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March 12, 2026American Journal of Orthopsychiatry0 citationsOpen Access

Psychosis, intimate partner violence, and self-esteem among a clinical sample of African American women with suicidal ideation.

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EGEllen GutowskiUniversity of TorontoAJAnn JonesWollongong HospitalDMDanielle R. MasonEmory University

Key Points

  • To examine the relationship between psychotic symptoms and intimate partner violence (IPV) in African American women and explore self-esteem as a mediator.
  • Used secondary self-report data from 208 clinical African American women ages 18-59 with prior suicide attempts.
  • Conducted a cross-sectional study design to assess associations between psychotic symptoms and three IPV types (controlling, nonphysical, physical).
  • Applied multiple regression analyses to examine mediation effects of self-esteem on these associations.
  • Found significant associations between psychotic symptoms and all three forms of IPV.
  • Self-esteem based on self-perceptions did not mediate the relationship between psychotic symptoms and physical or controlling IPV.
  • Self-esteem based on others' perceptions mediated the relationship between psychotic symptoms and nonphysical abuse.

Abstract

Both psychotic symptoms (i.e., delusions, hallucinations, disorganized speech/behavior, reduced emotional expression, social withdrawal, lack of motivation) and intimate partner violence (IPV; i.e., abuse by a current or former partner or spouse) disproportionately affect African American women who face increased mortality and morbidity associated with IPV due to delayed help-seeking. However, little research has focused on the association between these two concerns. Moreover, there is a dearth of information about mediators of the psychotic symptoms-IPV exposure link and virtually no exploration of this link among African American women. The current cross-sectional investigation using secondary self-report data from a clinical sample of 208 African American women ages 18-59 with a prior suicide attempt used multiple regression to examine whether there is an association between psychotic symptoms and three types of IPV (controlling, nonphysical, and physical abuse). Next, it explored whether two forms of self-esteem (based on self-perceptions and others' perceptions) mediated the psychotic symptoms-IPV exposure link. Findings supported an association between psychotic symptoms and exposure to all three forms of IPV. Neither form of self-esteem was a mediator in the psychotic symptoms-physical abuse relation. Further, while self-esteem based on self-perceptions did not mediate the psychotic symptoms-controlling behaviors link nor the psychotic symptoms-nonphysical abuse association, self-esteem based on others' perceptions did. As other-based self-esteem is shaped by one's social and cultural contexts and reflects experiences with ongoing abuse, stigma, racism, and gender-based oppression, findings highlight the value of frameworks that situate experiences of IPV as shaped by context. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

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Cite This Study

Gutowski et al. (2026) studied this question.

synapsesocial.com/papers/69b257a296eeacc4fcec6754https://doi.org/10.1037/ort0000919
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