Parsing dimensions of family violence exposure in early childhood: Shared and specific contributions to emergent psychopathology and impairment

Early childhood exposure to family violence predicts increased risk for psychopathology. However, violence between partners and towards children often co-occur. This complicates efforts to determine how experiences of family violence contribute to early mental health problems. Utilizing mother-report data on harsh parenting and intimate partner violence (IPV) from two large community-based, socioeconomically and ethnically diverse samples of 3–5-year-old children, we illustrate the value of a bifactor method for characterizing a family climate in which verbal and physical violence are more chronic and pervasive among family members. In our Calibration sample (N = 1,179), we demonstrate the fit of a bifactor model with a shared violence factor reflecting violence among partners and towards children and orthogonal factors for physically harsh parenting and IPV. Examination of item distributions along quartiles on the identified factors reveals that violent behaviors are most frequent/chronic in families with high scores on the shared violence factor. Next, we apply this model in Validation (N = 1,316) and lab-visit samples (N = 369). Children’s symptoms and impairment showed relatively strong and consistent associations with the shared factor. Some unique associations with IPV and harsh parenting were also observed. Overall, patterns suggest particularly negative impact when verbal and physical violence are more chronic and pervasive among family members. Finally, evidence supporting the bifactor model’s validity relative to multi-method data from coded interviews about child abuse and IPV and observed parenting is presented. Findings illustrate the value of a bifactor approach for the meaningful characterization of shared and specific features of family violence.     

Child abuse and physical punishment of children in Finland

This study looks at child abuse as a part of family violence and includes a literature review of the previous Finnish studies on child abuse. The data of the study comes from a poll conducted in Finland in the autumn of 1981 of 530 of the Finnish population older than 14 years of age: 3% of respondents had observed physical violence towards small children and 1% towards teenagers; 44% of the respondents were of the opinion that physical punishment of children was needed at least on certain occasions. In Sweden the corresponding percentage was only 26. The majority of Finns (60%), however, was in favor of a special law to ban all child abuse and physical punishment of children as was done in Sweden in 1979. The recommendation of the author, based on both theoretical consideration and the poll results is that such a law would be helpful in advancing the wellbeing of children.     

A survey on parent-child conflict resolution: intrafamily violence in Italy

OBJECTIVE: The purpose of this paper was to investigate factors associated with intrafamily violence toward children in Italy. Family structure and the characteristics of both caretakers and children were explored. Their association with the incidence of minor and severe violence was analyzed to test the hypothesis that child physical abuse is related to a combination of different factors involving the family as a whole. METHOD: This research was carried out by submitting an anonymous questionnaire to 2388 families residing in Tuscany, Italy. The form included two sections, one related to the family cultural substrate, and to potentially influential events affecting the family during the year 1998. The other one, taken from the conflict tactics (CT) scales, presented a hierarchy of possible responses to conflict. RESULTS: Physical punishment appeared to be a general behavior in Italy, because the incidence of minor violence was 77%. The incidence of severe violence was about 8%. When considering family, caretaker, and child characteristics mostly associated with physical punishment in Italy, we found that families with a low income, where caretakers had health problems or were stressed, and with younger and more "problematic" children presented the highest risk of intrafamily violence during conflict resolution. CONCLUSIONS: The results point to the importance of a balance between potentiating and compensatory factors in complex and dynamic relationships among family members, to avoid strategy resolution of conflict ultimately leading to violence. Moreover, minor and severe violence appeared to be two related but different phenomena.     

Long-term effects of child punishment on Mexican women: a structural model

OBJECTIVE: The aim of this study was to investigate long-term effects of parental use of physical and verbal punishment on Mexican women. To study both direct and indirect effects of these phenomena, a structural model was developed and tested. METHOD: One hundred and fifty Mexican women were interviewed with regard to their history of child abuse, their level of depression, alcohol use, antisocial behavior, and punishment of their own children. Factors representing such constructs were specified within a structural equation model and their inter-relations were estimated. Women's history of abuse was considered as an exogenous latent variable directly affecting three other factors: mothers' antisocial behavior, their alcohol consumption, and their levels of depression or anxiety. These factors, in turn, were specified as influencing mothers' harsh discipline of their own children. RESULTS: Data supported this model, indicating that a history of abuse has long-term effects on women's behavior and psychological functioning, which in turn cause women's punitive behavior against their children. CONCLUSIONS: These results are discussed in terms of the theoretical framework of intergenerational transmission of violence. The direct consequences (depression, anxiety, alcohol consumption, and antisocial behavior) of child punishment act as risk factors for the next generation of child abuse.     

Child and partner abuse: self-reported prevalence and attitudes in the north of Portugal

OBJECTIVES: To determine the self-reported prevalence of child and partner physical and emotional abuse in the north of Portugal and to investigate attitudes about these forms of family violence. METHODS: Data were collected by questionnaire from a representative sample of parents in two-parent families with children under the age of 18 years. A total of 2,391 parents participated (1,057 males), aged 20-67 years. Four questionnaires were used, one behavioral and one attitudinal, for each of the forms of abuse: child and partner. RESULTS: At least one act of emotional or physical abuse towards a child during the previous year was reported by 25.9% of participants (12.3% reported physically abusive and 22.4% emotionally abusive acts). Abuse of a partner was reported by 26.2% of participants; at least one act of physical abuse during the previous year was reported by 12% and of emotional abuse by 23.7%. The attitudinal data, however, showed general disapproval of the use of violence, both for disciplining children and within marital relationships. The degree of self-reported support for physical punishment was higher in participants who reported using abusive behavior. Females more commonly reported acts of child abuse, and males reported acts of partner abuse. Both forms of self-reported abuse showed an association with low educational and socio-economic status. CONCLUSIONS: This is the first study in Portugal to analyze family violence through self-report using a representative sample. The findings indicate that child and partner abuse constitute a significant problem in the region of northern Portugal. The discrepancy between the self-reported behavioral and attitudinal data may reflect conflicts in Portuguese society, which is undergoing substantial cultural changes.     

Effects of parental verbal aggression on children's self-esteem and school marks.

OBJECTIVE: The aim of the study was to distinguish the effects of verbal aggression from those of physical aggression and investigate whether parental verbal violence has negative effects on children's self-esteem and academic achievements. METHOD: One hundred and forty-four 10-year-old children completed the Harter Self-perception Profile for Children questionnaire and a questionnaire concerning their mothers' and fathers' verbal aggression towards them and their use of physical punishment. The researchers used school records to obtain the subjects' marks in French (their native language) and Mathematics. RESULTS: Six children had never been the targets of either verbal aggression or physical punishment. Thirty-four children had been subjected to both types of aggression. Verbal aggression alone was found to be in significant negative correlation with three of six components of self-esteem. Verbal aggression alone was also found to be in significant negative correlation with French marks. In addition children who had been subject to greater verbal aggression had lower self-esteem and lower marks in French than children who had been subject to lesser verbal aggression. They were also significantly negatively affected in a fourth component of self-esteem. CONCLUSIONS: Parental verbal aggression alone as separate and distinct from physical punishment contributes to lowering children's self-esteem and school achievements. Given the extent of the use of verbal aggression by ordinary parents the authors suggested a need for parent education on the topic of positive methods of child rearing.     

Violence among family members of children and adolescents evaluated for sexual abuse

OBJECTIVES: The two aims of this study were to: (1). describe the prevalence and characteristics of domestic adult and child physical violence in the homes of children and adolescents evaluated in a specialized sexual abuse clinic and (2). describe parent or caretaker responses to domestic adult and child violence and child sexual abuse, including tendencies to report or seek medical care. METHOD: A consecutive sample of 164 subjects (ages 7-19) were interviewed in a sexual abuse clinic regarding in-home violent or abusive experiences among family members that had occurred at any time during their childhood. RESULTS: Fifty-two percent of these children and teenagers reported spousal violence in their home. Fifty-eight percent of child sexual offenders who were in-home males also physically abused their adult female partner. Half of in-home males who were physically violent to children also sexually abused them. In 86% of homes with partner violence, the children were also physically assaulted. There was no difference in sexual abuse disclosure rates or patterns for children living with or without adult violence. CONCLUSIONS: Sexually abused children should be questioned about physical abuse and the presence of violence among adults in their home. Safety plans for sexually abused children should incorporate screening for family violence and safety plans for parents and siblings of child victims, when appropriate.     

Children exposed to child maltreatment and intimate partner violence: a study of co-occurrence among Hong Kong Chinese families

Objective

This study assessed the co-occurrence of child maltreatment and intimate partner violence (IPV) and examined the association between them.

Method

The cross-sectional study recruited a population-based sample of 1,094 children aged 12-17 years in Hong Kong. Structured questionnaires were used to collect data from the children. The prevalence of occurrence of child abuse and neglect by parents and exposure to IPV in both the past year and lifetime was examined, and their correlates were assessed using univariate and multivariate logistic regression.

Results

The results show that 26% and 14.6% of child participants had been exposed to IPV physical assault, and 44.4% and 22.6% had been subjected to a parent's corporal punishment or to physical maltreatment from a parent in their lifetime and the year preceding the study, respectively. Among those families characterized by IPV, 54.4% and 46.5% were involved in child physical maltreatment over the child's lifetime and in the preceding year, respectively.

Conclusions

Multivariate logistic regression analyses revealed that children exposed to IPV were at higher risk of being victims of neglect, corporal punishment, and physical maltreatment or severe physical maltreatment by their parents than children who were not exposed to IPV, even when child and parent demographic factors were controlled for.

Practical implications

The higher risk of child physical maltreatment associated with IPV highlights the need for an integrated assessment to screen for the presence of multiple forms of family violence within the family, and for intervention to assess effective responses to both IPV and child maltreatment by child protective service workers and domestic violence agencies.     

Gender differences in the risk for delinquency among youth exposed to family violence

OBJECTIVE: The purpose of this research was to illuminate gender differences in adolescent delinquency against a backdrop of childhood exposure to both marital violence and physical child abuse. Specifically, analyses were performed to trace the unique effects of exposure to either form of family violence (marital or child) on the violent and nonviolent delinquency of boys and girls. METHOD: This is a prospective study of 299 children who were interviewed with their mothers in 1991 about forms of abuse in the family. Approximately 5 years later a search of juvenile court records was performed for these same children. Details on the nature of the crimes were collected. Outcome variables included: (1) whether there was ever an arrest; and (2) whether there was ever an arrest for a violent crime. RESULTS: Preliminary analyses indicated no gender differences in overall referral rates to juvenile court, although boys were more likely than girls to be referred for property, felony, and violent offenses. Exposure to marital violence in childhood predicted referral to juvenile court. Girls with a history of physical child abuse were arrested for violent offenses more than boys with similar histories, but the context of violent offenses differed dramatically by gender: Nearly all referrals for a violent offense for girls were for domestic violence. CONCLUSIONS: Although boys and girls share similar family risk factors for delinquency, girls are more likely than boys to be arrested for violent offenses in the aftermath of child physical abuse. These findings suggest that it takes more severe abuse to prompt violence in girls than is necessary to explain boys' violent offending.     

Inappropriate child rearing practices as perceived by Jewish immmigrant parents from the former Soviet Union.

OBJECTIVES: First to explore what Jewish immigrant parents from the Former Soviet Union consider to be appropriate and inappropriate child rearing practices, and second what are their help seeking preferences in situations of children at risk. METHOD: Interviews with 273 immigrant parents were conducted in Israel. A semi-structured questionnaire included seven vignettes which related to three areas of parental behaviors: Lack of provision of child's needs, corporal punishment and psychological punishment. In addition, open-ended questions were included about the participants' personal beliefs regarding the use of physical punishment towards children. RESULTS: Suggest a concrete and practical approach towards child rearing practices, support for the utilization of certain types of corporal and psychological punishment, consideration of the gender of the child might be a factor in the approach towards corporal punishment. a perception of children as self sufficient at a fairly young age and a tendency not to cooperate with outsiders in situations of children at risk. CONCLUSIONS: Even though Jewish immigrants from the Former Soviet Union might be in a new country for several years, their background may still have a significant role in their child rearing practices and help seeking patterns. Awareness of their perceptions could provide information which is significant for the accurate assessment of situations of abuse and neglect among the immigrants and for defining appropriate treatment objectives and means for achieving change.     

Childhood adversity and behavioral health outcomes for youth: An investigation using state administrative data

This study aimed to measure the relative contribution of adverse experiences to adolescent behavioral health problems using administrative data. Specifically, we sought to understand the predictive value of adverse experiences on the presence of mental health and substance abuse problems for youth receiving publicly funded social and health services. Medicaid claims and other service records were analyzed for 125,123 youth age 12–17 and their biological parents. Measures from administrative records reflected presence of parental domestic violence, mental illness, substance abuse, criminal justice involvement, child abuse and/or neglect, homelessness, and death of a biological parent. Mental health and substance abuse status of adolescents were analyzed as functions of adverse experiences and other youth characteristics using logistic regression. In multivariate analyses, all predictors except parental domestic violence were statistically significant for substance abuse; parental death, parental mental illness, child abuse or neglect and homelessness were statistically significant for mental illness. Odds ratios for child abuse/neglect were particularly high in both models. The ability to identify risks during childhood using administrative data suggests the potential to target prevention and early intervention efforts for children with specific family risk factors who are at increased risk for developing behavioral health problems during adolescence. This study illustrates the utility of administrative data in understanding adverse experiences on children and the advantages and disadvantages of this approach.     

What predicts injury from physical punishment? A test of the typologies of violence hypothesis

OBJECTIVE: This study examined the power of child, perpetrator, and socio-economic characteristics to predict injury in cases of reported child physical abuse. The study was designed to assess the validity of the assumption that physically injurious incidents of child physical abuse are qualitatively different from those that do not result in injury, that their generative factors are distinctive, and that the quality of caregiving in these two types of incidents is different. METHOD: A weighted, nationally representative sample of 8,164 substantiated punishment abuse cases in Canada was used. Various models were constructed and evaluated through logistic regression. RESULTS: Of six potential predictors - child age, perpetrator sex, child functioning, parent functioning, economic stress, and social stress - none predicted injury to the child. CONCLUSIONS: The findings suggest that injurious and non-injurious physical abuse cannot be distinguished on the basis of the personal characteristics or circumstances of the child or perpetrator. PRACTICE IMPLICATIONS: A common criterion for child welfare intervention into cases of suspected physical abuse is injury or risk of injury. This criterion assumes that injurious and non-injurious assaults are qualitatively different phenomena, predicted by different risk factors. In the present study an attempt was made to differentiate between injurious and non-injurious cases of punitive physical abuse on the basis of characteristics of the child, perpetrator, family, and social context. None of these factors explained the likelihood of injury, suggesting that the prediction of injury as an intervention criterion may be questionable.     

Family patterns and child abuse in a nationally representative American sample

Data on 1, 146 families with a child age 3 through 17 at home are presented. Child abuse information was obtained for a randomly selected child in each family. Child abuse was defined as an attack by a parent involving punching, kicking, biting, hitting with an object, “beating up,” or using a knife or gun. Over 14 out of every 100 American children 3–17 are subjected to abusive violence each year. These figures are at least 26 times greater than those of the National Center For Child Abuse and Neglect. Even so, for reasons outlined in the paper, they are underestimates. Families in which child abuse occurred are compared with other families. The results suggest that child abuse is brought about by the very nature of the society and its family system. This has profound implications for the prevention and treatment of child abuse. Although psychotherapy may be appropriate in some cases, a more fundamental approach lies in such things as a more equal sharing of the burdens of child care, replacement of physical punishment with non-violent methods of child care and training, eliminating the stresses and insecurity which now characterize our economic system, and strengthening the ties of individual families to the extended family and the community.     

Risk factors for fatal and non-fatal child maltreatment in families previously investigated by CPS: A case-control study

The objective of this study was to identify individual, family and caregiver risk factors for serious child maltreatment, resulting in hospitalization or death, among children and families investigated by Child Protective Services (CPS). We conducted a matched case-control study of 234 children who sustained fatal or serious nonfatal maltreatment due to physical abuse or neglect and whose mother was named in a CPS investigation between 1999 and 2013. A total of 702 children and their caregivers were included in the study with 234 cases matched 2:1,resulting in 468 controls. Data on potential risk factors were abstracted from three county administrative databases. Differences between cases and controls were calculated and multivariable conditional logistic regression was used to estimate risk models. Variables associated with increased risk for serious maltreatment included male child gender,younger caregivers, three or more children under the age of 5 living in the home, families in which a biologic child was not living with either parent, and scoring moderate or high on the Structured Decision Making Risk Tool^®. Caregiver involvement in intimate partner violence (IPV) and child enrollment in public health insurance appears to mitigate the risk of serious maltreatment.     

The factors of child physical abuse in Korean immigrant families

OBJECTIVE: This study explores Korean immigrant mothers' attitudes toward child physical abuse based on an ecological perspective. METHOD: One hundred and forty-four Korean immigrant mothers who came to the US after age 16 and have at least one child under 18 years old participated in this study. Data were collected using instruments translated in Korean that measure mothers' attitudes toward child physical abuse in four areas: degree of agreement with physical abuse, conflict tactics, belief in the use of physical punishment, and perceptions regarding physical abuse. RESULTS: This study found that the following variables affect Korean immigrant mothers' attitudes toward child physical abuse at ecological levels of the environment: amount of time spent with children, experience of corporal punishment as a child, children's gender and age, family acculturation conflicts, mothers' age, and length of time in US at the micro level; involvement in their children's school and involvement in social organizations at the meso level; level of education and reported stress of immigrant life at the exo level; value of children in Korean culture, familiarity with Child Protective Services (CPS), perceived discrimination, and value of corporal punishment at the macro level. CONCLUSIONS: This study suggests the importance of cultural sensitivity in social work practice when working with Korean immigrants. It also implies that intervention and prevention efforts of child abuse should be targeted at more than one level of the environment.     

Responses of Physically Abused and Nonabused Children to Different Forms of Interadult Anger

Responses to various forms of interadult anger were examined in 2 groups of 6–11-year-olds: 44 low-SES children with a history of physical abuse and exposure to interspousal aggression, and 44 low-SES children exposed to interspousal aggression but with no history of physical abuse or other child maltreatment. Children were presented with videotaped segments of adults in angry and friendly interactions. Angry segments varied on ( a ) the type of anger expression (nonverbal, verbal, verbal-physical), and ( b ) whether anger was resolved. In general, physically abused children reported greater fear than nonabused children in response to all forms of interadult anger. Moreover, abused children appeared particularly sensitive to whether anger between adults was resolved. Findings are discussed with regard factors that may mediate relations between exposure to family violence and the development of psychopathology in children from highly aggressive home environments.     

Risk of mother-reported child abuse in the first 3 years of life

OBJECTIVE: The purpose of this research was to investigate, within an at-risk population, parent and child characteristics associated with a mother's self-reports of severe physical assault and assault on the self-esteem of the child in the first 3 years of life. DESIGN: The study population consisted of a community-based sample of mothers of newborns identified as at-risk for child maltreatment (n=595). Families were assessed annually from the child's birth through age 3 using instruments with established psychometric properties. Independent variables investigated included: family socio-demographics, parity, mother's social support, maternal depression, maternal problem drug or alcohol use, partner violence, child's age, child's sex, low birth weight/small for gestational age (SGA), and mother's perception of child's demand level. Associations with maltreatment were examined using multivariable methods for longitudinal data. RESULTS: Child severe physical assault was significantly associated with parent characteristics (maternal depression and partner violence); and child characteristics (SGA). Assault to the child's self-esteem was significantly associated with maternal depression, maternal illicit drug use, partner violence and mother's perception of child's demand level. Controlling for family sociodemographic characteristics did not change the associations. Likewise, while mother's perception of child demand level had an independent association with self-esteem assault, the associations described above persisted while demand level was held constant. In this high-risk sample, abuse was not associated with mother's age, education, race, parity, or household income level. CONCLUSIONS: While characteristics such as SGA can serve as markers for increased abuse risk, they are not amenable to intervention after the child is born. However, certain other risk factors, such as maternal depression and domestic violence are malleable and should be targeted for intervention with the goal of preventing child maltreatment.     

Intervening in severe physical child abuse cases: mental health, legal, and social services.

OBJECTIVE: To examine the child protection process in cases of severe physical abuse, to compare characteristics of the families with risk factors previously reported in the published literature, and to develop recommendations about the use of mental health professionals in such cases. METHOD: Reviewers examined 30 case records of severely physically abused children under age 5, nominated by child protection workers and mental health providers. The reviewers recorded demographic, clinical, and case process information such as mental health and other referrals, reunification status, and frequency of criminal prosecution. A case study was described. RESULTS: The parents displayed a range of psychological characteristics (e.g., depression, anxiety, personality disorders) and life problems (e.g., domestic violence, substance abuse, abused as child). The majority of parents denied the abuse. The children were very young (more than half under 6 months old) and many had difficult births or medical problems prior to the abuse. The most common services offered were individual psychotherapy and parenting classes. More than half of the children reunified with at least one parent within I year. Forty percent of the cases involved criminal prosecution. CONCLUSIONS: Reunification occurred more quickly and more often than expected based on the severity of the injuries. The system often relies on psychotherapy to correct the abusive behavior, even when the perpetrator remains unknown and specific risks such as substance abuse or domestic violence are present. The authors advise utilizing multidisciplinary teams for recommendations regarding reunification.     

Project interact: A study of patterns of interaction in abusive, neglectful and control families

Child Abuse refers to non-accidental physical and psychological injury to a child under the age of 18 as a result of acts of omission or commission perpetrated by a parent or caretaker. Conceptual problems abound in part because we are clearly dealing with behavior which falls along a continuum of caregiver-child relationships. At one end of the continuum we have seemingly innocuous verbal punishment — disparagement, criticism, threat and ridicule. Or, we have fairly typical forms of physical punishment such as a slap on the hand or a swat on the bottom. Then there are forms of physical punishment that exceed current community standards — hitting the child with a closed fist or with an object such as a razor strap, belt, cord, or paddle, slamming the child against the wall, kicking him, burning the child with a cigarette, scalding the child with hot water, torturing or even killing the child. It is not always clear where a particular case should be placed on this conceptual continuum. What is more devastating to the development of a child, a single occasion where a parent loses control and slams a child across the room, in the process knocking out a tooth and breaking a child's arm, or the persistent day-by-day, month-by-month, year-by-year use of ridicule, criticism and sarcasm toward that child? Nor is it always clear whether acts of omission which are harmful to the child (i.e., neglect) are functionally equivalent to acts of commission that harm the child. This problem of definition and the establishment of a uniform response class is but one of many problems plaguing the systematic study of child abuse. Other problems such as the tendency to dramatize the bizarre and extreme use of physical violence or aggression at the expense of more subtle forms of verbal punishment, the tendency to equate child abuse either with psychopathology, on the one hand, or with poverty, on the other, and the tendency to rely upon impressionistic accounts of behavior also have retarded the accumulation of sound knowledge about the causes, consequences, treatment and prevention of abusive behavior.