Transcript body image distress - Terri L. Weaver, Ph.D.

Posttraumatic Stress Disorder and Body Image Distress in Victims of
Physical and Sexual Assault
Terri L.
1Saint
1
Weaver ,
Ph.D., Michael G.
Louis University, and
2The
2
Griffin ,
Ph.D. and Elisha R.
University of Missouri -Saint Louis
ABSTRACT
Violence-related injury has consistently conferred increased risk for
developing posttraumatic stress disorder (PTSD) though most studies
have conceptualized injury as an acute phenomenon. However acute
injuries may lead to lasting physical changes including alterations in
appearance with marks or scars. Previous research with a small sample
of victims of intimate partner violence (IPV) (N = 31) found that IPVrelated residual injuries were significantly associated with body image
distress and body focused distress was significantly (and uniquely)
associated with symptoms of PTSD. The current study expands these
previous findings by exploring related associations within a sample of
victims of physical or sexual assault utilizing diagnostic assessments.
Eighty-one predominantly African-American victims of physical or
sexual assault were assessed for violence-related injury, body image
distress, PTSD and major depression. Within the entire sample,
severity of body image distress was significantly associated with
severity of PTSD and with PTSD diagnostic status. Associations with
the severity of symptoms of Major Depression were non-significant.
Additional analyses exploring the relationships between body image
distress, assault characteristics and PTSD were examined.
1
Mitchell
RESULTS
Table 1. Means and Correlations Among Measures
Mean
SD
Body
Image
PTSD
Sev
Age
BODY IMAGE DISTRESS
Body
Image
68.25
35.97
-
.37*
.22*
PTSD Sev
62.64
26.0
-
-
-.06
Age
34.16
10.20
-
-
-
* p < .01
 84% of women reported sustaining at least one acute or residual
injury as a result of their assault (See Figure 1).
 No significant differences in severity of body image distress were
observed between women who suffered from a physical versus sexual
assault.
 With regard to MDD, there was no difference in severity of body
image distress (t = -1.56, p = .12) for women positive versus those
negative for diagnosis of MDD.
Note. PTSD was measured by the CAPS and total severity score is shown.
 A small-moderate, significant correlation was observed between
body image distress and severity of PTSD (See Table 1).
Figure 1. Percentages of Type of Injury Sustained

In terms of assault-related factors, more trust (compared with less)
in perpetrator was significantly associated with increased severity of
body image distress. 27.2% of female victims indicated that they had
some trust in their perpetrator. Assault-related factors including presence
of a weapon and degree of restraint were NS associated with body image
distress.
INTRODUCTION
 Many experiences of IPV are associated with acute injuries which
can play an important role in the development of PTSD. However, an
individual’s appearance may be permanently altered as a result of these
acute injuries in the form of marks, scars, or other physical changes.
 Body image distress was a unique significant predictor of PTSD
symptom severity, and explained an additional 13% of the variance above
and beyond that explained by age and type of assault (See Table 2).
 Focus group studies have demonstrated that IPV-related residual
injuries may be associated with IPV-related self-blame, and may play a
role in victims’ self-identity and their perceived potential for future
relationships (Weaver et al, 2007b).
Current findings provide additional support for the association
between body image distress and PTSD (both at the diagnostic and
severity level) within a sample of injured female crime victims using
standardized diagnostic assessments.
 These lasting residual injuries may play an important role in the
maintenance of psychological distress in victims of IPV.
 Preliminary findings support an association between body image
distress and self-reported symptoms of PTSD among women who
experienced moderate to severe IPV, with body image distress emerging
as a unique predictor of PTSD (Weaver et al, 2007a).
 At this time, further research is needed using diagnostic
assessments of PSTD and an expanded sample of female victims of
interpersonal violence in order to further document the relationship
between PTSD and body image distress.
METHODS
DISCUSSION
Table 2. Group Differences and Regression Analysis
Group Differences
Variable
Sexual Assault M(SD)
Physical Assault M (SD)
t
p
Body Image Distress
78.53 (26.37)
65.91(37.59)
1.23
.22
PTSD+
PTSD-
Body Image Distress
Body Image Distress
Body Image Distress
73.63 (33.38)
55.46 (39.31)
MDD+
MDD-
76.59 (30.81)
63.97 (39.17)
Trust in Perp M(SD)
No Trust in Perp M(SD)
89.63 (30.03)
61.02 (35.31)
-2.21*
.04
-1.56
.12
-3.36** .001
PTSD Severity
68.77 (24.39)
59.81 (26.58)
-1.43 .17
 Participants were eighty-one women ranging in age from 18 to 66
who had been recent victims of physical and sexual assault.
Regression Analysis: Body Image Distress Predicts PTSD Symptom Severity
 Women were recruited from local victim assistance agencies and
police agencies, and postcards were mailed to recent crime victims
describing the study. Informational flyers were also posted in local
community agencies.
Variable
B
SEB
β
t
Type of Assault
-12.49
7.19
-.88
-1.74
Age
.19
.28
.07
.51
Body Image Distress
.26
.08
.37
3.42**
 On average, individuals participated in the study one month postassault.
* p < .05, **p < .01
This research was funded in part by NIMH R29-MH-55688, Griffin (PI)
Note. MDD was assessed with the SCID.
The lack of an association between severity of body image
distress and MDD suggest that body image distress adds to a
trauma-specific conceptualization, particularly when the distress is
anchored to a residual injury resulting from a violent crime.
FUTURE DIRECTIONS
The body image distress measure may not include all the potential
concerns experienced by sexual assault victims. Future work may
benefit from tailoring body image distress assessment to areas of
concern unique to women who have experienced sexual assault.
Meaning continues to appear important for associations with body
image distress. The way that betrayal of trust may negatively affect
body image concerns post-crime requires further study. Other assaultrelated factors such as pain may also be important correlates of body
image distress.
REFERENCES
Weaver, T.L., Resnick, H.S., Kokoska, M.S., & Etzel, J.C. (2007). Appearance-related
residual injury, posttraumatic stress, and body image: Associations within a sample of
female victims of intimate partner violence. Journal of Traumatic Stress, 20(6), 999-1008.
Weaver, T.L., Turner, P.K., Schwarze, N., Thayer, C.A., & Carter-Sand, S. (2007). An
exploratory examination of the meanings of residual injuries from intimate partner
violence. Women & Health, 45(3), 85-102.