Running Head: PERCEIVED SOCIAL SUPPORT

Perceived Social Support 1

Running Head: PERCEIVED SOCIAL SUPPORT

Women’s Perceived Social Support and Help-Seeking:

An Examination of Two Types of Violent Relationships

Janel M. Leone1

WakeForestUniversity

Michael P. Johnson2

Catherine L. Cohan3

PennStateUniversity

1Department of Pediatrics, Medical Center Blvd, Winston-Salem, NC27157. Phone: (336) 716-9640; FAX: (336) 716-7100

2Department of Sociology, 211 Oswald Tower, University Park, PA16802. Phone: (814) 865-1937; FAX: (814) 863-7216

3Population Research Institute, 601 Oswald Tower, University Park, PA16802. Phone: (814) 863-2939; FAX: (814) 863-8342

Paper to be presented at the

2004 Meetings of the National Council on Family Relations
Abstract

This study uses data from the Chicago Women’s Health Risk Study (Block, 2000) to examine perceived social support as a consequence of partner violence. Results demonstrate that compared to victims of situational couple violence, victims of intimate terrorism report significantlylower perceived social support. These findings indicate that victims of intimate terrorism report feeling less accepted and supported by others, having less access to tangible help in emergencies, and having less access to knowledge of resources. Findings also demonstrate that victims of intimate terrorism are less likely than victims of situational couple violence to seek help from friends/neighbors, which may be a function of their lower perceptions of social support. Finally, findings indicate that perceived social support is positively associated with seeking help from family members, although this factor does not moderate the relationship between violence type and this outcome. An important implication of these findings is that victims of intimate terrorism may feel unsupported in their decision to escape a violent relationship and may not feel comfortable seeking help from friends or family membersduring the escape process. These beliefsmight result in women enduring the violence for a longer period of time.

Women’s Perceived Social Support and Help-Seeking:

An Examination of Two Types of Violent Relationships

Introduction

Understanding and preventing partner violence has become a national public health issue. Healthy People 2010: National Health Promotion and Disease Objectives (U.S. Department of Health and Human Services, 2000) lists injury and violence as one of the ten major national health issues. The goal of reducing family violence and violence-related injuries, however, can only be achieved if effective prevention and intervention programs are developed. Unfortunately, situational barriers often prevent some women from seeking help, making it difficult to effectively evaluate these programs. Barriers to help-seeking include isolation from help sources, fear of retaliation from the violent partner, negative experiences with social institutions, a lack of economic resources, and social consequences of ending the relationship. The current study focuses on thefirstpotential barrier, isolation from help sources, and examines differences in perceived social support as a fundamental consequence of increased isolation for victims of two distinct types of partner violence. Further, we examine the role of perceived social support in help-seeking by examiningits association with where women seek help for the violence in their lives. Johnson’s (1995) typology of partner violence was used to distinguish the two major forms of partner violence.

Johnson (2001) has demonstrated empirically that two major types of partner violence exist: one embedded in a general pattern of power and control, which he called “intimate terrorism”, and the other not, which he has referred to as “situational couple violence.” The distinction between types of violence is defined in terms of the motivation behind the physical violence, as demonstrated through the pattern of non-violent, controlling behavior that exists within the relationship, rather than the severity or frequency of physical violence used (Johnson, 1995; 2001; Johnson & Ferraro, 2000). Intimate terrorism is defined as the attempt to dominate one’s partner, and to execute general power and control within the relationship. In contrast, situational couple violence is defined as partner violence that does not exist within the context of power and control. The motive behind this type of violence is not to generally control or dominate the other person and is therefore not characterized by a pattern of non-violent control tactics.

The importance of distinguishing between types of partner violence for the current study is grounded in the notion that not all victims of partner violence are isolated from potential help sources, and may therefore have different perceptions of social support. The current study extends previous research by examining differences in perceived social support between victims of intimate terrorism and victims of situational couple violence. Moreover, we expand this exploration further by examining how perceived social support relates to victim help-seeking. To date, no studies have compared perceived social support and help-seeking processes for victims of these two types of violence.

Isolation from Help Sources

Isolation is a common form of non-violent control used by violent partners to sever victims’ ties to social support networks and to people who may potentially aid in their escape (Sullivan & Bybee, 1999). This type of non-violent control is described as controlling what a woman does, whom she sees and talks to, what she reads and where she goes (Pence & Paymar, 1993). In sum, it is an effective strategy to entrap a partner in a violent relationship bylimiting her contact with family and friends, causing her to becomeemotionally and physically distanced from people whom she knows and trusts,less able to share her experiences with others, and less likely to receive perspectives that challenge the partner’s violent and non-violent behavior (Kirkwood, 1993). Given these strained ties, it may be impossible for an isolated woman to rely on or even locate a family member or friend for support. In fact, Rose et al. (2000) found that women who experienced forced isolation began to define themselves as “hard to get to know” (p.34) and uncomfortable around other people. For women in more rural settings, who are geographically isolated to begin with, isolation may be particularly detrimental in that being denied access to a vehicle or a phone can completely isolate them from any help sources (Merritt-Gray & Wuest, 1995).

Yet, as Johnson (1995; 2001) argues, the use and need for non-violent control, such as forced isolation, is not universal among violent relationships. Isolation is clearly more characteristic of intimate terrorism, where the main objective is to maintain control in the relationship and ultimately entrap a victim. By definition, isolation would not be an essential part of situational couple violence, as this type of violence is motivated by a need to exert general control. Thus, the experiences and subsequent consequences of isolation are most likely more relevant to victims of intimate terrorism as opposed to victims of situational couple violence.

A potential, and enormously damaging, consequence of forced isolation for victims of intimate terrorism is decreased perceived social support. Perceived social support can be described as feeling as if one is accepted and supported by other people, has access to tangible help in emergencies, and has access to and knowledge of resources (Block, 2000). Increased isolation and diminished perceived social support most likely work simultaneously to entrap victims of intimate terrorism in the relationship,by making a safe escape difficult, if not nearly impossible.A main implication of this “web of control” is that women may be less likely to rely upon help sources in the leaving process or use them in an attempt to escape.

Research on Help-Seeking

Previous research on help-seeking strategies used by victims of partner violence has demonstrated that victims of intimate terrorism are more likely to use formal help sources (i.e., police, medical agency, counseling) rather than informal help sources (i.e., friends, family members), at rates of 70% and 63%, respectively(Leone, 2003).Moreover, the same study indicated that compared to victims of situational couple violence, victims of intimate terrorism are significantly more likely to seek help from formal help-sources (70% vs. 44%, respectively), but areless likely to seek help from informal help sources (63% vs. 68%, respectively).One explanation of these findings is rooted in a “Needs-Based Model.” First, it is likely that intimate terrorism victims are in more imminent danger and need more immediate assistance, which is likely more available from formal sources of help. Second, it is probable that intimate terrorism victims have a stronger desire to escape the relationship, rather than strengthen it, and therefore seek to secure more resources in order to do this safely. In this case, seeking help from police, medical agencies, and counselors as opposed to family and friends might lead to a more permanent separation from the violent partner.

In addition to these explanations, it is also possible that victims of intimate terrorism are more likely to seek help from formal help sources because they do not believe that loved ones or friends are available to help them.Such a belief may result in them looking elsewhere for help.Although social support as a consequence of partner violence has been examined within the partner violence literature (e.g., Kocot & Goodman, 2003), the association between perceived social support and help-seeking has received very little attention. That is, the extent to which women’s perceptions of social support (e.g., feeling as if one is accepted and supported by other people, feeling that one has access to tangible help in emergencies, feeling as though one has access to and knowledge of resources) are associated with where they go for help is unclear. Given the web of control tactics that characterize intimate terrorism, particularly isolation, it is likely that these victims will report significantly less perceived social support compared to victims of situational couple violence. Consequently, it is likely that less perceived social support results in adecreased likelihood of seeking help from friends and family. Although a lack of perceived social support most likely influences one’s decision to seek formal help, it is likely more relevant to informal sources of help. Although intimate terrorisms use isolation to keep a victim away from any support system, they would likely sever existing ties, such as those with family and friends, in an attempt to destroy emotional support systems that are already in place.

Rationale and Hypotheses for the Current Study

The current study advances existing research by examining if partner violence type (i.e., intimate terrorism vs. situational couple violence) is differentially associated with perceived social support. Further, the current study examines the extent to which perceived social supportmoderates the relationship between type of violence and help-seeking efforts. We examined two research questions: (1) Is type of partner violence differentiallyassociated with women’s perceived social support?; and (2] Does perceived social support moderatethe association between type of violence and women’s use of informal help? We hypothesized that victims of intimate terrorism would report significantly less perceived social support compared to victims of situational couple violence. Second, we expected that once perceived social support was controlled statistically, differences in seeking informal help for victims of intimate terrorism and victims of situational couple violence would decrease. That is, we expected that the differences between victims of intimate terrorism and victims of situational couple violence inseeking help from informal sourcesare,to some degree, a function of differences in perceived social support.

Method

Design and Participants

Data for the current study come from the Chicago Women’s Health Risk Study (CWHRS), a cross-sectional study conducted to identify significant factors associated with partner perpetrated life-threatening injury or death (Block, 2000). CWHRS targeted specific neighborhoods in the Chicago area that, based on the Chicago Homicide Dataset, had high rates of lethal intimate violence relative to other Chicago areas. Data were collected between June 1997 and April 1998.

To minimize selection bias, the CWHRS employed a universal screening design, intended to screen all female trauma and walk-in patients for partner violence. The instrument used to screen respondents for partner violence was based on the Intimate Violence Screening Tool, developed by the Chicago Department of Health (Sheridan & Taylor, 1993). This screening process was instituted into the standard intake procedure for all women receiving treatment in the health care setting. A random sample of 2,616 female trauma and walk-in patients who entered one of three Chicago health care clinics/hospitals was screened. Patients were asked the following three questions: “Has your intimate partner ever hit, slapped, kicked or otherwise physically hurt or threatened you?”, “Has your intimate partner ever forced you to engage in sexual activities that made you feel uncomfortable?”, and “Are you afraid of your intimate partner?” Respondents who answered “yes” to any of the three screening questions, were in a current intimate relationship, and were 18 years or older were screened as “Abused” by the staff conducting the screening. Women who answered “No” to all of the questions or who experienced abuse more than one year prior to the screening were screened as “Not abused.”

Screening results were available for 2,177 women (524 “Abused” and 1,653 “Not Abused” women). The CWHRS sample design called for interviewing all women screened as “Abused” and 40% of the women screened as “Not Abused.” Approximately 86% (n = 497) of the “Abused” women were actually interviewed and 31% (n = 208) of the “Not Abused” women were interviewed, totaling 705 women. Interviews lasted approximately 45 minutes and were conducted in private, secure rooms. Interview questions included a calendar assessment and details of each violent incident, and also experiences of power and control, stalking, harassment, household composition, psychological and physical health, pregnancy, and firearm availability.

The sample for the current study consists of a sub-group of the 497 “Abused” women. Respondents who met the following four criteria were included in the current study. Respondents reported that (1) they experienced at least one incident of physical violence in the 12 months prior to the survey (n = 479, 96%); (2) all incidents of physical violence were committed by the same intimate partner (n = 456, 92%); and (3) the intimate partner was male (n = 475, 96%). Finally, women needed to have (4) answered all questions regarding experiences of non-violent power and control tactics (n = 434, 87%). These four criteria yielded a sample of 389 women.

Measures

Four types of measures are described below. First, measures of relationship violence include type of violence experienced, the severity of the physical violence, and whether or not the violence increased in frequency/severity in the year prior to the survey. Second, consequences of violence include the physical, psychological, and social effects of violence. Third, background characteristics include respondent, partner, and relationship demographic characteristics. Finally, help-seeking measures include informal sources of help sought. Although not described extensively in the literature review, we included a wide range of variables in the models to statistically control for other variables that may be associated with both perceived social support and informal help seeking. More detail on these variables is available from the first author.

Relationship Violence

Type of partner violence. Violence type was defined by responses to five dichotomous (0 = No; 1 = Yes) questions, which make up the Power and Control Scale (Violence Against Women Survey; Tjaden & Thonnes, 1999) which highly resemble the Power and Control Wheel developed by Pence and Paymar (1993). The Power and Control Scale items were, “In the past year, an intimate partner was jealous and didn’t want you to talk to another man,” “…tried to limit your contact with family or friends,” “insisted on knowing who you are with and where you are at all times,” “called you names to put you down or made you feel bad,” and “prevented you from knowing or having access to family income, even if you asked.” Measures of physical violence were not used in the categorization process since Johnson’s (1995) typology distinguishes among violence types by examining the use of non-violent control tactics rather than severity or frequency of the violence. Recall, however, that all women in this sample reported physical violence in the 12 months prior to the study.

A Ward’s Method cluster analysis of the Power and Control Scale was used to classify partner violence as either intimate terrorism or situational couple violence. This grouping method is consistent with Johnson (2001) and Johnson and Leone (in press). Ward’s method of cluster analysis is a hierarchical agglomerative clustering process that selects each new case to add to a cluster based on its effect on the overall homogeneity of the cluster (Aldenderfer & Blashfield, 1984). Results revealed a large increase between the one and two cluster solutions, suggesting that a two cluster solution is optimal for these data. Cluster 1 represented a less controlling group, with respondents reporting fewer than five types of control. We labeled this cluster “Situational Couple Violence” (0). Cluster 2 represented a highly controlling group, with respondents reporting all five types of control. We labeled this cluster “Intimate Terrorism” (1). Note that all women categorized as experiencing intimate terrorism reported that their partner tried to limit their contact with family or friends.