Intimate partner violence and child abuse: a child‐centred perspective

A substantial body of literature assessing the impact of intimate partner violence on children and associations between intimate partner violence and child abuse now exists. Central to knowledge about these areas of practice and research is a robust, child‐centred consideration of some of the more challenging conceptual issues they give rise to. In this paper, we aim to stimulate debate by presenting a critical, child‐centred perspective on the intersection between intimate partner violence and child abuse. Initially, we provide the context for the review by presenting a brief overview of the literature. We then consider three central issues from a child‐centred perspective. We discuss the language used to describe children forced to live with intimate partner violence, and the importance of hearing children's perspectives on their experiences of such conflict. Finally, we consider similarities and differences between the intimate partner violence and child abuse fields from a child‐centred viewpoint. We conclude that increasing conceptual clarity around these issues will enhance research in the field, and ultimately improve interventions designed to protect children forced to live with intimate partner violence. Copyright © 2009 John Wiley & Sons, Ltd.     

Lethal intimate partner violence in later life: Understanding measurements,strengths, and limitations of research

ABSTRACT

The aim of this article is to conduct a critical analysis of existing family violence literature related to elder abuse homicide, also known as “eldercide.” The focus relates to fatal violence perpetrated by current or former intimates. Men are the most likely victims of homicide but are rarely murdered by partners. Older women are most often killed in the home by a spouse or other family, consistent with the notion of “femicide.” The Federal Bureau of Investigation Supplemental Homicide Reports and the Bureau of Justice Statistics National Crime Victimization Survey are utilized to illustrate trends by sex over time. Intimate partner homicide-suicide is examined via news surveillance. Strengths and limitations of data and methods are addressed. Homicide trends among the members of the baby boom cohort are predicted based on current and future patterns as they age. To facilitate prevention, researchers are encouraged to move beyond simple prevalence estimates toward greater understanding of complex trends, distinctions, and motivations of these violent deaths.     

Multiple approaches to understanding and preventing elder abuse: Introduction to the cross-disciplinary National Institutes of Health workshop

ABSTRACT

On October 30, 2015, the National Institutes of Health (NIH) convened a workshop, “Multiple Approaches to Understanding and Preventing Elder Abuse,” in Bethesda, Maryland. The workshop brought together experts from across disciplines to discuss research challenges, opportunities, and lessons learned from other fields. Participants included experts in elder abuse, child abuse, intimate partner violence (IPV), emergency medicine, and neuroscience. In this special issue of the Journal of Elder Abuse and Neglect, participants address topics explored before, during, and after the day-long workshop.     

State of the science on prevention of elder abuse and lessons learned from child abuse and domestic violence prevention: Toward a conceptual framework for research

ABSTRACT

The goal of this review is to discuss the state of the science in elder abuse prevention. Findings from evidence-based programs to reduce elder abuse are discussed, drawing from findings and insights from evidence-based programs for child maltreatment and domestic/intimate partner violence. A conceptual measurement model for the study of elder abuse is presented and linked to possible measures of risk factors and outcomes. Advances in neuroscience in child maltreatment and novel measurement strategies for outcome assessment are presented.     

Implementation of an intimate partner violence screening program in a university health care clinic

Abstract

Objectives: To examine whether an intimate partner violence (IPV) screening program is related to a positive change in health care providers’ knowledge, attitudes, and self-efficacy of IPV screening. Participants: Eleven health care providers at a university health care clinic participated in the IPV screening program. Methods: A one-group pretest-posttest design was used to examine whether an IPV screening program was related to a change in health care providers’ knowledge, attitudes, and self-efficacy of IPV screening. Results: Findings indicated that there was a significant difference (p?<?000) between the posttest scores and the pretest scores on the Domestic Violence Healthcare Provider Survey Scale. Domain analysis of the scale revealed a significant difference in perceived self-efficacy (p?=?.001), system support (p?=?<.002), victim provider safety (p?=?.015), and beliefs of blaming victims (p?=?<.004). No statistical difference was found in professional role resistance/fear of offending (p?=?.158). Conclusions: A university health care clinic IPV screening program was related to a positive change in health care providers’ knowledge, attitudes, and self-efficacy of IPV screening.     

Prevalence estimates and correlates of elder abuse in the United States: The National Intimate Partner and Sexual Violence Survey

This study examines the prevalence and correlates of psychological abuse and physical abuse against women and men aged 70 or older. Self-report data from 2,185 respondents in the 2010 National Intimate Partner and Sexual Violence Survey (NISVS) were used to create weighted estimates for past-year experiences of abuse. Correlates were then examined using survey logistic regression models. More than 1 in 10 adults who are 70 years of age or older (14.0%) have experienced some form of abuse in the past year, with 12.1% experiencing psychological abuse and 1.7% experiencing physical abuse. One in five victims (20.8%) were abused by both intimate and nonintimate partners. Health care insecurity was the strongest correlate of past-year abuse. The odds of experiencing abuse were 4.53 times greater for those who experienced health care insecurity than for those who did not. This presents a significant challenge for identifying and helping victims of abuse.     

The role of parental emotional validation and invalidation on children’s clinical symptoms: A study with children exposed to intimate partner violence

Abstract

Parental emotional validation has been proposed of as a major explanatory mechanism of the association between intimate partner violence (IPV) and children’s psychological problems. The present study examined the effect of parental emotional validation and invalidation on the relationship between exposure to IPV, and both post-traumatic stress disorder (PTSD) and depression symptoms. Sample was composed of Portuguese children exposed to IPV and an age- and gender-matched control group. Structural equation modeling was conducted. Children who were exposed to IPV presented higher scores on PTSD (p?<?.001, d?=?.99) and depression symptoms (p?<?.01, d?=?.63), and paternal (p?<?.05, d?=?.67) and maternal (p?<?.01, d?=?.81) emotional invalidation. Children who were exposed to IPV presented lower scores on paternal emotional validation (p?<?.001, d?=?1.23). Exposure to IPV directly predicts both PTSD and depression symptoms but the indirect effect was stronger. Paternal emotional validation moderated the impact of exposure to IPV on clinical symptoms; the relationship between exposure to IPV and both PTSD and depression symptoms was mediated by maternal emotional invalidation. Findings suggest the potential usefulness of parental emotional validation and invalidation as treatment goals in clinical intervention with this population. Interventions to improve the therapist-patient alliance recommend that therapists use emotional validation. Training of emotional validation skills in parenting training may prevent the deleterious effects of exposure to IPV.     

Maternal experiences of intimate partner violence and adolescent delinquency: Pathways through parenting stress and harsh parenting behaviors

Abstract

Women with children in the home are more likely to report experiencing intimate partner violence (IPV) compared to women without children in the home. Consistently, research has identified an association between maternal experiences of IPV and adolescent delinquency. While research has suggested that this link may be explained through parenting factors, there are limited studies exploring sequential mediators that may explain how maternal experiences of IPV are related to distal outcomes, such as adolescent delinquency. The present study investigated mechanisms that might explain the association between early maternal experiences of IPV and adolescent delinquency. Data were collected as part of the Fragile Families and Child Wellbeing Study (FFCWS), a longitudinal birth cohort study. Using a structural equation modeling approach, parenting stress and both physically and psychologically harsh parenting behaviors were examined as sequential mediators in the association between the latent construct of maternal experiences of IPV and adolescent delinquency. Findings supported one sequential mediation mechanism: maternal parenting stress at child age five and psychologically harsh parenting at child age nine mediated the association between maternal experiences of IPV and adolescent delinquency at child age 15. In contrast, support was not demonstrated for the other proposed sequential mediation mechanism: maternal parenting stress at child age five and physically aggressive parenting at year nine did not mediate the link between maternal experiences of IPV and adolescent delinquency child age 15. The present study suggests maternal parenting stress and psychologically harsh parenting behaviors should be examined when referred for psychological services for experiences of IPV.     

“It's hard enough to deal with all the abuse issues”: Child welfare workers' experiences with intimate partner violence on their caseloads

Child welfare caseworkers (N = 19) were asked to discuss their experiences working with families experiencing intimate partner violence (IPV). The workers revealed that they found these cases particularly challenging, they had a difficult time collaborating with both battered women's services and law enforcement on these cases, and they lacked the training and education that they needed to understand and intervene when IPV was present. Workers talked about their fears for their own safety and discussed how their practice is impacted when they personally know a victim and/or perpetrator of IPV. The interviews also revealed a somewhat limited understanding of the impact of child exposure to IPV. Findings have important implications for the training and education of child welfare caseworkers, and highlight the important of improved cross-system collaboration when working with multi-problem families.     

“They're not my favourite people”: What mothers who have experienced intimate partner violence say about involvement in the child protection system

Although the primary aim of child protection services (CPS) is to ensure the well-being and safety of children, policy decision-makers and service providers are increasingly concerned about the potential harm children encounter when they witness the abuse of their caregivers. Researchers who have conducted reviews of child protection files in both Canada and the United States report that few cases in which intimate partner violence (IPV) is substantiated are referred for additional services. In this article, we question whether this response is appropriate. Through examining the results of a qualitative study with sixty-four women who experienced IPV and were thus involved in the child protection system, we have been able to analyze the impact of CPS practices on those women who received services and those who did not. Our findings suggest that CPS can be an important resource for women who experience IPV, but changes to current practices are necessary to ensure that services offered are beneficial.     

Clergy training for effective response to intimate partner violence disclosure: Immediate and long-term benefits

ABSTRACT

This study reports findings from an intimate partner violence-training project in which 104 Seventh-Day Adventist pastors received a 4-hr training in responding effectively to intimate partner violence (IPV) disclosure. The educational endeavor targeted three areas for improvement in clergy response: (a) increasing pastors’ understanding of the unique dynamics in abusive relationships, (b) providing information on IPV resources and services, and (c) developing pastors’ abilities and motivations to be proactive in addressing IPV. Pretest, posttest and 1-year follow up data indicate that pastors who engaged in IPV training demonstrated immediate and long-term positive changes. Specifically, participants showed improvements in each of the targeted areas. Beyond the gains in knowledge and attitudes about IPV, the study results also indicate that pastors receiving training expanded their activities to positively address IPV in their congregations. Social workers can play a significant role in addressing clergy training needs by strengthening pastors’ abilities to respond appropriately to parishioners’ IPV disclosures.     

The characteristics and extent of child abuse: findings from a study of the Swedish Social Services child protection

This paper addresses child abuse and the Social Services protection and builds upon a study of verdicts concerning § 2 Care of Young Persons Act (CYPA). The aim was to explore the extent of, and what characterised, the violence the children were being subjected to. A central finding was that of all the applications of § 2 CYPA during one year concerning 196 children, 13–18 years, 70% concerned children reported as subjected to violence. The violence was in most cases described as severe and systematically exerted over many years with intimidating tactics of power and control. More girls than boys were in question for care because of violence. Girls were also to a greater extent reported as having been subjected to sexual abuse or coercive control of their sexuality in relation to standards regarding honour and virginity. In an international perspective the findings can be said to confirm the need to analyse such factors as gender, power and control when research and interventions concerns children abused by their parents. In a Swedish context the findings can be said to suggest that the § 2 CYPA is a crucial intervention to protect children from violence.     

A new role for imaging in the diagnosis of physical elder abuse: results of a qualitative study with radiologists and frontline providers

Pediatric radiologists play a key role in the detection of child abuse through the identification of characteristic injury patterns. Emergency radiologists have the potential to play an equally important role in the detection of elder physical abuse; however, they currently play little to no part in this effort. We examine the reasons behind this limited role, and potential strategies to expand it, by interviewing attending faculty from Emergency Radiology, Geriatrics, Emergency Medicine, Pediatric Radiology, and Pediatrics. Our interviews revealed that radiologists’ contribution to elder abuse detection is currently limited by gaps in training, gaps in knowledge about imaging correlates, and gaps in inter-team clinical communication. Specifically, radiographic interpretation of elder trauma is severely restricted by lack of communication between frontline providers and radiologists about patients’ injury mechanism and functional status. Improving this communication and re-conceptualizing ED workflow is critical to expanding and optimizing radiologists’ role in elder abuse detection.     

2015 Rosalie Wolf Memorial Award Lecture: Past,present, and future of elder abuse

ABSTRACT

This article aims to advance the global issue of elder abuse through exploring how the current body of elder abuse literature can collectively pave the way for present and future directions for research, practice, and policy.     

Understanding of elder abuse and neglect among health care professionals in Malaysia: An exploratory survey

ABSTRACT

Elder abuse and neglect (EAN) is a hidden public health challenge for Malaysia. This cross-sectional survey studied the awareness of EAN among 148 doctors and nurses from two neighboring states in Malaysia using a self-administered questionnaire exploring their knowledge, perceptions, practices, and experience concerning EAN. Both doctors and nurses demonstrated poor understanding of signs of EAN and exhibited misperceptions on reporting requirements. Both groups perceived EAN as a national burden and reporting it as their responsibility; but most felt they had not been trained to diagnose it. Many were unsure of procedures and whether their own intervention could be effective. Only four (nurses) of 41 participants who suspected abuse during the past year reported the cases. Targeted education and uniform protocols are mandatory to ensure best practice with regards to EAN. Further research is crucial to extend this inquiry into the broader health care workforce.     

Conflict and Aggression as Stressors in the Work Environment of Nursing Assistants:

Elder abuse and mistreatment occuring in institutional settings is a phenomenon that is as yet poorly understood. In considering the context in which elder abuse and mistreatment may arise, understanding the caregivers' work environment is an important variable. As front line staff, nursing assistants are subject to multiple stressors that underscore the highly interpersonal nature of caregiving. This paper describes the results of a Canadian study that examined conflict, aggression, and burn-out in one group of nursing assistants. Nursing assistant burn-out scores were similar to scores reported for other health-care workers. Subjects reported that conflict with residents most commonly related to the resident wanting to go outside the facility or personal hygiene. An analysis of incident reports indicated that less than 0.3% of the physical and verbal aggression nursing assistants endure from residents is formally acknowledged. On average, a nursing assistant in this health care facility may expect to be physically assaulted by residents 9.3 times per month and verbally assaulted 11.3 times per month. Findings indicate a slight correlation between burn-out and conflict and also between burn-out and reported aggression from residents. A statistically significant relationship was noted between conflicts with residents and resident aggression from residents.