Risk Factors for Children in Situations of Family Violence in the Context of Separation and Divorce

Appendix B

A detailed overview of the impacts of exposure to family violence on children at each developmental stage

It is recognized that not all children will be affected in the same way by violence.  Individual, relational and contextual resiliency factors also play a role in understanding children’s developmental trajectories.  Moreover, children who have more chronic, frequent and severe experiences of abuse and adversity in childhood (e.g., victimized by more than one person; experience several forms of abuse) will tend to be more negatively impacted than those with fewer and less chronic abuse experiences (Finkelhor, Ormrod & Turner, 2007).  It is important to note that children exposed to family violence, regardless of developmental stage, may experience physical injuries from either being the target of the abuse or attempting to intervene in a domestic violence incident between parents (Wathen, 2012; Fantuzzo et al., 1997; Jaffe & Juodis, 2006).

Pregnancy

Experiences of family violence throughout pregnancy not only result in negative implications for the mother, but the infant as well. In comparison to mothers who have not been victimized by family violence, mothers who have suffered family violence while pregnant have infants who are at a higher risk for infant childhood mortality, preterm birth, and low birth weight (Alhusen, et al., 2013; Shah & Shah 2010). Where mothers use drugs and alcohol to cope with the violence, adverse neonatal outcomes may also result (Alhusen, et al., 2013). Alhusen and colleagues (2013) completed a study investigating the adverse outcomes of domestic violence during pregnancy. The results concluded that out of the sample of 166 low income pregnant women, one in five reported experiencing physical abuse during their pregnancy. Of the women who experienced domestic violence, 63% reported using marijuana during their pregnancy.  Moreover, pregnant women who experience family violence are at a greater risk for becoming victims of domestic homicide (Campbell et al., 2003; Krulewitch, Roberts, & Thompson, 2003; Shadigian & Bauer, 2004). Consequently, as a result of this heightened risk to pregnant mothers, unborn children are also at an increased risk for mortality.

Infants, Toddlers, and Preschoolers (ages 0-3)

Infancy is a critical time for child development, as it is the time in which children are developing attachments to their parents (Emanuel, 2004). The emotional state of the parent impacts the attachment formed between them and their child. For example, a parent who is experiencing domestic violence and is in a state of heightened anxiety and stress may not be able to form a healthy attachment with her child due to the unpredictability of her emotions and actions (Emanuel, 2004). This may ultimately impact the child's normal development, and emotional regulation (Levendosky, et al., 2006). Furthermore, children who experience family violence and/or child maltreatment are more likely to develop behavioural problems, social difficulties, post-traumatic stress symptoms, and have difficulty with empathy and verbal abilities (Holt, Buckley, & Whelan, 2008; Huth-Bocks et al., 2004). These children may also experience excessive irritability, aggression, temper tantrums, sleep disturbances, emotional distress, and resisting comfort (Holt, Buckley, & Whelan, 2008; Osofksy, 1999; Lundy & Grossman, 2005). Adverse psychosomatic effects are also observed amongst children exposed to family violence such as headaches, stomachaches, asthma, insomnia, nightmares, and sleep walking (Martin, 2002).

Research has shown that environmental stress, such as domestic violence, can negatively impact young children's neurocognitive development.  Exposure to domestic violence can lead to IQ suppression and delayed intellectual development for children (Koenen et al., 2003).  As well, exposure to domestic violence and physical abuse can elicit heightened neural activity in children's brains similar to that of soldiers exposed to violent combat situations (McCrory et al., 2011).  Another study found that exposure to violence in childhood (i.e., exposure to two or more types of violence including domestic violence, physical abuse, bullying) is associated with accelerated telomere (protective cap at the end of DNA chromosome) erosion leading to age-related diseases in adulthood (Shalev et al., 2012).

Recognition of the impact violence has on early child development has led to some good examples of a comprehensive system of monitoring early childhood outcomes in order to provide timely intervention (Hertzman, Clinton, & Lynk, 2011).  In 2009, Ontario initiated an enhanced 18-month well-baby visit with physicians recognizing that this would be the last regularly scheduled primary care encounter before the child begins school.  It was recommended by an expert panel, which included the Ontario College of Family Physicians and the Ministry of Children and Youth Services, that standardized tools (e.g., the Rourke Baby Record; Nipissing District Developmental Screen) be used during this visit to facilitate a broader discussion with parents about child development, parenting, access to programs and services that promote healthy child development and learning, and promoting early literacy (Williams & Clinton, 2011).

School-Age Children (ages 4–12)

School-age children have often developed increased emotional awareness and cognitive abilities, which is attributed to their tendency to better understand the family violence (Holt et al., 2008). This understanding often occurs in the form of developing reasoning for the abuse, and based on that, attempts to predict and prevent the abuse (Holt et al., 2008). These children are at a heightened risk for developing anti-social rationales for abusive behaviour, as they have a tendency to rationalize the behaviour of the parent by engaging in self-blame (Cunningham & Baker, 2004; Holt et al., 2008). Children who engage in self-blame may be doing so in order to cope with the violence; however, as a result of the self-blame they often experience internalizing behaviours of humiliation, shame, guilt, mistrust, and low self-esteem (Avanci et al., 2012). Moreover, these children are often in a state of anxiety and fear due to disorganized family life as an aftermath of family violence (Jaffe et al, 2012). The children may not be certain when to seek security from their family versus when to withdraw in case violence occurs.

School-age children who experience child maltreatment typically have increased difficulties with social skills, which in turn may result in inappropriate reactions to social situations, either overly aggressive or passive (Bauer et al, 2006; Cunningham & Baker, 2004). Unfortunately, these anti-social reactions can also lead to externalizing and internalizing behaviours such as difficulty adhering to school rules, negative peer relations, acting out, depression, and bullying (Avanci et al., 2012; Lundy & Grossman, 2005). According to Moore and Pepler (1998), academically, children experiencing child maltreatment are typically found to present in one of two ways. Either their academic abilities are compromised due to their inability to focus, lack of energy, and absenteeism, or they apply themselves completely to school in efforts to distract themselves or avoid going home. Most importantly, every child is different; therefore their displays of internalizing and externalizing behaviours may vary. Not all children experiencing child maltreatment develop behaviours that warrant clinical intervention (Kernic et al., 2003).

Adolescents (ages 13-19)

Compared to school-age children, adolescents are at an age of heightened independence and personal choice. To an extent, they have the freedom to make a number of positive or negative decisions for themselves, including moving out of the violent home, turning to other family members for support, engaging in anti-social activities with peers or running away from home. However, despite their newly acquired freedom, adolescents from violent homes are often tied down by similar, if not exacerbated, restraints found amongst school-age children. These include feelings of depression, suicidal ideation, anxiety, worry, aggression, and social withdrawal (Avanci et al., 2012; Holt et al., 2008; Jaffe et al., 2012).

Adolescents enter a period in life where the impact of a history with domestic violence and child maltreatment enters into their personal and social life. As previously mentioned, experience with family violence can result in maladaptive attachment styles. Most commonly observed amongst adolescents who have experienced family violence is an avoidant attachment style (avoiding parents; not rejecting attention but not seeking it out either; treating the caregiver/parent similarly to a stranger) (Levendosky, Huth-Bocks, & Semel, 2002). As a result of this attachment style, these adolescents have a difficult time forming and maintaining healthy intimate relationships. Growing up with family violence may result in a distorted view of intimate relationships, as well as the development of a lack of trust in intimate relationships (Levendosky, Huth-Bocks, & Semel, 2002). Not only do these adolescents experience a lack of trust, they are also at a heightened risk for engaging in violent behaviours by acting out toward peers or romantic partners (Wolfe, Wekerle, Scott, Straatman, & Grasley, 2004). Moreover, adolescents who have experienced child maltreatment are often unsure of their capacity to control themselves, doubting their ability to remain non-violent in romantic relationships (Goldblatt, 2003). There may be great variability in outcomes depending on whether they identify with a parent who is a perpetrator of violence or the parent in the victim role.

In order to cope with their experiences of violence, adolescents may turn to alcohol and illicit drugs, or withdraw themselves from the violent situations either physically or by mentally disengaging (Cunningham & Baker, 2004; Jaffe et al., 2012). Alternatively, adolescents may develop an intense anger toward the situation and attempt to prevent it or intervene (Hester, Pearson, & Harwin, 2000; Holt et al, 2008). The adolescent may typically engage in one of two behaviours: either they will attempt to reduce conflict by distracting or calming down those involved, or they will engage themselves physically to protect the victims (Goldblatt & Eisikovits, 2005; Jaffe et al., 2012). Although the actions of the adolescent may provide immediate relief to the victims; long-term results may include severe emotional distress as the adolescent was forced to become a responsible adult early on, therefore losing out on some normal stages of childhood development (Holt et al., 2008).

Adults

The longstanding theory of the intergenerational transmission of violence posits that maltreated children may become future perpetrators of violence in their own families (Curtis, 1963). Smith and colleagues (2011) began a longitudinal study in 1987 to evaluate the theory of intergenerational transmission of violence by studying close to1000 adolescents. The results concluded that those who were exposed to domestic violence throughout adolescence had increased odds of perpetrating relationship violence in early adulthood. Also, those who experienced relationship violence in early adulthood were at increased risk for experiencing partner violence later in life. Escape avoidance coping styles (disengaging or staying away from a stressful situation) are used by a number of children experiencing family violence. Those who continue to use those coping styles throughout life are at an increased risk for experiencing partner violence in adulthood, as they may not have developed adaptive mechanisms for problem solving (Hezel-Riggin & Meads, 2011).

Individuals who were victims of family violence throughout their childhood and adolescence are also more likely to develop symptoms such as depression, anxiety, dissociation, and post-traumatic stress in adulthood (Fijiwata, Okuyama, & Izumi, 2012; Hetzel-Riggin & Meads, 2011). The depressive and dissociative symptoms of adult survivors of childhood maltreatment are found to be associated with a decrease in parenting quality (Fijiwata et al., 2012). Specifically, as a result of their mental health problems, mothers who experienced childhood maltreatment were less likely to praise their children, than women who did not experience such violence.  Furthermore, exposure to child sexual abuse is associated with impairment in interpersonal functioning, education, and criminal behaviour (Wathen, 2012).  Other long-term physical health impairments can include liver disease, sexually transmitted diseases and heart disease (Wathen, 2012).

Filicide

Filicide (a parent killing their child) occurs in a small proportion of family violence cases. Fathers perpetrate filicide at an equal or slightly higher rate than mothers.  Filicide is associated with high rates of suicide, significant life stressors, lack of social support, social isolation and a history of childhood maltreatment (Bourget, Grace, & Whitehurst 2007). Although similar in terms of some risk factors present, fathers and mothers differ in the type of filicide they are most likely to commit. The most common category of fatal child maltreatment is severe physical abuse leading to death (UNICEF 2003; Baralic et al. 2010; Lee & Lathrop 2010; Kajese et al. 2011; Sidebotham et al. 2011). Such deaths are typically caused by a head injury resulting from a violent assault (e.g., shaking, impact-injuries) but also include beatings, stabbings, and strangulation where there was no obvious intent to kill. Fathers predominate as perpetrators of this form of filicide. Fathers also commit about half of the cases of deliberate filicides (Baralic et al., 2010; Sidebotham et al., 2011). Familicide (attempts to kill multiple members of the family) and retaliating filicide (deliberate murder of a child to cause harm and suffering to the other parent) are both specific classes of filicide much more commonly perpetrated by fathers and occur in the context of domestic violence (Finkelhor and Ormrod, 2001a; Liem and Koenraadt, 2008). In Ontario between 2002 and 2007, there were 23 father perpetrated child homicides that occurred in the context of domestic violence (DVDRC, 2008). Although research has indicated that many of these types of filicides are perpetrated in retaliation against the other parent (Ewing, 1997; Jaffe et al., 2012), some child deaths may occur indirectly as a result of the child attempting to protect the other parent during a violent incident or the child death may be part of a familicide where a parent, most often a father, kills multiple family members in an effort to maintain control and prevent a rupture of the family unit (Jaffe et al., 2012; Jaffe & Juodis, 2006; Websdale, 1999).  Furthermore, in domestic homicide cases where the child is not the victim, they still suffer the emotional, psychological, and physical repercussions of losing one or both parents and being exposed to horrific violence (Hamilton, Jaffe, & Campbell, 2013).

Mothers, in contrast, predominate as perpetrators of infanticide (killing of children less than 1 year of age) (Liem & Koenraadt, 2008). There appear to be two major profiles of risk for infanticide in developed nations. The first involves unplanned and unwanted pregnancies in young, single women who lack family support and who have complicated and problematic developmental histories (Porter & Gavin 2010; Shelton et al., 2011). A second group of infanticides is perpetrated by mothers with relatively few of the risk factors associated with the first group, but more profound mental health problems. Elevation in risk for a range of mental health illnesses (e.g., post-partum depression, bipolar disorder) in women in the days and months immediately following childbirth is thought to play an important role in many of these infant deaths.

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