Effects of Domestic Violence on Children

¶ … Domestic Violence on Children

Many people throughout the world have traditionally believed that women's natural roles were as mothers and wives and considered women to be better suited for childbearing and homemaking than for involvement in the public life of business or politics. This popular belief that women were somehow intellectually inferior to men, based in large part on religious authority, has led many societies throughout the world to limit women's education to learning domestic skills and relegating them to a second-class citizen status. By and large, the world has been run by well-educated, upper-class men who controlled most positions of employment and power in these societies and to a large extent continue to do so today. While the status of women today varies dramatically in different countries and, in some cases, among groups within the same country, such as ethnic groups or economic classes, women continue to experience the effects of this oppressive religious dogma as it relates to their lives. Violence against women in many cases is legitimized by religious authority which gives men the legal authority to discipline women. When domestic violence spills over into the mistreatment of children, though, there are other and more fundamental issues involved. As a result, domestic violence and children is a subject of importance for both scientific inquiry and social policy formation, since the family is a universal social framework for the bearing and care of children. Families are the systems within which cultural traditions, beliefs, and values are taught to children. Both social and environmental contexts have a great deal to do with the formation of future patterns of behavior and susceptibility to mental health issues, which may further affect behavior.

For human beings, prior experiences, motivations, and the context within which various experiences happen all influence a person's response to numerous things, including the development of various mental health problems.

The past few decades have seen the social sciences focusing more and more upon the context, as well as the immediate causes, of the mistreatment of children, as well as the developmental consequences of such abuse over the long-term (Gelles & Lanaster, 1987). This project is important in the context of further establishing whether there is a direct relationship between certain types of mental health problems and childhood sexual and/or physical abuse, through a more qualitative examination of the context as well as the data itself.

Literature Survey

Domestic violence is recognized as rising to the higher levels on today's list of worldwide public health problems posing a serious threat to both the psychological and physical well-being of women and children across a wide range of socioeconomic, racial and cultural groups (Flett, Kazantzis, Long, Macdonald & Millar, 2000). Although specific population-based research is so far lacking, the data that is available points to the fact that between 20% and 50% of women in most countries around the world today have been abused at some point in their lives (Heise, Raikes, Watts, & Zwi, 1994).

Domestic violence has been clearly linked as significant risk factor to a plethora of health risks to children, including but not limited to, low birth weight (Bullock & McFarlane, 1989). Victims of crime and other various types of disasters seem to suffer common responses, including anger, shock, confusion, fear, and anxiety. In fact, as a result of violence, a person's view of the world often is dramatically altered. In a recent book, Janoff-Bulman notes that "most of us, before suffering from trauma, believe that the world is benevolent and meaningful, and that we are worthy people" (Janoff-Bulman, 1992, p. 6).

Since everyone needs stability in their view of the world, these beliefs are generally quite resistant to change. However, events that threaten a person's survival cause a different view of the world to evolve. Assumptions can literally be shattered when people are exposed to traumatic situations and be replaced by new and negative assumptions. Domestic violence is especially horrifying and even mind-altering, given that a victim's former place of refuge and safety now causes extreme anxiety (Janoff-Bulman, 1992).

Child victims seldom have an alternative to remaining in the violent home, probably being dependent upon the abusive parent. Several studies have shown that since parents are normally the ones who provide the necessary assistance for children to interpret their experiences and turn them into lessons about life, the child's sense of self and their worldview may be seriously damaged or even destroyed by an abusive parent (Belsky & Vondra, 1989; Janoff-Bulman, 1992).

Victims of violence that has been perpetrated by a family member are frequently overcome by feelings of low self-esteem and depression (Friedrich & Einbender, 1983). Preschool and young school-aged children, have not yet developed a strong sense of self (Livesley & Bromley, 1973) and are not generally going to attribute what happens to them to their own personality or character. However, they do seem to believe that bad things that happen to them are the direct result of something they did wrong (Piaget, 1965).

Young children look to their parents as role models on how to react to things that happen in life. Therefore, an abusive mother or father wields great power over their child's thinking. When parents demean children or suggest that the child is the cause of the violence against them, young children will probably adopt that viewpoint as being true (Larrance & Twentyman, 1983). Several studies of traumatic maltreatment in childhood show that this may cause post-traumatic stress symptoms (Briere, 1992; Famularo, Fenton, Kinscherff, Ayoub & Barnum, 1994).

The beliefs and behaviors that are symptomatic of post-traumatic stress may then become chronic, eventually turning into overtly antisocial and criminal behavior in adulthood. At least two studies have shown that victimized children are indeed at an increased risk of later antisocial and criminal behavior (Luntz & Widom, 1994; Widom, 1991). The majority of researchers into child abuse are certain that it has multiple, and frequently, severe consequences for its victims.

In examining the socio-emotional consequences of the physical abuse of children, Egeland and Sroufe conducted a study in which they clearly asserted that "in the area of socio-emotional development, even the obvious is often difficult to demonstrate Uncovering the developmental consequences of child abuse is a prime example Yet, no one can doubt that there are consequences of being physically abused" (Egelund and Sroufe, 1981, p. 77).

The literature reveals that some of the consequences of child abuse include death, permanent disability, developmental delay, speech and learning problems, impaired attachment relations, self- and other-directed aggression, psychosis (notably multiple personalities), juvenile delinquency, depression, deficient social skills, and sexual dysfunction. In a comprehensive study of the consequences of abuse and neglect, Martin identified three major areas of problems. The first is medical, ranging from nutritional lacks to hearing loss and brain damage). The second is developmental, encompassing mental retardation, language deficiencies and impaired motor skills. The third is psychological, from being either very shy and inhibited or very aggressive and provocative to general unhappiness, poor attachment skills, and inadequate relationships with peers (Martin, 1980).

One idea is that a pattern develops whereby the damaged child receives responses from outside that simply reinforce the damage.

A number of studies indicate that causal relationships between child abuse and adult psychological disorders exist, including depression, anxiety disorders, post traumatic stress disorder, substance abuse, personality disorders, sexual dysfunction, eating disorders and dissociative disorders (Beitchman, Zucker, Hood, DaCosta, Ackaman & Cassavia, 1992; Briere, Berliner, Bulkley, Jenny, & Reid, 1996). Another New Zealand-based study found that even after controlling for variables related to various other childhood disadvantages, the relationships between child sexual abuse and many other disorders presenting themselves at or after the age of 18 are significant (Fergusson, Horwood, & Lynskey, 1996).

A review of 15 studies, encompassing a total of 817 female in-patients, indicated that 44% of these patients reported childhood physical abuse, 50% reported childhood sexual abuse, and 64% had suffered from either CSA or CPA (Read, 1997). Male in-patients also stated significantly higher rates of child abuse than did men in the general population (Rose, Peabody, & Stratigeas, 1991). A community survey of New Zealand women determined that the relationship between childhood sexual abuse and the likelihood of becoming an inpatient at some point in the future is obvious, even after controlling for other factors that could be responsible (Mullen, Martin, Anderson, Romans & Herbison, 1993).

Child abuse also seems to be related to the various psychotic symptoms and diagnoses of schizophrenia (Bryer, Nelson, Miller, & Krol, 1987; Read, 1997; Read, Perry, Moskowitz & Connolly, 2001; Ross, Anderson, & Clark, 1994). A New Zealand study determined that 77% of adult psychiatric in-patients who stated that they had suffered from either childhood sexual or physical abuse went on to experience hallucinations, delusions or thought disorder. The content of about fifty percent of these symptoms seemed to be related to the childhood abuse (Read & Argyle, 1999).

Yet another New Zealand study conducted with 200 adult outpatients, noted that child abuse is a significant forecaster of hallucinations, and combined childhood and adulthood abuse can significant increase the chance delusions and thought disorder (Read, Agar, Argyle, & Aderhold, in press, as noted in Lothian & Read, 2002). A history of abuse is also related to the severity of a given mental disturbance, including suicidality, age at first admission to facility for care, frequency and length of admissions, time spent in seclusion, likelihood and dosage of psychiatric medication, and global symptom severity (Beitchman, et al., 1992; Briere, et al., 1997; Bryer, et al., 1987; Pettigrew & Burcham, 1997).

Read also discovered that of those New Zealand inpatients who reported either childhood sexual abuse or childhood physical abuse, 64% were acutely suicidal on admission, as compared to only 22% of in-patients who had not suffered these types of abuse (Read, 1998). A later study of 200 adult outpatients determined that child abuse was a significantly stronger factor in current suicidality than was a more current diagnosis of depression (Read, Agar, Barker-Collo, Davies, & Moskowitz, 2001).

Sexual abuse research suggests that there is, at the very least, an associative relationship between sexual abuse and other disorders, if not a direct causal relationship based on the sexual trauma (Bagley, 1992; Farrell, 1988; Finkelhor & Browne, 1986). According to Farrell, a sexual abuse victim is very likely to develop serious psychological problems as a result of the victimization. Finkelhor and Browne also noted that the aftermath of molestation might be delayed long into adulthood.

Some of the various long-term effects that are often reported and specifically associated with sexual abuse include depression, self-destructive behavior, anxiety, feelings of isolation and stigma, poor self-esteem, difficulty in trusting others, tendency toward revictimization, substance abuse, and sexual maladjustment (Finkelhor & Browne, 1986, Herman & Hirschman, 1977; Tsai & Wagner, l978). Early identification of a sexual abuse victim seems to be the most critical element in the ability to reduce suffering, enhance of psychological development, and guarantee healthier adult functioning (Bagley, 1992; Whitlock & Gillman, 1989).

Sorensen and Snow (1991) suggested that policies and procedures geared only to those children who have disclosed the abuse fail to recognize the needs of the majority of victims (Sorensen & Snow, 1991). Children often fail to report their abuse because of the fear that telling someone about it will bring consequences that are even worse than being victimized. The child may feel guilty for creating these consequences for the abuser and may fear retaliatory actions. Unfortunately, disclosure of the abuse appears to be an ongoing problem for young victims. As long as that is the case, fear, suffering, and psychological distress will continue to plague the victims of childhood abuse.

Theoretical Framework

There are a number of theories about the relationship between child abuse and subsequent mental health problems.

Mental disorders and mental health problems appear in families of all social classes and of all backgrounds. Some children are at greater risk by virtue of a broad array of factors. These may include physical problems, intellectual disabilities (retardation), low birth weight, family history of mental and addictive disorders, multigenerational poverty, and caregiver separation, in addition to abuse and neglect. It is important to further clarify the reason behind the apparent cause-and-effect relationship between child abuse and the numerous mental health issues and problems suffered by children and young adults who have been the victims of physical, psychological or sexual abuse.

Research Method

The method used in this research project started with a review of the literature that discusses issues relating to the effects of domestic violence on children. Based on that literature review, it was determined that some of the effects of domestic violence on children include depression, low-self-esteem, anxiety disorders, post-traumatic stress disorder, substance abuse, personality disorders, sexual dysfunction, eating disorders, dissociative disorders, and other serious mental problems.

Structured interviews were determined to be the most effective method for obtaining the basic information necessary to determine whether abuse had occurred. Structured interviews require the interviewer to ask each respondent the same questions, utilizing an interview schedule. The interview schedule is a formal instrument that spells out the precise wording and ordering of all questions to be asked. The short version of the Childhood Maltreatment Interview Schedule (Briere, 1992) was selected as the appropriate interview schedule tool for this research and it can be found in Appendix A of this proposal. Participants will be chosen from among the population of both inpatients and outpatients, under the age of 25, who are seeking treatment for mental health problems, including depression, anxiety disorders, post traumatic stress disorder, personality disorders, sexual dysfunction, eating disorders and/or dissociative disorders.

Data Analysis

The motivation for doing qualitative research derives from the fact that qualitative research methods are designed to assist in understanding people, as well as the social and cultural contexts within which they live. Kaplan and Maxwell argue that the key to understanding any occurrence from the point-of-view of its participants and its social and institutional context is less likely to be discovered when all of the data are quantified (Kaplan & Maxwell, 1994). Although the structured interview schedule allows for consistency of data across subjects, it will still provide qualitative data that must be interpreted.

Content analysis can be used for "making replicable and valid references from data to their contexts" (Krippendorf, 1980). It will be important to look for structures and patterned regularities in the answers given, as well as to make inferences on the basis of the discovered regularities.

Potential Conclusions

Based on the literature review, it is safe to assume that the results of this survey may show that people who experience serious mental health problems, including depression, anxiety disorders, post traumatic stress disorder, personality disorders, sexual dysfunction, eating disorders and dissociative disorders are suffering from these problems because they were also the victims of childhood sexual and/or physical abuse. Various other studies have pointed to this correlation and it will be of significance to determine more clearly that this link definitely exists, with the insight that a more qualitative approach can bring to the study of the quantified data gathered to date.

Dissemination Plan

The results of this survey should be documented and disseminated via appropriate journals in the region, including the New Zealand Journal of Psychology and/or the Australian and New Zealand Journal of Psychiatry.

Appendix A Childhood Maltreatment Interview Schedule (adapted from Briere, 1992)

Age

Sex:

Male ____ Female

Race:

Caucasian/White ____ Black ____ Asian ____ Hispanic

Are you currently receiving psychotherapy or psychiatric treatment?

Yes ____ No

The following survey asks about things that may have happened to you in the past. Please answer all of the questions that you can, as honestly as possible.

1) Before age 17, did any parent, step-parent, or foster-parent ever have problems with drugs or alcohol that lead to medical problems, divorce or separation, being fired from work, or being arrested for intoxication in public or while driving?

Yes__ No

If yes, who?

About how old were you when it started?

____ years old

About how old were you when it stopped?

____ years old

Check here if it hasn't stopped yet __]

2) Before age 17, did you ever see one of your parents hit or beat up your other parent?

Yes ____ No

If yes, how many times can you recall this happening?

____ times

Did your father ever hit your mother? Yes ____ No