The effects of intimate partner violence on women and child survivors: an attachment perspective

Perinatal intimate partner violence among teen mothers and children's attachment disorders in Rwanda: potential mediating factors

Background: The alarming prevalence of teen mothers' exposure to perinatal intimate partner violence (IPV, 8.3-67%) and attachment disorders (ADs) among their children is a global concern, especially in sub-Saharan Africa with high teenage pregnancy rates. This study, therefore, aimed to examine the link between teen IPV and AD in their offspring. We sought also to explore the mediating roles of postpartum depression symptoms, maternal sensitivity, parenting stress, and perceived social support in the relationship between perinatal IPV and children's ADs.Method: This cross-sectional study selected a random sample of 309 teen mothers from Nyanza district. This sample size was determined using Yamane's formula, with random sampling. Various instruments were used for data collection, including questionnaires on intimate partner violence, social support, maternal sensitivity, postpartum depression symptoms and parenting stress and early trauma-related disorders. The data was analysed using SPSS, with mediation analyses performed using the PROCESS macro (version 4.1).Results: IPV was found to be significantly associated with attachment disorders. Simple mediation models showed that parenting stress completely mediated these relationships, while postpartum depression, perceived social support, and maternal sensitivity partially mediated the relationship between IPV and children's ADs. In parallel mediation model, the combined roles of all mediators fully mediated the associations between IPV and ADs.Conclusion: These findings offer valuable insights in designing or strengthening the appropriate interventions to prevent and mitigate the perinatal intimate partner violence and its detrimental impact on children's attachment disorders. Combating intimate partner violence in post-conflict situations is challenging in teen mothers, however, our results suggest that efforts to address maternal mental health and parenting practices may protect children from attachment disorders.

Parenting Among Women in Methadone Treatment: Contributions of Mental Health Problems and Violence Exposure

The aim of the current study is to explore factors associated with quality of parenting among women in treatment for opioid use disorders. 150 Black American women with 3-5 year old children were recruited through methadone treatment programs. Parenting representations were assessed through the Working Model of the Child Interview and parenting behavior through video recordings of mother-child interaction. Interviews were used to assess mothers' history of violence exposure and to make DSM diagnoses. Mothers' mood disorder was related to distorted representations and to expressions of concerned affect (anxiety, fear, guilt). Mothers' personality disorder was related to expressions of negative affect (anger and frustration) and inversely related to sensitive parenting behavior. Mothers' experience of family violence during childhood and partner violence during adulthood were related to concerned affect in their representations. Women in treatment for substance use disorder have complex and interconnected needs, including parenting supports and trauma-informed mental health services.

The Protective Effects of Parent-Child Emotion Dialogues for Preschoolers Exposed to Intimate Partner Violence

Exposure to intimate partner violence (IPV) during early childhood is associated with self-regulation difficulties. Caregivers can facilitate children's self-regulation through emotion-focused conversations about past experiences, buffering downstream effects. However, caregivers experiencing violence may avoid distressing emotions activated by such conversations. This paper explores two different models of relational stress responses, one involving indirect effects (i.e. spillover effects) and the other moderation (i.e. buffering effects). Mothers (n = 117), oversampled for violence exposure, self-reported on IPV and participated in an emotional reminiscing task with children (aged 3-5 years); narratives were coded for maternal sensitive guidance. Maternal sensitive guidance was related to children's self-regulation. Sensitive guidance did not have indirect effects in the association between IPV exposure and children's self-regulation, but did buffer the association between physical IPV and self-regulation; this pattern did not hold for psychological IPV. Results suggest sensitive guidance during reminiscing may promote self-regulation in contexts of high IPV.

Longitudinal Patterns of Multidimensional Violence Exposure and Adolescent Early Sexual Initiation

Early sexual intercourse is associated with sexually transmitted infections, pregnancy, and depressive symptoms, and delay of intercourse allows adolescents opportunities to practice relationship skills (Coker et al., 1994; Harden, 2012; Kugler et al., 2017; Spriggs & Halpern, 2008). Thus, understanding predictors of early sexual intercourse is crucial. Prior research has suggested that violence exposure is associated with early initiation of sexual intercourse in adolescence (Abajobir et al., 2018; Orihuela et al., 2020). However, most studies have looked only at a single type of violence exposure. In addition, little research has examined longitudinal patterns of violence exposure in order to determine whether there are particular periods when the violence exposure may have the strongest impact on sexual behavior. Guided by life history and cumulative disadvantage theories, we use longitudinal latent class analysis and data from the Future of Families and Child Well-being Study (N = 3,396; 51.1% female, 48.9% male) to examine how longitudinal patterns of multiple types of violence exposures across ages 3 to 15 are associated with early sexual initiation in adolescence. Findings suggest that experiencing persistent physical and emotional abuse across childhood was associated with the greatest prevalence of early sexual initiation. Early exposure to violence was not consistently associated with greater likelihood of sexual initiation; instead, early abuse was more strongly associated with sexual initiation for boys, while late childhood abuse was more strongly associated for girls. These findings suggest that gender-sensitive programs are highly needed to address unique risk factors for boys' and girls' sexual behaviors.

Intimate Partner Violence and Children: Essentials for the Pediatric Nurse Practitioner

Intimate partner violence (IPV) is a public health problem of epidemic proportions. IPV often starts early in adolescence and continues throughout an individual's lifespan. IPV is defined as abuse or aggression occurring in the context of a romantic relationship that is perpetrated by a current or former partner. IPV victims often experience severe psychological trauma, physical injury, and even death. The direct recipient of the violence is often not the only individual impacted. Children are often peripheral victims of IPV. It is vital that pediatric health care providers, including pediatric nurse practitioners, recognize that IPV is indeed a pediatric health care crisis requiring strategies for both identification and intervention. This continuing education article will discuss IPV and its impact on children from conception to adolescence while exploring implications for practice.

Longitudinal Association Between Intimate Partner Violence and Alcohol Use in a Population Cohort of South African Women

Intimate partner violence (IPV) is a common traumatic stressor for women worldwide, especially for women living in low-and-middle-income countries. One of the most common correlates of IPV victimization is alcohol use, but the dynamics of IPV and drinking among women are not well understood. Although some research suggests that women drink in the aftermath of IPV to cope with distress related to the violence they experienced, other studies imply that higher levels of alcohol use among one or both partners in a relationship make violence more likely. In this study, we examine this question in a secondary analysis of a longitudinal study of a population cohort of pregnant women in South Africa (N = 1238) using a Bayesian approach to latent growth curve structural equation modeling. Results indicate that on average, IPV decreases and alcohol use increases over time and that these trajectories are associated with each other. Further, results suggest that although IPV drives drinking (rather than the other way around), higher average levels of alcohol use are associated with a slower decrease in IPV. Findings have implications for future research on the association between IPV and alcohol use, as well as for clinical intervention for women who experienced IPV.

Adult Attachment as a Mediator of the Link Between Interpersonal Trauma and International Classification of Diseases (ICD)-11 Complex Posttraumatic Stress Disorder Symptoms Among College Men and Women

Previous research indicates that insecure attachment patterns are associated with interpersonal trauma and posttraumatic symptomatology, and that they mediate various trauma-related symptoms. However, no study to date has examined whether these patterns mediate the link between interpersonal trauma and the newly recognized diagnostic features of complex posttraumatic stress disorder (CPTSD), as published by the World Health Organization (2019) in the 11th version of the International Classification of Diseases (ICD-11). Mediators of CPTSD are important to identify because they can provide a deeper understanding of the condition's etiology. Moreover, if amenable to clinical intervention, they can be targeted to improve treatment effectiveness. The purpose of the present study was to formally test our hypothesis that two underlying dimensions of adult attachment insecurity (i.e., attachment anxiety and avoidance) would mediate the link between interpersonal trauma and ICD-11 CPTSD symptoms. Participants were a culturally diverse sample of 169 college men and women. They completed a modified version of the Life Events Checklist (LEC-5), the revised Experiences in Close Relationships (ECR-R) scale, and the International Trauma Questionnaire (ITQ). Results of path analysis partially supported our hypothesis, indicating that attachment anxiety, but not avoidance, partially mediated the link between interpersonal trauma and PTSD and DSO ("Disturbances in Self-Organization") features of CPTSD. Although longitudinal research is needed, findings suggest that attachment anxiety may contribute to the development and maintenance of CPTSD symptoms following interpersonal trauma. Clinical interventions that help individuals rework and integrate representations of attachment that involve a fear of not being able to access adequate care and protection, and a negative view of self may be particularly useful in ameliorating the symptoms of CPTSD.

Childhood maltreatment: The role of concurrent advantageous experiences on adolescents' psychosocial adjustment

Despite the growing body of evidence concerning the harmful effects of childhood maltreatment, intimate partner violence exposure (IPVE) and their correlates, little is currently known about the effects of co-occurring advantageous family conditions (e.g., instrumental support, inductive parenting, positive communication) and how they may serve to offset the detrimental effects of maltreatment and IPVE. The present study applied a three-step latent class analysis to identify the co-occurrence patterns of childhood maltreatment and advantageous family conditions among 1379 Spanish adolescents. The study also sought to identify the sociodemographic risk markers and psychosocial adjustment associated with each latent class membership. The analyses revealed four classes, namely (1) violent family context, (2) emotionally neglectful family context, (3) adverse and advantageous family conditions, and (4) positive family context. Having a lower socioeconomic status and being a migrant were both risk markers for membership to the violent family context as well as to the adverse and advantageous family conditions class. Adolescents who were exposed to advantageous family conditions (e.g., the positive family context or the adverse and advantageous family conditions) exhibited fewer psychosocial problems (e.g., depression, anxiety, somatisation) and lower frequencies of teen dating violence (TDV) when compared with those in the violent family context. Moreover, membership to the emotionally neglectful family context class was related to more psychological symptoms and a higher prevalence of TDV when compared with membership to the positive family context class, despite the absence of IPVE and maltreatment. Overall, the results provide evidence that advantageous family conditions contribute to better psychosocial adjustment on the part of adolescents even when exposed to IPV and maltreatment. Identifying the experiences that contribute to adolescents' psychosocial adjustment could help clinical and governmental interventions tailor their often-limited resources to children who are at greater risk of negative outcomes.

Association Between Intimate Partner Violence Subtypes and Post-traumatic Stress Disorder Symptoms and Hazardous Substance Use

Intimate partner violence (IPV) is a common problem for women in the United States and is associated with symptoms of post-traumatic stress disorder (PTSD) as well as hazardous use of substances like alcohol and drugs. However, not all subtypes of IPV (i.e., physical, sexual, and psychological) are equally predictive of PTSD and hazardous substance use. Although previous research suggests that psychological IPV has the strongest relative effect on PTSD symptoms and substance use, there is less research on IPV subtypes' cumulative effects. In this study, we examined the relative and cumulative effects of physical, sexual, and psychological IPV on PTSD symptoms and hazardous substance use in a sample of women in the United States recruited via Amazon's Mechanical Turk (N = 793) using bootstrapped multiple regression and configural frequency analyses. Results suggest that physical IPV had the most pronounced influence (medium-large effect sizes) on substance use across women, but that the cumulative effects of all three IPV subtypes were most closely associated with diagnostic levels of both PTSD and substance use at the level of groups of women. These findings clarify and extend previous research on the differential effects of IPV subtypes and provide directions for future research and clinical intervention.

The Role of Complex Trauma and Attachment Patterns in Intimate Partner Violence

OBJECTIVE

Even if the relationship between adverse childhood experiences and intimate partner violence (IPV) has already been established, there are no sufficient studies examining the relationships between these factors and attachment representations, specifically attachment disorganization. Thus, this study aimed to explore, in a sample of women who experienced IPV (a) the presence of interpersonal adversities during childhood, and (b) attachment representations, with a particular focus on disorganization.

METHODS

Women's representations of attachment experiences were investigated through the Adult Attachment Interview, while the presence of various forms of interpersonal adversities during childhood was assessed using the Complex Trauma Questionnaire. The results of the IPV group (n = 98) were compared with those of women with no history of IPV (control group, n = 81).

RESULTS

Women in the IPV group showed higher values of multiple forms of adverse experiences within their caregiving system. They presented significantly higher rates of disorganized states of mind regarding attachment, indicative of a lack of resolution regarding traumatic experiences, and of disorganized working models resulting from complex trauma. Our results highlighted that, more than the presence of traumatic experiences, it is their irresolution - reflected in the disorganized states of mind regarding attachment at the Adult Attachment Interview - to be a significant predictor of IPV.

CONCLUSION

These results suggest underline the significance of offering a trauma- and attachment-informed therapy to those who experience IPV. Such results could help both clinicians and researchers in formulating clearer guidelines for IPV interventions.

The Mediating Role of Cognitive Processing in the Relationship Between Negative and Positive Effects of Trauma Among Female Victims of Domestic Violence

Exposure to domestic violence may lead not only to negative but also positive consequences of trauma. Negative effects are indicated by posttraumatic stress symptoms (PTSSs), and positive effects by posttraumatic growth (PTG) changes. PTG has been conceptualized to follow experiences of PTSSs. Therefore, the positive and negative effects of trauma appear to be related to one another. The cognitive processing may play a special role in determining whether the positive and negative consequences of trauma exposure are experienced. The aim of the study was to establish the mediating role of multiple patterns of cognitive processing, reflected by the cognitive strategies used to cope with trauma, in the relationship between negative and positive posttraumatic changes in women following domestic violence. Data were obtained from 63 Polish women who had experienced domestic violence. The age of the respondents ranged from 19 to 71 years (M = 42.25, SD = 14.81). The Polish versions of the following standardized tools were used: the Posttraumatic Stress Disorder Checklist (PCL-5), the Posttraumatic Growth Inventory (PTGI), and the Cognitive Processing of Trauma Scale (CPOTS). PTSS severity appeared to be negatively related to that of PTG. Negative coping strategies were positively related to the PTSS severity but negatively to PTG, while positive strategies were negatively related to the PTSS severity but positively to PTG. Cognitive strategies for coping with trauma, such as resolution/acceptance, downward comparison, and regret, appeared to play a mediating role in the relationship between PTSS severity and PTG. Positive coping strategies strengthen the occurrence of positive posttraumatic changes while strategy of regret weakens the PTG changes occurrence. The process of adaptation and human development among people who have experienced traumatic events is favored by the use of more frequent positive and less frequent negative strategies of dealing with trauma.

Depression in childhood: The role of children's exposure to intimate partner violence and maternal mental disorders

BACKGROUND

Intimate partner violence (IPV) is a global problem with high prevalence rates, and is linked to maternal mental disorders (MMD). Children's exposure to IPV (CEIPV) can have impacts on their physical and mental health, including depression.

OBJECTIVE

To analyze the associations between exposure to both CEIPV and MMD and depression in schoolchildren.

PARTICIPANTS AND SETTING

630 mother-child pairs were evaluated in a poor urban district in Recife, Northeast Brazil.

METHODS

A cohort study investigated the effects of IPV during pregnancy, postpartum and six to nine years after delivery. Women were asked about their experience of IPV, their own mental health, and the exposure of their child to violence. The child's mood was reported by the mother, using the Short Mood and Feelings Questionnaire (SMFQ). Ten types of CEIPV, and the age of onset of exposure, were compared with the child's subsequent risk of depression.

RESULTS

IPV was associated with MMD in 31.9% of the women at some period of time. Depressive symptoms were reported in 15.7% of school-age children. All types of CEIPV were associated with depression at school age. Multivariable analyses of exposure to IPV and MMD at different ages showed that exposure to both IPV and MMD in the first year of life had the strongest association with childhood depression (OR = 9.1; 95% CI: 2.4-33.9).

CONCLUSIONS

The frequency of CEIPV and MMD, and the high prevalence of depression at school age, shows the importance of assessing MMD and identifying exposure to IPV in pregnancy and the early years.

Estilos de Apego en Mujeres Víctimas de Violencia

La violencia contra la mujer ha sido tipificada como un grave problema de salud pública con elevados índices que varían de acuerdo con la región. Existen muchos factores asociados, tales como el abuso de alcohol, depresión, patrones familiares de violencia de género que representan experiencias vividas de violencia, entre estos, el apego a la pareja es uno de los más frecuentes y se constituye una barrera para no afrontar una relación cargada de maltrato y violencia. Esta investigación la cual tiene un enfoque cualitativo y de tipo descriptivo, y cuyo objetivo es describir el estilo de apego predominante en mujeres víctimas de violencia a través de la aplicación de pruebas psicométricas, para contribuir a mejorar el abordaje terapéutico. Se realizó un estudio de campo, con 28 mujeres víctimas de violencia por parte de su pareja que acudieron a la Fundación Nosotras con Equidad en la ciudad Riobamba, Ecuador. Los datos se obtuvieron a través de la aplicación del Cuestionario de Evaluación del apego adulto de Melero y Cantero (2008), se analizaron con frecuencias absolutas y relativas. A través de los resultados, se pudo determinar el estilo de apego entre las mujeres participantes, siendo el más predominante el estilo huidizo-temeroso, seguido de huidizo-alejado y preocupado. El estilo afectivo-seguro se presentó en la escala muy bajo.

Women and Violence: Alexithymia, Relational Competence and Styles, and Satisfaction with Life: A Comparative Profile Analysis

Background: This research investigates the two sides of violence by profiling female interpersonal violence offenders (IVO) and female interpersonal violence victims (IVV). These groups of women have been compared on three key variables within the context of violence: satisfaction with life (SWL), alexithymia, and relational styles-defined according to the Relational Competence Theory (RCT). Regarding the latter, the experience of functional or dysfunctional relational styles in childhood and adult relationships has been evaluated and compared with both groups of women. Methods: This study involved 131 women: IVO (n = 41; enrolled in a penitentiary), IVV (n = 41; enrolled in an anti-violence center), and a control group (CG; n = 49; enrolled from the general population). Profile analysis was performed. Results: Female IVO showed low SWL, high levels of alexithymia, and a pattern of mixed relational styles with both parents and the current partner. Female IVV revealed low SWL, low levels of alexithymia and dysfunctional relational styles with both parents and current partner. Women from the CG showed high SWL, absence of alexithymia and functional relational styles with both parents and current partner. Conclusions: The profiles outlined in this study are extremely informative regarding alexithymia, relational styles, and SWL in both female IVV and IVO. Clinical interventions for both groups of women should be developed relying on these results.

Postpartum Depressive Symptoms as a Mediator Between Intimate Partner Violence During Pregnancy and Maternal-Infant Bonding in Japan

Studies show that experiencing intimate partner violence (IPV) during pregnancy is related to poor maternal-infant bonding. However, the mechanisms underlying this relationship are unclear. This article aims to examine whether maternal postpartum depressive (PPD) symptoms mediate the association between pregnancy IPV and maternal-infant bonding, and whether the relationship differs by maternal-infant bonding subscales-lack of affection, anger/rejection. A survey was conducted among women who participated in a postpartum health check-up program in Aichi prefecture, Japan (N = 6,590) in 2012. We examined whether experiences of emotional and physical IPV were related to maternal-infant bonding and whether PPD symptoms mediated this relationship. Path analysis showed that emotional and physical IPV were associated with PPD symptoms, and PPD symptoms predicted poor bonding. The total effect of emotional IPV on poor bonding was significant, showing a marginally significant direct effect and statistically significant indirect effect. The total effect of physical IPV on poor bonding was not statistically significant. Emotional IPV was significantly associated with both lack of affection and anger/rejection bonding subscales, which were similarly mediated by PPD symptoms. Findings revealed a modest indirect association between IPV, emotional IPV in particular, and poor maternal-infant bonding, which was mediated by PPD symptoms. While prevention of IPV is the ultimate goal, the treatment of PPD symptoms among women who experience IPV during pregnancy may improve maternal-infant bonding and mitigate cross-generational effects of IPV. Identifying opportunities for detection of IPV and PPD symptoms, as well as prevention and early intervention, may improve maternal-infant bonding.

Mothers' Experience of Intimate Partner Violence and Subsequent Offspring Attachment Security Ages 1-5 Years: A Meta-Analysis

Attachment status in early childhood is a key yet modifiable contributor to the development of social-emotional competence. The security and organization of the infant-mother attachment bond is particularly susceptible to stressors in the caregiving environment. While the impacts of normative interparental conflict on infant attachment are increasingly understood, the potentially unique place of intimate partner violence (IPV) in this pathway has been under-researched. This study surveyed all empirical work in this area, including unpublished literature (k = 6, N = 3,394), to examine meta-analytic associations between maternal experiences of IPV and offspring attachment security (ages 1-5 years) measured at least 6 months post-IPV exposure. Mothers' reports of IPV from pregnancy onward were inversely associated with offspring attachment security, r = -.23, CI [-0.42, -0.04], p = .02. Sample risk characteristics (e.g., clinical vs. community) moderated this association; child's age at attachment measurement and method of assessing child attachment (e.g., observational, representational, parent report) also moderated at a trend level. Implications for early screening, intervention, and future research are discussed.

Pathways From Witnessing Parental Intimate Partner Violence to Involvement in Bullying: Empirically Testing a Proposed Conceptual Framework

We tested a proposed conceptual framework in which we hypothesized that witnessing parental intimate partner violence (witnessing parental IPV) is linked to children's bullying and peer victimization. We also hypothesized that the relationship between witnessing parental IPV and bullying and peer victimization in childhood would be mediated by increased psychological problem behavior, school absences, and problematic peer interactions. We utilized data from the National Survey of Children's Health. We found that witnessing parental IPV was positively related to children's bullying and peer victimization not only directly, but also indirectly through the mediating role of psychological problem behavior, school absences, and problematic peer interactions. Our findings highlight the importance of exploring the mechanisms by which bullying and peer victimization increase in those who have witnessed parental IPV.

Impact of Intimate Partner Violence on Parenting and Children's Externalizing Behaviors: Transactional Processes Over Time

This study used longitudinal data to examine the transactional associations between mothers’ spanking and mother–child relationship quality with children’s externalizing behaviors in the context of intimate partner violence (IPV). Data came from a sample of 1,152 low-income mothers with children age 10–14 years. Results showed that past-year IPV triggered transactional associations by increasing children’s externalizing behaviors which, in turn, increased spanking and subsequently more externalizing behaviors. Transactional associations were also found for relationship quality. All outcomes used were mothers-reported except relationship quality. Implications for practice include the importance of the mother–child dyad and their reciprocal processes in assessment and treatment.

The Experience of the Infant Entering Refuge (Shelter) Setting with Their Mothers After Fleeing Family Violence

Almost nothing is known about how the infant may experience being in a women's Refuge (Shelter) setting with their mother after fleeing family violence, despite the high numbers of infants and young children in Refuges or Shelters. This research was concerned with exploring how the infant experienced refuge within a Refuge setting post family violence. Using a non-intrusive, ethically informed, 'infant led' approach, this research involved ten infants (aged 3 weeks to 16 months), ten mothers, and 13 staff in eight Refuges from three countries: Australia, Scotland and England. Data was collected through infant observation, interviews with mothers and then staff. Presented is a synthesis of a research methodology which was led by the infant, drew on concepts of 'inter-subjectivity' and used a constructivist grounded theory method. Infants were often lost from view within the Refuge setting. The mother, herself traumatised, was expected to be the refuge for her infant. Only the obviously distressed infant was assisted, and where available, from outside specialist workers. It was often too painful for the adults, both mothers and staff, to see or reflect on the infant's possible trauma. Significantly, in all cases the motivation for each mother to enter Refuge was ensuring their infant's safety. Concern for their infant or young child can be a powerful catalyst for women leaving a violent relationship. Refuges (Shelters) are in a unique position to respond to the infant in their own right whilst helping to heal and grow the infant/mother relationship.

Intimate partner violence and child attachment: A systematic review and meta-analysis

BACKGROUND

Intimate Partner Violence (IPV) is associated with increased risk of impairment to a child's emotional, behavioural, and psychological functioning. Further, the presence of IPV is negatively associated with a child's attachment to their primary caregivers, which is an additional risk factor for social, emotional, and psychological impairment.

OBJECTIVE

The aim of this systematic review and meta-analysis was to synthesise the evidence on the association between IPV and the attachment of infants, children, and adolescents to their primary caregiver/s.

METHOD

A systematic review was completed, in accordance with the PRISMA statement, on IPV and the parent-child attachment of infants, children, and adolescents (18 years and younger). Meta-analyses were conducted to estimate the magnitude of these associations.

RESULTS

A total of 15 studies were included. IPV was significantly associated with less secure child attachment. The pooled effect sizes (Pearson's r) for both longitudinal studies (n = 5) and cross-sectional and retrospective studies combined (n = 10) were small (r = -.22, 95 % CI [-.32, -.12], p < .001; r = -.10, 95 % CI [-.203, -.001], p = .048). Subgroup analyses identified that the effect size was larger when IPV and attachment were measured during infancy compared to childhood, and when attachment was measured via observational methods compared to self-report.

CONCLUSION

While the current literature base is limited, findings can inform further research alongside clinical assessment and intervention. It can also help guide attachment- and family-based intervention for families impacted by IPV.

Influence of personality traits on college women's appraisals of intimate partner violence

Intimate partner violence (IPV) is a common traumatic stressor for young adult women and results in a number of problems for those who experience it. The appraisals women make of IPV influence the degree of distress they experience in the aftermath of IPV. Research suggests that personality traits may influence IPV appraisals, although there are relatively few studies of this. In this study, we examine the association between Five Factor Model personality traits (i.e., Agreeableness, Conscientiousness, Extraversion, Neuroticism, and Openness) and appraisals of IPV in a sample of young adult women in college who experienced IPV (N = 241) using a Bayesian approach to multiple regression. Results suggest that Agreeableness, Extraversion, and Neuroticism predicted different styles of appraisals over and above the effect of IPV severity. Study findings clarify previous research on the role of personality traits in the response to IPV and suggest directions for future research.

Psychological Distress and Posttraumatic Stress Symptoms: The Role of Maternal Satisfaction, Parenting Stress, and Social Support Among Mothers and Children Exposed to Intimate Partner Violence

Studies of the effects of intimate partner violence (IPV) on parenting have usually not examined the role of the maternal perceptions, either its stress or maternal satisfaction, on the mothers' and children's mental health functioning. The present study aimed to assess whether maternal satisfaction, parenting stress, and social support are significantly associated with women's psychological functioning. The study also assessed whether maternal perceptions of the role of parenting were significantly associated with children's emotional well-being and social behavior. The sample included 160 mothers, 79 (49.4%) who were living with the aggressors and 81 (50.6%) in shelters, and their children (n = 61). The findings suggested that high levels of maternal satisfaction and perception of social support were significantly negatively associated with women's posttraumatic stress disorder (PTSD) symptoms and psychological distress, whereas parenting stress was significantly positively associated with these outcomes. Maternal satisfaction was the only parenting variable that predicted both maternal mental health and children's emotional and behavioral problems, suggesting that it is a protective factor for both mothers and children. This study suggests that increasing maternal satisfaction with parenting and reducing parenting stress might promote better adjustment for both women and children victims of IPV.

Adult Attachment Security and Different Types of Relational Violence Victimization Among College-Age Couples

This study aims to understand the associations between adult attachment security and different types of intimate partner violence victimization including that of emotional abuse, physical violence, and sexual coercion among heterosexual couples. Participants included 87 couples with the mean age 22.3 years. An actor-partner interdependence model was fit to the data. Findings indicated that adult attachment security accounted for 15% of the variance in the emotional abuse victimization of females, 9% of the variance in the sexual coercion victimization of females, and 7% of the variance in minor physical victimization of males. This may significantly impact risk factor assessment, and contribute to improved therapeutic intervention and increased understanding of the development and progression of relationship violence.

Interpersonal Style and Posttraumatic Stress Disorder Symptoms in Female Victims of Dating Violence

Symptoms of posttraumatic stress disorder (PTSD) are some of the most common mental health symptoms women experience following exposure to dating violence (DV). However, not all women who experience DV exhibit PTSD symptoms. One factor that may influence whether or not women exhibit PTSD symptoms in the aftermath of DV exposure is interpersonal style, often operationalized in terms of two orthogonal dimensions, warmth and dominance. In this study, we examined the main and moderating effects of warmth and dominance on the association between DV and PTSD symptoms using latent moderating structural equation modeling in a sample of 303 female college students who reported DV exposure in the past year. Results indicated that warmth exerted a main effect predicting fewer PTSD symptoms. In addition, dominance moderated the association between DV and PTSD symptoms such that at high levels of DV, women who were high on dominance reported fewer PTSD symptoms than did women who were low on dominance. These findings suggest that aspects of interpersonal style may promote resilience to symptoms of posttraumatic stress following DV exposure. Directions for future research are also discussed.

Perinatal depression, PTSD, and trauma: Impact on mother-infant attachment and interventions to mitigate the transmission of risk

Early interactions between infants and their caregivers are fundamental to child development, and the parent-infant relationship is believed to provide the foundation for healthy and secure attachment relationships and for infant mental health. Over time, these secure attachment relationships become the backbone for positive child outcomes across development. Abundant research to date confirms that parental mental illness, including depression and PTSD following trauma exposure, may have a detrimental impact on parenting quality and subsequent early child relationship formations. This review paper summarizes the literature on the role of sensitive parenting and a healthy mother-infant relationship in establishing a secure mother-infant attachment bond, which in turn is critical for the child's healthy socioemotional and cognitive development. The review also highlights the roles of maternal perinatal depression, PTSD, and/or exposure to interpersonal violence or childhood maltreatment onto parenting, bonding, and child attachment style towards the caregiver. The final section discusses existing therapeutic interventions and approaches that bolster early parenting practices and early maternal-child relationships. Specific emphasis is placed on relational interventions that address bonding and attachment disturbances in the context of maternal perinatal mental health risk and trauma.

Changes in Couple Relationship Dynamics among Low-Income Parents in a Relationship Education Program Are Associated with Decreases in Their Children's Mental Health Symptoms

Witnessing intimate partner violence (IPV) among parents negatively impacts millions of children in the United States each year. Low-income families are disproportionately affected by IPV compared to middle- and high-income individuals, and are beginning to be the focus of IPV secondary prevention interventions, including relationship education programs. Despite these developments, few studies have examined changes in psychosocial functioning among children of parents participating in relationship education programs. The current study examined the extent to which changes in specific couple dynamics among individuals from low-income backgrounds participating in a couple relationship education program, Within My Reach, were associated with changes in child mental health symptoms. A second purpose of this paper is to examine whether changes in parent–child relationship quality mediates the association between changes in couple dynamics and changes in child mental health difficulties. Participants (n = 347) were parents who participated in Within My Reach as part of programming offered at a large community agency. Decreases in negative couple conflict behaviors, including conflict engagement, withdrawal and compliance, over the course of the program were linked to decreases in child mental health difficulties. In addition, increases in parent–child relationship quality partially mediated the associations between decreases in compliance, as well as increase in overall couple relationship quality, and decreases in child symptoms. Community-based couple relationship education programs for low-income families can potentially have multiple positive impacts throughout the family system, including for children.

From "Buzzword" to Best Practice: Applying Intersectionality to Children Exposed to Intimate Partner Violence

Empirical studies on the impact of intimate partner violence (IPV) on children have burgeoned over the last three decades. Notably absent from existing approaches to studying children exposed to IPV, however, is attention to how various positionalities intersect to impact the experiences of children and their families. In fact, while the importance of an intersectional framework for understanding IPV has been discussed for over two decades, little or no attention has been given to issues of children's exposure to IPV. In this article, we examine the current state of the literature on children exposed to IPV through an exploratory meta-analysis, finding limited application of intersectionality and a focus on discrete categories of difference. We then demonstrate why and how an intersectional framework should be applied to children exposed to IPV, with specific strategies for research and policy. We suggest a child-centered approach that recognizes diversity among children exposed to IPV, extending the challenge to traditional "one-size-fits-all" models to include an intersectionality-informed stance.

A Diagnosis of Denial: How Mental Health Classification Systems Have Struggled to Recognise Family Violence as a Serious Risk Factor in the Development of Mental Health Issues for Infants, Children, Adolescents and Adults

Child and adolescent mental health services (CAMHS) routinely overlook assessing for, and providing treatment to, infants and children living with family violence, despite family violence being declared endemic across the globe. As contemporary neuro-developmental research recognises the harm of being exposed to early relational trauma, key international diagnostic texts such as the DSM-5 and ICD-10 struggle to acknowledge or appreciate the relational complexities inherent in addressing family violence and its impacts during childhood. These key texts directly influence thinking, funding and research imperatives in adult services as well as CAMHS, however, they rarely reference family violence. Their emphasis is to pathologise conditions over exploring causality which may be attributable to relational violence. Consequently, CAMHS can miss important indicators of family violence, misdiagnose disorders and unwittingly, not address unacceptable risks in the child's caregiving environment. Notwithstanding urgent safety concerns, ongoing exposure to family violence significantly heightens the development of mental illness amongst children. CAMHS providers cannot and should not rely on current diagnostic manuals alone. They need to act now to see family violence as a significant and important risk factor to mental health and to treat its impacts on children before these develop into enduring neurological difficulties.

Presence of children in the home and intimate partner violence among women seeking elective pregnancy termination

Introduction

Growing evidence identifies adverse health effects for children who witness intimate partner violence at home. Research has also identified that women seeking elective pregnancy termination are at high risk for partner violence. However, little is known about the risk for violence exposure among the children of women seeking elective pregnancy termination.

Methods

We conducted a cross-sectional study of 957 women seeking elective pregnancy termination at a large family planning clinic. All subjects completed a 10-minute, anonymous questionnaire administered by computer in a private room. Our main outcome was 12-month prevalence of physical and/or sexual violence by a current or former partner using the Abuse Assessment Screen instrument. The presence of children under the age of 18 living with the respondent was the main exposure variable.

Results

Women with children in the home had more than twice the odds of reporting physical and/or sexual IPV in the past year than women with no children, controlling for age (AOR: 2.23; 95% CI: 1.41–3.85). The increased odds of IPV among women with children as compared to women with no children was present across nearly all sociodemographic and lifestyle characteristics, and significantly higher for the youngest women (18–20 years). The highest odds for abuse occurred among women with children living at home, in a current relationship but not living with their current partner, and abused by a former partner (AOR = 10.9; 95% CI: 3.07–38.4).

Conclusion

Nearly one of every 14 children identified in this study lived in a home with IPV. These findings support the development of IPV interventions that are family-centered, as well as the integration of trauma-informed care into healthcare settings. Healthcare visits for contraception and pregnancy termination may be ideal opportunities for implementation of screening and family violence interventions.

Main and Moderating Influence of Temperament Traits on the Association Between Intimate Partner Violence and Trauma Symptoms

Trauma symptoms are common among survivors of intimate partner violence (IPV), although not all women who experience IPV develop trauma symptoms. One of the factors that may influence whether women develop trauma symptoms upon exposure to IPV is temperament. In this study, we examined the main and moderating effects of temperament traits (constraint, negative emotionality, and positive emotionality) on the association between IPV and trauma symptoms in a sample of young adult women ( N = 654) using a Bayesian approach to multiple linear regression to address significant non-normality in the data. Our results indicated that each temperament trait incrementally predicted trauma symptoms over and above the effects of IPV and other negative life events. Results further indicated that both negative emotionality and constraint moderated the influence of IPV on trauma symptoms such that IPV was positively associated with trauma symptoms at high levels of these traits but not at low levels. However, these effects differed depending on the type of violence experienced (physical, sexual, or psychological). These results extend previous research on the influence of temperament traits to the context of IPV; this underscores the importance of incorporating temperament in the study of IPV, as well as in the study of traumatic stress more generally.

Childhood Victimization, Attachment, Coping, and Substance Use Among Victimized Women on Probation and Parole

Justice-involved women report high rates of victimization across their life span, and these experiences contribute to their involvement in the criminal justice (CJ) system. Within this population, research has identified an overlap among victimization and substance use, a high-risk coping mechanism. Furthermore, research indicates attachment style is related to coping and high-risk behaviors. Research is needed to understand the relationship among these mechanisms as they relate to intimate partner violence (IPV). To address this gap, this study investigated the relationship between attachment, coping, childhood victimization, substance use, and IPV among 406 victimized women on probation/parole. Results of 6 multivariate regression analyses were statistically significant, accounting for 8%-13% of the variance in IPV. Particularly, childhood sexual victimization and negative coping were significant in all analyses. Findings provide practitioners, administrators, and policymakers information about the specific needs of justice-involved women.

Unresolved attachment and agency in women victims of intimate partner violence: A case-control study

OBJECTIVES

Women victims of IPV are more likely insecurely attached and have experienced childhood abuse, which according to the attachment theory is deeply related to disorganized attachment. This case-control study was performed with the aim to compare the attachment status and the defensive processing patterns of women victims of IPV (cases) with women with no experiences of IPV (controls).

METHODS

Cases were 16 women with an age range from 26 years to 51 years. The control group included 16 women with an age range from 26 years to 59 years. Women's states of mind in regard to attachment were evaluated with the Adult Attachment Projective Picture System, which allows classifying attachment status and defensive mechanisms.

RESULTS

Compared with control group, most IPV women resulted having an unresolved attachment status and describing characters less capable to draw upon internal resources, that is, internalized secure base, and less capable to act than controls. Women victims of IPV used significantly more words referring danger and failed protection than controls.

CONCLUSIONS

The results evidenced the strong effectiveness of the AAP on analysing the psychological attitudes of women victims of IPV. The dramatic events lived by the women victims of IPV are so dominant in their minds that they invade their stories. This could represent a clue of emotional dysregulation.

PRACTITIONER POINTS

The use of AAP improves the understanding of the agency of self and of the specific levels of trauma experienced by IPV victims, on clarifying their frightening/frightened dynamic, typical of the disorganized attachment relationship, which undermines their activity of mentalization. The therapist will assume the stance of a secure base and then both promoting exploration and contrasting impotence, humiliation, and subordination that IPV women have experienced. This therapeutic interpersonal context will be functional to reach two different but related therapeutic goals: (1) to facilitate the rebuilding of agency (through an activation of subject to explore concrete strategies for exiting from IPV), (2) to explore attachment-related segregated systems from awareness, and to integrate them in memory.

The Effects of Intimate Partner Violence Exposure on the Maternal Bond and PTSD Symptoms of Children

The quality of the maternal bond can be disrupted in women exposed to intimate partner violence (IPV), causing them to be less available to their children. The aim of this study was to examine difficulties in emotional regulation in women exposed to IPV and the impact of IPV on both the maternal bond and posttraumatic symptoms among children. A cross-sectional study was carried out with two groups: IPV dyads ( n = 36) comprising mothers who had been exposed to IPV and their children, and control dyads ( n = 27) comprising non-abused mothers and their children. Information was obtained via structured interviews including scales regarding IPV, posttraumatic stress disorder (PTSD) symptoms, maternal bond, and difficulties in emotional regulation. Correlation analyses showed a positive association between the severity of IPV, PTSD symptom severity in children, and difficulties of emotional regulation in mothers. They also showed a negative association between IPV and the quality of the maternal bond. Regression models demonstrated that exposure to sexual IPV, maternal difficulties in emotion regulation, and younger age of the mother are important predictors of lower quality of the maternal bond. Difficulties in emotional regulation and sexual IPV disrupted the quality of the maternal bond among women and their children. In addition, lower quality of maternal bond was associated with higher PSTD symptoms among children.

Witnessing intimate partner violence and child maltreatment in Ugandan children: a cross-sectional survey

OBJECTIVES

Existing evidence, mainly from high-income countries, shows children who witness intimate partner violence (IPV) at home are more likely to experience other forms of violence, but very little evidence is available from lower income countries. In this paper we aim to explore whether Ugandan children who witness IPV at home are also more likely to experience other forms of maltreatment, factors associated with witnessing and experiencing violence, and whether any increased risk comes from parents, or others outside the home.

DESIGN

A representative cross-sectional survey of primary schools.

PARTICIPANTS

3427 non-boarding primary school students, aged about 11-14 years.

SETTING

Luwero District, Uganda, 2012.

MEASURES

Exposure to child maltreatment was measured using the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional, and 2 questions measured witnessing IPV.

RESULTS

26% of children reported witnessing IPV, but nearly all of these children had also experienced violence themselves. Only 0.6% of boys and 1.6% of girls had witnessed partner violence and not experienced violence. Increased risk of violence was from parents and also from other perpetrators besides parents. Both girls and boys who witnessed and experienced violence had between 1.66 (95% CI 0.96 to 2.87) and 4.50 (95% CI 1.78 to 11.33) times the odds of reporting mental health difficulties, and 3.23 (95% CI 1.99 to 5.24) and 8.12 (95% CI 5.15 to 12.80) times the odds of using physical or sexual violence themselves.

CONCLUSIONS

In this sample, witnessing IPV almost never occurred in isolation-almost all children who witnessed partner violence also experienced violence themselves. Our results imply that children in Uganda who are exposed to multiple forms of violence may benefit from intervention to mitigate mental health consequences and reduce use of violence. IPV prevention interventions should be considered to reduce child maltreatment. Large numbers of children also experience maltreatment in homes with no partner violence, highlighting the need for interventions to prevent child maltreatment more broadly.

TRIAL REGISTRATION NUMBER

NCT01678846, results.

The Influence of Interpersonal Style on the Appraisal of Intimate Partner Violence

Intimate partner violence (IPV) is a common type of violence that is associated with a number of psychological problems among women who experience it. Recent research suggests that interpersonal style may influence the degree to which women exhibit psychological problems following IPV exposure. One possible mechanism through which interpersonal style may exert its effects is by influencing appraisals of the violence they experience, although this has not yet been tested empirically. In this study, we examined the effects of dimensions of interpersonal style (dominance and warmth) on IPV appraisals in a sample of young adult women (N = 219) who reported experiencing physical and/or sexual violence from their romantic partner in the past year using a Bayesian approach to multiple linear regression. Our results indicated that both dominance and warmth were associated with less negative (i.e., less betrayed, self-blaming, fearful, alienated, angry, and shameful) appraisals of IPV, exhibiting small- to medium-sized effects when controlling for severity of violence. However, this effect was more prominent for dominance than for warmth. These findings shed light on the role of interpersonal style in the response to IPV and indicate directions for future research.

Prevalence of Intimate Partner Violence and Associated Factors

INTRODUCTION

The aim of the present cross-sectional study was to investigate the prevalence of intimate partner physical violence among depressive Turkish women, as well as the association of intimate partner physical violence with attachment patterns, childhood traumas, and socio-demographic factors.

METHODS

The study included 100 women diagnosed with depressive disorder and 30 healthy women. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV axis I disorders, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Adult Attachment Style Questionnaire (AASQ), and Childhood Trauma Questionnaire (CTQ) were used for clinical assessment.

RESULTS

It was found that 64% of the women diagnosed with depression were suffering from intimate partner physical violence. In these women, the severity of depression and anxiety symptoms was higher, suicidal ideation and suicide attempts were more common, and the diagnosis of double depression was more prevalent. These women also achieved higher scores in the avoidant and ambivalent subscales of AASQ and higher total scores and higher scores in the physical abuse subscale of CTQ. The partner's and the woman's experiences of physical violence in their families during their childhood predicted intimate partner physical violence for women suffering from depression.

CONCLUSION

The investigation of domestic violence contributes to the treatment of depression and also to the recognition and prevention of domestic violence that has profound effects on successive generations.

Caregiver insightfulness and young children's violence exposure: testing a relational model of risk and resilience

This study employed a relational post-traumatic stress frame to explore the co-contribution of young children's exposure to violence and caregiver insightfulness on child behavioral outcomes in a high-risk, non-referred sample of caregivers and preschoolers (n = 64; mean age 3.83 years, SD = .77). Caregiver insightfulness did not have a main effect on child outcomes but did moderate the relation between violence exposure and child behavior across all observed outcomes. Violence-exposed children with non-insightful caregivers demonstrated higher caregiver-rated internalizing and externalizing behaviors and observer-rated negative affect than all other groups. Among children not exposed to violence, insightfulness was not related to children's behavior problems or negative affect, suggesting violence-specific processes. Though cross-sectional, results suggest that the effects of violence and caregiver insightfulness on child outcomes are contingent on one another and that caregiver insightfulness may play a protective role in contexts of violence.

Intimate partner violence victims as mothers: their messages and strategies for communicating with children to break the cycle of violence

Children whose mothers are victims of intimate partner violence (IPV) are at increased risk of adverse health and psychosocial consequences, including becoming victims or perpetrators of violence in their own relationships. This study aimed to understand the role mothers may play in preventing the perpetuation of violence in their children's lives. We performed semistructured interviews with 18 IPV victims who are mothers and were living at the Women's Center & Shelter of Greater Pittsburgh from July through November 2011. We sought to understand how they communicate with their children about IPV and relationships. These mothers described a desire to explain their IPV experience and offer advice about avoiding violence in relationships. As foundations for these discussions, they emphasized the importance of close relationships and open communication with their children. Although mothers are interested in talking about IPV and relationships and identify communication strategies for doing so, many have never discussed these topics with their children. These mothers need and want an intervention to help them learn how to communicate with their children to promote healthy relationships. Development of a program to facilitate communication between IPV victims and their children could create an important tool to empower mothers to break the cross-generational cycle of domestic violence.

Drawing conclusions: an intergenerational transmission of violence perspective

This article reviews the articles in this special issue on the effects of intimate partner violence on women and children, integrating the findings into critical questions about intergenerational transmission of violence. The author's own psychodynamically informed framework is used to interpret the results of the studies. Finally, clinically relevant implications and research directions are briefly proposed.

The intergenerational transfer of mother-daughter risk for gender-based abuse

In this 10-year longitudinal study 150 mother-daughter pairs were recruited to participate in a study examining gender-based abuse across three generations. Forms of gender-based abuse included: child sexual abuse, witnessing intimate partner violence against their mothers, and intimate partner violence or dating violence in adolescence or adulthood. Daughters were interviewed when they were on average 9, 14, and 16 years old. Regression analyses revealed that if the grandmother (G1) was abused by her husband, her daughter (G2) was more likely to be sexually molested in childhood and was also more likely to be in an abusive relationship as an adult. If the mother (G2) was sexually abused as a child her daughter (G3) was at increased risk for child sexual abuse. In turn, child sexual abuse for the daughters related to their reports of dating violence in adolescence. Daughters (G3) who were sexually abused expressed more anxiety about romantic relationships, reflecting early attachment conflicts. Both child sexual abuse and anxious romantic attachment style independently predicted adolescent sexual risk-taking as in having multiple sexual partners or dating older men. These findings demonstrate how informative it is to include multiple forms of gender-based abuse in research and practice to better illuminate complex family dynamics. In addition, the findings support previous empirical work showing the importance of attachment behavior in women who are in abusive relationships, which has unique clinical implications.

Interpersonal style moderates the effect of dating violence on symptoms of anxiety and depression

Over a quarter of young women have experienced some form of violence within a dating relationship. The experience of dating violence is associated with problems in psychological functioning, including symptoms of anxiety and depression. However, not all women who experience dating violence exhibit anxious or depressive symptoms. One factor that may influence symptom expression is interpersonal style. In this study, we examined the main and moderating effects of dimensions of interpersonal style (dominance and warmth) on the association between dating violence and symptoms of anxiety and depression. Warmth exhibited a main effect on anxious and depressive symptoms over and above the effects of dating violence and other life stressors. Dominance moderated the association between dating violence and anxious and depressive symptoms. When levels of dating violence were high, women with higher levels of dominance reported fewer symptoms of anxiety and depression than women with lower dominance. These results indicated that whereas high warmth was associated with fewer symptoms of psychopathology generally, high dominance was a buffer against the effect of dating violence on symptoms more specifically. Directions for future research are discussed.