04 PM

    @v.h: There’s a problem with having a lesser burden of proof. There unfortunately have been several cases where a woman falsely claimed they were raped. That’s why there needs to be a substantial amount of indisputable proof. Because of the severity of the crime, no-one wants to make a mistake.

    I’m glad we have DNA testing now available, that’s for sure. No man can argue with that evidence.

  • Colin Phelps

    Colin Phelps

    September 7th, 2011 at 11:50 PM

    @Reece Mason-Err, no man can argue with DNA evidence? Yes we can and have done so for years. There have been hundreds if not thousands of criminal sentences overturned because the conviction relied mainly upon DNA evidence which later was proven flawed.

    That’s why I’m against the death penalty. It’s only a matter of time until an innocent man’s executed instead of exonerated because of a faulty DNA analysis report.

  • Liza Wallace

    Liza Wallace

    September 8th, 2011 at 5:44 PM

    @reece: If DNA evidence was so solid, there would be no need for programs like Life After Exoneration. That’s ran by an organization that helps the wrongly convicted rebuild their shattered lives.

    Not all wrongful convictions are down to DNA analysis being botched of course. Humans are simply not infallible. Oversights, misjudgments and mistakes can be made in the lifetime of a case – by law enforcement, by juries, by witnesses, by lawyers and even by victims and yes, DNA scientists.

    DNA evidence isn’t always the watertight Holy Grail of evidence it’s perceived to be.

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