JOINING FORCES

Joining Families

Volume 15, Issue 2 • Fall 2015

R E A L W O R L D R E S E A R C H F O R F A M I LY A D V O C A C Y P R O G R A M S
F E AT U R E D I N T E R V I E WIntergeneration Transmission of Childhood Abuse
and Neglect: What is the Evidence?
An Interview with Cathy Spatz Widom
Cathy Spatz Widom

Cathy Spatz Widom is Distinguished Professor in the Psychology Department at John Jay
College and a member of the Graduate Center
faculty, City University of New York. She is afellow of the American Psychological Association (Division 41–Law and Psychology), theAmerican Psychopathological Association,and the American Society of Criminology. A
former faculty member at Harvard, Indiana,
University at Albany (SUNY), and New Jersey
Medical School, Widom is co-editor of Journal
In This issue

The topic of this issue of JFJF is the intergenerational transmission of childmaltreatment. Our interview is with Cathy Spatz Widom, PhD, Distinguished
Professor of Psychology at the John Jay College of Criminal Justice, City
University of New York. In the interview, she discusses her recent article
published in Science. We give the background of the intergenerational
study as well as her past research and recent research on a gene thatcan be affected by maltreatment. Building Bridges to Research describes
mediators and moderators, two important statistical concepts that are
helpful in understanding complex research. Websites of interest features the
National Institute of Health’s (NIH) Translational Research on Child Neglect
Consortium, the Social Policy Report summarizing biological factors in childmaltreatment, and current research on information on child neglect from the
NIH Office of Behavioral and Social Sciences Research (OBSSR).

Contents
Featured Interview: Cathy Spatz Widom......................................................................1
Summary of Dr. Widom’s Research on the Intergenerational Transmission of Child
Abuse and Neglect......................................................................................................4
Building Bridges to Research: Mediators and Moderators..........................................5
Child Maltreatment and Developments in Neuroscience.............................................6Interaction of Child Maltreatment with Monoamine Oxidase A (MAOA)......................7

Brief Summary of Dr. Widom’s Child Maltreatment Research........................9
Websites of Interest..................................................................................................12of Quantitative Criminology and has served on
the editorial boards of psychology and criminology journals. She is a frequent consultant on
national review panels and has been invited totestify before congressional and state committees.
She has published extensively on the long-term
consequences of child abuse and neglect, including numerous papers on the cycle of violence.
Widom served on the Committee on Law andJustice at the Commission on Behavioral andSocial Sciences at the National Research Council(NRC) and was co-chair of the NRC Panel on
Juvenile Crime, Juvenile Justice. Professor Widom
has received numerous awards for her research,
including the 1989 American Association for
the Advancement of Science Behavioral Science
Research Prize for her paper on the cycle of violence. She will be awarded the Stockholm Prizein Criminology in 2016. Since 1986, Widom has
been engaged in a large study to determine thelong term consequences of early childhood abuse(physical and sexual) and neglect and is currently completing research on the intergenerationaltransmission of violence, which she describes in
the interview in this issue of JFJF.



Dr. McCarroll: Your recent publication in
Science (2015) was important in learning
more about intergenerational childmaltreatment. Would you please describe
your study and how it is differs from otherpublished literature on this subject?
Dr. Widom: There are a lot of differences between it and other studies that have addressed
this same issue. My study was longitudinal andContinued on page 2

The offspring ofparents who havehistories of abuse
and neglect do notthemselves reporta higher incidenceof being physicallyabused than theoffspring of parents
who do not have thosehistories.

included three generations of parents and children. No one has used a design like this where
they have children who were abused and/or
neglected and then followed them as adults
and then followed their children. Anotherstrength of the study was that we had different
sources of information for the outcomes. In
many studies, there is a reliance on only one
reporter. In our study, we used reports fromparents and offspring as well as official reports.
Dr. McCarroll: What did you find about
physical abuse?
Dr. Widom: One of the most important
findings was that the offspring of those whohave histories of abuse and neglect do notthemselves report a higher incidence of being
physically abused than the offspring of parents
who do not have those histories. They both report fairly high rates of what we consider to bephysical abuse, but they do not differ. Similarly,
Child Protective Service (CPS) reports do notshow a difference between the two groups interms of being physically abused. This is very
provocative and really surprising. We are going
to try to tease this out, to see if we can get abetter handle on why there is not a difference. However, our sample is heavily weighted
toward lower socioeconomic status groups. It

JOINING FORCES
Joining Families
Editor-in-Chief
James E. McCarroll, PhD
Email:
James.McCarroll.ctr@usuhs.edu
Joining Forces Joining Families
is a publication of the U. S.
Army Installation Management Command and theFamily Violence and Trauma
Project of the Center for the
Study of Traumatic Stress(CSTS), Bethesda, Maryland
20814-4799, tel. 301-2952470. CSTS is part of the
Department of Psychiatry of
Uniformed Services University of the Health Sciences,which is our nation’s federal
medical school.

Editorial Advisor
LTC Ricky J. Martinez. PhD, MSC, USA
Family Advocacy Program Manager
Installation Management Command
Department of the Army
Editorial Consultant
Joshua C. Morganstein, MD
Commander, US Public Health Service
Assistant Professor/Assistant Chair andScientist
Center for the Study of Traumatic Stress
Uniformed Services University
Department of Psychiatry

may be that the kinds of things that are considered physical abuse are common practices anddo not differentiate between the two groups.
Dr. McCarroll: What were the findings for theother types of child maltreatment, sexual
abuse and neglect?
Dr. Widom: We found an increased risk for
those kids. If the parents have a history of sexual abuse, or any kind of abuse, their children
are at increased risk for being sexually abused.
But these findings do not indicate whether it is
the parent who is the perpetrator of the sexual
abuse. For example, we are speculating that if
you have a mother who has a history of neglect,
she may put her child at risk for being sexually
abused by someone else — if she has multiple
partners or she’s failing to supervise. Regardless,her kids are increased risk for being sexually
abused. That’s one thing that we want to investigate more carefully.
Dr. McCarroll: What did you find for theparents who were neglected?
Dr. Widom: Children whose parents had
histories of neglect were also at increased risk
for being maltreated. We are still working on
mediators between parents with histories ofneglect and their risk of maltreating their child.
We want to investigate the potential mediators
or moderators that may be at work there for theneglected and sexually abused kids.
Dr. McCarroll: You said that both groups ofparents, abused and non-abused, reported
fairly high rates of physical abuse. Can you
calculate the percentage of physical abuse inboth populations?
Dr. Widom: For the Science paper, we tried
to come up with one number for the intergenerational transmission, but it turns out that it
varies tremendously by type of abuse. We could
not come up with a simple number. But, if you
look at CPS reports, for example, about 5–7%of the parents who have histories of abuse havechildren who have been physically abused.
But, that is versus 5.4% of the children withparents without those histories. If you look at
the self-reports of the parents, it is very close. It
was 26% in the parents with histories of abuseversus 24% in the parents without abuse, nota significant difference. Thus, about a quarterof those in both groups are saying that theyphysically abuse their kids. Then, if you lookat the kids who are reporting physical abuse,Continued on p. 3

2 • Joining Forces/Joining Families

Fall 2015

We could not comeup with a simple
number for theintergenerationaltransmission ofmaltreatment. It varies
tremendously by thetype of abuse.

depending on the measure, it ranges from 27%
to 67% of the kids whose parents have histories. Among the control kids, that is, kids whoseparents who do not have histories, it’s an evenwider range — it goes from 21% to 75%: 75%of the kids whose parents do not have a historyof abuse are saying that they were physicallyabused before the age of 12. So, it’s just a very
complicated picture, but these data are notshowing a difference in risk of physical abuse
and we really do not know why.
Dr. McCarroll: There are many, many papers
on the intergenerational transmission ofchildhood maltreatment.
Dr. Widom: Most of these studies try tocome up with a single number, and people
report large differences in its likelihood, from
30–40% or 30–60%. Our goal was to come up
with a number that would show the percent of
parents who have these histories and go on toabuse their kids, that is, to go on to have kids
who are abused. We struggled for a long time,and finally decided we just could not do thatwith the data that we have. We cannot have just
one number because the pictures are so different depending on what type of abuse you aretalking about. That is still something that weare still struggling with because everyone wants
something that is a lot simpler. People may justlook at one type of abuse and then assume that
it is the same for all types of abuse.
Dr. McCarroll: Please tell me more about yourprevious research on child neglect.
Dr. Widom: Over the years we have been
studying a large sample of people with historiesof childhood neglect. People have made theassumption that it is poverty that is driving
neglect and its negative consequences. This
assumption is not supported by our empirical evidence. We looked at childhood neglect
and childhood poverty as separate and distinct
factors in an analysis and we looked at theextent to which they predicted mental healthoutcomes, academic achievement, and crime.
We found different patterns depending on theoutcome. So, the whole idea that it is really poverty driving the consequences is false. Poverty
does have an impact on outcomes, but so does
neglect — and they are independent. I thinkthat’s really important to understand that.
There is a lot of discussion of adverse childhood experiences leading to adverse long-term
physical health outcomes. We also looked at
physical health outcomes and, again, whether

http://www.CSTSonline.org

it’s neglect that is driving it. We did a multi-levelprospective analysis looking at childhood neglect and childhood poverty and their relation
to long-term physical health outcomes (Nikulina & Widom, 2014). We found differences
between black neglected children and whiteneglected children. Childhood family poverty
predicted increased risk for hypertension forblacks, but not for whites. In contrast, amongwhites, childhood neglect predicted elevated
C-Reactive Protein (CRP), an indicator of arisk for heart attack. This paper is an attempt tosay, is it the childhood poverty that’s leading tothese health outcomes or is it the neglect? And
how does race fit into that problem? We reallyneed to be paying more attention to race differences in consequences (Widom, Czaja, Wilson,
Allwood, & Chauhan, 2012).
Dr. McCarroll: What can you tell us about yourongoing work with the data from the three
generations of parents and children?
Dr. Widom: we will look at potential mediators that might explain the increased risk
for maltreatment that we find in children ofparents with histories of maltreatment. We will
look at depression, alcohol and/or substanceabuse, attachment, intimate partner violenceand other outcomes may be some of themechanisms that explain the intergenerationaltransmission of abuse and neglect. We are goingto have to look at these relationships by typeof abuse. We also want to ask what protects aparent with a history of abuse from becoming aperpetrator of neglect.
We have not gotten answers to those questions yet, although we are looking at several
factors that might lead to better outcomes forabused and neglected children. For example,
having a relationship, having strong support, isassociated with better outcomes for maltreatedchildren (Sperry & Widom, 2013). One would
think, in terms of mental health outcomes, that
there would also be a lower risk for abusing or
neglecting your own children. Social support isone thing, but we have also found that graduating from high school, getting married andgetting a job reduced the negative impact ofchild abuse and neglect on, for example, beingarrested as an adult (Allwood & Widom, 2013).
It may be that keeping abused and neglectedchildren in school as long as possible could lead
to better outcomes. We know that abused andneglected children are at greater risk of being
truant, are more often suspended, and expelled.
Continued on page 8
Joining Forces/Joining Families • 3

Summary of Dr. Widom’s Research on theIntergenerational Transmission of Child Abuse 		and Neglect
By James E. McCarroll, PhD
Dr. Widom’s researchis the first multilevellongitudinal study
to track how childabuse victims treat
their children.

Adults withhistories ofchildhood abuse
and neglect are
at increased risk
for being reported
to CPS for sexual
abuse and neglect,
but not for physicalabuse.

It is often assumed that parents who weremaltreated as children are more likely tomaltreat their children compared to those
without a history of maltreatment, a cycle ofviolence. Importantly, this is an uncommon
outcome in this group. The assumptionof increased risk has been challenged inscientific literature, perhaps beginning in 1987
(Kaufman & Ziegler, 1987), and continuing
through Dr. Widom’s research. The recent study
by Dr. Widom and her colleagues is the firstmultilevel longitudinal study to track how childabuse victims treat their children (Underwood,
2015; Widom, Czaja, & DuMont, 2015). This
complex research has documented a variety ofoutcomes, but has not supported the idea thatphysically abused parents will physically abuse
their children. However, there was evidence
that sexual abuse and neglect may occur insubsequent generations. Dr. Widom’s interview
expands on these points.
The study began in 1986 with a searchof archival court records (n=908) of childhood physical and sexual abuse and neglectvictims from ages 0–11 years during the years
1967–1971. These individuals were matchedwith a control group (n=667) from the sameneighborhood for age, sex, race, and childhood
neighborhood advantage and disadvantage
and then followed for 30 years. The parents ofthese two groups of children are referred to as
generation one–G1. The original participantsin Widom’s study are G2 and their offspring are
G3. Interviews were started in 1989 when theG2s were, on average, 29 years old (n=1,196).
Additional interviews were conducted in 2009
and 2010 with 649 G2 participants (average age=47 years) and with a subset of theiroffspring (n=697), G3, the third generation (average age=22.8 years). From 2011–2013, childprotective service (CPS) records were searched
for the entire sample.
Results of analyses of the G2 generation
indicated that they were twice as likely to bereported to CPS for childhood abuse or neglectcompared to the matched control group.
About one fifth (21.4%) of the G2 parents
who had been abused or neglected had been

4 • Joining Forces/Joining Families

reported to CPS for child maltreatment compared to 11.7% of the matched comparisons(adjusted odds ratio (AOR)=2.01, 95% confidence interval (CI)=1.42–2.85). However, as Dr.
Widom explains further in her interview here,
the results were surprising in that parents who
had been physically abused as children were
no more likely to physically abuse their own
children than were the parents in the control
group (AOR=1.26, CI=0.75–2.12, not statistically significant). However, sexual abuse andneglect were more likely to be experienced by
the G3 offspring of G2s with histories of abuseor neglect. These results were statistically significant. Sexual abuse was experienced by 7.7%of the children of G2 abused parents compared
to 3.4% of children of the G2 control group(AOR=2.31, CI=1.24–4.30). For neglect, thepercentages were 18.0% for the abused group
and 9.5% for the control group (AOR=2.06,
CI=1.42–3.01). A larger percent of the G2parents with a history of maltreatment reported
that they had neglected their children (42.7%)
that the non-abused comparison parents (29%).
This difference was statistically significant(AOR=1.92, CI=1.29–2.86).
Finally, there was an additional assessmentof the G3 generation through self-reports and
CPS records of the behavior of the G2 parents, who might have been reluctant to reporton their own maltreating behaviors. The G3
offspring of the G2 maltreating parents weresignificantly more likely to report having beensexually abused or neglected compared to parents without such history.
Dr. Widom indicated that these results showthat adults with histories of childhood abuse
and neglect are at increased risk for being reported to CPS for sexual abuse and neglect, but
not for physical abuse compared with matched
participants. A possible hypothesis from thisfinding is that parents previously known to the
CPS system are more likely to receive increased
scrutiny compared to parents who have not
had such contact. As a result, abuse and neglectthat occurs in this latter group may be underreported to the authorities. Dr. Widom advises
Continued on page 6
Fall 2015

BUILDING BRIDGES TO RESEARCHMediators and Moderators

By James E. McCarroll, PhD, and Joshua C. Morganstein, MD

Much of behavioral
science research is asearch for variables
that mediate ormoderate therelationships between
predictor variables
and outcomes.

In her interview, Dr. Widom referred tomediators between child maltreatment andoutcomes. One of her results was that parents
with histories of neglect were at increased
risk for neglecting their children. What affects
this risk? Her research team will look at suchpossible mediators as depression, alcohol andother substance abuse, and intimate partner
violence. Another possible mediator could besocial support of the parent with the history ofchild neglect that functions to reduce the riskof maltreating their child.
Much of behavioral science research is asearch for variables that mediate or moderate
the relationships between predictor variables

and outcomes. A mediator variable helps toaccount for the relationship between the twovariables (predictor and outcome) while a moderator variable influences the strength of theoutcome (Baron & Kenny, 1986). These important terms, often misused or used interchangeably, are very different concepts with important
implications for the understanding of research
procedures and results.
A mediator helps to explain how or why the
relationship exists. In order for a factor to be a
mediator, it must lie on the pathway between
the independent variable (the factor you areinterested in studying) and the dependent variContinued on page 6

Moderators explain what or in what subgroups certain relationships exist. Gender is often a moderator.
Example of a possible moderator in Dr. Widom’s researchParent with history of
being neglected
Gender of parent➙

Parent neglects own child

Gender of parent

Dr. Widom found that parents with histories of neglect were at increased risk for neglecting their children.
Possible moderators remain to be examined, but one such variable could be the gender of the parent or
the child. Gender is not on the path shown above, but could affect the outcome such that one gender isneglected more than the other.

A mediator is a factor that explains how or why the relationship exists.
Example of a possible mediator in Dr. Widom’s research
Substance abuse of parent
Parent with history ofmaltreatment

Child is maltreated

Dr. Widom’s research will look for variables that mediate the relationship between childmaltreatment and outcomes. Possible mediators could be depression, substance abuse, andintimate partner violence. In the example above, substance abuse, could be on the path between
the predictor (parent with history of maltreatment) and the outcome (Maltreatment or child byparent with history of maltreatment).

http://www.CSTSonline.org

Joining Forces/Joining Families • 5Child Maltreatment and Developments in Neuroscience
By James E. McCarroll, PhD
Studies of the effects
of maltreatment on
outcomes, primarily
child maltreatment,
are frequently focusedon neurobiologicalfactors such brain
functioning, genetics,
and their modificationby the environment
as well as bydevelopment.

Building Bridges to
Research, from page 5

If no relationshipexists, then the
hypothesized mediator
does not lie on thecausal path and hencecannot be a mediator.

Summary of Dr. Widom’s
Research, from page 4

Studies of the effects of maltreatment on
outcomes, primarily child maltreatment, arefrequently focused on neurobiological factors
such brain functioning, genetics, and theirmodification by the environment as well as bydevelopment. Research is conducted in a wide
variety of fields of neuroscience. The fields ofscience involved in this research sometimes
come with titles that might be somewhat
off-putting to persons working in behavioral
science. Nevertheless, increasing the understanding of how child maltreatment affects
health and particularly mental health is an
exciting new challenge for behavioral science.
In each issue of JFJF, we will feature an important article that sheds light on understandingof these phenomena as well tips for practice. In
this issue, we feature Dr. Widom’s research ona gene (MAOA) that encodes an enzyme thatbreaks down brain neurochemicals, chemicals

often treated in pharmacological treatment of
mental illness. In addition to these articles wewill provide some definitions of some of theterms that may be unfamiliar to many behavioral science clinicians and researchers.
Definitions of Terms Commonly Encountered in Research on Child Maltreatment andGenetics:■■ Genotype —The genetic makeup of anindividual.

able (the outcome). In order to be a mediator, avariable must demonstrate a significant degreeof relationship between the independent andthe dependent variable. If no relationship exists, then the hypothesized mediator does notlie on the causal path and hence cannot be a
mediator. Specifically, in Dr. Widom’s research,
if a variable is found in the pathway between
the independent variable (parent’s history ofneglect) and the outcome (risk of maltreating
their child), that variable is a mediator.
A moderating variable helps to explain
what or in what subgroups certain relationships exist. In other words, moderators help us
understand if there are certain characteristics
of people or environments that make the relationship between the independent variable andthe outcome stronger or weaker. A moderator

may affect the direction or the strength of therelationship of interest. A moderating variable
should have little or no statistical relationship toeither the independent or the dependent variable. Gender is often a moderator.
Overall, moderators and mediators help
us understand relationships. They can haveimportant implications for the development ofprevention and treatment interventions.

greater attention to prevention and promoting well-being for all families, abused or not.
She also noted the need for further studies tobetter understand the mechanisms underlying
maltreatment as well as intervention.

Underwood E. (2015). Measuring child abuse’s
legacy. Science; 347: 1408.

References■■ Phenotype — The observable and behavioral properties of an individual that are
produced by the interaction of the genotype
and the environment.
■■ Epigenetic mechanisms — The process bywhich modifications in how a gene functions (e.g., influences behavior, physiology,
or anatomy) in response to environmental
influences.

Reference

Baron R & Kenny D. (1986.) The moderator
mediator variable distinction in social psychological research: conceptual, strategic, andstatistical considerations. Journal of Personality
and Social Psychology; 51: 1173–1182.

Widom CSW, Czaja SJ, & DuMont KA. (2015).
Intergenerational transmission of child abuse
and neglect: Real or detection bias? Science;
347: 1480–1485.

Kaufman J & Ziegler E. (1987). Do abusedchildren become abused parents? American
Journal of Orthopsychiatry; 527(2): 186–192.
6 • Joining Forces/Joining Families

Fall 2015

Interaction of Child Maltreatment with 		Monoamine Oxidase A (MAOA)
By James E. McCarroll, PhD

The environment affects
how genes function.
In this study, complex
interactions were foundbetween the MAOA
gene, maltreatment,
and sex. Activity of the
MAOA gene interactedwith participant
sex and race on
depressive symptoms
and suggests theimportance of genetic
effects on mental healthsymptoms.

http://www.CSTSonline.org

It is well known and generally acceptedthat child maltreatment leads to a wide varietyof negative outcomes. As Dr. Widom stated in
her interview, “The way we conceptualize theconsequences of child abuse now, it is so broad.
It is almost like it is an independent variable
for every bad outcome that you can think of.”
Research of child maltreatment in its multiple
forms is often is an exploration of whether
some environmental factor (independent variable) can predict an outcome (dependent variable) and, if so, what might be done to change
negative outcomes and promote positive ones.
Child maltreatment research includes
explorations of how the body physiology suchas the brain is affected. While this is not new,it has become much more sophisticated andincludes such fields as neurochemistry andgenetics. Genes produce proteins as well as
many other substances that affect behavior. The
environment affects how genes function. Thisis termed gene expression. MAOA is a genethat produces an enzyme that breaks down
certain brain neurotransmitters, some of whichhave relationships to mental symptoms suchas depression. If MAOA is influenced by childmaltreatment, symptoms may be the result.
MAOA activity and its relation to childmaltreatment was looked at in Dr. Widom’s
prospective cohort study, largely the same
participants as in her study of the intergenerational transmission of child maltreatment.
As noted in the description of the intergenerational study, a sample of cases substantiated by courts for physical and sexual abuse
and neglect and controls matched for age, sex,
race, and approximate family socioeconomic
circumstances were followed into adulthood.
Children under the age of 12 years wererecruited through archival records during theperiod 1967–1971. When the participants werean average age of 41 years, interviews were conducted to determine whether depressive symptoms were present and blood was collected
for genetic analysis. There were no significant
differences between the samples of the abused
and neglected group and controls in race orsex indicating that the matching worked well.
The samples, however, were skewed toward thelower socioeconomic stratum.

When blood and interview data were analyzed, complex interactions were found between
the MAOA gene, maltreatment, and sex. For
females, high activity of the MAOA gene acted
as a risk factor suggesting greater vulnerability
to depressive symptoms for those who were
physically abused and multiply abused.
There was also an interaction for race,childhood sexual abuse, and the MAOA geno
for the prediction of depressive symptoms.
Low MAOA activity acted as a protective factor
for whites, but high MAOA activity acted as aprotective factor for nonwhites.
These are complex findings. While this study
has limitations that warrant further exploration,such research gives clues to how people respondto maltreatment and suggest potential avenues
for treatment.
As explained in the Building Bridges to
Research article, the path from predictors tooutcomes is influenced by variables that are
related to both the predictor and the outcome(mediators) and by variables that are characteristics of people or environments that makethe relationship between the predictor and theoutcome stronger or weaker. One example of amoderator is the sex of an individual. In the article reviewed here, sex and race moderated therelationship between the MAOA genotype andmental health symptoms (Nikulina, Widom, &Brzustowicz, (2012).

Reference

Nikulina V, Widom CS, & Brzustowicz LM.
(2012). Child abuse and neglect, MAOA, andmental health outcomes: A prospective examination. Biological Psychiatry; 71: 350–357.

“The way we conceptualize the consequencesof child abuse now, it is so broad. It is almost
like it is an independent variable for every bad
outcome that you can think of.” — Dr. Widom

Joining Forces/Joining Families • 7

Cathy Spatz Widom
Interview, from page 3

All of those experiences take them out of thenormative process and give them more opportunities to feel badly about themselves, be
influenced by delinquent peers, and get into
trouble.
Dr. McCarroll: Negative socialization, if you
will.
Dr. Widom: Exactly. Out of school, there
are more opportunities to get in trouble andto get involved in the juvenile justice system.
Once you get involved in the juvenile justicesystem, then there is a vicious cycle that occurs
amongst some kids. So, we think that education
is an important protective factor.
Regarding social support, we do not yet
know whether these kids are pushing people
away because of their behavioral problems
such as their anxiety, or their depression, or
their drinking, or alcohol problems, or whether
they have lacked social support and that leads
to some of these bad outcomes.
Dr. McCarroll: They may lack social skills todevelop social support.
Dr. Widom: Exactly.
Dr. McCarroll: In your work with the groups ofabused parents and non-abused parents, did
you get any data on emotional abuse?
Dr. Widom: A little bit shows up in the CPS
reports, but it’s much more difficult to define
and identify reliably. The original cases werefrom 1967 to 1971 and at that time, nobody
was talking about emotional abuse or psychological maltreatment. Our documented cases
are physical abuse, sexual abuse, and neglect.
Dr. McCarroll: You are in such a uniquesituation in a college of criminal justice.
Most child maltreatment researchers are inpediatrics or mental health. You cross a lot ofboundaries.
Dr. Widom: I started out as a traditional
psychologist, but I became interested in psychopaths and in female offenders. That led me
to an interest in child abuse and neglect. But,
really, if you think about the way we conceptualize the consequences of child abuse now, it isso broad. It is almost like it is an independent
variable for every bad outcome that you canthink of.
Dr. McCarroll: What of the issue of childhood
exposure to violence and intimate partner
violence? Are you going to be able to do

8 • Joining Forces/Joining Families

anything with any data that you have on theintimate partner violence and its relationshipto the intergenerational transmission ofmaltreatment?
Dr. Widom: We published papers on
intimate partner violence in the abused andneglected children that we have been studying
since the late 1980s (Widom, Czaja, & Dutton,2013). We may have asked the older offspringwhether they were involved in intimate partner
violence and, if so, we may examine this in the
future.
Dr. McCarroll: One of the issues that society
has to deal with is the overlap of childmaltreatment with intimate partner violence.
If you consider exposure to intimate partner
violence a type of abuse, it gets even more
complex.
Dr. Widom: We had written a grant proposal
to look at some of these questions in a focus
on children exposed to violence, that is, theoffspring of the people that we have been studying for all these years who have exposed theirchildren to violence and partner violence. We
have information about the parent’s own violent
behavior, and also whether they were engaged
in intimate partner violence.
Dr. McCarroll: Was there any militaryconnection in your samples, or did you have
any way of ascertaining that?
Dr. Widom: We have a question about
whether our individuals were in the military or
served in the military. That was another findingthat was surprising. We found very few thatreported military experience. I do not knowwhether the military had higher standards.
Because many of our people have fairly low IQ’s
and fairly low reading abilities (Perez & Widom,
1994), it is possible that they were not eligible
or not qualified. We thought that being in the
military would be a protective experience.
Dr. McCarroll: Thank you for your time here
and for your work. I look forward to continuing
to work with you, to shed some light on all ofthese important questions.
Dr. Widom: You are welcome.

References

Allwood MA, & Widom CS. (2013). Child abuse
and neglect, developmental role attainment
and adult arrests. Journal of Research in Crimeand Delinquency; 50(4): 551–578.

Continued on page 11
Fall 2015

Brief Summary of Dr. Widom’s Child Maltreatment
Research
By James E. McCarroll, PhD

In her writing, Dr.
Widom has almost
always included
recommendations
on the need for theprevention of childabuse and neglect.

http://www.CSTSonline.org

Dr. Widom’s research career is extensive. We
can only provide illustrative examples of herwork. Unlike many psychologists, she has published widely in journals describing criminal
behavior as well as the more standard journalsof psychology and psychiatry. Her early research was on psychopaths (Widom, 1976) andlater on female offenders (Widom, 1978). This
research led her to her long time interest inchild abuse and neglect and understanding thecomplexities of the concept “cycle of violence.”
In an early review of the literature on the“cycle” she found that the evidence that abuse
leads to abuse was sparse (Widom, 1989a).
In addition to questioning the validity of the“cycle” this review captured many of the issues
that are still awaiting more definitive research.
Among these are the long-term consequences
to a child of an abusive home environment andthe need to consider neglect separately fromabuse (although this is methodologically difficult because of their overlap). In addition toreviewing the literature on the “cycle” she noted
other possible effects of abuse on children suchas the effects of witnessing marital violence,delinquency, depression, withdrawal, andself-harm. She stressed the need for improved
methodology including the use of control
groups and base rate information. Finally, sheadmonished the field to not persistently transmit what appear to be confident conclusions on
the “cycle of violence” with little regard to dataor its absence. She further noted the need todetermine why some children do not succumb
to negative outcomes of abuse and neglect andlearn the workings of protective factors such as
dispositional attitudes, environmental conditions, biological predispositions, and positive
events that may militate against or mitigate
negative outcomes for abused children.
Widom continued her literature reviews on
the “cycle” in a paper in which she referred tothe intergenerational transmission of violence
as “the premier developmental hypothesis in
the field of abuse and neglect” (Widom, 1989b).
In this more technical paper, she continued herreview of the literature on the effects of childhood abuse and neglect on adult outcomes,
but also presented the design and results fromher longitudinal study, described more fully inthis edition of Joining Forces Joining Families.
Using arrest records, she found that abused andneglected children had a higher likelihood ofarrests for delinquency, adult criminality, andviolent criminal behavior than the matched
controls. She advised caution in that a large portion of such children do not later become antisocial and violent and that the links between
childhood abuse and these negative outcomesare far from certain. For example, 26% of childabuse and neglect victims had juvenile offenses
while 74% did not; 11% had an arrest for a violent act, almost 90% did not.
In her writing, Dr. Widom has almost always
included recommendations on the need forthe prevention of child abuse and neglect. In areview paper of child abuse prevention programs, physical abuse and sexual abuse prevention programs were described separately (Olsen& Widom, 1993). Among the physical abuse
prevention programs, they cited the importanceof home visitation and family or community
support centers, programs for pregnant andparenting teenagers, individual counseling, andsupport groups. Many of these programs are
multi-component meaning that they are notexclusively of one type, such as home visitation.
For example, a program for incarcerated offenders who wished to improve their parenting skills
was an example of a program not specificallydirected at abusers. Sexual abuse prevention
programs are usually directed toward children’sability to protect themselves. The authors alsostressed the importance of the preventionof neglect, a type of maltreatment with little
research although at that time it constituted
approximately two-thirds of all cases of childmaltreatment. A final comment in this paper
brought attention to possible negative effects ofchild abuse prevention programs, a topic notfrequently seen in current literature. Children insexual abuse prevention programs may develop
distrust of nurturing or touching and postprogram anxiety. Adverse effects on childrenof these programs are unknown and should
be considered in research design. Finally, they
noted potential methodological shortcomings
of prevention research including the lack ofclear articulation of goals, criteria for inclusion,
Continued on p. 10
Joining Forces/Joining Families • 9

Brief Summary of Dr.
Widom’s Research,from page 9

Understanding
the processes ofthe developmentof resilienceamong abused andneglected children
is as important as
understanding thepathways that lead tonegative outcomes.

rigorous evaluation involving random assignment to treatment conditions, pre- and posttest assessments and long-term follow-up.
Dr. Widom has continued to pursue theconnections between early childhood abuse
and neglect and negative adult outcomes using
the longitudinal data described in her interview. This prospective cohort design allowed
her to investigate possible links between abuse
and neglect and promiscuity, prostitution,and teenage pregnancy (Widom & Kuhns,
1997). She found that child abuse and neglect
were significant predictors of prostitution forfemales, but were not associated with increased
promiscuity or teenage pregnancy. In addition,
young women who are neglected and become
runaways on the street are at risk of being victimized or enticed into prostitution.
In a significant article dedicated to improving prevention of later delinquent and adultcriminal behavior, Dr. Widom proposed longrange strategies and opportunities for interventions (Widom, 1998). Intervening early, evenprenatally, can prevent malnutrition and physical abuse, both of which can adversely affectdevelopment. Interventions to prevent neglect
are important for two reasons: it is associatedwith later criminal behavior and it imposes thelargest burden on the child protective services
agencies. Because it tends to be chronic, neglect
may be easier to affect than physical abuse,
which can be episodic and explosive. Prevention should be based on the needs and the development of the child; one size does not fit all.
While surveillance is a key part of prevention,
surveillance may expose lower socio-economic
groups to more scrutiny and likelihood of appearing before child protection services thanchildren from more affluent families. Close
surveillance can also result in discriminationof these children affecting their self-esteem
and exacerbating the effects of victimization.
Resources must be made available to thosefamilies that need them. Barriers to accessing
resources can include lack of transportation,
language, cultural insensitivity, location, andstigma, among others.
The relation of childhood abuse and neglect
to the development of adult posttraumaticstress disorder (PTSD) is highly relevant totoday’s society in which large numbers of
persons have been deployed to war zones. In
her longitudinal sample, childhood victimization was associated with the risk for lifetimeand current PTSD; however, these relationships were complex (Widom, 1999). Childhood

10 • Joining Forces/Joining Families

abuse or neglect were significant predictors of
the number of PTSD symptoms in a multivariate model, but also significant were other variables: parent arrested; parent had drug problem;
separated, widowed, or divorced; less than acollege degree; and diagnosis of alcohol or drug
abuse or dependence. These results indicate that
exposure to certain types of environments may
be especially conducive to the development of
PTSD. It was also noted, in contrast, that growing up in homes characterized by poverty andhaving a large family were not associated withincreased risk for PTSD. Finally, in examining
the relationship of abuse and neglect to lifetime
PTSD symptoms, sexual abuse was highly significant in predicting PTSD symptoms; physicalabuse and neglect were marginally significant.
In addition, childhood behavior problems werea significant predictors of adult PTSD diagnosis
and symptoms.
Understanding the processes of the development of resilience among abused and neglectedchildren is as important as understanding thepathways that lead to negative outcomes. In her
study of abused and neglected children grown
up, resilience was operationalized as meetingthe criteria for success across six of eight domains of adult functioning: employment, homelessness, education, social activity, psychiatricdisorder, substance abuse, and two domains ofcriminal behavior — arrest and self-reports ofviolence. Twenty-two percent of abused andneglected individuals met these criteria; more
females were successful across a greater numberof domains than males (McGloin & Widom,2001).
Childhood abuse and neglect were significantly related to adult intimate partner violence(IPV) in both men and women (White & Widom, 2003). Overall, there was a link between
early childhood victimization and later perpetration of IPV for both men and women. Bothmales and females reported significantly higher
rates of ever hitting or throwing things at apartner than matched controls. When mediation analyses were conducted of the relationships between childhood abuse and neglect andadult IPV, it was found that antisocial personality disorder mediated the effects of abuse orneglect on IPV for both men and women. Hostility and alcohol problems mediated the effects
for abused and neglected women. The resultof these analyses was that the effects of abuse
and neglect were reduced to non-significancefor both men and women. These findings show
Continued on page 11
Fall 2015

Cathy Spatz Widom
Interview, from page 8

Nikulina V, & Widom CS. (2014). Do race, neglect, and childhood poverty predict physicalhealth in adulthood? A multilevel prospective analysis. Child Abuse & Neglect; 38(3):414–424.

Widom CS, Czaja S, & Dutton MA. (2013).
Child abuse and neglect and intimate partner violence victimization and perpetration:
A prospective examination. Child Abuse &Neglect; 38(4):Perez C, & Widom CS. (1994). Childhood
victimization and long term intellectual andacademic outcomes. Child Abuse & Neglect;18(5): 617–633.

Widom CS, Czaja S, Wilson HW, Allwood M, &Chauhan P. (2012). Do the long-term consequences of neglect differ for children on
different races and ethnic backgrounds? Child
Maltreatment; 18(1): 42–55.

Sperry DM, & Widom CS. (2013). Child abuse
and neglect, social support, and psychopathology in adulthood: A prospective investigation.
Child Abuse & Neglect; 37(6): 415–425.

Brief Summary of Dr.
Widom’s Research,from page 10

This review highlights
much of Dr. Widom’s
early research on therelationships between
childhood abuse andneglect, negative andpositive outcomes,
and preventionof childhood
maltreatment.

that it is the behavior in adulthood that is moreclosely related to IPV than the more remote effects of the earlier childhood abuse and neglect.
However, there was a link between childhood
abuse and neglect and the mediating variables,
antisocial personality disorder for both men
and women and alcohol problems and hostility
for women.
This review highlights much of Dr. Widom’s
early research on the relationships between
childhood abuse and neglect, negative andpositive outcomes, and prevention of childhood maltreatment. Much more research isforthcoming from her longitudinal sample of
now grown men and women who were abusedor neglected as children and the matched controls. We look forward to these results.

References

McGloin JM, & Widom CS. (2001). Resilienceamong abused and neglected children grown
up. Development and Psychopathology; 13:1021–1038.
Olsen JL, & Widom CS. (1993). Prevention ofchild abuse and neglect. Applied and Preventive Psychology; 2(4): 217–219.
White HR, & Widom CS. (2003). Intimate partner violence among abused and neglected

Widom CSW, Czaja SJ, & DuMont KA. (2015).
Intergenerational transmission of child abuse
and neglect: Real or detection bias? Science;
347: 1480–1485.
children in young adulthood: The mediating
effects of early aggression, antisocial personality, hostility and alcohol problems. Aggressive
Behavior; 29: 332–345.
Widom CS. (1976). Interpersonal conflict and cooperation in psychopaths. Journal of Abnormal
Psychology; 85(3): 330–334.
Widom CS. (1978). An empirical classification of
female offenders. Criminal Justice and Behavior; 5(1): 35–52.
Widom CS. (1989a). Does violence beget violence? A critical review of the literature. Psychological Bulletin; 106(1): 3–28.
Widom CS. (1989b). The cycle of violence. Science; 244:160–166.
Widom CS. (1998). Child victims: Searching foropportunities to break the cycle of violence.
Applied and Preventive Psychology; 7: 225–234.
Widom CS. (1999). Posttraumatic stress disorder in abused and neglected children grown
up. American Journal of Psychiatry; 156(8):1223–1229.
Widom CS, & Kuhns JB. (1997).Childhood
victimization and subsequent risk for promiscuity, prostitution, and teenage pregnancy: A
prospective study. American Journal of Public
Health; 86: 1607–1612.

2016 Stockholm Prize in Criminology

For information on Dr. Widom’s award of the 2016
Stockholm Prize in Criminology, see :http://www.su.se/english/about/prizes-awards/thestockholm-prize-in-criminology/criminology-prize-winners-2016-1.255296

http://www.CSTSonline.org

Joining Forces/Joining Families • 11

Websites of Interest
This issue of JFJF has emphasized the research of Cathy
Spatz Widom, PhD, on the intergenerational transmissionof child maltreatment. Dr. Widom has conducted extensive
research in child neglect. She was the principal investigator of the National Institute of Health’s (NIH) Translational
Research on Child Neglect Consortium. For a description of
the Consortium, which still exists as a working group, pleasesee Boyce and Maholmes (2013) and Widom (2013).
The Social Policy Report is an excellent summary of biological factors in child maltreatment. The focus of this document is the toxic effect of child abuse and neglect and theireffects on brain function, the immune system, and mental
and physical health. The neuroscience implications of childabuse and neglect are clearly explained with diagrams andextensive references.
http://www.srcd.org/sites/default/files/documents/spr_28_1.
pdf
The NIH Office of Behavioral and Social Sciences Research(OBSSR) gives information on current research on childneglect. This publication lists child neglect research grants
by title with an abstract, which is helpful for readers whowant to search for publications on the topics that have been
funded. There are also news items and a calendar of OBSSR
events.
https://obssr.od.nih.gov/funding_opportunities/requests_
for_applications/child_neglect_RFA.aspx

References

Boyce CA, & Maholmes V. (2013). Attention to the neglected:
Prospects for research on child neglect for the next decade.
Child Maltreatment; 18(1): 65–68.
Widom CS.(2013). Translational research on child neglect:
Progress and future needs. Child Maltreatment; 18(1): 1–7.

Resources for Help with Intimate Partner Violence (IPV), PTSD, and More
The National Center for PTSD, a resource of the Department of Veterans’ Affairs (VA), publishes a monthly
update on issues of trauma and posttraumatic stressdisorder (PTSD) http://www.ptsd.va.gov/about/subscribe.asp. Subscribers to this free service receive amonthly update. A wide variety of resources are available for providers, researchers, and other subscribers.
The subject of the October 2015 issue is PTSD and IPV.
Links are provided for information about both subjects
as well as the numbers for help lines for IPV (800-7997233) and the National Sexual Assault Hotline (800-12 • Joining Forces/Joining Families

656-4673). Free continuing education credits areavailable to providers outside the VA in the form ofa lecture series. The publication also briefly notes research underway at the Center and news about eventsof interest. An example is the story about infidelity
and its effects on Soldiers’ and veterans’ relationships
and mental health. This article was by Miranda Escobar and appeared in the 6 October 2015 issue of the
Yale News. This resource is a quick and easy way to be
informed of current developments affecting military
personnel and veterans and their families.

Fall 2015