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Writer's pictureGurprit Ganda

Post-Traumatic Stress Disorder in Women and Children: Incidence and Treatment in Australia

Introduction


Post-traumatic stress disorder (PTSD) is a significant mental health concern affecting women and children in Australia, with domestic violence (DV) being a major contributing factor. This article explores the prevalence of PTSD among DV survivors, its psychological impacts, and evidence-based treatment approaches.


Domestic Violence in Australia: Current Statistics


Recent data from the Australian Institute of Health and Welfare (2024) reveals:


  • Over 1 in 4 (27% or 2.7 million) women have experienced Family and Domestic Violence (FDV) since the age of 15

  • Around 1 in 16 (6.2% or 611,000) women have experienced violence since the age of 15 from a father, son, brother or other male relative or in-law

  • 12% (2.2 million) of people witnessed partner violence against their mothers when they were children.

Post-Traumatic Stress Disorder in Women

These statistics underscore the pervasive nature of DV and its potential to cause trauma.


Prevalence of Post-Traumatic Stress Disorder in Women and Children


Research indicates a high prevalence of PTSD among women and children affected by domestic violence. A meta-analysis by Golding (1999) found that 31-84% of DV survivors met diagnostic criteria for PTSD. More recent studies suggest these rates remain consistently high (Lagdon et al., 2014).


PTSD Symptoms in Women and Children


PTSD symptoms can manifest differently in women and children:


Women

  • Flashbacks and nightmares

  • Anxiety and depression

  • Hypervigilance

  • Sleep disturbances

  • Difficulty concentrating


Children

  • Re-enacting traumatic events through play

  • Nightmares or sleep problems

  • Withdrawal or irritability

  • Difficulty concentrating

  • Regressive behaviors


Long-Term Effects of PTSD on Domestic Violence Survivors

Post-traumatic stress disorder (PTSD) resulting from domestic violence can have significant and lasting impacts on survivors. Research has shown that the effects of PTSD can persist long after the abusive relationship has ended. Some of the potential long-term consequences include:


Chronic Health Issues

A study by Kendall-Tackett (2007) found that PTSD in DV survivors is associated with increased risk of cardiovascular disease, chronic pain, and autoimmune disorders.


Cognitive Impairment

PTSD can affect memory, attention, and decision-making abilities. A meta-analysis by Scott et al. (2015) revealed that individuals with PTSD showed deficits in verbal memory, attention, and executive function.


Relationship Difficulties

Survivors may struggle with trust, intimacy, and maintaining healthy relationships. Research by Taft et al. (2011) indicates that PTSD symptoms in DV survivors are associated with lower relationship satisfaction and increased conflict.


Economic Consequences

PTSD can impact work performance and employment stability. A study by Lagerveld et al. (2010) found that individuals with PTSD had higher rates of unemployment and lower work productivity.


Intergenerational Transmission

Children of DV survivors with PTSD may be at higher risk of developing mental health issues themselves. Research by Scheeringa and Zeanah (2001) suggests that parental PTSD can negatively affect child development and increase the risk of psychopathology in offspring.


Substance Abuse

DV survivors with PTSD may be at increased risk for substance abuse as a coping mechanism. A study by Kaysen et al. (2007) found a strong association between PTSD symptoms and alcohol use in women who had experienced intimate partner violence.


Understanding these long-term effects underscores the importance of early intervention and comprehensive treatment for DV survivors with PTSD. It also highlights the need for ongoing support and resources to address the multifaceted impacts of trauma on survivors' lives.


Evidence-Based Treatments for PTSD


The Australian Psychological Society's review (2018) recommends the following evidence-based treatments for PTSD:


For Adults:

  • Eye Movement Desensitization and Reprocessing (EMDR)

  • Trauma-focused Cognitive Behavioral Therapy (TF-CBT)

  • Dialectical Behavior Therapy (DBT)

  • Emotion-focused Therapy (EFT)

  • Metacognitive Therapy (MCT)

  • Mindfulness-Based Stress Reduction (MBSR)


For Children (ages 3-18):

  • Trauma-focused Cognitive Behavioral Therapy (TF-CBT)

  • Eye Movement Desensitization and Reprocessing (EMDR) for ages 8-18


Trauma-Focused CBT (TF-CBT)


TF-CBT, or Trauma-Focused Cognitive Behavioral Therapy, stands out as a highly effective and evidence-based approach designed to assist individuals in processing traumatic experiences. This structured intervention is specifically tailored to cater to the needs of both adults and children who have been impacted by trauma. By integrating cognitive restructuring techniques, TF-CBT aims to help individuals challenge and modify negative thought patterns associated with the traumatic event. Moreover, the therapy incorporates gradual exposure exercises (Cohen et al., 2017), allowing individuals to confront their fears in a safe and controlled environment, ultimately reducing the intensity of their emotional responses.


Additionally, a key component of TF-CBT involves the development of coping skills, empowering individuals to manage distressing emotions and navigate challenging situations more effectively. Through these comprehensive strategies, TF-CBT equips individuals with the tools necessary to address trauma-related symptoms and facilitate the healing process. The structured and goal-oriented nature of TF-CBT ensures that individuals receive targeted support to process their experiences, enhance their emotional well-being, and foster resilience in the face of adversity.


Eye Movement Desensitization and Reprocessing (EMDR)


EMDR, short for Eye Movement Desensitization and Reprocessing, is a psychotherapy technique developed by Dr. Francine Shapiro to help individuals process traumatic memories. By combining cognitive behavioral therapy with bilateral stimulation, such as eye movements or sounds, EMDR aims to reprocess distressing experiences and alleviate associated symptoms. Studies, like Chen et al. (2014), have shown EMDR's effectiveness in treating PTSD symptoms by reframing traumatic memories, reducing emotional intensity, and promoting healing. The focus on bilateral stimulation in EMDR facilitates adaptive processing of memories, allowing individuals to integrate experiences safely. EMDR is a valuable, evidence-based tool for trauma treatment, supporting individuals in healing and resilience.


Dialectical Behavior Therapy (DBT)

DBT is a cognitive-behavioral therapy developed for borderline personality disorder but now used for various mental health conditions. It teaches skills for emotion management, relationships, and stress coping through a balance of acceptance and change. Sessions include individual therapy for changing harmful patterns and skills training groups for mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. DBT is evidence-based and effective for enhancing quality of life.


Emotion-focused Therapy (EFT)

Emotion-focused Therapy (EFT) is commonly used to treat PTSD by helping individuals explore and understand their emotions to heal from trauma. EFT assists in identifying and expressing trauma-related feelings, developing coping strategies, and creating a safe environment to confront traumatic memories. Techniques like guided imagery and mindfulness are used to delve into emotions. EFT also focuses on fostering self-compassion and self-awareness to empower individuals with healthier coping mechanisms and resilience. This structured and compassionate approach promotes emotional healing and supports recovery and psychological well-being in those with PTSD.


Metacognitive Therapy (MCT)

Metacognitive Therapy (MCT) is a specialized approach for treating PTSD by helping individuals develop awareness and control over their thinking processes related to traumatic events. Patients explore and challenge negative thought patterns, beliefs, and assumptions, leading to improved mental well-being. MCT also focuses on developing metacognitive skills like cognitive flexibility and emotional regulation to enhance coping mechanisms. This structured therapy targets core cognitive processes to equip patients with tools for managing symptoms and promoting healing.


Mindfulness-Based Stress Reduction (MBSR)

Mindfulness-Based Stress Reduction (MBSR) is a recognized program for treating PTSD, utilizing mindfulness techniques like meditation, body scanning, and yoga to increase awareness and acceptance of thoughts, emotions, and sensations. Studies show MBSR significantly improves PTSD symptoms, reducing anxiety, depression, and hyperarousal. By fostering present-moment awareness, MBSR helps break the cycle of rumination and intrusive thoughts. It equips individuals with coping tools and promotes a sense of inner peace and resilience, improving overall quality of life. MBSR addresses not only PTSD symptoms but also underlying emotional factors. Overall, MBSR is an evidence-based approach that supports individuals in managing PTSD through mindfulness, self-awareness, and emotional regulation.


Conclusion


PTSD resulting from domestic violence is a significant concern for women and children in Australia. Early intervention and evidence-based treatments are crucial for recovery. If you or someone you know is experiencing symptoms of PTSD, seeking professional help is strongly recommended.


References


Australian Institute of Health and Welfare. (2024). Family and domestic violence (updated 12/04/2024). Retrieved from https://www.aihw.gov.au/family-domestic-and-sexual-violence/types-of-violence/family-domestic-violence. Retrieved on 02/07/2024


Chen, Y. R., Hung, K. W., Tsai, J. C., Chu, H., Chung, M. H., Chen, S. R., ... & Chou, K. R. (2014). Efficacy of eye-movement desensitization and reprocessing for patients with posttraumatic-stress disorder: A meta-analysis of randomized controlled trials. PLoS One, 9(8), e103676. https://doi.org/10.1371/journal.pone.0103676


Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2017). Treating trauma and traumatic grief in children and adolescents. Guilford Publications.


Golding, J. M. (1999). Intimate partner violence as a risk factor for mental disorders: A meta-analysis. Journal of Family Violence, 14(2), 99-132. https://doi.org/10.1023/A:1022079418229


Kaysen, D., Dillworth, T. M., Simpson, T., Waldrop, A., Larimer, M. E., & Resick, P. A. (2007). Domestic violence and alcohol use: Trauma-related symptoms and motives for drinking. Addictive Behaviors, 32(6), 1272-1283. https://doi.org/10.1016/j.addbeh.2006.09.007


Kendall-Tackett, K. (2007). Inflammation, cardiovascular disease, and metabolic syndrome as sequelae of violence against women: The role of depression, hostility, and sleep disturbance. Trauma, Violence, & Abuse, 8(2), 117-126. https://doi.org/10.1177/1524838007301161


Lagdon, S., Armour, C., & Stringer, M. (2014). Adult experience of mental health outcomes as a result of intimate partner violence victimisation: A systematic review. European Journal of Psychotraumatology, 5(1), 24794. https://doi.org/10.3402/ejpt.v5.24794


Lagerveld, S. E., Bültmann, U., Franche, R. L., van Dijk, F. J., Vlasveld, M. C., van der Feltz-Cornelis, C. M., ... & Nieuwenhuijsen, K. (2010). Factors associated with work participation and work functioning in depressed workers: A systematic review. Journal of Occupational Rehabilitation, 20(3), 275-292. https://doi.org/10.1007/s10926-009-9224-x


Scheeringa, M. S., & Zeanah, C. H. (2001). A relational perspective on PTSD in early childhood. Journal of Traumatic Stress, 14(4), 799-815. https://doi.org/10.1023/A:1013002507972


Scott, J. C., Matt, G. E., Wrocklage, K. M., Crnich, C., Jordan, J., Southwick, S. M., ... & Schweinsburg, B. C. (2015). A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder. Psychological Bulletin, 141(1), 105-140. https://doi.org/10.1037/a0038039


Taft, C. T., Watkins, L. E., Stafford, J., Street, A. E., & Monson, C. M. (2011). Posttraumatic stress disorder and intimate relationship problems: A meta-analysis. Journal of Consulting and Clinical Psychology, 79(1), 22-33. https://doi.org/10.1037/a0022196


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