Domestic Violence and Youth
Content
Running head: INTIMATE PARTNER VIOLENCE AND CHILDREN
Intimate partner violence and children:
Working with parents to mediate negative outcomes
Danielle Hernandez
Gettysburg College
1
INTIMATE PARNTER VIOLENCE AND CHILDREN
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Intimate partner violence and children: Working with parents to prevent negative outcomes
The present paper explores the relationship between parental cases of intimate partner
violence (IPV) and child development and how to best mediate its negative outcomes.
Literature on battered parents and their children during prenatal development, early
childhood, adolescence, and adulthood is reviewed.
Background
Domestic violence (sometimes called intimate partner violence or “IPV”), is one of the
most overlooked public health issues in the United States. Although most see it as a private
matter rather than a national concern, it causes physical, psychological, and economic
devastation for millions of people each year (Goodman & Smyth, 2011) and these numbers
have failed to decrease significantly over time (Stover & Lent, 2014). According to the Center
for Disease Control’s National Intimate Partner and Sexual Violence Survey (The National
Intimate Partner and Sexual Violence Survey, 2014), every minute, 34 people are physically
assaulted or stalked by an intimate partner (i.e. spouse, former or current dating partner). It has
also been estimated that 95% of the 12 million domestic violence victims from 2010 were
women (Dutton, 2007). Although these women and male batterers often take precedence in the
movement to end domestic violence in the United States, there are also many children who are
affected by witnessing the violence and by being raised by a parent who has been so severely
harmed by the violence that they lack the skills needed to raise a child in a healthy way.
Approximately 15 million children are exposed to domestic violence annually in the United
States and this number has been increasing dramatically over the last twenty years (Insana,
Foley, Montgomery-Downs, Kolko, and McNeil, 2014). About 30% of American children
currently live in domestic violence homes. (Skopp, McDonald, Jouriles & Rosenfield, 2007)
Upwards of 95% of these children also are victims of some form of parental physical abuse and
anywhere from 55% to 95% have also witnessed violence in the community (Garrido &
Taussig, 2013). Children who have witnessed domestic violence experience higher rates of
sleep disturbances, PTSD, depression, and tend to externalize their problems unhealthily more
than children in the general population and are at risk to continue to develop psychological and
physical problems into adulthood. (Skopp et al., 2007; Insana et al., 2014; Rajalin, Hirvikoski,
& Jokinen, 2012; McLeod, Fergusson, & Horwood, 2014; Vickerman & Margolin, 2007)
Prevention and Mediation
Why Parenting?
A number of treatment and intervention strategies have been identified by researchers
and clinicians in addressing secondary trauma and developmental problems in children
exposed to IPV. Of the strategies (i.e. trauma-focused cognitive behavioral therapy, reexposure therapy, violence education, emotion regulation, social problem solving, safety
planning, and parent training), parent training seems to be not only ideal but can also prevent
the future need for the other types of clinical treatments. (Vickerman & Margolin, 2007)
Parental intervention is also ideal not only because of its preventative value, but also
because attempts to use the other intervention strategies and treatments with youth in the
clinical setting have been unsuccessful. This is largely due to rigid professionals who opt for
treatments they are accustomed to and experienced with over evidence based therapies found
to be more successful, such as trauma focused cognitive behavioral therapies (TF-CBT) (Allen,
Wilson, & Armstrong, 2014). While there is resistance to becoming more trauma-focused (i.e.
through short term training courses with organizations such as Children and Youth Services or
Children’s Aid Society) in the clinical arena, the alternative would be non-clinical advocates
INTIMATE PARNTER VIOLENCE AND CHILDREN
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working in domestic violence and sexual assault agencies and shelters. These individuals are
equipped to work with populations affected by trauma and are a better source of services for
survivors of these traumas; however, these services have also been criticized for lacking
licensed clinicians or individuals trained in working with children and adolescents. (Stover &
Lent, 2014) Given the lack of good options for youth who have been affected by parental IPV,
attempts to remedy these problems should not begin with the children, but with the parents in
preventative interventions.
Ideally this interventionist approach with parents should begin prenatally, continue
through early childhood and into adolescence, and should begin to include child involvement
as time goes on. Prenatally, domestic violence situations hinder a woman’s development of
psychological understanding of herself as a mother and her relationship to her future child.
This understanding is referred to as maternal mental representations. (Levendosky, Bogat &
Huth-Bocks, 2011) In a longitudinal study by Levendosky, Huth-Bocks, and Bogat (2011),
intimate partner violence situations turned an expectant mother’s focus primarily inward on her
own immediate safety and well-being during a time when she should have been focusing on
her developing child and developing an identity as a mother. Evidence from this study
suggested that, in the absence of healthy maternal mental representations during pregnancy,
parent-child attachment styles after age one were often classified as anxious/ambivalent or
avoidant. Both of these attachment styles, according to the Strange Situation assessment
(Ainsworth & Wittig, 1969), were understood to be unhealthy and correlated with continued
unhealthy relationships in adulthood. After birth, focus on the child continued to be less than
necessary for healthy relationship development since the mothers reported childcare to be an
overwhelming responsibility on top of their own survival and sometimes reported that the child
acted as a posttraumatic trigger of the abuse that occurred during pregnancy. Parenting
continued to be unhealthy as babies in the study developed past infancy. Mothers became
overinvolved in children’s lives and employed harsh punishment and physical handling- a
source in and of itself of many developmental problems.
Researchers Insana, Foley, Montgomery-Downs, Kolko, and McNeil (2014) discovered
a strong correlation between a mother’s experience of IPV and sleep disturbances in their
children. A sample of 100 women from five different states who had experienced IPV was
compared to a sample of 60 women who had never experienced IPV. The women who had
experienced IPV had reported significantly more instances of their children experiencing
insomnia, late sleep, talking in their sleep, bed wetting, grinding of their teeth during sleep, and
nightmares. These symptoms are not only troubling, but can lead to physical and mental health
problems when left untreated. Sleep deprivation, for instance, has been correlated with
depression and even suicide ideation. While it was predicted that the sleep disturbances were
correlated with mothers’ depression, no such correlation was found. It seemed, instead, that
there was an unidentified covariate that ultimately affected a child’s adaptive functioning
negatively. Adaptive functioning skills (i.e. social and practical skills) may be negatively
affected by the same early unhealthy attachment styles (Insana et al., 2014).
An additional study by Rajalin and colleagues (2012), saw similar deleterious effects
resulting from poor adaptive functioning skills and early unhealthy attachment styles. In their
study of 181 male adults with history of parental or family IPV, IPV was found to be a factor
in better planned suicide attempts. More concerning was that this correlation existed
independent of a family history of suicide. Interestingly enough, this correlation also existed
only for males and not females, even though females in other studies seemed to express more
INTIMATE PARNTER VIOLENCE AND CHILDREN
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difficulties earlier in their lives as a result of parental IPV (Insana et al., 2014; Jouriles et al.,
2012).
In an attempt to prevent poor parenting from the beginning, research has suggested that
pregnant women experiencing IPV should primarily be treated for posttraumatic stress disorder
(PTSD) which has been found to correlate with the development of unhealthy maternal mental
representations more than any other variable. Treatment should be handled jointly between
advocates and clinicians to combat symptoms of PTSD both pharmacologically and
psychologically with a trauma-focus. In addition to treatment for PTSD, researchers Schechter,
Coots, Zeanah, Davies, Coates, Trabka, Marshall, Liebowitz, and Myers (2005) found that,
although it alone could not remedy unhealthy maternal mental representations resulting from
PTSD, working on improving reflective functioning correlated positively with improving
representations. To improve reflective functioning, clinicians taught expectant mothers the
importance of healthy attachment styles with continued engagement in attachment-informed
psychotherapy though childbirth.
Infancy and Early Childhood
The harsh parenting that was witnessed through the interviews by Levendosky, HuthBocks, and Bogat (2011) is one of the most influential behaviors postpartum on child
development and should be the next stage of intervention for parents. Sturge-Apple, Davies,
Cicchetti, and Manning (2012) came out with some pioneering and quantifiable chemical
changes that occur in children as a result of IPV-related harsh parenting and unhealthy
parenting styles. As children grew up and could comprehend these stressors, very startling
change began in the hypothalamic-pituitary adrenal axis (HPA). The HPA axis is the part of
the brain responsible for responding to environmental threats and stressors. Significantly lower
activation of the HPA axis was found when preschoolers who had parents with a history of IPV
were presented with laboratory setting. This reduced functioning is due to the lower production
of its activating agent, cortisol, in response to abnormally high levels of physical and mental
violence witnessed and, sometimes, experienced. One of the biggest risks associated with
hypocortisolism for children in these situations is the development of PTSD, thus perpetuating
a vicious cycle. Hypocortisolism is known to be connected to stress- and trauma-related illness
such as this.
Effects of IPV exposure can be quite different when the violence occurs when the child
is pre-school aged. Researchers examining the unique effects at this age explored the relation
between violence exposure and explicit memory. Explicit memory is engaged during processes
such as decision making and problem solving and has been known to correlate strongly with
future academic success and development of healthy interpersonal relationships.
Understandably, a deficiency or latency in development of explicit memory can have some
serious effects on a child including a risk of perpetuating a cycle of abuse in their own future
relationships. A sample of 37 mothers of two to five year olds was recruited via flyers
distributed in locations relevant to the target population (i.e. social services offices and
domestic violence shelters). The mothers who qualified for the study were interviewed to
gauge parental IPV, children's hyperarousal symptoms (i.e. attention deficits, sleep
disturbances, “feeling jumpy”), parent-child aggression (i.e. corporal punishment), and positive
parenting (i.e. warmth and authoritativeness). Children were tested in another room using three
explicit memory tasks: the Visual Reception scale, the Receptive Language scale, and the
Memory for Faces test to test the child’s ability to mentally manipulate symbols, sequences,
and to recognize faces, respectively. With parent-child aggression controlled for, high IPV
INTIMATE PARNTER VIOLENCE AND CHILDREN
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exposure during this age range was found to significantly correlate with poor performance on
explicit memory tasks, therefore putting that child at risk for developmental delay, poor
academic success, and perhaps negative interpersonal relationships in adolescence and
adulthood (Jouriles, Brown, McDonald, Rosenfield, Leahy, & Silver, 2008).
Children are also thought to learn emotional regulation from parents at this young age.
Taking this into consideration, it was hypothesized that observation of parental violence at the
pre-school age may influence similar overarousal in children. Regulation of emotions both
internally and externally is sometimes referred to as effortful control. This potential lack of
effortful control was subsequently examined as a correlate of IPV exposure. A sample was
taken from an ongoing longitudinal study of mostly rural families in North Carolina and
central Pennsylvania. A total of 705 ethnically and economically diverse families qualified for
the study by having experienced IPV and having a child of at most four years of age. The data
was obtained first through surveys administered to the mother to acquire level of IPV, stress,
aggression, and depression. Then, behavior was assessed through naturalistic observations in
the families’ homes as well as through observation of children and their mothers playing and
solving puzzles- both scenarios that would show whether or not the child is exhibiting effortful
control. A significant correlation was found between high levels of IPV exposure and low
effortful control; however, it was also found that harsh or intrusive parenting styles aggregated
the correlation further and positive parenting styles mediated it almost completely (Gustafsson,
Cox, & Blair, 2012).
Childhood and Adolescence
In adolescence, the effects of IPV on children become more severe and even dangerous
to others. The need, therefore, for preventative work with parents, is even greater for mothers
with children entering their teens. It has been concluded by numerous researchers that parents
can serve as models of violence and aggression during formative years of their children
(Palazzolo, Roberto & Babin, 2010). Teenagers of parents who experienced IPV are at higher
risk of both being abusive themselves and of being victimized by peers (Jouriles et al., 2012;
Espelage, Low & De La Rue, 2012). Research conducted by Jouriles, Mueller, Rosenfield,
McDonald, and Dodson (2012) on a sample of 88 teenagers and a parent found a pattern of
violence being passed down generations. In the study, both the teenager and their parent were
analyzed using two separate scales as to assess parent intimate partner violence experiences,
harshness of parenting, secondary trauma symptoms in children, and teenager intimate partner
violence instances. Their findings included a significant relationship between parent and teen
levels of IPV, especially for female teenagers. Although witnessing parental IPV was a
significant risk factor for teenage IPV perpetration, general secondary trauma and harsh
parenting were far stronger correlates.
In addition to increasing risk for IPV perpetuation, parent IPV and the resultant harsh
parenting also increased risk for peer victimization in teenagers as evident in a 2012 study of
992 middle school students. Harsh parenting, especially when it is harsh enough to be
considered maltreatment, was found to disrupt the development of a child’s prosocial skills.
Without these skills, there existed what Espelage, Low and De La Rue (2012) referred to as the
“cascading effect of vulnerability” which led to significantly more instances of peer
victimization such as bullying, especially in the school setting.
Garrido and Taussig (2013) from the University Of Colorado School Of Medicine
observed this relationship between children witnessing IPV amongst parents and then being
involves in teen dating violence situations later in life. The researchers, however, noticed that
INTIMATE PARNTER VIOLENCE AND CHILDREN
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of the teenagers they interviewed, 63% witness parental IPV but only 20% had perpetrated
violence in their own dating relationships. It was assumed, therefore, that there must be
mediating factors involved that could prove equally beneficial to other teenage witnesses of
violence. Social Development Theory- previously used to show that positive parental and peer
influences could reduce negative behaviors such as substance abuse in high-risk individualswas employed as the basis of their research. Interviews were conducted with 41 adolescents
aged twelve to fifteen who were receiving out-of-home care due to IPV and other abuse at
home and who stated they had been involved in altercations within a recent romantic
relationship. Garrido and Taussig (2013) controlled for other types of violence the youths had
witnessed or been the victims of and they found a significant mediation effect in teen dating
violence when teenagers who had witnessed high levels of parental IPV had reported having
friends involved in many prosocial activities and behaviors. They also found the expected
significant mediation effect of positive parenting (i.e. use of appropriate disciplinary
techniques); however, the effect was reversed when levels of IPV witnessed were low. Even in
light of their conditional results, Garrido and Taussig (2013) still advocate for increasing the
amount of positive parenting in these children’s lives. It is clear that an attempt to increase
these protective factors in alignment with Social Development Theory would be ideal.
Additionally, studies conducted by other researchers have not supported this reversal and have
found maternal warmth and responsiveness to be beneficial regardless of level of IPV (Skopp
et al., 2007; Tajima, Herrenkohl, Moylan & Derr, 2011).
Positive parenting was also found to alleviate negative youth outcomes of witnessing
IPV in a study at the University of Washington involving 416 children previously involved in a
longitudinal study regarding IPV. The researchers Tajima, Herrenkohl, Moylan, and Derr
(2010) identified myriad previously discussed negative outcomes of parental IPV in schoolaged children and they primarily examined six main negative youth outcomes- youth
victimization, violence, depression, school dropout, running away from home, and teenage
pregnancy. Other forms of child abuse and early childhood behavior problems were controlled
for. Surveys regarding these six outcomes and parenting from the participants were analyzed
and significant decreases in teenage pregnancy (33% to 19%) and run-aways (48% to 15%)
were found in the participants who had reported better parenting characterized by acceptance,
responsiveness, and proper control. Similar to the results of the Garrido and Taussig (2013),
Tajima and colleagues (2010) also found significant decrease in these effects due to positive
peer influence.
Maternal warmth was also studied as an alleviating factor in negative externalization of
problems by young children aged seven to nine who witnessed domestic violence. The
researchers found that maternal warmth was used as a model for prosocial behavior and that
candid conversation between a mother and her child about IPV would deter the formation of
positive images of aggression. The results, however, were only significant when the parental
warmth came from the parent who was the victim in the IPV situation. Warmth from the
abusive parent seemed to perpetuate youth development of aggressive behaviors in
adolescence (Skopp et al., 2007). Contact from the abusive parent, in general, tended to be
nearly non-existent in cases where IPV was worse and where the family experienced less social
and economic privilege (Hunter & Graham-Bermann, 2013) In fact, there is a considerable
amount of controversy surrounding the topic of involving the abusive parent at all in child
treatment and interventions (Vickerman & Margolin, 2007).
INTIMATE PARNTER VIOLENCE AND CHILDREN
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Parenting workshops and classes are some services currently offered by many domestic
violence agencies and shelters. Given the relationship between harsh parenting in abused
parents and child perpetuation of violence, victimization, and development of stress related
illness as well as the mediating value of positive parenting, these services need to be used and
also supplemented by more parenting improvement services. In a study conducted by Wolfe,
Edwards, Manion, and Koverola (1988), mothers who attended a parenting skills group at a
domestic violence agency did find an improvement in parent-child attachment style and overall
child development. These results were even stronger, however, when, in addition to attending
agency group, these women also participated in individual and mother-child behavioral parent
training in a clinical setting. These clinical interventions were performed by graduate students
in clinical child psychology and developmental psychology but were overseen by a licensed
professional. Results were derived from home and in-lab observations of behaviors exhibited
by the child and in the parent-child interaction both before and after the intervention. Only the
in-lab observations exhibited a significant changed from before versus after the experiment;
however, the home observations were extremely limited.
Barriers to Intervention
There are a number of different interventionist approaches that can be taken during
childhood and adolescence. However, if a parent continues to be in an intimate partner
violence situation, it may be difficult or impossible for them to seek services such as these
given the power and control dynamic characteristic of abusive relationships (Schechter &
Ganley, 1995). The commonly cited “Power and Control Wheel” developed in Duluth,
Minnesota by the Domestic Abuse Intervention Project presents coercion and threats,
intimidation, emotional abuse, isolation, male privilege, economic abuse, use of children, and
minimizing, denying, and blaming partners as mechanisms used by abusers that could
potentially prevent an abused parent from receiving the interventionist parenting services
discussed. (Pence & Paymar, 2011) The “Power and Control Wheel” can be found in Appendix
A.
Elements of power and control can also be cyclical. For example, economic dependence
has been found to sustain IPV, but IPV also sustains economic dependence (Bornstein, 2007).
Other factors also exist that thwart an abused partner’s attempts to seek help. Location can act
as a barrier, especially a rural location. While services are easier to obtain in an urban area,
rural areas can present an abused partner with obstacles such as isolated geographic location,
tight-knit communities where service providers may be acquaintances of the abuser, lack of
phone service, lack of access to a vehicle, and an overall lack of domestic violence shelters and
mental health services (Miller, Clark, & Herman, 2007). Abused partners have also cited
strong religious convictions as a reason for not seeking services since some faiths have strict
gender role beliefs that condone some of the elements of power and control (Miller, Clark, &
Herman, 2007). Not only do abused partners face a lack of access, but they also tend to lack
enough confidence or self-efficacy to reach out for help even if it is available. Psychologist,
Krista Chronister (2007) notes that abusive partners don’t only cut off resources for their
partners, but that they “systematically denigrate and criticize women” pushing them further
into a state of self-created dependency and removing even the simplest thought to seek help at
all.
Adulthood
Even though it is difficult for parents to seek proper support for their children at an
early age, there is surprisingly little research examining long-term effects of IPV exposure in
INTIMATE PARNTER VIOLENCE AND CHILDREN
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adult children. Nonetheless, these effects can be deleterious and can range from defensive (i.e.
the adult child takes active steps to never let the same thing happen to them) to violent (i.e. as a
way to account for their own victimhood or lack of development of prosocial skills) (BandWinterstein, 2014; McLeod et al., 2014). Some researchers beginning to explore this topic used
the findings from Ainsworth and Wittig’s (1969) Strange Situation assessment as a framework.
According to Ainsworth and Wittig (1969), the unhealthy mother-child attachment styles that
began prenatally continued to negatively affect adult relationships. A study of 30-year old
males who had been a part of a longitudinal study earlier in their lives that documented early
childhood parenting and attachment styles reported information through surveys about topics
such as relationship quality, partner social adjustment, intimate partner violence, and of course,
history of childhood IPV, physical punishment, and maltreatment. A positive correlation was
found between the harshness of punishment while growing up and the level of IPV experienced
in their adult relationships. IPV in adult relationships later in life increased for the child who
experienced harsh physical punishment both in victimization and perpetration (McLeod et al.,
2014). McLeod and colleagues (2014) understand this to be a result of an inability to engage in
or an ignorance of how to form healthy relationships with power and control in check.
As discussed earlier, Rajalin and colleagues (2012) also studied some effects of IPV on
child witnesses later in life in a sample of college-aged individuals. These individuals not only
attempted suicide at a higher rate than the general population (with other risk-factors such as
family history of suicide controlled for), but their suicide ideation was more thorough and, if
attempted, would be more successful. In fact, during the period of follow-up in this study, 11
participants successfully committed suicide. The reason proposed to account for this was poor
adaptive functioning skills and early unhealthy attachment styles. Two other peripheral
relationships were found in this study between childhood exposure to violence and adult
exposure to violence and between childhood exposure to violence and adult perpetration of
violent acts. The correlation was stronger for the former than the latter.
Another study of the college-age population and their parents was conducted to further
understand the effects of witnessing IPV during childhood at a more mature age. Similar to the
findings of Jouriles and colleagues (2012), the increased risk of perpetrating physical,
psychological, or sexual violence in an intimate partner relationship continued to prevail as the
child continued into adulthood. Self-report methods were used to obtain from young adult
children exposed to IPV in the past level of personal psychological aggression and perceived
parental verbal aggression. Similar verbal aggression self-reports were collected from the
participant’s parent to mediate bias. A significant correlation was found between exposure to
IPV at a young age and personal psychological aggression into adulthood that has the
possibility of being translated into physical and sexual aggression (Palazzolo et al., 2010).
A developmental psychopathology perspective has also been used as a framework for
the study of manifestations of childhood IPV-related trauma in adulthood. Megan R. Holmes
(2013) studied children’s aggressive behaviors from age three and with collection of this data
over time, was able to create a projection of development. Her conclusion was that the less IPV
a child was exposed to between birth and age three, the steeper the decline in aggression
projection into adulthood would be, and vice versa. The suggestion here is that interventions
should occur no later than age four. This very pessimistic conclusion would suggest that past a
very young age, the child’s aggression, although delayed, is set in a definitive trajectory into
adulthood and would quite possibly perpetuate a cycle of IPV into future generations.
INTIMATE PARNTER VIOLENCE AND CHILDREN
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Conclusion
There are certainly glaring limitations to the research that has been published on the
topic of children witnessing parental IPV and how parental interventions play into that. Studies
that are conducted on this topic are overwhelmingly based on self-report methods in surveys
administered to high-risk populations. Experimental studies are hard to come by and when they
do exist, they may pose a moral dilemma (Wolfe, Edwards, Manion, & Koverola, 1988).
Observations of parent-child interactions and child behavior are occasionally conducted;
however, these results are inconclusive since they tend to differ from naturalistic to laboratory
settings significantly (Wolfe et al., 1988). Studies of the effects of IPV exposure using
neuroscience are also in their fledgling state. Only recently have psychologists and
neuroscientists begun exploring the relation of brain chemistry to this type of trauma (SturgeApple et al., 2012). Certainly, most of the sampling is not random since researchers look to
women already in shelter, children in foster care and individuals already in IPV-related support
groups. Given the nature of IPV, it would be difficult to recruit participants in any other way.
Research on this subject and the potential of parental mediation of negative effects from
childhood through adulthood needs to continue and broaden to include more diverse
populations and methodologies.
INTIMATE PARNTER VIOLENCE AND CHILDREN
Appendix A
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INTIMATE PARNTER VIOLENCE AND CHILDREN
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Intimate partner violence and children:
Working with parents to mediate negative outcomes
Danielle Hernandez
Gettysburg College
1
INTIMATE PARNTER VIOLENCE AND CHILDREN
2
Intimate partner violence and children: Working with parents to prevent negative outcomes
The present paper explores the relationship between parental cases of intimate partner
violence (IPV) and child development and how to best mediate its negative outcomes.
Literature on battered parents and their children during prenatal development, early
childhood, adolescence, and adulthood is reviewed.
Background
Domestic violence (sometimes called intimate partner violence or “IPV”), is one of the
most overlooked public health issues in the United States. Although most see it as a private
matter rather than a national concern, it causes physical, psychological, and economic
devastation for millions of people each year (Goodman & Smyth, 2011) and these numbers
have failed to decrease significantly over time (Stover & Lent, 2014). According to the Center
for Disease Control’s National Intimate Partner and Sexual Violence Survey (The National
Intimate Partner and Sexual Violence Survey, 2014), every minute, 34 people are physically
assaulted or stalked by an intimate partner (i.e. spouse, former or current dating partner). It has
also been estimated that 95% of the 12 million domestic violence victims from 2010 were
women (Dutton, 2007). Although these women and male batterers often take precedence in the
movement to end domestic violence in the United States, there are also many children who are
affected by witnessing the violence and by being raised by a parent who has been so severely
harmed by the violence that they lack the skills needed to raise a child in a healthy way.
Approximately 15 million children are exposed to domestic violence annually in the United
States and this number has been increasing dramatically over the last twenty years (Insana,
Foley, Montgomery-Downs, Kolko, and McNeil, 2014). About 30% of American children
currently live in domestic violence homes. (Skopp, McDonald, Jouriles & Rosenfield, 2007)
Upwards of 95% of these children also are victims of some form of parental physical abuse and
anywhere from 55% to 95% have also witnessed violence in the community (Garrido &
Taussig, 2013). Children who have witnessed domestic violence experience higher rates of
sleep disturbances, PTSD, depression, and tend to externalize their problems unhealthily more
than children in the general population and are at risk to continue to develop psychological and
physical problems into adulthood. (Skopp et al., 2007; Insana et al., 2014; Rajalin, Hirvikoski,
& Jokinen, 2012; McLeod, Fergusson, & Horwood, 2014; Vickerman & Margolin, 2007)
Prevention and Mediation
Why Parenting?
A number of treatment and intervention strategies have been identified by researchers
and clinicians in addressing secondary trauma and developmental problems in children
exposed to IPV. Of the strategies (i.e. trauma-focused cognitive behavioral therapy, reexposure therapy, violence education, emotion regulation, social problem solving, safety
planning, and parent training), parent training seems to be not only ideal but can also prevent
the future need for the other types of clinical treatments. (Vickerman & Margolin, 2007)
Parental intervention is also ideal not only because of its preventative value, but also
because attempts to use the other intervention strategies and treatments with youth in the
clinical setting have been unsuccessful. This is largely due to rigid professionals who opt for
treatments they are accustomed to and experienced with over evidence based therapies found
to be more successful, such as trauma focused cognitive behavioral therapies (TF-CBT) (Allen,
Wilson, & Armstrong, 2014). While there is resistance to becoming more trauma-focused (i.e.
through short term training courses with organizations such as Children and Youth Services or
Children’s Aid Society) in the clinical arena, the alternative would be non-clinical advocates
INTIMATE PARNTER VIOLENCE AND CHILDREN
3
working in domestic violence and sexual assault agencies and shelters. These individuals are
equipped to work with populations affected by trauma and are a better source of services for
survivors of these traumas; however, these services have also been criticized for lacking
licensed clinicians or individuals trained in working with children and adolescents. (Stover &
Lent, 2014) Given the lack of good options for youth who have been affected by parental IPV,
attempts to remedy these problems should not begin with the children, but with the parents in
preventative interventions.
Ideally this interventionist approach with parents should begin prenatally, continue
through early childhood and into adolescence, and should begin to include child involvement
as time goes on. Prenatally, domestic violence situations hinder a woman’s development of
psychological understanding of herself as a mother and her relationship to her future child.
This understanding is referred to as maternal mental representations. (Levendosky, Bogat &
Huth-Bocks, 2011) In a longitudinal study by Levendosky, Huth-Bocks, and Bogat (2011),
intimate partner violence situations turned an expectant mother’s focus primarily inward on her
own immediate safety and well-being during a time when she should have been focusing on
her developing child and developing an identity as a mother. Evidence from this study
suggested that, in the absence of healthy maternal mental representations during pregnancy,
parent-child attachment styles after age one were often classified as anxious/ambivalent or
avoidant. Both of these attachment styles, according to the Strange Situation assessment
(Ainsworth & Wittig, 1969), were understood to be unhealthy and correlated with continued
unhealthy relationships in adulthood. After birth, focus on the child continued to be less than
necessary for healthy relationship development since the mothers reported childcare to be an
overwhelming responsibility on top of their own survival and sometimes reported that the child
acted as a posttraumatic trigger of the abuse that occurred during pregnancy. Parenting
continued to be unhealthy as babies in the study developed past infancy. Mothers became
overinvolved in children’s lives and employed harsh punishment and physical handling- a
source in and of itself of many developmental problems.
Researchers Insana, Foley, Montgomery-Downs, Kolko, and McNeil (2014) discovered
a strong correlation between a mother’s experience of IPV and sleep disturbances in their
children. A sample of 100 women from five different states who had experienced IPV was
compared to a sample of 60 women who had never experienced IPV. The women who had
experienced IPV had reported significantly more instances of their children experiencing
insomnia, late sleep, talking in their sleep, bed wetting, grinding of their teeth during sleep, and
nightmares. These symptoms are not only troubling, but can lead to physical and mental health
problems when left untreated. Sleep deprivation, for instance, has been correlated with
depression and even suicide ideation. While it was predicted that the sleep disturbances were
correlated with mothers’ depression, no such correlation was found. It seemed, instead, that
there was an unidentified covariate that ultimately affected a child’s adaptive functioning
negatively. Adaptive functioning skills (i.e. social and practical skills) may be negatively
affected by the same early unhealthy attachment styles (Insana et al., 2014).
An additional study by Rajalin and colleagues (2012), saw similar deleterious effects
resulting from poor adaptive functioning skills and early unhealthy attachment styles. In their
study of 181 male adults with history of parental or family IPV, IPV was found to be a factor
in better planned suicide attempts. More concerning was that this correlation existed
independent of a family history of suicide. Interestingly enough, this correlation also existed
only for males and not females, even though females in other studies seemed to express more
INTIMATE PARNTER VIOLENCE AND CHILDREN
4
difficulties earlier in their lives as a result of parental IPV (Insana et al., 2014; Jouriles et al.,
2012).
In an attempt to prevent poor parenting from the beginning, research has suggested that
pregnant women experiencing IPV should primarily be treated for posttraumatic stress disorder
(PTSD) which has been found to correlate with the development of unhealthy maternal mental
representations more than any other variable. Treatment should be handled jointly between
advocates and clinicians to combat symptoms of PTSD both pharmacologically and
psychologically with a trauma-focus. In addition to treatment for PTSD, researchers Schechter,
Coots, Zeanah, Davies, Coates, Trabka, Marshall, Liebowitz, and Myers (2005) found that,
although it alone could not remedy unhealthy maternal mental representations resulting from
PTSD, working on improving reflective functioning correlated positively with improving
representations. To improve reflective functioning, clinicians taught expectant mothers the
importance of healthy attachment styles with continued engagement in attachment-informed
psychotherapy though childbirth.
Infancy and Early Childhood
The harsh parenting that was witnessed through the interviews by Levendosky, HuthBocks, and Bogat (2011) is one of the most influential behaviors postpartum on child
development and should be the next stage of intervention for parents. Sturge-Apple, Davies,
Cicchetti, and Manning (2012) came out with some pioneering and quantifiable chemical
changes that occur in children as a result of IPV-related harsh parenting and unhealthy
parenting styles. As children grew up and could comprehend these stressors, very startling
change began in the hypothalamic-pituitary adrenal axis (HPA). The HPA axis is the part of
the brain responsible for responding to environmental threats and stressors. Significantly lower
activation of the HPA axis was found when preschoolers who had parents with a history of IPV
were presented with laboratory setting. This reduced functioning is due to the lower production
of its activating agent, cortisol, in response to abnormally high levels of physical and mental
violence witnessed and, sometimes, experienced. One of the biggest risks associated with
hypocortisolism for children in these situations is the development of PTSD, thus perpetuating
a vicious cycle. Hypocortisolism is known to be connected to stress- and trauma-related illness
such as this.
Effects of IPV exposure can be quite different when the violence occurs when the child
is pre-school aged. Researchers examining the unique effects at this age explored the relation
between violence exposure and explicit memory. Explicit memory is engaged during processes
such as decision making and problem solving and has been known to correlate strongly with
future academic success and development of healthy interpersonal relationships.
Understandably, a deficiency or latency in development of explicit memory can have some
serious effects on a child including a risk of perpetuating a cycle of abuse in their own future
relationships. A sample of 37 mothers of two to five year olds was recruited via flyers
distributed in locations relevant to the target population (i.e. social services offices and
domestic violence shelters). The mothers who qualified for the study were interviewed to
gauge parental IPV, children's hyperarousal symptoms (i.e. attention deficits, sleep
disturbances, “feeling jumpy”), parent-child aggression (i.e. corporal punishment), and positive
parenting (i.e. warmth and authoritativeness). Children were tested in another room using three
explicit memory tasks: the Visual Reception scale, the Receptive Language scale, and the
Memory for Faces test to test the child’s ability to mentally manipulate symbols, sequences,
and to recognize faces, respectively. With parent-child aggression controlled for, high IPV
INTIMATE PARNTER VIOLENCE AND CHILDREN
5
exposure during this age range was found to significantly correlate with poor performance on
explicit memory tasks, therefore putting that child at risk for developmental delay, poor
academic success, and perhaps negative interpersonal relationships in adolescence and
adulthood (Jouriles, Brown, McDonald, Rosenfield, Leahy, & Silver, 2008).
Children are also thought to learn emotional regulation from parents at this young age.
Taking this into consideration, it was hypothesized that observation of parental violence at the
pre-school age may influence similar overarousal in children. Regulation of emotions both
internally and externally is sometimes referred to as effortful control. This potential lack of
effortful control was subsequently examined as a correlate of IPV exposure. A sample was
taken from an ongoing longitudinal study of mostly rural families in North Carolina and
central Pennsylvania. A total of 705 ethnically and economically diverse families qualified for
the study by having experienced IPV and having a child of at most four years of age. The data
was obtained first through surveys administered to the mother to acquire level of IPV, stress,
aggression, and depression. Then, behavior was assessed through naturalistic observations in
the families’ homes as well as through observation of children and their mothers playing and
solving puzzles- both scenarios that would show whether or not the child is exhibiting effortful
control. A significant correlation was found between high levels of IPV exposure and low
effortful control; however, it was also found that harsh or intrusive parenting styles aggregated
the correlation further and positive parenting styles mediated it almost completely (Gustafsson,
Cox, & Blair, 2012).
Childhood and Adolescence
In adolescence, the effects of IPV on children become more severe and even dangerous
to others. The need, therefore, for preventative work with parents, is even greater for mothers
with children entering their teens. It has been concluded by numerous researchers that parents
can serve as models of violence and aggression during formative years of their children
(Palazzolo, Roberto & Babin, 2010). Teenagers of parents who experienced IPV are at higher
risk of both being abusive themselves and of being victimized by peers (Jouriles et al., 2012;
Espelage, Low & De La Rue, 2012). Research conducted by Jouriles, Mueller, Rosenfield,
McDonald, and Dodson (2012) on a sample of 88 teenagers and a parent found a pattern of
violence being passed down generations. In the study, both the teenager and their parent were
analyzed using two separate scales as to assess parent intimate partner violence experiences,
harshness of parenting, secondary trauma symptoms in children, and teenager intimate partner
violence instances. Their findings included a significant relationship between parent and teen
levels of IPV, especially for female teenagers. Although witnessing parental IPV was a
significant risk factor for teenage IPV perpetration, general secondary trauma and harsh
parenting were far stronger correlates.
In addition to increasing risk for IPV perpetuation, parent IPV and the resultant harsh
parenting also increased risk for peer victimization in teenagers as evident in a 2012 study of
992 middle school students. Harsh parenting, especially when it is harsh enough to be
considered maltreatment, was found to disrupt the development of a child’s prosocial skills.
Without these skills, there existed what Espelage, Low and De La Rue (2012) referred to as the
“cascading effect of vulnerability” which led to significantly more instances of peer
victimization such as bullying, especially in the school setting.
Garrido and Taussig (2013) from the University Of Colorado School Of Medicine
observed this relationship between children witnessing IPV amongst parents and then being
involves in teen dating violence situations later in life. The researchers, however, noticed that
INTIMATE PARNTER VIOLENCE AND CHILDREN
6
of the teenagers they interviewed, 63% witness parental IPV but only 20% had perpetrated
violence in their own dating relationships. It was assumed, therefore, that there must be
mediating factors involved that could prove equally beneficial to other teenage witnesses of
violence. Social Development Theory- previously used to show that positive parental and peer
influences could reduce negative behaviors such as substance abuse in high-risk individualswas employed as the basis of their research. Interviews were conducted with 41 adolescents
aged twelve to fifteen who were receiving out-of-home care due to IPV and other abuse at
home and who stated they had been involved in altercations within a recent romantic
relationship. Garrido and Taussig (2013) controlled for other types of violence the youths had
witnessed or been the victims of and they found a significant mediation effect in teen dating
violence when teenagers who had witnessed high levels of parental IPV had reported having
friends involved in many prosocial activities and behaviors. They also found the expected
significant mediation effect of positive parenting (i.e. use of appropriate disciplinary
techniques); however, the effect was reversed when levels of IPV witnessed were low. Even in
light of their conditional results, Garrido and Taussig (2013) still advocate for increasing the
amount of positive parenting in these children’s lives. It is clear that an attempt to increase
these protective factors in alignment with Social Development Theory would be ideal.
Additionally, studies conducted by other researchers have not supported this reversal and have
found maternal warmth and responsiveness to be beneficial regardless of level of IPV (Skopp
et al., 2007; Tajima, Herrenkohl, Moylan & Derr, 2011).
Positive parenting was also found to alleviate negative youth outcomes of witnessing
IPV in a study at the University of Washington involving 416 children previously involved in a
longitudinal study regarding IPV. The researchers Tajima, Herrenkohl, Moylan, and Derr
(2010) identified myriad previously discussed negative outcomes of parental IPV in schoolaged children and they primarily examined six main negative youth outcomes- youth
victimization, violence, depression, school dropout, running away from home, and teenage
pregnancy. Other forms of child abuse and early childhood behavior problems were controlled
for. Surveys regarding these six outcomes and parenting from the participants were analyzed
and significant decreases in teenage pregnancy (33% to 19%) and run-aways (48% to 15%)
were found in the participants who had reported better parenting characterized by acceptance,
responsiveness, and proper control. Similar to the results of the Garrido and Taussig (2013),
Tajima and colleagues (2010) also found significant decrease in these effects due to positive
peer influence.
Maternal warmth was also studied as an alleviating factor in negative externalization of
problems by young children aged seven to nine who witnessed domestic violence. The
researchers found that maternal warmth was used as a model for prosocial behavior and that
candid conversation between a mother and her child about IPV would deter the formation of
positive images of aggression. The results, however, were only significant when the parental
warmth came from the parent who was the victim in the IPV situation. Warmth from the
abusive parent seemed to perpetuate youth development of aggressive behaviors in
adolescence (Skopp et al., 2007). Contact from the abusive parent, in general, tended to be
nearly non-existent in cases where IPV was worse and where the family experienced less social
and economic privilege (Hunter & Graham-Bermann, 2013) In fact, there is a considerable
amount of controversy surrounding the topic of involving the abusive parent at all in child
treatment and interventions (Vickerman & Margolin, 2007).
INTIMATE PARNTER VIOLENCE AND CHILDREN
7
Parenting workshops and classes are some services currently offered by many domestic
violence agencies and shelters. Given the relationship between harsh parenting in abused
parents and child perpetuation of violence, victimization, and development of stress related
illness as well as the mediating value of positive parenting, these services need to be used and
also supplemented by more parenting improvement services. In a study conducted by Wolfe,
Edwards, Manion, and Koverola (1988), mothers who attended a parenting skills group at a
domestic violence agency did find an improvement in parent-child attachment style and overall
child development. These results were even stronger, however, when, in addition to attending
agency group, these women also participated in individual and mother-child behavioral parent
training in a clinical setting. These clinical interventions were performed by graduate students
in clinical child psychology and developmental psychology but were overseen by a licensed
professional. Results were derived from home and in-lab observations of behaviors exhibited
by the child and in the parent-child interaction both before and after the intervention. Only the
in-lab observations exhibited a significant changed from before versus after the experiment;
however, the home observations were extremely limited.
Barriers to Intervention
There are a number of different interventionist approaches that can be taken during
childhood and adolescence. However, if a parent continues to be in an intimate partner
violence situation, it may be difficult or impossible for them to seek services such as these
given the power and control dynamic characteristic of abusive relationships (Schechter &
Ganley, 1995). The commonly cited “Power and Control Wheel” developed in Duluth,
Minnesota by the Domestic Abuse Intervention Project presents coercion and threats,
intimidation, emotional abuse, isolation, male privilege, economic abuse, use of children, and
minimizing, denying, and blaming partners as mechanisms used by abusers that could
potentially prevent an abused parent from receiving the interventionist parenting services
discussed. (Pence & Paymar, 2011) The “Power and Control Wheel” can be found in Appendix
A.
Elements of power and control can also be cyclical. For example, economic dependence
has been found to sustain IPV, but IPV also sustains economic dependence (Bornstein, 2007).
Other factors also exist that thwart an abused partner’s attempts to seek help. Location can act
as a barrier, especially a rural location. While services are easier to obtain in an urban area,
rural areas can present an abused partner with obstacles such as isolated geographic location,
tight-knit communities where service providers may be acquaintances of the abuser, lack of
phone service, lack of access to a vehicle, and an overall lack of domestic violence shelters and
mental health services (Miller, Clark, & Herman, 2007). Abused partners have also cited
strong religious convictions as a reason for not seeking services since some faiths have strict
gender role beliefs that condone some of the elements of power and control (Miller, Clark, &
Herman, 2007). Not only do abused partners face a lack of access, but they also tend to lack
enough confidence or self-efficacy to reach out for help even if it is available. Psychologist,
Krista Chronister (2007) notes that abusive partners don’t only cut off resources for their
partners, but that they “systematically denigrate and criticize women” pushing them further
into a state of self-created dependency and removing even the simplest thought to seek help at
all.
Adulthood
Even though it is difficult for parents to seek proper support for their children at an
early age, there is surprisingly little research examining long-term effects of IPV exposure in
INTIMATE PARNTER VIOLENCE AND CHILDREN
8
adult children. Nonetheless, these effects can be deleterious and can range from defensive (i.e.
the adult child takes active steps to never let the same thing happen to them) to violent (i.e. as a
way to account for their own victimhood or lack of development of prosocial skills) (BandWinterstein, 2014; McLeod et al., 2014). Some researchers beginning to explore this topic used
the findings from Ainsworth and Wittig’s (1969) Strange Situation assessment as a framework.
According to Ainsworth and Wittig (1969), the unhealthy mother-child attachment styles that
began prenatally continued to negatively affect adult relationships. A study of 30-year old
males who had been a part of a longitudinal study earlier in their lives that documented early
childhood parenting and attachment styles reported information through surveys about topics
such as relationship quality, partner social adjustment, intimate partner violence, and of course,
history of childhood IPV, physical punishment, and maltreatment. A positive correlation was
found between the harshness of punishment while growing up and the level of IPV experienced
in their adult relationships. IPV in adult relationships later in life increased for the child who
experienced harsh physical punishment both in victimization and perpetration (McLeod et al.,
2014). McLeod and colleagues (2014) understand this to be a result of an inability to engage in
or an ignorance of how to form healthy relationships with power and control in check.
As discussed earlier, Rajalin and colleagues (2012) also studied some effects of IPV on
child witnesses later in life in a sample of college-aged individuals. These individuals not only
attempted suicide at a higher rate than the general population (with other risk-factors such as
family history of suicide controlled for), but their suicide ideation was more thorough and, if
attempted, would be more successful. In fact, during the period of follow-up in this study, 11
participants successfully committed suicide. The reason proposed to account for this was poor
adaptive functioning skills and early unhealthy attachment styles. Two other peripheral
relationships were found in this study between childhood exposure to violence and adult
exposure to violence and between childhood exposure to violence and adult perpetration of
violent acts. The correlation was stronger for the former than the latter.
Another study of the college-age population and their parents was conducted to further
understand the effects of witnessing IPV during childhood at a more mature age. Similar to the
findings of Jouriles and colleagues (2012), the increased risk of perpetrating physical,
psychological, or sexual violence in an intimate partner relationship continued to prevail as the
child continued into adulthood. Self-report methods were used to obtain from young adult
children exposed to IPV in the past level of personal psychological aggression and perceived
parental verbal aggression. Similar verbal aggression self-reports were collected from the
participant’s parent to mediate bias. A significant correlation was found between exposure to
IPV at a young age and personal psychological aggression into adulthood that has the
possibility of being translated into physical and sexual aggression (Palazzolo et al., 2010).
A developmental psychopathology perspective has also been used as a framework for
the study of manifestations of childhood IPV-related trauma in adulthood. Megan R. Holmes
(2013) studied children’s aggressive behaviors from age three and with collection of this data
over time, was able to create a projection of development. Her conclusion was that the less IPV
a child was exposed to between birth and age three, the steeper the decline in aggression
projection into adulthood would be, and vice versa. The suggestion here is that interventions
should occur no later than age four. This very pessimistic conclusion would suggest that past a
very young age, the child’s aggression, although delayed, is set in a definitive trajectory into
adulthood and would quite possibly perpetuate a cycle of IPV into future generations.
INTIMATE PARNTER VIOLENCE AND CHILDREN
9
Conclusion
There are certainly glaring limitations to the research that has been published on the
topic of children witnessing parental IPV and how parental interventions play into that. Studies
that are conducted on this topic are overwhelmingly based on self-report methods in surveys
administered to high-risk populations. Experimental studies are hard to come by and when they
do exist, they may pose a moral dilemma (Wolfe, Edwards, Manion, & Koverola, 1988).
Observations of parent-child interactions and child behavior are occasionally conducted;
however, these results are inconclusive since they tend to differ from naturalistic to laboratory
settings significantly (Wolfe et al., 1988). Studies of the effects of IPV exposure using
neuroscience are also in their fledgling state. Only recently have psychologists and
neuroscientists begun exploring the relation of brain chemistry to this type of trauma (SturgeApple et al., 2012). Certainly, most of the sampling is not random since researchers look to
women already in shelter, children in foster care and individuals already in IPV-related support
groups. Given the nature of IPV, it would be difficult to recruit participants in any other way.
Research on this subject and the potential of parental mediation of negative effects from
childhood through adulthood needs to continue and broaden to include more diverse
populations and methodologies.
INTIMATE PARNTER VIOLENCE AND CHILDREN
Appendix A
10
INTIMATE PARNTER VIOLENCE AND CHILDREN
11
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