Family
Advocacy
Research
Digests

RESEARCH REVIEWCURRENT RESEARCH FOR FAMILY ADVOCACY PROGRAMS • Volume 1, Issue 1 • Winter 2016

Welcome to Research Review
Research Review is a new publication of the Joining Forces Joining Families (JFJF) group of
publications. It is a companion to the JFJF. Research Review presents new information for use by
Army Family Advocacy Program (FAP) personnel on a variety of important topics. Each review
provides the most important points of a recent publication. Readers can go to the reference
cited for complete information. We will publish Research Review twice per year. Please distribute
Research Review to your colleagues in FAP as well as medical and social service providers.

Is Adolescent-to-Parent Abuse Domestic Violence?
The prevalence of a young person hitting their parent wasestimated at between 6.5 and 12% in a three year period and
60% for verbal aggression in the last six months. Mothers
have been the predominant victims and young men significantly likely instigators. Serious legal and social questions areraised by considering this issue. Is adolescent-to-parent family conflict, domestic violence, or violence against women?
Additional issues are the importance of not criminalizingchildren and labeling them as perpetrators of abuse, interference with the ability to parent effectively, and harm to other
CONTENTSIs Adolescent-to-Parent Abuse Domestic Violence?........................... 1
Bullied and Maltreated Children Are More Likely to Have Adult
Mental Health Problems................................................................. 2
Deployment and Risk of Maltreatment of Very Young Children...... 2
Military-Connected Kids Have Greater Risk of Adverse Outcomesthan Nonmilitary Kids.................................................................... 3
Negative Self-Appraisals Due to Intimate Partner Violence
can Worsen Posttraumatic Stress Symptoms................................ 3
What Happened When Physical Punishment of Children
was Banned?..................................................................................... 3
Stalking Can Cause Distress Even When People Do Not Report
Being Afraid...................................................................................... 4
New Connections between Adverse Childhood Experiences and
Health................................................................................................ 4
Posttraumatic Stress Disorder Symptoms and Victims of Intimate

family members, particularly other children who witness. The
author favors a restorative framework of maintaining a relationship between the adolescent and the parent. This article
provides few solutions, but highlights the challenges to thoseworking in this field.
Reference
Holt A. (2015). Adolescent-to-parent abuse as a form of “domestic violence”: a conceptual review. Trauma Violence Abuse.
doi: 10.1177/1524838015584372.

Partner Violence: Men and Women Differ................................... 5
Resources for Help with Intimate Partner Violence, PosttraumaticStress Disorder, and More............................................................... 5
Intimate Partner Violence: Health Care Provider Self-Awareness
Can Improve Care............................................................................ 5
What are the Helpful Ingredients of Social Support?......................... 6
Crying Babies: Helping Parents Cope................................................... 6Children and Adolescents Who Damage Property:
A Form of Parent Abuse?................................................................ 7
Intimate Partner Violence is Strongly Associated with Sleep
Disturbance....................................................................................... 7
Five Effects of Exposure to Intimate Partner Violence on Children... 8
Effects of Intimate Partner Violence on Very Young Children.......... 8
Risk Factors for Suicidal Ideation in Female Victims of Intimate
Partner Violence............................................................................... 8Center for the Study of Traumatic Stress
Uniformed Services University of the Health Sciences
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org

Bullied and Maltreated Children Are More Likely to
Have Adult Mental Health Problems
Bullying in childhood may have significant effects on
adult mental health and should be inquired by family advocacy workers in addition to child maltreatment. Both maltreatment and bullying have long-term negative effects. Does
bullying have a unique effect? Both were investigated withinterviews and questionnaires in samples of children andparents in the UK (4,026 children) and the US (1,420 children). In the US sample, children who were only maltreated
were at increased risk for depression in young adulthoodcompared to children who were not maltreated or bullied.
In the UK sample, only those who were both maltreated andbullied were at increased risk for mental health problems:anxiety, depression, and self-harm. Children in both groups
who were only bullied were more likely than children who
were only maltreated to have mental health problems.
Reference
Lereya ST, Copeland WE, Costello EJ, & Wolke D. (2015). Adult
mental health consequences of peer bullying and maltreatment in childhood: two cohorts in two countries. Lancet
Psychiatry; 2: 524-531.

Deployment and Risk of Maltreatment of Very Young Children
Maltreatment of children less than two years of age wasmeasured in relation to the deployment periods (before, during, after) of soldiers who had deployed only once and those
who had deployed twice. Maltreatment rates were highest
in the six months after deployment for soldiers who had deployed only once. For soldiers who had deployed twice, maltreatment was highest during the deployment, nearly doublethat of those in the first deployment period. These findings
illustrate the complexity of the study of deployment and its
effects on soldiers and families. Soldiers were not the only
perpetrators identified. Different rates of maltreatment during and after deployment suggests different stressors basedon the time period as well as soldier-family variables such asprior experience with deployment and many other factors
beyond the scope of this study. Importantly, the period prior
to deployment did not yield elevated risk of child maltreat-ment compared to the other periods. This is surprising in thatthe time prior to deployment is filled with increased tempo
of operations including time away from home for training.
Perhaps resilience is mobilized during this period, but a different resilience is needed both during and after deployment
to counter the unique stresses of these time periods. Documentation of the stresses and strategies during these periods
would be helpful to the improvement of prevention andintervention efforts by the helping agencies.
Reference
Taylor CM, Ross ME, Wood JN, Griffis HM, Harb GC, Mi L,… Rubin DM. (2015). Differential child maltreatment risk
across deployment periods of US Army soldiers. American
Journal of Public Health; published online ahead of print.

JOINING FORCES
Joining Families

RESEARCH REVIEW
Editor-in-Chief
James E. McCarroll, PhD
e-mail to James.McCarroll.ctr@usuhs.mil(301) 319-8003
Joining Forces Joining Families—Research Review is a
publication of the Family Violence and Trauma Project,
Center for the Study of Traumatic Stress, Departmentof Psychiatry, Uniformed Services University, Bethesda,
Maryland 20814, and the U.S. Army Installation
Management Command, Fort Sam Houston, TX 78234.

2 • RESEARCH REVIEW | Joining Forces/Joining Families

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, M.D.
Commander, U.S. Public Health Service
Scientist, Center for the Study of Traumatic Stress
Department of Psychiatry, Uniformed Services University

Winter 2016

Military-Connected Kids Have Greater Risk of Adverse
Outcomes than Nonmilitary Kids
The 2013 California Healthy Kids Survey of 54,679
military-connected and 634,034 nonmilitary-connected
secondary school students found that the military-connected
kids had greater odds of substance use, experience of physicalviolence and nonphysical harassment, and weapon carrying.
The military-connected kids had a 73% greater odds of druguse (cocaine and LSD) and twice the odds of bringing a gun
to school compared with nonmilitary-connected kids. Similarly, the odds of the military-connected kids being threatened with a weapon or being in a fight were almost twicethat of the nonmilitary-connected kids. The odds of military-connected kids having adverse outcomes also showed anincrease over data collected in 2011. It was concluded thatmilitary-connected adolescents require concern regarding thewell-being of their families during wartime.
Reference
Sullivan K, Capp G, Gilreath TD, Renbenishty R, Roziner I,& Astor RA. (2015). Substance abuse and other adverse
outcomes for military-connected youth in California. JAMA
Pediatrics; doi:10.1001/jamapediatrics.2015.1413. Published
online August 17, 2015.

Negative Self-Appraisals Due to Intimate Partner Violence canWorsen Posttraumatic Stress Symptoms
Non-treatment seeking women who were victims of intimate partner violence (IPV) were studied for their self-appraisals and the relation of those appraisals to posttraumaticstress disorder (PTSD) symptoms. This research characterized the way female victims of IPV reported trauma-related
symptoms. Not all PTSD is the same. Profiles of different
responses can suggest different treatments. Women were
given measures of PTSD and trauma-related symptoms and a
trauma questionnaire that asks respondents to describe their
cognitive reactions to a traumatic event. 46% had a very low
endorsement of PTSD symptoms while others had intermediate levels of different PTSD symptoms (hypervigilence,exaggerated startle, re-experiencing, and avoidance). Threetypes of self-appraisals were related to PTSD symptoms: fear,
alienation, and self-blame. Fear appraisals were associatedwith more symptomatic PTSD; alienation appraisals wereassociated with intermediate symptoms. Self-blame appraisals were more complex. They were less likely to belong to theleast and most symptomatic profiles. Self-blame might be an
attempt to identify ways to prevent or change the outcomeof the traumatic event, but more research is needed here. The
greater the severity of the IPV incident, the more likely was
the woman to have more severe symptoms. Clinical interventions for IPV may also help to alleviate other trauma-related
symptoms such as depression and substance abuse.
Reference
Hebenstreit CL, MaGuen S, Koo KH, & DePrince AP. (2015). Latent profiles of PTSD symptoms in women exposed to intimate
partner violence. Journal of Affective Disorders; 180: 123–128.

What Happened When Physical Punishment of Children was Banned?
Stopping physical punishment of children can result in
fewer mental health and social problems. After passage ofa law in 1983 in Finland banning the physical punishmentof children, there was a significant drop in reports of beingslapped or beaten and in the number of murdered children.
In an investigation in 2011 of 4,609 persons born between
1931 and 1996, ages 15-80 years, respondents answered aquestionnaire on physical punishment during childhood.
There was a significant drop in reports of being slapped orbeaten among respondents who were born after the law was
passed. There was also a decline in the number of murderedchildren. However, respondents who had been exposed tohttp://www.CSTSonline.org

higher than average amounts of physical punishment before
the law was passed scored significantly higher on alcoholabuse, depression, mental health problems, and schizotypal
personality. Those who were divorced and those who had attempted suicide in the past 12 months reported having beensignificantly more physically punished than others.
ReferenceŐsterman K, Björkqvist K, & Wahlbeck K. (2014). Twenty-eight
years after the complete ban on the physical punishment ofchildren in Finland: trends and psychosocial concomitants.
Aggressive Behavior; 40(6): 568–581.

RESEARCH REVIEW | Joining Forces/Joining Families • 3

Stalking Can Cause Distress Even When People
Do Not Report Being Afraid
Stalking often occurs in the context of intimate partner
violence (IPV), but it can be difficult to define and to identify. State and federal definitions make a distinction between
stalking and harassment. Harassment can involve the same
behaviors as in stalking, but the victim does not feel fearful
nor experience actions by the stalker in which a reasonable
person would feel fear. This definition is intended to prevent
harassment from being criminalized. 1,430 victims of stalking were identified by the 2006 Supplemental Victim Survey,
part of the National Crime Victimization Survey (Catalano,2012) to assess stalking in the past 12 months. Fear experiences of stalking victims differ. The victim who does not feel
fear of stalking can suffer other effects
Owens (2015) differentiated between two types of fears
from being stalked (a) subjective fear and (b) that which
would cause a reasonable person to feel fear, from no fear.
Most respondents reported some measure of fear, but usually
not both. Of the three groups that reported fear, 15.3% experienced subjective fear, but no threats or attacks that would
cause reasonable fear. 20.8% (n=298) experienced at least oneof the 23 measures of reasonable fear, but did not report feeling afraid, and 20.4% (n=292) experienced both types of fear.
However, 43.4% (n=621) did not report experiencing either
form of fear, but did report anger or annoyance when the
behaviors started or progressed.

The group that experienced both types of fear had themost severe stalking experiences and negative effects. However, the group that experienced no fears still reported serious
stalking behaviors and effects. They reported being followed
for long periods of time, used self-protecting behaviors, andwere financially burdened. These analyses suggest that by
excluding persons who did not feel either type of fear will
underestimate the number of people affected by stalking
and thereby reducing the understanding of stalking and its
consequences.
Estimates by the BJS of stalking were that between 1 and3.5 million people are annually stalked. The percentage ofmale victims varied between 13.8-33.1% suggesting that they
are undercounted. In all persons reporting stalking it is important to assess all effects on the individual’s life, particularly
when fear is not reported.
References
Catalano S. (September, 2012). Stalking victims in the UnitedStates — Revised. U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. NCJ224527.
Owens JG. (2015). Why definitions matter: Stalking victimization in the United States. Journal of Interpersonal Violence.
doi: 10.1177/0886260515573577.

New Connections between Adverse Childhood
Experiences and Health
The many negative effects of adverse childhood experiences are well-known (Felitti et al., 1998). The Adverse Childhood Experiences (ACE) scale assesses 10-items that havebeen shows to predict health outcomes. In order to improve
the prediction of negative health outcomes, four new items
were added based on data from the National Survey of Children’s Exposure to Violence 2014 (Finkelhor, Shattuck, Turner, & Hamby, 2015). This was a telephone survey conducted
between August 2013 and April 2014 of 1,949 children andadolescents aged 10–17 and caregivers. Caregivers were asked
for demographic information, the child’s physical health condition, and mental health symptoms. Child and adolescentparticipants were asked about adversities using the existing
10 items from the ACE scale: five on child maltreatment(physical abuse, psychological abuse, sexual abuse, physicalneglect, and emotional neglect) and five on parental or family
incapacities (substance abuse, mental illness, parental loss
separation or divorce, parental imprisonment, and violenceagainst the mother). Four new measures added in this study
to determine their effectiveness at predicting health out4 • RESEARCH REVIEW | Joining Forces/Joining Families

comes. The new items were: low socioeconomic status (SES),
peer victimization, peer isolation/rejection, and exposure tocommunity violence. Peer victimization, peer isolation/rejection, and community violence exposure added significantly
to the prediction of mental health symptoms. Low SES added
significantly to the prediction of physical health problems.
These four new items are valuable because of their connection with adverse health outcomes and suggest the need forincreased understanding of how ACEs affect development
and what can be done to mitigate their effects.
References
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM,
Edwards V, & Marks JS. (1998). Relationship of childhood
abuse and household dysfunction to many of the leading
causes of death in adults. American Journal of Preventive
Medicine; 14(4): 245–258.
Finkelhor D, Shattuck A, Turner H, & Hamby S. (2015). A
revised inventory of Adverse Childhood Experiences. Child
Abuse & Neglect; 48: 123–21.
Winter 2016

Posttraumatic Stress Disorder Symptoms and Victims of Intimate
Partner Violence: Men and Women Differ
In a nationally representative U.S. sample of men andwomen who had been in a relationship in the past year, aposttraumatic stress disorder (PTSD) diagnosis within thepast year was associated with a two-fold increased rate ofperpetration of physical intimate partner violence (IPV).
Arousal/reactivity symptoms were associated with IPV perpetration for both men and women. Intrusive symptoms wereassociated with PTSD for men only; for women, negative
cognitions and mood were significant. Avoidance symptoms
were not associated with PTSD for either sex. The differencesin symptoms by men and women were unexpected. The
authors speculated that men and women were differentiallydisturbed by their symptoms: men by intrusion and womenby negative mood. Because this was a cross-sectional study,
it was not possible to determine if the PTSD caused the IPV.
However, it was suggested that examining symptoms clusters
of PTSD may help clinically in identifying those with PTSD
who are at higher risk for perpetration of IPV.
Reference
Smith KZ, Smith PH, Violanti JM, Bartone PT, & Homish GG.
(2015). Posttraumatic stress disorder symptom clusters andperpetration of intimate partner violence: Findings from U.S.
nationally representative sample. Journal of Traumatic Stress;
28: 469–474.

Resources for Help with Intimate Partner Violence,
Posttraumatic Stress Disorder, 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 stress disorder (PTSD)
http://www.ptsd.va.gov/about/subscribe.asp. Subscribers tothis free service receive a monthly update. A wide variety ofresources are available for providers, researchers, and othersubscribers. The subject of the October 2015 issue is PTSD
and intimate partner violence (IPV). Links are provided for
information about both subjects as well as the numbers forhelp lines for IPV (800-799-7233) and the National Sexual

Assault Hotline (800-656-4673). Free continuing educationcredits are available to providers outside the VA in the formof a lecture series. The publication also briefly notes researchunderway at the Center and news about events of 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 andeasy way to be informed of current developments affecting
military personnel and veterans and their families.

Intimate Partner Violence: Health Care Provider
Self-Awareness Can Improve Care
Statistics abound on the prevalence of intimate partner
violence (IPV) (Breiding, Smith, Basile, Walters, Chen, & Merrick, 2014). Practitioners in the health fields often encounter
victims and perpetrators, some known and some unknown. In
addition to recognition, referral, and treatment of both groups,
it is important for professionals in health practice to recognize
the barriers that might exist between them and their patients/ clients in addition to the complexity of treatment and legal
issues that can exist (Chapman & Monk, 2015). For example,
practitioners may share such issues such as the presence of aggression and impulse control with perpetrators; empathy, pity,
fear of abandonment, and self-preservation with victims.
Recognition of these feelings can help to reduce the barriers that exist when the practitioner sees the victim as themand self as me. How to approach this dichotomy is a profes-

http://www.CSTSonline.org

sional as well as a personal decision. Admission of such feelings to colleagues can be embarrassing and could lead to consequences for the person who admits to facing this struggle.
Regardless of how it is approached, it is a duty to continually
be aware of how such feelings affect health care.
References
Breiding MJ, Smith SG, Basile KC, Walters ML, Chen J, & Merrick MT. 2014). Prevalence and characteristics of sexual
violence, stalking, and intimate partner violence victimization – National Intimate Partner and Sexual Violence Survey,
United States, 2011. Morbidity and Mortality Weekly Report.
Surveillance Summaries, September 5, 2014/63 (SSo8): 1-18.
Chapman A, & Monk C. (2015). Domestic violence awareness.
American Journal of Psychiatry; 172(10): 944-945.

RESEARCH REVIEW | Joining Forces/Joining Families • 5

What are the Helpful Ingredients of Social Support?
Social support is commonly advocated as a means toprevent and alleviate stress. It has been a topic of research
for nearly 50 years. Social isolation is associated with poorer
psychological functioning and the increased risk for childmaltreatment. The question raised by this article is how tounderstand the relation of social support, particularly when
the family is socially isolated, to the prevention of childmaltreatment. What is the nature of the isolation? How is
it related to the risk of child maltreatment? What are thecharacteristics of support that buffer against risks? What are
the barriers to creating support? Which people are capable ofproviding it? Is support alone enough? These are challenges
to creating effective interventions.
Most often, support comes from informal networks that
may or may not be helpful in providing constructive behaviors to the at-risk families. Support can be provisioningor monitoring. Provisioning consists of emotional support
through encouraging, counseling and guiding, giving accessto information and resources, and skill acquisition. However
valuable and easily conducted, it may fall short of helping
families when it rationalizes or fails to challenge harmful
family practices.

Monitoring, on the other hand, consists, in part, of challenging dysfunctional behavior. Formal supports, such ashome visitors, need to include the monitoring function if
they are to be effective in changing parents’ behavior. Those
who assist at-risk families need to have the skills to integrate
proactive parenting guidance and correction with emotional
support. Effective monitoring also requires close attention to
the reactions of the recipient so as not to alienate that person.
Support includes assistance in accessing resources. This isparticularly important when the home visiting is short-lived.
Families often need continued support from many networks
for lessons to stick. The goals of home visiting research andprogram development have been to identify the effective
ingredients of support to at-risk families, efforts that are challenging, but worthwhile.
Reference
Thompson RA. (2015). Social support and child protection: Lessons learned and learning. Child Abuse & Neglect; 41: 19–29.

Crying Babies: Helping Parents Cope
It is well-known that infant crying is distressing forparents and can result in behaviors that cause harm to theinfant. In addition, excessive infant crying can cause parents
to question their parenting ability. This study summarizes
literature on infant crying in order to improve professional
understanding of parental response to and experiences ofit. Better understand may lead to enhanced infant-parent
attachment, better infant development, and reduced risk ofmaltreatment. Health visitors can be crucial in helping parents prevent as well as manage this problem and access additional resources. This literature review found that common
experiences of parents were feeling angry, frustrated, guilty,
ashamed, unprepared for parenthood, and having unrealistic
expectations of life with a new baby. Parents can also feel lesstender and empathetic toward their baby and feel rejected by
the baby. Fathers spent less time alone with the baby due tothe impact of crying. Parents felt most frustrated when they
were tired. Harmful actions found during the first six months
including smothering, slapping, and shaking. Other actions
reported were losing their temper, screaming, crying, and hitting things. Some parents reported feeling a loss of the baby
they had expected to have such as one that was happy andeasy to love.

6 • RESEARCH REVIEW | Joining Forces/Joining Families

Impairment in the parent-infant bonding can haveadverse effects on a child’s development during the first
24-36 months of life, particularly for brain development.
It is important that steps be taken to identify parents withthese frustrations and provide support to them. Suggested
interventions were pre-parenting programs that are educationally-based to help parents develop knowledge and skills
to respond positively to infant crying. Both parents should be
included in outreach and education programs. Parents should
be encouraged to talk about their feelings regarding thepotential impact of crying on bonding. Early identification ofparents experiencing difficulties is an essential component oflowering risk to infants.
The Army has emphasized preparing parents for crying
infants through a pre-natal program for first time parents andhome visiting. (For a helpful tip card on soothing a crying
baby, see Joining Forces Joining Families, Winter 2014 http://
www.cstsonline.org/resources/resource-master-list/joiningforces-joining-families-winter-2014).
Reference
Oldbury S, & Adams K. (2015). The impact of infant crying on
the parent-infant relationship.Community Practitioner; 88(3):29–34.

Winter 2016

Children and Adolescents Who Damage Property:
A Form of Parent Abuse?
Domestic property violence (DPV) can be considered
an important type of family violence, that of children andadolescents toward parents. It is unlikely to ever be considered under state or military criteria for maltreatment, but it
can have a significant effect on parents and their relations
with each other and with their children. DPV is property
damage or loss carried out “as a means of causing emotional
distress or financial harm, intimidating, threatening, or assuming control over a parent.” Parents’ experiences of making
meaning of DPV were described by interviews of 14 volunteer women and men. DPV was almost always accompaniedwith verbal and physical abuse, often of an extreme naturethat was experienced by the parent as traumatic and createdfear, uncertainty, anger, sadness, hopelessness, desperation,
self-blame, and guilt. All participants reported the experience of loss, particularly in terms of the parent-child relationand emotional impacts, rather than the financial losses. Most
parents who had sought help reported a lack of support, unhelpful advice, and negative judgments about their parenting.
Causes were difficult to determine. Parental separation andimpacts of grief and loss were common, but also suspected
were child mental health and drug and alcohol problems

as well as school stress and peer pressure. Five participants
reported their child’s exposure to adult family violence. This
study showed that DPV can create unique and harmful impacts that should not be underestimated. The facets of DPV
are personal, social, cultural, political, and environmental
and any of these can impede or facilitate parents seeking
help. Self-blame did not lead to better personal adjustment
for the parents. Better levels of adjustment were associatedwith making meaning such as strengthening their resolve
to overcome the violence and achieve turning points sooner
rather than later. DPV is complex legally and socially. It could
be a topic for Child Protective Service or Family Advocacy interms of precipitating factor if a child or adolescent accuses aparent of abuse. However, it is also politically volatile. If social
service providers encounter property destruction in thecourse of investigation or intervention of family violence, it isimportant to consider its role in family dynamics rather thanfocusing on individual disorders as the basis of causation.
Reference
Murphy-Edwards L, van Heugten K. (2015). Domestic property
violence: A distinct and damaging form of parent abuse. Journal of Interpersonal Violence. doi:10.1177/0886260515613341.

Intimate Partner Violence is Strongly Associatedwith Sleep Disturbance
While intimate partner violence (IPV) has frequently been
associated with physical and mental health problems, there
is little information on the role of sleep disturbance in thisrelationship. IPV, sleep disturbance, and physical and mental
health were assessed in 34,975 females and males in the 2006
Behavioral Risk Factor Surveillance System (the BRFSS), a
state-based system of health surveys collecting information
on health risk behaviors related to chronic disease and injury.
Three types of IPV were assessed: threatened, physically hurt,or forced to have sex by an intimate partner. Sleep disturbance was measured as difficulty falling asleep, staying asleep,or sleeping too much for at least 6 of the last 14 days. Whenadjusted for age, sex, race, income, education, and physical andmental health, IPV predicted sleep disturbance. For example,
those who were ever threatened, hurt, or forced to have sex
were two to three times as likely to report sleep disturbanceat least three times per week. Those reporting being hurt orforced to have sex in the past year were 7-8 times as likely toreport sleep disturbances.
These results are relevant for practice in that relieving insomnia has the possibility of at least partially reducing the effects of IPV on physical and mental health. Family Advocacy
Program (FAP) staff may not often think about physiologic
http://www.CSTSonline.org

issues when dealing with clients. Reducing sleep disturbancecan mitigate the effects of both IPV and sleep disturbanceon physical and mental health. Compounding IPV withinsomnia and other associated health issues is a double(or triple) hit making it harder for clients to think clearlyand evaluate choices or information provided. Individuals
reporting insomnia should be referred for treatment basedon their preferences. These authors suggested that cognitivebehavioral therapy (CBT) for insomnia, an inexpensive
therapy that gives tools for the client to change thoughts andbehaviors that maintain insomnia regardless of the cause.
However, people who are stressed or exhausted may not havethe time or energy or cognitive resources to engage in 4-10
weeks of therapy just to start getting some rest. Short term
use of hypnotic drugs can address sleep issues quickly andeffectively while the clients anticipates participating in CBTor short-term trauma-focused therapy.
Reference
Lalley-Chareczko, Segal, Perlis, Nowakowski, Tal & Grandner.
(2015). Sleep disturbance partially mediates the relationshipbetween intimate partner violence and physical/ mental
health in women and men. Journal of Interpersonal Violence;
1-25. doi: 10.177/0886260515592651.
RESEARCH REVIEW | Joining Forces/Joining Families • 7

Five Effects of Exposure to Intimate Partner Violence on Children
Thirty women in Spain who were intimate partner violence (IPV) victims were interviewed about their children’s
reactions. Five main themes were identified: (a) children weredirectly victimized, (b) child were indirectly victimized bywitnessing the violence, (c) children’s direct reactions included fear or attempting to intervene, (d) academic, social, andpsychological consequences for children, and (e) mothers
developed strategies for protecting her children during andafter the violent incident. The direct victimization of children
was largely psychological consisting of threats of harm to thechild or mother, but physical violence toward the child also
occurred. Mothers’ strategies were to talk to the children andexplain. Another strategy was to lock children in their room
when an incident began. Eight of the 30 interviewed womenreported that their adolescent children had used violenceagainst them. Although many children showed negative
reactions to the IPV, some appeared to develop resilienceand displayed maturity Women who are IPV victims carry
their own burden of abuse, but also carry a burden of theirchildren’s suffering and possibly becoming a victim of theirchildren’s violence.
Reference
Izaguirre A, & Calvete E. (2015). Children who are exposed to
intimate partner violence: Interviewing mothers to understand its impact on children. Child Abuse & Neglect. doi:
10.1016/ jchiabu.2015.05.002.

Effects of Intimate Partner Violence on Very Young Children
Few studies have examined the effects of intimate partner
violence (IPV) on the behavior of children under 24 months.
This is a time when children are developing self-regulatingskills. If maladaptive development occurs during this time
period, it may be difficult and costly to reverse. IPV iscomplex. It can occur with each parent in a variety of types(psychological and physical), severity, and chronicity. Likewise, similar abuse of children occurs in addition to the useof corporal punishment by parents. The participants of thisstudy were first-time young adolescent mothers participating in a home visiting program. They were evaluated at an
initial interview and then 12 and 24 months later. Evaluation
included IPV perpetrated and received, maternal depression
and history of maltreatment, and child behavior regulation. Both physical and psychological IPV by parents wereassociated with greater toddler behavior problems. Children
who experienced corporal punishment (considered as childmaltreatment here), evidenced even a higher level of behavior problems when IPV was occurring in the household.
These results indicated that corporal punishment can amplify
the effects of IPV and supports the need for early preventive
education in supporting parents as well as cultivating healthy
adult relationships, both to reduce negative effects on childdevelopment.
Reference
Easterbrooks MA, Katz RC, Kotake C, Stelmach NP, & Chaudhuri JH. (2015). Intimate Partner Violence in the first 2 yearsof life: Implications for toddlers’ behavior. Journal of Interpersonal Violence. doi: 10.1177/0886260515614562.

Risk Factors for Suicidal Ideation in Female Victimsof Intimate Partner Violence
Factors associated with suicidal thoughts were explored ina study of women of New Zealand in face-to-face interviews.
Of the 956 women who had ever experienced physical or sexual intimate partner violence (IPV). Women were more likely toreport that they had thought about taking their own life if:• Their partner ‘s behavior had affected their mental health.
• They were current or former users of recreational drugs.
• Had experienced a stillbirth, abortion, or miscarriage.
• Experienced emotional abuse in the previous 12 month.
Health care providers need to be able to assess for andrespond to IPV among their female patients presenting with

8 • RESEARCH REVIEW | Joining Forces/Joining Families

suicidal ideation as well as reverse: to assess suicidal ideation
among patients with IPV. Women’s suicidal ideation is also affected by other factors such as having experienced a stillbirth,abortion, or miscarriage.
Reference
Gulliver P, & Fanslow J. (2013). Exploring risk factors for suicidal ideation in a population-based sample of New Zealandwomen who have experienced intimate partner violence.
Australian and New Zealand Journal of Public Health,37(6):27–33.

Winter 2016