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

Am J Orthopsychiatry. 2026 Mar 9. doi: 10.1037/ort0000919. Online ahead of print.

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).

PMID:41801719 | DOI:10.1037/ort0000919