651624
JIVXXX10.1177/0886260516651624Journal of Interpersonal ViolenceRefaeli et al.
research-article2016
Article
Personal and
Environmental Predictors
of Depression Among
Victims of Intimate
Partner Violence:
Comparison of Immigrant
and Israeli-Born Women
Journal of Interpersonal Violence
2019, Vol. 34(7) 1487–1511
© The Author(s) 2016
Article reuse guidelines:
sagepub.com/journals-permissions
https://doi.org/10.1177/0886260516651624
DOI: 10.1177/0886260516651624
journals.sagepub.com/home/jiv
Tehila Refaeli, PhD,1 Drorit Levy, PhD,1
Anat Ben-Porat, PhD,1 Rachel Dekel, PhD,1
and Haya Itzhaky, PhD1
Abstract
In the present study, ecological theory was used as a basis for predicting
depression among women who survive intimate partner violence (IPV).
The predictors examined in the study derived from three ecological
systems: the microsystem (background variables and frequency of the
violence), the ontogenic system (personal resources), and the mesosystem
(support resources). One hundred twenty-five women who immigrated
from the Former Soviet Union and 149 Israeli-born Jewish women filled in
questionnaires when they entered shelters for victims of IPV. The research
findings indicate that background variables, including immigration, did not
contribute significantly to the women’s depression. Frequency of violence
contributed slightly to depression, whereas the women’s sense of mastery
and social support contributed most significantly. The results highlight the
need to strengthen these resources when women are in shelters, and to
conduct further research to determine whether these results also hold
1Bar-Ilan
University, Ramat-Gan, Israel
Corresponding Author:
Tehila Refaeli, Bar-Ilan University, Ramat-Gan 52900, Israel.
Email: tehilarefaeli@gmail.com
1488
Journal of Interpersonal Violence 34(7)
true for women who receive services for prevention of violence in the
community.
Keywords
intimate partner violence, depression, immigration, shelters, sense of
mastery, social support, ecological model and cultural contexts
Introduction
Violence against women by their intimate partners is a widespread, universal
phenomenon in modern as well as traditional societies. There has been growing recognition of intimate partner violence (IPV) as a social problem
throughout the world, and research has been conducted in an attempt to identify the consequences of violence for the victims. To date, studies have
focused on mental health consequences of IPV in general and depression in
particular (Golding, 1999). In addition, attempts have been made to identify
the factors that make some women who experienced IPV vulnerable to
depression, and the findings of these studies indicate that immigration can be
identified as a risk factor for depression (Stockman, Hayashi, & Campbell,
2015; Wong, Tiwari, Fong, Humphreys, & Bullock, 2011).
The present study was based on the ecological theory, which has been
adopted in previous research on IPV (Dutton, 1985; Heise, 1998). According
to this perspective, IPV occurs within various diverse environments, where
the individual simultaneously affects those environments and is influenced by
them (Dutton, 1985; Heise, 1998). However, the ecological theory has not yet
been used to explore the association of experiencing IPV and immigration
with depression. The present study examined whether immigrant women from
the Former Soviet Union (FSU) who experience IPV have specific characteristics that distinguish them from Israeli-born Jewish women with regard to
depression and predictors of depression. We focused on three ecological systems that can provide a basis for predicting depression among women in the
context of immigration: The microsystem includes characteristics of the environment in which violence occurs — the frequency of violence, and the women’s immigration status. The ontogenic system refers to personal resources,
which were represented by the women’s sense of mastery. The mesosystem,
which refers to the women’s external environment, was represented by the
women’s social support and their use of services. Previous studies have examined the contributions of each of these systems to depression. However, they
examined each system separately among groups of IPV victims from different
cultures, and mainly among those who receive community services. The
unique contribution of the present study lies in the combination of factors
Refaeli et al.
1489
from different ecological systems, and the integration of these factors into one
model to provide a comprehensive picture of the predictors of depression
among IPV victims. In addition, the present study focused on women in shelters, who are the most vulnerable group of IPV victims (Alsaker, Kristoffersen,
Moen, & Baste, 2011).
Depression Among Women Who Are Victims of Violence
Depression is mainly expressed in loss of mood reactivity, or lack of interest
and pleasure in life (American Psychiatric Association, 1994). Many studies
have found a high frequency of depression among women who are victims of
violence (Bargai, Ben-Shakhar, & Shalev, 2007; Martinez-Torteya, Bogat,
von Eye, Levendosky, & Davidson, 2009; Rodriguez et al., 2008). Bargai and
colleagues (2007) found that of 101 women who stayed in shelters for victims of IPV in Israel, 40% had major depression.
Predictors of Depression Among Women Who Are Victims of
Violence
The microsystem
Type and frequency of violence. Previous studies have distinguished
between physical violence, that is, bodily harm, and emotional abuse, that
is, aspects such as isolating the women, preventing access to resources, and
verbal threats (Eisikovits, Winstok, & Fishman, 2004; Golding, 1999; Matud,
2005). It was assumed that when the frequency and severity of violence were
greater, women would report higher levels of depression. In addition, a metaanalysis conducted by Golding (1999) presented 18 studies which found that
the severity and duration of violence was related to depression. In addition,
relationships have been found between the severity of violence and emotional distress (Chandra, Satyanarayana, & Carey, 2009; Matud, 2005). This
might be attributed to the increased likelihood that women who experience
physical and sexual abuse will also experience emotional abuse (Sullivan,
McPartland, Armeli, Jaquier, & Tennen, 2012). Therefore, these women
might experience cumulative damage resulting from exposure to different
types of violence. However, the differences in the results regarding the frequency of various types of violence and depression among different ethnic
groups have not yet been examined.
Immigration and violence. Immigration is defined as a situation of multiple
stressors (Ding et al., 2011; Foster, 2001). Individuals and families experience
multiple stressors relating to immigration, including language barriers,
1490
Journal of Interpersonal Violence 34(7)
problems with employment and integration into the indigenous society, and
emotional distress derived from the separation from familiar people and places
(Borges et al., 2009; Remennick, 2005; Taler, 1998). These cumulative stressors increase the risk of frequent IPV (Hadas, Markovitzky, & Sarid, 2008). Raj
and Silverman (2002) argued that the proportion of immigrant women who are
victims of IPV is higher than their proportion in the total population. Contrary
to this argument, in a literature review on immigration and IPV throughout the
world, Menjivar and Salcido (2002) argued that in developed countries, immigrant women do not experience more violence than indigenous women. However, the literature has revealed that certain characteristics of IPV are more
prevalent among immigrant women than among all women who experience
violence. Research findings have revealed that immigrant women frequently
experience social isolation (Menjivar & Salcido, 2002), because they have
broken off their social and family relationships, and because the violent men
prevent them from establishing new relationships (Abraham, 2000). The theoretical discussion above points to possible differences between immigrants
and nonimmigrants in the prevalence and characteristics of IPV. However,
only a few studies have compared these two populations. This gap in the literature is addressed in the current study.
In Israel, the largest group of immigrants is from the FSU (Lissitsa &
Peres, 2000), and these immigrants constitute about 16% of the general population (Almagor-Lotan, 2009; Israel Central Bureau of Statistics, 2011).
Various testimonies have revealed that immigrant women from the FSU in
Israel are at high risk of experiencing IPV (Grynbaum, Biderman, Levy, &
Petasne-Weinstock, 2001). For example, data from the Israel Police Force
and the welfare services indicate that 18% of the women staying in shelters
in 2009 were born in the FSU. Data also indicate that immigrants from the
FSU constitute 55% of the immigrants under the care of violence prevention
centers, and 22% of the complaints relating to IPV were lodged to the police
by immigrant women from the FSU (Almagor-Lotan, 2009; Mizrahi, 2012).
One explanation for this phenomenon is that the Russian Commonwealth
countries are characterized by a patriarchal culture, in which women are
expected to submit to their husbands and deny family problems (Kagan &
Shafer, 2001). In patriarchal societies, violence is a result of the men’s need
to control their wives by any means necessary, and to display their control
even when the women have submitted to them (M. P. Johnson, 1995).
However, the implications of these patriarchal traditions among immigrants
who arrived in Israel from the FSU for the characteristics and consequences
of IPV have not been explored to date.
In addition to the possible implications of immigration at the level of
interpersonal relationships (the microsystem), several studies around the
Refaeli et al.
1491
world have examined immigration as a risk factor for emotional distress, and
have revealed differences between immigrants and veterans with regard to
emotional distress. The immigrants experienced higher emotional distress
than did members of the indigenous population who had similar characteristics (Frankenberg, Kupper, Wagner, & Bongard, 2013; Lee, Park, Hwang,
Im, & Ahn, 2014). Moreover, a relationship has been found between IPV
and depression among immigrant women (Kagan & Shafer, 2001; Newcomb
& Carmona, 2004; Wong et al., 2011). Therefore, the present study also
examined the role of immigration as a variable that moderates the contribution of the rest of the research variables described below to the women’s
emotional distress.
The ontogenic system: Sense of mastery. Sense of mastery refers to the perceived control of individuals over their future, their appreciation of cause–
effect relationships, and their perceived ability to cope with life stressors
(Hobfoll & Walfisch, 1984; Pearlin & Schooler, 1978). Mastery has sometimes been referred to as agency in the literature (Lehavot, Walters, &
Simoni, 2009). IPV is perceived as a situation in which women experience
recurring lack of mastery, and often have difficulty assessing the triggers for
IPV (Walker, 2009). As a result, they develop learned helplessness, which
inhibits their desire to leave the violent relationship (Walker, 2009).
The relationship between immigration and impaired sense of mastery is
based on the perspective of immigration as a stress situation that can undermine a person’s confidence in everything that is familiar. However, as far as
we know, no studies have compared the sense of mastery among immigrants
versus indigenous residents. A study conducted among 600 immigrants from
the FSU five years after their arrival in Israel revealed that a low sense of
mastery is one predictor of emotional distress among immigrants in general,
and that the predictive power of emotional distress is especially high among
immigrant women (C. Lerner, Kertes, & Zilber, 2005).
The lower sense of mastery as a consequence of experiencing IPV might
be an important predictor of higher depression levels. Previous studies conducted among women who have experienced IPV have revealed a low sense
of mastery being associated with depression (Bargai et al., 2007; McGuigan
& Middlemiss, 2005; Rodriguez et al., 2008). Specifically, Bargai and her
colleagues found that the lower the sense of mastery reported by women, the
stronger the relationship between the experience of violence and depression.
In addition, studies focusing on immigrant populations have revealed a relationship between low mastery and depression (Chou, 2009; C. Lerner et al.,
2005; Nicholson, Miller, Schwertz, & Sorokin, 2013). The existing literature
has examined the implications of both immigration and IPV for a low sense
1492
Journal of Interpersonal Violence 34(7)
of mastery separately, in addition to examining the relationships between a
low sense of mastery and high depression. Based on the literature, we examined the role of immigration as a moderator to determine whether the correlation between lower sense of mastery and higher depression is stronger among
the immigrant groups who have experienced the multiple stressors of both
immigration and IPV.
The mesosystem
Social support and use of services. Studies have revealed that women who
are victims of violence receive little social support, and many of them are
socially isolated (El-Bassel, Gilbert, Rajah, Foleno, & Frye, 2001; Rodriguez
et al., 2008; Theran, Sullivan, Bogat, & Stewart, 2006). The main reason
for this is that as part of the cycle of violence, the violent partners isolate
the women and prevent them from contacting their families and friends. The
literature indicates that immigrant women who are victims of violence have
limited social support, both due to their immigration and due to the characteristics of violence among that population (Han & Resurrecoon, 2008; Raj
& Silverman, 2003). It has also been found that the prevalence and severity
of IPV are higher among immigrant women with low levels of social support
(Liao, 2006).
Another potential source of support for immigrant and Israeli-born Jewish
women who are victims of IPV may be social services. Findings have revealed
that these women use various services, particularly legal services and social
services, to deal with the problem of violence (Hutchison & Hirschel, 1998;
Zanville & Cattaneo, 2012). However, immigrant women face more barriers
which prevent them from using these services, including language barriers
(Raj & Silverman, 2002). In Israel, language can be a significant barrier for
women from the FSU who are seeking help, because only a few social services have Russian-speaking workers (Almagor-Lotan, 2009). In addition,
immigrants from the FSU harbor suspicion of formal government services
and institutions, which is related, among other factors, to the negative perspective of the government in their countries of origin (Gorbatov, 2010). This
suspicion can prevent them from seeking help even when they are aware that
the services exist. Although the theoretical literature has claimed that the barriers preventing immigrant women from receiving different kind of support,
no studies have examined differences in levels of both formal and informal
support among immigrant versus nonimmigrant women staying in shelters,
nor have the potential differences in the implications for women’s psychological distress been addressed. The presented study attempted to fill this gap.
Research has revealed a correlation between high levels of social support
and low depression among women who are victims of violence in general and
Refaeli et al.
1493
among immigrant women in particular (Beeble, Bybee, Sullivan, & Adams,
2009; Coker et al., 2002; McGuigan & Middlemiss, 2005; Wong et al., 2011).
The results of these studies indicate that woman who have experienced IPV
and have limited support tend to experience higher levels of psychological
distress. Because immigrant women experience the double stress of immigration and violence, in the present study, we examined the moderating effect of
immigration, whether there are differences in the relationship between support and emotional distress among immigrant women versus Israeli-born
Jewish women. However, owing to the lack of research on the relationship
between use of social services and depression among women who are victims
of violence, we examined this issue in the present study.
In light of the above literature review, we examined the contribution of
immigration and IPV to depression. In addition, we examined whether there
are differences in the predictors of depression among immigrant women from
the FSU versus Israeli-born Jewish women. The predictors examined in this
study included variables in the microsystem (frequency of violence), the ontogenetic system (sense of mastery), and the mesosystem (social support and use
of services). Specifically, the following research goals were formulated:
1.
2.
3.
To examine differences in depression and in the above-mentioned
personal and environmental variables that predict depression among
Israeli-born Jewish women versus women who immigrated to Israel
from the FSU.
To examine the power of personal and environmental variables to predict depression among women who are victims of IPV.
To examine the moderating role of immigration in the association
between background variables, personal and environmental variables
and depression.
Method
Participants
The sample consisted of 505 women who were referred to 12 shelters for
victims of IPV in Israel. A total of 1,409 IPV survivors applied to Israeli shelters between September 2009 and April 2014. After removing women with
cognitive impairments or pathological conditions as well as women who left
the shelter within 7 days of arrival from the sample, data were collected from
526 women, a response rate of 68.97%. Twenty-one participants were
excluded from the research sample because they had responded to less than
40% of the items in the questionnaire. Thus, the final sample included 505
1494
Journal of Interpersonal Violence 34(7)
Table 1. Distribution of Background Variables by Country of Birth and t Tests.
All Women
(n = 274)
Age
No. of childrena
Years of education
35.65 (9.44)
2.50 (1.55)
12.22 (2.51)
Israeli-Born
(n = 149)
Immigrants
(n = 125)
37.13 (10.53) 33.75 (7.42)
2.67 (1.41)
2.28 (1.68)
12.39 (2.47) 12.03 (2.56)
t
2.89**
1.97
1.14
df
255
244
265
aCalculated for mothers (N = 246).
**p < .01.
participants. One hundred forty-nine of the participants were Jewish (29.5%),
154 were Arab (30.5%), 125 had immigrated from the FSU (24.8%), and 77
had immigrated from Ethiopia (15.2%). The present article will focus on
comparing the Israeli-born Jewish women with women who immigrated to
Israel from the FSU (henceforth, the immigrants).
Table 1 presents the background characteristics of the research population,
and the results of t tests for independent samples. The age range of the women
was between 20 and 75 years; more than half of them were aged 35 and
below. As shown in Table 1, the Israeli-born Jewish women were significantly older than the immigrant women. About 95% of the women had children. The number of children ranged from one to 14; the mode was one child
(29.2%). As can be seen in the table, there were no differences between the
two groups of participants with regard to the number of children. Similarly,
no difference between the groups was found in years of education, where the
average number of years was more than 12 (the minimum required for a high
school diploma in Israel).
In addition, we used the chi-square test to examine differences in marital
status and employment. Among both groups of participants, the largest percentage was married (56.8% of the Israeli-born Jewish women, and 35.8% of the
immigrant women). A high percentage of the immigrant women were separated
(30.1% compared with 17.8% of the Israeli-born Jewish women). Accordingly,
a significant difference was found between the marital status of the Israeli-born
participants versus the immigrants: χ2(3) = 12.35, p = .01. No difference was
found between the groups with regard to employment during the year preceding
their arrival at the shelter: χ2(1) = 0.62, p = n.s. In both groups, about half of the
women had not worked during the year prior to their arrival at the shelter.
Procedure
The research was conducted by social workers at the shelters. A self-report
questionnaire in Hebrew and Russian was distributed to the participants, who
Refaeli et al.
1495
were asked to complete the questionnaire within three weeks of their arrival
at the shelter. All of the women signed informed consent forms stating that
refusal to participate would not affect their stay at the shelter. Completed
questionnaires were returned in sealed envelopes, and participants were
ensured of anonymity. The study was conducted according to the ethical
guidelines of the authors’ university and was approved by the ethical committees of the university and the Ministry of Welfare and Social Services.
Measures
Demographic questionnaire. The questionnaire included data on the women’s
background characteristics: year of birth, origin, marital status, number of
children, years of education, and employment status.
Frequency of violence. The questionnaire was developed by Eisikovits et al.
(2004), which measures different types and frequencies of violence: verbal
aggression (e.g., insulting), psychological/emotional abuse (e.g., limitation
of contact with family and friends), physical assault (e.g., breaking things),
and sexual assault (forced intercourse). For each of these items, the women
were asked to rank the frequency of abuse in their relationship with their
partner on a scale ranging from 1 (one-time) to 4 (daily). Factor analysis
yielded two main factors that explained 44.83% of the variance in the data:
physical assault and threats (seven items, Cronbach’s α = .82) and emotional
abuse (5 items, Cronbach’s α = .69). The overall Cronbach’s alpha reliability
of the instrument used in this study was .83.
Personal Variables
Sense of mastery. The questionnaire was developed by Pearlin and Schooler
(1978) and translated into Hebrew by Hobfoll and Walfisch (1984). The
questionnaire examines feelings of control over the environment and the
future, and includes seven items (e.g., “What happens to me in the future
mostly depends on me”). Participants were asked to rate the extent to which
they agree with each item, on a 5-point scale ranging from 1 (strongly disagree) to 5 (strongly agree). One score was derived by calculating the mean
of the scores on all items: the higher the score, the greater the participant’s
sense of mastery. In the present study, Item 2 was mistakenly omitted from
the questionnaire. In an early study, Hobfoll, Nadler, and Leiberman (1986)
reported a Cronbach’s alpha reliability of .78 for the Hebrew version of the
questionnaire. The Cronbach’s alpha reliability of the questionnaire used in
the present study was .74.
1496
Journal of Interpersonal Violence 34(7)
Environmental Variables
Social support. The questionnaire used in the present study was originally
developed by Karlsson, Sjöström, and Sullivan (1995), and adapted by Soskolne and Manor (2010). It contained six statements which measure the participants’ perceptions of emotional, financial, and informational support
(e.g., “How often is someone available to you during a crisis to offer advice,
information or guidance?”). Responses were based on a 5-point Likert-type
scale ranging from 1 (never) to 5 (all the time). Soskolne and Manor reported
a Cronbach’s alpha reliability of .89, and the reliability of the instrument used
in the current study was .85.
Use of services. The questionnaire was developed for the present study. Participants were asked to report on the extent to which they used 14 different
services listed in the questionnaire. Responses were based on a 4-point scale
ranging from 1 (not at all) to 4 (continuously). The general measure was the
average frequency of use of different services. The general Cronbach’s alpha
reliability of the questionnaire was .84.
The Dependent Variable
Depression. We used a scale that measures depression based on the Brief
Symptom Inventory (BSI), which examines psychiatric disorders (Derogatis,
1992). The questionnaire consisted of a list of six problems. Participants were
asked to indicate the extent to which they had experienced each of the problems
(e.g., “no hope for the future”) on a 5-point scale ranging from 0 (not at all) to
4 (to a great extent). The Cronbach’s alpha internal reliability of the scale used
in a previous study was .80 (Wang et al., 2010). Norms for the general population were constructed for the BSI. The average norm in Israel for the depression
subscale was M = 0.70, SD = 0.69 (Gilbar & Ben-Zur, 2002). In a study conducted among immigrants from different countries, the average on the depression scale was .94 (Aroian, Patsdaughter, Levin, & Gianan, 1995).
Data Analysis
First, t tests and analyses of variance (ANOVAs) were conducted to examine
the differences between the Israeli-born and immigrant women. Afterwards,
Pearson’s correlations were conducted to verify the relationship between the
variables and depression. A four-step hierarchical regression was conducted
in accordance with ecological theory to examine the contribution of the variables from the different systems to predicting depression.
1497
Refaeli et al.
Table 2. Differences in Depression and Personal and Environmental Resources—
Israeli-Born Jewish Women Versus Immigrant Women From the Former Soviet
Union.
Depression
Sense of mastery
Social support
Use of services
All Women
M (SD)
Israeli-Born
M (SD)
Immigrants
M (SD)
t
df
2.34 (1.04)
3.23 (0.98)
3.05 (1.05)
1.70 (0.59)
2.47 (0.97)
3.11 (0.99)
3.19 (1.02)
1.76 (0.59)
2.25 (1.11)
3.29 (0.95)
2.89 (1.06)
1.61 (0.59)
1.69
−1.51
2.31*
2.00*
271
266
264
261
*p < .05.
Findings
To examine whether there were differences between the Israeli-born and
immigrant women in levels of depression, a t test for independent samples
was conducted (see Table 2). As shown in the table, no significant difference between the groups was found in levels of depression. Following this
finding, t tests were conducted to examine differences in levels of depression among the women in the sample versus the level found among the
overall population of Israel (M = 0.70; Gilbar & Ben-Zur, 2002). The findings revealed that the level of depression among the women in the sample
(M = 2.36, SD = 1.04) was significantly higher than the level among the
overall population: t(272) = 26.46, p < .001. This finding remained significant when the average levels of depression among the Israeli-born Jewish
women and the immigrant women were compared separately with the overall population: t(148) = 22.13, p < .001, and t(125) = 15.58, p < .001,
respectively.
In the next stage, to examine differences between the Israeli-born and
immigrant women in variables that might predict depression, ANOVAs as
well as t tests for independent samples were conducted (see Table 2). The
analysis of variance conducted for differences between the two groups in
types of IPV revealed a significant but weak difference between the groups in
the frequency of violence: F(1, 258) = 3.47, p < .05, η2 = .026. However, post
hoc Bonferroni analyses revealed no significant difference between the
groups with regard to physical violence and threats: F(1, 258) = 1.58, n.s.,
nor was a significant difference found with regard to emotional abuse: F(1,
258) = 2.56, n.s. Table 2 presents the results of t tests conducted for independent samples to examine the differences between the groups with regard to
the variables: mastery, support, and use of services.
1498
Journal of Interpersonal Violence 34(7)
Table 3. Pearson’s Correlations of Background Variables, Characteristics, and
Personal and Environmental Resources With Depression.
All Women
(n = 274)
Background and violence variables
Age
.11
No. of children
.06
Years of schooling
−.02
Physical violence
.16**
and threats
Emotional abuse
.19**
Personal and environmental variables
Mastery
−.45***
Social support
−.21***
Use of services
.10
Israeli-Born
(n = 149)
Immigrants
(n = 125)
.09
.18*
−.09
.08
.09
−.07
.03
.27**
.04
−.43***
−.32***
.11
z test
−2.02**
−1.55*
.32***
−2.33**
−.48***
−.12
.07
0.53
−1.71*
*p < .05. **p < .01. ***p < .001.
The t tests for independent samples revealed no significant difference
between the Israeli-born and immigrant women with regard to sense of
mastery. However, the immigrants from the FSU were found to have less
support and use services less frequently than the Israeli-born Jewish
women.
Correlations of Background Variables, Personal and
Environmental Variables With Depression
To examine the correlations of background variables, characteristics of violence, and personal and environmental variables with depression, we conducted a series of Pearson’s correlations (see Table 3).
The Pearson’s correlations revealed that most of the background variables did not correlate significantly with depression, except for a positive
correlation between number of children and depression among the Israeliborn Jewish women. The frequency of violence correlated with depression,
and the source of this correlation was found mainly among the immigrant
women. Moreover, we found negative correlations between mastery and
depression among the women in both groups. Negative correlation between
social support and depression was found among the Israeli-born Jewish
women. There was no significant relationship between use of services and
depression.
Refaeli et al.
1499
Predictors of Depression Among Women Who Are Victims of
Violence
To assess the overall contribution of the background variables, violence variables, and personal and environmental variables as well as the contribution of
their interactions with the participants’ country of origin, we conducted hierarchical regression analysis. Only country of origin and the variables that
correlated with depression were entered into the regression equation. These
variables were entered in four steps. In the first step, background variables
(country of origin and number of children) were entered. The violence variables (physical violence and threats, and emotional abuse) were entered in
the second step. Personal and environmental variables (sense of mastery and
social support) were entered in the third step, and the interactions between
country of origin and frequency of violence as well as sense of mastery and
social support were entered in the fourth step.
As shown in Table 4, the research variables explained 29% of the variance
in depression. Except for background variables, all of the sets of variables
examined in the regression contributed significantly to predicting depression.
The variables entered in the second step contributed 4%. In this step, emotional abuse was found to be a predictor; the more the women experienced
emotional abuse, the more they reported depression. However, the variables
that contributed most significantly were personal and environmental variables (sense of mastery and social support), which explained 20% of the variance in depression: High mastery and high social support were associated
with lower levels of depression, and vice versa. In addition, the interaction
variables entered in the fourth step explained 3% of the variance, but none of
the variables was found to be a significant predictor of depression.
Discussion
In the present study, we examined differences in levels of depression as well
as predictors of depression among immigrant women from the FSU versus
Israeli-born Jewish women who are victims of IPV. The findings revealed no
differences in levels of depression between the immigrant versus Israeli-born
Jewish women. The lack of differences in levels of depression among immigrants versus indigenous populations is inconsistent with the results of a previous study conducted among the overall population (Frankenberg et al.,
2013; Lee et al., 2014; Mirsky, 2009). The multiple demands and losses in the
process of immigration might explain the previous results. However, the literature indicates that immigrants from the FSU are less inclined to report
emotional distress, and they tend to express their distress through somatic
1500
Table 4. Standardized Regression (Beta) Coefficients Measuring the Contribution of the Variables to Explaining Depression.
Model 1
B
Model 2
β
Background variables
−.20
−.10
Origina
No. of children
.03
.05
Violence variables
Physical violence
Emotional abuse
Personal and environmental variables
Mastery
Social support
Interactions
Physical Violence × Origin
Emotional Abuse × Origin
Mastery × Origin
Social support × Origin
F
(2, 246) = 1.63
.01
R2
—
∆R2
a0 = Israeli-born, 1 = immigrants.
*p < .05. **p < .01. ***p < .001.
Model 3
Model 4
B
β
B
β
−.20
.02
−.10
.03
−.18
.00
−.08
.01
−.18
.00
−.09
.00
.11
.14
.12
.14
.08
.09
.15
.11
.10
.07
−.44**
−.15**
−.41
−.15
.16
.21*
(4, 244) = 3.58**
.05**
.04**
(6, 242) = 14.13***
.26***
.20***
B
−.43***
−.16**
β
−.41
−.16
.09
.08
.10
.09
−.06
−.06
.10
.10
(10, 238) = 9.79***
.29*
.03*
Refaeli et al.
1501
symptoms (V. Lerner, Kanevsky, & Witztum, 2008). This might explain why
we did not find differences between the groups when we used the questionnaire that examined psychological distress.
We did find that the levels of depression among both groups of women
examined in this study were significantly higher than among the overall population. These findings are consistent with the results of previous studies,
which have revealed high rates of depression among women who are victims
of IPV (Bargai et al., 2007; Rodriguez et al., 2008). In addition, findings have
revealed no differences among women by country origin with regard to the
prevalence of IPV. These findings highlight the universal nature of IPV
against women of different backgrounds and origins (Clements, Sabourin, &
Spiby, 2004; Plichta & Falik, 2001).
The explanation for the absence of differences between the two groups of
participants might derive from the fact that the shelter is the last line in the
series of services provided to women who are victims of IPV, and that the
women arrive at shelters after they have been exposed to extremely severe or
life-threatening physical abuse (Grossman & Lundy, 2011; McFarlane,
Maddoux, Nava, & Gilroy, 2014). Both immigrant and Israeli-born Jewish
women who arrive at the shelters are from the most disadvantaged populations, as reflected in their background variables (e.g., high rates of unemployment). This assumption is consistent with the findings of a study that
compared the characteristics of women who arrive at shelters for victims of
IPV with those who receive community services for prevention of IPV
(Grossman & Lundy, 2011). The study revealed that the socioeconomic status of the women who arrived at the shelter was lower, and they had lower
levels of education than the women in the other group. In this vein, another
study revealed that women who arrive at shelters experience more violence
and more depression than women who receive services for prevention of violence in the community (McFarlane et al., 2014). Therefore, the finding that
immigration status was not a moderating variable indicates that immigration
from the FSU was no longer a significant characteristic that distinguished
these women from the most disadvantaged social groups who arrive at
shelters.
The findings indicate that with regard to depression and violence as well
as background characteristics, there were more similarities than differences
between the two groups of women. However, the immigrant women from the
FSU had fewer environmental resources than the Israeli-born Jewish women.
In addition to having lower levels of social support, they used social services
less than the Israeli-born women. The findings of the present research are
consistent with those of other studies, which indicate that informal support
from family and friends is less available for immigrant women who are
1502
Journal of Interpersonal Violence 34(7)
victims of violence, than it is for women in the indigenous population (Han
& Resurrecoon, 2008; Raj & Silverman, 2003). Among other factors, this can
be attributed to the role of immigration in diminishing the woman’s network
of close relationships. In addition, the findings of our study are consistent
with results presented in the literature review, which indicate that immigrant
women face obstacles in seeking assistance from various services (Abraham,
2000; Bauer, Rodriguez, Quiroga, & Flores-Ortiz, 2000; McFarlane, Soeken,
Reel, Parker, & Silva, 1997). Our findings also highlight the prevailing cultural norm among immigrants from the FSU, which demands that they keep
domestic problems within the family and avoid seeking help from external
agencies (Crandall, Senturia, Sullivan, & Shiu-Thornton, 2005; Kagan &
Shafer, 2001). These findings are noteworthy, because the low levels of support among victims of IPV can lead to dependence on the violent partner and
make it difficult to leave him (Anderson & Saunders, 2003; Barnett, 2001).
This is especially true of women from the FSU, who often have no family
members in Israel other than their partners. Nonetheless, it is important to
note that in the present study, the women in both groups received assistance
from various community services before going to the shelter. This finding
indicates that women who are victims of IPV used different sources of support for a long time before leaving their abusive partners (D. M. Johnson &
Zlotnick, 2007; Lewis, 2002).
In the second part of the study, we examined the variables that predict
depression among women who are victims of IPV. The findings reveal that in
keeping with ecological theory, several of the systems in the women’s environment contributed to exacerbating their depression. The first system
addressed in the study was the microsystem. In that context, we examined the
contribution of IPV to the women’s emotional distress. As mentioned, several
studies have found that the severity and frequency of violence are related to
depression among victims of IPV (Carbone-López, Kruttschnitt, &
Macmillan, 2006; Golding, 1999; Newcomb & Carmona, 2004). However,
the findings of the present study revealed that even though physical violence
is related to depression, especially among immigrant women, it does not predict the intensity of depression when background variables are taken into
account. Nonetheless, the present study’s findings highlight the contribution
of emotional abuse to depression, particularly for immigrant women. These
findings are important because family violence is often perceived only as
physical abuse, whereas research has revealed that emotional abuse is also a
significant component, and in many cases the only component of violent relationships (Eisikovits et al., 2004; Sullivan et al., 2012).
In the second ecological system, the ontogenic system, we examined the
contribution of mastery to the women’s emotional distress. A high sense of
Refaeli et al.
1503
mastery plays an important role in enabling these women to break the cycle
of violence (Patzel, 2001). This can be explained by our findings as well as
by previous findings which indicate that sense of mastery can play a role in
preventing the negative mental health consequences of violence (Bargai
et al., 2007; McGuigan & Middlemiss, 2005; Rodriguez et al., 2008). Notably,
women who believe they have control over their situation tend to experience
less depression connected to passive behavior, and therefore might have the
ability to leave their abusive husband. In addition, findings have revealed that
women who remain in a violent relationship for an extended period have a
low sense of mastery (Frisch & MacKenzie, 1991). This might lead to a
vicious cycle in which women who are exposed to ongoing violence experience depression besides damage to their sense of mastery, which limits their
ability to leave their abusive partners.
The finding that low social support predicts high levels of depression is
related to the mesosystem. This finding is in line with the results of previous
studies conducted among women who are victims of IPV (e.g., Coker et al.,
2002; Wong et al., 2011). As such, these findings are of great importance
because they show that informal support contributes significantly to psychological distress, whereas formal support has not been found to predict depression. In the present study, we examined concrete and emotional assistance as
one variable. However, Wong and colleagues (2013) found that specific intervention with IPV victims improved the depression symptoms among nonimmigrant women but did not have the same effect on the immigrant women.
These findings underscore the need to further examine the results from each
of the different services separately for immigrant and nonimmigrant women.
Limitations
Several limitations of the study should be noted. First, it was conducted
among residents of a shelter for women who are victims of IPV. Notably,
women who arrive at these shelters often experience more severe physical
abuse and significantly greater danger to their lives than women who are
treated for IPV in community settings (Alsaker et al., 2011). In addition, studies have revealed that the women who seek help are the ones with higher
psychological distress (Ford-Gilboe et al., 2015). Moreover, the transition to
the shelters and the rules of the shelters might cause loss of support from family and friends and undermine the women’s sense of mastery (Glenn &
Goodman, 2015). However, this study did not examine the implications of
the transition to the shelter. It is important to take this into account in evaluating the implications of the findings for women who experienced IPV did not
go to shelters. Furthermore, when the women’s personal resources and their
1504
Journal of Interpersonal Violence 34(7)
use of services are addressed, there is a need to take into account that women
in shelters have already sought help from various services before their arrival
at the shelter. In addition, the immigrant women in our study succeeded in
receiving support from services, and were able to arrive at the shelter while
they were overcoming language barriers that they encountered in the Israeli
services. It is possible that in this aspect, these women differ substantially
from victims of IPV who remain in the community and do not seek help or do
not succeed in finding help. In addition, the response rate of participants in
the present sample amounted to about 70% of the women. This was mainly
due to the fact that many women left the shelter after short periods, and the
findings apparently do not reflect their situation.
Clinical and Policy Implications
Although we did not find differences between the immigrant and Israeli-born
Jewish women with regard to the prevalence of depression, the relationship
between the severity of different types of violence and levels of depression
was more significant among the immigrant women. Besides these findings,
the literature indicates that immigrants from the FSU are less inclined to
report emotional distress and they tend to express their distress through
somatic symptoms (V. Lerner et al., 2008). Therefore, it is important to conduct a comprehensive examination of depression among immigrant women
who are victims of violence by identifying somatic aspects that might be
indicative of depression (e.g., fatigue, lack of appetite, or excessive appetite).
This would provide a basis for offering a solution for the emotional distress
of these women.
In addition, it is important to examine the factors that might protect women
from the consequences of IPV, with emphasis on strengthening these factors
through interventions (Sullivan, 2013). In the present study, we examined the
contribution of sense of mastery and social support to depression among
women. These aspects can and should be reinforced through individual and
group interventions while the women are staying at shelters.
Research Implications
As mentioned, the differences between the immigrant and Israeli-born Jewish
women diminished in the setting of the shelter but might have been more
significant among victims of IPV who receive services in the community.
Therefore, it is important that future studies examine whether there are differences in levels of emotional distress and levels of resources among immigrant women from different countries versus nonimmigrant women who are
Refaeli et al.
1505
victims of IPV and receive services in different community settings. This
would create a basis for providing appropriate, culturally sensitive services to
women in these situations.
It should also be noted that due to the cross-sectional design of the study,
the results are correlational, and cannot be used as a basis for determining
causal relationships. Hence, it would be worthwhile to conduct longitudinal
studies to establish causality.
In addition, the study examined one ethnic group in Israel and compared it
with the Israeli-born Jewish group. It is important to mention that Israel is
home to other groups such as Israeli-born Arabs and Ethiopian immigrants,
who belong to traditional communities, in contrast to the immigrants from
the FSU who are mainly secular. These groups may differ in terms of the
resources at their disposal at each of the ecological levels. The initial results
from Israel have revealed differences in levels of depression as well as physical victimization among Arab versus Jewish IPV victims (Kattoura, 2013).
This discrepancy highlights the need to further explore women from different
communities to better assess the risk factors for experiencing violence as well
as psychological distress.
Acknowledgments
The authors thank the women and the shelters’ staff for their collaboration.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research,
authorship, and/or publication of this article: The study was supported by the Israel
Ministry of Immigrant Absorption.
References
Abraham, M. (2000). Isolation as a form of marital violence: The South Asian immigrant experience. Journal of Social Distress and the Homeless, 9, 221-236.
doi:10.1023/A:1009460002177
Almagor-Lotan, O. (2009). Violence against women: Summary of data for 2009 and
dealing with the problem from a comparative perspective. Jerusalem, Israel:
Knesset Research and Information Center. (In Hebrew)
Alsaker, K., Kristoffersen, K., Moen, B. E., & Baste, V. (2011). Threats and acts
of intimate partner violence reported by users at Norwegian women’s shelters.
Journal of Interpersonal Violence, 26, 950-970. doi:10.1177/0886260510365864
1506
Journal of Interpersonal Violence 34(7)
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Anderson, D. K., & Saunders, D. G. (2003). Leaving an abusive partner: An empirical review of predictors, the process of leaving, and psychological well-being.
Trauma, Violence, & Abuse, 4, 163-191. doi:10.1177/1524838002250769
Aroian, K. J., Patsdaughter, C. A., Levin, A., & Gianan, M. E. (1995). Use
of the Brief Symptom Inventory to assess psychological distress in three
immigrant groups. International Journal of Social Psychiatry, 41, 31-46.
doi:10.1177/002076409504100104
Bargai, N., Ben-Shakhar, G., & Shalev, A. Y. (2007). Posttraumatic stress disorder
and depression in battered women: The mediating role of learned helplessness.
Journal of Family Violence, 22, 267-275. doi:10.1007/s10896-007-9078-y
Barnett, O. W. (2001). Why battered women do not leave, part 2: External inhibiting factors—Social support and internal inhibiting factors. Trauma, Violence, &
Abuse, 2, 3-35. doi:10.1177/1524838001002001001
Bauer, H. M., Rodriguez, M. A., Quiroga, S. S., & Flores-Ortiz, Y. G. (2000). Barriers
to health care for abused Latina and Asian immigrant women. Journal of Health
Care for the Poor and Underserved, 11, 33-44. doi:10.1353/hpu.2010.0590
Beeble, M. L., Bybee, D., Sullivan, C. M., & Adams, A. E. (2009). Main, mediating, and moderating effects of social support on the well-being of survivors
of intimate partner violence across 2 years. Journal of Consulting and Clinical
Psychology, 77, 718-729. doi:10.1037/a0016140
Borges, G., Medina-Mora, M. E., Orozco, R., Fleiz, C., Cherpitel, C., & Breslau, J.
(2009). The Mexican migration to the United States and substance use in northern
Mexico. Addiction, 104, 603-611. doi:10.1111/j.1360-0443.2008.02491.x
Carbone-López, K., Kruttschnitt, C., & Macmillan, R. (2006). Patterns of intimate
partner violence and their associations with physical health, psychological distress, and substance use. Public Health Reports, 121, 382-392.
Chandra, P. S., Satyanarayana, V. A., & Carey, M. P. (2009). Women reporting
intimate partner violence in India: Associations with PTSD and depressive
symptoms. Archives of Women’s Mental Health, 12, 203-209. doi:10.1007/
s00737-009-0065-6
Chou, K. L. (2009). Pre-migration planning and depression among new migrants
to Hong Kong: The moderating role of social support. Journal of Affective
Disorders, 114, 85-93. doi:10.1016/j.jad.2008.06.005
Clements, C. M., Sabourin, C. M., & Spiby, L. (2004). Dysphoria and hopelessness following battering: The role of perceived control, coping, and self-esteem. Journal
of Family Violence, 19, 25-36. doi:10.1023/B:JOFV.0000011580.63593.96
Coker, A. L., Davis, K. E., Arias, I., Desai, S., Sanderson, M., Brandt, H. M., &
Smith, P. H. (2002). Physical and mental health effects of intimate partner violence for men and women. American Journal of Preventive Medicine, 23, 260268. doi:10.1016/S0749-3797(02)00514-7
Crandall, M., Senturia, K., Sullivan, M., & Shiu-Thornton, S. (2005). “No way out”:
Russian-speaking women’s experiences with domestic violence. Journal of
Interpersonal Violence, 20, 941-958. doi:10.1177/0886260505277679
Refaeli et al.
1507
Derogatis, L. R. (1992). The Brief Symptom Inventory (BSI) administration, scoring, and procedures manual–II. Baltimore: Clinical Psychometric Research
Corporation.
Ding, D., Hofstetter, C. R., Norman, G. J., Irvin, V. L., Chhay, D., & Hovell, M. F.
(2011). Measuring immigration stress of first-generation female Korean immigrants in California: Psychometric evaluation of Demand of Immigration Scale.
Ethnicity & Health, 16, 11-24. doi:10.1080/13557858.2010.523107
Dutton, D. G. (1985). An ecologically nested theory of male violence towards intimates. International Journal of Women’s Studies, 8, 404-413.
Eisikovits, Z., Winstok, Z., & Fishman, G. (2004). The first Israeli national
survey on domestic violence. Violence Against Women, 10, 729-748.
doi:10.1177/1077801204265549
El-Bassel, N., Gilbert, L., Rajah, V., Foleno, A., & Frye, V. (2001). Social support among women in methadone treatment who experience partner violence:
Isolation and male controlling behavior. Violence Against Women, 7, 246-274.
doi:10.1177/10778010122182433
Ford-Gilboe, M., Varcoe, C., Noh, M., Wuest, J., Hammerton, J., Alhalal, E., &
Burnett, C. (2015). Patterns and predictors of service use among women who
have separated from an abusive partner. Journal of Family Violence, 30, 419-431.
doi:10.1007/s10896-015-9688-8
Foster, R. P. (2001). When immigration is trauma: Guidelines for the individual
and family clinician. American Journal of Orthopsychiatry, 71, 153-170. doi:
10.1037/0002-9432.71.2.153
Frankenberg, E., Kupper, K., Wagner, R., & Bongard, S. (2013). Immigrant youth in
Germany: Psychological and sociocultural adaptation. European Psychologist,
18, 158-168. doi:10.1027/1016-9040/a000154
Frisch, M. B., & MacKenzie, C. J. (1991). A comparison of formerly and chronically
battered women on cognitive and situational dimensions. Psychotherapy: Theory,
Research, Practice, Training, 28, 339-344. doi:10.1037/0033-3204.28.2.339
Gilbar, O., & Ben-Zur, H. (2002). Adult Israeli community norms for the Brief
Symptom Inventory (BSI). International Journal of Stress Management, 9, 1-10.
doi:10.1023/A:1013097816238
Glenn, C., & Goodman, L. (2015). Living with and within the rules of domestic
violence shelters: A qualitative exploration of residents’ experiences. Violence
Against Women, 21, 1481-1506. doi:10.1177/1077801215596242
Golding, J. M. (1999). Intimate partner violence as a risk factor for mental disorders: A meta-analysis. Journal of Family Violence, 14, 99-132.
doi:10.1023/A:1022079418229
Gorbatov, R. (2010). Survey of the pilot program for training social service workers who deal with immigrants from the former Soviet Union. Jerusalem, Israel:
Department for Research, Planning & Training, Ministry of Social Services. (In
Hebrew)
Grossman, S. F., & Lundy, M. (2011). Characteristics of women who do and do
not receive onsite shelter services from domestic violence programs. Violence
Against Women, 17, 1024-1045. doi:10.1177/1077801211414169
1508
Journal of Interpersonal Violence 34(7)
Grynbaum, M., Biderman, A., Levy, A., & Petasne-Weinstock, S. (2001). Domestic
violence: Prevalence among women in a primary care center—A pilot study.
The Israel Medical Association Journal, 3, 907-910. Retrieved from http://europepmc.org/abstract/med/11794912
Hadas, D., Markovitzky, G., & Sarid, M. (2008). Spousal violence among immigrants
from the former Soviet Union—General population and welfare recipients.
Journal of Family Violence, 23, 549-555. doi:10.1007/s10896-008-9166-7
Han, C. K., & Resurrecoon, B. P. (2008). Struggling alone: Gender, migration and
domestic violence among Thai women in Bangkok. Asian Journal of Women’s
Studies, 14(1), 34-71.
Heise, L. L. (1998). Violence against women: An integrated, ecological framework.
Violence Against Women, 4, 262-290. doi:10.1177/1077801298004003002
Hobfoll, S. E., Nadler, A., & Leiberman, J. (1986). Satisfaction with social support during crisis: Intimacy and self-esteem as critical determinants. Journal
of Personality and Social Psychology, 51, 296-304. doi:10.1037/00223514.51.2.296
Hobfoll, S. E., & Walfisch, S. (1984). Coping with a threat to life: A longitudinal study
of self-concept, social support, and psychological distress. American Journal of
Community Psychology, 12, 87-100. doi:10.1007/BF00896930
Hutchison, I. W., & Hirschel, J. D. (1998). Abused women: Help-seeking strategies and police utilization. Violence Against Women, 4, 436-456. doi:10.1177/
1077801298004004004
Israel Central Bureau of Statistics. (2011). Israel statistical yearbook 2011. Jerusalem,
Israel: Central Bureau of Statistics. (In Hebrew)
Johnson, D. M., & Zlotnick, C. (2007). Utilization of mental health treatment and
other services by battered women in shelters. Psychiatric Services, 58, 15951597. doi:10.1176/appi.ps.58.12.1595
Johnson, M. P. (1995). Patriarchal terrorism and common couple violence: Two
forms of violence against women. Journal of Marriage and the Family, 57,
283-294. doi:10.2307/353683
Kagan, H., & Shafer, K. C. (2001). Russian-speaking substance abusers in transition-New country, old problems. In S. L. A. Straussner (Ed.), Ethnocultural
Factors in Substance Abuse Treatment (pp. 250-271). New York: The Guilford
Press.
Karlsson, J., Sjöström, L., & Sullivan, M. (1995). Swedish Obese Subjects (SOS)—
An intervention study of obesity. Measuring psychosocial factors and health
by means of short-form questionnaires. Results from a method study. Journal
of Clinical Epidemiology, 48, 817-823. doi:10.1016/0895-4356(94)00196-W
Kattoura, O. (2013). Battered women residents in shelters: A comparison between
battered Arab and Jewish women in self-control, life threatening and depression
(Unpublished master’s thesis). Bar-Ilan University, Israel. (In Hebrew)
Lee, S. H., Park, Y. C., Hwang, J., Im, J. J., & Ahn, D. (2014). Mental health of
intermarried immigrant women and their children in South Korea. Journal of
Immigrant and Minority Health, 16, 77-85. doi:10.1007/s10903-012-9747-7
Refaeli et al.
1509
Lehavot, K., Walters, K. L., & Simoni, J. M. (2009). Abuse, mastery, and health among
lesbian, bisexual, and two-spirit American Indian and Alaska Native women. Cultural
Diversity & Ethnic Minority Psychology, 15, 275-284. doi:10.1037/a0013458
Lerner, C., Kertes, J., & Zilber, N. (2005). Immigrants from the former Soviet
Union, five years post-immigration to Israel: Adaptation and risk factors for
psychological distress. Psychological Medicine, 35, 1805-1814. doi:10.1017/
S0033291705005726
Lerner, V., Kanevsky, M., & Witztum, E. (2008). The influence of immigration on
the mental health of those seeking psychiatric care in southern Israel: A comparison of new immigrants to veteran residents. The Israel Journal of Psychiatry
and Related Sciences, 45, 291-298. Retrieved from http://www.ncbi.nlm.nih.gov/
pubmed/19439835
Lewis, S. F. (2002). An investigation of help-seeking behavior in battered women
(Unpublished doctoral dissertation). West Virginia University, Morgantown.
Liao, M. S. (2006). Domestic violence among Asian Indian immigrant women: Risk
factors, acculturation, and intervention. Women & Therapy, 29(1-2), 23-39.
doi:10.1300/J015v29n01_02
Lissitsa, S., & Peres, Y. (2000). Immigrants from the former Soviet Union in Israel:
Formulating an identity and processes of integration. Israeli Sociology, 3, 7-30.
(In Hebrew)
Martinez-Torteya, C., Bogat, G. A., von Eye, A., Levendosky, A. A., & Davidson,
W. S. (2009). Women’s appraisals of intimate partner violence stressfulness
and their relationship to depressive and posttraumatic stress disorder symptoms.
Violence and Victims, 24, 707-722. doi:10.1891/0886-6708.24.6.707
Matud, M. P. (2005). The psychological impact of domestic violence on Spanish
women. Journal of Applied Social Psychology, 35, 2310-2322. doi:10.1111/
j.1559-1816.2005.tb02104.x
McFarlane, J., Maddoux, J., Nava, A., & Gilroy, H. (2014). Abused women with
children who are first-time users of a shelter or applicants for a protection order:
Entry data of a 7-year prospective analysis. Violence Against Women, 21, 249268. doi:10.1177/1077801214564680
McFarlane, J., Soeken, K., Reel, S., Parker, B., & Silva, C. (1997). Resource use
by abused women following an intervention program: Associated severity of abuse and reports of abuse ending. Public Health Nursing, 14, 244-250.
doi:10.1111/j.1525-1446.1997.tb00297.x
McGuigan, W. M., & Middlemiss, W. (2005). Sexual abuse in childhood and interpersonal
violence in adulthood: A cumulative impact on depressive symptoms in women.
Journal of Interpersonal Violence, 20, 1271-1287. doi:10.1177/0886260505278107
Menjivar, C., & Salcido, O. (2002). Immigrant women and domestic violence:
Common experiences in different countries. Gender & Society, 16, 898-920.
doi:10.1177/089124302237894
Mirsky, J. (2009). Mental health implications of migration: A review of mental health
community studies on Russian-speaking immigrants in Israel. Social Psychiatry
and Psychiatric Epidemiology, 44, 179-187. doi:10.1007/s00127-008-0430-1
1510
Journal of Interpersonal Violence 34(7)
Mizrahi, S. (2012). Violence against women: Summary of data for 2012. Jerusalem,
Israel: Knesset Research and Information Center. (In Hebrew)
Newcomb, M. D., & Carmona, J. V. (2004). Adult trauma and HIV status among
Latinas: Effects upon psychological adjustment and substance use. AIDS and
Behavior, 8, 417-428. doi:10.1007/s10461-004-7326-1
Nicholson, L. M., Miller, A. M., Schwertz, D., & Sorokin, O. (2013). Gender differences in acculturation, stress, and salivary cortisol response among former
Soviet immigrants. Journal of Immigrant and Minority Health, 15, 540-552.
doi:10.1007/s10903-012-9752-x
Patzel, B. (2001). Women’s use of resources in leaving abusive relationships: A naturalistic inquiry. Issues in Mental Health Nursing, 22, 729-747.
doi:10.1080/01612840152712992
Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of Health and
Social Behavior, 19, 2-21.
Plichta, S. B., & Falik, M. (2001). Prevalence of violence and its implications for
women’s health. Women’s Health Issues, 11, 244-258. doi:10.1016/S10493867(01)00085-8
Raj, A., & Silverman, J. (2002). Violence against immigrant women: The roles of culture, context, and legal immigrant status on intimate partner violence. Violence
Against Women, 8, 367-398. doi:10.1177/10778010222183107
Raj, A., & Silverman, J. G. (2003). Immigrant South Asian women at greater risk for
injury from intimate partner violence. American Journal of Public Health, 93,
435-437. doi:10.2105/AJPH.93.3.435
Remennick, L. (2005). Immigration, gender, and psychosocial adjustment: A study
of 150 immigrant couples in Israel. Sex Roles, 53, 847-863. doi:10.1007/s11199005-8297-z
Rodriguez, M. A., Heilemann, M. V., Fielder, E., Ang, A., Nevarez, F., & Mangione,
C. M. (2008). Intimate partner violence, depression, and PTSD among pregnant
Latina women. Annals of Family Medicine, 6, 44-52. doi:10.1370/afm.743
Soskolne, V., & Manor, O. (2010). Health inequalities in Israel: Explanatory factors
of socio-economic inequalities in self-rated health and limiting longstanding illness. Health & Place, 16, 242-251. doi:10.1016/j.healthplace.2009.10.005
Stockman, J. K., Hayashi, H., & Campbell, J. C. (2015). Intimate partner violence
and its health impact on ethnic minority women. Journal of Women’s Health, 24,
62-79. doi:10.1089/jwh.2014.4879
Sullivan, T. P. (2013). Think outside: Advancing risk and protective factor research
beyond the intimate-partner-violence box. Psychology of Violence, 3, 121-125.
doi:10.1037/a0032125
Sullivan, T. P., McPartland, T., Armeli, S., Jaquier, V., & Tennen, H. (2012). Is it the
exception or the rule? Daily co-occurrence of physical, sexual, and psychological partner violence in a 90-day study of substance-using, community women.
Psychology of Violence, 2. doi:10.1037/a0027106
Taler, Y. (1998). Integration into work of unemployed new immigrant women from
single parent families. International Journal of Rehabilitation Research, 21, 195209. doi:10.1097/00004356-199806000-00007
Refaeli et al.
1511
Theran, S. A., Sullivan, C. M., Bogat, G. A., & Stewart, C. S. (2006). Abusive partners and ex-partners: Understanding the effects of relationship to the abuser
on women’s well-being. Violence Against Women, 12, 950-969. doi:10.1177/
1077801206292871
Walker, L. E. A. (2009). The battered woman syndrome (3rd ed.). New York, NY:
Springer-Verlag.
Wang, J., Kelly, B. C., Booth, B. M., Falck, R. S., Leukefeld, C., & Carlson, R. G.
(2010). Examining factorial structure and measurement invariance of the Brief
Symptom Inventory (BSI)-18 among drug users. Addictive Behaviors, 35, 23-29.
doi:10.1016/j.addbeh.2009.08.003
Wong, J. Y. H., Tiwari, A., Fong, D. Y. T., Humphreys, J., & Bullock, L. (2011).
Depression among women experiencing intimate partner violence in a Chinese
community. Nursing Research, 60, 58-65. doi:10.1097/NNR.0b013e3182002a7c
Wong, J. Y. H., Tiwari, A., Fong, D. Y. T., Yuen, K. H., Humphreys, J., & Bullock,
L. (2013). Intimate partner violence, depressive symptoms, and immigration
status: Does existing advocacy intervention work on abused immigrant women
in the Chinese community? Journal of Interpersonal Violence, 28, 2181-2202.
doi:10.1177/0886260512475311
Zanville, H. A., & Cattaneo, L. B. (2012). The nature of risk and its relationship to
coping among survivors of intimate partner violence. Psychology of Violence, 2,
355-367. doi:10.1037/a0028198
Author Biographies
Tehila Refaeli, PhD, is currently a postdoctoral fellow in the school of social work at
the Hebrew University, and an adjunct lecturer at the School of Social Work at BarIlan University. In recent years, she has been involved in various research projects that
examined violence against women and youth at risk during transition to adulthood.
Drorit Levy, PhD, is a lecturer and the coordinator of community and organization
development program in the School of Social Work at Bar-Ilan University. In the last
decade, she has been involved in various research projects that focus on immigrant
women.
Anat Ben-Porat, PhD, is a lecturer in the School of Social Work at Bar-Ilan
University. In the last decade, she has been involved in various studies that examined
different aspects of family violence.
Rachel Dekel, PhD, is the director and professor in the School of Social Work at BarIlan University, Ramat-Gan, Israel. In the last decade, she has been involved in various research projects that examined different facets of human coping with traumatic
events such as, war, terror, and family violence.
Haya Itzhaky, PhD, is the Head of the Graduate Committee Studies and Professor in
the School of Social Work at Bar-Ilan University. In the last decades, she has been
involved in various research projects that examined different phenomena in functional
communities such as family violence, traditional communities, and backpackers.