Laura A. McCloskey

The Contribution of Marital Violence to Adolescent Aggression Across Different Relationships

Different forms of aggression were measured in 296 young men and women participating in a study dating from their childhood that included families with marital violence. The youth reported on their perpetration of physical aggression with same-sex peers, dating partners, and parents. Measures were also collected on youth depression and empathy. Childhood exposure to marital violence predicted aggression toward peers for all youth. Marital violence was also related to child-to-parent aggression but only for youth older than 18. Youth from maritally violent homes were more likely to be depressed as adolescents. Elevated depression partially mediated the impact of marital violence on peer aggression and was associated with dating aggression among girls. Although marital violence in childhood was unrelated to empathy scores in adolescence, empathic youth were less likely to engage in dating aggression and peer aggression. Findings indicate that further emphasis should be placed on mental health problems and empathy building in youth exposed to marital violence.

Sexual abuse, family violence, and female delinquency: findings from a longitudinal study.

The current study examines the effects of three forms of childhood victimization on self-reported delinquency and aggression in adolescent girls. These analyses are based on a longitudinal sample of 141 mother-daughter pairs participating in a study about marital violence and child development. When the children were school aged, mothers and children provided reports describing (a) child exposure to marital violence, (b) escalated physical abuse against the child, and (c) child sexual abuse. Children were followed up into adolescence and re-interviewed. Self-reports of delinquency (violent and nonviolent), running away, and violence against parents were collected. Results indicate that out of the three forms of victimization, child sexual abuse emerged as the strongest predictor of girls’ violent and nonviolent criminal behavior. Girls with a history of physical abuse in childhood were most likely to assault their parents. Witnessing marital violence failed to contribute further to delinquency, beyond the adverse association with childhood sexual abuse. Findings highlight a unique avenue for delinquency in girls via childhood sexual exploitation.

Traumatic Stress Symptoms of Women Exposed to Different Forms of Childhood Victimization and Intimate Partner Violence

Interviews of women with (n = 193) and without (n = 170) recent exposure to intimate partner violence (IPV) were used to examine how IPV and past exposure to child abuse influence self-reports of posttraumatic stress disorder (PTSD) symptoms. The measurement of IPV included assessing psychological, physical, escalated physical, and sexual abuse. Women’s retrospective accounts of childhood victimization included reports of physical abuse, sexual abuse, and witnessing domestic violence growing up. Each form of adult IPV showed an independent association with PTSD symptoms, as did each form of childhood victimization. In regression models including child and adult abuse together, adult IPV and childhood sexual abuse were related to PTSD symptoms, and adult IPV mediated the association between childhood physical abuse and adult PTSD. Tests of the interactions between childhood and adulthood victimization on PTSD symptoms were not significant. Findings are discussed within the context of a life-course perspective of trauma.

Assessing Intimate Partner Violence in Health Care Settings Leads to Women's Receipt of Interventions and Improved Health

Objective. This study investigated whether disclosure of violence to health care providers and the receipt of interventions relate to womens exit from an abusive relationship and to their improved health. Methods. A volunteer sample of 132 women outpatients who described intimate partner violence during the preceding year were recruited from multiple hospital departments and community agencies in suburban and urban metropolitan Boston. Through in-person interviews, women provided information on demographics, past year exposure to violence, past year receipt of interventions, and whether they disclosed partner violence to their health care provider. They also described their past month health status with the 12-Item Short-Form Health Survey and further questions. Results. Of the 132 women, 44% had exited the abusive relationship. Among those who were no longer with their partner, 55% received a domestic violence intervention (e.g. advocacy, shelter, restraining order), compared with 37% of those who remained with their partner. Talking to their health care provider about the abuse increased womens likelihood of using an intervention (odds ratio [OR]=3.9). Those who received interventions were more likely to subsequently exit (OR=2.6) and women no longer with the abuser reported better physical health based on SF-12 summary scores (p=0.05) than women who stayed. Conclusions. Health care providers may make positive contributions to womens access to intimate partner violence services. Intimate partner violence interventions relate to womens reduced exposure to violence and better health.

The "Medea complex" among men: the instrumental abuse of children to injure wives.

It has been previously documented that wife and child abuse often co-occur. The present study tested competing hypotheses about the reasons for this co-occurrence, specifically trait versus instrumental theories of aggression within families. Three commonly cited catalysts (unemployment, drinking, and life-stress events) for men’s abuse of family members were analyzed to determine whether they equally predict partner or child abuse. Interviews were conducted with 363 women and children about spousal and paternal abuse, and women were interviewed about sociodemographics and the stressors described above. Families were oversampled for the presence of spousal violence. Logistic regressions revealed that heavy drinking (log-odds ratio 4.86) and life stress events (log-odds ratio 1.6) predicted men’s abuse of their partners. These risk factors were unrelated to child abuse. Wife battering, however, placed children at heightened risk (log-odds ratio = 2.77). Children of battered women stood a 42% chance of receiving escalated abuse from their fathers. It is proposed that men’s abuse of children is in many instances instrumental in order to coerce or retaliate against women, echoing the Greek myth of Medea who killed her own children to spite their father.

Predicting the Timing of Women's Departure From Abusive Relationships

The aim of this study was to investigate forces that affect the timing of womens exit from violent relationships with men. Abused women were recruited from posters in the community and battered womens shelters, interviewed, and followed up for 10 years. Data for this study are based on 100 women and were analyzed using event history analysis. Age, ethnicity, and alcohol consumption levels of both partners predicted the timing of womens termination of abusive relationships. An interaction effect showed that women who scored above the mean on an index of physical aggression and who never used shelter services had the longest trajectories of violence exposure; severely abused women without shelter use were more likely to stay. Our findings indicate that women who receive shelter services endure shorter periods of violence than women who do not access such services. Further outreach, especially to women experiencing high rates of physical aggression, is recommended.

Intersections of Harm and Health A Qualitative Study of Intimate Partner Violence in Women's Lives

Eight focus groups of women with recent exposure to intimate partner violence (IPV) were conducted to elicit womens descriptions of how IPV affects their health. Their shared narratives reveal a complex relationship with three main points of intersection between IPV and health: IPV leading to adverse health effects; IPV worsening already compromised health; and womens illness or disability increasing dependency on abusive partners, thereby lengthening the duration of IPV exposure. Women describe bidirectional and cyclical ways through which IPV and health intersect over time. Service providers, including physicians, need to better understand the myriad ways that abuse affects womens health.

The impact of childhood sexual abuse and intimate partner violence on sexually transmitted infections.

Childhood sexual abuse (CSA) and adult intimate partner violence (IPV) have both been found to be associated with sexually transmitted infections (STIs) independently, but studies of STIs have rarely looked at victimization during both childhood and adulthood. This paper examines the relationship between CSA, IPV and STIs using data from a nested casecontrol study of 309 women recruited from multiple health care settings. Overall, 37.3% of women experienced no violence, 10.3% experienced CSA only, 27.3% experienced IPV only, and 25.0% experienced both CSA and IPV. Having ever been diagnosed with an STI was associated with violence (CSA only, odds ratios [OR] = 2.8, 95% confidence intervals [CI] = 1.0–7.5; IPV only, OR = 2.2, 95% CI = 1.0–4.9; CSA and IPV: OR = 4.0, 95% CI = 1.7–9.4), controlling for demographic characteristics. Women who experienced CSA were younger when they were first diagnosed. Understanding how both childhood and adult victimization are associated with diagnosis of STIs is important to reducing the incidence and prevalence of STIs, as well as the associated consequences of STIs.

Community preferences for health states associated with intimate partner violence.

Background:One in 4 women is affected by intimate partner violence in her lifetime. This article reports on a cross-sectional survey to estimate community preferences for health states resulting from intimate partner violence. Methods:A secondary analysis was conducted of data from a convenience sample of 93 abused and 138 nonabused women (231 total) recruited for in-person interviews from hospital outpatient department waiting rooms in metropolitan Boston, Massachusetts. SF-12 data were converted to utilities to describe community-perspective preferences for health states associated with intimate partner violence. Linear regression analysis was used to explore the association between violence and utility while controlling for other health and demographic factors. Results:Median utility for intimate partner violence was between 0.58 and 0.63 on a scale of 0 (equivalent to death) to 1.0 (equivalent to optimal health), with a range from 0.64 to 0.66 for less severe violence to 0.53 to 0.62 for more severe violence. The data do not reveal whether violence itself is responsible for lower utility or whether a constellation of factors contributes to disutility experienced by women victims of abuse. Discussion:The utility of health states experienced by women exposed to intimate partner violence is substantially diminished compared with optimal health and even other health conditions. These values quantify the substantial negative health impact of the experience of intimate partner violence in terms that allow comparison across diseases. They can be used in cost-effectiveness analyses to identify the benefits and potential returns from resources allocated to violence prevention and intervention efforts.

The Intergenerational Transfer of Mother- Daughter Risk for Gender-Based Abuse

In this 10-year longitudinal study 150 mother-daughter pairs were recruited to participate in a study examining gender-based abuse across three generations. Forms of gender-based abuse included: child sexual abuse, witnessing intimate partner violence against their mothers, and intimate partner violence or dating violence in adolescence or adulthood. Daughters were interviewed when they were on average 9, 14, and 16 years old. Regression analyses revealed that if the grandmother (G1) was abused by her husband, her daughter (G2) was more likely to be sexually molested in childhood and was also more likely to be in an abusive relationship as an adult. If the mother (G2) was sexually abused as a child her daughter (G3) was at increased risk for child sexual abuse. In turn, child sexual abuse for the daughters related to their reports of dating violence in adolescence. Daughters (G3) who were sexually abused expressed more anxiety about romantic relationships, reflecting early attachment conflicts. Both child sexual abuse and anxious romantic attachment style independently predicted adolescent sexual risk-taking as in having multiple sexual partners or dating older men. These findings demonstrate how informative it is to include multiple forms of gender-based abuse in research and practice to better illuminate complex family dynamics. In addition, the findings support previous empirical work showing the importance of attachment behavior in women who are in abusive relationships, which has unique clinical implications.