Childhood maltreatment and intimate partner violence victimization: A meta-analysis

BackgroundIntimate partner violence (IPV) victimization is a serious public health problem in the world. It is imperative to examine risk factors for IPV victimization.ObjectiveThis meta-analysis aimed to explore the relationship between childhood maltreatment (CM) and IPV victimization and investigate the moderating effects of gender and marital status.Participants and SettingExamination of the literature produced a sample of 56 effect sizes (N = 23,127) for review.MethodsPsycINFO, PsycArticles, EBSCO-ERIC, Medline, Google Scholar, and ProQuest Dissertations & Theses databases were systematically searched until March 31, 2018. Forty-six eligible studies were included in the meta-analysis. Random effects model was used for meta-analysis of the studies.ResultsResults indicated a significant association between total CM and IPV victimization (r = .18, p < .001). Further subgroup analyses revealed that all four types of CM (childhood physical abuse, psychological abuse, sexual abuse, and neglect) were positively related to IPV victimization (r = .19, .18, .17, and .12, respectively). Moreover, the moderation analyses revealed that the association between CM and IPV victimization was stronger for dating couples than for married ones. However, this relation did not show significant difference between males and females.ConclusionsThere is an association between CM and IPV victimization, and it is moderated by marital status.     

Exposure to intimate partner violence and internalizing symptoms: The moderating effects of positive relationships with pets and animal cruelty exposure

BackgroundIt is estimated that more than half of children living in households where intimate partner violence (IPV) occurs are also exposed to animal cruelty (AC). Although prior research links bonds with pets with higher levels of socioemotional competence among school-age children, exposure to AC may negate the protective effects of pet ownership and/or exacerbate the potentially deleterious effect of IPV on children’s mental health.ObjectiveThe current study evaluates whether and to what extent the associations between exposure to IPV and several indicators of children’s mental health vary as a function of children’s positive engagement with pets and exposure to AC.Participants and SettingParticipants included 204 children (aged 7–12 years; 47% female; 57% Latinx) and their maternal caregiver who were recruited from domestic violence agencies in a western U.S. state.MethodMultiple moderation analysis evaluated whether the association between children’s exposure to IPV and internalizing and posttraumatic stress symptoms vary as a function of children’s positive engagement with pets and exposure to AC.ResultsAnalyses revealed several moderation effects for positive engagement with pets (e.g., internalizing problems: [b = −.15, t(195) = −2.66, p = .008]; posttraumatic stress symptoms: [b = −.13, t(195) = −2.24, p = .026]), whereas exposure to AC only moderated the association between IPV and anxious/depressed symptoms (b = .32, t(195) = −2.41, p = .017).ConclusionsThese findings highlight the potential protective effects of positive engagement with pets and importance of screening for exposure to AC when engaging in trauma-informed work with children exposed to IPV.     

Maternal intimate partner violence victimization and child maltreatment

There is some limited evidence of an association between maternal intimate partner victimization (IPV) and children’s experience of maltreatment. Using data from a longitudinal study, we examine whether this relationship is independent of range of potential confounders including socio-economic, familial and psychological factors. Data were taken from the 14 and 30-year follow-ups of the Mater-University of Queensland Study of Pregnancy (MUSP) in Australia. A subsample of 2064 mothers and children (59.0% female) whose data on maternal IPV and child maltreatment was available, were analysed. In families with maternal IPV, two in five children reported being maltreated, compared to one in five children maltreated in families without maternal IPV. Except for sexual maltreatment which was consistently higher in female offspring, there was no gender differences in experiencing different types of maltreatment in families manifesting maternal IPV. Although both males and females were at increased risk of child maltreatment in families where mothers were victimized by their male partners, male children were more likely to be emotionally maltreated. The main associations were substantially independent of measured confounders, except for father’s history of mental health problems which attenuated the association of maternal IPV victimization and male offspring’s physical abuse. Our findings confirm that there is a robust association between maternal IPV and child maltreatment. Both maternal IPV victimization and child maltreatment co-occur in a household characterized by conflict and violence. Consequences of IPV go beyond the incident and influence all family members. Efforts to reduce child maltreatment may need to address the greater level of IPV associated with the cycle of family violence.     

The impact of perceived childhood victimization and patriarchal gender ideology on intimate partner violence (IPV) victimization among Korean immigrant women in the USA

Childhood victimization experiences are common among intimate partner violence (IPV) victims. This study examines the link between childhood physical and sexual victimization experiences and adulthood IPV among Korean immigrant women in the USA. As Korean immigrants often use physical punishment to discipline their children, and reporting sexual abuse is discouraged due to stigmatization in this community, cultural factors (e.g. patriarchal values) related to childhood victimization and IPV were also examined. Survey data from Korean immigrant women in the USA were collected. Using a case-control design, we compared 64 Korean immigrant women who have experienced IPV in the past year with 63 Korean immigrant women who have never experienced IPV in their lifetime. The findings of this study reveal that IPV victims, compared with non-victims, experienced higher childhood victimization rates. Logistic regression analysis demonstrated that childhood victimization and patriarchal gender ideology strongly predict IPV victimization among Korean immigrants. However, patriarchal values did not moderate the relationship between childhood victimization and IPV. To prevent IPV among Korean immigrant population, we need to make special efforts to prevent childhood abuse and change ingrained cultural attitudes about child physical and sexual abuse among immigrant communities through culturally sensitive programs.     

Maltreatment in childhood and intimate partner violence: A latent class growth analysis in a South African pregnancy cohort

Intimate partner violence (IPV) is a significant global problem, prevalent in low and middle-income countries (LMICs). IPV is particularly problematic during the perinatal and early postnatal period, where it is linked with negative maternal and child health outcomes. There has been little examination of profiles of IPV and early life adversity in LMIC contexts. We aimed to characterize longitudinal IPV and to investigate maternal maltreatment in childhood as a predictor of IPV exposure during pregnancy and postnatally in a low resource setting. This study was nested in the Drakenstein Child Health Study, a longitudinal birth cohort. Maternal IPV (emotional, physical and sexual) was measured at six timepoints from pregnancy to two years postpartum (n = 832); sociodemographic variables and maternal maltreatment in childhood were measured antenatally at 28–32 weeks’ gestation. Associations between maternal maltreatment in childhood and IPV latent class membership (to identify patterns of maternal IPV exposure) were estimated using multinomial and logistic regression. We observed high levels of maternal maltreatment during childhood (34%) and IPV during pregnancy (33%). In latent class analysis separating by IPV sub-type, two latent classes of no/low and moderate sexual IPV and three classes of low, moderate, and high emotional and physical IPV (separately) were detected. In combined latent class analysis, including all IPV sub-types together, a low, moderate and high exposure class emerged as well as a high antenatal/decreasing postnatal class. Moderate and high classes for all IPV sub-types and combined analysis showed stable intensity profiles. Maternal childhood sexual abuse, physical abuse and neglect, and emotional abuse predicted membership in high IPV classes, across all domains of IPV (aORs between 1.99 and 5.86). Maternal maltreatment in childhood was associated with increased probability of experiencing high or moderate intensity IPV during and around pregnancy; emotional neglect was associated with decreasing IPV class for combined model. Intervening early to disrupt this cycle of abuse is critical to two generations.     

Differential effects of psychological maltreatment on children of mothers exposed to intimate partner violence

Objective

Psychological maltreatment (PM) is the most prevalent form of child abuse, and is the core component of most of what is considered as child maltreatment. The aim of this work was to explore differential adverse outcomes of the different types of PM in the mental health and functioning of children living in homes in which they are exposed to intimate partner violence (IPV).

Method

Participants were 168 children, aged between 4 and 17, whose mothers experienced IPV. They were assessed using different measures of psychopathology and functioning: Diagnostic Interview for Children and Adolescents-IV, Child Behavior Checklists and Child and Adolescent Functioning Assessment Scale. Furthermore, IPV was assessed with the Schedule for Assessment of Intimate Partner Violence Exposure in Children and the Index of Spouse Abuse. Statistical analyses were carried out with regression models adjusted by means of Generalized Estimating Equations.

Results

Spurning was the PM subtype with the greatest global effect on the children, as it was significantly associated with internalizing and externalizing problems. Denying emotional responsiveness specifically increased the risk of internalizing psychopathology and impairment in the emotional area. Terrorizing was not significantly associated with a greater number of negative outcomes in children's psychopathology or functioning in this population.

Implications

The results suggest the importance of taking PM types into account in order to fully understand the problems of children exposed to IPV at home, and for the design of effective treatment and prevention programs.     

Aggressive behavior of children exposed to intimate partner violence: An examination of maternal mental health,maternal warmth and child maltreatment

Objectives

Over 4.5 million children each year are exposed to intimate partner violence (IPV). Furthermore, IPV rarely occurs without other forms of violence and aggression in the home. IPV is associated with mental health and parenting problems in mothers, and children experience a wide variety of short-term social adjustment and emotional difficulties, including behavioral problems. The current study investigated the influence of IPV exposure on children's aggressive behavior, and tested if this relation was mediated by poor maternal mental health, and, in turn, by maternal warmth and child maltreatment, and moderated by children's age and gender. Study findings highlight the indirect consequences of IPV in the home on children's aggressive behavior.

Methods

Secondary data analysis using structural equation modeling (SEM) was conducted with the National Survey of Child and Adolescent Well-Being (NSCAW). Children were between the ages of 3–8 (n = 1,161). Mothers reported past year frequency of phsycial assualt by their partner, frequency of child psychological and physical abuse, maternal mental health, and children's aggressive behavior problems. Maternal warmth was measured by observation.

Results

IPV was significantly related to poor maternal mental health. Poor maternal mental health was associated with more child aggressive behavior, lower maternal warmth, and more frequent child physical and psychological abuse. Psychological abuse and low maternal warmth were directly related to more aggressive behavior while IPV exposure and physical abuse were not directly associated with aggressive behavior. Neither age nor gender moderated the modeled paths.

Conclusions

Expanding knowledge about child outcomes is especially critical for children who were involved in investigations of child maltreatment by child protective services (CPS) in order to identify relevant risk factors that can lead to interventions. The results identified maternal mental health as an important variable in mediating the relationship between IPV exposure and aggressive behavior. One implication is for multicomponent family interventions that could be tailored toward helping the mother cope with such mental health issues while also addressing deficits in children's social behavior development.     

The role of callous/unemotional traits in mediating the association between animal abuse exposure and behavior problems among children exposed to intimate partner violence

Children exposed to intimate partner violence are at increased risk for concomitant exposure to maltreatment of companion animals. There is emerging evidence that childhood exposure to maltreatment of companion animals is associated with psychopathology in childhood and adulthood. However, few studies have explored developmental factors that might help to explain pathways from animal maltreatment exposure to children’s maladjustment. The present study addresses this gap in the literature by examining relations between children’s exposure to animal maltreatment, callous/unemotional traits (i.e., callousness, uncaring traits, and unemotional traits), and externalizing and internalizing behavior problems. A sample of 291 ethnically diverse children (55% Latino or Hispanic) between the ages of 7 and 12 was recruited from community-based domestic violence services. A meditational path model indicated that child exposure to animal maltreatment was associated with callousness (β = 0.14), which in turn was associated with greater internalizing (β = 0.32) and externalizing problems (β = 0.47). The effect of animal maltreatment exposure on externalizing problems was mediated through callousness. Results suggest that callous/unemotional traits are a potential mechanism through which childhood exposure to animal maltreatment influences subsequent behavior problems. Future research is needed to evaluate the extent to which exposure to animal maltreatment affects children’s adjustment over time in the context of other co-occurring adverse childhood experiences.     

Maternal experiences of childhood abuse and intimate partner violence: Psychopathology and functional impairment in clinical children and adolescents

Objectives

The current study examined the independent effects of mothers’ childhood abuse (CA) and intimate partner violence (IPV) on psychopathology and functional impairment in children; and the potential moderating and mediating role of individual and family factors in these relationships. Additionally, this study explored the potential cumulative effects of both maternal CA and IPV on children's outcomes.

Method

The sample included 547 Spanish children and adolescents aged between 8 and 17 years, and their parents, who had accessed mental health services. The assessment was based on structured interviews with the children and their parents. Statistical analyses were carried out through hierarchical multiple, negative-binomial and logistic regressions, and Structural Equation Models.

Results

Children whose mothers experienced CA and those whose mothers suffered physical IPV showed increased DSM-IV disruptive disorders and externalizing behavior problems, respectively. Children who directly observed physical IPV and also suffered physical punishment by parents showed increased internalizing problems. IPV had effects, either direct or indirect by physical punishment, on children's externalizing problems. Cumulative effect analyses indicated that the prevalence of disruptive disorders was highest in children whose mothers had suffered both CA and IPV.

Conclusion

Spanish children whose mothers have suffered CA, IPV or both, are at high risk of serious conduct problems, whereas children exposed to IPV and who were also physically abused are at greater risk of internalizing problems. Physical punishment of children contributes in part to explain externalizing problems of IPV-exposed children. These findings indicate potential targets of assessment and intervention for families seeking help in mental health services.     

Occult abusive injuries in children brought for care after intimate partner violence: An exploratory study

Children in homes with intimate partner violence (IPV) are at increased risk for physical abuse. We determined the frequency and injury patterns in children who underwent child abuse consultation after IPV exposure by retrospectively analyzing the "Examination of Siblings To Recognize Abuse" cohort of children referred for physical abuse. Children were selected who presented after IPV exposure. Among 2890 children evaluated by child abuse pediatricians, 61 (2.1%) patients presented after IPV exposure. Of the 61, 11 (18.0%) were exposed to IPV, but had no direct involvement in the IPV event, 36 (59.0%) sustained inadvertent trauma during IPV, and 14 (23.0%) were directly assaulted during IPV. Thirty-six patients (59.0%) had an injury: 31 (51.0%) had cutaneous injuries and 15 (24.6%) had internal injuries including fracture(s), intracranial or intra-abdominal injury. Of the 15 patients with internal injuries, 14 (93.3%) were less than 12 months old. Among the 36 patients with injuries, 16 (44.4%) had no report of direct injury, a report of a mechanism that did not explain the identified injuries, or a report of trauma without a specific mechanism. Five (13.9%) did not have physical examination findings to suggest the extent of their internal injuries. Injuries are present in a significant proportion of children presenting to Emergency Departments after IPV exposure. History and physical examination alone are insufficient to detect internal injuries especially in infants. These preliminary results support the need for future, prospective studies of occult injury in children exposed to IPV.     

Outcomes of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence

Witnessing violence toward a caregiver during childhood is associated with negative impact on children’s health and development, and there is a need for effective interventions for children exposed to intimate partner violence in clinical as well as in community settings. The current effectiveness study investigated symptom reduction after participation in two established group interventions (one community-based psychoeducative intervention; one psychotherapeutic treatment intervention) for children exposed to intimate partner violence and for their non-offending parent. The study included 50 children—24 girls and 26 boys—aged 4–13 years and their mothers. Child and maternal mental health problems and trauma symptoms were assessed pre- and post-treatment. The results indicate that although children showed benefits from both interventions, symptom reduction was larger in the psychotherapeutic intervention, and children with initially high levels of trauma symptoms benefited the most. Despite these improvements, a majority of the children’s mothers still reported child trauma symptoms at clinical levels post-treatment. Both interventions substantially reduced maternal post-traumatic stress. The results indicate a need for routine follow-up of children’s symptoms after interventions.     

Effects of childhood multiple maltreatment experiences on depression of socioeconomic disadvantaged elderly in Brazil

Childhood maltreatment is a risk factor for depression in nonelderly individuals. We investigated the effect of childhood abuse and neglect on the development of geriatric depression and its severity in socioeconomically disadvantaged individuals. A cross-sectional study investigated 449 individuals aged 60–103 years sorted by data using the enrollment list health coverage from the city of Porto Alegre, Brazil. The fifteen-item Geriatric Depression Scale was used to assess depression. The Childhood Trauma Questionnaire was used to identify emotional and physical neglect, in addition to emotional, physical, and sexual abuse. Geriatric depression was associated with emotional and physical abuse and neglect. Emotional abuse and neglect, as well as physical abuse, increased the odds of an individual developing severe depression. Correlations were observed for combined forms of maltreatment, with two to five maltreatment types producing mild to moderate symptoms. Similar trends were observed for severe symptoms in a limited number of cases. The cross-sectional design limit causal inference. Retrospective measurement of childhood maltreatment may increase recall and response bias. Late-life depression and its severity significantly correlated with the extent of childhood emotional and physical abuse and neglect. Thus, research should focus on supporting trauma survivors late in life, particularly when they come from low or middle income countries because these patients have higher rates of depression in elderly populations.     

Mental health of children exposed to intimate partner violence against their mother: A longitudinal study from Brazil

BackgroundExposure to intimate partner violence (IPV) is an important adverse childhood experience, but there are few longitudinal studies in low and middle-income countries.ObjectiveTo investigate the consequences of exposure to IPV for a child’s mental health.Participants and setting614 mother-child pairs were evaluated in a poor urban district in Recife, northeastern Brazil.MethodsWomen were interviewed in pregnancy, postpartum and six to nine years after delivery, and asked about their experience of IPV, and the exposure of their child to violence. The Strengths and Difficulties Questionnaire (SDQ) was completed by child’s mother and teacher. Ten types of child experience of IPV and the age of onset of exposure were compared with the child’s behavioral profile at school age.ResultsThe mothers reported that 372/614 (60.6%) children had been exposed to IPV. The commonest types of child exposure to IPV were “prenatally”, “overheard”, “eyewitnessed”, and 10.0% of children were physically or verbally involved in the IPV. Mothers reported high SDQ Total Difficulties scores in 71.7% of all children exposed to IPV and teachers in 59.8%. Multivariate logistic regression analysis demonstrated the strongest association with behavioral difficulties was with exposure to IPV in the age group 1–2 years (OR 2.5 [95% CI: 1.3–4.8]).ConclusionYoung children are sensitive to the age of first exposure to IPV and to the type of IPV. Interventions to reduce IPV should be targeted on vulnerable women from poor urban communities during their pregnancies and in the first two years of their child’s life.     

Child abuse and neglect and intimate partner violence victimization and perpetration: A prospective investigation

This paper describes the extent to which abused and neglected children report intimate partner violence (IPV) victimization and perpetration when followed up into middle adulthood. Using data from a prospective cohort design study, children (ages 0–11) with documented histories of physical and sexual abuse and/or neglect (n = 497) were matched with children without such histories (n = 395) and assessed in adulthood (M_age = 39.5). Prevalence, number, and variety of four types of IPV (psychological abuse, physical violence, sexual violence, and injury) were measured. Over 80% of both groups – childhood abuse and neglect (CAN) and controls – reported some form of IPV victimization during the past year (most commonly psychological abuse) and about 75% of both groups reported perpetration of IPV toward their partner. Controlling for age, sex, and race, overall CAN [adjusted odds ratio (AOR) = 1.60, 95% CI [1.03, 2.49]], physical abuse (AOR = 2.52, 95% CI [1.17, 5.40]), and neglect (AOR = 1.64, 95% CI [1.04, 2.59]) predicted increased risk for being victimized by a partner via physical injury. CAN and neglect also predicted being victimized by a greater number and variety of IPV acts. CAN and control groups did not differ in reports of perpetration of IPV, although neglect predicted greater likelihood of perpetrating physical injury to a partner, compared to controls. Abused/neglected females were more likely to report being injured by their partner, whereas maltreated males did not. This study found that child maltreatment increases risk for the most serious form of IPV involving physical injury. Increased attention should be paid to IPV (victimization and perpetration) in individuals with histories of neglect.     

Exposure to violence,typology, and recidivism in a probation sample of domestic violence perpetrators

The present study investigated the predictive utility of self-reported domestic violence perpetrators’ exposure to violence in their family of origin and patterns related to this exposure through the use of longitudinal analyses on a sample of 228 men on probation in Lake County, Illinois. Differences in typology, recidivism, recidivism frequency, and violent behavior survival patterns in men with a history of domestic violence perpetration and with varying levels of family of origin violence exposure were examined. Findings suggest that those who witnessed interparental violence (either alone, or in combination with experiencing violence) were most likely to be classified as Generally Violent offenders (e.g., perpetrators who direct violence toward their family and others), compared to those who did not report experiencing or witnessing violence. In addition, results also indicate that men who experienced both witnessing interparental violence and receiving physical abuse in childhood were more likely to recidivate more frequently compared to those who did not report experiencing or witnessing violence. No significant findings for typology and recidivism were noted. Clinical and policy/practice implications are discussed.     

Relational trauma in the context of intimate partner violence

The relational model of trauma (Scheeringa & Zeanah, 2001) proposes that infants’ trauma symptoms may be influenced by their mothers' trauma symptoms and disruptions in caregiving behavior, although the mechanisms by which this occurs are less well understood. In this research, we examined the direct and indirect effects of a traumatic event (maternal intimate partner violence [IPV]), maternal trauma symptoms, and impaired (harsh and neglectful) parenting on infant trauma symptoms in a sample of mother–infant dyads (N = 182) using structural equation modeling. Mothers completed questionnaires on IPV experienced during pregnancy and the child's first year of life, their past-month trauma symptoms, their child's past-month trauma symptoms, and their parenting behaviors. Results indicated that the effects of prenatal IPV on infant trauma symptoms were partially mediated by maternal trauma symptoms, and the relationship between maternal and infant trauma symptoms was fully mediated by neglectful parenting. Postnatal IPV did not affect maternal or infant trauma symptoms. Findings support the application of the relational model to IPV-exposed mother–infant dyads, with regard to IPV experienced during pregnancy, and help identify potential foci of intervention for professionals working with mothers and children.     

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.     

Comparing policies for children of parents attending hospital emergency departments after intimate partner violence,substance abuse or suicide attempt

To improve identification of child maltreatment, a new policy (‘Hague protocol’) was implemented in hospitals in The Netherlands, stating that adults attending the hospital emergency department after intimate partner violence, substance abuse or a suicide attempt should be asked whether they care for children. If so, these children are referred to the Reporting Center for Child Abuse and Neglect (RCCAN), for assessment and referrals to support services. An adapted, hospital-based version of this protocol (‘Amsterdam protocol’) was implemented in another region. Children are identified in the same manner, but, instead of a RCCAN referral, they are referred to the pediatric outpatient department for an assessment, including a physical examination, and referrals to services. We compared results of both protocols to assess how differences between the protocols affect the outcomes on implementation, detection of child maltreatment and referrals to services. Furthermore, we assessed social validity and results of a screening physical examination. We included 212 families from the Amsterdam protocol (cohort study with reports by pediatric staff and parents) and 565 families from the Hague protocol (study of RCCAN records and telephone interviews with parents). We found that the RCCAN identified more maltreatment than pediatric staff (98% versus at least 51%), but referrals to services were similar (82% versus 80% of the total sample) and parents were positive about both interventions. Physical examination revealed signs of maltreatment in 5%. We conclude that, despite the differences, both procedures can serve as suitable methods to identify and refer children at risk for maltreatment.