Predictors of mental healthcare use among domestic violence survivors in shelters.

We examined sociodemographic and illness/need associations with mental health care use and service use intensity (i.e., number of visits) among domestic violence survivors. Data from 252 women recruited from 5 Midwestern domestic violence shelters were analyzed. Univariate analyses indicated a more positive treatment attitude was related to increased mental health service use and service use intensity. Second, being Caucasian and greater PTSD severity were associated with increased service use intensity. A sociodemographic and attitudinal multivariate predictor model explained 14% of variance in treatment use intensity, and a need/illness model significantly contributed an additional 10% variance. In contrast, the interaction of PTSD Symptom Severity × Perceived Need was significant. Results demonstrate illness has a significant effect above and beyond sociodemographic variables in accounting for mental health care use, and that PTSD severity moderated the relationship between perceived need and service use.

Evidence for a unique PTSD construct represented by PTSD's D1-D3 symptoms.

Two models of posttraumatic stress disorder (PTSD) have received the most empirical support in confirmatory factor analytic studies: King, Leskin, King, and Weathers' (1998) Emotional Numbing model of reexperiencing, avoidance, emotional numbing and hyperarousal; and Simms, Watson, and Doebbeling's (2002) Dysphoria model of reexperiencing, avoidance, dysphoria and hyperarousal. These models only differ in placement of three PTSD symptoms: sleep problems (D1), irritability (D2), and concentration problems (D3). In the present study, we recruited 252 women victims of domestic violence and tested whether there is empirical support to separate these three PTSD symptoms into a fifth factor, while retaining the Emotional Numbing and Dysphoria models' remaining four factors. Confirmatory factor analytic findings demonstrated that separating the three symptoms into a separate factor significantly enhanced model fit for the Emotional Numbing and Dysphoria models. These three symptoms may represent a unique latent construct. Implications are discussed.