Approximately 25% of women in the United States report having experienced intimate partner violence (IPV) in an adult relationship with a male partner. For affected women, IPV has been shown to increase the risk of psychopathology such as depression, anxiety, and symptoms of posttraumatic stress. Further, studies suggest that the risk of IPV (victimization or perpetration) may be carried intergenerationally, and children exposed to IPV are at a greater risk of both attachment insecurity and internalizing/externalizing problems. The authors employ an attachment perspective to describe how insecure/non-balanced working models of the relational self and others may be evoked by, elicit, or exacerbate maladaptive outcomes following experiences of IPV for mothers and their children. This article draws on both rich theory and empirical evidence in a discussion of attachment patterns in violent relationships, psychopathological outcomes for exposed women, disruptions in the caregiving relationship that may confer risk to children of exposed mothers, and the biological, social, and attachment risk factors for children exposed to IPV. A clinical case example is presented and discussed in the context of attachment theory.

High rates of drop-out from treatment of PTSD have challenged implementation. Care models that integrate PTSD focused psychotherapy and complementary interventions may provide benefit in retention and outcome. The first 80 veterans with chronic PTSD enrolled in a 2-week intensive outpatient program combining Prolonged Exposure (PE) and complementary interventions completed symptom and biological measures at baseline and posttreatment. We examined trajectories of symptom change, mediating and moderating effects of a range of patient characteristics. Of the 80 veterans, 77 completed (96.3%) treatment and pre- and posttreatment measures. Self-reported PTSD (p < .001), depression (p < .001) and neurological symptoms (p < .001) showed large reductions with treatment. For PTSD, 77% (n = 59) showed clinically significant reductions. Satisfaction with social function (p < .001) significantly increased. Black veterans and those with a primary military sexual trauma (MST) reported higher baseline severity than white or primary combat trauma veterans respectively but did not differ in their trajectories of treatment change. Greater cortisol response to the trauma potentiated startle paradigm at baseline predicted smaller reductions in PTSD over treatment while greater reductions in this response from baseline to post were associated with better outcomes. Intensive outpatient prolonged exposure combined with complementary interventions shows excellent retention and large, clinically significant reduction in PTSD and related symptoms in two weeks. This model of care is robust to complex presentations of patients with varying demographics and symptom presentations at baseline.

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Vicarious traumatization of nonvictim members of communities targeted by bias crimes has been suggested by previous qualitative studies and often dominates public discussion following bias events, but proximal and distal responses of community members have yet to be comprehensively modeled, and quantitative research on vicarious responses is scarce. This comprehensive review integrates theoretical and empirical literatures in social, clinical, and physiological psychology in the development of a model of affective, cognitive, and physiological responses of lesbian, gay, and bisexual individuals upon exposure to information about bias crimes. Extant qualitative research in vicarious response to bias crimes is reviewed in light of theoretical implications and methodological limitations. Potential pathways to mental health outcomes are outlined, including accumulative effects of anticipatory defensive responding, multiplicative effects of minority stress, and putative traumatogenic physiological and cognitive processes of threat. Methodological considerations, future research directions, and clinical implications are also discussed.

Over a quarter of young women have experienced some form of violence within a dating relationship. The experience of dating violence is associated with problems in psychological functioning, including symptoms of anxiety and depression. However, not all women who experience dating violence exhibit anxious or depressive symptoms. One factor that may influence symptom expression is interpersonal style. In this study, we examined the main and moderating effects of dimensions of interpersonal style (dominance and warmth) on the association between dating violence and symptoms of anxiety and depression. Warmth exhibited a main effect on anxious and depressive symptoms over and above the effects of dating violence and other life stressors. Dominance moderated the association between dating violence and anxious and depressive symptoms. When levels of dating violence were high, women with higher levels of dominance reported fewer symptoms of anxiety and depression than women with lower dominance. These results indicated that whereas high warmth was associated with fewer symptoms of psychopathology generally, high dominance was a buffer against the effect of dating violence on symptoms more specifically. Directions for future research are discussed.

Asian-American college students have reported higher scores of depression than European-American college students. This study examined the mediating effects of loss of face and intergenerational family conflict between race/ethnicity and depression and hypothesized that these variables would explain previously observed depression differences. The sample consisted of 488 undergraduate students: 209 self-identified as Asian American and 279 as European American. Participants filled out paper-andpencil questionnaires. As predicted, the study found that Asian Americans reported higher scores on depression, loss of face, and intergenerational family conflict than European Americans. Loss of face explained more variance in depression among Asian Americans than European Americans. However, intergenerational family conflict explained equal levels of variance in depression for both groups. A structural equation model revealed that the relationship between race/ethnicity and depression was fully mediated by loss of face and intergenerational family conflict. In conclusion, using the disentangling approach, differences in depression scores between Asian-American and European-American college students can be explained by differences in culturally relevant constructs, such as loss of face and intergenerational family conflict.

Current work in multicultural competency has emphasized factors such as race and ethnicity, age, disability status, socioeconomic status, sexual orientation and gender. For those clinicians who work with military and veteran populations, grounding in military cultural competence is also critical as a prerequisite for providing quality care. We believe that engaging these populations from a specifically cognitive behavioural orientation allows bridging of cultural gaps and that there is a natural alignment between cognitive behavioural therapy (CBT) and many aspects of warrior culture. This paper outlines several factors related to the values of military culture and strategies of the CBT therapist to better understand and use these values effectively in clinical practice, including lessons learned from an intensive outpatient program providing speciality care to veterans and military service members.

Maternal representations of the infant and self-as-mother predict attachment security and may be differentially influenced by environmental stressors such as intimate partner violence (IPV), but no study has yet examined potential direct and interactive effects of maternal personality. Maternal representations (Working Model of the Child Interview; C.H. ), and experiences of domestic violence (Severity of Violence Against Women Scales; L. Marshall, 1992) were assessed in a community sample of 180 women during pregnancy and 1 year postpartum. Logistic regression analyses assessed main and interaction effects of personality traits and IPV exposure on maternal representations in pregnancy and stability and change over the first year of life. Maternal openness and agreeableness increased the odds of balanced prenatal representations while extraversion predicted change from nonbalanced to balanced representations when the child was age 1 year. The relationship with conscientiousness and openness was moderated by IPV exposure. The authors conclude that the interaction of IPV and maternal personality has significant implications for the earliest substrates of parenting. Future research may include maternal personality variables to further explicate their role as broad predictors of caregiving representations. Clarification of the role of neuroticism is needed. These findings may inform the development of family-based interventions targeting caregiving and insecure attachment relationships.