Exposure to abuse, neglect, and household dysfunction among adults who witnessed intimate partner violence as children: implications for health and social services

Intimate partner violence (IPV) damages a woman's physical and mental well-being, and indicates that her children are likely to experience abuse, neglect and other traumatic experiences. Adult HMO members completed a questionnaire about adverse childhood experiences (ACEs) including childhood abuse, neglect, and household dysfunction. We used their responses to retrospectively assess the relationship between witnessing intimate partner violence and experiencing any of the 9 ACEs and multiple ACEs (ACE score). Compared to persons who grew up with no domestic violence, the adjusted odds ratio for any individual ACE was approximately two to six times higher if IPV occurred (p < 0.05). There was a powerful graded increase in the prevalence of every category of ACE as the frequency of witnessing IPV increased. In addition, the total number of ACEs was increased dramatically for persons who had witnessed IPV during childhood. There was a positive graded risk for self-reported alcoholism, illicit drug use, i.v. drug use and depressed affect as the frequency of witnessing IPV increased. Identification of victims of IPV must include screening of their children for abuse, neglect and other types of adverse exposures, as well as recognition that substance abuse and depressed affect are likely consequences of witnessing IPV. Finally, this data strongly suggest that future studies, which focus on the effect of witnessing IPV on long-term health outcomes, may need to take into consideration the co-occurrence of multiple ACEs, which can also affect these outcomes.     

The contribution of childhood family violence on later intimate partner violence among robbery victims

This study examined the relative contributions of the three forms of childhood family violence exposure on physical intimate partner violence (IPV) victimization among recent robbery victims and tested a gender-matching modeling prediction for IPV risk. Data from a sample of 103 male and 93 female victims of a robbery were analyzed to investigate the effects of exposure to childhood physical abuse (CPA), childhood sexual abuse (CSA), and witnessing parental violence on the likelihood of IPV in adulthood. As expected, witnessing parental violence was associated with a 2.4-fold increase in IPV for both men and women. Neither CPA nor CSA was significantly associated with IPV after accounting for the effect of witnessing parental violence. There was support for the gender-matching hypothesis with men more likely to report IPV if they had witnessed mother-to-father violence and women more likely to report IPV if they had witnessed father-to-mother violence. Witnessing parental violence is strongly associated with risk for IPV victimization, particularly when the victim is the same-gender parent. Future directions and clinical implications are discussed.     

Relationship Between Childhood Sexual Abuse and Borderline Personality Disorder in Women Psychiatric Inpatients

The rclationshp between childhood sexual abuse (CSA) and borderline personality disorder (BPD) in 50 women psychiauic inpatients was examined. Inpatienfs were inletviewed using he Diagnostic Interview for Borderlines (Revised) (DIB-R). Women sexually abused as children (n = 30) scored significantly higher than those who were not (n = 20) on the total DIB-R and three of its four section scores. Women sexually abused as children were significantly more likely to have a definite diagnosis of BPD than women not sexually abused as children. who largely exhibited symptom patterns indicative of diagnoses other than BPD. An unexpected finding was that women sexually abused as children were more likely to have eating disorders than those who were not. Treatment for borderlines should explicilly address and validate the tremendous consequences of CSA on etiology and course of symptoms.     

Early abuse experiences and subsequent gender differences in couple adjustment

The main purpose of the current study was to evaluate the relationship between early abusive experiences (sexual abuse, parental violence, and witnessing parental violence) and subsequent couple adjustment with a theoretical model that incorporates attachment and psychological distress as mediator variables. We specifically examined the variability in long-term psychosocial characteristics of child abuse survivors across women and men. A representative sample of French-Canadian couples composed of 632 men and women completed measures of child abuse, attachment, psychological distress, and dyadic adjustment. Structural equation analyses showed that, for both women and men, sexual abuse was related to dyadic adjustment through anxiety about abandonment and psychological distress. For men, experiencing physical or psychological violence was associated with dyadic adjustment through psychological distress. For women, there was an indirect relationship between witnessing physical violence and dyadic adjustment through abandonment anxiety. Differences between men and women in the long-term adjustment to childhood sexual abuse were small and not consistent with a gender-specific model of psychosocial repercussions.     

The joint contribution of experiencing and witnessing violence during childhood on child abuse in the parent role

This article examines adult respondents' abuse of children as a consequence of their own childhood experiences of abuse, both direct experiences of childhood violence (hitting) and exposure to interparental violence (witnessing). In particular, the study examines the extent to which these factors function interactively: Are both experience and exposure necessary or is either sufficient to increase disproportionately the probability of child abuse? Using data from the Second National Family Violence Survey, results of a logistic regression analysis show that either or both factors produced higher than average and relatively similar rates of child abuse. Only respondents with neither form of family violence reported lower than average rates of abuse of their own children. The analysis controlled for gender, race, family income, and family structure; race was the only control variable to be significantly associated with child abuse. Finally, no control variable modified the interaction between the family violence variables.     

Repeated suicide attempts

Attempted suicide is an act associated with childhood sexual abuse, depression, bipolar illness, substance abuse, and other diagnoses, as documented in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) (American Psychiatric Association [APA], 1994). Three women, who attended a group to decrease their depression and increase their self-esteem and who had histories of multiple suicide attempts, agreed to participate in interviews designed to determine the common factors associated with their suicide attempts and to examine the assertion that their suicide attempts were an addiction, similar to their addictions to alcohol and drugs. The common factors found were depression, substance use disorders with early abuse and risky behaviors, history of sexual abuse, faulty relationships, alteration of mood with a suicide plan, and distorted and illogical thinking and motivation. The similarities to addiction also were described. Based on the complexity of factors that emerged and the addictive nature of the suicide attempts, treatment for similar patients needs to be multidimensional and ongoing to allow sufficient time to monitor progress and address the numerous factors involved.     

Development of a framework for classifying threat and neglect in childhood: A qualitative study

Quantification of childhood adversity has typically involved a cumulative risk approach in which total number of discrete adversities serves as an index of overall risk. However, this approach fails to account for the growing evidence of differential outcomes following exposure to childhood adversities. An alternative approach adopts a dimensional perspective, with growing evidence for distinct developmental impacts associated with exposure to threat (violence/abuse) and deprivation (neglect). This study developed a framework for the classification of these dimensions through a thematic analysis of health practitioners' views and accounts of different forms of childhood adversity. Ten health practitioners experienced in working with children with challenging behaviours and neurodevelopmental disorders participated in semi-structured interviews regarding definitions and examples of six categories of adversity: physical/emotional/sexual abuse, physical/emotional neglect, and domestic and family violence. The qualitative analysis identified 23 themes across the six categories of adversity, along with two overarching themes regarding ambiguity of classifying exposures and non-specific outcomes of exposures. Themes were integrated to provide a framework and checklist for classifying indicators of exposure to threat and deprivation. The findings offer a framework and checklist for the assessment of threat and deprivation that will allow for further testing of the dimensional risk model.     

Pathways Linking Childhood Maltreatment and Adolescent Sexual Risk Behaviors: The Role of Attachment Security

Previous research has shown an association between child maltreatment (sexual abuse, physical abuse, neglect, or witnessing interparental violence) and adolescent sexual risk behaviors (SRBs). The mechanisms explaining this association are not well understood, but attachment theory could provide further insight into them. This study examined the relationships between child maltreatment and SRBs and investigated anxious and avoidant attachment as mediators. The sample comprised 1,900 sexually active adolescents (13 to 17 years old; 60.8% girls) attending Quebec high schools. The results of path analyses indicated that neglect was associated with a higher number of sexual partners, casual sexual behavior, and being younger at first intercourse. Anxious attachment mediated the relation between neglect and number of sexual partners, whereas avoidant attachment explained the relation between neglect and number of sexual partners, casual sexual behavior, and age at first intercourse (for boys only). Sexual abuse was directly associated with all three SRBs. Neither anxious attachment nor avoidant attachment mediated these associations. Youth with a history of neglect and sexual abuse represent a vulnerable population that is likely to engage in SRBs. Interventions designed to induce a positive change in attachment security may reduce SRBs among victims of neglect.     

Sexual abuse,family violence,and female delinquency: findings from a longitudinal study

The current study examines the effects of three forms of childhood victimization on self-reported delinquency and aggression in adolescent girls. These analyses are based on a longitudinal sample of 141 mother-daughter pairs participating in a study about marital violence and child development. When the children were school aged, mothers and children provided reports describing (a) child exposure to marital violence, (b) escalated physical abuse against the child, and (c) child sexual abuse. Children were followed up into adolescence and re-interviewed. Self-reports of delinquency (violent and nonviolent), running away, and violence against parents were collected. Results indicate that out of the three forms of victimization, child sexual abuse emerged as the strongest predictor of girls' violent and nonviolent criminal behavior. Girls with a history of physical abuse in childhood were most likely to assault their parents. Witnessing marital violence failed to contribute further to delinquency, beyond the adverse association with childhood sexual abuse. Findings highlight a unique avenue for delinquency in girls via childhood sexual exploitation.     

Long‐Term Physical Health Consequences of Adverse Childhood Experiences

This study examined associations between adverse childhood family experiences and adult physical health using data from 52,250 U.S. adults aged 18 to 64 from the 2009 to 2012 Behavioral Risk Factor Surveillance System. We found that experiencing childhood physical, verbal, or sexual abuse, witnessing parental domestic violence, experiencing parental divorce, and living with someone who was depressed, abused drugs or alcohol, or who had been incarcerated were associated with one or more of the following health outcomes: self‐rated health, functional limitations, diabetes, and heart attack. Adult socioeconomic status and poor mental health and health behaviors significantly mediated several of these associations. The results of this study highlight the importance of family‐based adverse childhood experiences on adult health outcomes and suggest that adult socioeconomic status (SES) and stress‐related coping behaviors may be crucial links between trauma in the childhood home and adult health.     

Economic predictors of child maltreatment in an Australian population-based birth cohort

A correlation between socioeconomic disadvantage and child maltreatment has long been observed, but the drivers of this association are poorly understood. We sought to estimate the effects of economic factors on risk of child maltreatment after adjusting for other known influences using the Australian Temperament Project, a population-based birth cohort of 2443 individuals and their parents. We used logistic regression to estimate associations of childhood economic factors (parental education, occupation, and unemployment; type of housing; and retrospective perception of poverty) with retrospective reports of perceived child maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, and witnessing of domestic violence), controlling for demographic factors, parental mental health and substance use, and child health. We then used these estimates to approximate the proportions of child maltreatment—population attributable fractions—that are theoretically preventable by addressing childhood economic disadvantage. Economic factors were associated with all types of child maltreatment. For the most part, these associations diminished only partially when controlling for noneconomic confounders, supporting hypotheses of causal relationships. Jointly, economic factors were significant predictors of physical abuse, sexual abuse, and witnessing of domestic violence but not of emotional abuse or neglect. Retrospective perceptions of childhood poverty were, in particular, strongly associated with most forms of child maltreatment but not with sexual abuse after accounting for other economic factors. We estimated that 27% of all child maltreatment was jointly attributable to economic factors. These findings suggest that strategies that reduce economic disadvantage are likely to hold significant potential to reduce the prevalence of child maltreatment.     

Child protection fathers' experiences of childhood,intimate partner violence and parenting

Research on mothers in child protection families has revealed that they often have a history of childhood abuse. Research has also shown that a considerable proportion of child maltreatment co-occurs with intimate partner violence (IPV) towards the mother. However, there is a dearth of research on the childhood histories and IPV victimization experiences of fathers in child protection families. To address these gaps in the literature this exploratory mixed method study of 35 men associated with a parenting program in Australia investigated fathers' childhood experiences, exposure to IPV and concern for their children's safety. Although this study was conducted with a specific group of fathers screened for serious personal problems, the findings suggest that, similar to mothers in child protection families, there are some fathers within typical child protection populations who have histories of childhood abuse and IPV victimization. In addition, many of the fathers in this study tried to protect their children from maltreatment related to the other parent. The main implication of the findings is that child protection fathers who have histories of abuse and IPV victimization should be afforded the same support and assistance as mothers in similar situations.     

New Directions for Research Examining Sexual Trauma Histories of Gay Men

Summary

Research efforts have been unable to accurately examine the effect of childhood sexual trauma in the adult lives of gay men. Complications stemming from precise definitions of abuse, as well as the subjectivity inherent in the terms, make comprehensive research difficult. As abuse and traumatic events may sometimes be subtle and not involve overt violence, these more delicate events are often overlooked or unaccounted for. Further, because it is a complex endeavor to obtain accurate reporting from children, research efforts rely on the self-reports of adults remembering traumatic events. The symptomatology that results from trauma, including amnesia and dissociation, also affects the reliability of self-report. Additionally, gay men have been notably absent from sexual trauma research efforts for a variety of reasons. A research study which investigates childhood sexual trauma in the histories of adult gay men is discussed. Directions for future research efforts are suggested.     

Trauma symptoms, sexual behaviors, and substance abuse: correlates of childhood sexual abuse and HIV risks among men who have sex with men

Childhood sexual abuse is associated with high-risk sexual behavior in men who have sex with men. This study examined psychological and behavioral correlates of HIV risk behavior associated with childhood sexual abuse in a sample of men who have sex with men. Men attending a large gay pride event (N = 647) completed anonymous surveys that assessed demographic characteristics, childhood sexual abuse history, symptoms of dissociation and trauma-related anxiety, borderline personality characteristics, substance use, and sexual risk behavior. Results indicated that men who have a history of childhood sexual abuse were more likely to: engage in high-risk sexual behavior (i.e., unprotected receptive anal intercourse), trade sex for money or drugs, report being HIV positive, and experience non-sexual relationship violence. Results of this study extend previous research to show that men who have sex with men and who have a history of child sexual abuse are more likely to be at high risk for HIV infection.     

Domestic Violence and Parental Divorce as Predictors of Best Friendship Qualities Among College Students

Data regarding the effects of domestic violence and parental divorce have been inconsistent. Assessments of the effects of childhood trauma on psychosocial adjustment might be enhanced by an examination of the way developmental stressors interact. A total of 370 college students with histories of combinations of parental divorce and domestic violence participated in this correlational study of best friendships in early adulthood. College students exposed to domestic violence during childhood described their best friendships as relatively less reinforcing, helpful, and sustainable than those without the abuse history. Participants from intact families, as compared to those with parental divorce histories, described their best friendship as relatively more reinforcing and favorable. The combination of parental divorce and exposure to domestic violence was linked to magnified effects regarding these best friendship qualities. Average effect sizes for domestic violence (d?=?.31), parental divorce (d?=?.18), and the interaction between domestic abuse and divorce (d?=?.85) pointed to mild to modest links between these stressors and best friendship qualities. These results emphasized the benefits of interaction analysis in attempts to predict the adverse effects of developmental stressors on late psychological functioning.     

Experiences of Violence, Post-Traumatic Stress, Academic Achievement and Behavior Problems of Urban African-American Children

This study examined the frequency of family violence, community violence, and witnessing of violence for 110 African-American children. Levels of post-traumatic stress, academic achievement and behavior problems of the children were also examined. The students were sixth graders between the ages of 11 and 13 from four inner-city Chicago public schools. The level of exposure to family violence was significantly related to levels of behavior problems and negatively related to school achievement. The level of exposure to community violence was associated with levels of behavior problems and approached significance in a negative direction with school achievement. Academic achievement was not significantly related to behavior, but was significantly associated with post-traumatic stress disorder, family violence, witnessing violence and approached significance with community violence exposure.     

Prevalence, perpetrators, and characteristics of witnessing parental violence and adult dating Violence in Latina, East Asian, South Asian, and Middle Eastern women

The present study describes and compares the prevalence, perpetrators, and characteristics of witnessing parental violence during childhood and experiencing adult relationship violence in 251 college-educated South Asian/Middle Eastern (n = 93), East Asian (n = 72), and Latina (n = 86) women residing in the United States. Results showed that more than 50% of each ethnic group witnessed parental and adult relationship violence. For all three groups, adult psychological violence was more prevalent than physical violence, which, in turn, was more prevalent than injury violence. Significant differences were found for paternal and maternal psychological, physical, and injury violence witnessed within ethnic groups. High prevalence rates and significant differences emerged for psychological, physical, and injury violence experienced as a victim and enacted as a perpetrator within ethnic groups. The implications of college-educated, higher socioeconomic status (SES) women of color being at risk for witnessing and experiencing family violence are discussed.     

Propensity to perpetrate abusive behaviors: Internet survey of the role of gender,childhood maltreatment,and perception of maltreatment in Nigeria

This article reports on propensity to perpetrate abusive behaviors and examines the role of gender, childhood maltreatment, and perception of abusive behaviors on the propensity. Findings suggest that propensity to perpetrate abusive behaviors cuts across all types of maltreatment (i.e., physical, sexual, and emotional abuse, child neglect, and child labor). Although abusive behavior with high propensity for perpetration includes corporal punishment, propensity to perpetrate abusive behaviors differed by gender. Men were more likely than women to indicate propensity to perpetrate abusive behaviors. Those who perceived behaviors as not abusive, as well as those who reported childhood experience of abusive behaviors, were more likely to intend to perpetrate abusive behaviors. Although childhood experience of sexual abuse was related to perpetration of sexual abuse, history of perpetrating sexual abuse comprised the largest effect size of the propensities to perpetrate abusive behaviors. Implications of findings for policy, practice, and services are discussed.     

Clinical correlates and repetition of self-harming behaviors among female adolescent victims of sexual abuse

This study investigated self-harming behaviors in 149 female adolescent victims of sexual abuse, first, by determining the rates of nine types of self-mutilating behavior at intake and nine months later and, second, by investigating comorbidity of clinical correlates associated with these behaviors. The adolescents were divided into three groups according to level of self-mutilating behavior and then compared on symptom self-reports; 62.1% of the adolescents engaged in at least one self-mutilating behavior. A graded relation was observed between level of self-mutilating behavior and rate, and total number of clinical disorders. At nine month follow-up, one in four teenagers still reported a moderate or high level of self-harm. The need for systematic assessment and intervention of self-mutilating behaviors is discussed.     

Childhood abuse and psychiatric impairment in a sample of welfare to work women

Since 1996, individuals who participate in welfare programs are mandated to find employment. Welfare recipients may have difficulty transitioning to the work force due to impairments in psychosocial functioning. Examples include mental health and substance use disorders, medical problems, academic and learning difficulties, and lack of resources such as childcare and transportation. In addition, many welfare recipients have histories of abuse and violence, which further complicate their job finding efforts given the documented relationship between past maltreatment and psychiatric impairment. An area unexplored is the relationship between a history of childhood abuse and psychiatric impairment in Welfare to Work (WtW) recipients. We evaluated the relationships among demographics, personality pathology, substance abuse, cognitive functioning, and histories of childhood abuse in a group of 158 WtW recipients in order to assess predictors of psychiatric impairment. Results suggest that participants with higher levels of psychiatric impairment also had higher levels of interpersonal problems related to personality pathology, higher drug and alcohol use impairment, and endorsed more severe histories of childhood abuse. Personality pathology, alcohol use severity, and self-reported childhood abuse emerged as the best predictor of psychiatric impairment in this WtW sample. These results have implications for identifying individuals at risk for unsuccessful transition into the work force and for the development of effective rehabilitation strategies that considers the unique needs of women in WtW programs.