Childhood Maltreatment and PTSD: Spiritual Well-Being and Intimate Partner Violence as Mediators
Open accessAbstract
Childhood maltreatment places individuals, including African American women who are undereducated and economically disadvantaged, at risk for developing posttraumatic stress disorder (PTSD) symptoms. Participants were 192 African American women with a history in the prior year of both a suicide attempt and intimate partner violence (IPV) exposure. They were recruited from a public hospital that provides medical and mental health treatment to mostly low-income patients. A simple mediator model was used to examine if (1) existential well-being (sense of purpose) and/or religious well-being (relationship with God) mediated the link between childhood maltreatment and adult PTSD symptoms. Sequential multiple mediator models determined if physical and nonphysical IPV enhanced our understanding of the mediational association among the aforementioned variables. Findings suggest that existential well-being mediated the association between childhood maltreatment and adult PTSD symptoms in a simple mediator model, and existential well-being and recent nonphysical IPV served as sequential multiple mediators of this link. However, religious well-being and physical IPV were not significant mediators. Findings underscore the importance of enhancing existential well-being in the treatment of suicidal African American women with a history of childhood maltreatment and IPV.
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The Index of Spouse Abuse (ISA) has been found to have good reliability and validity, including among African American women.
“The ISA has been found to have good reliability and validity, including among African American women (Zhang et al., 2015).”
From Childhood Physical Abuse and Antisocial Traits: Mediating Role of Posttraumatic Stress Symptom Clusters (2022) · cites this paper as Zhang et al., 2015
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“Existential well-being mediated the association between childhood maltreatment and adult PTSD symptoms (Zhang et al., 2015).”
BackgroundInfluentialLamis, D. A., Kapoor, S., & Evans, A. P. B. (2018) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12438 · Cited by 22 · see citing works
“Thus, our study contributes to the growing evidence suggesting a distinct protective role of EWB (e.g., Hirsch, Webb, & Kaslow, 2014; Rasic et al., 2009; Zhang et al., 2015).”
ResultSelf-citationAi, A. L., & Lee, J. (2018) · Substance Use & Misuse · doi:10.1080/10826084.2018.1455701 · Cited by 21 · see citing works
“The model simultaneously demonstrated (a) a positive link of negative stress reactions immediately after the 9/11 with elevated spiritual coping and (b) the mitigating effect of such coping on better follow-up outcomes (i.e., low PTSD symptoms and greater posttraumatic growth) (Ai, Tice, Lemieux, & Huang, 2011).”
BackgroundHappiness, Meaning in Life, and PTSD Symptoms Among National Guard Personnel: A Multilevel Analysis
Bryan, C. J., Bryan, A. O., Rugo, K. F., Hinkson, K. D., & Leifker, F. R. (2019) · Journal of Happiness Studies · doi:10.1007/s10902-019-00129-3 · Cited by 22 · see citing works
Childhood abuse, posttraumatic stress symptoms, and alcohol misuse among African-American women
Florez, I. A., Mekawi, Y., Hunnicutt-Ferguson, K., Visser, K. F., Clunie, A. M., Dunn, S. E., & Kaslow, N. J. (2022) · Journal of Ethnicity in Substance Abuse · doi:10.1080/15332640.2020.1725707 · Cited by 13 · see citing works
“…has demonstrated good convergent and divergent validity, as well as test-retest and internal consistency reliability (a¼ 0.85–0.99) (Davidson, 2003; Davidson et al., 1997; McDonald, Beckham, Morey, & Calhoun, 2009), including among African American childhood trauma survivors (Zhang et al., 2015).”
BackgroundInfluentialSelf-citationIntimate Partner Violence, Existential Well-Being, and Africultural Coping in African American Women
Hampton-Anderson, J. N., Watson‐Singleton, N. N., Mekawi, Y., Dunn, S. E., & Kaslow, N. J. (2022) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2022.2038751 · Cited by 11 · see citing works
“Among African American women with past suicide attempts, existential well-being protects against posttraumatic stress disorder (PTSD), hopelessness, and suicidal ideation (Fischer et al., 2016; Florez et al., 2018; Zhang et al., 2015).”
BackgroundSelf-citationSymes, L., McFarlane, J., Maddoux, J., & Fredland, N. (2020) · Violence Against Women · doi:10.1177/1077801219841444 · Cited by 10 · see citing works
“There is evidence that having a sense of purpose mediates between childhood abuse and PTSD (Zhang et al., 2015).”
BackgroundYılmaz, F. B., & Satıcı, S. A. (2023) · Journal of Religion and Health · doi:10.1007/s10943-023-01965-7 · Cited by 9 · see citing works
“…researchers found that psychological maltreatment is directly predictive of spiritual well-being, such that high levels of maltreatment cause low levels of spiritual well-being in Turkish university students (Arslan, 2021a, 2021b) and in the general population (Feinauer, 2003; Zhang et al., 2015).”
Devine, C., & Cohen‐Cline, H. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191710578 · Cited by 3 · see citing works
Harris, C. E., Allbaugh, L. J., & Kaslow, N. J. (2022) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-021-00364-y · Cited by 2 · see citing works
“The ISA has been found to have good reliability and validity, including among African American women (Zhang et al., 2015).”
BackgroundSelf-citationTrauma, existential isolation, and their associated clinical outcomes
Loso, T., Gehman, R. M., Pinel, E. C., & Pyszczynski, T. (2025) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2025.44.4.273 · Cited by 1 · see citing works
Maddox, R. P., & McInerney, Z. M. (2025) · The Journal of Humanistic Counseling · doi:10.1002/johc.70032
Spirituality and Mental Health Among Vulnerable Women: A Systematic Review
Chyczij, F., Caramelo, A., Morgado, P. F., & Gonçalves, S. D. (2026) · Women · doi:10.3390/women6030045
- Authors
- Zhang, H., Pittman, D. M., Lamis, D. A., Fischer, N. L., Schwenke, T. J., Carr, E. R., Shah, S., & Kaslow, N. J.
- Affiliations
- Indiana University (US)
- George Washington University (US)
- Emory University (US)
- Marymount University (US)
- Georgia Department of Behavioral Health and Developmental Disabilities (US)
- Yale University (US)
- Corresponding author
- Lamis, Dorian A.
- Venue
- Journal of Aggression, Maltreatment & Trauma
- Publisher
- Informa UK Limited
- Published
- 2015-05-28
- Volume
- 24
- Issue
- 5
- Pages
- 501-519
- ISSN
- 1092-6771 (ISSN-L)
- 1545-083X
- PMC
- PMC4792129
- OpenAlex
- W1530522992
- Cited by
- 18
- References
- 72
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 1 · 2019: 4 · 2018: 4 · 2017: 1
- FWCI
- 2.07
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Aggression Maltreatment & Trauma (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Centers for Disease Control and Prevention (R49 CCR421767-01)
- National Institute of Mental Health (1R01MH078002-01A2)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Keywords
- child abuse, post-traumatic stress disorder, African American women, intimate partner violence, spiritual well-being, existential well-being, religious well-being, suicide attempts, mediation, physical violence, low-income women
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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