Int. J. Environ. Res. Public Health 2009, 6 3158 study designs lack inferential power and there is also a possibility of publication bias. As consistent and powerful as these findings may be, more rigorous study is needed on this phenomenon. It is widely recognized that alcoholism and relationship violence often have serious consequences for adults (e.g., emotional, economic, behavioral, physical, social); however, children living with alcoholic or drug-abusing parents are susceptible to the deleterious familial environments these caregivers frequently create. Although many genetic and environmental factors may increase offspring risk, and this is not to say that other factors (i.e., parenting practices, peer values, neighborhood influences) should not be examined in tandem, IPV in the context of parental alcohol abuse plays a very significant, but often overlooked, role in children’s short- and long-term outcomes. Thus, our argument, theoretical explanations, and suggestions for future research focus on the need for researchers to establish how children’s exposure to IPV and parental alcohol misuse may individually or in combination create risk for negative psychosocial outcomes. Moreover, given the clear evidence for the relationship between parental alcohol abuse and IPV, for perhaps the majority of children, mental health treatment should address both the potential harm that exposure to interparental violence and parental alcoholism create. Given the prevalence of IPV among patients entering substance abuse treatment, coupled with the negative familial consequences associated with these types of behavior, this review will further explore what have been, to this point, two divergent lines of research: (a) the effects of parental alcoholism on children, and (b) the effects of children’s exposure to intimate partner violence. Separate literatures have evolved because in general the majority of studies have compared children of alcoholics (COAs) to non-COAs and children who witness interparental violence to controls. As such, first, we explore the impact of parental alcoholism on children’s development. Second, we examine the effect of IPV on children living in these environments. Third, we highlight theories that may help to explain the effects of IPV, parental alcoholism, and the interaction of these variables on child outcomes. Finally, we provide a brief argument for investigating IPV in the context of alcohol use disorder, which may be especially detrimental for children’s mental health treatment. 2. Parental Alcohol Abuse and Child Development Although alcoholism often has serious emotional, economic, behavioral, physical, and social consequences for alcohol abusers and their partners, children who live with alcoholic parents often experience negative psychosocial outcomes. In general, the literature supports that COAs are more likely to develop externalizing problems such as conduct disorder, oppositional defiant disorder, delinquency, and attention deficit disorder (e.g., [21,22]), and are at elevated risk for internalizing behaviors such as depression and anxiety [23,25]. In addition, offspring of alcoholics drink earlier (e.g., [24]), are more likely to develop alcohol use problems [25-28], progress from initial alcohol use to alcohol use disorder more quickly [25,28], and are less likely to mature out of moderate to heavy drinking [30]. Although, in general, the literature supports an elevated risk for negative psychosocial development among children with a family history of alcoholism (e.g., [31]), many children who live with an alcohol-abusing parent display normal psychosocial development (e.g., [32-34]). With respect to parental alcohol abuse and IPV, Nicholas and Rasmussen [33] found that when they controlled for