Partner Abuse of Mothers Compromises Children's Behavioral Functioning Through Maternal Mental Health Dysfunction: Analysis of 300 Mother-Child Pairs

Multiple Informant Cluster Analysis Findings: Which Military-Connected Preschool Aged Children Are Doing Well and Why?

Informed by models of resilience in military families, we explored factors theorized to be associated with social-emotional resilience and risk among young military-connected children. Our secondary analysis of cross-sectional data from 199 military-connected families (n = 346 parents) with at least one preschool-age child in the home (n = 199) led to the empirical identification of two distinct clusters: families with children demonstrating healthy social-emotional functioning and those showing indicators of poor social-emotional functioning. We then identified factors associated with membership in each cluster to determine which deployment and parental wellbeing variables were salient for young child adjustment. Parent psychological health symptoms, parenting, child behavior, and parent-child relationships were measured by parent report and observed interaction. Children with healthier social-emotional functioning were found to be residing with families experiencing less stress and distress. The importance of maternal trauma history is highlighted in our study, as elevated maternal symptoms across all three posttraumatic stress disorder symptom domains were associated with child social-emotional risk. Basic family demographic characteristics did not contribute significantly to the cluster distinctions, nor did military service factors such as active duty, reserve or veteran status, military rank or parent deployment history. These findings are important as the results deemphasize the importance of military service characteristics and highlight the importance of parent wellbeing when considering social-emotional risk and resilience of young children within military families.

Mothers' Intimate Partner Violence Victimization and Depression: Associations with Children's Behavioral Functioning

Despite robust bodies of literature documenting that both mothers' intimate partner violence (IPV) victimization and mothers' mental health are consequential for children's behavioral functioning, the conjunction of these two risk factors is less understood. Findings are mixed as to whether mental health mediates the effect of IPV on behavioral functioning. Such mixed findings may result from literature primarily examining samples selected from clinical, shelter, or intervention settings. Furthermore, few studies have expanded the literature to assess moderation, rather than mediation, effects. While mediation analysis tests whether behavioral problems result from mothers' IPV because IPV increases depression, moderation analysis instead tests whether mother's IPV victimization has a different impact for their children based on whether or not the mother is also experiencing depression. The current study uses a representative survey of neighborhoods and households in Los Angeles County, the Los Angeles Family and Neighborhood Survey (n = 1,913), to examine the combined effects of mothers' IPV victimization and depression on children's internalizing and externalizing behavior problems. The findings suggest that mothers' IPV victimization and depression have direct, positive effects on both internalizing and externalizing behavior problems. Additionally, there is a moderation effect such that children of mothers who suffer from both IPV victimization and depression have higher levels of internalizing behavior problems. These results emphasize the importance of addressing the mental health of IPV victims, not only for the benefit of the direct victim, but also for the benefit of her children.

Children Exposed to Intimate Partner Violence During Confinement: Characteristics by Age and Sex

The COVID-19 pandemic and restrictions imposed to stop its advance have affected the entire population. Children living with difficulties or in vulnerable situations prior to the pandemic might have suffered an even greater impact. This present study examines the psychological impact of quarantine on children and adolescents exposed to intimate partner violence against their mothers. Participants were 185 mothers who reported 269 children, as well as 108 children who self-reported. An emotional and behavioral checklist was administered to both mothers and children throughout confinement. Results show mothers observed changes in their children's psychological state. Children, in turn, reported an increase in different variables. Mothers reported a higher percentage of overall increase for both general and severe symptoms than their children. Differences were found by sex and age. Future research with similar population groups is necessary to establish the support and intervention children require in similar contexts, as well as to clarify possible causes of differences found by age and sex.

Intimate Partner Violence and Depression of Mothers and Their Adolescent Children: The Roles of Housing Insecurity and System Contacts

Intimate partner violence (IPV) victimization is a prominent risk factor for depression among mothers. Less is known about the long-term relationship between IPV and maternal depression, impacts of IPV exposure on children, and mechanisms linking IPV with long-term mental health problems. IPV threatens stable housing for survivors, which increases likelihood of surveillance and sanctioning by formal systems - in particular, child welfare and criminal justice. The present study investigates whether housing insecurity and system contacts mediate the relationship between maternal IPV victimization and depression among both mothers and children 10 years later. Data comes from the Fragile Families and Child Well-being Study, a longitudinal survey of at-risk families with children. Structural equation modeling investigates pathways from IPV victimization of mothers to maternal and child depression via housing insecurity and contact with the child welfare and criminal justice systems. Results show IPV victimization is directly associated with housing insecurity, child welfare contact, and adolescent depression. Further, housing insecurity leading to both types of system contact mediates the link from IPV to maternal depression; in contrast, housing insecurity alone mediates the link from IPV to depression among children when they are 15 years old. Findings suggest IPV toward mothers has enduring, multigenerational effects on mental health that unfold over a long period following victimization. Complex pathways suggest housing insecurity and contact with punitive social systems that disproportionately impact low-income families explain in part the link from IPV to depression. Lack of housing options may deter survivors from leaving violent relationships, and housing insecurity in the wake of victimization may contribute to interactions with punitive social systems. Efforts to address housing, stigma, and psychological needs of IPV survivors are crucial to stabilize families.

Clinical Measures of Allostatic Load in Children and Adolescents with Food Allergy, Depression, or Anxiety

PURPOSE

Sustained high stress exposure results in chronic activation of the stress response system, dysregulated stress responses, high allostatic load, and poor later-life health. Children and adolescents with chronic health conditions face stressors related to their condition in addition to those typical of childhood and adolescence, placing them at risk of high allostatic load. The purpose of this secondary analysis was to examine whether youth with chronic health conditions differ from controls on clinical measures of allostatic load.

DESIGN AND METHODS

A secondary analysis of two datasets, the electronic health record of a tertiary children's hospital and data from the Survey of the Health of Wisconsin, compared youth with chronic health conditions to controls on clinical measures of allostatic load. Additional analyses explored whether parental stress and mental health influenced these relationships.

RESULTS

Analyses identified differences in BMI, blood pressure, and waist circumference between youth with food allergy, anxiety, or depression, and controls. These relationships differed for males and females and for those with comorbid mental and physical conditions, and were influenced by parent stress and mental health.

CONCLUSIONS

Results support future studies exploring whether high stress in youth with chronic health conditions leads to increased allostatic load. Incorporating biomarkers as well as genetic and epigenetic factors will provide critical insights.

PRACTICE IMPLICATIONS

Youth with mental and physical CHCs may be at increased risk of high allostatic load, reflected in clinical measures of metabolism, and should have regular assessments of their metabolic health.

Effect of Psychoeducation Group Training Based on Problem-Solving Skills for Women Experiencing Bipolar Spouse Abuse

Aim: Wives of patients with bipolar disorder as informal caregivers are at high risk for spouse abuse and need to learn coping strategies such as problem-solving skills to manage problematic situations. The purpose of this study was to assess the effectiveness of the psychoeducation group training based on problem-solving skills for women experiencing bipolar spouse abuse. Methods: A randomized clinical trial design was used for this study. In intervention group, women experiencing bipolar spouse abuse participated in four problem-solving skills training sessions and women in two groups (intervention = 30 and control = 30) completed the Index of Spouse Abuse at baseline and after 2 months. Results: The results indicated that changes in abuse scores (physical, non-physical and total of Index of Spouse Abuse) after the intervention were significantly different among the two groups (p < 0.0001). Although abuse scores decreased in both the intervention and the control groups, but lower abuse scores in the intervention than control group were statistically significant. Conclusion: Our findings support that the problem-solving skills training intervention can help to decrease the women experience of bipolar spouse abuse.

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

BACKGROUND

It is estimated that more than half of children living in households where intimate partner violence (IPV) occurs are also exposed to animal cruelty (AC). Although prior research links bonds with pets with higher levels of socioemotional competence among school-age children, exposure to AC may negate the protective effects of pet ownership and/or exacerbate the potentially deleterious effect of IPV on children's mental health.

OBJECTIVE

The current study evaluates whether and to what extent the associations between exposure to IPV and several indicators of children's mental health vary as a function of children's positive engagement with pets and exposure to AC.

PARTICIPANTS AND SETTING

Participants included 204 children (aged 7-12 years; 47% female; 57% Latinx) and their maternal caregiver who were recruited from domestic violence agencies in a western U.S. state.

METHOD

Multiple moderation analysis evaluated whether the association between children's exposure to IPV and internalizing and posttraumatic stress symptoms vary as a function of children's positive engagement with pets and exposure to AC.

RESULTS

Analyses revealed several moderation effects for positive engagement with pets (e.g., internalizing problems: [b = -.15, t(195) = -2.66, p = .008]; posttraumatic stress symptoms: [b = -.13, t(195) = -2.24, p = .026]), whereas exposure to AC only moderated the association between IPV and anxious/depressed symptoms (b = .32, t(195) = -2.41, p = .017).

CONCLUSIONS

These findings highlight the potential protective effects of positive engagement with pets and importance of screening for exposure to AC when engaging in trauma-informed work with children exposed to IPV.

A Systematic Review of Risk and Protective Factors for Externalizing Problems in Children Exposed to Intimate Partner Violence

Intimate partner violence (IPV) is a serious public health issue with innumerable costs to the victims, children, and families affected as well as society at large. The evidence is conclusive regarding a strong association between exposure to IPV and children's externalizing problems. Moving forward, the next step is to enhance our understanding of risk and protective factors associated with these outcomes in order to tailor treatments to meet the needs of both parents and children. The databases Medline, PubMed, and PsyINFO were searched combining variations of the key words such as parent*, child*, mother, partner abuse, domestic abuse, spousal abuse, interpersonal violence, domestic violence, or intimate partner violence. This search were combined with child externalizing behaviors specifically conduct*, oppositional defiant disorder, externaliz*, aggress*, hyperactivity, and ADHD. A total of 31 studies from all three databases were reviewed following application of inclusion and exclusion criteria. The main findings were that child age and gender, callous-unemotional traits, cognitive appraisals, maternal mental health, and quality of parenting emerged as key mediating and moderating factors of the relationship between IPV exposure and child externalizing problems. These findings suggest that interventions provided to families exposed to IPV need to target both maternal and child risk factors in order to successfully reduce child externalizing problems.

"Getting my Independence Back": Economic solvency program ideas from residents of a women's shelter

OBJECTIVE

Intimate partner violence (IPV) is a serious public health issue that affects many women all over the world. One of the most consistent risk factors for IPV is poverty. On the other hand, IPV is also a risk factor for continued poverty, which puts many women in a cycle of violence and poverty that is difficult to escape. Interventions are needed to help women improve their economic solvency and decrease their poverty-based risk for IPV.

DESIGN

The current study is a qualitative study to examine how women who have experienced IPV would plan and execute an intervention to improve economic solvency.

SAMPLE

The participants were 21 diverse women living in a women's shelter.

RESULTS

The major themes that came from the women's suggestions were as follows: addressing mental health, accountability, financial management classes, job skills and education, and other resources.

CONCLUSION

Implications of this study include the need for more comprehensive programs, a general desire amongst the women for mentoring and accountability, and the need to address knowledge deficits about resources. This information can help resource providers to help build interventions to improve economic solvency in women who have experienced IPV and improve their overall safety.

Maternal reflective functioning, interpersonal violence-related posttraumatic stress disorder, and risk for psychopathology in early childhood

The aim of this study was to examine associations between maternal mentalization, interactive behavior, and child symptoms in families in which mothers suffer from interpersonal violence-related posttraumatic stress disorder (IPV-PTSD). Fifty-six mothers and children (aged 12-42 months) including mothers with a diagnosis of IPV-PTSD were studied. Mentalization was measured by the Parental Reflective Functioning (PRF) Scale. Interactive behavior during free-play was measured via the CARE-Index. Child symptoms were measured by the Infant-Toddler Social and Emotional Assessment (ITSEA). Data analyses included non-parametric correlations and multiple linear regression. Results showed that lower IPV-PTSD and higher Maternal Reflective Functioning (MRF) were related to greater maternal sensitivity. Lower MRF and greater controlling behavior were related to child dysregulation. MRF was found to be lower in the subgroup of IPV-PTSD when the child's father was the perpetrator of IPV. Both MRF and interactive behavior are thus likely to be important targets for intervention during sensitive periods of early social-emotional development.

Mothers and Children Exposed to Intimate Partner Violence: A Review of Treatment Interventions

Although a growing field, much is still unknown about how different clinical and social care services might improve outcomes for female victims of intimate partner violence (IPV) and their children who are indirectly exposed to it. This review sought to characterize the structure of programs that have been tested and documented in existing literature, and the mechanisms by which change, if any, may occur. Seventeen individual interventions and two follow-ups (n = 19) were included in the review. Findings suggest that a multileveled program of mothers and children working both separately and jointly together across sessions might generate the most successful psychosocial recovery for mothers and children who have experienced violence in the home. The mechanism by which this happens is likely a collaborative one, focused on enhancing the dyadic interaction. This article adds to the growing evidence base on IPV and confirms the positive impact on well-being that programs for IPV victims can have. The evidence-base overall could benefit from testing and replicating a combination of the results found in this review.

Reporting Maltreatment to Child Protective Services in the Context of Intimate Partner Violence Research

Given the overlap between intimate partner violence (IPV) and child maltreatment, IPV-exposed child participants in research might disclose instances of child maltreatment. Such disclosures might require researchers to report the maltreatment to child protective services (CPS). However, the literature provides minimal guidance on how to navigate the complex challenges and ethical dilemmas around reporting in the context of research. To help address this gap and stimulate discussion regarding protocols and policies for reporting child maltreatment, this article presents a CPS reporting protocol developed as part of a community-engaged research project evaluating a parenting intervention for system-involved mothers experiencing IPV.

The effectiveness of critical time intervention for abused women leaving women's shelters: a randomized controlled trial

Objectives

To examine the effectiveness of critical time intervention (CTI)—an evidence-based intervention—for abused women transitioning from women’s shelters to community living.

Methods

A randomized controlled trial was conducted in nine women’s shelters across the Netherlands. 136 women were assigned to CTI (n = 70) or care-as-usual (n = 66). Data were analyzed using intention-to-treat three-level mixed-effects models.

Results

Women in the CTI group had significant fewer symptoms of post-traumatic stress (secondary outcome) (adjusted mean difference − 7.27, 95% CI − 14.31 to − 0.22) and a significant fourfold reduction in unmet care needs (intermediate outcome) (95% CI 0.06–0.94) compared to women in the care-as-usual group. No differences were found for quality of life (primary outcome), re-abuse, symptoms of depression, psychological distress, self-esteem (secondary outcomes), family support, and social support (intermediate outcomes).

Conclusions

This study shows that CTI is effective in a population of abused women in terms of a reduction of post-traumatic stress symptoms and unmet care needs. Because follow-up ended after the prescribed intervention period, further research is needed to determine the full long-term effects of CTI in this population.

Electronic supplementary material

The online version of this article (10.1007/s00038-017-1067-1) contains supplementary material, which is available to authorized users.

Effects of interpersonal violence-related post-traumatic stress disorder (PTSD) on mother and child diurnal cortisol rhythm and cortisol reactivity to a laboratory stressor involving separation

Women who have experienced interpersonal violence (IPV) are at a higher risk to develop posttraumatic stress disorder (PTSD), with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and impaired social behavior. Previously, we had reported impaired maternal sensitivity and increased difficulty in identifying emotions (i.e. alexithymia) among IPV-PTSD mothers. One of the aims of the present study was to examine maternal IPV-PTSD salivary cortisol levels diurnally and reactive to their child's distress in relation to maternal alexithymia. Given that mother-child interaction during infancy and early childhood has important long-term consequences on the stress response system, toddlers' cortisol levels were assessed during the day and in response to a laboratory stressor. Mothers collected their own and their 12-48month-old toddlers' salivary samples at home three times: 30min after waking up, between 2-3pm and at bedtime. Moreover, mother-child dyads participated in a 120-min laboratory session, consisting of 3 phases: baseline, stress situation (involving mother-child separation and exposure to novelty) and a 60-min regulation phase. Compared to non-PTSD controls, IPV-PTSD mothers - but not their toddlers, had lower morning cortisol and higher bedtime cortisol levels. As expected, IPV-PTSD mothers and their children showed blunted cortisol reactivity to the laboratory stressor. Maternal cortisol levels were negatively correlated to difficulty in identifying emotions. Our data highlights PTSD-IPV-related alterations in the HPA system and its relevance to maternal behavior. Toddlers of IPV-PTSD mothers also showed an altered pattern of cortisol reactivity to stress that potentially may predispose them to later psychological disorders.

Maternal Intimate Partner Violence: Relationships with Language and Neurological Development of Infants and Toddlers

Objectives This longitudinal study examined the influence of Intimate Partner Violence (IPV) experience of pregnant women participating in the Domestic Violence Enhanced Home Visitation Program on the language and neurological development of infants and toddlers. Methods A total of 210 infants and toddlers born to women reporting low, moderate, and high levels of IPV were included in the analysis. Logistic regression analysis was used to determine the bivariate association between maternal IPV and risk of language and neurological delay of infants and toddlers and between covariates and language and neurological delay. Generalized estimating equation models with logit link was used to predict the risk of language and neurological delay of infants and toddlers as a result of maternal IPV. Results Infants and toddlers born to women exposed to moderate levels of IPV had increased odds of language delay compared to infants and toddlers of women who experienced low levels of violence (OR 5.31, 95 % CI 2.94, 9.50, p < 0.001). Infants and toddlers born to women who experienced moderate and high levels of IPV were at higher risk of neurological delay respectively, compared to infants and toddlers of women who experienced low levels of IPV (OR 5.42, 95 % CI 2.99, 9.82, p < 0.001 and OR 2.57, 95 % CI 1.11, 5.61, p = 0.026). Conclusions for Practice Maternal IPV is associated with increased risk of language and neurological delay of infants and toddlers. These findings have implications for health care for women and infants exposed to IPV. Clinicians including pediatricians working with pregnant women should screen for IPV throughout pregnancy to identify women and children at risk. Interventions to reduce maternal IPV and early intervention services for infants and toddlers exposed to IPV are necessary for optimal maternal and child health.