The meta-analytic relationship between exposure to domestic violence and dissociative symptoms. Engaging in interventions with clients experiencing relationship difficulties; risk factors and impact on clinician well-being

Abstract

This meta-analysis sought to examine the meta-analytic relationship between exposure to domestic violence and dissociative symptoms. The results of a systematic literature search of PsycInfo, Medline, Web of Science and PTSDpubs yielded 1331 studies, 12 of which were eligible for review. A random effects meta-analysis was conducted to investigate the strength of the association between exposure to physical domestic violence and dissociative symptoms. Meta-analysis resulted in a total effect size of r=.302 with a 95% confidence interval (CI) spanning .22 and .38, (Z = 7.59, p < .001). This represents a statistically significant positive relationship between the two variables which suggests that exposure to physical domestic violence is associated with greater number of dissociative symptoms. The studies demonstrated considerable heterogeneity, I² = 76%.

The empirical study aimed to examine the level of understanding mental health practitioners have regarding coercive control, a complex subtype of domestic violence, and how this level of understanding and other risk factors contributes to poorer practitioner wellbeing. A cross-sectional survey design was used. An opportunity sample was obtained of 237 mental health practitioners working in Northern Ireland who engage with patients experiencing domestic violence. Understanding of obvious coercive control scenarios were appropriate with 99.6% of practitioners viewing the behaviours as a crime and 93% reporting the victim-survivor was at risk of physical harm. Practitioner understanding of less obvious scenarios was poorer at 76% and 44% respectively. Job role, lower levels of coercive control understanding, and lower levels of self-compassion were risk factors for secondary traumatic stress. Risk factors for burnout were job role, lower levels of perceived organisational support, increased awareness to safeguarding risks, and lower levels of self-compassion. Specific training regarding more subtle forms of coercive control behaviour is required. Increased organisational support may also be important for improving safeguarding and practitioner psychological wellbeing.

Thesis is embargoed until 31 December 2028.

Date of Award	Dec 2025
Original language	English
Awarding Institution	Queen's University Belfast
Supervisor	Kevin Dyer (Supervisor), David Curran (Supervisor), Julie-Ann Jordan (Supervisor) & Dave Rogers (Supervisor)