The CEASE study looks at the biological effect of domestic violence and abuse (DVA) on women's mental health. The biological mechanisms through which DVA causes mental disorders are very poorly understood. Similar to other demands, DVA activates the biological stress system, of which the chief component is the hypothalamic-pituitary-adrenal (HPA) axis, which produces chemical cortisol. Cortisol levels increase in response to short-term demand and help organisms deal with it by changing the processes of getting energy from food and also mental function. However constant activation of the HPA axis can cause damage and accelerate disease.

This study tests the hypothesis that those abused women, who have developed mental disorders have altered cortisol outline, compared with other abused women, who do not have mental illness, and that this alteration in the cortisol outline is predicted by an experience of abuse, then by the mental disorder. To examine the hypothesis the following research questions will be addressed: 1) whether cortisol levels are related to mental health state; 2) whether cortisol levels are related to type, severity, duration and cessation of abuse; 3) whether there is any difference in cortisol concentrations between those women exposed to both childhood abuse and DVA and those who have experienced only the latter; 4) whether cortisol levels vary between women, living in refuge and those not living in refuge?

To answer these research questions 128 women will be recruited through a specialized domestic violence agency. Baseline and 3-monthly follow-up measures will be taken over 6 months after recruitment. Women will be asked to fill in a questionnaire to evaluate their demographics, mental and physical health, experience of childhood abuse and DVA. Participants will also be asked to collect three saliva samples: one in the evening before bed, the second one next morning upon awakening, and the third one thirty minutes after awakening. Saliva will be collected with plastic tubes with cotton swab and returned by post or via collection by the researcher. Then the saliva samples will be analyzed for cortisol and its breakdown product cortisone.

Results of the study will increase our understanding of the biological mechanisms of DVA impact on a woman's health and tell researchers and practitioners about the possibility of using cortisol as an indicator to diagnose abuse-related health problems and develop more targeted intervention for abuse survivors.

For more information, contact Dr Natalia Lokhmatkina

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