Child abuse and neglect and intimate partner violence victimization and perpetration: A prospective investigation

Abstract

This paper describes the extent to which abused and neglected children report intimate partner violence (IPV) victimization and perpetration when followed up into middle adulthood. Using data from a prospective cohort design study, children (ages 0–11) with documented histories of physical and sexual abuse and/or neglect (n = 497) were matched with children without such histories (n = 395) and assessed in adulthood (M_age = 39.5). Prevalence, number, and variety of four types of IPV (psychological abuse, physical violence, sexual violence, and injury) were measured. Over 80% of both groups – childhood abuse and neglect (CAN) and controls – reported some form of IPV victimization during the past year (most commonly psychological abuse) and about 75% of both groups reported perpetration of IPV toward their partner. Controlling for age, sex, and race, overall CAN [adjusted odds ratio (AOR) = 1.60, 95% CI [1.03, 2.49]], physical abuse (AOR = 2.52, 95% CI [1.17, 5.40]), and neglect (AOR = 1.64, 95% CI [1.04, 2.59]) predicted increased risk for being victimized by a partner via physical injury. CAN and neglect also predicted being victimized by a greater number and variety of IPV acts. CAN and control groups did not differ in reports of perpetration of IPV, although neglect predicted greater likelihood of perpetrating physical injury to a partner, compared to controls. Abused/neglected females were more likely to report being injured by their partner, whereas maltreated males did not. This study found that child maltreatment increases risk for the most serious form of IPV involving physical injury. Increased attention should be paid to IPV (victimization and perpetration) in individuals with histories of neglect.

Introduction

Intimate partner or domestic violence (IPV) continues to be a serious problem in the United States and internationally. It is estimated that more than a third of women (35.6%) and more than a quarter of men (28.5%) in the United States experience rape, physical violence, and/or stalking by an intimate partner in their lifetime (Black et al., 2011). Estimates from the National Family Violence Surveys indicate that approximately 1 out of 6 couples experience IPV annually (Schafer, Caetano, & Clark, 1998). The medical care, mental health services, and lost productivity costs associated with IPV have been estimated to be more than $8.3 billion (Max, Rice, Finkelstein, Bardwell, & Leadbetter, 2004).

Another form of family violence, child maltreatment, also represents a major public health concern in the United States and abroad (Gilbert et al., 2009). In the United States in fiscal year 2010, approximately 3.3 million children were referred to child protection service agencies for suspected maltreatment, and about 695,000 children were determined by state and local child protective service agencies to be victims of maltreatment. About 1,560 children died as a result of child abuse or neglect in 2010 (U.S. Department of Health and Human Services, 2011).

This paper examines the extent to which experiencing abuse or neglect in childhood increases a person's risk for intimate partner violence perpetration and victimization in adulthood. Numerous studies have reported a relationship between child abuse and neglect (CAN) and the perpetration of IPV. Using data from the Toledo Adolescent Relationships Study, Swinford, DeMaris, Cernkovich, and Giordano (2000) found that child abuse (measured by exposure to harsh physical discipline) predicted IPV. In another study controlling for early family violence, Linder and Collins (2005) found that individuals exposed to child abuse were at risk for IPV in romantic relationships. In one of the few prospective studies to examine this relationship, Ehrensaft et al. (2003) found that childhood physical abuse was the best predictor of perpetrating partner violence as well as injury to the victim, but that the effect was due to other factors, including exposure to partner violence between parents. Although White and Widom (2003) found that CAN was a significant predictor of perpetration of IPV in adulthood, other researchers have questioned the relationship between experiencing abuse as a child and subsequent spouse abuse (Herrera and McCloskey, 2003, O’Leary and Jouriles, 1993, Simons et al., 1995).

In their meta-analysis of the research literature on the intergenerational transmission of spouse abuse, Stith et al. (2000) concluded that the findings suggest a “weak-to-moderate relationship between growing up in an abusive family and becoming involved in a violent martial relationship” (p. 640), with an overall effect size of .16 across 30 studies. More than 10 years later, Capaldi, Knoble, Shortt, and Kim (2012) concluded that the “findings indicate a low-to-moderate significant association of child abuse and neglect with later IPV” (p. 247), based on their systematic review of risk factors for intimate partner violence that included the role of child abuse. Capaldi and colleagues also cautioned that these findings are “generally over-reliant on retrospective reports” (p. 247).

Studies have also examined whether child abuse is associated with increased risk for being victimized in the context of partner violence (Cappell and Heiner, 1990, Feerick et al., 2002, McKinney et al., 2009, Mihalic and Elliot, 1997, Murphy, 2011, Renner and Slack, 2006, Renner and Whitney, 2012, Seedat et al., 2005, Simons et al., 1993). Many of these studies have focused on childhood sexual abuse as a risk factor IPV victimization. For example, Renner and Slack (2006) found that childhood physical and sexual abuse predicted IPV victimization, controlling for demographic and other childhood factors. One recent systematic review of data from the East Asia and Pacific Region reported that children who had been sexually abused had a threefold increase in risk of IPV victimization later in life (Fry, McCoy, & Swales, 2012). In studies of civilian women (Caetano, Ramisetty-Mikler, & Field, 2005) and female enlisted soldiers married to civilian men (Forgey & Badger, 2010), women reporting severe bi-directional IPV were more likely to endorse a child sexual abuse history. In a large nationally representative Canadian sample, childhood sexual abuse was associated with later IPV victimization for women and men, although the relationship was stronger for women than for men (Daigneault, Hebert, & McDuff, 2009). In contrast, a study of young adults participating in the National Longitudinal Study of Adolescent Health found no relationship between reports of sexual abuse and partner violence (Renner & Whitney, 2012), and another study involving adult methadone users found that forceful child sexual abuse or sexual abuse by a family member was not associated with an increased risk of later IPV (Engstrom, El-Bassel, & Gilbert, 2012).

Thus, findings on the extent to which exposure to violence in childhood increases a person's risk for IPV in adulthood are not always consistent. Part of the problem for these contradictory findings may be related to a number of issues that Stith et al. (2000) note that make studying the intergenerational transmission of spouse abuse complex. The first issue concerns potentially different effects of witnessing violence compared to experiencing violence as a child. Although much of the existing literature focuses on children who witness violence between parents, a number of studies suggest that the consequences of these two childhood experiences may differ (Cappell and Heiner, 1990, Dunlap et al., 2002, Mihalic and Elliot, 1997, Moffitt and Caspi, 1999, Simons and Johnson, 1998). In this paper, we focus exclusively on the experience of abuse and neglect in childhood and its impact on risk for intimate partner violence in adulthood.

The second issue raised by Stith et al. (2000) and relevant here is the extent to which children growing up in violent homes are at risk for becoming perpetrators and/or victims of intimate partner violence. As noted, there is some support for each of these outcomes, with some studies showing increased risk for perpetration of partner violence and others showing increased risk for IPV victimization.

Third, there is some reason to expect that rates and patterns of victimization and perpetration may vary by gender and that the link between childhood abuse and subsequent partner violence perpetration and victimization may be manifest differently in males and females (Langhinrichsen-Rohling et al., 1995, Mihalic and Elliot, 1997, Stith et al., 2000). Downey, Feldman, Khuri, Reynolds, and William (1994) suggested that the consequences of child abuse may parallel gender differences in the expressions of psychopathology, with maltreated boys being more likely to externalize their pain and suffering and becoming perpetrators of violence, whereas maltreated girls more likely to internalize their pain (Friedrich, Urquiza, & Beilke, 1986) and become attached to men who victimize them and increase their risk of IPV victimization in the process (Carmen et al., 1984, Jaffee et al., 1990, Widom, 1989b). In their meta-analysis, Stith et al. (2000) predicted that there would be gender differences in socialization experiences, based on the rationale that where men are socialized to be aggressive and to use violence to settle arguments and conflicts (Sugarman & Frankel, 1996), this is not the case for women. The results of their meta-analysis provided support for their hypothesis, with males from violent homes being more likely to be perpetrators of spouse abuse (d = .21) compared to women from violent homes (d = .11).

Studies that have investigated whether there are gender differences in these relationships are few and have also produced mixed results. Women who grow up in violent families have been reported to be at increased risk to become victims of spouse abuse (Cappell and Heiner, 1990, Doumas et al., 1994). However, the majority of studies report a link between family of origin violence and men's perpetration of marital violence (Barnett et al., 1997, Delsol and Margolin, 2004). For example, it is estimated that males who report experiencing family violence are 3–10 times more likely to engage in partner violence than males without such histories (Gover et al., 2008, Lawson, 2008, Murphy et al., 1993, Straus et al., 1980). Doumas et al. (1994) found that abused boys were at higher risk for perpetrating IPV as adults than girls. However, Magdol, Moffitt, Caspi, and Silva (1998) reported similar developmental antecedents for male and female perpetrators of IPV, but the link between abuse history and IPV perpetration was stronger for females. Capaldi and Clark (1998) also found that childhood family experiences were more predictive of female than male perpetration of IPV. Using data from the Seattle Social Development Project, Herrenkohl et al. (2004) found that child abuse was a predictor of IPV for men, but for females, the relationship was moderated by the quality of the relationship to the partner. White and Widom (2003) found that both males and females with documented histories of childhood abuse and/or neglect reported significantly higher rates of ever hitting or throwing things at a partner, ever hitting or throwing first, and ever hitting or throwing first more than once in young adulthood, compared to controls without such histories.

Understanding these relationships is further complicated because CAN and IPV are correlated with socioeconomic status (Fang and Corso, 2008, Kruttschnitt et al., 1994, Straus and Gelles, 1990). This is particularly true for assessing partner violence, because rates of IPV vary by demographic characteristics (Cunradi et al., 2002, Field and Caetano, 2004, Gelles, 1993, Rennison and Rand, 2003). Low socioeconomic status has also been associated with higher rates of marital conflict and divorce (Conger, Ge, Elder, Lorenz, & Simons, 1994). Thus, children from economically disadvantaged homes may be more likely than other children to be exposed to less stable marital models. Matching for social class is important because it is theoretically plausible that any relationship between CAN and later outcomes is confounded or explained by social class differences (Adler et al., 1994, Bradley and Corwyn, 2002, Conroy et al., 2010, MacMillan et al., 2001, Widom, 1989b). Studies that lack groups from comparable backgrounds make it difficult to establish the effect of child abuse on later behaviors, independent of the impact of socio-economic disadvantage.

Drawing firm conclusions from these studies is also problematic for a number of other reasons. Many of the studies are cross-sectional in design and, therefore, there is ambiguity in interpreting study findings, because information on outcomes was collected at the same time as information about the predictor (child maltreatment). Most studies have relied on retrospective self-reports of childhood victimization, raising questions about the reliability and validity of such measures (Henry et al., 1994, McCauley et al., 1997, Ross, 1989, Squire, 1989). IPV offenders may inaccurately report a history of prior abuse in order to justify their current behavior (Romans, Martin, Anderson, O'Shea, & Mullens, 1995). Studies have often used only one indicator of IPV or a few questions, potentially yielding an incomplete assessment of IPV. Finally, since males and females are not distributed equally across different types of abuse and neglect (i.e., more females are sexually abused), gender differences in these relationships may be confounded with the type of maltreatment.

The present study has several advantages. First, the prospective longitudinal design of this study allows for determination of the correct temporal sequence of the variables of interest. We trace long-term outcomes for individuals with documented histories of childhood physical and sexual abuse and neglect and a matched control group. Second, we use documented cases of childhood maltreatment that minimizes potential problems with reliance on retrospective self-reports and avoids problems of recall of abuse and neglect. Third, we include more than one type of abuse and/or neglect and males and females. Fourth, we use a clear operational definition of CAN. Fifth, we utilize multiple indicators of IPV (prevalence, number, and variety) so that we can examine the extent of IPV comprehensively. Finally, because we recognize the bidirectional nature of these IPV relationships, we examine both IPV victimization (partner to participant) and perpetration (participant to partner).

The purpose of this research is to examine whether abused and neglected children report higher levels of intimate partner violence (victimization and perpetration) in adulthood than a matched control group and whether there are differences in these relationships by gender. Specifically, we address three basic questions:

• Are individuals with documented histories of CAN at increased risk for intimate partner violence victimization and perpetration (prevalence, number, and variety) in adulthood compared to matched controls?

• Are individuals with histories of childhood physical abuse (i.e., those who experienced physical violence as children) more likely to be violent toward their partner than matched controls (perpetration), based on the theory that harsh discipline or physical abuse increases the probability that children will grow up to behave aggressively toward family members?

• Are there gender differences in the relationships between childhood maltreatment and IPV in adulthood? That is, are females with documented histories of CAN more likely to be victims of IPV in adulthood than matched female controls? Are abused and neglected males more likely to perpetrate IPV in adulthood compared to matched male controls?