Women in abusive relationships who have been threatened with a firearm are likely to exhibit more severe symptoms of post-traumatic stress disorder, according to new research published in the journal Violence and Gender.

The study, by researchers at Yale University, found that threats made with a firearm — and the fear of firearms violence — emerged as “significant and unique predictors” of PTSD symptoms in women in abusive relationships.

“People just don’t think about guns being involved in domestic violence incidents unless it’s homicide,” said Tami Sullivan, director of Family Violence Research at the Yale University School of Medicine and a co-author of the paper. “There’s been almost no research on all those times women have been threatened but the actions were never followed through.”

As many as 4.5 million American women have been bullied or coerced with a firearm by an abuser, according to one study. Another 1 million women have been shot at, or survived a shooting.

Sullivan and her co-author Nicole Weiss interviewed 298 women whose male partners had been arrested and seen in court for a domestic violence offense in the previous 12 to 15 months, assessing the frequency of physical, psychological, and sexual victimization that the participants had experienced within the previous 30 days.

Almost a quarter of women had been threatened with a firearm over the course of their relationship. Another 12.5 percent were afraid that their partners would use a gun on them in the 30 days before they were interviewed.

Federal law bars convicted abusers from purchasing firearms. But the law also has serious gaps: As The Trace has reported, abuse is considered domestic violence only if a woman is married to or living with the abuser, or if the parties have a child together. Many states also do not require batterers to relinquish their firearms after being convicted of abuse.

One out of five women reported that their partner had kept a gun during their relationship. Nearly half of all respondents said it would be “easy” or “very easy” for their partner to acquire a gun if he wanted to.

The researchers assessed the severity of victims’ PTSD symptoms using the Posttraumatic Stress Diagnostic Scale, a self-reported measure of the disorder that is used in clinical and research settings.

The threat of using a firearm was the greatest predictor for more severe PTSD symptoms.

“I think it shows that the first focus should be on what we need to do to stop people from gaining access to guns who shouldn’t have access to guns,” Sullivan said. “And I think it’s incredibly important to understand how this affects PTSD symptom severity, because PTSD is associated with memory difficulties, with work difficulties, and with difficulties in interpersonal relationships.”

Younger women experienced a greater threat of firearm violence, the study found. Victims were more likely to report fear of gun violence if they were still in a relationship or living with their abusive partner after he appeared in court.

Sullivan said the results can play an important role in helping women who are still involved in an abusive relationship. Some women never leave their abusive partners, but understanding the prevalence of firearm threats can make it easier for advocates and victims to develop safety plans that explicitly address the risk of gun violence. According to Sullivan, the research also shows that a better assessment is needed to identify women at risk for firearm threats and violence.

“It’s not an area that gets a tremendous amount of attention, but it’s important to think about what we can do to help women be resilient, to reduce their risk for PTSD symptom severity,” Sullivan said. “It’s really more about getting more understanding of this experience from the women themselves, and recognizing how firearm threat really affects a woman’s sense of safety.”

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