IPV is prevalent in the United Kingdom and research suggests it has a profound impact on children that witness it. IPV can affect children of all ages and both genders, and has developmental, social, emotional and behavioural consequences that can persist into adulthood.
Intimate partner violence, known also as “Domestic Violence” is an umbrella term encompassing a range of abusive behaviours exhibited by an individual and directed towards a current or former partner. While the term itself emphasises physical violence (for which it has received some criticism ) the abuse can be psychological, sexual and even financial in nature [2, 3]. Further criticism of the term comes from its gender neutrality in the face of the overwhelming evidence that women are abused by men far more often than the reverse [1, 3].
In the United Kingdom IPV is widespread; 36% of people have reported experiencing some form of abuse. Lifetime adult (aged 16 and above) prevalence of IPV is 45% for women and 26% for men . It is when we examine those who suffer repeatedly and severely from IPV, however, that we begin to see that women are affected far more than men; of those who had experienced 4 or more incidents of IPV from the same perpetrator, 89% were women .
Of course, in addition to the impact of IPV on the affected partner, there is also the question of risk to children of the man or woman. The Royal College of Psychiatrists state that in 75% of the reported cases of IPV there is a child witness; this amounts to 750,000 children each year in the United Kingdom . Further studies have suggested that in 75-90% of incidents of IPV witnessed by children, that child is in the next room to, or even the same room as, the incident .
This essay aims to examine the effects of IPV on the children who witness it (including the impact on development of the child, links to psychiatric illness and social problems) and will address the issue of influencing factors on the affected child’s response to witnessing IPV. It will then explore the matter of the intergenerational transmission of IPV. It will finish by identifying the current strategies employed by healthcare and counselling services to mitigate the impact of IPV on the child.
Impact in Childhood
Of all the research into the effect of IPV on children, comparatively little has been done concerning the impact on infants and toddlers. This is most likely due to pragmatism; it is difficult to assess the impact since the affected infant cannot express his or her feelings regarding the violence that they witnessed. Despite the relatively few rigorous studies (most of which have been done involving violence in general, rather than IPV), there is much speculation on this matter and numerous authors have put forward theories attempting to gauge the result of IPV witnessed by the very young.
The existing research is strongly suggestive of an association between violence and behavioural and emotional problems in the affected infants, which infants witnessing IPV having been seen to; display behaviour that is not appropriate for their expected level of development; show signs of excessive irritability; experience marked sleep disturbances; suffer from emotional distress and fears of isolation disproportionate to their age; and show regression in their toileting an language . Furthermore, it has been shown that exposure to trauma (particularly IPV) negatively influences an infant’s normal development of trust and natural inquisitiveness, which delays and impairs their development of autonomy .
Impact in Childhood
There is much evidence to suggest an impact of violence on school aged children; they are more likely to have sleep difficulties, but less likely to be explorative in their behaviour. They often have problems in school with concentration and attention due to distraction by intrusive thoughts. Additionally, due to their increased intellect compared to infants, school aged children are more cognisant of violence, and be troubled by their own attempts to ask themselves if they could have prevented it .
Studies indicate that children who have witnessed IPV are more likely to develop externalising behaviour problems such as aggression, disobedience and non-compliance, as compared to children without exposure . However, there are discrepancies in the research; some studies undertaken were unable to corroborate the positive findings mentioned previously .
Children witnessing IPV also have been seen to develop internalising problems, such as fearful or inhibited behaviour, lowered self-esteem, anxiety and depression, at a much higher incidence that otherwise similar children without exposure to IPV . Again, however, there is much disagreement in the literature; some studies failed to detect any evidence of increased internalising problems, compared with non-exposed children, at all .
There has also been research into the possibility of the development of post-traumatic stress disorder on children who have witnessed IPV. Such an exposure is postulated to qualify as a traumatic stressor through its involvement of the harm or threat of harm to a loved one, and a sense of helplessness in the child . Children can experience: flashbacks or vivid dreams in which they relive the incident; hypervigilance and heightened startle reflex; and emotional withdrawal. A number of studies in child witnesses of IPV have found that these posttraumatic stress symptoms were present; indeed one of these studies in shelter children found 95 per cent of the children interviewed met the criteria for clinical post-traumatic stress disorder . This study was unique in that it excluded children who had been the victims of direct abuse, which is not only known to be common in witnesses of IPV, but also associated with PTSD in its own right. In this way, the study examined as much as possible the effect of solely witnessing IPV on children, whereas the other studies may have been detected the effect of abuse of the child. Of course, it is to be expected that children in shelters would be the most severely affected due to the nature of abuse that forced the mother into a shelter, and this is a limitation of the study. However, another of the studies examined the effect of IPV on children in a range of settings, thus removing the limitation of bias in shelter children, and found that exposure to IPV was predictive of PTSD scores. This study, however, was limited by the aforementioned failure to exclude victims of direct abuse .
After the peak of research interest into school aged children there is a drop off in terms of focus, with studies into the effects if witnessing IPV on adolescents relatively few in number. Furthermore, these studies do not always seem to agree in their findings, indicating that more, and larger, studies may be needed to assess the impact of IPV on the teenage years.
It has been reported that adolescence males exposed in the home to IPV were more likely to exhibit abusive behaviours in intimate relationships, and both male and females were more likely to be a victim of abuse in such relationships .
One relevant study, published in 2002, examined the effects of IPV and child abuse on adolescent mental health and ability to form and maintain relationships, collecting data on 111 adolescents aged between 14 and 16 . Interestingly, the data suggests that by the time of adolescence, witnessing IPV has a much reduced deleterious impact, compared to the impact on a younger child. The authors speculate that it may be the fact that older children are more able to physically remove themselves from violence when it occurs, or a greater emotional distance from their parents, that results in this lesser impact on adolescents. The authors go on to raise the salient point that in light of this finding interventions should be aimed at families with younger children where the impact of IPV is greater, a topic which will be discussed in greater detail towards the end of this essay. Next, the study reported that adolescents who had witnessed IPV were more likely to have an avoidant attachment style, as opposed to a secure style. Affected teens are more likely to have negative attitudes towards forming new relationships, and have reduced satisfaction in the nature of the relationship with their closest friend. Finally, this study reported findings that, to a degree, contrasted with the point made earlier regarding the link between exposure to IPV and abusive behaviour in relationships. This study found that adolescents were not more likely to be involved in violent relationships as perpetrators, although they were at greater risk of being the victims.
Factors affecting outcome of witnessing IPV
Considering IPV in isolation, and children and IPV as absolutes is both inappropriate and unhelpful. In order to assess the nature of the problem effectively, the plethora of confounding factors must be taken into account.
The IPV itself
Studies that have examined how the nature of the IPV affects its impact on children have suggested that the following are of importance: the nature and intensity of the IPV; the frequency of the IPV; and the duration of the IPV.
Research shows that whilst IPV involving direct physical harm to either partner may be more upsetting to the child than non-physical incidents, other forms of IPV, such as verbal abuse, threats and aggression directed to objects (e.g. furniture) are just as important in predicting child behaviour problems .
Further study reveals that, perhaps predictably, longer lasting, more intense and more recent IPV is associated with greater levels of distress in the children who witness it. What is interesting, however, is that children exposed to frequent IPV over large time periods are more likely to react in a more negative way than those who are not exposed for so long and often. The authors comment that this suggests than rather than become resistant to the effect of IPV over time, instead repeated and chronic exposure to IPV seems to sensitise children. Speculated to be a reason for this is the possibility of hyperarousal of affected children, and the erroneous interpretation of some benign behaviour as anger .
The literature seems to indicate that there is differential reaction between boys and girls in response to witnessing IPV. Boys tend to exhibit externalised problems such as aggression, while girls a more likely to exhibit internalised problems such as depression and anxiety [16, 17]. This is suggested to be as a result of boys perceiving threats from the violence and responding with their own aggression, while girls a more self-blaming and internalise the problems.
As touched upon previously, witnessing IPV affects children of different ages in different ways. Research seems to suggest that earlier exposure to IPV is more detrimental than later exposure.
Direct abuse of the child
It has been long established that children exposed to IPV are at a higher risk of being the victims of abuse by their parents; however, the literature regarding the effects of this simultaneity is mixed. Some studies suggest there is an additive effect i.e. those children experiencing both direct abuse and witnessing IPV are doubly affected . However, other studies report that children who witness IPV and are abused do not seem to be affected to any greater extent than children either solely abused or solely witnessing IPV .
The Intergeneration Transmission of IPV
Studies have shown that there is an association between witnessing IPV as a child, and committing or being a victim of IPV in adulthood and a meta-analysis was published in 2004 confirming this observation . This meta-analysis included 39 studies which collectively included data from 12,981 sampled individuals. Social learning theory has been used to explain this phenomenon, with children learning social interaction, what is and what isn’t acceptable, from important figures in their young life. Therefore when children witness IPV, they are learning to associate the use of violence to resolve disputes with a positive outcome .
Interventions: How best to help?
There is no dedicated service in the United Kingdom to provide support for children who have witnessed IPV beyond the existing legislation for the safeguarding of children.
There are two important approaches to mitigating the damaging effects of IPV to children; primary and secondary of prevention of IPV; and directly helping witnesses of IPV to cope through therapy etc.
Primary prevention of IPV can be through classes aimed at training parents to more effectively resolve family disputes, and classes in schools aimed at educating children regarding healthy relationships and conflict resolution . Secondary prevention can be achieved through regular screening for IPV when either the parent or the child comes into contact with the health care service .
The main focus of services to children affected by IPV should be of unlearning the negative behaviour they developed as a result of the violence .