The Psychopathological Model of Family Violence Includes the Following Approaches to Child Abuse

Child Dev. Author manuscript; available in PMC 2013 Jul viii.

Published in final edited class as:

PMCID: PMC3703534

NIHMSID: NIHMS487796

Furnishings of Family Violence on Psychopathology Symptoms in Children Previously Exposed to Maltreatment

Abstruse

Although many studies suggest that family violence is associated with child psychopathology, multiple features of the home surroundings might account for this association, such every bit poverty and caregiver psychopathology. Studies are needed examining how change in psychopathology symptoms is affected by home violence, controlling for children's ain developmental symptom histories and other predictors of psychopathology. This study used latent difference score structural equation modeling to examination if witnessing home violence and/or experiencing harsh physical bailiwick predicted changes in psychopathology symptoms among 2,925 youth aged five – xvi years previously exposed to violence. Results demonstrated that harsh physical discipline predicted kid-specific changes in externalizing symptoms, whereas witnessing violence predicted kid-specific changes in internalizing symptoms across time. Implications for research and policy are discussed.

Many American children are exposed to violence in their homes. The U.S. Section of Health and Man Services, Assistants for Children and Families, Children's Agency (2005) reported that child protective service (CPS) agencies receive over l,000 reports of suspected child maltreatment each week. After reviewing the available literature, Straus et al. (1998) concluded that approximately 5% of children are the victims of astringent physical assault and that rates of physical abuse are potentially much higher depending on the exact definition of abuse utilized in any given study. These researchers also ended that at to the lowest degree ane in six American couples take engaged in partner-against-partner assault, and Straus (1992) estimated that 10 million American children witness domestic violence in their homes each year. Many children experience both forms of family violence (Slep & O'Leary, 2001). The majority of studies reviewed past Edleson (1999) found 30% – lx% co-occurrence rates, and several additional studies and reviews have too reported loftier rates of overlap (eastward.g., Appel & Holden, 1998; Moffitt & Caspi, 1998).

A plethora of studies now provide compelling evidence that children who are maltreated and children who witness family violence (e.g., developed partner violence) are at increased gamble of psychopathology compared with children who are not exposed to violence (east.g., Jouriles, Murphy, & O'Leary, 1989; Kaplan, Pelcovitz, & Labruna, 1999; Kernic et al., 2003; Trickett & McBride-Chang, 1995; Wolfe, Crooks, Lee, McIntyre-Smith, & Jaffe, 2003). Jaffe, Wolfe, Wilson, and Zak (1986) found that abused boys and boys who had witnessed domestic violence had like adjustment problem patterns and that both groups of boys had significantly more problems than a control group. In a recent meta-analysis, Wolfe et al. (2003) concluded that children who were both driveling and exposed to domestic violence had college levels of emotional and behavioral issues than did children who had only been exposed to domestic violence. Thus, children who are both victimized past violence and who witness domestic violence may be particularly vulnerable to developing psychopathology symptoms and are therefore an important population to study.

The extant literature suggests that in that location are several direct links between physical abuse and negative child outcomes. For example, children who are physically abused are more likely to encode violence as an acceptable interaction strategy (Blackness & Newman, 1996) and accept deficits in their attention self-regulatory abilities that cause them to overattend to anger cues (Shackman, Shackman, & Pollak, 2007). There are also indirect links between physical corruption and negative child outcomes. Corruption of a child is oft associated with a host of suboptimal parenting practices that in and of themselves contribute to increases in children'south internalizing and externalizing symptoms (e.g., Belsky, 1993; Burgess & Conger, 1978). For example, compared with nonabusive parents, abusive parents engage in significantly fewer positive interactions with their children, have interactions that more frequently incorporate aroused and punitive statements, and interact less often with their children (Burgess & Conger, 1978; Vasta, 1982). Other researchers have found that nonabusive parents are more likely to employ reasoning and uncomplicated commands and to choose disciplinary techniques that match the child's misbehavior, whereas abusive parents nearly always utilize punitive disciplinary techniques fifty-fifty for very minor child misdeeds (Trickett & Kuczynski, 1986).

Parenting practices and children's well-existence might also be afflicted by the relatively high rates of stress and mental health problems that adult victims of family violence feel (Farver, Crooks, Lee, McIntyre-Smith, & Jaffe, 2005; Margolin & Gordis, 2000). For example, Farver et al. (2005) showed that the association betwixt family and customs violence and children's depressive symptoms was partially mediated by mothers' depressive symptoms. Furthermore, Wolfe, Crooks, Lee, McIntyre-Smith, and Jaffe (1985) found that the association between witnessing violence and children'southward problems was at least partially mediated by maternal stress and associated factors, and Holden and Ritchie (1991) institute that maternal stress and paternal irritability were the 2 major predictors of beliefs bug in children of battered women. Maternal depression may contribute to children's internalizing and externalizing symptoms past making mothers less consistently supportive and reliable caregivers (Katz & Gottman, 1997).

Although parenting problems might be one pathway by which family violence increases adventure for child psychopathology, children who are exposed to violence are also probable to feel many other stressors that are associated with elevated rates of psychopathology such every bit poverty, community violence, and poor schools (Hay & Jones, 1994; National Enquiry Quango, 1993). Even if families and children receive social services, children'south homes frequently remain chaotic and violent, even if non sufficiently "calumniating" to merit further action by CPS. The multiple stressors and risk factors for psychopathology that are associated with violence in the home need to exist accurately measured and accounted for in enquiry studies in order to isolate the effects of corruption and witnessing violence, as the association betwixt family violence and children's problem behaviors may be accounted for by social disadvantage more more often than not.

Moreover, although family violence may pb to symptoms of low, anxiety, substance use, or assailment in developed victims and perpetrators, adults who have histories of mental wellness problems and beliefs issues are more probable to grade relationships that get physically and psychologically calumniating (Magdol, Moffitt, Caspi, & Silva, 1998). They are also more likely to abuse their children (Bland & Orn, 1986a, 1986b; Egami, Ford, Greenfield, & Crum, 1996). This implies that the effects of family unit violence on child well-being may be genetically mediated. Given that adult depression, anxiety, substance apply, and antisocial beliefs are all moderately heritable (McGuffin, Owen, & Gottesman, 2002), it is possible that family violence is merely a marker for genetic risk for psychopathology that parents transmit to children (DiLalla & Gottesman, 1991; Jaffee, Caspi, Moffitt, Taylor, & Arseneault, 2002, 2004).

In this study, nosotros examined how the levels of violence children reported witnessing in their dwelling house and the amount of harsh concrete field of study caregivers reported using with their children were associated with changes in the externalizing and internalizing symptoms of children previously exposed to violence. We hypothesized that both harsh physical bailiwick and witnessing violence would exist associated with changes in externalizing and internalizing symptoms above children's expected trajectories in this sample of children previously exposed to violence. Externalizing and internalizing beliefs problems typically pass up from childhood to adolescence, although some children maintain consistently loftier levels of trouble behaviors (Broidy et al., 2003; Chang, Halpern, & Kaufman, 2007). I goal of our study was to test whether reexposure to violence would account for private differences in children'south trajectories and explain why some children do not show the expected pass up in trouble behaviors.

Our study attempted to redress several methodological limitations of previous studies in this field. First, whereas many studies examine physical violence against children or adult domestic violence, these forms of violence tend to co-occur. Therefore, we judge the unique effect of each type of violence on children's mental health. Second, whereas many studies estimate the concurrent or prospective associations betwixt family violence and child psychopathology, our study examines the relationship betwixt family unit violence and change over time in children's symptoms. This allows united states of america to get a amend handle on the direction of the relationship between family violence and children's problem behaviors and is a meliorate test of whether family unit violence is a potential cause of children'south psychopathology.

Method

Subjects

The National Survey of Child and Adolescent Well-Being (NSCAW) is a nationally representative sample of U.Southward. children who take had contact with CPS (Dowd et al., 2004). The full cohort includes 5,501 children (fifty% female), younger than i twelvemonth to 16 years when first sampled, who were subjects of child abuse or fail investigations conducted past CPS agencies from October 1999 to December 2000. The sample was selected using a two-stage stratified sample pattern. At the first phase, the United States was divided into ix sampling strata. Viii strata corresponded to the 8 states with the largest child welfare caseloads, and the 9th stratum consisted of the remaining 38 states and the District of Columbia. Within each of the 9 strata, principal sampling units (PSUs) were formed and randomly selected. PSUs were divers as geographic areas that encompassed the population served past a single CPS bureau (e.g., counties). At the second stage, equal numbers of children were selected from each PSU, regardless of PSU size. Children were selected from eight mutually exclusive and exhaustive domains such that the concluding sample fairly represented relevant combinations of (a) infants versus children anile 1 – fourteen years, (b) children receiving CPS-funded agency services versus children receiving no services, (c) children in out-of-abode intendance versus children not in out-of-domicile care, and (d) children who were investigated for allegations of sexual corruption versus other forms of abuse or neglect. Additional information nigh the sample composition is available from Dowd et al. (2004).

Field staff completed 12 days of training on the protocol. At baseline (Wave 1), face-to-face interviews or assessments were conducted with children, their caregivers (due east.m., biological parents, foster parents, custodial kin caregivers), their teachers (when children were of school age), and their caseworkers (when applicative). Follow-up interviews were conducted at 12, 18, and 36 months postbaseline. (Merely the data from the showtime, third, and 4th waves of data drove were used in this article, as the data collection protocol was significantly different for the second wave.) Current caregivers were paid $50 for their participation and children were given gift certificates worth $10 – $xx.

The current analyses were restricted to children who were v years or older at Wave 1 (N = 2,925; 53% female) because younger children did non report on witnessing dwelling violence. The racial/ethnic makeup of our sample was 46% White (not-Hispanic), 30% Black (non-Hispanic), 17% Hispanic, and 8% other races or ethnicities. Caseworkers reported on all subtypes of maltreatment children experienced and also designated the most serious type of maltreatment children experienced based on their review of the children's files and their ratings of the frequency, severity, and duration of each alleged or substantiated case of abuse or fail. For xl% of children, the near serious type of abuse was neglect; for 26%, it was physical; for eighteen%, it was sexual; for ix%, it was "other"; and for 8%, it was emotional. Within our sample, 34% of children experienced multiple types of maltreatment, and 62% of cases were substantiated. The hateful child ages were 9.63 years (SD = two.98) at Wave 1, ten.94 years (SD = 3.01) at Moving ridge 3, and 12.24 years (SD = 2.99) at Wave 4.

Measures

Descriptive statistics are found in Table 1.

Tabular array 1

Descriptive Statistics for Variables Included in the Latent Difference Score Models

	M	SD	Range
Externalizing symptoms, baseline	16.thirteen	xi.52	0 – lx
Externalizing symptoms, 18 months	15.14	11.thirteen	0 – 60
Externalizing symptoms, 36 months	xiv.59	eleven.14	0 – 65
Internalizing symptoms, baseline	10.forty	8.67	0 – 58
Internalizing symptoms, xviii months	nine.72	viii.35	0 – 47
Internalizing symptoms, 36 months	9.48	8.09	0 – 54
Witnessed violence, baseline	iii.57	2.72	0 – 12
Witnessed violence, 18 months	iii.15	two.56	0 – 12
Witnessed violence, 36 months	2.80	2.55	0 – 12
Physical discipline, baseline	half-dozen.80	11.xviii	0 – 142
Concrete discipline, 18 months	4.94	9.65	0 – 87
Physical subject area, 36 months	3.87	eight.08	0 – 94
Income a	2.82 a	i.41	i – 5
Caregiver mental health	48.48	11.16	12 – 70
Kid age, baseline	9.63	2.98	5 – 16

Externalizing symptoms

At each wave of data collection, caregivers were administered the Child Beliefs Checklist (CBCL; Achenbach, 1991), which consists of 113 questions on a three-point Likert-type scale (0 = non true, 1 = somewhat or sometimes true, 2 = very true or often true). We used the child's score on the CBCL Externalizing scale (which taps delinquent and aggressive beliefs) as our mensurate of externalizing symptoms. Internal consistency reliability was high for this scale (α = .92). At each moving ridge of analysis, 33%, 30%, and 28% of children had clinically meaning externalizing scores, respectively (i.due east., t scores at or above 65; Achenbach, 1991).

Internalizing symptoms

We used children's scores on the Internalizing scale of the CBCL (which comprises withdrawn behavior, somatic complaints, and anxious/depressed domains) equally our measure of children's internalizing symptoms. Internal consistency reliability was loftier for this scale (α = .xc). At each wave of analysis, 25%, 18%, and 17% of children had clinically pregnant internalizing scores, respectively (i.eastward., t scores at or above 65; Achenbach, 1991).

Witnessed violence

Children were administered the Violence Exposure Scale for Children (Fox & Leavitt, 1995), during which they were asked 23 questions regarding their exposure to violence and criminal events. Children younger than eleven years were besides shown a drawing delineation of each act, and all children were asked how often they had witnessed each human activity at home (never, once, a few times, or lots of times). They were then asked if they had witnessed the act in the past month (1 = yes, 2 = no). Internal consistency on this measure ranged from αs = .72 to .86 in a sample of inner-metropolis minority preschool children (Shahinfar, Fox, & Leavitt, 2000).

In two-factor analyses, Raviv et al. (2001) and Raviv, Shimoni, Play tricks, & Leavitt (1999) identified a "mild" and a "astringent" violence categorization scheme for the items on this mensurate. At that place were six types of trigger-happy acts that loaded onto the witnessing mild violence category. These included observing an developed yell at someone, observing an developed throw something at some other person, watching an adult button or shove someone, watching an adult slap someone, observing an developed beat out someone up, and observing another kid getting spanked. The half-dozen items that loaded onto the witnessing severe violence category included observing a person steal things from another person, seeing an developed point a knife or gun at someone, observing someone stab some other person, seeing someone shoot some other person with a gun, observing someone getting arrested, and seeing someone deal drugs. We summed the number of dissimilar types of incidents children reported witnessing in the past month to create a total witnessed violence scale. Thus, children received a score betwixt 0 and 12. In the NSCAW sample, internal consistency was loftier for the total score (α = .96). Across waves of data collection, between 71% and 80% of children did not witness any of the severe violence category events.

Caregiver use of harsh concrete discipline

Caregivers were administered the Parent – Child Disharmonize Tactics Scales (CTSPC; Straus et al., 1998), which ask caregivers how often they used 22 disciplinary practices in the past twelvemonth (0 = never or not in the past 12 months; 1 = ane time; two = 2 times; four = 3 – 5 times; 8 = 6 – 10 times; xv = 11 – xx times; 25 = more than 20 times). We used the caregivers' total score on the physical assault scale equally our measure of harsh physical discipline, later on dividing the total score by ten in club to make the scale commensurate with that of our other variables. Examples of items on this scale range from spanking children with a bare manus to choking children. In the NSCAW sample, internal consistency for the measure was α = 0.92. Across waves of data collection, 86% – 91% of children did not experience whatsoever of the "severe" or "very astringent" concrete discipline category events, then scores on this measure out primarily reflected corporal punishment equally opposed to concrete abuse.

Income

Families were classified into five categories based on full family income in 1 year (1 = $0 – $9,999; 2 = $ten,000 – $xix,999; 3 = $20,000 – $29,000; 4 = $xxx,000 – $39,999; 5 = $40,000 and over).

Caregiver's mental health

Caregivers were administered the short-form health survey (Ware, Kosinski, & Keller, 1998), which assesses mental and concrete health. We used the mental health subscale as our measure of caregiver mental health. This subscale has been shown to differentiate groups known to differ in terms of the presence and seriousness of their mental health problems (Ware, Kosinski, & Keller, 1996). Some of the questions on this subscale asked caregivers how often they felt a certain manner, such every bit "downhearted or blue," and others asked how much emotional problems interfered with their daily life and social functioning (1 = all the time; ii = almost of the time; 3 = a practiced bit of the fourth dimension; iv = some of the time; 5 = a picayune of the fourth dimension; 6 = none of the fourth dimension). Caregivers were asked to respond to all questions based on their experiences during the past month. Age- and gender-standardized scores were created, with college scores indicating better mental wellness. Internal consistency for the mental wellness scale in the NSCAW sample was acceptable (α = .79).

Results

Statistical Analyses

In this study, we used a series of latent departure score (LDS) models (Hamagami & McArdle, 2001; Rex et al., 2006) to examine our hypothesis that witnessing violence in the home and existence subjected to harsh concrete subject would predict changes in the externalizing and internalizing symptoms of children previously exposed to violence. LDS modeling has recently been put frontwards as an innovative methodological approach for advancing the longitudinal study of trauma (Male monarch et al., 2006). LDS models are office of a larger family of longitudinal structural models designed to assess growth and alter and offer an advantage over traditional change score approaches by division the truthful score from the mistake variance in a time series and producing an optimally reliable latent change score over assessment points. In the present report, LDS models provide a dynamic ways of testing whether violence exposure predicts changes in children'due south psychopathology symptoms beyond fourth dimension. The structural equation modeling (SEM) framework adopted here besides offers the reward of accounting for the nonindependence of children'southward violence exposure over fourth dimension, and allows usa to accost the question of whether violence exposure predicts changes in children's psychopathology symptoms, after accounting for children'due south prior symptoms and other cardinal predictors of psychopathology.

The analyses proceeded in 3 steps. The aforementioned steps were followed for both externalizing and internalizing symptoms. First, a baseline LDS model was fit to the data to derive the latent symptom change scores. Second, we built on the baseline models to investigate whether witnessing violence in the home and/or experiencing harsh physical discipline predicted changes in children'southward externalizing and internalizing symptoms relative to their own developmental histories after accounting for other of import kid and family gamble factors for psychopathology. Tertiary, nosotros ran multiple group models to examine whether children's previous exposure to physical abuse moderated the relationship between violence exposure and changes in psychopathology symptoms.

Models were estimated using Amos version 5.0 (Arbuckle, 2003). In order to evaluate model fit, we used the model chi-square test; all the same, because the interactive effect of sample size and model error on this test typically causes the model chi-square to exist statistically pregnant with large samples even when the model represents a close fit to the data (MacCallum, 1990), nosotros employed three additional fit indices: the comparative fit index (CFI; Bentler, 1990), the Tucker – Lewis index (TLI; Tucker & Lewis, 1973), and the root hateful square mistake of approximation (RMSEA; Steiger, 1990). Model chi-foursquare values with accompanying p values greater than .05 indicate a good model fit. CFI and TLI values greater than 0.95 and RMSEA values less than 0.05 signal a adept fit; CFI and TLI values between 0.xc and 0.95 and RMSEA values between 0.05 and 0.08 point an acceptable fit. (For a discussion of the various fit indices, run across Browne & Cudeck, 1992; Medsker, Williams, & Holahan, 1994).

Missing information

Missing data ranged from 0% to 36% beyond variables (Mdn = 16%). The most oftentimes missing data were for harsh concrete discipline (26% missing at baseline, 36% missing xviii months postbaseline, and 34% missing 36 months postbaseline). Missing information were addressed using full data maximum likelihood estimation under the supposition that the data were missing completely at random or for reasons that could be explained by other variables included in the model (Little & Rubin, 1987). In technical terms, a covariance coverage matrix is created that provides the proportion of bachelor observations for each time point and pairs of fourth dimension points. This method is a widely accustomed method of addressing missing data within an SEM framework while assuasive for the inclusion of all available data points (Arbuckle, 1996; Enders, 2001; Raykov, 2005), and in the present study retained all two,925 participants for the analyses.

Key Variable Correlations

The correlations between all variables in the models are displayed in Table two. Within-wave correlations between witnessing violence and children's internalizing and externalizing symptoms were consistently small, but significant (rs = .09 – .17). Within-wave correlations between harsh physical discipline and children's internalizing and externalizing symptoms were small to moderate in magnitude (rs = .11 – .25). Within-wave correlations between witnessing violence and harsh physical discipline were modest, but statistically significant (rs = .07 – .10)

Table 2

Correlation Matrix of All Variables in Latent Deviation Score Models

	1	2	iii	four	5	6	seven	8	9	10	11	12	xiii	xiv	fifteen	16
1. Gender	1.00
2. Age	.07	1.00
3. Income, W1	−.01	.05	1.00
four. CGMH, W1	−.01	−.03	.17	1.00
5. Ph. disc., W1	−.09	−.xviii	−.07	−.14	i.00
half-dozen. Ph. disc., W3	−.05	−.18	NA	NA	.50	1.00
seven. Ph. disc., W4	−.06	−.21	NA	NA	.43	.54	1.00
8. Wit. viol., W1	.02	−.08	−.01	−.05	.ten	.08	.07	1.00
9. Wit viol., W3	.05	−.03	NA	NA	.08	.07	.07	.32	1.00
10. Wit. viol., W4	.08	.04	NA	NA	.04	.03	.08	.26	.43	1.00
11. Int., W1	.01	.16	.01	−.31	.xi	.06	.02	.10	.09	.11	one.00
12. Int., W 3	.01	.13	NA	NA	.07	.xiv	.10	.x	.14	.xiii	.66	1.00
13. Int., W4	.03	.x	NA	NA	.06	.10	.16	.08	.11	.16	.46	.57	i.00
14. Ext., W1	−.13	.13	0	−.26	.25	.17	.thirteen	.09	.12	.12	.65	.43	.37	1.00
xv. Ext., W3	−.eleven	.11	NA	NA	.16	.23	.18	.07	.15	.13	.37	.66	.45	.60	1.00
16. Ext., W4	−.xi	.08	NA	NA	.16	.19	.25	.07	.11	.17	.32	.41	.67	.52	.65	1.00

Externalizing Symptoms

Baseline model

We estimated a baseline LDS model for the repeated measure out of externalizing symptoms as assessed at baseline, 18 months postbaseline, and 36 months postbaseline, thereby creating two LDS that represent the change in externalizing symptoms betwixt data collection waves (Figure 1). Blastoff was prepare at .05, and thus all results reported as meaning are p < .05 or better. The baseline model fit the observed data well, and the model fit was meaning, χ²(ane) = 23.31, CFI = 0.99, TLI = 0.95, RMSEA = 0.09. The model-implied mean level of externalizing symptoms decreased significantly from 16.xv to 14.43 externalizing symptoms from baseline to 36 months postbaseline. As displayed in Table 3, results from the model indicated that in that location was enough variability in how children inverse between assessment points (i.due east., variance in the difference scores) to justify testing whether the variation in children'southward latent externalizing change scores could exist explained by witnessing violence and/or experiencing harsh physical field of study.

Baseline latent difference score (LDS) model for externalizing symptoms.

Annotation. In this model, Δ Score 1 is the LDS representing the modify in externalizing symptoms from baseline to xviii months. Δ Score ii is the LDS representing the change in externalizing symptoms from 18 months to 36 months. Double-headed arrows in a higher place the LDS correspond the variance (σ) of the difference scores. Observed scores (externalizing scores) reflect true scores plus error. Double-headed arrows attached to the observed scores represent the error variance (σ) of the externalizing scores at each assessment.

Tabular array 3

Latent Difference Score Model for Witnessed Violence and Concrete Subject on Externalizing Symptoms

Parameter estimates	Estimates	CR
Baseline model
Externalizing symptoms intercept	16.15	75.48***
Initial status variance	72.28	27.58***
Divergence score1 mean	−1.fifteen	−v.65***
Deviation score1 variance	8.68	4.09***
Difference score2 mean	−0.58	−2.99***
Difference score2 variance	xi.82	3.87***
Model with covariates
Exposure to violence
Witnessone→Diff1	0.04	1.02
Witness3→Difftwo	0.03	1.02
Physical discipline1→Unequali	0.12	ii.95**
Physical subject area3→Difftwo	0.12	2.95**
Witness1→Witnessiii	0.38	25.79***
Witness3→Witness4	0.36	25.79***
Physical field of studyane→Physical subject fieldthree	0.55	37.68***
Physical disciplineone→Physical discipline3	0.47	37.68***
Covariates
Historic period→Externalizing intercept	0.xv	7.10***
Gender→Externalizing intercept	−0.16	−seven.79***
Caregiver mental wellness→Externalizing intercept	−0.24	−ten.97***
Income→Externalizing intercept	0.03	1.32

Fit indices	Baseline model	Model with covariates
χ2/df	23.31/ane	315.60/26
CFI	0.99	0.93
TLI	0.95	0.88
RMSEA	0.09	0.07

Does exposure to violence predict changes in children's externalizing scores?

Side by side, nosotros built on the baseline LDS model (Effigy 2) to examine the effects of witnessing abode violence and experiencing harsh concrete subject field on children's externalizing symptoms, after controlling for child gender, family income, caregiver psychopathology, and child age (for ease of presentation, these covariates do non appear in the figure, although the parameter estimates announced in Table three). The model fit the data adequately, and the model fit was pregnant, χⁱⁱ(32) = 315.60, CFI = 0.93, TLI = 0.88, RMSEA = 0.07. Although the TLI has fallen below 0.90, the CFI and RMSEA were however good for a model of this complexity. In that location was no relationship betwixt witnessing violence and change in externalizing symptoms across assessments (β₁ = 0.04, z = 1.02, ns; β_two = 0.03, z = one.02, ns). However, experiencing harsh physical discipline did predict significant changes in children'southward externalizing symptoms across assessments (β_one = 0.12, z = 2.95; β_ii = 0.09, z = 2.95). Although, on average, externalizing bug declined over fourth dimension, children who experienced relatively loftier levels of harsh physical bailiwick showed more gradual declines and, in some cases, increases in externalizing problems from baseline to 36 months postbaseline. This effect remained statistically pregnant after controlling for child and family risk factors.

Latent difference score (LDS) model for the human relationship between witnessing violence, physical discipline, and externalizing symptoms (North= two,925).

Notation. In this model, Δ Score ane is the LDS representing the change in externalizing symptoms from baseline to 18 months. Δ Score 2 is the LDS representing the change in externalizing symptoms from eighteen months to 36 months. The nonindependence of witnessing violence across assessments is represented past the regression of witnessing violence on itself across baseline, 18-month and 36-month assessments. The nonindependence of experiencing physical discipline across assessments is represented by the regression of physical discipline on itself across baseline, xviii-month and 36-month assessments. Double-headed arrows represent the variance of latent and observed variables. Although not shown in the model for sake of clarity, the correlation between witnessed violence and harsh physical bailiwick was pocket-sized but significant (r = .06, p < .05). Parameter estimates in Figure two are adjusted for age, gender, caregiver mental health, and income. Parameter estimates for the covariate controls are non included in Figure 2 but are available in Table 3.

**p < .01. ***p < .001.

We besides ran a multiple group model in order to examine whether maltreatment subtype moderated the relationship between exposure to violence (harsh physical discipline or witnessing violence) and changes in externalizing problems. Specifically, nosotros were interested in whether the furnishings of exposure to violence differed for children who had been physically driveling versus children who had experienced other forms of abuse. We hypothesized that exposure to violence might evoke a response that either reflected habituation or sensitization processes in youth who had already experienced physical violence. Notwithstanding, the model in which the effects of exposure to violence on children'southward externalizing symptoms were constrained to be the same for children who were physically driveling versus children who were not physically abused was not a significantly worse fit than the model in which the upshot of exposure to violence was gratuitous to vary across corruption subgroups, χ²(2) = 0.7, ns. Full analyses are available from the authors upon request.

Internalizing Symptoms

Baseline model

We estimated a baseline LDS model for the repeated measure of internalizing symptoms as assessed at baseline, 18 months postbaseline, and 36 months postbaseline, thereby creating two LDS that stand for the change in internalizing symptoms between data collection waves (Figure 3). The baseline model fit the observed information fairly and the model fit was meaning, χ²(1) = 32.53, CFI = 0.98, TLI = 0.90, RMSEA = 0.x. The model-implied hateful level of internalizing symptoms decreased significantly from 10.41 to 9.32, internalizing symptoms from baseline to 36 months postbaseline. As displayed in Table iv, results from this baseline model indicated that there was enough variability in how children changed betwixt assessment points to justify testing whether the variation in children'due south latent internalizing change scores could be explained by witnessing violence and/or experiencing harsh concrete discipline.

Baseline latent difference score (LDS) model for internalizing symptoms.

Notation. In this model, Δ Score 1 is the LDS representing the change in internalizing symptoms from baseline to 18 months. Δ Score ii is the LDS representing the change in internalizing symptoms from 18 months to 36 months. Double-headed arrows above the LDS represent the variance (σ) of the difference scores. Observed scores (internalizing scores) reflect true scores plus error. Double-headed arrows attached to the observed scores represent the fault variance (σ) of the internalizing scores at each assessment.

Tabular array 4

Latent Deviation Score Model for Witnessed Violence and Physical Discipline on Internalizing Symptoms

Parameter estimates	Estimates	CR
Baseline model
Internalizing symptoms intercept	ten.41	64.64***
Initial status variance	35.99	25.69***
Difference score1 mean	−0.78	−4.74***
Departure score1 variance	ii.91	two.35*
Divergence score2 mean	−0.31	−1.95***
Divergence score2 variance	iii.fifty	1.86
Model with covariates
Exposure to violence
Witness1→Diffane	0.11	2.91**
Witness3→Unequal2	0.12	two.91**
Concrete field of studyone→Unequal1	0.07	1.56
Physical subject field3→Unequalii	0.06	i.56
Witness1→Witness3	0.38	25.81***
Witness3→Witness4	0.36	25.81***
Physical field of studyane→Physical discipline3	0.55	37.64***
Physical disciplineone→Physical subject field3	0.47	37.64***
Covariates
Age→Internalizing intercept	0.19	ix.00***
Gender→Internalizing intercept	−0.01	−.29
Caregiver mental health→Internalizing intercept	−0.31	−xiii.94***
Income→Internalizing intercept	0.06	two.46*

Fit indices	Baseline model	Model with covariates
χ2/df	32.53/i	361.60/26
CFI	0.98	0.92
TLI	0.90	0.85
RMSEA	0.10	0.07

Does exposure to violence predict changes in children's internalizing scores?

Next, nosotros built on the baseline LDS model (Figure 4) to examine the effects of witnessing home violence and experiencing harsh physical field of study on children'due south internalizing symptoms, after decision-making for kid gender, family unit income, caregiver psychopathology, and child age (for ease of presentation, these covariates practice not appear in the figure, although the parameter estimates announced in Table four). The model fit the data adequately, and the model fit was significant, χ^two(32) = 361.60, CFI = 0.92, TLI = 0.85, RMSEA = 0.07. Although the TLI has fallen beneath .90, the CFI and RMSEA were still good for a model of this complexity. At that place was no human relationship between harsh physical subject area and modify in internalizing symptoms across assessments (β₁ = 0.07, z = 1.56, ns; β_ii = 0.06, z = 1.56, ns). However, witnessing violence in the home did predict significant changes in children's internalizing symptoms across assessments (β₁ = 0.11, z = 2.91; β₂ = 0.12, z = 2.91). Although, on average, internalizing problems declined over time, children who witnessed relatively high levels of home violence showed more gradual declines and, in some cases, increases in internalizing problems from baseline to 36 months postbaseline. This result remained statistically significant after controlling for child and family unit risk factors.

Latent divergence score (LDS) model for the human relationship between witnessing violence, physical discipline, and internalizing symptoms (N = 2,925).

Annotation. In this model, Δ Score ane is the LDS representing the modify in internalizing symptoms from baseline to eighteen months. Δ Score two is the LDS representing the change in internalizing symptoms from 18 months to 36 months. The nonindependence of witnessing violence beyond assessments is represented past the regression of witnessing violence on itself across baseline, 18-month and 36-month assessments. The nonindependence of experiencing physical discipline across assessments is represented by the regression of physical discipline on itself across baseline, 18-month and 36-calendar month assessments. Double-headed arrows correspond the variance of latent and observed variables. Although non shown in the model for sake of clarity, the correlation between witnessed violence and harsh physical discipline was minor but significant (r = .06, p < .05). Parameter estimates in Figure 2 are adjusted for age, gender, caregiver mental health, and income. Parameter estimates for the covariate controls are non included in Figure 4 but are available in Table 4.

**p < .01. ***p < .001.

Nosotros likewise ran a multiple group model in order to examine whether maltreatment subtype moderated the relationship between exposure to violence and internalizing problems. Again, we were specifically interested in whether the furnishings of exposure to violence differed for children who had been physically driveling versus children who had not been physically driveling. The model in which the consequence of exposure to violence on children's internalizing symptoms was constrained to be the same for children who were physically abused versus children who were not physically abused was not a significantly worse fit than the model in which the effect of exposure to violence was costless to vary across abuse subgroups, χ²(2) = iii.30, ns. Full analyses are available from the authors upon request.

Discussion

Exposure to violence was associated with changes in children'southward psychopathology symptoms in this study of children previously reported to CPS. Specifically, harsh physical subject field was associated with deviations from the normative sample trajectory of failing externalizing symptoms and witnessing home violence was associated with deviations from the normative sample trajectory of declining internalizing symptoms. These effects of family violence were pregnant even controlling for two potential confounds—family income and caregiver mental wellness—and later controlling for the child's gender and age.

This study had several methodological strengths. Beginning, the sample size was big (N = 2,925) and nationally representative of children involved with CPS in the United States. 2nd, whereas current caregivers reported on their children's externalizing and internalizing symptoms, the children themselves reported on the levels of violence they witnessed in the home. Past studies suggest that caregivers significantly underestimate the amount of domestic violence to which their children are exposed (Jaffe, Wolfe, & Wilson, 1990; O'Brien, John, Margolin, & Erel, 1997). Third, nosotros utilized an SEM approach (LDS modeling) that allowed us to examine the association betwixt witnessing violence, harsh physical subject field, and child psychopathology after controlling for normative developmental changes in children's externalizing and internalizing symptoms over a 36-month period every bit well as a number of potential confounds. The modeling technique too allowed united states to account for the nonindependence of exposure to violence over time. Many past studies in this field have lacked either longitudinal data or sufficient power to have into account children's normative symptom changes and to adequately control for important confounds. Furthermore, because fierce bailiwick tactics and domestic violence witnessed past children frequently co-occur, it is important to attempt to tease apart the effects of each type of violence so as to inform future studies and interventions. Our modeling technique allowed us to examine these questions.

Our findings were largely consistent with the extant literature showing that violence exposure is associated with psychopathology symptoms in children. Additionally, we ruled out three alternative explanations for why harsh physical subject field and witnessing violence were associated with child psychopathology.

First, in light of the extensive trunk of literature showing that mental health problems run in families (east.g., Kendall, 2000), it is not surprising that in our sample, caregivers with poor mental health were raising children who had elevated levels of externalizing and internalizing symptoms. Yet, exposure to violence was notwithstanding predictive of children'south psychopathology symptom changes fifty-fifty subsequently decision-making for caregiver mental health. Thus, we can conclude that our results are not simply reflective of a spurious clan between family violence and child psychopathology generated by caregiver mental wellness issues or by transmission of a genetic vulnerability for mental health problems from parents to children.

Second, multiple studies have shown that poverty is associated with elevated rates of child psychopathology (Bradley & Corwyn, 2002; Brooks-Gunn & Duncan, 1997; Costello et al., 2003; McLoyd, 1997). In improver, studies suggest that low-socioeconomic status (SES) parents are more likely than high-SES parents to engage in harsh or neglectful parenting styles, which are associated with more childhood trouble behaviors (e.g., Bradley & Corwyn, 2002). Even so, harsh physical discipline was uniquely associated with externalizing symptoms and witnessing violence was uniquely associated with internalizing symptoms fifty-fifty controlling for family income.

3rd, it is conceivable that changes in children'southward symptoms merely reflect the passage of fourth dimension and normative trajectories. Even so, in our models, we controlled for children's expected symptom trajectories and showed that exposure to violence predicted deviations from these trajectories.

Implications for Research and Theory

We propose that more enquiry is needed to better understand why family violence increases risk for children'southward mental health issues. For instance, although NSCAW children reported on the violent events they witnessed, they were not asked how they encoded or interpreted the events (or indeed how they encoded physical punishment). Upon reviewing the literature on children who witness domestic violence, Black and Newman (1996) concluded that researchers should give more consideration to the ways in which children cognitively interpret the violent events they witness, and Crockenburg and Forgays (1996) found that children's negative emotional reactions to their fathers during marital arguments independently predicted children'due south behavioral aligning. Future studies might look more than closely at how children who have previously been exposed to violence encode violent events they witness and the ways in which their parents subject field them in order to aid amend empathize the long-term effects of family violence.

Children who have been exposed to violence astringent enough to bring them to the attention of CPS, such every bit the children in this sample, might exist particularly vulnerable to encoding the incidents they witness or feel themselves in a way that contributes to an internal representation of the globe as extremely violent, unsafe, and unpredictable and, consequently, might accept stronger and more negative emotional reactions to violence and conflict. Several studies accept shown that children's histories, including their past exposure to parental conflict, influence how and how much witnessing marital conflict affects them (eastward.g., Cummings, Vogel, Cummings, & El-Sheikh, 1989; Davies, Myers, Cummings, & Heindel, 1999). Specifically, children who have been exposed to marital conflict more often in the past accept more negative emotional reactions to new incidences of interparental conflicts (Davies & Cummings, 1998). If children who take already been victims of maltreatment encode adult domestic violence as especially threatening, this may increase their vulnerability to internalizing and externalizing problems. Pollak'due south piece of work with physically abused children, for instance, suggests that abused children display increased anticipatory monitoring in response to aroused interpersonal situations in the surroundings and display a deficit in their ability to regulate their arousal (Pollak, Vardi, Bechner, & Curtin, 2005).

There are two aspects of the results that should be examined further in future studies. First, concrete abuse did not sally as a significant moderator of the human relationship between family violence and children's internalizing and externalizing problems in these analyses. However, the relationship between family violence and other types of psychopathology (or specific symptoms of internalizing and externalizing issues) may indeed depend on the blazon of corruption the kid experienced. 2nd, experiencing harsh concrete subject field was associated with changes in externalizing symptoms, whereas witnessing violence was associated with changes in internalizing symptoms. As reviewed higher up, other studies accept demonstrated that both forms of family violence are associated with both internalizing and externalizing problems. Thus, our findings volition need to be replicated in other samples before nosotros can conclude with certainty that dissimilar types of family unit violence accept specific furnishings on dissimilar types of kid trouble behaviors. To the extent that our finding is real, however, one possibility is that the unlike cerebral meanings these 2 forms of violence have for children lead to different manifestations of distress.

Finally, other research conducted with the NSCAW sample (Jaffee & Gallop, 2007) and with other samples (Cicchetti & Rogosch, 1997) has institute that formerly driveling children who are "free" of meaning mental health bug at 1 bespeak in fourth dimension rarely maintain good mental health over fourth dimension. Our written report suggests that i reason may exist that children with histories of corruption are often reexposed to various forms of violence that predict the recurrence of mental wellness problems. Again, more research is needed in this surface area.

Implications for Do and Policy

Victims of abuse and neglect are at elevated hazard of witnessing and experiencing other forms of family violence. The results of this study suggest that intervention efforts to reduce rates of mental health problems in child victims of maltreatment must focus non only on protecting children from revictimization just must also work to decrease even nonabusive forms of concrete field of study and the amount of adult domestic violence children witness in their homes. Intervention efforts might help parents manage relationship conflict or, at the very least, educate parents about the importance of buffering children from exposure to conflict.

Past research on children's emotional responses to witnessing marital disharmonize suggests that children are less distressed by irenic conflict when conflicts are resolved with a compromise or an apology (Cummings, Ballard, El-Sheikh, & Lake, 1991). Future studies could explore whether this finding holds for children who witness violent conflict in the home. The impact of various resolution strategies might differ for children who witness violent forms of conflict, in that children who witness a continuous cycle of domestic violence and resolution of violence (such as an abusive father who breaks down into tears and apologizes to the child'south mother just and then abuses her over again the next week) might actually normalize violence and be more prone to future problems. Given past research suggesting that children who witness domestic violence are at risk of encoding violence as an acceptable behavior in relationships (Blackness & Newman, 1996), resolution-improving interventions might emphasize not only that the behavior was unacceptable but besides model for children more appropriate conflict-resolution strategies and disciplinary techniques.

In sum, our findings suggest that reducing the amount of violence that children witness in the abode and the frequency with which their parents use harsh physical bailiwick could be of import foci of effective family therapy interventions and prevention programs for this vulnerable population. Preventing abuse from reoccurring may not be enough to divert children from the maladaptive trajectories on which their by corruption and home environments contributed to placing them in the offset place.

Limitations

First, although harsh physical field of study and witnessing violence were significant and unique predictors of psychopathology symptoms, the zero-order correlations amidst these variables were modest. Second, although reliability and validity statistics for the short-course wellness survey (from which we created our caregiver mental health variable) were skilful, the measure is a broad and general measure of mental wellness. It does non ask questions about specific mental illnesses but rather asks more about daily impairment due to emotional problems. Third, it is possible that some parents underreported their use of vehement disciplinary techniques or children's problems, given that they had already been brought to the attending of CPS. Although efforts were made to minimize this possibility by administering questions nigh concrete discipline via an audio estimator-assisted interview and interviewers were thus unaware of parents' responses, Tourangeau and Yan's (2007) meta-assay establish that estimator administration did non lead to significantly increased reporting of sensitive information past research participants and, indeed, rates of missing data were college for this variable than for others.

4th, although we included a number of variables in the LDS models that might have accounted for the association between children's experiences of family violence and their problem behaviors, information technology is possible that important confounds were non assessed (e.m., measures of neighborhood violence). Moreover, although we attempted to rule out the possibility that poverty accounted for the association between family violence and child psychopathology, it is possible that there was bereft variability in income in this high-hazard sample to fairly examination this hypothesis. Fifth, although youth reported on witnessed violence in the dwelling house, caregivers reported on children'due south experiences of harsh physical subject field too as child psychopathology symptoms, introducing shared informant variance. Sixth, although our models tested whether higher levels of violence predicted changes in psychopathology symptoms, we did non explicitly test whether changes in harsh discipline and witnessed violence predicted changes in psychopathology. Future research should examine this question, especially research intervention designs that modify parenting practices.

Children proceed to be victimized by and exposed to domestic violence at alarming rates. In all likelihood, these children are at increased risk of psychopathology symptoms not simply because they accept been maltreated or exposed to violence merely likewise considering of their family's poverty condition, the neighborhood violence they witness, the poor schools they attend, and the inadequacy of their housing. Thus, studies that explore how and why specific aspects of these early childhood environments affect children's mental health are of import foundational work that will allow for the development of more efficacious, cost-effective, and targeted interventions. Studies that exam alternative hypotheses virtually links between family violence and kid psychopathology help researchers develop more specific hypotheses near mechanisms that link early on babyhood stressors to child socioemotional development.

Acknowledgments

This work was supported past grant HD050691 from the National Constitute of Kid Health and Human Development to Sara R. Jaffee. This document includes data from the National Survey of Child and Adolescent Well-Being, which was developed under contract with the Administration on Children, Youth, and Families, U.Due south. Department of Health and Human Services. The data and opinions expressed herein reflect solely those of the authors.

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703534/

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