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How Domestic Violence Trauma Research Informed PTSD Diagnoses in Veterans.

By Rachel DePalma | Certified Advocate 

May is Mental Health Awareness Month. No Peace No Quiet is starting off our awareness campaign with an article to help others understand the connection between PTSD in victims of abuse and veterans.

Post-Traumatic Stress Disorder (PTSD) was officially recognized as a mental health condition in 1980, primarily in response to the psychological suffering observed in Vietnam War veterans. However, the foundation for understanding PTSD was not laid by military studies alone. Research into the long-term trauma experienced by domestic violence survivors—particularly women in abusive relationships—played a pivotal role in shaping how PTSD is diagnosed and treated today.
From the US Department of Veteran Affairs in the article History of PTSD in Veterans: Civil War to DSM-5. “PTSD became a diagnosis with influence from a number of social movements, such as Veteran, feminist, and Holocaust survivor advocacy groups. Research about Veterans returning from combat was a critical piece to the creation of the diagnosis. So, the history of what is now known as PTSD often references combat history.” - Matthew J. Friedman, MD, PhDSenior Advisor and former Executive Director, National Center for PTSD.
Shared Roots of Trauma Research

In the 1970s, psychologists began documenting the deep psychological impacts of prolonged domestic abuse. These survivors displayed a range of symptoms—chronic anxiety, emotional numbing, flashbacks, hypervigilance—that were eventually recognized as consistent with PTSD.

This research was instrumental in expanding the scope of trauma-related diagnoses. Initially, the focus was on “combat neurosis” or “shell shock,” with the assumption that PTSD was exclusive to soldiers in war zones. However, clinicians working with survivors of domestic violence noticed strikingly similar symptoms, challenging that narrow perspective.
Key Source: Walker, L. E. (1979). The Battered Woman. New York: Harper and Row. Walker introduced the “Cycle of Violence” and emphasized the psychological consequences of abuse, paving the way for PTSD-related frameworks.
Connecting Interpersonal and Combat Trauma
Judith Herman, a Harvard psychiatrist, was among the first to argue that interpersonal trauma—such as domestic violence, sexual abuse, and captivity—could be as psychologically damaging as combat exposure.

Key Source: Herman, J. L. (1992). Trauma and Recovery. New York: Basic Books. Herman demonstrated that both abuse survivors and veterans experienced similar disruptions in identity, safety, and relationships.

This work helped clinicians and researchers recognize PTSD as a broader category of response to trauma, not limited to combat situations. By comparing the experiences of abused women with those of war veterans, Herman and others expanded the understanding of what trauma looks like—and who it affects.
Broadening PTSD Diagnosis

In 1980, the American Psychiatric Association included PTSD in the DSM-III, influenced by both combat veteran data and studies of interpersonal trauma.

Key Source: American Psychiatric Association. (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd ed.). Washington, DC: APA. The initial PTSD criteria included symptoms found in both domestic violence survivors and veterans.
This convergence of research helped mental health professionals move beyond stereotypes of trauma. It validated the struggles of both groups and contributed to the development of treatments that could address chronic trauma, including prolonged exposure therapy, cognitive processing therapy, and EMDR (Eye Movement Desensitization and Reprocessing).
Top 5 Similarities Between Survivors of Abuse and Veterans with PTSD

1.	Hypervigilance and Exaggerated Startle Response: Both veterans and abuse survivors often remain in a constant state of alertness, scanning their environments for threats. This reaction, though protective, can interfere with everyday functioning. (Source: American Psychological Association (2023). PTSD Symptomatology in Survivors and Veterans).
2.	Intrusive Memories and Flashbacks: Unwanted and distressing memories, including vivid flashbacks, are common in both groups. These can be triggered by seemingly benign stimuli, such as sounds or smells. (Source: van der Kolk, B. (2014). The Body Keeps the Score. New York: Viking).
3.	Emotional Numbing and Detachment: Difficulty experiencing pleasure or forming emotional connections often emerges in people with PTSD, whether from war or abuse. (Source: National Center for PTSD (U.S. Department of Veterans Affairs)).

4.	Avoidance of Triggers: Both veterans and abuse survivors may avoid people, places, or conversations that remind them of the trauma, limiting their social lives and employment opportunities. (Source: Diagnostic criteria from DSM-5-TR (APA, 2022)).

5.	Shame, Guilt, and Self-Blame: Veterans may feel guilt over decisions made in combat; abuse survivors may feel responsible for not leaving. In both cases, misplaced guilt complicates healing. (Source: Herman, J. L. (1992). Trauma and Recovery).

Conclusion

By studying domestic violence survivors, researchers gained a deeper appreciation of the lasting psychological wounds caused by chronic interpersonal trauma. These findings not only expanded the medical understanding of PTSD but also legitimized the experiences of millions of veterans and civilians alike. Thanks to the intersection of these research domains, trauma-informed care today is more compassionate, accurate, and inclusive.
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