An interpersonally based intervention for low-income pregnant women with intimate partner violence: a pilot study

“Although stressful life events often have detrimental effects on physical and psychological health, social support has been found to limit these negative stress reactions (Cohen and Willis 1985; House et al. 1988; Oakley 1985; Ritter 1988).”

“1999; Zlotnick and Johnson 2002) and exposure to these traumas relative to other traumatic events increases the likelihood of PTSD (Kessler et al. 1995; Zlotnick et al. 2008), we controlled for the presence of childhood sexual trauma in secondary analyses.”

“Although stressful life events often have detrimental effects on physical and psychological health, social support has been found to limit these negative stress reactions (Cohen and Willis 1985; House et al. 1988; Oakley 1985; Ritter 1988).”

“The CTS2 has demonstrated excellent reliability and validity (Straus et al. 1996).”

“Overall, a consistent finding across varied clinical samples is that the mental health consequences most frequently associated with IPV are posttraumatic stress disorder (PTSD; Astin et al. 1993; Gleason 1993; Houskamp and Foy 1991; Kemp et al. 1991; Roberts, Lawrence et al. 1998; Saunders 1994; West et al. 1990; Wood…”

“Moreover, social support has been found to mediate the impact of material loss on depressive symptoms among inner-city women (Hobfoll et al. 2003) and has been aptly referred to as “strategies for survival in a hostile world” for low-income women (Stack 1974).”

“Furthermore, perinatal depression has been found to be related to increased risk for recurrent episodes of depression, chronic depressive disorder, and infant and child developmental difficulties (Beck 1998; Carter et al. 2001; Cicchetti et al. 2000; Cogill et al. 1986; Hay et al. 2001; Kurstjens and Wolfe 2001; Lyons…”

“Even working within these tight restrictions, we were able to consent 12% of women approached, which is above the reported rates of IPV within the last year for pregnant women (Gazmararian et al. 1996) and had only 15% drop-out rate once women were randomized, which is consistent with the only other preventive interve…”

“In addition to IPV, low-income women are frequently exposed to chronic strain and sources of stress, such as inadequate income, inadequate housing, and parenting worries (Dunkel-Schetter, 1998; Rini et al. 1999; Turner et al. 1990).”

“…Cogill et al. 1986; Hay et al. 2001; Kurstjens and Wolfe 2001; Lyons-Ruth et al. 1986; Lyons-Ruth et al. 2000; Martins and Gaffan 2000; Murray 1992; Murray and Cooper 1997; Newport et al. 2001; Nonacs and Cohen 1998; Philipps and O'Hara 1991; Sharp et al. 1995; Sinclair and Murray 1998; Weinberg…”

“…et al. 2001; Cicchetti et al. 2000; Cogill et al. 1986; Hay et al. 2001; Kurstjens and Wolfe 2001; Lyons-Ruth et al. 1986; Lyons-Ruth et al. 2000; Martins and Gaffan 2000; Murray 1992; Murray and Cooper 1997; Newport et al. 2001; Nonacs and Cohen 1998; Philipps and O'Hara 1991; Sharp et al.…”

“Since there is accumulating evidence from community-based studies that childhood sexual abuse and rape increases the risk of a major depressive disorder in women (Burnam et al. 1988; Buzi et al. 2007; Nolen-Hoeksema 2006; Weiss et al. 1999; Zlotnick and Johnson 2002) and exposure to these traumas relative to other tra…”

“Furthermore, perinatal depression has been found to be related to increased risk for recurrent episodes of depression, chronic depressive disorder, and infant and child developmental difficulties (Beck 1998; Carter et al. 2001; Cicchetti et al. 2000; Cogill et al. 1986; Hay et al. 2001; Kurstjens and Wolfe 2001; Lyons…”

“…to be related to increased risk for recurrent episodes of depression, chronic depressive disorder, and infant and child developmental difficulties (Beck 1998; Carter et al. 2001; Cicchetti et al. 2000; Cogill et al. 1986; Hay et al. 2001; Kurstjens and Wolfe 2001; Lyons-Ruth et al. 1986;…”

“The IPT approach with its emphasis on strengthening social relationships is especially relevant to low-income women (Belle 1990; Collins et al. 1993 ).”

“…to increased risk for recurrent episodes of depression, chronic depressive disorder, and infant and child developmental difficulties (Beck 1998; Carter et al. 2001; Cicchetti et al. 2000; Cogill et al. 1986; Hay et al. 2001; Kurstjens and Wolfe 2001; Lyons-Ruth et al. 1986; Lyons-Ruth et al.…”

“Since there is accumulating evidence from community-based studies that childhood sexual abuse and rape increases the risk of a major depressive disorder in women (Burnam et al. 1988; Buzi et al. 2007; Nolen-Hoeksema 2006; Weiss et al. 1999; Zlotnick and Johnson 2002) and exposure to these traumas relative to other tra…”

“The IPT approach with its emphasis on strengthening social relationships is especially relevant to low-income women (Belle 1990; Collins et al. 1993).”

“Furthermore, perinatal depression has been found to be related to increased risk for recurrent episodes of depression, chronic depressive disorder, and infant and child developmental difficulties (Beck 1998; Carter et al. 2001; Cicchetti et al. 2000; Cogill et al. 1986; Hay et al. 2001; Kurstjens and Wolfe 2001; Lyons…”

“…support, is especially relevant for women with IPV because research has found social support to be protective against the negative effects of partner violence on women's mental health (Coker et al. 2003; Mitchell and Hudson 1983; Tan et al. 1995) such as symptoms of depression, PTSD, and anxiety.”

“…1993; Houskamp and Foy 1991; Kemp et al. 1991; Roberts, Lawrence et al. 1998; Saunders 1994; West et al. 1990; Woods 2000) and depression (Bergman et al. 1987; Cascardi and O'Leary 1992; Gleason 1993; Golding 1999; Hathaway et al. 2000; Roberts et al. 1998; West et al. 1990; Zlotnick et al. 1998).”

“Furthermore, perinatal depression has been found to be related to increased risk for recurrent episodes of depression, chronic depressive disorder, and infant and child developmental difficulties (Beck 1998; Carter et al. 2001; Cicchetti et al. 2000; Cogill et al. 1986; Hay et al. 2001; Kurstjens and Wolfe 2001; Lyons…”

“Overall, a consistent finding across varied clinical samples is that the mental health consequences most frequently associated with IPV are posttraumatic stress disorder (PTSD; Astin et al. 1993; Gleason 1993; Houskamp and Foy 1991; Kemp et al. 1991; Roberts, Lawrence et al. 1998; Saunders 1994; West et al. 1990; Wood…”

“Additionally, an IPT-based intervention has demonstrated initial efficacy to reduce postpartum depression in pregnant woman on public assistance at risk for postpartum depression (Zlotnick et al. 2001; Zlotnick et al. 2006).”

“Some researchers suggest that the actual prevalence may be even higher due to reluctance of women to disclose IPV, especially during pregnancy (Rennison and Welchans 2000).”

“…1993; Houskamp and Foy 1991; Kemp et al. 1991; Roberts, Lawrence et al. 1998; Saunders 1994; West et al. 1990; Woods 2000) and depression (Bergman et al. 1987; Cascardi and O'Leary 1992; Gleason 1993; Golding 1999; Hathaway et al. 2000; Roberts et al. 1998; West et al. 1990; Zlotnick et al. 1998).”

“…pregnancy is related to maternal infections, anemia, failure to gain weight during pregnancy, and other adverse obstetric outcomes that include preterm labor, preterm low birthweight, preterm delivery, and neonatal death (see HuthBocks et al. 2002 for review; Coker et al. 2004; Sarkar, 2008).”

“Since pregnant women are more likely than postpartum women or women at other times in their lives to generally be less compliant with mental health interventions (O'Mahen and Flynn 2008), perhaps women would be willing to receive more intervention sessions during the postpartum period.”

“Overall, a consistent finding across varied clinical samples is that the mental health consequences most frequently associated with IPV are posttraumatic stress disorder (PTSD; Astin et al. 1993; Gleason 1993; Houskamp and Foy 1991; Kemp et al. 1991; Roberts, Lawrence et al. 1998; Saunders 1994; West et al. 1990; Wood…”

“…support, is especially relevant for women with IPV because research has found social support to be protective against the negative effects of partner violence on women's mental health (Coker et al. 2003; Mitchell and Hudson 1983; Tan et al. 1995) such as symptoms of depression, PTSD, and anxiety.”

“Overall, a consistent finding across varied clinical samples is that the mental health consequences most frequently associated with IPV are posttraumatic stress disorder (PTSD; Astin et al. 1993; Gleason 1993; Houskamp and Foy 1991; Kemp et al. 1991; Roberts, Lawrence et al. 1998; Saunders 1994; West et al. 1990; Wood…”

“Furthermore, a history of child sexual abuse is associated with current PTSD symptoms within the cumulative context of other adult trauma (Nishith et al. 2000).”

“Furthermore, perinatal depression has been found to be related to increased risk for recurrent episodes of depression, chronic depressive disorder, and infant and child developmental difficulties (Beck 1998; Carter et al. 2001; Cicchetti et al. 2000; Cogill et al. 1986; Hay et al. 2001; Kurstjens and Wolfe 2001; Lyons…”

“…developmental difficulties (Beck 1998; Carter et al. 2001; Cicchetti et al. 2000; Cogill et al. 1986; Hay et al. 2001; Kurstjens and Wolfe 2001; Lyons-Ruth et al. 1986; Lyons-Ruth et al. 2000; Martins and Gaffan 2000; Murray 1992; Murray and Cooper 1997; Newport et al. 2001; Nonacs and Cohen…”

“The only study with pregnant women, to date, that found significant reductions in IPV and depressive symptoms postpartum for the intervention group compared to a comparison condition (Tiwari et al. 2005) found differences in psychological abuse and minor physical abuse.”

“…for recurrent episodes of depression, chronic depressive disorder, and infant and child developmental difficulties (Beck 1998; Carter et al. 2001; Cicchetti et al. 2000; Cogill et al. 1986; Hay et al. 2001; Kurstjens and Wolfe 2001; Lyons-Ruth et al. 1986; Lyons-Ruth et al. 2000; Martins and…”

“Additionally, an IPT-based intervention has demonstrated initial efficacy to reduce postpartum depression in pregnant woman on public assistance at risk for postpartum depression (Zlotnick et al. 2001; Zlotnick et al. 2006).”

“In addition to IPV, low-income women are frequently exposed to chronic strain and sources of stress, such as inadequate income, inadequate housing, and parenting worries (Dunkel-Schetter, 1998; Rini et al. 1999; Turner et al. 1990).”

“The EPDS has established psychometric properties and is one of the most widely used self-reported instruments to assess for depressive symptoms in the postpartum and antenatal periods in diverse populations of perinatal women (Cox and Holden 2003; Thompson et al. 1998).”

“2) At 3 months postpartum, the Longitudinal Interval Follow-up Examination (LIFE; Keller et al. 1987; Warshaw et al. 1994) a brief standardized interview was used to assess for the presence of a major depressive disorder and PTSD from intake until 3month postpartum.”

“, advice on safety, choice making, and problem solving as well as community resources) with one ethnic group (Chinese women or Hispanic women; McFarlane et al. 2000; Tiwari et al. 2005).”

“Overall, a consistent finding across varied clinical samples is that the mental health consequences most frequently associated with IPV are posttraumatic stress disorder (PTSD; Astin et al. 1993; Gleason 1993; Houskamp and Foy 1991; Kemp et al. 1991; Roberts, Lawrence et al. 1998; Saunders 1994; West et al. 1990; Wood…”

“…(Beck 1998; Carter et al. 2001; Cicchetti et al. 2000; Cogill et al. 1986; Hay et al. 2001; Kurstjens and Wolfe 2001; Lyons-Ruth et al. 1986; Lyons-Ruth et al. 2000; Martins and Gaffan 2000; Murray 1992; Murray and Cooper 1997; Newport et al. 2001; Nonacs and Cohen 1998; Philipps and O'Hara…”

“... a consistent finding across varied clinical samples is that the mental health consequences most frequently associated with IPV are posttraumatic stress disorder (PTSD; Astin et al. 1993; Gleason 1993; Houskamp and Foy 1991; Kemp et al. 1991; Roberts, Lawrence et al. 1998; Saunders 1994; West et al. 1990; Woods 200…”

“The only two studies to date that have examined the rate of PTSD in perinatal women have found prevalent rates for current PTSD of 2.3% to 3% (Smith et al. 2004; Söderquist et al. 2004).”

“We were careful to follow the recommended precautions (see Sullivan and Cain, 2004 ) to maximize study participant safety throughout the research study.”

“1999; Zlotnick and Johnson 2002) and exposure to these traumas relative to other traumatic events increases the likelihood of PTSD (Kessler et al. 1995; Zlotnick et al. 2008), we controlled for the presence of childhood sexual trauma in secondary analyses.”

“Furthermore, perinatal depression has been found to be related to increased risk for recurrent episodes of depression, chronic depressive disorder, and infant and child developmental difficulties (Beck 1998; Carter et al. 2001; Cicchetti et al. 2000; Cogill et al. 1986; Hay et al. 2001; Kurstjens and Wolfe 2001; Lyons…”

“Childhood sexual abuse has been found to be related to depressive symptoms among low-income women (Rayburn et al. 2005), among women who have left an abusive relationship (Koopman et al.”

“In addition, IPV during pregnancy is related to maternal infections, anemia, failure to gain weight during pregnancy, and other adverse obstetric outcomes that include preterm labor, preterm low birthweight, preterm delivery, and neonatal death (see Huth-Bocks et al. 2002 for review; Coker et al. 2004; Sarkar, 2008).”

“Intervention mothers reported lower levels of IPV compared to a control group during the intervention phase (but not during follow-up assessments); this was only true for physical abuse (Bair-Merritt et al. 2010).”

“…to be good to excellent for all affective disorders (Warshaw et al. 1994) and has been successfully used in over 100 different research programs with diverse populations (e.g., Gallagher-Thompson et al. 1990; Dawson et al. 1999) and even depressed mothers with infant children (Seifer et al. 2001).”

“Furthermore, a woman's behavior may be unrelated to the occurrence of abuse (McFarlane et al. 1998; Parker et al. 1999; Sullivan 2003).”

“Childhood sexual abuse has been found to be related to depressive symptoms among low-income women (Rayburn et al. 2005), among women who have left an abusive relationship (Koopman et al. 2007), and among postpartum women (Buist and Janson 2001).”

“The only two studies to date that have examined the rate of PTSD in perinatal women have found prevalent rates for current PTSD of 2.3% to 3% (Smith et al. 2004; Söderquist et al. 2004).”

“Although stressful life events often have detrimental effects on physical and psychological health, social support has been found to limit these negative stress reactions (Cohen and Willis 1985; House et al. 1988; Oakley 1985; Ritter 1988).”

“Additionally, mothers with PTSD have more difficulty in providing bonding, protection, and support to a developing child (Graham-Bermann 1998).”

“Research has found that women with IPV during pregnancy have an increased risk of physical abuse in the postpartum period which is associated with postpartum depression in over 50% of these women (Stewart 1994), and the onset of the depression usually occurs within 8 to 10 weeks postpartum (Ansara et al. 2005).”

“Additionally, research has found a high co-occurrence of childhood sexual abuse and PTSD, especially hyperarousal symptoms (Griffing et al. 2006).”

“Since severity of IPV is related to greater impairment (Johnson et al. 2008), the impact of a relatively brief intervention may be limited in women with severe forms of abuse.”

“It is a widely used measure with good reliability and validity (Zlotnick et al. 1996).”

“... clinical samples is that the mental health consequences most frequently associated with IPV are posttraumatic stress disorder (PTSD; Astin et al. 1993; Gleason 1993; Houskamp and Foy 1991; Kemp et al. 1991; Roberts, Lawrence et al. 1998; Saunders 1994; West et al. 1990; Woods 2000) and depression (Bergman et al. 1…”

“Our intervention incorporated strategies from stabilization and empowerment models of treatment for women with IPV, which have been found to be efficacious in reducing PTSD symptoms in women with recent IPV (Johnson and Zlotnick 2008).”

“…stress disorder (PTSD; Astin et al. 1993; Gleason 1993; Houskamp and Foy 1991; Kemp et al. 1991; Roberts, Lawrence et al. 1998; Saunders 1994; West et al. 1990; Woods 2000) and depression (Bergman et al. 1987; Cascardi and O'Leary 1992; Gleason 1993; Golding 1999; Hathaway et al. 2000;…”

“Furthermore, a woman's behavior may be unrelated to the occurrence of abuse (McFarlane et al. 1998; Parker et al. 1999; Sullivan 2003).”

“…to be good to excellent for all affective disorders (Warshaw et al. 1994) and has been successfully used in over 100 different research programs with diverse populations (e.g., Gallagher-Thompson et al. 1990; Dawson et al. 1999) and even depressed mothers with infant children (Seifer et al. 2001).”

“Furthermore, perinatal depression has been found to be related to increased risk for recurrent episodes of depression, chronic depressive disorder, and infant and child developmental difficulties (Beck 1998; Carter et al. 2001; Cicchetti et al. 2000; Cogill et al. 1986; Hay et al. 2001; Kurstjens and Wolfe 2001; Lyons…”

“The EPDS has established psychometric properties and is one of the most widely used self-reported instruments to assess for depressive symptoms in the postpartum and antenatal periods in diverse populations of perinatal women (Cox and Holden 2003; Thompson et al. 1998).”

“Overall, a consistent finding across varied clinical samples is that the mental health consequences most frequently associated with IPV are posttraumatic stress disorder (PTSD; Astin et al. 1993; Gleason 1993; Houskamp and Foy 1991; Kemp et al. 1991; Roberts, Lawrence et al. 1998; Saunders 1994; West et al. 1990; Wood…”

“It is a widely used measure with good reliability and validity (Zlotnick et al. 1996).”

“A recent study of perinatal women found that pregnant women who reported histories of abuse were five times at greater risk for postpartum depression than their counterparts without such experiences (Records and Rice 2009).”

“2005), among women who have left an abusive relationship (Koopman et al. 2007), and among postpartum women (Buist and Janson 2001).”

“…studies that childhood sexual abuse and rape increases the risk of a major depressive disorder in women (Burnam et al. 1988; Buzi et al. 2007; Nolen-Hoeksema 2006; Weiss et al. 1999; Zlotnick and Johnson 2002) and exposure to these traumas relative to other traumatic events increases the…”

“Although experts strongly recommend increased assessment and interventions for IPV in health-care settings (Campbell et al. 2000), the existing literature provides few models for interventions for pregnant women with IPV.”

“…to be good to excellent for all affective disorders (Warshaw et al. 1994) and has been successfully used in over 100 different research programs with diverse populations (e.g., Gallagher-Thompson et al. 1990; Dawson et al. 1999) and even depressed mothers with infant children (Seifer et al. 2001).”

“…Brown University, Providence, RI, USA e-mail: caron_zlotnick@brown.edu e-mail: czlotnick@butler.org C. Zlotnick :N. M. Capezza Women and Infants Hospital, 101 Dudley Street, Providence, RI 02905, USA D. Parker Memorial Hospital of Rhode Island, Pawtucket, RI 02860, USA 2000; Gottlieb 2008).”

“Although stressful life events often have detrimental effects on physical and psychological health, social support has been found to limit these negative stress reactions (Cohen and Willis 1985; House et al. 1988; Oakley 1985; Ritter 1988).”

“98 This highlights the need for additional large-scale, rigorous research to provide evidence about the effects of interventions in mitigating the impact of violence.”

“Interpersonal therapy, delivered during pregnancy, was associated with reductions in PTSD symptoms but not depressive symptoms relative to controls (Zlotnick et al., 2011).”