Exploring Coercive Control,PTSD,and the Use of Physical Violence in the Pre-prison Heterosexual Relationships of Incarcerated Women

Abstract

Although coercive control has been recognized over the past few decades as a form of intimate partner violence (IPV), researchers have often overlooked the role of coercive control in criminal behavior. Moreover, little is known about the effects of coercive control in the lives of incarcerated women. Using data from the 2014 Oklahoma Study of Incarcerated Women and Their Children (n = 337), this study utilizes a feminist pathways theoretical framework to explore the relationships between coercive control, posttraumatic stress disorder (PTSD) symptomology, and the use of physical violence in the preprison heterosexual relationships of incarcerated women. Results indicate that coercive control is significantly related to PTSD. Moreover, the relationship between coercive demands and women’s use of physical violence was partially mediated by PTSD symptoms suggesting that PTSD may play a significant role in women’s pathways to using physical violence in their intimate relationships.

Keywords

coercive control PTSD feminist pathways physical violence incarcerated women

Introduction

The United States incarcerates a larger share of its population than any other country (Walmsley, 2016). Recent estimates suggest that about 1 in 38 U.S. adults are currently incarcerated (Kaeble & Cowhig, 2018). Over the past quarter century, there has been significant growth in the number of women involved in the criminal justice system. Female incarceration has increased more than sevenfold since 1980 (Bronson & Carlson, 2019; Kalish, 1981). Indeed, in 2017 alone, 111,360 women (approximately 7% of the total national prison population) were incarcerated in state or federal correctional facilities (Bronson & Carlson, 2019).

In response to these trends, it has become increasingly important for researchers to understand more about women’s pathways to incarceration. Past research shows that abuse and trauma in both childhood and adulthood are among the most significant predictors of women’s offending and incarceration (Jones et al., 2018, 2019; Owen, 1998; Sharp, 2014). When it comes to experiences with intimate partner violence (IPV), past studies suggest that incarcerated women experience significantly higher rates of IPV than women in the general population (Bloom et al., 2003; Owen, 1998; Swan & Snow, 2002). It is estimated that 70% to 90% of women in prison have experienced IPV (Radatz & Wright, 2017) compared to just over a third (35.6%) of nonincarcerated women (Black et al., 2011). IPV experiences have also been strongly linked to posttraumatic stress disorder (PTSD) symptomology (Jones et al., 2018; Salisbury & Van Voorhis, 2009) and offending behaviors for women (Sharp, 2014).

While much research has established strong relationships between exposure to IPV, mental illnesses, and later involvement in the criminal justice system for women, the role of coercive control in pathways to PTSD symptomology and the perpetration of physical violence in intimate relationships have been significantly overlooked in such explorations. Coercive control refers to the nonphysical tactics used by abusers to maintain power and control over their partners. These tactics often include the use of intimidation/threat of harm, surveillance/isolation, economic control, and controlling the partner’s activities/decisions (Cook & Goodman, 2006; Stark, 2007).

As most research has focused on coercive control in the context of other forms of IPV, such as physical violence (Anderson, 2009; Johnson, 1995, 2008; Stark, 2007), little is known about the independent consequences of coercive control for women (for exceptions see Anderson, 2008; Crossman & Hardesty, 2018). Thus, the effects of, and processes involved in coercive control, including its relationship to PTSD symptoms and to the use of physical violence in intimate relationships of incarcerated women, remains unclear. Drawing upon a feminist pathways theoretical framework, this study addresses this gap in the literature by examining how coercive control may be associated with PTSD symptomology and the perpetration of physical violence in the preprison intimate relationships of incarcerated women. Findings from this study can not only expand our knowledge on the complexity of the relationships between exposure to nonphysical IPV, mental health, and offending behaviors but also inform current treatment needs of incarcerated women.

Literature Review

Coercive Control

For decades now, coercive control has been recognized as a tool that is used to establish dominance over a partner in an intimate relationship. Coercive control is central to the distinctions between Johnson’s (1995, 2008) two main types of IPV: intimate terrorism and situational couple violence. Intimate terrorism involves physical violence embedded in a general pattern of controlling behaviors that are often used by the perpetrator to exert control over one’s partner. In contrast, situational couple violence is not connected to a pattern of control. Instead, this form of violence arises in a single argument where one or both partners physically harm the other (Johnson, 1995, 2008). Women who experience coercive controlling violence often report more frequent, severe, injurious violence, and psychological distress than women who experience situational couple violence (Johnson, 2008). In addition, coercive controlling abuse in heterosexual relationships is highly gendered, with women overwhelmingly the victims of IPV coercion (Anderson, 2009; Myhill, 2015; Velonis, 2016).

Stark (2007) focuses on gender as a form of structural inequality that increases women’s vulnerability to control by men. He suggests that as Western society has moved toward more egalitarian and gender-inclusive norms, physical violence alone has become a less-effective mechanism for maintaining male privilege (see also Dutton & Goodman, 2005). He maintains that to regain patriarchal control, expressions of male dominance now include a systematic practice of manipulative and coercion tactics that at times are enforced through physical and sexual violence and intimidation of women (see also Anderson, 2009). Recent work has supported Stark’s (2007) assertions, with male partners having committed close to twice as many acts of coercive control in comparison to their female partners (Myhill, 2015; Swan et al., 2008).

Coercive Control and PTSD Symptoms

Coercive control has been linked to PTSD symptoms among both incarcerated (Cook & Goodman, 2006) and nonincarcerated women (Myhill, 2015). PTSD is a serious potentially debilitating condition that can occur in people who have experienced or witnessed traumatic terrifying events in which serious harm occurred or was threatened. Symptoms of PTSD can include flashbacks, nightmares, severe anxiety, avoidance coping, uncontrollable thoughts about the event(s), and even anger (Golding, 1999; Weathers et al., 1993). Women who experience coercive control coupled with more severe physical violence (e.g., choke or attempt to drown, hit with an object, beat with a weapon) have been found to be more likely to report greater psychological consequences, such as depression (Anderson, 2008), anxiety, fear, PTSD (Myhill, 2015), and/or a sense of loss of identity (Johnson, 2008) than women who do not. Other research suggests that coercive control has an independent effect on the development of PTSD symptoms among women (Anderson, 2008); however, little work has been done in this area.

Coercive Control, PTSD, and Women’s Use of Violence in Intimate Relationships With Men

Research focusing on coercive control among women finds that women who experience violence in the context of coercive control often report using physical violence against their abusive male partners (Anderson, 2008; Myhill, 2015; Stark, 2007). More specifically, the more frequently women report their male partners’ use of physical aggression and coercive behaviors against them, the more likely they are to report their own use of physical aggression toward their partners (Barbcock et al., 2003; Swan et al., 2008; Swan & Snow, 2006) out of self-defense or to protect their children (Caldwell et al., 2009; Hamberger & Larsen, 2015; Swan & Snow, 2002). PTSD symptoms are also prevalent among women who report being victims of coercive control (Cook & Goodman, 2006; Myhill, 2015) and perpetrators of physical violence (Swan, Gambone, & Fields, 2005). Taken together, prior studies suggest that coercive control may play an important role in the development of PTSD and women’s use of physical violence in intimate relationships.

Although previous studies have documented relationships between coercive control, PTSD, and violence perpetration, we know considerably less about whether PTSD symptoms mediate the relationship between coercive control and the use of physical violence (for examples see Sullivan et al., 2005; Swan et al., 2005). Studies have shown that exposure to severe and repeated abuse across the life course over long periods of time may be associated with an increased risk of developing PTSD (Cloitre et al., 2009) and aggression that manifests as IPV toward a male partner (Kubiak et al., 2017; Swan et al., 2005). In addition, individuals with PTSD symptoms often have difficulties with regulating their emotions, which has been related to perpetrating physical violence in intimate relationships (Breet et al., 2019).

Coercive Control, PTSD, and the Use of Physical Violence in the Lives of Incarcerated Women

While researchers have established links between coercive control, PTSD symptoms, and women’s use of physical violence against a male intimate partner, these relationships have been significantly understudied in the lives of incarcerated women. There is some work on the relationship between coercive control and women’s later involvement in the criminal justice system (DeHart, 2008; Slocum et al., 2005). For example, some women in custody have reported using physical violence against their intimate partner to escape or stop abuse (Henning et al., 2006; Miller & Meloy, 2006). Other studies indicate that coercive control has been directly linked to women’s incarceration, with some women reportedly taking the blame for a crime or being forced by abusive partners to engage in theft or robbery, prostitution, and/or selling drugs (DeHart, 2008; DeHart et al., 2014).

Theoretical Framework: Feminist Pathway Approaches

Feminist pathway approaches research has focused on girls’ and women’s life histories in order to understand how both childhood and adult experiences are linked to offending behaviors (Belknap, 2015). The pathways perspective emphasizes that experiences of abuse and oppression of women and girls may narrow their options and can place them on a trajectory where crime may be a response to manage these difficulties. In particular, feminist pathways highlight the ways women endure inequality, lack social power, and experience oppressive circumstances that can lead to life-long trauma and abuse (Belknap & Holsinger, 2006; Daly, 1992; Salisbury & Van Voorhis, 2009). Considerable research on women’s pathways to crime has documented experiences with childhood abuse (Belknap & Holsinger, 2006; Owen, 1998; Sharp, 2014), substance abuse (Daly, 1992; Salisbury & Van Voorhis, 2009), unhealthy intimate relationships (Salisbury & Van Voorhis, 2009), and a lack of self-efficacy (Sharp, 2014) as direct pathways into offending for women. Other factors such as mental illnesses are often interconnected with extensive histories of childhood and adult abuse as well as substance abuse problems (Daly, 1992; Jones et al., 2018; Salisbury & Van Voorhis, 2009) and violent behavior (Swan & Snow, 2006). Owing to the overlap of these events, pathways into crime are not mutually exclusive, and women may fall into any combination of pathways (Sharp, 2014).

Most feminist pathways approaches describe multiple pathways into crime for women. For example, childhood abuse may “push” girls into further negative experiences, such as drug and alcohol use, running away from home, living on the streets, and introducing them to criminogenic men or other circumstances that can increase their likelihood of experiencing further oppression and victimization (Belknap & Holsinger, 2006; Daly, 1992; Owen, 1998; Salisbury & Van Voorhis, 2009; Sharp, 2014). Another established pathway includes battered women who sometimes become violent, especially toward their abusive partners (Daly, 1992). Indeed, for some women, criminal behavior may become necessary for survival. This may be particularly true among women who use violence in self-defense against a controlling intimate partner (Caldwell et al., 2009; Miller & Meloy, 2006; Velonis, 2016). Overall, feminist pathways’ focus on the role of abuse/trauma, mental health issues, and women’s involvement in criminal behavior can help us further understand how coercive control may relate to PTSD symptomology and the use of physical violence in intimate relationships.

The Current Study

This study uses data from a stratified random sample of incarcerated women in Oklahoma (n = 337) and a feminist pathways theoretical framework to explore the relationships between coercive control, PTSD, and the use of physical violence against an intimate partner. Moreover, this study utilizes a modified version of Dutton et al.’s (2005) measure of coercive control (see more in Endnote 3) that captures multiple forms of coercive control to explore these relationships. This investigation endeavors to further understand the complex relationships between coercive control, mental health, and offending behaviors for justice involved women. Based on the proposed theoretical framework for this study and prior research on coercive control and incarcerated women, the following hypotheses are investigated:

Hypothesis 1: Coercive control will be positively associated with both the perpetration of physical violence against a male intimate partner and PTSD symptomology.

Hypothesis 2: PTSD symptoms will mediate the relationship between coercive control and the perpetration of physical violence against a male intimate partner.

Method

Participants

The data are from the 2014 Oklahoma Study of Incarcerated Mothers and Their Children (Sharp et al., 2014). Participants were sampled from the only three women’s correctional facilities in the state of Oklahoma: Mabel Bassett Correctional Center (MBCC), Dr. Eddie Warrior Correctional Center (EWCC), and Kate Bernard Community Correctional Center (KBCCC). The Oklahoma Department of Corrections (ODOC) provided the researchers with a random sample of 500 women, who were stratified by age, race, and security level. Controlling for demographics of the study sample (N = 500), ODOC assigned each woman with a randomly generated identification number, the list was sorted by identification numbers, and the first 1 to N (249 from MBCC, 203 from EWCC, and 48 from KBCCC) women were selected from each list for each facility. Comparisons of the study sample with the full population demographics conducted by the ODOC confirmed that the study sample did not differ statistically from Oklahoma’s incarcerated women population on any of the selected demographics. To minimize sample attrition due to discharges, transfers, or segregation, the sample from each facility was drawn the business day before the survey was undertaken; however, some women were unavailable due to work assignments, transfer, or being placed in segregated housing. Participants were given a 26-page self-administered paper/pencil questionnaire containing questions about their criminal record, abuse histories, family lives, and other demographic characteristics. Women were instructed¹ that completion of the questionnaire was voluntary, and no compensation was provided. Out of 500 women, 367 completed questionnaires for an overall response rate of 73.4%. After excluding records with missing data on key variables and women who reported living with a female partner before incarceration, the final analysis sample consisted of 337 women.

Measures

Victim of Coercive Control

Coercive control was measured by two latent constructs: (a) Coercive Demands and (b) Coercive Threat of Harm, using a modified version of Dutton et al.’s (2005) Coercive Control Measure for IPV.² Coercive Demands were measured by four indicators: (a) Household Demands, (b) Legal Demands, (c) Children/parenting Demands, and (d) Intimate Relationship Demands. Household demands were measured by asking participants whether their partner in the last 12 months of their most recent relationship had demanded something related to: (a) “taking care of the house” and (b) “buying or preparing food.” Affirmative responses to each of the two demand items were summed together into an index representing Household Demands (α = 0.76) Legal demands were measured by asking participants whether their partner in the last 12 months of their most recent relationship had demanded something related to: (a) “doing something against the law” and (b) “using street drugs.” Affirmative responses to each of the two demands items were summed together into an index representing Legal Demands (α = 0.81). Children/parenting demands were measured by asking participants whether their partner in the last 12 months of their most recent relationship had demanded something related to: (a) “taking care of children,” (b) “disciplining the children,” (c) “making every day decisions about the children,” (d) “making important decisions about the children,” and (e) “talking to child protective authorities.” Affirmative responses to each of the five demands items were summed together into an index representing Children/parenting Demands (α = 0.82). Intimate relationship demands were measured by asking participants whether their partner in the last 12 months of their most recent relationship had demanded something related to: (a) “having sex,” (b) “doing certain sexual behaviors,” (c) “having sex in exchange for money, drugs, or other things,” and (d) “photographing you nude or while having sex.” Affirmative responses to each of the four demands were summed together into an index representing Intimate Relationship Demands (α = 0.78).

Coercive Threat of Harm was measured using three indicators: (a) Psychological Threat of Harm, (b) Physical Threat of Harm, and (c) Economic Threat of Harm. Psychological threat of harm was measured by asking participants whether their partner in the last 12 months of their most recent relationship made them think he or she might do the following if they did not do what he or she wanted: (a) “say something mean, embarrassing or humiliating to you,” (b) “keep you from seeing or talking to family or friends,” (c) “tell someone else personal or private information about you,” (d) “keep you from leaving the house,” (e) “limit your access to transportation,” (f) “destroy or take something that belongs to you,” and (g) “have sex with someone else.” Affirmative answers to each of the seven acts were summed together into an index representing Psychological Threat of Harm (α = 0.84).

Physical threat of harm was measured by asking participants whether their partner in the last 12 months of their most recent relationship made them think he or she might do the following if they did not do what he or she wanted: (a) “physically hurt you,” (b) “try to kill you,” (c) “scare you,” (d) “force you to engage in unwanted sexual acts,” and (e) “physically hurt or kill your pet or other animal.” Affirmative answers to each of the five acts were added together into a Psychological Threat of Harm index (α = 0.80). Economic threat of harm was measured by asking participants whether their partner in the last 12 months of their most recent relationship made them think he or she might do the following if they did not do what he or she wanted: (a) “keep you from going to work,” (b) “cause you to lose your job,” (c) “cause you to lose your housing,” and (d) “hurt you financially.” Affirmative answers were added together into an Economic Threat of Harm index (α = 0.80).

PTSD

The latent mediating variable PTSD was measured using three indicators (a) Re-experiencing, (b) Avoidance and Numbing, and (c) Arousal Symptoms, which were measured using items from the PTSD Checklist-Civilian Version (PCL) (Weathers et al., 1993). This measure required participants to indicate the degree of distress they had experienced for each of the 17 PTSD symptoms indicated in Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association [APA], 1994) on a 5-point scale in response to past stressful experiences.³ Each PTSD symptom was recoded into a dummy variable with “extremely,” “quite a bit,” and “moderately,” coded as 1 (symptomatic), while “not at all” and “a little bit” were coded as 0 (nonsymptomatic). Re-experiencing was measured by asking participants if they have been bothered by the following four experiences: (a) repeated disturbing memories, (b) repeated disturbing dreams, (c) suddenly feeling as though the abuse were happening again, and (d) feeling very upset when something reminded them of their past abuse. The four re-experiencing items were summed together into a Re-experiencing index, ranging from 0 to 4 (α = 0.86). Avoidance and numbing was measured by asking participants if they have been bothered by the following six experiences: (a) avoided thinking about it or talking about abuse, (b) avoided situations that reminded the participant of the abuse, (c) had trouble remembering important parts of the abuse, (d) felt a loss of interest in activities that she used to enjoy, (e) feeling emotionally numb, and (f) feeling distant or cut off from other people. The six items were summed into an Avoidance and Numbing index, ranging from 0 to 6 (α = 0.88). Arousal symptoms was measured by asking participants if they have been bothered the following seven experiences: (a) feeling as though her future was somehow to be cut short, (b) had trouble falling asleep or staying asleep, (c) feeling irritable or having angry outbursts, (d) having difficulty concentrating, (e) being “super-alert” or watchful or on guard, (f) feeling jumpy or easily started, and (g) having physical reactions when something reminded her of a stressful experience. The seven items were then summed into an Arousal Symptoms index, ranging from 0 to 7 (α = 0.91).

Use of Physical Violence

The latent dependent variable of Use of Physical Violence is represented by two indicators: (a) Simple Assault and (b) Aggravated Assault.⁴ Simple assault and aggravated assault indices were created using measures from The Revised Conflict Tactics Scale (CTS2) (Straus et al., 1996). Simple assault was measured by asking the participant whether she had done any of the following six acts to her intimate partner in the last 12 months of her most recent relationship before coming to prison: (a) “I grabbed my partner,” (b) “I pushed or shoved my partner,” (c) “I threw something at my partner that could hurt,” (d) “I slapped my partner,” (e) “I twisted my partner’s arm or hair,” and (f) “I kicked my partner.” Affirmative responses to each of the six acts were summed together into an index representing Simple Assault (α = 0.84). Aggravated assault was measured by asking the participant whether she had done any of the following six acts to her intimate partner in the last 12 months of her most recent relationship before coming to prison: (a) “I punched or hit my partner with something that could hurt,” (b) “I slammed my partner against a wall,” (c) “I choked or strangled my partner,” (d) “I burned or scalded my partner on purpose,” (e) “I beat my partner up,” and (f) “I used or threatened to use a knife or gun.” Affirmative responses to each of the six acts were summed together into an index representing Aggravated Assault (α = 0.80).

Control Variables

Demographic characteristics were utilized as controls. Age was measured by respondents’ self-identified age in years and ranged from 18 to 69. Race/ethnicity was measured through self-identification. The possible responses categories were White, African American, Native American, Hispanic, and Other. In the analyses, this variable was recoded into dummy variables representing Black, Native American, Latinx/Other,⁵ with White as the reference group. Education was measured by asking participants to report their level of education prior to prison. In the analyses, education was recoded into dummy variables representing education as high school (Educ = HS), education greater than high school (Educ > HS), with less than high school representing the reference category. Marital status was measured by asking participants their marital status at the time they were arrested for the offense for which they were currently serving time. In the analyses, marital status was recoded into dummy variables representing cohabit (affirmative responses to not married but living with a male partner, not married but living with a female partner, and widowed but living with a partner), not married/widowed (affirmatives responses to divorced, separated, and widowed no/partner), with married representing the reference group. Current offense was measured by asking participants to report their most current offense (alcohol- and drug-related offenses, crimes against persons, and property-related crimes).

Procedures

Structural equation modeling (SEM) was used to explore the relationships between coercive control, PTSD, and the use of physical violence. SEM offers several advantages over other analytic methods. First, as demonstrated in the present analyses, it allows for the estimation of multiple equations simultaneously, so that the association between multiple predictor and outcome variables can be assessed in the same model. SEM specifies hypothesized relationships between observed variables and their latent constructs and the relationships among latent constructs in the model. The measurement model describes the hypothesized relationship between a number of measurement variables and the latent or unobserved constructs. The structural relations model expresses the hypothesized causal relationships among latent constructs as regression coefficients. This procedure also evaluates the estimated models and obtains maximum-likelihood estimates of model parameters and goodness-of fit indices. A model that provides a good fit to the data is generally considered one that has a root mean square of approximation (RMSEA) value of less than .05 with a p test for closeness of fit for RMSEA of .05 (Browne & Cudeck, 1992) and a comparative fit index (CFI) with a value close to 1 (Bentler, 1990).

The analyses were conducted in two stages. First, the baseline model was estimated specifying the relationships between coercive demands and coercive threats of harm on use of violence against an intimate partner. Using that model as a basis for comparison, the second model was estimated decomposing the relationship of coercive control (i.e., coercive demands and coercive threats of harm) on the use of violence by specifying PTSD symptoms as the mediating variable (the theoretical model). Coercive demands and coercive threats of harm are modeled as influencing PTSD symptoms and the use of violence against an intimate partner. The PTSD symptoms variable is modeled as influencing use of violence. Social demographic characteristics are modeled as influencing both forms of coercive control, PTSD symptoms, and the use of violence against an intimate male partner. It is also important to note that due to the cross-sectional and retrospective nature of the data, coercive control and perpetration of physical violence are measured during the same time frame (12 months before incarceration). Moreover, while PTSD symptomology is measured by respondents indicating past experiences with PTSD symptomology, a specific time frame is not identified in the data. While this is a limitation, this approach has been utilized in other studies exploring these processes (Caldwell et al., 2009; Swan et al., 2005) and can help us gain further insights into these relationships in the lives of incarcerated women.

Results

Descriptive Characteristics of Oklahoma Incarcerated Women

Table 1 presents the basic descriptive statistics for the key observed variables in the analyses. The average age of the sample of women was 37. There were 167 Whites (49.6%), 51 Blacks (14.9%), 50 Native American (14.9%), and 69 Latinx/Other (20.5%). Education levels were low, with 130 (38.6%) women having less than high school education, 116 (34.4%) reporting high school graduation or General Educational Development (GED), and the remaining 91 (27.0%) reporting education beyond high school including vocational and college. Marriage was not common in the sample, with 85 (25.2%) reporting being married, 96 reporting cohabitation (28.5%), and 156 (46.3%) women reporting they were not married, separated, divorced, or widowed prior to incarceration. The most common offense types for which these women were currently incarcerated⁶ included alcohol- and drug-related offenses (40.0%), crimes against persons (26.8%), and property-related crimes (20.8%), which closely matches the breakdown of the incarcerated offenses of the women’s prison population in Oklahoma (ODOC, 2015).

Table 1:

Sample Characteristics (n = 337)

Variables	Range	Frequency	Percent
Demographics
Age, mean	18–65		37.0
Race
White (reference category)	0–1	167	49.6
Black	0–1	51	15.1
Native American	0–1	50	14.9
Latinx/Other	0–1	69	20.5
Education at Incarceration
Education < high school (reference category)	0–1	130	38.6
Education = high school	0–1	116	34.4
Education > high school	0–1	91	27.0
Marital status
Married (reference category)	0–1	85	25.2
Cohabit	0–1	96	28.5
Not married/widowed	0–1	156	46.3
Incarcerated offense
Alcohol- or drug-related offenses		134	40.0
Crimes against people		129	38.4
Property-related crimes		73	21.6
Use of violence
Simple assault, (M = 1.5)	0–6	166	49.3
Aggravated assault, (M = 0.6)	0–6	92	27.3
Coercive demands
Household demands, (M = 0.8)	0–2	165	49.0
Legal demands, (M = 0.7)	0–2	141	41.8
Children/parenting demands, (M = 0.9)	0–4	116	34.4
Intimate relationship demands, (M = 0.9)	0–4	148	43.9
Coercive threats of harm
Psychological threat of harm, (M = 2.2)	0–7	197	58.5
Physical threat of harm, (M = 1.1)	0–5	151	44.8
Economic threat of harm, (M = 0.9)	0–4	133	39.5
PTSD symptoms
Re-experiencing, (M = 1.9)	0–4	234	69.4
Avoidance and numbing, (M = 3.0)	0–6	252	74.8
Arousal symptoms, (M = 3.6)	0–7	269	79.8

Note. PTSD = posttraumatic stress disorder.

Approximately half of the women (49.3%) in the sample reported using simple assault and one third (28.5%) reported using aggravated assault against their most recent intimate partner prior to incarceration. Experiences of coercive control were fairly common among the women, with 165 (49.0%) reporting household demands, 141 (41.8%) reporting legal demands, 116 (34.4%) reporting children/parenting demands, 148 (43.9%) reporting intimate relationship demands, 197 (58.5%) reporting psychological threat of harm, 151 (44.8%) reporting physical threat of harm, and 133 (39.5%) reporting economic threat of harm. PTSD symptomology was quite high, with 69.4% of the women reporting re-experiencing symptoms, 74.8% reporting avoidance and numbing symptoms, and 79.8% reporting arousal symptoms.

Baseline Model

The standardized factor loadings of the measurement variables on each latent construct are presented in Table 2. The table provides the unstandardized and standardized coefficients as well as the standard errors and p values of each coefficient. To identify each latent construct, the metric was set for one of the measurement variables (indicated by an unstandardized coefficient of 1.00). Coercive demands, coercive threats of harm, and the use of violence as latent variables represented by multiple indicators. The factor loading for each latent construct is considerable and statistically significant.

Table 2:

Measurement Model for Baseline Model

Construct and indicators	Unstandardized	Standardized	p
Coercive demands
Household demands	1.00	.65	.00
Legal demands	0.96	.62	.00
Children/parenting demands	0.96	.60	.00
Intimate relationship demands	1.37	.68	.00
Coercive threats of harm
Economic threats of harm	1.00	.83	.00
Psychological threats of harm	1.57	.98	.00
Physical threats of harm	1.06	.78	.00
Use of violence
Simple assault	1.00	.85	.00
Aggravated assault	0.54	.80	.00

Note. χ² = 97.46 (df = 65), p ≤ .001; RMSEA = .04; CFI = .98. RMSEA = root mean square of approximation; CFI = comparative fit index.

The structural effects, presented in Figure 1,⁷ partially support the first hypothesis. Coercive demands were positively related to coercive threats of harm (β = .40, p < .001), indicating that coercive demands were significantly related to coercive threats of harm or vice-versa. Moreover, coercive demands were positively related to the use of physical violence (β = .40, p = .04), indicating that being a victim of coercive demands were significantly associated with women’s use of physical violence against an intimate male partner prior to incarceration. Surprisingly, coercive threats of harm were not directly related to perpetration of physical violence after controlling for coercive demands. Several demographics were also significantly related to having experienced coercive demands, coercive threats of harm, and reported use of physical violence. Black women experienced less coercive demands (β = −.13, p = .03) and coercive threats of harm (β = −.12, p = .01) compared to White women. In addition, Native American women experienced less coercive demands at the hands of an intimate partner (β = −.14, p = .02) compared to White women. Cohabiting before incarceration had a positive and significant effect on use of physical violence (β = .28, p < .001) compared to married women. Furthermore, not married/widowed women before incarceration was positively related to experiences of coercive threats of harm (β = .13, p = .03) compared to married women. The R² value for the use of physical violence in the baseline model was .28. The baseline model predicting perpetration of physical violence fits the data relatively well, χ² = 97.46, (df = 65), p ≤ .01; RMSEA = .04; CFI = 98.

Figure 1:

Baseline Model Illustrating the Relationship Between Coercive Control and Use of Violence

Theoretical Model

The baseline model suggests that coercive demands were associated significantly with the use of physical violence. Next, this study examined whether the relationship between being a victim of coercive control and the use of physical violence is fully or partially mediated by PTSD. The theoretical model estimates the relationships of coercive demands and coercive threats of harm on PTSD symptomology and the use of physical violence, controlling for social demographics. Table 3 presents the unstandardized and standardized factor loadings, along with the standard errors and p values, of the observed variables of each construct. The theoretical model has one more variable, PTSD symptoms, measured as a latent construct represented by multiple indicators. The factor loadings for each latent construct are appreciable and significant. All loadings exceed or approach .5. The loadings are all statistically significant (p ≤ .001).

Table 3:

Measurement Model for Theoretical Model

Construct and indicators	Unstandardized	Standardized	p
Coercive demands
Household demands	1.00	.57	.00
Legal demands	1.29	.73	.00
Children/parenting demands	0.93	.58	.00
Intimate relationship demands	1.84	.73	.00
Coercive threats of harm
Economic threats of harm	1.00	.72	.00
Psychological threats of harm	1.97	.97	.00
Physical threats of harm	1.22	.79	.00
PTSD symptoms
Re-experiencing	1.00	.98	.00
Avoidance and numbing	1.30	.90	.00
Arousal symptoms	1.48	.88	.00
Use of violence
Simple assault	1.00	.85	.00
Aggravated assault	0.55	.81	.00

Note. χ² = 151.02 (df = 106), p ≤ .001; RMSEA = .04; CFI = .99. PTSD = posttraumatic stress disorder; RMSEA = root mean square of approximation; CFI = comparative fit index.

The structural effects in the theoretical model are represented in Figure 2. Coercive demands were positively associated with coercive threats of harm or vice-versa (β = .73, p < .001), among women. Coercive demands and coercive threats of harm were both positively associated with PTSD (β = .19, p = .04; β = .38, p < .001), as predicted. These relationships were independent of age, race, education, and marital status. Moreover, PTSD was significantly and positively associated with the use of physical violence (β = .15, p < .001). In the model, the relationship of coercive demands on the use of physical violence was significantly reduced once PTSD is added to the equation. This suggests that the association of coercive demands on the use of physical violence was partially mediated by PTSD, as predicted.⁸ Similar to the baseline model, coercive threats of harm were not directly related to use of physical violence after controlling for coercive demands, suggesting that PTSD does not mediate the relationship between coercive threats of harm and the use of violence. However, coercive threats of harm were significantly related to the perpetration of physical violence through the pathways of coercive demands and PTSD symptoms. Several demographics were also significantly related to coercive demands, coercive threats of harm, PTSD, and the use of physical violence against an intimate male partner. Similar to the baseline model, Black women experienced less coercive demands (β = −.14, p = .02) and coercive threats of harm (β = −.13, p = .01) compared to White women. In addition, Native American women experienced less coercive demands at the hands of a male intimate partner (β = −.14, p = .02) compared to White women. Cohabiting was significant and positively related to using physical violence (β = .28, p < .001). Both cohabiting or not married/widowed before coming to prison was negatively related to PTSD (β = −.11, p = .05; β = −.16, p < .01) compared to married women. The R² value for PTSD was .31 and the R² for the use of physical violence was improved to .35 from .28 at the baseline model. The theoretical model predicting use of physical violence fits the data relatively well, χ² = 151.02, (df = 106), p ≤ .01; RMSEA = .04; CFI = 99.

Figure 2:

Theoretical Model Illustrating the Relationship Between Coercive Control, PTSD, and Use of Violence

Discussion and Conclusion

This study sought to add to the growing literature on coercive control and women’s pathways to prison using a feminist pathways theoretical framework to help highlight the significance of coercive control and PTSD symptoms as important factors in using physical violence in the preprison heterosexual relationships of incarcerated women. This study found that coercive demands and coercive threats of harm were positively related to experiencing PTSD symptoms for incarcerated women in Oklahoma. This pattern is supported by feminist pathways and suggests that coercive control is related to PTSD symptomology as suggested by previous research (Cook & Goodman, 2006; Myhill, 2015). Moreover, women who reported more coercive demands also reported more coercive threats of harm and vice-versa, which indicates that women may experience multiple forms of coercion from their male intimate partners before coming to prison.

In addition, this study found that women who experienced coercive control also reported using violence against their male intimate partner before coming to prison. This finding supports past research and suggests that coercion may be directly linked to women’s use of physical violence intimate relationships (Bair-Merritt et al., 2010; Barbcock et al., 2003; Caldwell et al., 2009; Hamberger & Larsen, 2015; Swan et al., 2005; Velonis, 2016). These women may be motivated to use physical violence in self-defense, fear, defense of children, gaining control over their abusive situation and/or retribution against their abusive partners (Barbcock et al., 2003; Caldwell et al., 2009; Hamberger & Larsen, 2015).

Surprisingly, coercive threats of harm were not directly related to the use of physical violence. However, coercive threats of harm were partially related to the use of physical violence through the pathway of PTSD and had a larger effect on PTSD symptomology than coercive demands. This suggests that coercive threats of harm may evoke significantly more psychological distress than coercive demands and that using physical violence in intimate relationships may be connected to PTSD symptoms among incarcerated women who experience coercive threats of harm. These findings indicate that economic, psychological, and/or physical threats of harm may be related to women’s long-term mental health more so than other forms of coercive control used by men.

This study also explored the mediating role of PTSD symptomology as conceptualized in the theoretical model. The results of this study indicated that PTSD symptoms partially mediate the relationship between coercive demands and the use of physical violence. This relationship suggests that PTSD symptomology is likely a central mechanism in understanding use of physical violence in heterosexual relationships among incarcerated women who have experiences of coercive control. Suffering from PTSD symptoms, such as re-experiencing, avoidance and numbing, and arousal symptoms, women may use violence in response to those symptoms (Caldwell et al., 2009; Sullivan et al., 2005; Swan et al., 2005). This important finding supports feminist pathways literature that shows that offending behaviors may be embedded in PTSD symptomology developed from exposure to abusive and traumatic life experiences (Daly, 1992; DeHart, 2008; DeHart et al., 2014).

This study’s findings extend feminist pathways examinations by providing a better understanding of how coercive control as well as accompanying PTSD symptoms relate to women’s use of physical violence. Consistent with feminist pathways (Belknap & Holsinger, 2006; Owen, 1998; Salisbury & Van Voorhis, 2009; Sharp, 2014) and prior work on coercive control (Fanslow et al., 2015; Sullivan et al., 2005; Swan et al., 2005), many of the women in the sample reported experiencing high levels of nonphysical coercive control, a form of IPV, and developed psychological distress as well as perpetrated physical violence against a male intimate partner. Approximately half of the women reported experiences of coercive demands and coercive threats of harm before coming to prison. Moreover, the majority of the women reported having PTSD symptoms and a third-to-half of the women reported using aggravated or simple assault against their male intimate partner prior to incarceration.

Overall, this study offers several important contributions to the literature on women’s use of physical violence. First, the findings provide support for considering the role of coercive control when it comes to understanding women’s pathways to using physical violence. In particular, experiences of male dominance through nonphysical coercive control are significantly related to women’s use of physical violence. This significant finding suggests that researchers must consider the independent effects of coercive control (also see Anderson, 2008; Crossman & Hardesty, 2018) on women’s use of violence in heterosexual relationships rather than only examining it in the context of physical violence. Second, the findings of this study indicate that coercive control is strongly related to PTSD symptomology and that PTSD may partially mediate the relationship between coercive control and women’s use of physical violence. This significant finding suggests that PTSD may work as a central mechanism for women’s use of violence.

Limitations and Future Research

While the results of this study are informative and can be generalized to incarcerated women in Oklahoma, there are several limitations. First, this study focuses specifically on women who use physical violence in response to coercive control. Prior research suggests that women may be the sole aggressor in some intimate relationships (Caldwell et al., 2009; Swan & Snow, 2002). Indeed, some women may use other forms of IPV, such as psychological aggression and control, in response to IPV victimization (Swan & Snow, 2006) or they may be exerting their own control in the relationship (Swan & Snow, 2002). Future research should further explore women’s motives for IPV, as well as other possible IPV responses to coercive control. Second, a common critique of the feminist pathways theoretical framework is that it overlooks intersectionality. The intersection of gender, race, and class likely influence the relationships between coercive control, PTSD, and physical violence. Future research should utilize an intersectional approach to further examine these processes. Third, this study is limited in only focusing on heterosexual relationships. Prior work suggests that IPV experiences in lesbian and gay relationships are linked to more depressive symptoms and great involvement in violent behaviors compared to heterosexual relationships (Gehring & Vaske, 2015). Thus, future research should also examine coercive control in same-sex couples.

Fourth, the incarcerated women questionnaire utilized in this study only contained measures of PTSD from the DSM-IV. The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; APA, 2013) contains much more exhaustive and complex measures of PTSD including measures that pays more attention to the behavioral symptoms that accompany PTSD (e.g., negative emotional states, and reckless and self-destructive behavior) (also see endnote 3). In addition, this study only examined whether or not these women experienced different forms of coercive control within 12 months before coming to prison. Prior work suggests that complex traumatic events that are repetitive, prolonged, and cumulative are linked to the development of a complex posttraumatic stress disorder (C-PTSD) diagnosis (Cloitre et al., 2009). Complex PTSD symptoms are distinctively different from PTSD in that those who are diagnosed with C-PTSD experience extreme violence and stress over an extended period of time while those who have PTSD are exposed to more short-lived trauma. C-PTSD is associated with enduring personality change, relational dysfunction, identity disturbance, and difficulties with regulating emotions, such as anger (van Dijke et al., 2015). Thus, further investigations that examine additional elements of PTSD including C-PTSD as well as complex trauma in relation to violence perpetration would be informative.

Finally, since the data in this study were cross-sectional and retrospective, it is difficult to determine time-ordered relationships such as mediation. One cannot rule out the possibility that PTSD symptomology began after experiencing other abusive or traumatic events perhaps in late childhood or early adolescence rather than coercive control (though in results not shown modeling PTSD symptoms as a predictor of experiences of coercive control was not statistically significant). In addition, there may be bidirectional relationships between physical violence and experiences of coercive control since the use of only past-year IPV (as opposed to life time) makes it difficult to determine if the use of physical violence followed or proceeded coercive control for these women. While this study cannot definitively establish temporal priority, a number of studies suggest that PTSD symptoms are directly related to prior experiences of coercive control and women’s use of violence in intimate relationships (Caldwell et al., 2009; Sullivan et al., 2005; Swan et al., 2005). Data collected from a prospective, longitudinal design that measures the timing and onset of coercive control, PTSD, and use of violence, would help clarify these sequences.

Policy Implications

Despite these limitations, this study is unique from previous work in that it measures the independent effects of multiple forms of coercive control (Dutton et al., 2005) on PTSD symptoms, as they are linked to the perpetration of physical violence against a male intimate partner in a sample of incarcerated women. Based on the findings of this study, experiences of coercive control should be brought to the center of inquiry on women’s use of physical violence in intimate relationships including how coercive control may work as a direct pathway to offending behaviors for women. Based on the results, both criminologists and policy makers should consider the role of coercive control in the development of PTSD symptoms in understanding women’s pathways to prison. Given the prevalence of coercive controlling experiences and PTSD symptoms, as well as the significant number of women in this study’s sample who reported using some form of violence against their male intimate partner before coming to prison, it is imperative that prisons implement programming to help women understand these relationships (Bloom et al., 2003). Moreover, because PTSD symptoms are a central mechanism in understanding the connection between coercive control and the perpetration of physical violence, it is critical that incarcerated women receive help in resolving emotional and psychological issues that resulted from these abusive experiences. Helping these women resolve psychological distress, coupled with teaching them how to deal with other negative emotions such as anger, could help empower these women whose lives are often riddled with trauma and abuse. This in turn could also further help prepare these women for re-integration back into society.

Footnotes

Acknowledgements

I would like to thank John P. Hoffmann, B. Mitchell Peck, Susan F. Sharp, and Meredith G. F. Worthen for helpful comments on earlier versions of this paper.

ORCID iD

Melissa S. Jones

Notes

Melissa S. Jones is an assistant professor in the Department of Sociology at Brigham Young University. She offers expertise in the fields of criminology, gender, family, and general sociology. Her research focuses on gender, crime, and deviance, childhood adversity, intimate partner violence, the incarceration of women, and the impact of both trauma and abuse on criminal behaviors.

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