Emotion regulation in women who are psychologically abused by their intimate partners : a systematic review

Abstract

Intimate partner violence refer to those acts that include physical violence, sexual violence, stalking, and psychological aggression (including coercive tactics), performed by a current or former intimate partner. One potential consequence of intimate partner violence may be maladaptive emotion regulation patterns which in turn, could lead to the onset of psychopathology. Although a number of studies have been published on the emotion regulation of women within different violence and abuse contexts, these findings have not previously been synthesized to provide us with an evidence-based scientific understanding of emotion regulation, specifically within intimate partner relationships. The aim of this study was therefore to systematically review the literature on how psychologically abused women regulate their emotions within intimate partner relationships. More specifically, to explore (a) the types of emotion regulation they apply; (b) factors that play a role in how they regulate their emotions; and (c) evidence on adaptive and maladaptive outcomes of emotion regulation. A systematic review was done through a comprehensive and stepwise keywords search, using Boolean operators to combine key words and inclusion criteria. Validated search filters were used to restrict the search according to exclusion criteria. Quality assessment of the identified articles was based on international guidelines as stipulated in EPPI, NICE, QCC, ADA and CASP. As a result, 22 articles, published between 1999 and 2015, were identified for final inclusion in the study and analyzed from a qualitative content analysis approach. The review indicates that abused women use four main emotion regulation strategies, namely: avoidance or disengagement strategies, approach or engagement strategies, problem-focused strategies, and emotion-focused strategies. Choice of strategy seems to be influenced by external resources, cognitive processes, depressive symptomatology, length of the relationship, the nature of the abuse and the woman's culture and norms. Approach or engagement strategies and problem-focused strategies (when leaving the relationship was not an outcome goal) were generally associated with adaptive outcomes, while avoidance or disengagement strategies and emotion-focused strategies were generally associated with maladaptive outcomes. It was concluded that the context of the various circumstances surrounding the abusive relationship is extremely important when taking into account how and why abused women tend to make use of the specific strategy they employ to manage their emotions and cope with the situation at hand. Emotion regulation therefore seems to be complex, context-determined and situation-specific. It was recommended that future research should focus on further clarification and distinction amongst the various emotion regulation strategies, as well as the classification of these strategies into clearly defined entities to guide intervention strategies. Healthcare practitioners should take note of the complexity with which psychologically abused women regulate their emotions, and should acknowledge the importance of context when assessing the adaptability of the strategy employed and should take care when setting outcome goals for therapy.