Witness Domestic Violence Research Articles

The effect of child–parent relationship therapy‐based play support on parental stress and acceptance, and child behaviours in children who witness domestic violence: Randomized controlled study

AbstractIn domestic violence (DV), the deterioration of parental skills in mothers, increased stress levels and child behaviour issues are the most common problems. In DV, the way to cope with the difficulties encountered is to strengthen relationships within the family. In this study, we aimed to reduce maternal stress levels and problematic child behaviours and increase the child acceptance level in children who have witnessed domestic violence (WDV) with child–parent relationship therapy (CPRT). This study is a randomized controlled study with pretest–posttest intervention and control groups. In the study, 20 mothers were in the intervention group, and 18 were in the control group. A 10‐week CPRT‐focused training program was applied to the intervention group. After the training of the mothers in the intervention group was completed, 2‐h training on communication skills was given to the mothers in the control group. The data include parents' reports through three surveys: the Parenting Stress Index (PSI), the Parental Acceptance‐Rejection Parental Form (PAR) and the Strengths and Difficulties Questionnaire (SDQ). In the study, it was determined in the group comparisons that the total scores of PSI, PAR and SDQ significantly reduced between the application and pre‐application terms for the intervention group (p < 0.05), and there was no significant difference in the control group (p > 0.05). The results highlight the benefits and importance of including both mothers and children in therapeutic interventions for children who have WDV, with particular emphasis on CPRT benefits.

A Study on the Establishment of Concept to Recognize Children who Witness Domestic Violence as Victims

A Study on the Establishment of Concept to Recognize Children who Witness Domestic Violence as Victims

Psychiatric aspects of children who witness domestic violence

Background The presence of domestic violence witnessed by children leads to development of different mental disorders of childhood. Objectives This study was aimed to assess the prevalence of psychiatric disorders in children who witness domestic violence. Patients and methods A community-based case–control study was designed to assess the prevalence of psychiatric disorder in children who witness domestic violence of both sexes aged 6–18 years old with different socioeconomic classes. Tools of measurement used in the current study were Hurt, Insulted, Threatened with Harm and Screamed tool; socioeconomic scale by El-Gilany; symptoms check list (SCL-90); and Structured Clinical Interview for DSM-IV Childhood Diagnoses for child’s interview. Results The most common disorders among children witness domestic violence is conduct disorder (15%), major depressive disorder (10%), and attention-deficit hyperactive disorder (8.3%). Children who are not affected among studied families (cases) represented 33.3%. There was a statistically significant difference among cases that witness domestic violence and controls who did not witness it regarding additional signs, loss of appetite, insomniac problems, death ideas, aggressive symptom, and reactive sensitivity symptoms reported as well as global stress indices measured by SCL-90. The most common reason for domestic violence was the financial reasons. Fathers are more responsible for most of the violence incidents. Conclusions Ignoring of suffering and the long duration spent with domestic violent atmosphere without seeking help increase the risk for psychiatric disorder in those children. So legal empowerment and aid projects are essential in raising awareness to influence cultural change and put an end to domestic violence.

Traumatic Experiences and PTSD Symptoms in the Chinese Male Intrafamilial Physical Violence Perpetrators: A Comparative and Structural Equation Modeling Study.

We aimed to compare traumatic experiences among the groups of perpetrators with or without violent pedigree, and establish a structural model of posttraumatic stress disorder (PTSD) symptoms as mediators of traumatic experiences and severe intrafamilial physical violence among Chinese male perpetrators. A cross-sectional survey and a face-to-face interview were conducted to examine intimate partner violence (IPV) perpetration and violent pedigree, childhood maltreatment, other traumatic events, PTSD symptoms, and severe intrafamilial physical violence in a community sample of 229 abusive men and 303 controlled men in China. Using structural equation modeling (SEM) techniques, the scores of the questionnaires were entered into the theoretical model and calculated. Findings demonstrated that the numbers of the traumatic events in four groups were significantly different with a declining trend, and the SEM data had an adequate fit. The loadings of pathways from childhood witness domestic violence (DV) to severe physical violence (SPV) were more salience than other pathways, and the indirect effect of every pathway, except for the childhood witness DV to PTSD symptoms, on severe intrafamilial physical violence in the model was significant. The results suggest that PTSD symptoms cluster as mediator of the intergenerational transmission of SPV perpetration in Chinese abusive men. Childhood witness IPV has effects on adulthood perpetration of IPV.

Domestic Violence Awareness.

Domestic or intimate partner violence is alarmingly prevalent, and, for victims, a major contributor to depression, anxiety, and other forms of mental illness. Psychological problemsandpsychiatric syndromesoften are the antecedents of domestic violence for the perpetrator and also can be risk factors for becoming a victim. Remarkably, the two dominant mental health fields, psychiatry and clinical psychology—the ones charged with investigating and attending to the mind, brain, andbehavior—are largelyabsent fromdomestic violence research and intervention. More than one in three women and at least one in four men have been the victim of rape, physical violence, or stalking by an intimate partner (1). However, women are far more likely than men to experience severe sexual and physical violence from apartnerortobekilledbyone(1,2). IntheUnitedStates, intimate partnerhomicidesmakeupbetween40%and50%ofallmurders of women (3). Domestic violence crosses geographic and socioeconomic stratification, although studies indicate that lowerincomewomen in rural communities experience higher rates of violence and, specifically, sexual abuse (4, 5). Victims suffer from dramatic rates of depression, anxiety, and posttraumatic stress disorder,aswellassubstanceabuseandsuicidality(6–8).Arecent study based on a representativeU.S. sample ofmore than 25,000 adults indicatedthatnewonsetsofmajormentalhealthproblems were more than twice as common among those exposed to domestic violence in the past year than among nonvictims (9). Millionsofchildren—asmanyas 15million, according to some estimates—witness domestic violence each year (10). For male children there is a 1,000% greater risk of reproducing this violence in their own spousal relationships (11). A recent epidemiologic study found prior domestic violence victimization to bemore strongly associatedwith domestic violence perpetration than any other factor (12). Despite its prevalence in the general population, domestic violence is underrepresented in our consulting rooms in part because victims, and especially perpetrators, rarely voluntarily self-identifyorseektreatment(8, 13, 14).Shame,guilt, anddenial are obvious deterrents. These factors are often compounded by a sense of futility resulting from learned helplessness, and a profound unraveling of self-esteem (15). More practical considerations include fears for personal security, economic codependence, and the concerns that disclosure will trigger social services engagement, particularly child protection (8). Finally, disclosure represents a potential threat to the continuance of a romantic relationship, which, though abusive, involves emotional investment. Without experience handling domestic violence situations, clinicians can feel ill-prepared and deskilled, lacking knowledge about referral sources, emergent threats of bodily harm, and the accompanying legal and ethical obligations. This lack of presentation in clinical settings contributes to a “don’t ask” scenario (8). Since 1986, numerous medical institutions have advocated for domestic violence screening inroutinemedicalcare(16, 17); in2001, theAmerican Psychiatric Association followed suit. That same year, the AmericanPsychologicalAssociation’s IntimatePartner Abuse and Relationship Violence Working Group launched a curriculumon domestic violence but appears to have done little to foster relevant training in clinical interventions. Domestic violence is an exceptionally challenging clinical situation. Those in domestic violence relationships areat risk for repeating this experience, and likely have abuse or exposure to it in their backgrounds (11, 18), adding immense complexity to treatment. Thework presents unique challenges, including safety planning and patients’minimization of abuse, which may induce feelings of helplessness in the context of significant urgency anddanger (19–21). There noware targeted treatments for domestic violence intervention, such as Seeking Safety (22) and Child-Parent Psychotherapy (23), though few psychologists and psychiatrists are trained in them. Of course the question of how clinically to respond to perpetrators is a complicated one, independentof thenecessary legal consequences.However, treatment and prevention programs are emerging, such as the Melissa Institute for Violence Prevention and Treatment. Beyond the “professional counter-transference” is possibly a more personal one. Aggression is a fundamental human impulse, and violence a socially unacceptable manifestation of it. Underlying any violent interaction is the universal human struggle with aggression and its myriad complex antecedents: family and developmental history; self-esteem; power dynamics; fear of abandonment and humiliation; emotional regulation; impulse control; and the capacity for empathy, guilt, and remorse. The possibility that domestic

Adverse Childhood Experiences Among Immigrants to the United States.

A growing number of studies have examined the "immigrant paradox" with respect to health behaviors in the United States. However, little research attention has been afforded to the study of adverse childhood experiences (ACE; neglect, physical and sexual abuse, and witnessing violence) among immigrants in the United States. The present study, using Waves I and II data from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), aims to address these gaps by comparing forms of ACE of first- and second-generation immigrants with native-born American adults in the United States. We also examined the latent structure of ACE among immigrants and conducted analyses to assess the psychiatric correlates of identified latent classes. With the exception of neglect, the prevalence of ACE was markedly higher among native-born Americans and second-generation immigrants compared with first-generation immigrants. Four latent classes were identified-limited adverse experience ( n = 3,497), emotional and physical abuse ( n = 1,262), family violence ( n = 358), and global adversity ( n = 246). The latter three classes evinced greater likelihood of being diagnosed with a mood, anxiety, personality, and substance use disorder, and to report violent and non-violent antisocial behavior. Consistent with prior research examining the associations between the immigrant paradox and health outcomes, results suggest that first-generation immigrants to the United States are less likely to have experienced physical and sexual abuse and witness domestic violence. However, likely due to cultural circumstances, first-generation immigrants were more likely to report experiences that are deemed neglectful by Western standards.

Addressing domestic violence through support and prevention

At least 750 000 children witness domestic violence every year, which can have a serious impact on their health and wellbeing. Sandra Horley, chief executive of Refuge, explains the role training and prevention can play in addressing domestic violence.

Learning From Youth Exposed to Domestic Violence: Decentering DV and the Primacy of Gender Stereotypes

Up to 8 million American children witness domestic violence (DV) every year. Since this discovery in the mid-1980s, psychologists and social service professionals have conducted research with children exposed to DV. This ethnographic study expands on existing research by examining how youth exposed to DV perceive their experiences and staff interventions. Findings show they draw on gender stereotypes for behaviors, and these frequently resist DV education and the advocates' suggestions for coping. Findings also showed the staff's formal interventions with the youth contradict gender norms and their casual interactions with the youth often inadvertently reinforce stereotypical gender identities and behaviors.

In This Issue

In This Issue

Profiles of Behavioral Problems in Children Who Witness Domestic Violence

Unlike previous investigations of shelter-based samples, our study examined whether profiles of adjustment problems occurred in a community-program-based sample of 175 school-aged children exposed to domestic violence. Cluster analysis revealed three stable profiles/clusters. The largest cluster (69%) consisted of children below clinical thresholds for any internalizing or externalizing problem. Children in the next largest cluster (18%) were characterized as having externalizing problems with or without internalizing problems. The smallest cluster (13%) consisted of children with internalizing problems only. Comparison across demographic and violence characteristics revealed that the profiles differed by child gender, mother's education, child's lifetime exposure to violence, and aspects of the event precipitating contact with the community program. Clinical and future research implications of study findings are discussed.

STRICTLY LIABLE: GOVERNMENTAL USE OF THE PARENT-CHILD RELATIONSHIP AS A BASIS FOR HOLDING VICTIMS LIABLE FOR THEIR CHILD'S WITNESS TO DOMESTIC VIOLENCE

Studies estimate that between three and ten million children in the United States witness domestic violence annually. Although studies have demonstrated a co-occurrence of domestic violence and child abuse, there is no concrete evidence to support the assumption that a child's exposure to domestic violence increases the risk to the child of abuse or neglect. Recently the New York State Court of Appeals determined that a child's witness to abuse does not suffice, in and of itself, to show that removal of the child is necessary or that removal is in the “best interests” of the child. Programs which have developed alternatives to presumptive removal understand the importance of viewing the interests of the battered parent and children as being in accord with each other rather than in opposition. Private and government sponsored programs have demonstrated some success in protecting the parent-child relationship, ensuring the safety of both parent and child, and increasing accountability of batterers while reducing the necessity for removals. Alternative programs are less costly to the state than foster care, and emotionally less costly to the families.

PTSD, Other Disorders Evident in Kids Who Witness Domestic Violence

Back to table of contents Previous article Next article Professional NewsFull AccessPTSD, Other Disorders Evident in Kids Who Witness Domestic ViolenceEve BenderEve BenderSearch for more papers by this authorPublished Online:4 Jun 2004https://doi.org/10.1176/pn.39.11.0390014aChildren who witness domestic violence are especially vulnerable to a wide range of developmental and psychiatric problems as they grow older, according to Graeme Hanson, M.D., a clinical professor of psychiatry and pediatrics and director of residency training in child and adolescent psychiatry at the University of California, San Francisco (UCSF).“Domestic violence has significant negative effects on children's emotional, cognitive, social, and behavioral development,” Hanson told attendees at APA's annual meeting in New York City last month.As many as 10 million children a year are exposed to domestic violence, Hanson said. Children who witness domestic violence may have twice the rate of psychiatric disorders as those who do not witness violence in the home, he added.The multitude of mental health and developmental problems arising from witnessing domestic violence includes increased aggression, phobias, insomnia, poor self-esteem, poor academic performance, and decreased problem-solving skills, Hanson said.With prolonged exposure to violence at home, children can also develop symptoms related to posttraumatic stress disorder, such as emotional numbing, avoidance of reminders of the abuse, and obsessing about a violent event.Children who witness domestic violence are often caught in a bind, Hanson explained. “They may be terrified at what they see, but the very person to whom the child would turn—the mother—is often emotionally unavailable because she is trying to deal with the abuse,” he said.Hanson pointed out that studies by Alicia Lieberman, Ph.D., a child-development specialist and an associate professor of psychology at UCSF, show that children who witness violence in their home express a great deal of anger at their abused mothers. Identifying with the abuser is a common defense mechanism in children who are either abused or who witness abuse at home.In families in which abusive fathers have been taken into custody, children may idealize them or “miss the good parts of dad,” Hanson noted. The fact that the father has been removed from the home may also spark fear in children that their mother will soon be gone as well. “As a result, these children are at increased risk for separation anxiety.”Lieberman has studied and implemented a therapy that aims to resolve conflicts in the parent-child relationship and create a setting in which the mother is better able to facilitate the child's development, Hanson noted. Lieberman studied 45 mother-child pairs in which mothers had severed their relationship with the abusers. The intervention lasted once a week for one year, and Lieberman found that 60 percent of the children had increases in IQ scores and a reduction in PTSD symptoms, among other evidence of improvement, Hanson said. ▪ ISSUES NewArchived

What are providers' reporting requirements for children who witness domestic violence?

Each year, 3.3 to 10 million children are exposed to domestic violence/abuse (DV). Providers' reporting obligations for these children are unclear. The child maltreatment statutes available on state's web sites (through August 2003) were reviewed. Only Alaska defines DV in the presence of a child as child abuse within its juvenile code. Within their child abuse definition and reporting statutes, many states include language such as "substantial risk" or "imminent danger" of "physical harm" or "mental injury." Although knowledge of the state law is an important first step, abiding by it may be challenging because most statutes are open to wide interpretation. As a result, providers are encouraged to seek advice from local child maltreatment specialists who understand the local legal interpretations and resources.

Pediatric Residency Training on Domestic Violence: A National Survey

Between 3.3 and 10 million children witness domestic violence (DV) each year. These children are at risk for both emotional and behavioral problems. In 1998, the American Academy of Pediatrics issued guidelines for pediatricians to screen for DV and for residency programs to include DV education. Prior studies have assessed practicing pediatricians' DV screening habits. This study was designed to assess chief residents' attitudes and training regarding DV screening. A 53-question survey regarding residents' attitudes and training surrounding DV was mailed to the chief residents of all 194 nonmilitary US pediatric residency programs. Descriptive and inferential analyses were performed. Sixty-eight percent of surveys were returned. Sixty-eight percent of respondents were female. Although 93% of chief residents felt that pediatricians should screen for DV, only 21% screen every patient. Only 24% agreed or strongly agreed that they felt experienced in handling DV cases. Although 60% of respondents say that they received 11 or more hours of residency training in how to handle child abuse, the majority (80%) received 4 hours or less of DV training. Seventy-one percent agreed or strongly agreed that pediatricians do not screen secondary to lack of training. Pediatric chief residents believe that DV is a significant pediatric health problem. However, screening practices are variable. Most chief residents feel that their training was not sufficient to make them comfortable screening for DV. Chief residents demonstrated openness to incorporating DV training into their programs, indicating a positive environment for DV curricula.

Protecting Children who Witness Domestic Violence: Is Nicholson v. Williams an Adequate Response?

Protecting Children who Witness Domestic Violence: Is Nicholson v. Williams an Adequate Response?

Mental Health Services for Children Who Witness Domestic Violence

Exposure to domestic violence has significant negative repercussions for children's social, emotional, and academic functioning. In the past decade, mental health professionals have developed treatment programs and approaches aimed at mitigating these deleterious effects. Their efforts, however, are often hampered by difficulty identifying and gaining access to the target population because the occurrence of domestic violence remains a family secret in many households. Clinicians and researchers have published descriptions of group and individual therapy approaches for children who witness domestic violence. These approaches share several goals: promoting open discussion about children's experiences with domestic violence, helping children to deal with the emotions and consequences that follow such exposure, reducing the problematic symptoms children experience, strengthening children's relationships with their nonabusive caregivers, and helping children and their families to create and maintain relationships and living situations that are free from violence and abuse. One limitation of the literature describing these interventions is the absence of controlled outcome studies demonstrating the effects of these programs, in the short and long terms. Thus, development of such evaluative components is an important future direction for this field. Some of the other challenges that confront clinicians include working with children's families, addressing children's complex and intense emotional experiences, and determining whether children have themselves been victims of abuse or neglect (and then interfacing with child protective services).

Children Who Witness Domestic Violence: A Review of Empirical Literature

This article presents a review of the empirical literature examining the initial effects of witnessing domestic violence on children's functioning. Previous reviews of the literature suggested that witnessing was harmful to children, but they also indicated that the state of knowledge was quite limited due to an emphasis on exploratory methodologies, reliance on untested theories, and inconsistent findings. Nearly a decade of research has been conducted since the most recent review. Although results are still somewhat inconclusive regarding children's social, cognitive, and physical development, the findings of recently conducted investigations, when combined and compared with the previously reviewed literature, suggest much less equivocation concerning the negative effects of witnessing domestic violence on children's emotional and behavioral development. Theoretical developments and methodological refinements appear related to the recent findings.