Published June 27, 2026
Why This Evidence Matters
Understanding the mental health consequences of psychological abuse and coercive control has become increasingly important as legal systems and public health institutions reckon with forms of intimate partner violence (IPV) that extend beyond physical assault. According to the CDC’s National Intimate Partner and Sexual Violence Survey (NISVS) 2016/2017 report, experiencing intimate partner violence is associated with many negative health outcomes, with victims more likely to report anxiety, depression, post-traumatic stress disorder (PTSD) symptoms, and negative risk behaviors. Data from NISVS indicate that over 61 million women and 53 million men in the United States have experienced psychological aggression by an intimate partner in their lifetime. These figures underscore the scale at which mental health psychological abuse intersects with public health, and why research into IPV mental health outcomes warrants attention from clinicians, legislators, and courts.
Coercive Control as a Distinct Category of Harm
The sociologist Evan Stark, in his 2007 book “Coercive Control: The Entrapment of Women in Personal Life” (Oxford University Press), defined coercion as “the use of force or threats to compel or dispel a particular response” while control refers to “structural forms of deprivation, exploitation, and command that compel obedience indirectly.” Stark describes IPV as a “liberty crime,” meaning it is not solely about physically hurting the victim but is instead “a course of conduct: a repeated pattern of behavior” directed at diminishing the victim’s autonomy and limiting their space for action.
This framing has significant implications for understanding mental health outcomes. Coercive control is both highly prevalent, occurring in up to 58% of IPV relationships, and a particularly insidious form of IPV that likely has more severe mental health implications than situational psychological IPV, or even physical IPV that is not embedded in the context of coercive control. The distinction matters because, as Stark argued in testimony to the Vermont legislature in 2015, victims face elevated risk for a range of medical, mental health, behavioral, and psychosocial problems, including substance abuse, suicide attempts, and depression, and because these problems only become disproportionate after the onset of abuse, their emergence is explained by the abuse, not by a pre-existing condition.
Key Findings from Systematic Reviews and Meta-Analyses
A growing body of coercive control trauma research has investigated the specific mental health consequences of this form of abuse. A landmark study published in Trauma, Violence, and Abuse by Lohmann, Cowlishaw, Ney, O’Donnell, and Felmingham (2024) conducted the first systematic review and meta-analysis focused specifically on coercive control and mental health. The search identified 68 studies, and data from 45 studies were included in the meta-analyses. The researchers found that coercive control exposure was moderately associated with PTSD and depression symptom severity, and that the strength of these associations was comparable to those involving measures of broader psychological IPV and to those for physical IPV found in previous meta-analyses.
Notably, the findings showed variation across study settings. A statistically significant difference in the strength of mean correlations between coercive control and PTSD appeared according to study setting, with a stronger pooled association observed in domestic violence support services or shelter settings (r = .40) compared to community settings (r = .26).
A separate systematic review and meta-analysis published in Systematic Reviews by Dokkedahl et al. (2022), which included 194 studies, examined the psychological subtypes of IPV and their effects on mental health. Psychological violence had strong associations with PTSD, depression, and anxiety, with the strongest association for PTSD in both female and male victims. Coercive control was particularly associated with PTSD for female victims, while emotional or verbal abuse and dominance or isolation tactics had the strongest association with depression.
The Role of Complex PTSD
An emerging area of inquiry within coercive control trauma research concerns complex PTSD (CPTSD). Lohmann et al. note that given the chronic terror and entrapment experiences that characterize coercive control, the likelihood of developing CPTSD may be high, which may explain in part the more detrimental mental health outcomes compared to other types of IPV. It is possible that coercive control may have stronger associations with CPTSD compared to types of IPV that reflect situational couple violence, because of the prolonged exposure to interpersonal trauma. Research in this area remains limited, and the Lohmann et al. review notes that more research on CPTSD is needed and that most studies were conducted in developed countries and predominantly focused on women in heterosexual relationships.
Methodological Considerations and Limitations
Several important caveats apply to the current evidence base. The Australian Institute of Family Studies (AIFS) has observed that higher levels of coercive control victimization can be associated with specific outcome variables such as higher levels of negative mental health symptoms, but cross-sectional research cannot establish the direction of this relationship or demonstrate change over time. This distinction between correlation and causation remains a central methodological limitation in the literature.
Additionally, as research from White et al. (2024) noted, emotional and psychological IPV were consistently linked to psychological distress and PTSD severity, while the nature and strength of the association varied by type of abuse and population. Research has focused less on the independent effect of psychological violence on mental health compared to physical and sexual IPV. Originally, researchers primarily considered psychological violence as a risk factor for later physical IPV until qualitative interviews with female IPV victims, published in 1990, revealed that victims actually perceived psychological IPV to be worse than physical IPV.
Public Health and Institutional Responses
The CDC recognizes the breadth of mental health consequences associated with intimate partner violence. According to the CDC, many negative health outcomes are associated with IPV, including conditions affecting multiple organ systems, and survivors can experience mental health problems such as depression and PTSD symptoms, with higher risk for behaviors such as smoking, binge drinking, and risky sexual activity. The lifetime economic cost of IPV-related medical care, lost productivity from paid work, and criminal justice costs is estimated at $3.6 trillion.
These figures reflect the intersection of mental health psychological abuse with broader economic burdens, suggesting that IPV mental health outcomes carry consequences well beyond the individual.
Closing Note
Those seeking further information on the mental health consequences of coercive control and psychological abuse may consult the CDC’s NISVS reports, the full text of Lohmann et al. (2024) at PMC, and resources published by the Australian Institute of Family Studies. National domestic violence hotlines and local victim services organizations also provide confidential support.
Sources
- Lohmann et al., “The Trauma and Mental Health Impacts of Coercive Control: A Systematic Review and Meta-Analysis,” Trauma, Violence, and Abuse, 2024, PMC
- Dokkedahl et al., “The Psychological Subtype of Intimate Partner Violence and Its Effect on Mental Health: A Systematic Review with Meta-Analyses,” Systematic Reviews, 2022
- Australian Institute of Family Studies, “What the Research Evidence Tells Us about Coercive Control Victimisation”
- CDC, “About Intimate Partner Violence,” updated February 2026
- CDC NISVS 2016/2017 Report on Intimate Partner Violence
- Stark, E. (2007). Coercive Control: The Entrapment of Women in Personal Life. Oxford University Press
- White et al., “Childhood Abuse, Adult Intimate Partner Violence and Mental Health Outcomes,” Journal of Family Violence, 2025
Disclaimer
Coercive control law moves fast. Jurisdictions are actively criminalizing it, amending definitions, and changing the scope of litigation. This article is current as of its date of publication and may not reflect subsequent changes. It is provided for general educational purposes and is not legal advice.