Chapter 24: Domestic Violence: Intimate Partner Violence, Child Maltreatment, and Co-Occurrence

How Common is Family Maltreatment

• impacts millions worldwide

• most family violence goes unreported

  • official states don’t necessarily represent full amount of family maltreatment because many cases never get reported to authorities

• US lifetime prevalence rates of physical IPV

  • 30.6% women

  • 31.0% men

• worldwide prevalence rates of childhood sexual abuse

  • 8-31% for girls

  • 3-17% for boys

• about 80% of reported US child abuse/neglect perpetrated by parents

What is Abuse

• difficult to define

• what counts as abuse

  • definitions aren’t standardized

  • context matters

  • severity matters

  • impact/potential impact matters

  • culture can influence perceptions

The FAIR System

• different communities may have different ideas about what is considered normal physical punishment (if a behaviour causes significant harm or potential for harm but is socially/culturally considered normal, should it count as abuse or not?)

  • FAIR uses impact threshold to help address this issue

• FAIR = field-tested assessment, intervention-planning, and response

  • created to improve definitions

  • considers impact/potential harm

  • helped distinguish normative parenting from abuse

  • influenced DSM-5 and ICD-11 definitions

Measuring Abuse

• prevalence depends on measurements

  • official records tend to provide lower estimates

    • small percentage reported

  • surveys tend to provide higher estimates

    • ask if things are happening but not necessarily about the severity or context so maltreatment may be overidentified

• why?

  • underreporting

  • different definitions

  • different measurement methods

  • context may or may not be considered

Co-Occurrence of Maltreatment

• different forms of maltreatment often occur together

  • IPV → child exposed to violence → psychological impact → possible direct child maltreatment

• also

  • physical and emotional abuse

  • sexual and other forms of abuse

  • IPV and child abyse

  • neglect and other forms of abuse

Children Exposed to IPV

• witnessing IPV is associated with increased risk

• children who witnessed partner violence had increased odds of experiencing (witnessing IPV does not necessarily mean child maltreatment has occurred)

  • neglect

  • sexual abuse

  • physical abuse

  • psychological abuse

• impacts of exposure on children

  • social skills impairments

  • feelings of shame

  • anxiety

  • depression

• increased risk of

  • substance use

  • suicidal ideation

  • delinquency

CONTEXT MATTERS

• need to factor in:

  • how frequently the child is exposed

  • how severe the violence is

  • the child’s age and development

  • child’s emotional response

Polyvictimization

• experiencing multiple types of victimization instead of just 1

  • physical abuse

  • sexual abuse

  • emotional abuse

  • neglect

  • exposure to IPV

• 45.1% of women in one population study who reported abuse said they experienced more than one type

  • assessment needs to consider bigger picture and ask about multiple forms of abuse rather than focusing on just one and missing others

Why Does Abuse Co-Occur?

• individual factors

  • impulsivity

  • hostility

  • depression

  • substance use

  • history of violence

• stress

  • financial stress

  • transition to parenthood

  • relationship to stress

• spillover hypothesis

  • violence in one relationship affects another

    • ex; conflict between partners could increase the likelihood of aggression toward a child

• sequential effects

  • victimization → psychological difficulties → increased risk of perpetration

Risk Factors Associated with Maltreatment

• individual

  • impulsivity

  • hostility

  • depression

  • substance abuse

  • anger

  • history of aggression

• family/relationship

  • family conflict

  • relationship problems

  • power imbalance

  • poor family cohesion

  • poor parent-child relationship

  • parenting difficulties

• environmental

  • poverty/economic disadvantage

  • social instability

  • stress

  • education

Role-Independent Risk Factors

• can contribute to aggression across relationships

  • depression

  • stress

  • impulsivity

  • anger

  • history of aggression

Role-Specific Risk Factors

• partner

  • jealousy

  • dominance

  • relationship dissatisfaction

  • power imbalance

• parent

  • parenting dissatisfaction

  • overreactive discipline

  • negative views of child

Why Risk Factors Matter

• risk factors can help clinicians

  • identify victims

  • identify perpetrators at risk

  • understand different patterns of maltreatment

  • develop individualized treatment

  • identify people who haven’t sought help

Why Prevention is Difficult

• prevention isn’t always successful

  • healthy start program → largely unsuccessful at changing risk

    • possible explanation: interventions home visitors being insufficiently trained to identify risks and to connecting families to community resources

  • IPV prevention → mixed feelings

  • some interventions had weak effects or paradoxical increases in abuse

    • possible explanations: timing of intervention, difficulty with retention, other methodological constraints