The relationship between exposure to family violence in childhood and post-traumatic stress symptoms in young adulthood: The mediating role of social support

Abstract

Background

Extensive research has examined the relationship between exposure to family violence and its long-term mental health effects. Social support has been found to moderate this relationship, but there is a dearth of research on its mediating role.

Objectives

The article presents the results of a study on the relationship between witnessing interparental violence and experiencing parental violence during childhood and adolescence on the one hand, and post-traumatic stress symptoms (PTSS) during young adulthood on the other. In addition, the article presents results on the role of social support as a mediator in this relationship.

Method, participants, and setting

A cross-sectional survey was conducted among 516 Israeli university and college students (90.7% female, and 9.3% male; M age = 24.9, SD = 2.7) using a retrospective, self-administered questionnaire.

Results

The results revealed that exposure to each pattern of family violence (i.e., witnessing interparental violence and experiencing parental violence) predicted higher levels of PTSS. Furthermore, social support was found to partially mediate the relationship between exposure to family violence during childhood and adolescence and current PTSS as well as its four symptoms, i.e., depression, sleep disturbance, dissociation, and anxiety.

Conclusions

The results of the current study highlight the important role of social support in the association between adversities experienced early in life and young adulthood outcomes. The findings are interpreted on the basis of Conservation of Resources Theory (Hobfoll et al., 1990), which served as the conceptual framework for the study. The limitations of the study and implications for future research are discussed.

Introduction

Children and youth who live in homes in which violence occurs between their parents can be exposed to various forms of family violence. They may witness or hear violent acts, experience parental violence themselves, or both (Edleson, 1999; Haj-Yahia & Bargal, 2015; Hamby, Finkelhor, Turner, & Ormrod, 2011; Holden, 2003). Such exposure is associated with a range of mental health symptoms – both long-term (e.g., Norman et al., 2012) and short-term (e.g., Kitzmann, Gaylord, Holt, & Kenny, 2003). One of the most documented mental health effects is post-traumatic stress symptoms (PTSS), and there is extensive research dealing with the effect of exposure to family violence on the development of PTSS (Dovran et al., 2016; Haj-Yahia & Bargal, 2015; McLaughlin et al., 2013). Nevertheless, not all victims of family violence experience long-term mental health consequences, and a substantial proportion of the adults who were exposed to violence during childhood have shown positive adaptation and reported no mental health problems (Collishaw et al., 2007). This variability had led researchers to examine factors that might mediate or moderate the outcomes of exposure to family violence.

Social support is considered a protective factor that buffers the negative effects of risk factors (Heaney & Israel, 2008), and may contribute to explaining the variability in outcomes. There is evidence that the relationship between exposure to family violence and PTSS is stronger among people with low levels of social support (Evans, Steel, & DiLillo, 2013), i.e., that social support moderates this relationship. Alternatively, it is possible that PTSS is exacerbated by low levels of social support. According to this interpretation, exposure to family violence increases the risk of PTSS; however, this relationship is inversely related to the levels of social support available to the individual. That is, when levels of social support are low, the risk of developing PTSS is greater (Schumm, Briggs-Phillips, & Hobfoll, 2006). In the context of family violence, the source of stress is within the family, has a substantial influence on the relations between family members, on trust in others and on perceptions of one's personal security or the safety of a loved family member (such as the mother or siblings). In this context, some researchers believe that social support will not have a moderating effect (Margolin, 2005; McCloskey, Figueredo, & Koss, 1995).

Notwithstanding the above-mentioned evidence, few studies to date have focused on the mediating role of social support in the context of exposure to family violence and its effects (Melkman, 2017; Vranceanu, Hobfoll, & Johnson, 2007). The present study aimed to examine the association of exposure to family violence (mainly witnessing interparental violence and experiencing parental violence) during childhood and adolescence, with post-traumatic stress symptoms (PTSS) during young adulthood. We also examined whether social support in the present constitutes a mediating factor for the relationship between exposure to family violence and PTSS, as well as depression, anxiety, sleep disturbance, and dissociation, in young adulthood.

In the current study, the expression exposure to family violence consists of two patterns: (a) witnessing interparental violence, and (b) direct experience with parental violence. In each of these patterns, both types of violence, i.e., physical violence (PV) and psychological aggression (PA) were examined. Physical violence is defined as "the intentional use of physical force with the potential for causing death, disability, injury, or harm. Physical violence includes, but is not limited to: scratching, pushing, shoving, throwing, grabbing, biting, choking, shaking, hair-pulling, slapping, punching, hitting, burning, use of a weapon (gun, knife, or other object), and use of restraints or one’s body, size, or strength against another person" (Breiding, Basile, Smith, Black, & Mahendra, 2015, p. 11). Psychological aggression is defined as " the use of verbal and non-verbal communication with the intent to: a) harm another person mentally or emotionally, and/or b) exert control over another person" (Breiding et al., 2015, p. 15).