Appearance-related residual injury, posttraumatic stress, and body image: Associations within a sample of female victims of intimate partner violence


  • Mimi S. Kokoska is now at Surgical Services, John L. McClellan VA Hospital and Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AK.

    Julie C. Etzel is now at Evanston Northwestern Healthcare, Evanston, IL.

    This work was supported in part by National Institutes of Health Grant R03 MH 61661 02, Terri L. Weaver, PhD, principal investigator. Additional support for this project was provided by an internal grant from Saint Louis University. We would like to express our tremendous appreciation for the willingness of the women in this study to share their experiences. We would also like to thank the domestic violence community within the greater Saint Louis region for their collaboration on this project. In addition, we would like to thank Stacey Sand, Maysa Akbar, Mary Uhlmansiek, Traci Sitzer, and Emily McVay for their assistance with participant recruitment, data collection, and data entry.

    Points of view expressed within this paper are those of the authors and do not necessarily reflect the official position of the National Institutes of Health or the National Institute of Mental Health.


One third of women who experience intimate partner violence (IPV) receive some form of injury. After acute injuries have healed, a victim's physical appearance may be altered with residual changes including marks or scars. This study included 56 female victims of IPV (31 with appearance-related residual injury and a comparison group of 25 with no appearance-related residual injury) and examined the associations between violence-related experiences, body image distress, and symptoms of posttraumatic stress disorder (PTSD). Appearance-related residual injury status moderated the relationship between body image distress and symptoms of PTSD. In addition, within the appearance-related residual injury group, body image distress emerged a unique predictor of PTSD explaining incremental variance beyond that explained by severity of psychological maltreatment.