Predictors of change in mental health and distress among women attending a women's shelter

Figures & data

Table 1 DVSA stages, descriptions, and typical answers for “How would you describe your mental health?”

Stage of change	Description	Typical responses on administered questionnaire
1 – Committed to continuing	Stressed, possibly depressed and confused.	“Overall it is good. I don't have any problems like that; I am just stressed a little.”
2 – Questioning commitment	Stressed/depressed, etc. May dislike self and have other symptoms.	“Some days are good, some days I feel stressed out, sad, nervous or have nightmares. I wish it would get better and I would be like myself again.”
3 – Considers change: abuse and options	High anxiety, panic attacks, fantasizes murder. Fears she is crazy.	“Not good, sometimes I fear I'm going crazy. I have some of these symptoms: always feeling scared, panic attacks, very sad, thinking of suicide or that killing him would be a way out, thinking and worrying about him all the time, jumpy and nervous, can't sleep, nightmares or sleeping too much, not hungry or hungry all the time.”
4 – Breaks away or partner curtails	Senses she can gain control of “out of control” feelings.	“It's not good, but I know I am not crazy, just under a lot of stress from the abuse. Some days I can control my reactions and others are not so good yet.”
5 – Establishes a new life apart or together	Grief rises then recedes. Lower self esteem slowly improves.	“Six or more months with no abuse and it is slowly getting better.”

From Dienemann et al., 2002.

Table 2 DVSA categories

DVSA category
Triggers of abusive incidents
Managing partner abuse
Seeking legal sanctions
Attachment
Views relationship and considers options
Managing loyalty to norms and own beliefs
Accessing help
Self-identity
Self-efficacy
Personal feelings
Mental health
Control of money
Medical care

From Dienemann et al., 2007.

Fig. 1 Study flow diagram.

Table 3 Participant characteristics

Characteristic		n	%
Abuser uses alcohol	Yes	37	34.3
	No	71	65.7
	<$1,000	93	85.3
Monthly income	≥¯$1,000	15	13.8
	Missing	1	0.9
Immigration status	Canadian citizen/permanent resident	55	50.9
	Other	54	49.5
	Partner	76	70.4
Abuser's relationship	Other	18	16.7
to victim	Missing	14	13.0
	Mean 3.31
Number of visits	Standard deviation 1.46
	Range 2–8
Type of abuse		n	%
Verbal abuse	Yes	95	88.0
	No	13	12.0
Emotional abuse	Yes	95	88.0
	No	13	12.0
Psychological abuse	Yes	92	85.2
	No	3	2.8
	Missing	13	12.0
Physical abuse	Yes	71	65.7
	No	24	22.2
	Missing	13	12.0
Financial abuse	Yes	64	59.3
	No	31	28.7
	Missing	13	12.0
Sexual abuse	Yes	30	27.8
	No	65	60.2
	Missing	13	12.0
Spiritual abuse	Yes	10	9.3
	No	59	54.6
	Missing	39	36.1

Fig. 2 Progression through the stages by number of visits.

Table 4 Logistic regression analysis for progression through the mental health stages

	Univariate		Multivariate
Characteristic	Odds ratio (95% CI)	p	Odds ratio (95% CI)	p
Increased number of visits	1.694 (1.237–2.322)	0.001	1.928 (1.292–2.877)	0.001
Abused by spouse/partner	1.167 (0.481–2.831)	0.732	5.167 (0.0867–30.797)	0.071
Monthly income >$1,000	0.682 (0.201–2.314)	0.539	1.389 (0.281–6.869)	0.687
Abuser uses alcohol	1.905 (0.829–4.376)	0.129	2.265 (0.802–6.395)	0.123
Physical/sexual abuse	2.891 (0.773–10.807)	0.115	1.770 (0.381–8.219)	0.466
Non-citizen	1.439 (0.643–3.223)	0.376	1.477 (0.453–4.819)	0.518

Du Mont J., Hyman I., O'Brien K., White M. E., Odette F., Tyyskä V. Factors associated with intimate partner violence by a former partner by immigration status and length of residence in Canada. Annals of Epidemiology. 2012; 22(11): 772–777. [PubMed Abstract].

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Dienemann J., Glass N., Hanson G., Lunsford K. The Domestic Violence Survivor Assessment (DVSA): A Tool for Individual Counseling with Women Experiencing Intimate Partner Violence. Issues in Mental Health Nursing. 2007; 28(8): 913–925. [PubMed Abstract].

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