Physical Intimate Partner Violence and Emotional Harm in Five U.S. States

Abstract

The purpose of this study was to assess the relationship between physical intimate partner violence (IPV) victimization and four related aspects of emotional well-being: threat sensitivity, intolerance of uncertainty, impulse control, and access to resources for emotional regulation. We draw on a transactional model of IPV and emotional regulation to theorize how invalidation and partner threats in relationships can generate harmful emotional outcomes. We used representative data collected for residents living in five U.S. states: Colorado, Minnesota, Mississippi, New Jersey, and Texas. Our analytic sample included individuals who reported having been in a romantic relationship in the past year (N = 2,501). Data were collected using a probability-based web panel, between April 29 and May 15, 2022. Following the presentation of descriptive statistics and bivariate correlations, we developed a series of four multivariate models (ordinary least squares [OLS], negative binomial) to analyze the association between IPV victimization and each emotional outcome. All models adjusted for pertinent demographic and geographic control measures. Physical IPV victimization was associated with increased intolerance of uncertainty and heightened threat sensitivity. IPV victimization also corresponded with poorer impulse control and fewer resources for emotional regulation. Overall, our results demonstrate that experiences of physical IPV victimization are linked to poorer emotional outcomes. These outcomes can be harmful to broader mental health and potentially impact long-term well-being. The findings underscore the importance of mental health screenings that extend beyond assessments of diagnostic-level functions and allocating resources toward alleviating other clinically relevant factors that might arise from or even prompt additional exposure to physical IPV.

Keywords

violence exposure mental health and violence domestic violence

Intimate partner violence (IPV) is defined as mistreatment from current and former romantic partners through physical or sexual violence, stalking, and/or psychological aggression (Breiding et al., 2015). Data from the Centers for Disease Control and Prevention’s National Intimate Partner and Sexual Violence Survey show that approximately 41% of women and 26% of men experience sexual violence, physical violence, and/or stalking by an intimate partner throughout their life in the United States (National Center for Injury Prevention and Control, Division of Violence Prevention, 2022). Given the prevalence of IPV, substantial research has examined its consequences, repeatedly finding negative impacts across a range of physical and mental health outcomes (Stubbs & Szoeke, 2022).

A large body of evidence shows that IPV victimization generates harm across psychological domains (Devries et al., 2013; Grose et al., 2019; Stubbs & Szoeke, 2022; Zancan & Habigzang, 2018), often leaving victims to experience clinically significant levels of functional impairment (Hellmuth et al., 2014). Victimization can also exacerbate nonclinical emotional concerns that contribute to future psychological diagnoses (Bonomi et al., 2009; Dichter et al., 2017; Golding, 1999; Iverson et al., 2013). For example, evidence demonstrates that emotional dysregulation is a substantial contributing factor for post-traumatic stress (PTS) (Weiss et al., 2020).

The current study examines the connections between experiences of physical IPV and four related aspects of emotional harm. We address three gaps in the extant literature. First, much of the literature on IPV exposure and mental health has focused on outcomes traditionally categorized in the DSM-5-TR, such as depression, anxiety, and PTS. Less attention has focused on other emotional characteristics, such as altered threat sensitivity, intolerance of uncertainty, and resources for emotional regulation. Second, many studies that examine the relationship between IPV victimization and psychological functioning draw upon nonrepresentative samples. Our study employs data from a recent representative survey in 2022 from five U.S. states (Mississippi, New Jersey, Colorado, Texas, and Minnesota). Our final analytic sample includes about 2,400 men and women, providing more generalizable evidence than prior studies among a robust and representative sample across diverse regions of the country.

Finally, reported increases in IPV throughout the COVID-19 pandemic have been linked to proximity to the perpetrator for extended hours, safety concerns regarding contracting COVID-19, and increased isolation (Leigh at al., 2022; Muldoon et al., 2021; Opanasenko et al., 2021). The 2022 survey data used in this study provide timely insight into experiences of IPV during the ongoing pandemic that will likely continue to shape mental health impacts in the coming years (Muldoon et al., 2021). Indeed, studies have already examined shifts in safety planning and interventions in light of COVID-19, and these changes will continue to warrant additional research around long-term mental health outcomes and IPV victimization during this time (Metheny et al., 2021).

Background

Violent victimization is associated with significant harms to mental, physical, and behavioral health across the life course (Demaris & Kaukinen, 2005; Exner-Cortens et al., 2013; Semenza et al., 2021, 2022; Testa et al., 2022, 2023). Research demonstrates significant health harms particularly associated with physical IPV victimization. Overall, about 75% of female IPV survivors and 48% of male IPV survivors experience some form of physical injury related to their victimization (National Center for Injury Prevention and Control, Division of Violence Prevention, 2022). A recent systematic review by Stubbs and Szoeke (2022) examined the long-term effects of IPV on physical health outcomes and health-related behaviors, showing that IPV has negative effects on physical health particularly for women, including worsening menopause symptoms and increasing the risk of developing diabetes, contracting sexually transmitted infections, engaging in risk-taking behaviors such as drug and alcohol use, and developing chronic diseases and pain.

The relationship between IPV victimization and negative mental health outcomes is also well-established (Zancan & Habigzang, 2018). In one systematic review, evidence across studies including 36,163 participants suggested that IPV experience is associated with an increased risk of depression and suicidality, while individuals with mental illnesses are also at increased risk of violent victimization (Devries et al., 2013). In another systematic review of 58 studies, Lagdon and Colleagues (2014) found that IPV contributes to more adverse mental health outcomes for victims compared to individuals who have never experienced IPV or those who experienced other traumatic events. Additional reviews have found that women exposed to IPV experience a 1.5 to 2-fold increased risk of elevated depressive symptoms and postpartum depression compared to women who have not experienced IPV (Beydoun et al., 2012). Collectively, these reviews indicate that experiences of IPV are associated with heightened risk for a range of deleterious psychological outcomes.

Transactional Model of IPV Victimization and Emotional Harm

Much of the research on IPV and mental health has focused on clinical diagnoses of depression and PTS with a particular emphasis on the role of trauma in generating psychological harm (Grose et al., 2019; Lagdon et al., 2014). The current study extends the extant literature by examining nonclinical yet related aspects of emotional well-being (emotional regulation, threat sensitivity, impulse control, intolerance of uncertainty) associated with physical IPV victimization. We consider these areas of emotional adaptation and well-being because they are understudied compared to diagnostic outcomes like depression and PTS.

We draw on the transactional model for emotional dysregulation to consider how those who have experienced IPV may develop challenges related to regulating emotions in numerous ways (Fruzzetti & Iverson, 2006; Fruzzetti et al., 2005; Linehan, 1993). Transactional theory outlines how increases in emotional dysregulation can stem from continuous interactions between a person’s heightened emotional vulnerability and invalidating social responses from those around them (Iverson et al., 2009). The transactional model focuses on the person–environment relationship mediated by the processes of cognitive appraisal and coping (Lazarus & Folkman, 1987). Transactional theory has been used to investigate a wide range of relational dynamics among family members (Fruzzetti et al., 2005), romantic couples (Fruzzetti & Iverson, 2004), organizational colleagues (Perrewé & Zellars, 1999), and product consumers (Duhachek & Kelting, 2009).

Transactional theory is particularly useful for assessing how emotional dysregulation can arise within physically abusive intimate partner relationships as a result of changes to the dual processes of cognitive appraisal and coping (Biggs et al., 2017; Lazarus & Folkman, 1987). Invalidation from an abusive partner can include criticism and physical punishment resulting in shame, grief, anxiety, and fear (Fruzzetti & Iverson, 2004). Physical violence is likely to be extraordinarily distressing to victims of abuse, heightening emotional vulnerability contributing to emotional dysregulation. Victims of physical abuse in invalidating situations can develop increased sensitivity to their partners and may exhibit more extreme reactions stemming from the continued presence of a dangerous and unpredictable partner (Iverson et al., 2009). These stressors contribute to higher levels of negative emotions (like sadness and anxiety), which can evolve into depression, hopelessness, difficulties in making decisions, and self-blame.

Within the transactional framework, we anticipate that experiencing physical IPV can shape emotional sensitivity and induce heightened vulnerabilities across numerous domains (Weiss et al., 2021; Weiss et al., 2022). For example, a path analysis of a sample of 354 women revealed that physical, sexual, and psychological IPV were associated with emotional dysregulation as well as PTS symptom severity (Simpson et al., 2022). Multiple studies involving military members, college students, and married couples mirror similar results, showing that difficulties with emotional regulation are associated with severity and occurrence of IPV victimization (Audet et al., 2022; Berke et al., 2019; Cole et al., 2022; Gurtovenko & Katz, 2020; Lee et al., 2020; McNulty & Hellmuth, 2008). In one study identifying factors associated with IPV survivors’ perceptions of safety and risk of revictimization following police intervention, 164 women were surveyed and 11 took part in qualitative interviews (Ditcher & Gelles, 2012). The findings illustrated that feeling unsafe and perceiving oneself to be at risk of future violence was associated with experiencing particular forms of IPV, including battery and sexual violence (Ditcher & Gelles, 2012).

Although research demonstrates an association between physical IPV and outcomes like emotional regulation and poorer perceptions of safety, less work has been conducted on the link between IPV victimization and intolerance of uncertainty. Yet, increased sensitivities resulting from physical abuse victimization may manifest into hypervigilance and a heightened sense of threat, generating greater fear of the unknown and a lower tolerance for uncertainty. To date, the research that has been done on this topic has been conducted largely around the issue of child abuse. For instance, recent research drawing on a sample of young adults in Turkey demonstrated that psychological child abuse victimization was linked to intolerance of uncertainty later in life (Dirican et al., 2023). In another study of 700 high school students in Iran, childhood maltreatment was associated with increased risk for non-suicidal self-injury, mediated by both emotional dysregulation and intolerance of uncertainty (Ghaderi et al., 2020).

The transactional model also suggests that victims of physical abuse may experience altered impulse control generated from a need to engage in immediate reactions or extreme responses to everyday occurrences in an abusive relationship (Tull et al., 2020; Weiss et al., 2020). While self-control has been found to influence future risk of victimization, experiences of violent victimization are also likely to shape victims’ coping responses and influence subsequent impulse control (Pratt et al., 2014). Experimental research has shown that distress can lead to poor impulse control, providing short-term affect regulation at the risk of long-term harm (Tice et al., 2018). Experiences of physical abuse and the resultant distress could therefore lead to poorer impulse control, although there has been limited research on the specific link between physical abuse and subsequent impulse control. However, in one longitudinal study, researchers found that experiences of childhood sexual abuse were negatively associated with impulse control in a nationally representative sample of adolescents and adults (Tasharrofi & Barnes, 2019). Despite this initial study, it is clear that more research is needed on the issue, especially in relation to physical IPV.

Current Study

In light of the extant literature, we assess how physical IPV victimization is associated with numerous aspects of emotional well-being. We argue that IPV victimization is likely to be associated with harm to emotional functioning due, at least in part, to the invalidation and consistent vulnerability experienced by many victims in abusive relationships. We focus on the four specific aspects of emotional functioning here because they capture how people experience and respond to both their internal (e.g., emotions, impulses, sense of uncertainty) and external (perceived threat) environments. Drawing on a recent representative sample of U.S. respondents in five geographically diverse states, we hypothesize that physical IPV victimization will be positively associated with each main outcome of interest, including: elevated intolerance of uncertainty, greater threat sensitivity, poorer impulse control, and fewer resources for emotional regulation.

Methods

Data

The data for this study include 3,510 U.S. adults (aged 18+) recruited from the following five states: Colorado (N = 415), Minnesota (N = 673), Mississippi (N = 178), New Jersey (N = 540), and Texas (N = 1,704). When designing the survey, the authors of this study chose these five states, given their geographical, cultural, and political diversity across major regions of the United States. For the present study, we only include individuals who indicate having been in an intimate relationship in the past year (N = 2,501). All participants provided informed consent prior to completing the survey and all procedures were reviewed by the Rutgers University Institutional Review Board prior to the onset of the study.

Participants were recruited by Ipsos via KnowledgePanel (KP), a probability-based web panel, between April 29 and May 15, 2022. All participants completed the surveys online and were entered into the KP sweepstakes to enable compensation after completion of the survey.¹ The data were weighted via three consecutive steps. First, design weights for KP assignees were computed to reflect selection probabilities. Next, design weights for all screened respondents were raked according to geographic and demographic distributions, including: sex by age, race/ethnicity, race/ethnicity by state, education by state, sex by state, and household income by state. Geodemographic adjustments were made within states according to benchmarks provided by the 2019 American Community Survey. Finally, the resulting weights were scaled to add up to the total number of qualified respondents, resulting in both a total sample and state weight for each respondent. We used total sample weights for the present analysis.

Physical IPV

Our primary independent variable measured whether or not a respondent has experienced physical IPV victimization in the past 12 months. For those who indicated having been in a romantic relationship in the past 12 months, respondents were asked about a number of positive and negative experiences with their current partner using select items derived from the Conflict Tactics Scale (CTS) (Straus, 1979). We used four items regarding experiences of physical violence, including: (a) having been injured by a partner in a fight, (b) pushed, shoved, or slapped by a partner, (c) punched, kicked, or beat up by a partner, and (d) having to go to the doctor because of injuries sustained in a fight with a partner. Respondents were asked to indicate how many times each experience had occurred, including: (a) never, (b) once in the past year, (c) twice in the past year, (d) 3–5 times in the past year, (e) 6–10 times in the past year, (f) 11–20 times in the past year, and (g) more than 20 times in the past year. We created binary items for each to indicate any experience of victimization in the past year (1 = yes; 0 = no). The resulting scale demonstrated sufficient reliability (α = .753). We added the four items together and then recoded the scale into a binary measure to indicate whether the respondent had experienced any form of physical IPV in the past year or not (1 = yes; 0 = no).

Emotional Outcomes

We examined four related emotional harm outcomes as our dependent measures. Intolerance of uncertainty (IOU) was measured using a shortened seven-item version (α = .815) of the validated IOU scale (Sexton & Dugas, 2009). Respondents were given a series of statements regarding how people may react to uncertainties in life and asked to describe to what extent each item is characteristic of them, ranging from 1 (not at all characteristic) to 5 (entirely characteristic). Items included statements such as: “Unforeseen events upset me greatly,” “It frustrates me not having all the information I need,” and “I always want to know what the future has in store for me.”

We measured threat sensitivity using three items (α = .825) from the Post-Traumatic Cognitions Inventory (Foa et al., 1999). Respondents were asked to indicate how strongly they agreed with the following statements using a seven-point scale, ranging from totally agree to totally disagree: (a) “People can’t be trusted” (b) “I can’t rely on other people” and (c) “People are not what they seem.” Text referencing a specific traumatic event was removed, consistent with prior work leveraging this scale as an assessment of threat sensitivity (e.g., Anestis & Bryan, 2021). Higher index scores indicated greater levels of IOU and threat sensitivity.

We used two subscales from the larger Difficulty in Emotional Regulation Scale (Gratz & Roemer, 2004). We focused on these two subscales, given our focus on emotional regulation in this study. The first subscale includes six items to measure impulse control (α = .823). The second subscale includes seven items to measure limited emotional regulation strategies (α = .850). For each scale, respondents were asked how often they agree with a variety of statements using a scale of 1 (almost never [0%–10%]) to 5 (almost always [91%–100%]). The items were added up for each subscale to create two index measures. The impulse control scale included items such as, “I experience my emotions as overwhelming and out of control” and “When I’m upset, I become out of control.” The access to emotion regulation strategies scale included items such as, “When I’m upset, I believe that I will remain that way for a long time” and “When I’m upset, I believe that I’ll end up feeling very depressed.” Higher scores on these subscales indicated greater inability to engage in impulse control and access strategies for emotional regulation.

Control Measures

In addition to the main independent measure, all models accounted for geodemographic differences across the following factors: age (continuous), sex assigned at birth (male, female), education level (no high school, high school graduate, some college, Bachelor’s degree or higher), household income (<$25 k through $150 k or more), marital status (married, widowed, divorced/separated, never married), race (White, Black, other racial identity), rurality (nonmetro rural, metro rural, urban), and state of residence. Please see Table 1 for a descriptive summary of all variables used in the analysis.

Table 1.

Weighted Descriptive Statistics (N = 2,501).

Measures	Mean	SD	Range
Intolerance of uncertainty	19.36	5.62	3–35
Threat sensitivity	11.92	3.96	3–21
Impulse control	9.17	3.99	3–30
Emotional regulation	11.66	5.21	2–35
IPV victimization	0.16	0.37	0–1
Age	47.58	15.71	18–92
Female	0.52
Education
No high school	0.09
High school graduate	0.28
Some college or associate’s	0.30
Bachelor’s or higher	0.33
Household income
<$25,000	0.12
$25,000–$49,999	0.17
$50,000–$74,999	0.17
$75,000–$99,999	0.14
$100,000–$149,999	0.19
$150,000 or more	0.20
Marital status
Married	0.56
Widowed	0.04
Divorced/separated	0.11
Never married	0.30
Race
White	0.72
Black	0.12
Other racial identity	0.16
Rurality
Nonmetro rural	0.40
Metro rural	0.30
Urban	0.30
State
Texas	0.55
Minnesota	0.11
New Jersey	0.17
Colorado	0.12
Mississippi	0.06

Note. IPV = intimate partner violence.

Analytic Strategy

We ran four multivariate models to assess the relationship between physical IPV victimization and each outcome measure. We first used ordinary least squares (OLS) models to analyze the IOU and threat sensitivity outcomes, given the normal distributions of the measures. We then used negative binomial regression models to assess the impulse control and emotional regulation scales, given the skewed and over dispersed nature of the two measures. The negative binomial coefficients were then transformed into incidence risk ratios (IRRs) for ease of interpretation. All models were adjusted for the control measures. We used listwise deletion to account for missing data across all variables, resulting in a final sample of 2,390 respondents.² All analyses were carried out in Stata 17 (StataCorp LLC).

Results

Table 2 depicts a correlation matrix of all bivariate relationships among variables in the models. The multivariate results for the IOU and threat sensitivity outcomes are depicted in Table 3.³ Physical IPV victimization was significantly associated with increased IOU (coef. = 1.848; SE = 0.447) and heightened threat sensitivity (coef. = 1.385; SE = 0.325).

Table 2.

Correlation Matrix.

Measures	1	2	3	4	5	6	7	8	9	10	11	12	13
1. Intolerance of uncertainty	—
2. Threat sensitivity	0.27	—
3. Impulse control	0.37	0.31	—
4. Emotional regulation	0.41	0.34	0.76	—
5. IPV victimization	0.11	0.16	0.21	0.22	—
6. Sex	0.07	0.02	0.13	0.14	0.03	—
7. Age	−0.22	−0.18	−0.31	−0.33	−0.07	−0.17	—
8. Education	0.03	−0.17	−0.15	−0.13	−0.10	−0.09	0.00	—
9. Household income	−0.00	−0.19	−0.18	−0.17	−0.17	−0.11	0.03	0.43	—
10. Marital status	0.08	0.13	0.19	0.24	0.07	0.10	−0.36	−0.12	−0.30	—
11. Race	−0.00	0.14	0.10	0.07	0.07	0.01	−0.13	−0.07	−0.14	0.14	—
12. Rurality	0.03	−0.01	0.03	0.04	0.02	−0.02	−0.04	0.08	0.04	0.13	0.08	—
13. State	0.01	−0.03	−0.01	0.01	−0.05	0.06	0.01	0.10	0.05	0.01	−0.03	−0.02	—

Note. Bold text = p < .001. IPV = intimate partner violence.

Table 3.

Multivariate Results for Intolerance of Uncertainty and Threat Sensitivity (N = 2,390).

	Intolerance of Uncertainty					Threat Sensitivity
Measures	Coef.	Std. Coef.	SE	[95% CI]		Coef.	Std. Coef.	SE	[95% CI]
IPV victimization	1.848***	0.122	0.447	0.970	2.725	1.385***	0.130	0.325	0.749	2.022
Female	0.788*	0.070	0.336	0.129	1.448	0.071	0.009	0.215	−0.349	0.492
Age	−0.073***	−0.203	0.013	−0.098	−0.047	−0.043***	−0.170	0.008	−0.059	−0.027
Education (No high school)
High school graduate	1.134	0.087	1.051	−0.926	3.194	−0.203	−0.022	0.634	−1.446	1.039
Some college or associate’s	1.383	0.114	0.985	−0.548	3.314	−0.059	−0.007	0.613	−1.261	1.143
Bachelor’s or higher	1.713	0.149	0.990	−0.228	3.654	−1.251*	−0.154	0.629	−2.484	−0.017
Household income (<$25,000)
$25,000–$49,999	−0.687	−0.042	0.825	−2.304	0.930	−0.304	−0.026	0.531	−1.346	0.737
$50,000–$74,999	−0.379	−0.026	0.844	−2.034	1.276	−0.827	−0.079	0.502	−1.810	0.157
$75,000–$99,999	0.126	−0.008	0.904	−1.648	1.899	−0.999	−0.089	0.570	−2.116	0.119
$100,000–$149,999	−0.410	−0.030	0.831	−2.039	1.219	−0.965	−0.102	0.544	−2.031	0.102
$150,000 or more	−0.489	−0.037	0.904	−2.262	1.284	−1.489*	−0.156	0.572	−2.612	−0.367
Marital status (married)
Widowed	−0.425	−0.007	1.147	−2.675	1.825	0.200	0.005	0.860	−1.487	1.886
Divorced/separated	1.497**	−0.075	0.513	0.490	2.503	0.329	0.023	0.363	−0.383	1.041
Never married	−0.154	−0.011	0.634	−1.397	1.089	−0.256	−0.026	0.382	−1.006	0.493
Race (White)
Black	−1.163	−0.063	0.691	−2.519	0.193	0.575	0.044	0.419	−0.246	1.396
Other racial identity	−0.765	−0.051	0.498	−1.742	0.211	0.909**	0.085	0.322	0.278	1.541
Rurality (nonmetro rural)
Metro rural	0.312	0.025	0.426	−0.523	1.147	−0.252	−0.029	0.261	−0.763	0.260
Urban	0.318	0.026	0.436	−0.537	1.173	−0.120	−0.014	0.288	−0.685	0.444
State (Texas)
Minnesota	−0.307	−0.018	0.440	−1.171	0.556	−0.619*	−0.051	0.247	−1.102	−0.135
New Jersey	0.828	0.054	0.441	−0.036	1.692	0.578	0.054	0.317	−0.043	1.199
Colorado	−0.221	−0.013	0.509	−1.220	0.777	0.005	0.001	0.366	−0.712	0.723
Mississippi	0.966	0.038	0.712	−0.429	2.362	0.104	0.006	0.392	−0.665	0.873
Constant	21.039***		1.289	18.511	23.566	15.008***		0.919	13.206	16.809
R ²		.079					.131

Note. IPV = intimate partner violence.

p < .05. **p < .01. ***p < .001.

Certain control variables were associated with heightened IOU, including sex (coef. = .788; SE = 0.336) and being divorced or separated (coef. = 1.497; SE = 0.513). On the other hand, age was negatively associated with IOU (coef. = −0.073; SE = 0.013). Age (coef. = −0.043; SE = 0.008), having at least a Bachelor’s degree (coef. = −1.251; SE = 0.629), making $150,000 or more (coef. = −1.489; SE = 0.572), and living in Minnesota (coef. = −0.619; SE = 0.247) were all inversely associated with threat sensitivity. Compared to White respondents, individuals who identified as belonging to a racial category other than White or Black were more likely to have increased threat sensitivity (coef. = 0.909; SE = 0.322).

We similarly found that those who experienced physical IPV victimization were more likely to endorse poorer impulse control and more limited emotional regulation strategies in our negative binomial models (Table 4). IPV victimization corresponded to a heightened incidence risk ratio of poorer impulse control (IRR = 1.222; SE = 0.041) as well as increased risk for more limited emotional regulation (IRR = 1.244; SE = 0.041).

Table 4.

Multivariate Results for Impulse Control and Limited Emotional Regulation Strategies (N = 2,390).

	Impulse Control				Emotional Regulation
Measures	IRR	SE	[95% CI]		IRR	SE	[95% CI]
IPV victimization	1.222***	0.041	1.144	1.304	1.244***	0.041	1.166	1.328
Female	1.090***	0.025	1.042	1.141	1.076**	0.026	1.026	1.128
Age	0.993***	0.001	0.991	0.995	0.993***	0.001	0.991	0.995
Education (no high school)
High school graduate	0.958	0.052	0.860	1.066	0.950	0.062	0.836	1.081
Some college or associate’s	0.968	0.054	0.869	1.079	0.953	0.058	0.846	1.073
Bachelor’s or higher	0.906	0.048	0.816	1.006	0.895	0.053	0.797	1.005
Household income (<$25,000)
$25,000–$49,999	0.890*	0.045	0.806	0.984	0.939	0.056	0.836	1.056
$50,000–$74,999	0.903	0.048	0.814	1.002	0.926	0.052	0.830	1.035
$75,000–$99,999	0.866**	0.042	0.787	0.953	0.892	0.053	0.794	1.002
$100,000–$149,999	0.858**	0.047	0.770	0.955	0.922	0.051	0.828	1.027
$150,000 or more	0.843**	0.046	0.758	0.937	0.874*	0.049	0.783	0.975
Marital status (married)
Widowed	0.968	0.062	0.854	1.097	1.047	0.062	0.932	1.175
Divorced/separated	1.080	0.044	0.997	1.171	1.076	0.042	0.995	1.162
Never married	1.003	0.040	0.928	1.085	1.119**	0.048	1.030	1.217
Race (White)
Black	0.930	0.037	0.860	1.005	0.876***	0.033	0.814	0.942
Other racial identity	1.054	0.037	0.984	1.130	1.024	0.036	0.955	1.097
Rurality (Nonmetro rural)
Metro rural	0.992	0.030	0.935	1.052	0.994	0.031	0.936	1.056
Urban	1.057*	0.030	1.000	1.116	1.012	0.031	0.952	1.074
State (Texas)
Minnesota	0.981	0.030	0.923	1.042	0.991	0.029	0.937	1.049
New Jersey	1.031	0.037	0.961	1.106	1.062	0.035	0.996	1.133
Colorado	0.976	0.035	0.909	1.048	1.010	0.042	0.932	1.095
Mississippi	1.072	0.056	0.967	1.188	1.035	0.046	0.949	1.128
Constant	13.733***	0.916	12.050	15.651	16.993***	1.575	14.171	20.377
R ²	.045				.047

Note. IPV = intimate partner violence; IRRs = incidence risk ratios.

p < .05. **p < .01. ***p < .001.

Regarding the control measures, being female was associated with greater risk for both outcomes, while being younger corresponded to lowered risk of poor impulse control and emotional dysregulation. On the other hand, greater household income was generally associated with lower risk for poor impulse control and emotional dysregulation (among those who earn $150,000 or more). Finally, living in an urban area was associated with a slightly increased risk of poorer impulse control (IRR = 1.057; SE = 0.030), while never marrying was associated with a heightened risk of poorer emotional regulation (IRR = 1.119; SE = 0.048). Respondents who identified as Black were significantly less likely to have poorer emotional regulation (IRR = 0.876; SE = 0.033).

Discussion

The purpose of this study was to examine associations between experiences of physical IPV and impaired psychological and emotional functioning. While much of the existing literature links physical IPV victimization to diagnostic mental health outcomes such as depression, anxiety, and PTS, our study focused on additional impairing aspects of emotional dysfunction. Prior work has hypothesized that these psychological domains compound negative behaviors and underlie a variety of mental health diagnoses (Fruzzetti & Iverson, 2006; Fruzzetti et al., 2005; Linehan, 1993). Our findings support our main hypothesis by illustrating that physical IPV victimization is significantly associated with increased IOU and a heightened threat sensitivity, as well as poor impulse control and more limited emotional regulation strategies.

These results corroborate prior work that associates IPV experience with emotional dysregulation and heightened threat sensitivity, particularly when considering these psychological dysfunctions as predecessors to further psychological diagnoses (Simpson et al., 2022). This work also contributes to an understanding of the association between IPV victimization and impulse control and IOU from a survivor’s perspective. In general, the results align with a broader transactional model of emotional dysregulation, such that heightened vulnerability and emotional invalidation as a result of IPV victimization may be harmful to numerous facets of emotional well-being (Fruzzetti et al., 2005; Iverson et al., 2009). The findings support the notion that experiences of physical IPV victimization not only corresponds with clinical, mental, and physical health outcomes explored in past work, but also a more nuanced reorientation of emotional behaviors that can be harmful in the long term.

Our study was conducted using a diverse sample of respondents across five U.S. states. We examined the emotional health outcomes related to physical intimate partner victimization, an experience that disproportionately impacts women and particularly women of color. Our findings therefore have important implications for addressing disparities in emotional well-being derived from violence exposure in intimate relationships. Although our cross-sectional data preclude us from making causal inferences, the findings suggest that the inclusion of heightened sensitivities and inappropriate responses around emotional control and appropriate reactions may be valid areas for targeted supports for people who have experienced physical IPV (Assari, 2017; Romero-Martínez et al., 2019). The results underscore the importance of examining these theoretically relevant pathways to better capture the association between physical IPV, mental health, and overall well-being outcomes. The findings are not designed to pathologize IPV survivors but rather highlight the broader emotional harms endured by victims of violent abuse.

The findings also contribute to the IPV and psychological functioning literature by pulling from a large, representative sample of five diverse states in the later stages of the global COVID-19 pandemic. In particular, the recent nature of the data provides timely insight into the prevalence of physical IPV in the immediate years following the onset of COVID-19. Our study suggests that about 14% of respondents experienced physical IPV in the past year, a rate substantially higher than past-year estimates in the United States prior to the pandemic (Reid et al., 2008; Thompson et al., 2006). This corroborates other recent studies suggesting that IPV significantly increased in the wake of the pandemic (Boserup et al., 2020; Piquero et al., 2021).

Taken together, the findings underscore the importance of interventions that extend beyond assessments of diagnostic-level functions and allocate resources toward alleviating other clinically relevant factors that might arise from or even prompt further exposure to physical IPV. The magnitude of the standardized coefficients for physical IPV victimization are notable. For instance, IPV victimization exerted the second largest effect size of any variable except age in the model for IOU (standardized coefficient = 0.122) and was one of the largest in the model for threat sensitivity (standardized coefficient = 0.130) besides age and particularly high levels of education and household income. IPV victimization was associated with roughly 22%–24% increased rates of poor impulse control and limited emotional regulation, respectively. As demonstrated by the R² statistics in Tables 3 and 4, our models accounted for about 5%–13% of the variability across outcomes with more variability captured for IOU (8%) and threat sensitivity (13%). Our findings may therefore offer greater explanatory power and practical consideration for these better-explained models than those with lower R² values regarding impulse control and emotional regulation.

Emotion dysregulation, threat sensitivity, poor impulse control, and IOU can all theoretically contribute to an individual’s suffering, interpersonal difficulties, and risk for harm. As such, if IPV exposure prompts or increases the severity of these emotional factors among victims, it is vital that these domains not only be assessed but that interventions be integrated into resources provided to IPV victims. Furthermore, programming to enhance strategies for emotional regulation can be an important treatment for people who are victims/survivors of physical IPV. Interventions that address emotional regulation among targets of IPV have already been implemented, supporting continued research and programming in understanding these pathways to improve practices aimed at positive emotional regulation and overall psychological well-being (Casas et al., 2021; Hesser et al., 2017; Nesset et al., 2021).

Limitations and Opportunities for Future Research

The findings of this study should be interpreted with the following limitations in mind. First, the cross-sectional nature of the data limits our ability to make claims of causality or the direction of the association between physical IPV and the onset of the four emotional functions we analyzed. For instance, it is possible that some of the respondents experienced varying degrees of emotional dysregulation, a heightened sense of threat sensitivity, poorer impulse control, and/or higher levels of intolerance to uncertainty compared to others in the study prior to experiencing physical IPV. As such, although our theoretical conceptualization and prior empirical work supports the notion that IPV victimization generates emotional harms, temporally ordered longitudinal research that measures change over time is needed to fully disentangle the causal relationship between the measures explored here.

Second, as with any self-report measure, determination of under- or overreporting of IPV victimization remains a challenge. Future studies in this area may consider using clinical measures that do not rely on self-report, where available. Third, our data only included information about experiences of physical IPV victimization and we were unable to measure other forms of abuse such as psychological or financial harm. Future studies will benefit from including an analysis of the relationship between other forms of abuse (including combinations of victimization types) and the four outcome domains assessed here. Fourth, although we control for a range of sociodemographic covariates, there are likely additional confounding factors not included in our models. Future studies should consider additional methodological approaches, such as propensity score weighting, to further address confounding and the non-random nature of IPV exposure. Finally, the findings of this study are not nationally representative and can only be generalized to the five states included in the survey. Additional research is needed using a fully representative U.S. study to determine if the associations found here are applicable throughout the country.

Despite these limitations, our findings align with a substantial body of literature linking physical IPV victimization and adverse psychological functioning. The findings of increased IOU, heightened threat sensitivity, and poorer impulse control and emotional regulation among people who have experienced physical IPV warrant consideration of programming and practices that recognize and treat these functions to help survivors. This may not only improve emotional well-being among those who have been harmed but also serve to reduce the risk for more adverse psychological outcomes over time.

Footnotes

Appendix

Appendix A.

Physical IPV and Psychological Functioning (Unadjusted Models, N = 2,390).

	Intolerance of Uncertainty					Threat Sensitivity
Measures	Coef.	Std. Coef.	SE	[95% CI]		Coef.	Std. Coef.	SE	[95% CI]
IPV victimization	1.886***	0.125	0.440	1.023	2.748	1.975***	0.185	0.313	1.360	2.589
Constant	19.122***		0.193	18.743	19.501	11.581***		0.120	11.345	11.817
R ²		.016					.034
	Impulse Control					Emotional Regulation
	IRR		SE	[95% CI]		IRR		SE	[95% CI]
IPV victimization	1.303***		0.048	1.213	1.399	1.308***		0.047	1.220	1.403
Constant	8.729***		0.12	8.499	8.966	11.094***		0.177	10.753	11.447
R ²		.012					.011

Note. IPV = intimate partner violence; IRRs = incidence risk ratios.

p < .05. **p < .01. ***p < .001.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

Funding

The author(s) received no financial support for the research and/or authorship of this article.

ORCID iD

Daniel C. Semenza

Notes

Author Biographies

Daniel Semenza, PhD, is an assistant professor in the Department of Sociology, Anthropology, and Criminal Justice and the Department of Urban-Global Public Health in the School of Public Health at Rutgers University. He is also the director of Interpersonal Violence Research at the New Jersey Gun Violence Research Center at Rutgers. His research focuses on the causes and consequences of violence and related health disparities.

Devon Ziminski is a doctoral student in the School of Social Work at Rutgers University and a senior research project administrator at the Senator Walter Rand Institute for Public Affairs. Her research focuses on the intersection of social policy and research, with emphasis on violence prevention, poverty narratives, and economic mobility.

Michael D. Anestis, PhD, is the executive director of the New Jersey Gun Violence Research Center and an associate professor of Urban-Global Public Health in the School of Public Health at Rutgers University. His research focuses on the risk of suicide, both within the military and among civilians, with a particular emphasis on firearms.

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