hypothesis on domestic violence

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Domestic violence theories.

There is no single causal factor related to domestic violence. Rather, scholars have concluded that there are numerous factors that contribute to domestic violence. Feminists found that women were beaten at the hands of their partners. Drawing on feminist theory, they helped explain the relationship between patriarchy and domestic violence. Researchers have examined other theoretical perspectives such as attachment theory, exchange theory, identity theory, the cycle of violence, social learning theory, and victim-blaming theory in explaining domestic violence.

Theories of Domestic Violence:

Attachment theory.

Attachment theory is a useful lens through which to understand perpetrator behavior. It explains how early childhood experiences have led to a particular way of experiencing close relationships. It also helps therapists to see how, depending on the attachment status of the client, interventions will need to be developed to address their specific needs and that cookie cutter approaches will not advance the profession. The attachment findings make it clear that domestic violence is not just a result of social conditioning; if anything, it is at least the interaction between psychological conditioning and the social context. Therefore, while social changes are necessary, violence will never stop as long as the psychological and biological factors are minimized or altogether ignored. Read more about Attachment Theory .

Cycle of Violence

Since the late 1970s, researchers and theorists have focused increased attention on the widespread problem of domestic violence in contemporary society. Research has shown that domestic violence cuts across racial, ethnic, religious, and socioeconomic lines. In particular, researchers have sought to identify the factors associated with intimate violence in an effort to develop theories explaining the causes of battering. One of the most widely cited theories in the domestic violence literature is Lenore Walker’s cycle of violence. According to Walker, the cycle of violence is characterized by three distinct phases which are repeated over and over again in the abusive relationship. As a result, domestic abuse rarely involves a single isolated incident of violence. Rather, the abuse becomes a repetitive pattern in the relationship. Read more about Cycle of Violence .

Exchange Theory

As with the general exchange theory, the key assumption of an exchange theory of family violence is that human interaction is guided by the pursuit of rewards and the avoidance of punishment and costs. Simply stated, individuals will use force and violence in their relationships with intimates and family members if they believe that the rewards of force and violence outweigh the costs of such behavior. A second assumption is that a person who supplies reward services to another obliges the other to fulfill a reciprocal obligation; and thus, the second individual must furnish benefits to the first (Blau 1964). Blau (1964) explains that if reciprocal exchange occurs, the interaction continues. However, if reciprocity is not received, the interaction will be broken off. Of course, family relations, including partner relations, parent–child relations, and sibling relations, are more complex and have a unique social structure compared with the exchanges that typically exist outside of the family. Read more about Exchange Theory .

Identity Theory

Identity theory provides an important avenue for theoretical development in domestic violence research because all behavior, including aggression, is rooted in issues of self and identity. To understand aggression, we need to understand the meanings individuals attribute to themselves in a situation, that is, their self-definitions or identities. In all interactions, the goal of individuals is to confirm their identities. When their identities are not confirmed, persons may control others in the situation to make them respond differently in order to confirm their identities. If control does not work, aggression may be used as a last resort to obtain control and, in turn, confirmation of identity. Thus, identity theory can help explain domestic violence by showing how a lack of identity confirmation at the individual level is tied to the control process and aggression at the interactive level. Read more about Identity Theory .

Social Learning Theory

Social learning theory is one of the most popular explanatory perspectives in the marital violence literature. Often conceptualized as the ‘‘cycle of violence’’ or ‘‘intergenerational transmission theory’’ when applied to the family, the theory states that people model behavior that they have been exposed to as children. Violence is learned through role models provided by the family (parents, siblings, relatives, and boyfriends/girlfriends), either directly or indirectly (i.e., witnessing violence), is reinforced in childhood, and continues in adulthood as a coping response to stress or as a method of conflict resolution. During childhood and adolescence, observations of how parents and significant others behave in intimate relationships provide an initial learning of behavioral alternatives which are ‘‘appropriate’’ for these relationships. Children infer rules or principles through repeated exposure to a particular style of parenting. If the family of origin handled stresses and frustrations with anger and aggression, the child who has grown up in such an environment is at greater risk for exhibiting those same behaviors, witnessed or experienced, as an adult. Gelles (1972) states that ‘‘not only does the family expose individuals to violence and techniques of violence, the family teaches approval for the use of violence.’’ Children learn that violence is acceptable within the home and is an effective method for solving problems or changing the behavior of others. Read more about Social Learning Theory .

Victim-Blaming Theory

Victim-blaming theory describes the practice of holding victims partly responsible for their misfortune. It represents the faulting of individuals who have endured the suffering of crimes, hardships, or other misfortunes with either part or whole responsibility for the event. Often, victim-blaming theories rely on the premise that individuals should recognize the dangers that exist in society and therefore should take the necessary precautions to maintain a certain level of safety. Those who do not take such precautions are perceived as blameworthy for their demise even if they have not acted carelessly. These perceptions in effect shift the culpability away from the perpetrator of the crime onto the victim. When discussing issues of family violence, violence against women, or sexual assault, one often hears victim-blaming statements such as, ‘‘Why didn’t she leave?’’ or ‘‘She was asking for it.’’ Within the context of family violence, victim blaming often includes condemnation of the victim for staying in an abusive relationship. Read more about Victim-Blaming Theory .

Lauren Isaac, MSW

Domestic Violence in Families: Theory, Effects, and Intervention

If a person experiences trauma; specifically that of domestic violence, either directly or vicariously (indirectly) from a young age, they do not properly pass though the appropriate developmental stages. This will hinder their emotional growth—causing them to remain stuck in one particular stage. Therefore, this child will not develop and maintain a normal level of trust in his/her parents because they will not feel the appropriate amount of safety in their environment. This alone, will affect how the family members relate to one another from that point on and will put the child at a disadvantage because they will be unable to form healthy relationships with those outside the family system as well. Depending on the frequency, intensity, and duration of the violence, these effects may be life-altering, devastating, and last for many years to come.

A child who experiences this type of trauma at a young age, will not have an appropriately developed brain. This idea suggests that there will be significant differences between the brain of child who has grown up or is currently growing up in a loving, supportive, and caring environment, and the brain of a child who is witnessing domestic violence within their family system, causing them to experience constant fear and inconsistency; hence the inability to grow and thrive. This type of upbringing will cause the child to develop the sense that he/she is in constant danger; also known as the “fight or flight” response; meaning that they will be in a consistent state of hyper vigilance. It is well documented that the cycle of violence is a constant, causing patterns of violence to develop within the family over a period of generations.

Much of the client population we serve in the field of social work, have experienced or at least witnessed some form of violence whether it is indirectly within their neighborhood or directly from someone they know/love or watching someone they love be badly hurt, beaten, or killed. Becoming more knowledgeable of the effects that this trauma has on children and families developmentally as well as socio-emotionally allows us to provide a higher quality of care to our clients and their families.

One of those main ideas is the cycle of violence and what makes a victim consistently return to their abuser; the classic question. It has been relayed to me many times by various professional sources that it takes a woman 5 or 7 times of attempting to leave her abuser, before she will actually not return. (Yamawaki, Ochoa-Shipp, Pulsipher, Harlos & Swindler, 2012) Stemming from this idea, a child being brought up in this violent environment will not develop the same way as a child who is raised in a loving and nurturing environment. I decided I wanted to explore these differences in physical and psychosocial development as a result of experiencing vicarious or direct violence/trauma. I also wanted to look at the short-term as well as the long-term effects of domestic violence on the various family members, emotionally as well as behaviorally. There is quite a bit of speculation regarding the theories of domestic violence as well as the contributing factors and I think that learning more about those would benefit me greatly because I will obtain greater insight on where/how to identify and recognize domestic violence and its effects. Lastly, I believe that it’s vital especially in the social work profession, to possess current and up-to-date information about what services are currently in place and/or are being offered to help individuals and families in domestic violence situations or who have been in the past.

Domestic violence (DV) cuts across all age groups, social classes and travels beyond the extent of physical abuse. It includes emotional abuse including threats, isolation, extreme jealousy and humiliation, and sexual abuse as well. Whenever an individual is placed in a situation involving physical danger or when she is controlled by the threat or use of physical force, this is considered domestic abuse. Domestic violence generally occurs in cycles, requiring the social worker to be able to recognize it so that he/she can intervene appropriately. (“Ohio physicians’ domestic,” 1995) Many barriers exist to identifying DV. Many of these women are either reluctant or unable to get help for themselves and their children. Some may be held captive, while others may be lacking transportation or the financial means to acquire help. (Yamawaki, Ochoa-Shipp, Pulsipher, Harlos & Swindler, 2012)

A woman’s cultural, ethnic, or religious background may also influence her response to the abuse as well as her awareness of viable resources and options. (“Ohio physicians’ domestic,” 1995) In this profession, we are all aware of the immediate effects of DV such as physical injuries. Further research has also shown me that the abused spouse may experience chronic psychosomatic pain or pain due to diffuse trauma without visible evidence. The abused spouse and/or child may develop chronic post-traumatic stress disorder, other anxiety disorders, or depression. These conditions can be recognized by various symptoms including sleep and appetite disturbances, fatigue, decreased concentration, chronic headaches…etc. (“Ohio physicians’ domestic,” 1995) Battered women experiencing PTSD can become entangled in a myriad of symptoms such as avoidance, numbness, fear, and flashbacks; interrupting normal functioning and interfere with adapting coping mechanisms. (Basu, Malone, Levendosky & Dubay, 2009) Psychosomatic complaints are also detected with frequent visits to the physician’s office without evidence of any physiological problems. Suicide rates are also known to be higher in battered women than other women. (“Ohio physicians’ domestic,” 1995)

Some additional psychiatric problems related to the effects of DV include severe and ongoing depression, panic disorder, suicidal tendencies and substance abuse, which may hinder the battered spouse’s ability to appropriately assess her situation and take necessary action. Alcohol and/or drug use is frequently used to rationalize violent behavior. (“Ohio physicians’ domestic,” 1995) The family members affected as well as the abuser may insist that substance abuse is the problem and refuse to place the blame where it belongs. Stressful or violent relationships between adult partners can also lead to an increased sense of negativity in the parent-child dyad and exacerbate the negative effects of exposure; particularly for women with anxiety symptoms or diagnosis of PTSD. (Basu, Malone, Levendosky & Dubay, 2009) According to Systems Theory, a family can be thought of as a system, regarding each member as a subject, mutually influencing each other and displaying patterns and various developmental processes. (Robbins, Chatterjee & Canda, 2012)Each of these members of the family system has a certain level of autonomy and independence but is interdependent by the other subjects to a degree as well; meaning that what affects one family member affects another. (Robbins, Chatterjee & Canda, 2012)

Children are often a factor in the woman’s decision to remain in a violent relationship. An estimated 3.3 million to 10 million children are exposed to domestic violence in their home each year. (Richards, 2011)Children’s exposure to DV and the effects that this exposure can have has been increasingly recognized in recent years. Research even suggests that when a child does not directly witness DV, they may still be negatively affected. (Richards, 2011)The stereotypical view of a child who has witnessed DV between his/her parents is that they are “emotionally traumatized” by the event. There has been much controversy over what “witnessing” DV really means. Research indicates that witnessing DV can involve a broad range of incidents including: hearing the violence, being used as a physical weapon, being forced to watch/participate in the assault, being informed that they are to blame for the violence, being used as a hostage, defending a parent, and/or having to intervene or stop the violence from occurring. Literature also indicates that the aftermath effects for a child include having to see a parent with bruises, see a parent be arrested, having their own injuries and/or the becoming the “parentified” child. Most research conducted on the impacts of childhood exposure to domestic violence focus on the range of psychological and behavioral impacts including but not limited to depression, anxiety, trauma symptoms, increased aggression levels, anti-social behaviors, lower social competence, temperament issues, low self-esteem, dysregulated mood, loneliness and increased likelihood of substance abuse. (Richards, 2011)These children are also at higher risk for school difficulties such as peer conflict or impaired cognitive functioning. Teenage pregnancy, truancy, suicide attempts, and delinquency are also listed as impacts. Long-term physical impacts have rarely been documented, but one study done indicated that children from violent homes are found to have significantly higher heart rates than other children even post-abuse. (Moylan, Herrenkohl, Sousa, Tajima, Herrenkohl & Russo, 2009) Another study found that living in a violent home is a also an attributing factor to a range of serious health conditions as mentioned above such as depression and substance abuse. (Moylan, Herrenkohl, Sousa, Tajima, Herrenkohl & Russo, 2009) Studies have also indicated that children from violent homes may be more likely to exhibit attitudes and behaviors reflecting their childhood experiences witnessing DV. (Richards, 2011) Domestic violence increases a child’s risk for internalizing and externalizing these outcomes during their adolescence. (Moylan, Herrenkohl, Sousa, Tajima, Herrenkohl & Russo, 2009) Research indicates that females are 229% more likely to become victims of DV than their peers from non-violent homes. (Yamawaki, Ochoa-Shipp, Pulsipher, Harlos & Swindler, 2012) In males, the prominent effect of abuse direct or indirect victimization is hyper aggression; suggesting that boys who witness DV or who are somehow involved, are more likely than girl to identify with the aggressor thus eventually perpetuating the abuse on their spouse and/or child. This may justify their own use of violence and or cause them to carry violence-tolerant roles to their adult relationships. (Moylan, Herrenkohl, Sousa, Tajima, Herrenkohl & Russo, 2009)

Based on self-reports from survivors of domestic violence whom I have had the privilege to personally speak to in confidence, I have been able to obtain first-hand information about the effects and devastating impacts of DV. Most of these battered women report having permanent problems with attachment in their personal relationships involving a lack of trust, a lack of ability to soothe their child or to be soothed by another person, difficulty sleeping, self-harm, and a lack of empathy or over-involvement in the distress of others. One of these women explained to me that the DV she experienced at the hands of her ex-husband exacerbated her substance abuse problem; primarily alcoholism. Another woman stated “My son and I haven’t been able to sleep for weeks.” In the brief time spent with these women and their children, I observed an abundance of hypervigilance and inattention. Many of the children appeared to be in the “fight or flight” heightened sense of defensiveness on a consistent basis. A mother’s little boy explained to me that he could no longer trust any man around his mother and that he still has “nightmares about seeing her get beat up and have bruises.” In many of these self-reporting cases, both the mother and her children were exhibiting characteristics of PTSD. Abraham Maslow’s Transpersonal Theory of Self-Actualization and Self-Transcendence Hierarchy of Needs explains that there is an inherent tendency of people to express their innate potentials for love, creativity, and spirituality. According to Maslow, in order for an individual to self-actualize successfully, a nurturing environment, providing all basic needs and social support. A child who is exposed to domestic violence will be unable to establish survival, security, and a sense of being loved, not allowing him the ability to transcend to the higher levels of creativity and spirituality. (Moylan, Herrenkohl, Sousa, Tajima, Herrenkohl & Russo, 2009) These children often grow up and are still unable to move past the level of safety and physiological needs. Each woman that I spoke to across the board reported having selected or continuing to select abusive partners. This leads me to believe that domestic abuse can turn into a pattern. In other words, until the woman is ready to tackle her feelings at the source of her emotional void, she will continue to place herself and her children at risk.

While treating these children in their school environment, I have come to find out that many of their behavioral problems stemmed from feelings of insecure attachment and a lack of sense of safety. Many of them exhibited psychomotor agitation and remained in a consistent, intense emotional state. As I moved through treatment with them and often times their mothers, I came to realize that they were both very distrusting and the child would often have lost his/her ability to “play.” I found myself having to be very creative in play therapy activities with these children because they remained so guarded. Depending on the child’s personality, some of them would internalize these feelings, while others would externalize them. The children who internalized their feelings were quite introverted, rarely socialized with other kids, had a very low self-esteem and were very hypervigilent and sensitive. Externalized behaviors would manifest themselves in more off-task, non-compliant, and defiant/disruptive behaviors. I would usually give these children a diagnosis of Oppositional Defiant Disorder. Many of them had problems with attention and impulse control as well and were given Attention-Deficit Hyperactivity Disorder. These families usually continued to struggle throughout the course of treatment. Due to many of the mothers’ fear of being alone, they would continue to associate with controlling men because that is what they were accustomed to. I always knew that my number one priority is to the safety and well-being of the child and would do my best to empower them and be consistent in treatment so that they would slowly realize that there are people you can trust. I was able to help a mother find a doctor for her and her son who prescribed her son medication for his ADHD. As a result, his behavior problems at school have greatly decreased and assisted him and his mother in mending their broken relationship. With patience, understanding and attunement, I was able to take most of the children at least one step further than where they started.

The intergenerational transmission of domestic violence has been one of the most commonly reported influences in DV during adulthood. Research conducted on this transmission of DV, further perpetuation the “cycle of violence” is based largely on Social Learning Theory. (McCluskey, 2010) This theory validates that observing violence in one’s home as a child creates ideas and norms about how, when, and toward whom aggression is appropriate. Early studies found a high frequency of violence in families from which the family of origin included domestically violent man/men. A national sample found that exposure to inter-parental spousal DV contributes to the probability for martial aggression for both men and women. (McCluskey, 2010) In aiding victims of domestic violence, the social worker must be able to identify the developmental origins of the client’s struggles and inner-conflicts. Based on an article written by a social work graduate student about her experience interning at a domestic violence shelter, one of her client’s early life was disrupted by an adverse social environment filled with unreliable sources of support and a lack of nurturance. This caused the woman to internally replicate a persistent and pervasive mistrust of others throughout her life, develop a terrible self- of herself as well as negative feelings regarding her external world. (McCluskey, 2010) She had become self-injurious, and she did not develop the ability to care for her children properly, stating that doing for them was “too overwhelming.” This woman’s early object relations have set the tone for her adult patterns of relating to others and her present-day conflicts. As explained in this student’s article, when object relations theory is applied to social work within the context of domestic violence, it illuminates the psychological aspects associated with early relational patterns. (McCluskey, 2010)

Erickson’s Psychosocial Stage 1- Trust versus Mistrust provides that during the years of early infancy, the child must develop a sense of trust for their caregiver. The experience of trauma; specifically domestic violence during this beginning stage, can lead to inadequate emotional development, causing this child to remain at this stage instead of passing through to the appropriate ongoing stages. If this trust is not gained at an early age, the child will grow up anticipating that the world will reflect danger and volatility and that people are not to be trusted. (McCluskey, 2010)

Psychological theories of DV perpetration analyze more individual factors including personality disorders, neurobiological/neuroanatomical factors, disordered or insecure attachment, cognitive distortions, and post-traumatic symptoms as previously stated. (Corvo, Dutton & Chen, 2008)Evidence suggests that violent husbands show more psychological distress, more tendencies to personality disorders, more attachment/dependency issues, a higher tendency towards anger and hostility and more alcohol problems than non-violent men. There is a much larger body of research that examines the relationship between psychological factors and DV in general. (Yamawaki, Ochoa-Shipp, Pulsipher, Harlos & Swindler, 2012)

It is well documented that one of the impacts of prolonged exposure to DV is a decrease in cognitive ability. (Corvo, Dutton & Chen, 2008)The brain stem to the frontal cortex is often negatively impacted. One area of particular importance is the association between frontal lobe deficits and DV. In general, frontal lobe deficits refer to compromised abilities to inhibit impulsivity or aggression or to redirect attention from repetitive behavior. Multi-disciplinary health and development studies have illustrated the factors most closely correlated with DV were associated with general criminal offending, a scope of mental health problems, academic failure, economic resource deficits, and early onset anti-social behavior. (Corvo, Dutton & Chen, 2008)

Attachment Theory suggests that an assaultive male’s violent outbursts may be a form of protest behavior directed at his attachment figure that may have rejected him and/or precipitated by perceived threats of separation or abandonment. (Robbins, Chatterjee & Canda, 2012) Thus, the central features of a fearful attachment pattern are anxiety and anger. Early life separation and loss were strongly correlated with adult DV perpetration as well as exposure to parental violence, validating that insecure attachment style is related to the dis-regulation of the negative flow of emotions in intimate relationships. (Moylan, Herrenkohl, Sousa, Tajima, Herrenkohl & Russo, 2009)

Most group interventions to treat the effects of domestic violence generally focus on male batterers whereas treatment groups for battered women and their children are rare. There are many potential benefits of these interventions for the women and their children such as increasing empowerment, decreasing feelings of isolation, developing interpersonal skills, increasing coping strategies and gaining knowledge of resources. A DV shelter can be the answer in the short-term aftermath of the abuse, as a temporary safe house for the woman and her children where all basic needs are met. While DV shelters often provide counseling and support services for battered women and their children, these programs are typically informal and lack empirical support. (Yamawaki, Ochoa-Shipp, Pulsipher, Harlos & Swindler, 2012) Group intervention for trauma survivors is common, victim-advocacy support groups, as well as Trauma-Focused Cognitive Behavioral Therapy and other CBT based interventions for both victims/families and their perpetrators. (Yamawaki, Ochoa-Shipp, Pulsipher, Harlos & Swindler, 2012)

The prevalence for minorities to be exposed to domestic violence is much higher than that of the general population. Underlying causes for this include the fact that they are more likely to be poor, allowing them less access to services, they have to endure more foster care changes as well as experience more cumulative effects of DV. (Swartz, 2012) Another statistic shows that more than half of minorities have a diagnosed mental illness, but 75% of them do not receive services within 12 months of receiving a child abuse/neglect investigation. (Swartz, 2012) Several studies conducted on the impact of coordinated community response to DV validate that minority populations are overrepresented in shelter populations; meaning that the current wave of interventions indicate little to no accommodation to the needs of racial minorities. (Swartz, 2012) Historically, the development of the DV shelter movement and community-based interventions emerged from predominantly Caucasian populations with an upper-middle class socioeconomic status. In many ways, the field of Social Work is still lacking culturally competent approaches consistent with creating an environment consistent for helping minority groups succeed in treatment. Studies show that increased cultural sensitivity and an individualized perspective integrating racial and ethnic background is suggested to promote understanding of culturally specific underpinnings of violence and aggression; particularly in the African American and Latino communities. (Swartz, 2012

The first step towards ending family violence is for the victims and their children to be able to engage with practitioners they can trust and whom they can confide in. In order for our profession to remain effective in our work with these vulnerable women and their children, it is essential that we provide culturally and gender-sensitive skills. The social worker often struggles to find a balance between ensuring the safety of the mother and child while simultaneously empowering the mother to do that herself. As far as future directions, I believe that more attention needs to be paid to preventative work. (Keeling & van Wormer, 2011) I think that women survivors of domestic violence can be an excellent source for engaging in DV advocacy leading to improved service provision and policy development. (Barner and Carney, 2011) It is suggesting that by embracing this approach, we can open the door to better engagement with these vulnerable individuals, striving together to ensure safety and increased ability to access service and support. (Barner and Carney, 2011) In terms of prevention, there definitely needs to be more inter-agency coordination when attending to the needs of women and their children. Funding for victim-based services is currently at an all-time low. A stronger need for community-based advocacy needs to be promoted, as well as flexibility in victim informed arrest, prosecution, sentencing, and intervention services. (Barner and Carney, 2011) Unfortunately, the system has become increasingly bureaucratic and punitive, causing women to continuously suffer in silence rather than seek the help that they need. (Keeling & van Wormer, 2011)

In social work practice, social workers and students of social work must continue to work for institutional change in making relationship building with women experiencing DV, a priority. Social work values related to the topic of DV are service (mental health treatment for domestic violence trauma), importance of human relationships (within the family system and larger social environment), dignity and worth of the person (each member of the family), social justice (domestic violence awareness and prevention), and competence (a social worker’s ability to serve this population objectively, professionally, and effectively). I believe the domestic violence training along with integrating policy and decision-making regarding DV services training into social work curriculum. Even for those who are most oppressed such as women, poverty-stricken individuals, those with mental illness, children, and other minorities, there is always an opportunity to act. In conjunction with the values of social work, we should always treat every person as an individual and respect their personal choices, including them in the implementation of their treatment/safety plans as well as continue to support them in obtaining professional and community support, contributing to their healing process.

Robbins, S. P., Chatterjee, P., & Canda, E. R. (2012). Contemporary human behavior theory: A critical perspective for social work . (3rd edition ed.). Upper Saddle River, NJ: Pearson Education Inc.

The Ohio State Medical Association, The Ohio Department of Human Services-Ohio Domestic Violence Advisory Committee. (1995). Ohio physicians’ domestic violence prevention project: Trust talk- break the silence, begin the cure

Barner, J. R., & Carney, M. M. (2011). Interventions for intimate partner violence: A historical review. Journal of Family Violence , (26), 235-244. doi: 10.1007/s10896-011-9359-3

Basu, A., Malone, J. C., Levendosky, A. A., & Dubay, S. (2009). Longitudinal treatment effectiveness outcomes of a group intervention for women and children exposed to domestic violence. Journal of Child and Adolescent Trauma , 2 , 90-105. doi: 10.1080/19361520902880715

Corvo, K., Dutton, D., & Chen, W. (2008). Toward evidence-based practice with domestic violence perpetrators. Journal of Aggression, Maltreatment & Trauma , 16 (2), doi: 10.1080/10926770801921246

Keeling, J., & van Wormer, K. (2011). Social worker interventions in situations of domestic violence: What we can learn from our survivors’ personal narratives?. British Journal of Social Work , (42), 1354-1370. doi: 10.1093/bjsw/bcr137

McCluskey, M. J. (2010). Psychoanalysis and domestic violence: Exploring the application of object relations theory in social work field placement. Clinical Social Work Journal , (38), 435-442. doi: 10.1007/s10615-010-0266-5

Moylan, C. A., Herrenkohl, T. I., Sousa, C., Tajima, E., Herrenkohl, R. C., & Russo, M. J. (2009). The effects of child abuse and exposure to domestic violence on adolescent internalizing and externalizing behavior problems. Journal of Family Violence , (25), 53-63. doi: 10.1007/s10896-009-9269-9

Richards, K. (2011). Children’s exposure to domestic violence in Australia. Trends and Issues in crime and criminal justice , (419), 1-5.

Yamawaki, N., Ochoa-Shipp, M., Pulsipher, C., Harlos, A., & Swindler, S. (2012). Perceptions of domestic violence: The effects of domestic violence myths, victim’s relationship with her abuser, and the decision to return to her abuser. Journal of Interpersonal Violence , 27 (16), 3195-3212. doi: 10.1177/0886260512441253

In Christine Swartz PCC (Chair). Developmental trauma and its effects on children . (2012).

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A review of "Understanding Domestic Violence: Theories, Challenges and Remedies," edited by Rafael Art. Javier and William G. Herron

A plethora of data is offered in this book that offers the reader a deeper understanding of the prevalence of IPV (e.g., three women are killed daily by a husband or boyfriend; one woman is beaten every nine seconds in the United States and twenty-four every minute). A look at abuse throughout the world is also discussed, with specific details in terms of prevalence in different countries. To mention a few statistics: “Over 1,259,390 domestic violence incidents take place per year (Truman, Langton & Planty, 2013) worldwide. More than three women are murdered by their husbands or boyfriends everyday (Catalano, 2012) and one woman is beaten by her husband or intimate partner every nine seconds in the United States and 24 every minute” p. 15.

An overview of aggression, domestic violence and risk factors is offered through the lens of psychodynamic and social learning theories that point to “the probability of an innate psychobiological disposition in the formation of an aggressive character” (p.57).

Attachment theory is also explored, and four theoretical models of violence (psychological, socio-psychological, sociocultural general systems/global and ecological) are identified and discussed.

The General Aggression Model (GAM) of domestic violence (Warburton & Anderson, Chapter 4) offers a model of the psychological processes that make domestic violence cyclical, happening over and over again in the same pattern. This chapter offers many ideas on assessment (e.g. evaluating the function of violence on three aggressive domains: (1) What needs does each violent instance meet for the DV client? Does the violence serve the purpose of benefiting the perpetrator or hurting the other? How? Why? (2) Are DV instances typically affectively charge or cold and calculated? What are the emotions that are aroused? How does violence satisfy these emotions? (3) How thought-through is each instance? Is there a pattern? Do episodes play out automatically, almost like scripts? Are there opportunities to think-through responses? If violent responses are thought-through, what goals does the violence achieve? (p.92). This chapter also addresses Within-Person Factors that include aggressive traits, low empathy or emotional intelligence, an aggressive personality style that can lead to interpretation of others behaviors negatively. Also discussed is a tendency to interpret the outcomes of aggression positively. The presence of aggressive schemas and scripts are reviewed and interventions (e.g. reducing person risk factors and bolstering protective factors, reducing risk factors in the environment and looking at opportunities for reappraisal) are described. These factors alone are not the bases for therapy alone that are effective in reducing the risk of domestic violence in clients.

Herron and Javier (Chapter 5) offer an in-depth look at the psychodynamic theory of domestic violence, offering the reader a means to look at how the past influences feelings and behaviors in the present. They explore the dynamics of domestic violence (mentalizations, causal pathways, revenge) as a means of understanding the why of the domestic abuse. They further examine the theoretical synthesis, looking at the abuser as an individual with a history of narcissistic injuries that have shamed them, and whose feelings need to be relieved. Anger at these psychic wounds turns into rage and is expressed in physical action against the partner.

Chisholm and Magee (Chapter 6) offer eye-opening statistics about female perpetuated violence (e.g., one out of six serial killers is a woman; 53% of child abuse is by a woman) and an in-depth look at female initiated violence. A discussion of many perspectives that look at female initiated violence is offered with the conclusion that “the etiology of violent behavior is more complex and nuanced” (p.163). Intervention programs designed specifically for women who commit violent offenses is discussed.

El-Jamil & Abi-Hashem (Chapter 7) examine the psychological, cultural, religious and legal aspects of domestic violence within Arab-Middle Eastern countries, bringing to life an in-depth understanding of how these societies foster and justify IPV based on cultural expectations subsumed in their psychology, customs and religious beliefs. A thorough list of emotional, mental social, spiritual and cultural insights and guidelines is offered to help the practitioners who treat this population.

Chapter 8 covers the crucial considerations in the understanding the treatment of IPV in African American couples (West, C). An ecological model (individual, relationship and community levels) is presented that explores the increased risk of IPV for African Americans, as well as suggestions for conducting a culturally sensitive assessment. The author goes into depth describing each part of the ecological model to enable the reader to obtain a deeper understanding on how to assess IPV in this population, pgs. 223-230.

Clauss-Ehlers, Milan and Zhao (Chapter 9) write about understanding domestic violence within a Latino/Hispanic/Latinx context, looking at environmental, cultural and ecological mapping as a culturally relevant assessment tool. This model is further enhanced by an exploration of gender roles, cultural scripts, immigration status, perceptions of seriousness and stressors created by homophobia and heterosexism. The authors present a case using the application of environmental and ecological mapping that can serve as a model for treating domestic violence within this cultural context. The tripartite model is presented and includes relevant information on research, training and practice to better understand and work with this population.

Disabled individuals are also victims of domestic violence, and in Chapter 10, Banks offers an insightful look at the social situations, risks and types of abuse faced by women with disabilities, noting that 70% of women with disabilities report that they are victims of abuse (Baladerian, Coleman, & Stream, 2013). Brain injury can be a telltale symptom of possible physical violence, and Banks offers detailed assessment tools and a view on how to treat this population.

In Chapter 11, Murray and Crowe explore the impact of stigma on survivors of intimate partner violence and the implications for counseling. Types of stigmas are noted (blame, discrimination, loss of status, isolation and shame) and explained to enable the practitioner to better understand the discrimination to which IPV victims are subjected. Discussion and suggestions are offered to practitioners to enable provision of non-stigmatizing support to help victims overcome the effects of being abuse victims.

Walker and Jungersen (Chapter 12) offer the essential elements for an effective treatment model of domestic violence in our complex world, integrating feminist and trauma theories with the knowledge and skills to promote healing. They describe the STEP program, which offers the practitioner a model of helping victims that includes safety, trustworthiness, choice, collaboration and empowerment. This model has been applied to many types of settings including private practice, jails, prisons and hospital settings.

Understanding Domestic Violence: Theories, Challenges and Remedies concludes with a chapter by Javier and Heron (Chapter 13) that looks at the importance of viewing IPV from a trauma lens. They state that it is essential to distinguish between characterological violent perpetrators and situational perpetrators and includes an analysis of how different types of violence may have different consequences for different victims.

I recommend this book without reservation as an integral part of your reference and psychotherapy library. Enjoy the read and improve your understanding and therapy skills in understanding domestic violence and treating IPV.

Baladerian, N.J, Coleman,T.F, & Stream, J. (2013). Abuse of People with Disabilities: Victims and their families speak out: A report on the 2012 National Survey on Abuse of People with Disabilities. Los Angeles, CA: Spectrum Institute: Disability and Abuse Project.

Truman, J., Langton, L. & Planty, M. (2013, October). Criminal victimization , 2012. Retrieved from http://www.bjs.gov/content/pub/pdf/cv12.pdf .

World Health Organization (2005). Summary Report: Multi-country Study on Women’s Health and Domestic Violence Against Women. Initial results on prevalence, health outcomes and women’s responses. Geneva, World Health Organization.

Evolutionary Approaches to Domestic Violence

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Mads Larsen 2

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Child abuse ; Coercive control ; Conflict between the sexes ; Familial violence ; Familicide ; Filicide ; Infidelity ; Intimate partner violence ; Men’s violence ; Partner abuse and homicide ; Partner violence ; Partner-directed violence ; Physical aggression ; Relationship violence ; Sexual jealousy ; Siblicide ; Uxoricide ; Violence as coercive control ; Women’s violence

Domestic violence is physical, psychological, or sexual abuse between intimate partners, offspring, parents, and siblings within a family structure. Evolutionary approaches illuminate the psychological mechanisms that underpin these behaviors. Partner abuse has been explained as a male mate guarding strategy. Jealousy-motivated violence was seen as an adaptive means for reducing paternity uncertainty through controlling women’s sexual behavior. Newer research reveals that Western women, as a consequence of gender equality, have become similarly violent and controlling against intimate partners. Scholars suggest...

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Larsen, M. (2023). Evolutionary Approaches to Domestic Violence. In: Shackelford, T.K. (eds) Encyclopedia of Domestic Violence. Springer, Cham. https://doi.org/10.1007/978-3-030-85493-5_501-1

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Understanding domestic violence against women: using evolutionary psychology to extend the feminist functional analysis

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1 School of Social Work, University of Maine, Orono 04469, USA. [email protected]
PMID: 12033558
DOI: 10.1891/vivi.17.2.255.33644

Evolutionary psychologists such as Wilson and Daly (1993b) hypothesize that one goal of male-perpetrated domestic violence is control over female sexuality, including the deterrence of infidelity. According to this hypothesis, domestic violence varies with women's reproductive value or expected future reproduction, declining steeply as women age. We tested this hypothesis with a sample of 3,969 cases of male-perpetrated partner-abuse reported to a single police precinct in a large urban area over a 14-year period. Results show that (a) rates of domestic violence decrease as women age, (b) younger men are at greatest risk for perpetrating domestic violence, (c) younger, reproductive age women incur nearly 10 times the risk of domestic violence as do older, post-reproductive age women, and (d) the greater risk of domestic violence incurred by reproductive age women is not attributable solely to mateship to younger, more violent men. Discussion addresses theoretical implications of these findings and suggests a refinement of the feminist hypothesis of domestic violence against women.

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Published: 20 June 2023

A qualitative quantitative mixed methods study of domestic violence against women

Mina Shayestefar 1 ,
Mohadese Saffari 1 ,
Razieh Gholamhosseinzadeh 2 ,
Monir Nobahar 3 , 4 ,
Majid Mirmohammadkhani 4 ,
Seyed Hossein Shahcheragh 5 &
Zahra Khosravi 6

BMC Women's Health volume 23 , Article number: 322 ( 2023 ) Cite this article

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Violence against women is one of the most widespread, persistent and detrimental violations of human rights in today’s world, which has not been reported in most cases due to impunity, silence, stigma and shame, even in the age of social communication. Domestic violence against women harms individuals, families, and society. The objective of this study was to investigate the prevalence and experiences of domestic violence against women in Semnan.

This study was conducted as mixed research (cross-sectional descriptive and phenomenological qualitative methods) to investigate domestic violence against women, and some related factors (quantitative) and experiences of such violence (qualitative) simultaneously in Semnan. In quantitative study, cluster sampling was conducted based on the areas covered by health centers from married women living in Semnan since March 2021 to March 2022 using Domestic Violence Questionnaire. Then, the obtained data were analyzed by descriptive and inferential statistics. In qualitative study by phenomenological approach and purposive sampling until data saturation, 9 women were selected who had referred to the counseling units of Semnan health centers due to domestic violence, since March 2021 to March 2022 and in-depth and semi-structured interviews were conducted. The conducted interviews were analyzed using Colaizzi’s 7-step method.

In qualitative study, seven themes were found including “Facilitators”, “Role failure”, “Repressors”, “Efforts to preserve the family”, “Inappropriate solving of family conflicts”, “Consequences”, and “Inefficient supportive systems”. In quantitative study, the variables of age, age difference and number of years of marriage had a positive and significant relationship, and the variable of the number of children had a negative and significant relationship with the total score and all fields of the questionnaire (p < 0.05). Also, increasing the level of female education and income both independently showed a significant relationship with increasing the score of violence.

Conclusions

Some of the variables of violence against women are known and the need for prevention and plans to take action before their occurrence is well felt. Also, supportive mechanisms with objective and taboo-breaking results should be implemented to minimize harm to women, and their children and families seriously.

Peer Review reports

Violence against women by husbands (physical, sexual and psychological violence) is one of the basic problems of public health and violation of women’s human rights. It is estimated that 35% of women and almost one out of every three women aged 15–49 experience physical or sexual violence by their spouse or non-spouse sexual violence in their lifetime [ 1 ]. This is a nationwide public health issue, and nearly every healthcare worker will encounter a patient who has suffered from some type of domestic or family violence. Unfortunately, different forms of family violence are often interconnected. The “cycle of abuse” frequently persists from children who witness it to their adult relationships, and ultimately to the care of the elderly [ 2 ]. This violence includes a range of physical, sexual and psychological actions, control, threats, aggression, abuse, and rape [ 3 ].

Violence against women is one of the most widespread, persistent, and detrimental violations of human rights in today’s world, which has not been reported in most cases due to impunity, silence, stigma and shame, even in the age of social communication [ 3 ]. In the United States of America, more than one in three women (35.6%) experience rape, physical violence, and intimate partner violence (IPV) during their lifetime. Compared to men, women are nearly twice as likely (13.8% vs. 24.3%) to experience severe physical violence such as choking, burns, and threats with knives or guns [ 4 ]. The higher prevalence of violence against women can be due to the situational deprivation of women in patriarchal societies [ 5 ]. The prevalence of domestic violence in Iran reported 22.9%. The maximum of prevalence estimated in Tehran and Zahedan, respectively [ 6 ]. Currently, Iran has high levels of violence against women, and the provinces with the highest rates of unemployment and poverty also have the highest levels of violence against women [ 7 ].

Domestic violence against women harms individuals, families, and society [ 8 ]. Violence against women leads to physical, sexual, psychological harm or suffering, including threats, coercion and arbitrary deprivation of their freedom in public and private life. Also, such violence is associated with harmful effects on women’s sexual reproductive health, including sexually transmitted infection such as Human Immunodeficiency Virus (HIV), abortion, unsafe childbirth, and risky sexual behaviors [ 9 ]. There are high levels of psychological, sexual and physical domestic abuse among pregnant women [ 10 ]. Also, women with postpartum depression are significantly more likely to experience domestic violence during pregnancy [ 11 ].

Prompt attention to women’s health and rights at all levels is necessary, which reduces this problem and its risk factors [ 12 ]. Because women prefer to remain silent about domestic violence and there is a need to introduce immediate prevention programs to end domestic violence [ 13 ]. violence against women, which is an important public health problem, and concerns about human rights require careful study and the application of appropriate policies [ 14 ]. Also, the efforts to change the circumstances in which women face domestic violence remain significantly insufficient [ 15 ]. Given that few clear studies on violence against women and at the same time interviews with these people regarding their life experiences are available, the authors attempted to planning this research aims to investigate the prevalence and experiences of domestic violence against women in Semnan with the research question of “What is the prevalence of domestic violence against women in Semnan, and what are their experiences of such violence?”, so that their results can be used in part of the future planning in the health system of the society.

This study is a combination of cross-sectional and phenomenology studies in order to investigate the amount of domestic violence against women and some related factors (quantitative) and their experience of this violence (qualitative) simultaneously in the Semnan city. This study has been approved by the ethics committee of Semnan University of Medical Sciences with ethic code of IR.SEMUMS.REC.1397.182. The researcher introduced herself to the research participants, explained the purpose of the study, and then obtained informed written consent. It was assured to the research units that the collected information will be anonymous and kept confidential. The participants were informed that participation in the study was entirely voluntary, so they can withdraw from the study at any time with confidence. The participants were notified that more than one interview session may be necessary. To increase the trustworthiness of the study, Guba and Lincoln’s criteria for rigor, including credibility, transferability, dependability, and confirmability [ 16 ], were applied throughout the research process. The COREQ checklist was used to assess the present study quality. The researchers used observational notes for reflexivity and it preserved in all phases of this qualitative research process.

Qualitative method

Based on the phenomenological approach and with the purposeful sampling method, nine women who had referred to the counseling units of healthcare centers in Semnan city due to domestic violence in February 2021 to March 2022 were participated in the present study. The inclusion criteria for the study included marriage, a history of visiting a health center consultant due to domestic violence, and consent to participate in the study and unwillingness to participate in the study was the exclusion criteria. Each participant invited to the study by a telephone conversation about study aims and researcher information. The interviews place selected through agreement of the participant and the researcher and a place with the least environmental disturbance. Before starting each interview, the informed consent and all of the ethical considerations, including the purpose of the research, voluntary participation, confidentiality of the information were completely explained and they were asked to sign the written consent form. The participants were interviewed by depth, semi-structured and face-to-face interviews based on the main research question. Interviews were conducted by a female health services researcher with a background in nursing (M.Sh.). Data collection was continued until the data saturation and no new data appeared. Only the participants and the researcher were present during the interviews. All interviews were recorded by a MP3 Player by permission of the participants before starting. Interviews were not repeated. No additional field notes were taken during or after the interview.

The age range of the participants was from 38 to 55 years and their average age was 40 years. The sociodemographic characteristics of the participants are summarized in table below (Table 1 ).

Five interviews in the courtyards of healthcare centers, 2 interviews in the park, and 2 interviews at the participants’ homes were conducted. The duration of the interviews varied from 45 min to one hour. The main research question was “What is your experience about domestic violence?“. According to the research progress some other questions were asked in line with the main question of the research.

The conducted interviews were analyzed by using the 7 steps Colizzi’s method [ 17 ]. In order to empathize with the participants, each interview was read several times and transcribed. Then two researchers (M.Sh. and M.N.) extracted the phrases that were directly related to the phenomenon of domestic violence against women independently and distinguished from other sentences by underlining them. Then these codes were organized into thematic clusters and the formulated concepts were sorted into specific thematic categories.

In the final stage, in order to make the data reliable, the researcher again referred to 2 participants and checked their agreement with their perceptions of the content. Also, possible important contents were discussed and clarified, and in this way, agreement and approval of the samples was obtained.

Quantitative method

The cross-sectional study was implemented from February 2021 to March 2022 with cluster sampling of married women in areas of 3 healthcare centers in Semnan city. Those participants who were married and agreed with the written and verbal informed consent about the ethical considerations were included to the study. The questionnaire was completed by the participants in paper and online form.

The instrument was the standard questionnaire of domestic violence against women by Mohseni Tabrizi et al. [ 18 ]. In the questionnaire, questions 1–10, 11–36, 37–65 and 66–71 related to sociodemographic information, types of spousal abuse (psychological, economical, physical and sexual violence), patriarchal beliefs and traditions and family upbringing and learning violence, respectively. In total, this questionnaire has 71 items.

The scoring of the questionnaire has two parts and the answers to them are based on the Likert scale. Questions 11–36 and 66–71 are answered with always [ 4 ] to never (0) and questions 37–65 with completely agree [ 4 ] to completely disagree (0). The minimum and maximum score is 0 and 300, respectively. The total score of 0–60, 61–120 and higher than 121 demonstrates low, moderate and severe domestic violence against women, respectively [ 18 ].

In the study by Tabrizi et al., to evaluate the validity and reliability of this questionnaire, researchers tried to measure the face validity of the scale by the previous research. Those items and questions which their accuracies were confirmed by social science professors and experts used in the research, finally. The total Cronbach’s alpha coefficient was 0.183, which confirmed that the reliability of the questions and items of the questionnaire is sufficient [ 18 ].

Descriptive data were reported using mean, standard deviation, frequency and percentage. Then, to measure the relationship between the variables, χ2 and Pearson tests also variance and regression analysis were performed. All analysis were performed by using SPSS version 26 and the significance level was considered as p < 0.05.

Qualitative results

According to the third step of Colaizzi’s 7-step method, the researcher attempted to conceptualize and formulate the extracted meanings. In this step, the primary codes were extracted from the important sentences related to the phenomenon of violence against women, which were marked by underlining, which are shown below as examples of this stage and coding.

The primary code of indifference to the father’s role was extracted from the following sentences. This is indifference in the role of the father in front of the children.

“Some time ago, I told him that our daughter is single-sided deaf. She has a doctor’s appointment; I have to take her to the doctor. He said that I don’t have money to give you. He doesn’t force himself to make money anyway” (p 2, 33 yrs).

“He didn’t value his own children. He didn’t think about his older children” (p 4, 54 yrs).

The primary code extracted here included lack of commitment in the role of head of the household. This is irresponsibility towards the family and meeting their needs.

“My husband was fired from work after 10 years due to disorder and laziness. Since then, he has not found a suitable job. Every time he went to work, he was fired after a month because of laziness” (p 7, 55 yrs).

“In the evening, he used to get dressed and go out, and he didn’t come back until late. Some nights, I was so afraid of being alone that I put a knife under my pillow when I slept” (p 2, 33 yrs).

A total of 246 primary codes were extracted from the interviews in the third step. In the fourth step, the researchers put the formulated concepts (primary codes) into 85 specific sub-categories.

Twenty-three categories were extracted from 85 sub-categories. In the sixth step, the concepts of the fifth step were integrated and formed seven themes (Table 2 ).

These themes included “Facilitators”, “Role failure”, “Repressors”, “Efforts to preserve the family”, “Inappropriate solving of family conflicts”, “Consequences”, and “Inefficient supportive systems” (Fig. 1 ).

Themes of domestic violence against women

Some of the statements of the participants on the theme of “ Facilitators” are listed below:

Husband’s criminal record

“He got his death sentence for drugs. But, at last it was ended for 10 years” (p 4, 54 yrs).

Inappropriate age for marriage

“At the age of thirteen, I married a boy who was 25 years old” (p 8, 25 yrs).

“My first husband obeyed her parents. I was 12–13 years old” (p 3, 32 yrs).

“I couldn’t do anything. I was humiliated” (p 1, 38 yrs).

“A bridegroom came. The mother was against. She said, I am young. My older sister is not married yet, but I was eager to get married. I don’t know, maybe my father’s house was boring for me” (p 2, 33 yrs).

“My parents used to argue badly. They blamed each other and I always wanted to run away from these arguments. I didn’t have the patience to talk to mom or dad and calm them down” (p 5, 39 yrs).

Overdependence

“My husband’s parents don’t stop interfering, but my husband doesn’t say anything because he is a student of his father. My husband is self-employed and works with his father on a truck” (p 8, 25 yrs).

“Every time I argue with my husband because of lack of money, my mother-in-law supported her son and brought him up very spoiled and lazy” (p 7, 55 yrs).

Bitter memories

“After three years, my mother married her friend with my uncle’s insistence and went to Shiraz. But, his condition was that she did not have the right to bring his daughter with her. In fact, my mother also got married out of necessity” (p 8, 25 yrs).

Some of their other statements related to “ Role failure” are mentioned below:

Lack of commitment to different roles

“I got angry several times and went to my father’s house because of my husband’s bad financial status and the fact that he doesn’t feel responsible to work and always says that he cannot find a job” (p 6, 48 yrs).

“I saw that he does not want to change in any way” (p 4, 54 yrs).

“No matter how kind I am, it does not work” (p 1, 38 yrs).

Some of their other statements regarding “ Repressors” are listed below:

Fear and silence

“My mother always forced me to continue living with my husband. Finally, my father had been poor. She all said that you didn’t listen to me when you wanted to get married, so you don’t have the right to get angry and come to me, I’m miserable enough” (p 2, 33 yrs).

“Because I suffered a lot in my first marital life. I was very humiliated. I said I would be fine with that. To be kind” (p1, 38 yrs).

“Well, I tell myself that he gets angry sometimes” (p 3, 32 yrs).

Shame from society

“I don’t want my daughter-in-law to know. She is not a relative” (p 4, 54 yrs).

Some of the statements of the participants regarding the theme of “ Efforts to preserve the family” are listed below:

Hope and trust

“I always hope in God and I am patient” (p 2, 33 yrs).

Efforts for children

“My divorce took a month. We got a divorce. I forgave my dowry and took my children instead” (p 2, 33 yrs).

Some of their other statements regarding the “ Inappropriate solving of family conflicts” are listed below:

Child-bearing thoughts

“My husband wanted to take me to a doctor to treat me. But my father-in-law refused and said that instead of doing this and spending money, marry again. Marriage in the clans was much easier than any other work” (p 8, 25 yrs).

Lack of effective communication

“I was nervous about him, but I didn’t say anything” (p 5, 39 yrs).

“Now I am satisfied with my life and thank God it is better to listen to people’s words. Now there is someone above me so that people don’t talk behind me” (p 2, 33 yrs).

Some of their other statements regarding the “ Consequences” are listed below:

Harm to children

“My eldest daughter, who was about 7–8 years old, behaved differently. Oh, I was angry. My children are mentally depressed and argue” (p 5, 39 yrs).

After divorce

“Even though I got a divorce, my mother and I came to a remote area due to the fear of what my family would say” (p 2, 33 yrs).

Social harm

“I work at a retirement center for living expenses” (p 2, 33 yrs).

“I had to go to clean the houses” (p 5, 39 yrs).

Non-acceptance in the family

“The children’s relationship with their father became bad. Because every time they saw their father sitting at home smoking, they got angry” (p 7, 55 yrs).

Emotional harm

“When I look back, I regret why I was not careful in my choice” (p 7, 55 yrs).

“I felt very bad. For being married to a man who is not bound by the family and is capricious” (p 9, 36 yrs).

Some of their other statements regarding “ Inefficient supportive systems” are listed below:

Inappropriate family support

“We didn’t have children. I was at my father’s house for about a month. After a month, when I came home, I saw that my husband had married again. I cried a lot that day. He said, God, I had to. I love you. My heart is broken, I have no one to share my words” (p 8, 25 yrs).

“My brother-in-law was like himself. His parents had also died. His sister did not listen at all” (p 4, 54 yrs).

“I didn’t have anyone and I was alone” (p 1, 38 yrs).

Inefficiency of social systems

“That day he argued with me, picked me up and threw me down some stairs in the middle of the yard. He came closer, sat on my stomach, grabbed my neck with both of his hands and wanted to strangle me. Until a long time later, I had kidney problems and my neck was bruised by her hand. Given that my aunt and her family were with us in a building, but she had no desire to testify and was afraid” (p 3, 32 yrs).

Undesired training and advice

“I told my mother, you just said no, how old I was? You never insisted on me and you didn’t listen to me that this man is not good for you” (p 9, 36 yrs).

Quantitative results

In the present study, 376 married women living in Semnan city participated in this study. The mean age of participants was 38.52 ± 10.38 years. The youngest participant was 18 and the oldest was 73 years old. The maximum age difference was 16 years. The years of marriage varied from one year to 40 years. Also, the number of children varied from no children to 7. The majority of them had 2 children (109, 29%). The sociodemographic characteristics of the participants are summarized in the table below (Table 3 ).

The frequency distribution (number and percentage) of the participants in terms of the level of violence was as follows. 89 participants (23.7%) had experienced low violence, 59 participants (15.7%) had experienced moderate violence, and 228 participants (60.6%) had experienced severe violence.

Cronbach’s alpha for the reliability of the questionnaire was 0.988. The mean and standard deviation of the total score of the questionnaire was 143.60 ± 74.70 with a range of 3-244. The relationship between the total score of the questionnaire and its fields, and some demographic variables is summarized in the table below (Table 4 ).

As shown in the table above, the variables of age, age difference and number of years of marriage have a positive and significant relationship, and the variable of number of children has a negative and significant relationship with the total score and all fields of the questionnaire (p < 0.05). However, the variable of education level difference showed no significant relationship with the total score and any of the fields. Also, the highest average score is related to patriarchal beliefs compared to other fields.

The comparison of the average total scores separately according to each variable showed the significant average difference in the variables of the previous marriage history of the woman, the result of the previous marriage of the woman, the education of the woman, the education of the man, the income of the woman, the income of the man, and the physical disease of the man (p < 0.05).

In the regression model, two variables remained in the final model, indicating the relationship between the variables and violence score and the importance of these two variables. An increase in women’s education and income level both independently show a significant relationship with an increase in violence score (Table 5 ).

The results of analysis of variance to compare the scores of each field of violence in the subgroups of the participants also showed that the experience and result of the woman’s previous marriage has a significant relationship with physical violence and tradition and family upbringing, the experience of the man’s previous marriage has a significant relationship with patriarchal belief, the education level of the woman has a significant relationship with all fields and the level of education of the man has a significant relationship with all fields except tradition and family upbringing (p < 0.05).

According to the results of both quantitative and qualitative studies, variables such as the young age of the woman and a large age difference are very important factors leading to an increase in violence. At a younger age, girls are afraid of the stigma of society and family, and being forced to remain silent can lead to an increase in domestic violence. As Gandhi et al. (2021) stated in their study in the same field, a lower marriage age leads to many vulnerabilities in women. Early marriage is a global problem associated with a wide range of health and social consequences, including violence for adolescent girls and women [ 12 ]. Also, Ahmadi et al. (2017) found similar findings, reporting a significant association among IPV and women age ≤ 40 years [ 19 ].

Two others categories of “Facilitators” in the present study were “Husband’s criminal record” and “Overdependence” which had a sub-category of “Forced cohabitation”. Ahmadi et al. (2017) reported in their population-based study in Iran that husband’s addiction and rented-householders have a significant association with IPV [ 19 ].

The patriarchal beliefs, which are rooted in the tradition and culture of society and family upbringing, scored the highest in relation to domestic violence in this study. On the other hand, in qualitative study, “Normalcy” of men’s anger and harassment of women in society is one of the “Repressors” of women to express violence. In the quantitative study, the increase in the women’s education and income level were predictors of the increase in violence. Although domestic violence is more common in some sections of society, women with a wide range of ages, different levels of education, and at different levels of society face this problem, most of which are not reported. Bukuluki et al. (2021) showed that women who agreed that it is good for a man to control his partner were more likely to experience physical violence [ 20 ].

Domestic violence leads to “Consequences” such as “Harm to children”, “Emotional harm”, “Social harm” to women and even “Non-acceptance in their own family”. Because divorce is a taboo in Iranian culture and the fear of humiliating women forces them to remain silent against domestic violence. Balsarkar (2021) stated that the fear of violence can prevent women from continuing their studies, working or exercising their political rights [ 8 ]. Also, Walker-Descarte et al. (2021) recognized domestic violence as a type of child maltreatment, and these abusive behaviors are associated with mental and physical health consequences [ 21 ].

On the other hand and based on the “Lack of effective communication” category, ignoring the role of the counselor in solving family conflicts and challenges in the life of couples in the present study was expressed by women with reasons such as lack of knowledge and family resistance to counseling. Several pathologies are needed to investigate increased domestic violence in situations such as during women’s pregnancy or infertility. Because the use of counseling for couples as a suitable solution should be considered along with their life challenges. Lin et al. (2022) stated that pregnant women were exposed to domestic violence for low birth weight in full term delivery. Spouse violence screening in the perinatal health care system should be considered important, especially for women who have had full-term low birth weight infants [ 22 ].

Also, lack of knowledge and low level of education have been found as other factors of violence in this study, which is very prominent in both qualitative and quantitative studies. Because the social systems and information about the existing laws should be followed properly in society to act as a deterrent. Psychological training and especially anger control and resilience skills during education at a younger age for girls and boys should be included in educational materials to determine the positive results in society in the long term. Manouchehri et al. (2022) stated that it seems necessary to train men about the negative impact of domestic violence on the current and future status of the family [ 23 ]. Balsarkar (2021) also stated that men and women who have not had the opportunity to question gender roles, attitudes and beliefs cannot change such things. Women who are unaware of their rights cannot claim. Governments and organizations cannot adequately address these issues without access to standards, guidelines and tools [ 8 ]. Machado et al. (2021) also stated that gender socialization reinforces gender inequalities and affects the behavior of men and women. So, highlighting this problem in different fields, especially in primary health care services, is a way to prevent IPV against women [ 24 ].

There was a sub-category of “Inefficiency of social systems” in the participants experiences. Perhaps the reason for this is due to insufficient education and knowledge, or fear of seeking help. Holmes et al. (2022) suggested the importance of ascertaining strategies to improve victims’ experiences with the court, especially when victims’ requests are not met, to increase future engagement with the system [ 25 ]. Sigurdsson (2019) revealed that despite high prevalence numbers, IPV is still a hidden and underdiagnosed problem and neither general practitioner nor our communities are as well prepared as they should be [ 26 ]. Moreira and Pinto da Costa (2021) found that while victims of domestic violence often agree with mandatory reporting, various concerns are still expressed by both victims and healthcare professionals that require further attention and resolution [ 27 ]. It appears that legal and ethical issues in this regard require comprehensive evaluation from the perspectives of victims, their families, healthcare workers, and legal experts. By doing so, better practical solutions can be found to address domestic violence, leading to a downward trend in its occurrence.

Some of the variables of violence against women have been identified and emphasized in many studies, highlighting the necessity of policymaking and social pathology in society to prevent and use operational plans to take action before their occurrence. Breaking the taboo of domestic violence and promoting divorce as a viable solution after counseling to receive objective results should be implemented seriously to minimize harm to women, children, and their families.

Limitations

Domestic violence against women is an important issue in Iranian society that women resist showing and expressing, making researchers take a long-term process of sampling in both qualitative and quantitative studies. The location of the interview and the women’s fear of their husbands finding out about their participation in this study have been other challenges of the researchers, which, of course, they attempted to minimize by fully respecting ethical considerations. Despite the researchers’ efforts, their personal and professional experiences, as well as the studies reviewed in the literature review section, may have influenced the study results.

Data Availability

Data and materials will be available upon email to the corresponding author.

Abbreviations

Intimate Partner Violence

Human Immunodeficiency Virus

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Acknowledgements

The authors of this study appreciate the Deputy for Research and Technology of Semnan University of Medical Sciences, Social Determinants of Health Research Center of Semnan University of Medical Sciences and all the participants in this study.

Research deputy of Semnan University of Medical Sciences financially supported this project.

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Amir Al Momenin Hospital, Social Security Organization, Ahvaz, Iran

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Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran

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Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran

Monir Nobahar & Majid Mirmohammadkhani

Clinical Research Development Unit, Kowsar Educational, Research and Therapeutic Hospital, Semnan University of Medical Sciences, Semnan, Iran

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Student Research Committee, School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran

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M.Sh. contributed to the first conception and design of this research; M.Sh., Z.Kh., M.S., R.Gh. and S.H.Sh. contributed to collect data; M.N. and M.Sh. contributed to the analysis of the qualitative data; M.M. and M.Sh. contributed to the analysis of the quantitative data; M.SH., M.N. and M.M. contributed to the interpretation of the data; M.Sh., M.S. and S.H.Sh. wrote the manuscript. M.Sh. prepared the final version of manuscript for submission. All authors reviewed the manuscript meticulously and approved it. All names of the authors were listed in the title page.

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Shayestefar, M., Saffari, M., Gholamhosseinzadeh, R. et al. A qualitative quantitative mixed methods study of domestic violence against women. BMC Women's Health 23 , 322 (2023). https://doi.org/10.1186/s12905-023-02483-0

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DOI : https://doi.org/10.1186/s12905-023-02483-0

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Social-Cognitive Mechanisms in the Cycle of Violence: Cognitive and Affective Theory of Mind, and Externalizing Psychopathology in Children and Adolescents

Charlotte heleniak.

1 Department of Psychology, Columbia University

Katie A. McLaughlin

2 Department of Psychology, Harvard University

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Children who are victims of interpersonal violence are at markedly elevated risk of engaging in aggressive behavior and perpetrating violence in adolescence and adulthood. Although alterations in social information processing have long been understood as a core mechanism underlying the link between violence exposure and externalizing behavior, scant research has examined more basic social cognition abilities that might underlie this association. To that end, this study examined the associations of interpersonal violence exposure with cognitive and affective theory of mind (ToM), core social-cognitive processes that underlie many aspects of social information processing. In addition, we evaluated whether difficulties with ToM were associated with externalizing psychopathology. Data were collected in a community-based sample of 246 8–16 year old children and adolescents with a high concentration of exposure to interpersonal violence. Violence exposure was associated with lower accuracy during cognitive and affective ToM, and associations persisted after adjusting for co-occurring forms of adversity characterized by deprivation, including poverty and emotional neglect. Poor ToM performance, in turn, was associated with externalizing behaviors. These findings shed light on novel pathways that increase risk for aggression in children who have experienced violence.

Exposure to violence in childhood is a powerful predictor of psychopathology across the lifespan ( Green et al., 2010 ; Keyes et al., 2012 ; McLaughlin et al., 2012 ; Molnar, Buka, & Kessler, 2001 ; Ward, Flisher, Zissis, Muller, & Lombard, 2001 ). In particular, violence exposure in childhood is a strong predictor of aggressive behavior in childhood, adolescence, and adulthood ( Bingenheimer, 2005 ; Dodge, Bates, & Pettit, 1990 ; McCloskey & Lichter, 2003 ; Widom, 1989 ), particularly when violence exposure occurs within the family. Current estimations indicate that approximately one in four US children have been exposed to some form of maltreatment or domestic violence in their lifetime ( Finkelhor, Turner, Shattuck, & Hamby, 2013 ), highlighting the critical need to identify mechanisms underlying the cycle of violence.

Social information processing deficits have frequently been studied as a key mechanism linking violence exposure with aggression and violence perpetration ( Dodge, Pettit, Bates, & Valente, 1995 ; Dodge et al., 1990 ; Weiss, Dodge, Bates, & Pettit, 1992 ). Social information processing is comprised of a variety of specific processes that are relevant for interpreting and responding to social behavior in other people, particularly in ambiguous social situations—including attention to and encoding of relevant social cues, interpretations of those cues, access to appropriate behavioral responses, and understanding of the consequences and desirability of different behavioral responses ( Crick & Dodge, 1994 , 1996 ) Existing evidence suggests that exposure to harsh discipline and family violence can influence each of these processes, producing elevated risk for externalizing problems later in development ( Dodge et al., 1990 ; Dodge et al., 1995 ; Weiss et al., 1992 ). Prior research on this topic has largely relied on children’s verbal or written responses to specific vignettes or videotaped social scenarios to evaluate these social information processing mechanisms. To date, scant research has examined other social cognition abilities related to social information processing and that might be altered following interpersonal violence exposure. The current research addresses this gap in knowledge by examining whether theory of mind—a core social cognitive ability that is central to many aspects of social information processing, particularly interpretations of social behavior and attributions about the intentions driving that behavior—is altered in children who have been exposed to violence within the family. Identification of social-cognitive processes that are influenced by exposure to violence has the potential to reveal novel mechanisms in the cycle of violence and provide new targets for interventions aimed at reducing externalizing psychopathology ( Smith, 2006 ).

Theory of mind refers to the ability to infer another person’s thoughts, beliefs, intentions, and feelings ( Baron-Cohen, Leslie, & Frith, 1985 ; Perner, 1991 ; Wellman, 1992 ). Recent evidence suggests that theory of mind involves both a cognitive component that involves understanding other’s thoughts, intentions, beliefs and an affective component that involves understanding other’s feelings ( Sebastian et al., 2012 ), and the neural networks underlying cognitive and affective theory of mind are at least partially dissociable ( Kalbe et al., 2010 ; Shamay-Tsoory & Aharon-Peretz, 2007 ). Children who experience violence within the family environment exhibit an information processing style that prioritizes the identification of social threat ( McLaughlin & Lambert, 2017 ; Pollak, Cicchetti, Hornung, & Reed, 2000 ; Pollak & Kistler, 2002 ; Pollak & Sinha, 2002 ; Pollak & Tolley-Schell, 2003 ; Shackman & Pollak, 2005 ; Shackman, Shackman, & Pollak, 2007 ); this pattern reflects an adaptation that likely facilitates safety when growing up in an environment characterized by danger. Although work on social information processing biases suggests that exposure to violence within the family leads children to attribute hostile intent to other’s behavior more frequently than among children without a history of violence exposure ( Dodge et al., 1995 ; Dodge et al., 1990 ; Weiss et al., 1992 ), it is possible that more basic aspects of theory of mind are also influenced by these experiences. Because children living in violent households must focus on salient concerns regarding threat and safety, interpretations of social behavior may be focused primarily on determining whether someone has hostile intent or not, constraining the range of possibilities considered when evaluating the thoughts, beliefs, and intentions of others. As a result, children living in violent environments may have fewer opportunities to consider the full range of internal experiences of others, hindering the development of cognitive theory of mind. When these challenges in perspective-taking are paired with the well-established difficulties in identifying and understanding emotional cues in others that have been observed among children who have experienced family violence (e.g. Pollak et al., 2000 ; Pollak & Kistler, 2002 ; Pollak & Sinha, 2002 ), this may produce particularly pronounced differences in affective theory of mind. Indeed, a growing body of evidence indicates that children who have experienced violence perform more poorly on tasks assessing both cognitive and affective theory of mind than children who have never experienced violence ( Barahal, Waterman, & Martin, 1981 ; Burack et al., 2006 ; Cicchetti, Rogosch, Maughan, Toth, & Bruce, 2003 ; O’Reilly & Peterson, 2015 ; Pears & Fisher, 2005 ).

Initial evidence suggests that children exposed to violence have worse performance on cognitive theory of mind tasks than children who have never experienced violence, demonstrating difficulty with false belief understanding—the ability to understand that others may have inaccurate beliefs about the world based on knowledge that differs from one’s own ( Cicchetti et al., 2003 ; O’Reilly & Peterson, 2015 ; Pears & Fisher, 2005 ). This prior research has been conducted largely with young children, as cognitive theory of mind develops rapidly during the preschool period ( Wellman, Cross, & Watson, 2001 ), and indicates that associations between family violence and difficulties in this domain of social cognition emerge early in childhood. O’Reilly and Peterson (2015) additionally tested children up to age 13 in their sample, providing preliminary indication that problems with cognitive theory of mind in children exposed to violence could persist into adolescence. Similarly, family violence exposure has been negatively associated with performance on Chandler’s Bystander Cartoons Test across childhood and adolescence ( Burack et al., 2006 ). This task involves narrating a cartoon sequence first from the perspective of the main character, and then requires the child to set aside knowledge of the full sequence of events to re-tell the story from a bystander character’s perspective. Although a weakness of this study design is an overreliance on children’s verbal abilities and memory, these findings provide further evidence that family violence may disrupt cognitive theory of mind ability well into adolescence. It is important to note than many studies of maltreatment and cognitive theory of mind have included children who were abused or neglected ( Cicchetti et al., 2003 ; O’Reilly & Peterson, 2015 ), or included an even wider range of adverse experiences such as abuse, neglect, lack of supervision, and exposure to domestic violence ( Burack et al., 2006 ). This heterogeneity in sample composition makes it difficult to isolate the specific role of violence versus other types of childhood adversity on cognitive theory of mind. Cicchetti and colleagues (2003) conducted the only study that examined the relative influence of adversity types separately, finding that physical abuse, but not neglect, predicted poor cognitive theory of mind. This finding suggests that there may be specificity in the association of violence, as opposed to other types of adversity, with cognitive theory of mind development in children, although greater research is needed to confirm this pattern.

Adolescents exhibit worse performance on tasks of affective theory of mind than adults, suggesting that this ability follows a more protracted developmental course than cognitive theory of mind, which largely develops in early childhood ( Wellman et al., 2001 ). Relatively little research has examined the association between family violence exposure and the affective component of theory of mind. Three studies have found that children who experienced family violence were less accurate on tasks in which they were directed to predict the emotion of a story character whose expectations were or were not met ( O’Reilly & Peterson, 2015 ; Pears & Fisher, 2005 ), a puppet who acted in a way that was either emotionally congruent or incongruent to how a child would likely react in a similar situation ( Pears & Fisher, 2005 ), and a puppet whose affect slowly changed from the beginning to the end of a story ( Barahal et al., 1981 ). Surprisingly, no studies to date have examined associations between violence exposure and affective theory of mind in adolescents, despite evidence that affective theory of mind continues to develop throughout adolescence ( Sebastian et al., 2012 ). This study will be the first to examine associations of violence exposure and other forms of childhood adversity with both cognitive and affective theory of mind in a large sample comprised of both children and adolescents.

Children who are less able to understand the thoughts, beliefs, intentions, and emotions of others may be more likely to engage in externalizing behavior than children with better abilities in these domains. If a child is sensitive to early warning signs of violence, for example a menacing expression from a caregiver or an unprompted remark from a stranger, he or she will be poised to enact behavioral strategies to promote safety. Detection of danger, real or imagined, is likely to be reinforced over time when safety-seeking behavior is facilitated and anticipated threat is either avoided through escape or prevented through aggression. Although this pattern represents an adaptation in dangerous environments, a proclivity to perceive threat of violence in safe social contexts may ultimately predispose children to engage in a variety of externalizing behaviors. These children may become so distracted by signs of danger they have difficulty attending to schoolwork, chores, and social interactions. They may break rules more frequently because they misunderstand or distrust the directions of authority figures. These children may also act aggressively in an unnecessary bid for self-protection. Indeed, there has been extensive theoretical speculation that deficits in social cognition underlie antisocial and aggressive behavior in youth ( Blair, 2005 ; Davidson, Putnam, & Larson, 2000 ; Herpertz & Sass, 2000 ; Hoffman, 2001 ; Raine, Venables, & Mednick, 1997 ; Zahn-Waxler, Cole, Welsh, & Fox, 1995 ). Initial evidence for weaker cognitive theory of mind ability among children who are aggressive has emerged from several studies of false-belief understanding ( Malti, Gasser, & Gutzwiller-Helfenfinger, 2010 ; Olson, Lopez-Duran, Lunkenheimer, Chang, & Sameroff, 2011 ; Renouf et al., 2010 ; Shakoor et al., 2012 ). Research examining the question of whether aggression is associated with affective theory of mind in youth is both limited and mixed. One study has examined this relationship among toddlers, and found that bullying was positively associated with emotion recognition and identification of relevant contextual causes of emotions, but not with recognition of mixed emotions and hiding of emotions ( Belacchi & Farina, 2010 ). However, a neuroimaging study of 47 adolescents boys with and without significant conduct problems found no significant association between diagnosis and behavioral performance on an affective theory of mind task ( Sebastian et al., 2012 ). Critically, this study will be the first to examine the association of cognitive and affective theory of mind with externalizing symptoms and associated mental health problems, specifically oppositional defiant disorder and conduct disorder, in girls and boys across childhood and adolescence.

A final goal of our study was to evaluate whether interpersonal violence exposure has a unique association with theory of mind in children and adolescents or whether other types of adversity also exhibit a similar pattern of association. Childhood adversity is defined as “exposure during childhood or adolescence to environmental circumstances that are likely to require significant psychological, social, or neurobiological adaptation by an average child and that represent a deviation from the expectable environment” ( McLaughlin, 2016 ). These adverse experiences encompass a broad range of severe and chronic negative experiences ranging from abuse and neglect to institutionalization to poverty and parental mental illness, and have been linked to an equally broad range of deleterious long-term mental and physical health consequences (e.g., Cicchetti & Rogosch, 2001 ; Cicchetti & Toth, 2005 ; Felitti et al., 1998 ; Green et al., 2010 ; McLaughlin et al., 2012 ). Despite evidence that interpersonal violence and other forms of adversity influence social-cognitive processes, the pattern of results is highly variable across types of adversity. For example, although both neglected and physically abused children show atypical patterns of emotion perception, evidence suggests that neglected children show discrimination difficulty across many emotions whereas abused children tend to show a specific pattern of over-identification of anger ( Pollak et al., 2000 ). As such, a critical next step in this area of research is to identify how specific aspects of social-cognitive processing are disrupted as a result of specific forms of adversity. Recent conceptual models ( McLaughlin & Sheridan, 2016 ; McLaughlin, Sheridan, & Lambert, 2014 ) argue for the importance of distinguishing between experiences of threat that involve harm or threat of harm (i.e., exposure to violence, physical and sexual abuse) and experiences of deprivation that involve an absence of expected material and emotional inputs from the environment (i.e., neglect, institutional rearing, poverty) and their downstream consequences on developmental outcomes. Building on that framework, this study will specifically examine the associations of abuse and domestic violence, clear forms of potential threat to a child’s physical integrity, with theory of mind and its role in increasing risk for externalizing symptoms and psychopathology related to aggression.

The current study examines behavioral performance during cognitive and affective theory of mind as a potential pathway linking exposure to interpersonal violence with externalizing psychopathology in children and adolescents. This cross-sectional study will provide a necessary first step in demonstrating the plausibility of our model, one we hope to substantiate in further longitudinal research. The following hypotheses will be examined. First, we expect that violence exposure (including abuse and domestic violence) will be associated with slower reaction times and lower accuracy during both cognitive and affective conditions of a theory of mind task. Second, we expect that these differences in performance on cognitive and affective theory of mind will be associated with greater externalizing problems primarily characterized by aggression, and will explain the association between violence exposure and externalizing psychopathology. Finally, we expect that associations of interpersonal violence with performance on cognitive and affective theory of mind tasks will persist while controlling for adversities reflecting material and emotional deprivation, including poverty and emotional neglect respectively, demonstrating a specific influence of violence on theory of mind.

Children aged 8–16 years and a parent or guardian were recruited to participate in a study examining child trauma exposure, emotion regulation, and psychopathology. A total of 262 children aged 8–16 years were enrolled into the study. Exposure to maltreatment and other inclusion and exclusion criteria were assessed during the first study visit, along with several behavioral tasks and self-report measures. Children and caregivers were recruited for participation at schools, after-school and prevention programs, adoption programs, food banks, shelters, parenting programs, medical clinics, and the general community in Seattle, WA between January 2015 and June 2017. Recruitment efforts were targeted at recruiting a sample with variation in exposure to maltreatment-related trauma. To do so, we recruited from neighborhoods with high levels of violent crime, from clinics that served a predominantly low-SES catchment area, and agencies that work with families who have been victims of violence (e.g., domestic violence shelters, programs for parents mandated to receive intervention by Child Protective Services). Inclusion criteria for the maltreated group included exposure to physical, sexual, or emotional abuse or direct witnessing of domestic violence. Children in the control group were matched to children in the maltreated group on age, sex, and handedness; inclusion criteria required an absence of exposure to maltreatment or other forms of significant interpersonal violence. Exclusion criteria included IQ < 80, presence of pervasive developmental disorder, active psychotic symptoms or mania, active substance abuse, and presence of safety concerns. Of the 262 children enrolled in the first study visit, three were excluded from all analysis due to low IQ (n=1), presence of pervasive developmental disorder (n=1), and presence of psychotic symptoms and drug abuse (n=1) and thirteen were excluded because they did not complete the theory of mind task. The total sample size for the present analysis was 246 children and adolescents (mean age 12.61, SD = 2.60, 46.7% girls). Approximately 26.0% of the sample identified as Black (n=64), 11.8% as Hispanic/Latino (n=29), 11.4% as Asian (n=28), 40.7% as White (n=100), and 10.2% as members of other racial/ethnic groups (n=25).

During the first study visit, participants and a caregiver completed assessments of violence exposure, maltreatment, and symptoms of psychopathology; children and adolescents additionally completed the theory of mind task. A sub-sample of participants (n=168) completed two additional study visits, one of which involved an MRI (which is not the focus of the current report). Only maltreated children who had experienced interpersonal violence within the family (i.e., physical or sexual abuse, domestic violence exposure) were eligible for continued participation in the MRI portion of the study. For those children completing an MRI, a clinical interview was also completed to evaluate the presence of mental disorders. Analyses using externalizing disorders as the outcome utilize this smaller sample. Both the first and second study visits took place in a university psychology laboratory an average of 46 days apart.

All procedures were approved by the Institutional Review Board at the University of Washington. Written informed consent was obtained from legal guardians; children provided written assent. Maltreatment not previously reported to the relevant authorities was reported to Child Protective Services using standard clinical procedures. Children with active safety concerns were not enrolled in the study. See Table 1 for socio-demographic characteristics of the sample.

Distributions of demographic and deprivation information, means and standard error of age, theory of mind task performance, externalizing symptoms, and proportion and standard error of ODD and CD diagnoses by violence group

	No Violence (n=123)		Physical or Sexual Abuse (n=121)		Emotional Abuse (n=76)		Domestic Violence (n=94)

Demographics	Mean		Mean		Mean		Mean
Age	12.36	2.58	12.81	2.65	13.09	2.72	12.81	2.59

	%		%		%		%

Sex (Female)	44.7	55	46.3	56	55.3	42	46.8	44

Measures	Mean		Mean		Mean		Mean

ToM Performance
Cognitive theory of mind
Accuracy	.95	.01	.92	.01	.91	.02	.92	.01
Reaction Time (ms)	5204.10	205.64	4983.63	214.79	4942.03	253.27	4929.89	221.79
Affective theory of mind
Accuracy	.94	.01	.92	.01	.89	.02	.92	.01
Reaction Time (ms)	4326.91	167.40	4679.58	231.19	4673.32	310.97	4473.88	259.47
CBCL/YSR
Externalizing	51.54	.81	62.39	.82	63.59	.98	62.57	.99
KSADS	Proportion		Proportion		Proportion		Proportion

Oppositional Defiant Disorder	.04	.02	.07	.04	.08	.05	.07	.05
Conduct Disorder	.01	.01	.03	.02	.04	.03	.04	.03

Deprivation	%		%		%		%

Poverty	17.1		37.2		27.6		39.4
Emotional Neglect	7.3		37.2		57.9		45.7

Children completed a task assessing both cognitive and affective components of theory of mind during the first study visit ( Figure 1 ). This task has been used in prior research on theory of mind with older children and adolescents ( Sebastian et al., 2012 ). Stimuli were 30 cartoons depicting a story that appeared in three frames. Before each trial, an instruction screen with the text “ What happens next? ” appeared for 3 seconds. One cartoon then appeared in sequence, with each of the three frames displayed for 2 seconds before the next frame appeared (6 seconds total). Following presentation of the cartoon, two response options appeared and participants were asked to select the appropriate conclusion to the story depicted in the cartoon using a key press response. There was no time limit with which they had to make a response. The cartoons were divided into three conditions: cognitive theory of mind, affective theory of mind, and physical causality. Trials in the cognitive theory of mind condition required children to interpret the thoughts, beliefs, and intentions of the characters in the story, whereas trials in the affective theory of mind condition required children to interpret how one character was likely to respond emotionally to another character. In contrast, physical causality cartoons simply required children to understand cause and effect relationships (e.g., that sunshine will cause snow to melt) but did not require understanding of the mental states of other people. The physical causality condition is typically included as control condition for neuroimaging studies ( Sebastian et al., 2012 ) but is of no interest to the study questions examined here. These trials were included as we wanted to use a task that has been previously validated in the age range of our sample and it was unclear how removing these trials might alter performance on the conditions of interest. The order of cartoon presentation was randomized across participants. Cognitive and affective theory of mind accuracy scores reflect the proportion of correctly answered items within each respective condition. Reaction time scores were calculated by averaging the participants response times across items within each condition.

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Theory of Mind Task. Cognitive and affective theory of mind were assessed using a task designed to be developmentally appropriate for children and adolescents ( Sebastian et al., 2012 ). Participants viewed cartoon stories and were asked to select the appropriate ending. Some trials require the ability to imagine another person’s thoughts or beliefs (cognitive) and others require the ability to imagine another’s feelings (affective). A control condition simply requires understanding of physical causal relationships (e.g., heat melts snow).

Maltreatment Exposure.

We used a multi-informant, multi-method approach for assessing exposure to child maltreatment. Children completed two interview measures with a trained member of our research team assessing child maltreatment experiences and exposure to interpersonal violence: the Childhood Experiences of Care and Abuse (CECA) Interview ( Bifulco, Brown, & Harris, 1994 ) and the Violence Exposure Scale for Children-Revised (VEX-R) ( Raviv et al., 2001 ; Raviv, Raviv, Shimoni, Fox, & Leavitt, 1999 ). The CECA assesses caregiving experiences, including physical and sexual abuse and emotional neglect. We modified the interview to ask parallel questions about witnessing domestic violence (i.e., directly observing violence directed at a caregiver). Inter-rater reliability for maltreatment reports is excellent, and validation studies suggest high agreement between siblings on maltreatment reports ( Bifulco, Brown, Lillie, & Jarvis, 1997 ). The VEX-R assesses the frequency of exposure to different forms of violence. Children are presented with a cartoon and caption depicting a child of the same sex witnessing a type of violence (e.g., “Chris sees a person slap another person really hard”) and experiencing that same type of violence (e.g., “A person slaps Chris really hard”). Children are then asked to report how frequently they have witnessed or experienced that type of violence (e.g., “How many times have you seen a person slap another person really hard?”; “How many times has a person slapped you really hard?”) on a Likert scale ranging from 0 (Never) to 3 (Lots of times). We added follow-up questions for each item that was endorsed to gather additional information (e.g., the perpetrator, age of onset). The VEX-R demonstrates good reliability and has been validated with children as young as second grade ( Raviv, et al., 2001 ; Raviv, et al., 1999 ).

Children also completed two self-report measures: the Childhood Trauma Questionnaire (CTQ) ( Bernstein, Ahluvalia, Pogge, & Handelsman, 1997 ) and the UCLA PTSD Reaction Index (PTSD-RI) ( Steinberg, Brymer, Decker, & Pynoos, 2004 ). The CTQ is a 28-item scale that assesses the frequency of maltreatment during childhood, including physical, sexual, and emotional abuse. Validated thresholds for exposure to physical, sexual, and emotional abuse ( Walker et al., 1999 ) were applied here in evaluating abuse exposure based on the CTQ. The CTQ has excellent psychometric properties including internal consistency, test-retest reliability, and convergent and discriminant validity with interviews and clinician reports of maltreatment ( Bernstein, et al., 1997 ; Bernstein, Fink, Hondelsman, Foote, & Lovejoy, 1994 ). To adapt this measure for children under the age of 12, a trained experimenter read the items out loud to ensure that the child understood the questions and the responses. The PTSD-RI includes a trauma screen that assesses exposure to numerous traumatic events, including physical abuse, sexual abuse, and domestic violence and additionally assesses PTSD symptoms. The PTSD-RI has good internal consistency and convergent validity ( Steinberg et al., 2013 ).

Caregivers completed three self-report measures: the Conflict Tactics Scale-Parent Child Version (CTS) ( Straus, Hamby, Finkelhor, Moore, & Runyan, 1998 ), the Juvenile Victimization Questionnaire (JVQ) lifetime caregiver report ( Finkelhor, Hamby, Ormrod, & Turner, 2005 ), and the caregiver version of the PTSD-RI. The CTS includes 22 items assessing caregiver responses to child disobedience or misbehavior in the past year. Caregivers indicate how frequently they have used each strategy (e.g., shook him/her) on a Likert scale ranging from 0 (This has never happened) to 6 (more than 20 times in the past year) and can also indicate if they have used the strategy in the past but not in the last year. The CTS has adequate reliability and good discriminant and construct validity ( Straus, et al., 1998 ). The JVQ includes 34 items assessing exposure to crime, child maltreatment, peer and sibling victimization, sexual victimization, and witnessing and indirect victimization and has excellent psychometric properties, including test-retest reliability and construct validity ( Finkelhor, et al., 2005 ). Caregivers endorsed whether their child had experienced each event in his/her lifetime. Caregivers also completed the trauma screen included in the PTSD-RI, described above. A trained interviewer followed up with the caregiver if the endorsed any form of abuse or domestic violence to gather additional information about the experience.

Children were classified as experiencing physical or sexual abuse if abuse was endorsed by the child (on the CECA interview, PTSD-RI trauma screen, or above the validated CTQ threshold) or parent (on the CTS, JVQ, or PTSD-RI trauma screen). A total of 121 children (49.2%) experienced physical or sexual abuse. Inter-rater reliability was good for child and caregiver reports (82.0% agreement; kappa=0.62). Exposure to emotional abuse (on the CECA, or above the validated CTQ threshold) and domestic violence (on the VEX-R interview or PTSD-RI trauma screen) was determined based on child report only. A total of 76 children (30.9%) reported experiencing emotional abuse and 94 (38.2%) reported witnessing domestic violence. For the children exposed to violence, we created a categorical variable to reflect whether they had experienced one, two, or all three kinds of violence. Among these children (n=123), 42.3% (n=52) were exposed to one type of violence, 19.6% (n=28) were exposed to two types of violence, and 35.0% (n=43) were exposed to all three types of violence. Finally, we used the total score on the VEX-R as a continuous variable to reflect the frequency of exposure to all forms of violence experienced by each child.

Externalizing Psychopathology.

During the first study visit, children and caregivers completed the Youth Self-Report (YSR) and Child Behavior Checklist (CBCL) ( Achenbach, 1991 ). The YSR/CBCL scales are among the most widely used measures of youth emotional and behavioral problems and use extensive normative data to generate age-standardized estimates of symptom severity. Although originally designed for youth 11 to 18 years of age, multiple studies have demonstrated reliability and validity of the YSR among younger children ( Ebesutani, Bernstein, Martinez, Chorpita, & Weisz, 2011 ; Kolko & Kazdin, 1993 ; Yeh & Weisz, 2001 ). Self-reported psychopathology was assessed using the broad-band externalizing scale, comprised of rule-breaking behavior (e.g., “I don’t feel guilty after doing something I shouldn’t”) and aggressive behavior (e.g., “I physically attack people”) subscales. The externalizing scale has demonstrated validity in discriminating between youths with and without psychiatric disorders ( Achenbach, 1991 ; Chen, Faraone, Biederman, & Tsuang, 1994 ; Seligman, Ollendick, Langley, & Baldacci, 2004 ). We used the highest T-score from the parent or child report for this measure.

Clinical interviews were completed with children and caregivers in the sub-sample (n=168) who completed the second study visit. Specifically, we administered the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS) – Present and Lifetime Version ( Kaufman et al., 1997 ). Here, we focus on disruptive behavior disorders that are associated with aggressive behavior, including oppositional defiant disorder (ODD) and conduct disorder (CD). ODD was assessed only by caregiver report, and both children and caregivers reported on CD. Diagnostic thresholds were applied based on DSM-IV, as the DSM-5 version was not yet available when we began the study. Current CD and ODD diagnoses were included in this study. A total of 6 children (4%) met criteria for CD, and a total of 10 children met criteria for ODD (6%), consistent with population prevalence estimates of these disorders ( Nock, Kazdin, Hiripi, & Kessler, 2007 ; NSCH, 2007; NSCH, 2012; Perou et al., 2013 ). Clinical interviews were conducted by a licensed clinician, doctoral graduate student, or full-time study staff with extensive diagnostic and clinical training. Diagnoses were reviewed and confirmed by a licensed clinician who supervised all clinical interviewing procedures.

Deprivation.

Caregivers provided information about total household income that was used to assess whether the family was living in poverty, a measure of material deprivation. The income-to-needs ratio was calculated by dividing total household income by the 2015 U.S. census-defined poverty line for a family of that size, with a value less than one indicating that a family was living below the poverty line. This ratio was used to create a dichotomous poverty variable indicating whether the participant met criteria for living in poverty. Emotional deprivation was assessed using an eight item self-report measure assessing the frequency of neglectful parenting behaviors that is embedded in the CECA interview (Bifulco, Bernazzani, Moran, & Jacobs, 2005). This measure was completed separately in reference to neglectful behaviors on the part of each caregiver for children living with two caregivers. We elected to use this measure rather than the emotional neglect subscale of the CTQ as this measure more closely aligns with accepted definitions of neglect (Straus & Kantor, 2005) by assessing neglectful behaviors (e.g., “She would leave me unsupervised before the age of 10”) as compared to the CTQ which focuses largely on appraisals (e.g., “My family was a source of strength and support”). Participants who reported levels greater than predefined cutoff scores (Bifulco et al., 2005) for either parent were classified as emotionally neglected.

Statistical Analysis

We evaluated the role of theory of mind ability as a potential mechanism linking interpersonal violence exposure to externalizing psychopathology using several methods. First, we examined associations of violence exposure with externalizing psychopathology using univariate analysis of covariance (ANCOVA) for continuous symptom scores and logistic regression for diagnostic outcomes. We examined several forms of interpersonal violence: exposure to physical or sexual abuse, emotional abuse, and domestic violence, as well as a continuous variable reflecting the total frequency of violence exposure in the child’s life. Next, we examined the associations of each of the three interpersonal violence variables with performance on the theory of mind task (i.e., cognitive and affective accuracy and reaction time) using ANCOVA for dichotomous exposure variables and linear regression for frequency of violence exposure. We additionally used MANCOVA to test whether there were differences in cognitive and affective theory of mind accuracy and reaction time among children exposed to one, two, or three kinds of violence (the independent categorical variable). We then examined the associations of accuracy and reaction time on the theory of mind task with externalizing symptoms using linear regression and with diagnostic outcomes using logistic regression. Finally, we conducted a mediation analysis in SPSS software using the PROCESS test ( Hayes, 2013 ), a standard bootstrapping approach that provides confidence intervals for indirect effects in statistical mediation estimated from 1000 resamples of the data ( Preacher & Hayes, 2008 ), to determine whether poor theory of mind performance mediated the association of violence exposure with externalizing psychopathology. The PROCESS test of mediation is particularly advantageous as it employs a bootstrapping method to address non-normal data distributions, accepts dichotomous dependent variables, and is particularly suited to small sample sizes ( Preacher & Hayes, 2008 ). When zero is not included in the lower and upper endpoints of the bias-corrected bootstrap confidence interval provided by PROCESS, the indirect effect is interpreted as significant.

Following analysis of our three main models, we conducted several hypothesis-driven sensitivity analyses. First, we examined whether other adversities unrelated to threat exposure—including poverty and child-reported emotional neglect—were associated with theory of mind performance, and whether they were significant after controlling for violence exposure. When covarying violence exposure, we used a dichotomous variable indicating whether participants had experienced any physical, sexual, emotional abuse or domestic violence. Second, we examined whether associations between violence and accuracy and reaction time during cognitive and affective theory of mind remained significant after controlling for these other forms of adversity.

We also conducted several exploratory analyses. Given the wide age range of the sample and age differences in theory of mind across development (Sebastian et al., 2011), we examined the effects of age on theory of mind performance. We also evaluated whether the associations of violence exposure with theory of mind varied by age by creating interaction terms between the age and violence exposure variables, and whether the associations of theory of mind with psychopathology varied by age by creating interaction terms between age and theory of mind performance. We used linear regression to test whether the interaction terms predicted outcome measures (i.e., theory of mind and externalizing psychopathology respectively) using standard methods ( Hayes & Matthes, 2009 ).

In all models predictors were mean-centered to ensure that effects were always within the range of the data and to reduce multicollinearity ( Hayes, Glynn, & Huge, 2012 ). Age and sex were controlled for in all models, given established age and sex-related differences in both violence exposure and externalizing psychopathology. All analyses were conducted using SPSS software Version 19.

Descriptive Statistics

Table 1 provides the means and standard deviations of all measures separately by group. Table 2 provides the zero-order correlations among all measures of violence exposure, other adversities, covariates, cognitive and affective theory of mind, and externalizing psychopathology.

Correlations of violence exposure, theory of mind task performance, and externalizing symptoms and diagnoses a

	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15
1. Age	__
2. Sex	.12	__
3. Poverty	−.09	−.14	__
4. Emotional Neglect	.11	.09	.10	__
5. Physical or Sexual Abuse	.08	−.01	.30	.32	__
6. Emotional Abuse	.12	.11	.05	.54	.45	__
7. Domestic Violence	.06	.01	.27	.41	.40	.40	__
8. Violence Frequency	.32	−.05	.17	.39	.50	.53	.44	__
9. Cognitive ToM Accuracy	.17	.06	−.06	−.11	−.13	−.15	−.11	−.17	__
10. Cognitive ToM Reaction Time	−.39	−.13	.07	−.05	−.04	−.04	−.05	−.10	−.28	__
11. Affective ToM Accuracy	−.01	.07	.03	−.05	−.09	−.19	−.03	0.19	.61	−.06	__
12. Affective ToM Reaction Time	−.28	−.22	.06	−.03	.08	.05	−.01	.03	−.20	.49	−.22	__
13. Externalizing Symptoms	.01	−.01	.21	.32	.54	.43	.38	.44	−.16	.04	.15	.16
14. Oppositional Defiant Disorder	−.23	−.09	.20	.25	.22	.16	.20	.09	.01	.06	.01	.06	.35	__
15. Conduct Disorder	.07	−.03	.04	.13	.11	.10	.10	.25	−.09	.01	−.17	−.03	.25	.10	__

Interpersonal Violence Exposure and Externalizing Psychopathology

We observed strong and consistent associations between exposure to violence and externalizing psychopathology. Physical and sexual abuse, emotional abuse, domestic violence exposure, and the frequency of violence exposure were all strongly associated with our continuous measure of externalizing problems (r =.38-.54, all p < .001; see Table 2 ). Exposure to violence was also associated with externalizing disorder diagnoses, particularly ODD. Specifically, physical and sexual abuse (OR=12.18, p = .021), emotional abuse (OR=4.33, p = .039), and domestic violence (OR=5.31, p = .024) were each associated with elevated odds of ODD (see Table 2 ). None of these exposures were associated with conduct disorder. Frequency of violence exposure, however, was significantly associated with both ODD (OR=1.09, p = .018) and conduct disorder (OR=1.08, p = .028), such that each addition point on the violence exposure total score was associated with an 8–9% increase in the odds of ODD and conduct disorder, respectively.

Interpersonal Violence Exposure and Theory of Mind

Cognitive theory of mind..

Although performance was generally high on the cognitive theory of mind task, violence was associated with task accuracy across multiple forms of exposure ( Figure 2 ). Specifically, accuracy on cognitive theory of mind was lower among children who experienced physical or sexual abuse, F (1,245) = 5.38, p = .021 and emotional abuse, F (1,245) = 7.71, p = .006, as compared to children who never experienced each form of violence ( Table 1 ). The frequency of exposure to violence was also associated with worse performance on cognitive theory of mind, β = −0.24, p < .001. Exposure to domestic violence and to more than one type of violence were not significantly associated with cognitive theory of mind accuracy. Violence exposure was not significantly associated with reaction time during cognitive theory of mind.

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Object name is nihms-1539749-f0002.jpg

Mean cognitive theory of mind accuracy by type of violence exposure. Note: Children were not classified into distinct groups, therefore some overlap exists among children represented by each of the violence bars.

Affective theory of mind.

Accuracy was also relatively high on the affective theory of mind task. Despite generally good performance across the entire sample, differences in affective theory of mind accuracy emerged as a function of violence exposure ( Figure 3 ). In particular, children who experienced emotional abuse performed significantly worse on affective theory of mind than children who had never experienced that form of interpersonal violence, F (1,245) = 9.84, p = .002 ( Table 1 ). There was also a significant main effect of exposure to more than one kind of violence on affective theory of mind accuracy, F (1,123) = 4.93, p = .009, such that children exposed to two (mean(SD)=0.87(0.19)) and three (mean(SD)=0.90(0.16)) types of violence were significantly less accurate at affective theory of mind than children exposed to only one type of violence (mean(SD)=0.96(0.07)). We re-ran our analysis of the association between emotional abuse and affective theory of mind accuracy while covarying exposure to physical or sexual abuse and domestic violence. The association remained significant, F (1,245) = 8.39, p = .004, suggesting that it is not driven by exposure to other kinds of violence. We also observed an association between frequency of violence exposure and accuracy on affective theory of mind, β = −0.20, p = .003, such that greater exposure frequency was associated with worse performance. Neither physical and sexual abuse nor domestic violence was associated with affective theory of mind accuracy. Violence exposure was not significantly associated with reaction time during affective theory of mind.

An external file that holds a picture, illustration, etc.
Object name is nihms-1539749-f0003.jpg

Mean affective theory of mind accuracy by type of violence exposure. Note: Children were not classified into distinct groups, therefore some overlap exists among children represented by each of the violence bars.

Theory of Mind and Externalizing Psychopathology

Lower accuracy and slower reaction time during cognitive theory of mind were each associated with externalizing problems, though not with diagnoses of ODD or conduct disorder ( Table 3 ).

Cognitive and affective theory of mind task performance and externalizing problems

	Highest CBCL or YSR T-Score	KSADS Current Diagnosis

	Externalizing	Conduct Disorder	Oppositional Defiant Disorder
	β	OR	OR
Cognitive theory of mind
Accuracy	−0.17	0.04	8.58
Reaction time (ms)	0.05	1.00	1.00
Affective theory of mind
Accuracy	−0.15	0.01	4.74
Reaction time (ms)	0.18	1.00	1.00

Lower accuracy during affective theory of mind was significantly associated with higher levels of externalizing problems and greater odds of meeting criteria for conduct disorder ( Table 3 ). Reaction time during affective theory of mind was significantly associated with higher levels of externalizing behavior but not with diagnoses of ODD or conduct disorder ( Table 3 ).

Indirect Effects

We tested indirect effects using a multiple mediator approach. Specifically, we examined performance on cognitive and affective theory of mind simultaneously as mediators of the associations between violence exposure and externalizing psychopathology. We only included mediators that were associated with violence exposure in each model. We examined a total of three indirect effects models: 1) the indirect effects of physical and sexual abuse on externalizing symptoms through cognitive theory of mind accuracy, 2) the indirect effect of emotional abuse on externalizing symptoms through cognitive and affective theory of mind accuracy, and 3) the indirect effect of frequency of violence exposure on externalizing symptoms through cognitive and affective theory of mind accuracy. We did not include a domestic violence model as no association was observed between domestic violence and cognitive and affective theory of mind performance. Although exposure to violence occurred at an earlier point in development than our theory of mind assessment, because theory of mind and externalizing psychopathology are measured at only one point in time, caution is warranted in interpretation of these mediation results as evidence for theory of mind as a mechanism linking violence exposure and externalizing problems ( Maxwell & Cole, 2007 ).

In our first model, we found a significant indirect effect of physical and sexual abuse on externalizing problems through cognitive theory of mind performance (95% CI: 0.051 – 1.084). The indirect effects of emotional abuse and frequency of violence exposure on externalizing problems through cognitive and affective theory of mind performance did not reach statistical significance. These findings suggest that relative reductions in the ability to understand the thoughts and intentions of others is a potential mechanism linking physical and sexual abuse with externalizing problems in children and adolescents.

Sensitivity Analyses

Deprivation-related adversities and theory of mind..

Poverty was not significantly associated with reaction time or accuracy during cognitive or affective theory of mind, either in bivariate analysis or when controlling for violence exposure.

Emotional neglect.

Emotional neglect was not significantly associated with reaction time during cognitive theory of mind, or with accuracy or reaction time during affective theory of mind. Children who reported being emotionally neglected were less accurate at cognitive theory of mind than children who had never experienced emotional neglect, F (1,245) = 4.50, p = .040. This association was no longer significant when controlling for violence exposure. Associations between emotional neglect and cognitive theory of mind reaction time and affective theory of mind reaction time and accuracy were also not significant when controlling for violence exposure measured dichotomously. To ensure sensitivity of these analyses, we reran them controlling for all four primary violence exposure variables together and in four separate models and still found no significant associations.

Interpersonal violence and theory of mind controlling for emotional neglect and poverty.

To determine whether violence exposure was associated with theory of mind over and above the effects of other co-occurring forms of adversity reflecting deprivation, we conducted two sets of sensitivity analyses. In the first, we adjusted for poverty, which is well established to be associated not only with increased risk for violence exposure but also deprivation in material, emotional, and cognitive domains (see McLaughlin, Sheridan, Lambert, 2014 ; Sheridan & McLaughlin, 2014; 2016 for reviews). A total of 17 participants declined to provide information on family income, which reduced our sample size for these analyses. Adjusting for poverty had no effect on the associations of violence exposure with cognitive and affective theory of mind performance. All associations that were significant without inclusion of poverty as a covariate remained statistically significant (see Supplemental Table 1 ).

We additionally completed a more stringent sensitivity analysis adjusting for exposure to emotional neglect, which is a more extreme form of deprivation. Notably, after adjustment for exposure to emotional neglect, violence exposure continued to be associated with both cognitive and affective theory of mind performance. The only meaningful differences were that the association of physical and sexual abuse with cognitive theory of mind accuracy was reduced to trend-level significance, and domestic violence was no longer associated with cognitive theory of mind accuracy. All other associations were unchanged (see Supplemental Table 1 ).

Exploratory Analyses

Variation by age..

Age was associated with higher theory of mind accuracy, β = 0.17, p = .009, and faster reaction times, β = −0.38, p < .001, during the cognitive condition of the task. Age was also associated with faster affective theory of mind reaction times, β = −0.26, p < .001. Interactions between age and violence were added to regression models examining the associations between violence and theory of mind performance. None of these interactions were statistically significant ( Supplemental Table 2 ). Age was also associated greater likelihood of being diagnosed with oppositional defiant disorder (OR=5.31, p = .024). Interactions between age and theory of mind performance were added to each of the models examining theory of mind performance and externalizing psychopathology to determine whether associations varied by age. In no cases did these interactions reach statistical significance ( Supplemental Table 3 ).

Prior research has documented that interpersonal violence exposure in childhood is a powerful predictor of externalizing problems across the lifespan ( Bingenheimer, 2005 ; Dodge et al., 1990 ; McCloskey & Lichter, 2003 ; Widom, 1989 ). Although deficits in social information processing have been demonstrated to be a core mechanism in this association (e.g., Dodge et al., 1990 ; 1995 ), few studies have investigated forms of social cognition related to social-information processing deficits, such as theory of mind. Furthermore, prior research examining social cognitive abilities following adversity has largely ignored whether associations are due specifically to violence exposure versus other forms of adversity, such as emotional neglect and poverty, with notable exceptions ( Cicchetti et al., 2003 ). The current study addressed these gaps in the literature by examining whether interpersonal violence influences cognitive and affective theory of mind in ways that may ultimately contribute to externalizing behavior in a community-based sample of children and adolescents with a high concentration of exposure to interpersonal violence. Although it is not possible to establish that alterations in theory of mind are preceded and driven by violence exposure rather than inherited traits in a cross-sectional study, our findings contribute to accumulating evidence that theory of mind development is strongly affected by non-heritable environmental factors ( Cutting & Dunn, 1999 ; Hughes et al., 2005 ). First, we found that exposure to interpersonal violence was associated with altered theory of mind performance, including greater difficulty understanding thoughts, beliefs, and intentions of others (i.e., cognitive theory of mind) as well as lower accuracy when predicting emotional states of others (i.e., affective theory of mind) in a variety of social situations. Second, difficulty across these domains was associated with externalizing psychopathology. Finally, worse performance on cognitive and affective theory of mind mediated the association between many measures of violence exposure with externalizing psychopathology. Importantly, this pattern of results was nearly identical after controlling for co-occurring forms of adversity reflecting material and emotional deprivation. Taken together, these findings suggest that atypical theory of mind development may be an additional social cognitive mechanism that contributes to risk for externalizing problems among children who have experienced interpersonal violence.

Consistent with our hypotheses and a great deal of prior research (e.g., Bingenheimer, 2005 ; Cicchetti & Toth, 2005 ; McLaughlin et al., 2012 ), we found strong associations of interpersonal violence exposure with externalizing problems in children and adolescents. More covert, non-violent forms of rule-breaking behaviors are quite common among children exposed to violence ( Miller, Wasserman, Neugebauer, Gorman-Smith, & Kamboukos, 1999 ; Mrug & Windle, 2010 ). Although it may be adaptive to distrust the demands of authority figures following prior experiences with dangerous individuals, oppositional behavior is likely to arouse frustration and rejection in otherwise safe school and home environments. Higher engagement in aggressive behavior also likely reflects a developmental adaptation to a dangerous environment. For children growing up in environments characterized by threat, reacting with aggression may be a strategy intended to promote safety. However, a tendency to engage in these behaviors is particularly problematic for a number of reasons. First, and most obvious, adolescent aggressive behavior is associated with a wide range of negative interpersonal, educational, legal, and health outcomes ( Huesmann, Dubow, & Boxer, 2009 ; Kokko & Pulkkinen, 2000 ). Second, a tendency to behave aggressively is likely to provoke a similar response in others. Indeed, bidirectional relationships have been observed between children’s aggressive behavior and both peer victimization and harsh parenting ( Anderson, Lytton, & Romney, 1986 ; Brunk & Henggeler, 1984 ; Reijntjes et al., 2011 ). As a result, children who develop externalizing behaviors create more opportunities for re-victimization, a well-established finding among youths who have experienced violence ( Classen, Palesh, & Aggarwal, 2005 ; Desai, Arias, Thompson, & Basile, 2002 ; Hosser, Raddatz, & Windzio, 2007 ). This is particularly concerning because the risk for virtually all forms of psychopathology, including externalizing psychopathology, increases with each traumatic experience ( Copeland, Keeler, Angold, & Costello, 2007 ; McLaughlin et al., 2012 ). Thus, while aggressive and rule-breaking responses may emerge in order to promote safety in the short-term they have many deleterious long-term outcomes. Identifying the mechanisms through which interpersonal violence may alter how children interact with their social environment in ways that increase risk for externalizing problems is of critical importance. Here, we provide evidence that a fundamental social cognitive ability—theory of mind—may play a meaningful role in these associations.

Children in our sample who experienced many forms of interpersonal violence demonstrated difficulty with the cognitive component of theory of mind, which involves understanding others’ thoughts, beliefs, and intentions. This finding is in line with a growing body of research that has largely been conducted on younger samples of children ( Barahal, Waterman, & Martin, 1981 ; Burack et al., 2006 ; Cicchetti, Rogosch, Maughan, Toth, & Bruce, 2003 ; O’Reilly & Peterson, 2015 ; Pears & Fisher, 2005 ). We extend this prior research by demonstrating that violence produces an atypical pattern of cognitive theory of mind well into adolescence. While all forms of violence exposure were unassociated with reaction time during cognitive theory of mind, physical and sexual abuse was associated with lower accuracy when identifying other peoples’ thoughts and intentions across different contexts. Moreover, the overall frequency of violence exposure was strongly associated with cognitive theory of mind performance, suggesting that children who experience more frequent interpersonal violence are particularly likely to have difficulty with cognitive theory of mind. These associations remained consistent for most forms of violence exposure even after accounting for deprivation-related adversities, including poverty and emotional neglect. Although emotional neglect was associated with cognitive theory of mind, this association was no longer significant after adjusting for exposure to violence. These findings suggest that difficulties with cognitive theory of mind are largely driven by exposure to threatening early environments rather than by experiences of poverty and emotional neglect. What might explain this pattern? One possibility is that children exposed to more chronic violence become hypersensitive to potential cues of hostile intentions, a positive adaptation that facilitates the quick decision making necessary for escaping from or responding to dangerous individuals ( Dodge et al., 1990 ; Pollak & Kistler, 2002 ). Although advantageous in dangerous circumstances, the tendency to assume that others are harboring malevolent thoughts and plans may undermine children’s ability to learn antecedents to neutral and prosocial behaviors. As a result, these children can fail to accurately predict other peoples’ thoughts and intentions in a variety of safe contexts. Indeed, extensive evidence suggests that children exposed to violence exhibit these types of hostile attribution biases ( Dodge et al., 1990 ; 1995 ; Weiss et al., 1992 ). Another possibility is that children who experience violence have less experience with perspective taking. Caregivers who engage in abusive and violent behaviors frequently model inappropriate emotional and behavioral responses and children raised in these environments likely have few opportunities to observe adaptive perspective taking. A growing body of research also suggests that parents of children raised in neighborhoods with higher rates of violence exposure are more likely to limit their children’s social activities in order to limit exposure to more violence ( Garbarino, Kostelny, & Dubrow, 1991 ; Letiecq & Koblinsky, 2004 ). This parenting practice is protective in dangerous areas, yet it may inadvertently restrict exposure to a wide range of interpersonal peer and adult interactions that could stimulate theory of mind development.

In addition to difficulties with cognitive theory of mind, we also found that children who have experienced violence also performed more poorly at affective theory of mind, which required them to understand how another person might feel in a specific context. This pattern of poor performance during affective theory of mind was specific to threat-related adversity (i.e., violence exposure), was unrelated to poverty and emotional neglect, and remained similar with regard to associations with violence even after controlling for these deprivation-related adversities. Moreover, emotional abuse and the total frequency of violence exposure were the adversities that had the strongest associations with affective theory of mind. How might interpersonal violence, and emotional abuse in particular, alter affective theory of mind? Violence typically reflects an emotional reaction that is inappropriate to the situation at hand. Over time, repeated encounters with extreme negative emotion and difficulty controlling behavioral responses to those emotions may alter children’s views about the situations that trigger negative emotions, the intensity of these emotions, and appropriate corresponding behavior. As a result, we would expect that children who have routinely experienced violence would have more difficulty with affective theory of mind. Here, we found that poor performance on affective theory of mind in children was associated with greater frequency of violence exposure. These findings extend those of a prior study showing that young children who were bullied had more difficulty identifying relevant contextual causes of emotions ( Belacchi & Farina, 2010 ). Children who experienced emotional abuse also had particular difficulty with the affective theory of mind task. As emotional abuse involves subjecting children to threats of violence and emotional cruelty, it is unsurprising that this form of maltreatment may limit a child’s ability to understand and be able to predict a broader range of prosocial emotions in others.

Our second aim was to examine whether atypical performance across cognitive and affective theory of mind accounted for greater levels of externalizing behavior and conduct problems in children. Although children and adolescents with high levels of externalizing problems performed just as quickly as children who were not aggressive when considering the thoughts, intentions, and beliefs of others, they were less accurate at cognitive theory of mind. This finding builds upon prior research linking difficulties in cognitive theory of mind with aggression in younger children ( Cicchetti et al., 2003 ; O’Reilly & Peterson, 2015 ; Pears & Fisher, 2005 ), by demonstrating that this association persists well into adolescence. Consistent with expectations, we also found that lower accuracy predicting how others might be feeling across a variety of social situations was associated with greater levels of externalizing problems, and higher likelihood of receiving a conduct disorder diagnosis. Slower reaction times during affective theory of mind were also associated with greater levels of externalizing behavior. These findings extend the literature by highlighting the potential importance of difficulties with the affective dimension of theory of mind for children with a variety of externalizing psychopathology symptoms, a topic that has been studied infrequently. Our finding is consistent with the limited existing evidence that children and adolescents with conduct problems exhibit problems not only with cognitive, but also affective, forms of theory of mind ( Hughes, Dunn, & White, 1998 ). This pattern is also broadly consistent with the well-documented difficulties with social information processing observed among children with externalizing problems ( Dodge et al., 1990 ), which often emerge in situations where the intentions and emotions of others are ambiguous or unclear. Anticipation of negative interpersonal consequences, specifically the victim’s immediate negative emotions and the resulting negative judgment from peers and adults, provides a strong rationale for inhibiting rule breaking and aggression. Failure to anticipate these consequences may contribute to externalizing behavior in adolescents with theory of mind deficits. However, not all youth with impairments in perspective taking behave aggressively. For example, a sizable proportion of children and adolescents with autism-spectrum disorders are not aggressive ( Kanne & Mazurek, 2011 ). The specific pattern of mentalizing difficulties characterized by difficulty understanding the intentions and feelings of others paired with a tendency to assume hostile emotions and intentions in ambiguous social situations (i.e., hostile attribution bias; Dodge et al., 1990 ; Molano, Jones, Brown, & Aber, 2013 ; Pornari & Wood, 2010 ) may differentiate children whose difficulties with theory of mind contribute to risk for aggressive behavior from those who do not become aggressive. As a result of their inaccurate predictions of others’ thoughts and feelings, these children may also need more time to consider why people are feeling contrary to their expectations in any given situation.

Our findings suggest that alterations in cognitive and affective theory of mind represents a plausible mechanism that may contribute to risk for externalizing problems among children who have experienced violence. It is possible that difficulties with cognitive and affective theory of mind may contribute to the well-established social information processing biases that have previously been identified as a mechanism in the cycle of violence ( Dodge et al., 1990 ; 1995 ). Moreover, our indirect effects models indicate that difficulty accurately predicting others’ intentions and emotions might represent a vulnerability factor for a broader range of externalizing behaviors that emerge specifically after exposure to forms of early adversity that involve a high degree of threat (i.e., violence exposure) but not following exposure to material and emotional deprivation. For children who experience violence, the most critical time to accurately evaluate other people’s mental states occurs when there is a possibility that someone is hostile or threatening. Developing hyper-sensitivity to cues that someone may be angry or hostile is a positive adaptation to living in dangerous environments, alerting children to seek safety either by escaping or responding aggressively for self-protection. Attunement to what other people are thinking or feeling during more routine interactions may be far less important for adapting to an environment characterized by threat. Indeed a small number of studies indicate that children exposed to interpersonal violence exhibit impairments in social cognition and emotion perception characterized by high sensitivity to hostility in others yet insensitivity to other types of emotions and cognitions ( Barahal et al., 1981 ; Bowen & Nowicki, 2007 ; Cicchetti et al., 2003 ; Elbedour, Baker, & Charlesworth, 1997 ; Pollak et al., 2000 ; Pollak & Kistler, 2002 ; Pollak & Sinha, 2002 ; Pollak & Tolley-Schell, 2003 ; Shackman & Pollak, 2005 ; Smetana, Kelly, & Twentyman, 1984 ). Together with our findings, these patterns suggest that hypersensitivity to threat and hostility in others comes at the expense of understanding the full range of intentions, beliefs, and emotions that other people experience among children who have experienced violence. Although this pattern of social information processing may promote safety in dangerous environments, it also appears to confer risk for externalizing problems.

Our findings should be interpreted with caution given the following limitations. First, these data are cross-sectional, which precludes us from examining deficits in theory of mind and changes in externalizing and conduct problems over time or making strong conclusions about the role of theory of mind as a mechanism in the cycle of violence. For this reason, we interpret the results of the indirect effects models with caution. An important next step will be to replicate these findings in longitudinal studies, which we aim to do once the longitudinal portion of this study is complete. Second, children and adolescents may have been motivated to under-report their own aggressive behavior (e.g., Cantwell et al., 1997 ). However, this limitation was addressed by including parent report of aggression and externalizing symptoms and parent diagnostic interview data. Third, the theory of mind task was originally designed for use in a neuroimaging study ( Sebastian et al., 2012 ), where constrained variability in task accuracy is advantageous, in order to ensure neural processes are specific to the cognitive processes of interest. Indeed, our sample generally performed near ceiling on this task, suggesting it may not be capturing the more complex social situations requiring perspective taking that are relevant for older children and adolescents. At the same time, poor performance on this task likely reflects particularly severe impairment in theory of mind, suggesting our findings are robust even when using conservative measures of theory of mind. It will be important for future research to develop assessments that are sensitive to a broader range of theory of mind abilities, in particular affective theory of mind. Fourth, we relied on child and parent report of maltreatment rather than substantiated records provided by Child Protective Services. While it is possible that some families may have withheld abuse histories from study investigators, prior research has demonstrated that reliance on CPS records results in significant under-classification of maltreatment exposure (Widom, Weiler, & Cottler, 1999). Finally, because we did not include a measure of physical neglect in our sensitivity analyses, we cannot conclude that violence exposure has greater effects on theory of mind than all forms of deprivation.

We provide novel evidence for the potential role of difficulties with cognitive and affective theory of mind in the cycle of violence. Children exposed to a many forms of interpersonal violence demonstrated greater difficulty in predicting other people’s thoughts, intentions, and beliefs and were less accurate at identifying others’ emotions across a variety of contexts. This pattern of poor theory of mind ability appears to be specific to adverse environments characterized by danger, as other forms of adversity characterized by emotional and material deprivation—including poverty and emotional neglect—were unassociated with theory of mind after accounting for violence exposure. The same pattern of difficulties with cognitive and affective theory of mind observed among children exposed to violence was associated with externalizing problems. These findings suggest that preventive interventions that target perspective taking may be useful for preventing the development of externalizing behavior among children who have experienced violence. It may also be useful to consider supplementing evidence-based trauma treatments (e.g., trauma-focused cognitive behavioral therapy; see Dorsey et al., 2017 for a review) with modules that specifically target these social-cognitive abilities. Future longitudinal research is needed to further disentangle the ways in which violence exposure in childhood alters the development of social cognitive processes in ways that increase risk of aggression. Identifying these mechanisms is critical for breaking the cycle of violence.

Supplementary Material

Acknowledgments.

This research was supported by a Doris Duke Fellowship for the Promotion of Child Wellbeing to Charlotte Heleniak, and by grants from the National Institute of Mental Health to Charlotte Heleniak (F31-MH108245) and to Katie McLaughlin (R01-MH103291).

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Crime and Courts

Hochul unveils plan to fight gun violence, domestic terrorism after buffalo shooting, authorities allege that an 18-year-old, white gunman committed the massacre at the tops friendly market-- a massacre they say was driven by racism, published may 18, 2022 • updated on may 18, 2022 at 6:01 pm.

Gov. Kathy Hochul revealed proposed measures to combat the rise of domestic terrorism and violent extremism, as direct response to racist shooting attack at a Buffalo, New York, grocery store that killed 10 on Saturday .

"The horrific and despicable act of terror committed by a white supremacist this past weekend in Buffalo showed that we as a country are facing an intersection of two crises: the mainstreaming of hate speech - including white nationalism, racism and white supremacy - and the easy access to military-style weapons and magazines," Hochul said in a statement following her announcement Wednesday. "This is a wake-up call and here in New York we are taking strong steps to directly address this deadly threat."

Hochul signed two executive orders, with the first calling for the Division of Homeland Security and Emergency Services to establish a new unit, dedicated solely to the prevention of domestic terrorism.

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According to Hochul's office, the creation of the new unit referenced in one of the executive orders "will focus on threat assessment management, disbursing funding to localities to create and operate their own threat assessment management teams and utilizing social media to intervene in the radicalization process. It will also educate law enforcement members, mental health professionals and school officials on the recent uptick in domestic and homegrown violent extremism and radicalization, as well as create best practices for identifying and intervening in the radicalization process."

Additionally, this executive order also calls for the state police to establish a dedicated unit within the New York State Intelligence Center to track domestic violent extremism through social media.

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Meanwhile, the second executive order that Hochul signed will require the state police to file an Extreme Risk Protection Order (ERPO) under New York State's Red Flag Law whenever they have probable cause to believe that an individual is a threat to themselves or others.

Typically, red-flag laws, also known as extreme risk protection orders, are intended to temporarily remove guns from people with potentially violent behavior, usually up to a year. In many cases, family members or law enforcement must petition the court for an order, though New York is a rare state in which educators can also start the process.

Removing weapons for that long, however, requires a hearing in which prosecutors must convince a judge that the person poses a risk. Most states also block the person from buying more guns during that period.

Red-flag laws are often adopted after tragedies. Florida did so after the 2018 mass shooting at Marjory Stoneman Douglas High School in Parkland that killed 17 students. Law enforcement officials had received numerous complaints about the 19-year-old gunman’s threatening statements.

"Today, I issued Executive Orders to devote substantial resources and focus toward combating the troubling surge in domestic terrorism by identifying radicalized individuals and tracking their threats amplified on social media, and further empower State Police to keep guns away from dangerous people," Hochul said.

The governor also issued a referral letter to Attorney General Letitia James to probe social media's role in the Buffalo shooting. Investigators will look at online resources the gunman "used to discuss and amplify his intentions and acts to carry out this attack."

Amazon's Twitch, Discord, 4chan Face New York AG Probe After Buffalo Shooting

Hochul said she will also work with legislators to pass two bills that aim to address and streamline the investigations connected to gun-related crimes, including "semiautomatic pistols manufactured or delivered to licensed dealers in the state to be microstamping-enabled" in order to mark bullets and casings and link them to potential crimes.

The second bill calls for law enforcement agencies to report the recovery of a gun connected to any crime within 24 hours of their discovery.

Hochul is also proposing new legislation to close a gun loophole by widening the definition of a firearm in order to make more guns subject to preexisting firearm laws.

The executive orders and proposed legislation come following the tragic events over the weekend in which authorities allege that an 18-year-old, white gunman committed the massacre at the Tops Friendly Market-- a massacre they say was driven by racism. Authorities have said that the suspect allegedly planned to continue his rampage down the street before he was stopped.

Authorities said he shot, in total, 11 Black people and two white people. The shooter livestreamed the attack on Twitch, prompting scrutiny of how fast social platforms react to violent videos .

Investigators pouring through the gunman's history and evidence obtained at the scene as well as house say he wanted to keep targeting Black Buffalo residents after the supermarket attack.

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The Cycle of Domestic Abuse

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Sociological Theories to Explain Intimate Partner Violence: A
To assess whether models of partner aggression (cycle of violence, family systems theory, Duluth model) fit with three patterns of system dynamics (periodic, chaotic, random) United States: Camargo (2019) To examine the correlation between intimate partner violence and the type of domestic decision-making: Bolivia, national study: Carbone-Lopez ...
Exploring factors influencing domestic violence: a comprehensive study
2.4.3. Density (B3) Moreover, the issue of overcrowding within households has emerged as another important factor influencing domestic violence. Overcrowding refers to the stress caused by the presence of a large number of individuals in a confined space, leading to a lack of control over one's environment (44).
Domestic Violence Theories
There is no single causal factor related to domestic violence. Rather, scholars have concluded that there are numerous factors that contribute to domestic violence. Feminists found that women were beaten at the hands of their partners. Drawing on feminist theory, they helped explain the relationship between patriarchy and domestic violence. Researchers have examined other theoretical ...
Cycle of violence in women victims of domestic violence: Qualitative
1. INTRODUCTION. Violence refers to the concept of power and the use of superiority over the other (Minayo et al., 2018).More specifically, domestic violence places women as victim and man as the aggressor and there is damage or lack of physical and psychological well‐being—Maria da Penha Law (Brazil, 2006; Cortez, Souza, & Queiróz, 2010): physical violence, psychological violence, or ...
Domestic Violence and Abuse: Theoretical Explanation and ...
Domestic violence and abuse (DVA) is a complex issue and it is important to understand how and why this happens. Such understanding can help find strategies to minimise DVA. Over past decades, many explanations have been proposed to explain DVA from various perspectives. This chapter aims to present an aggregated overview of that information to ...
A behavioral approach to understanding domestic violence: A functional
The purpose of this study is to introduce a new Battering Assessment Tool (BAT) consisting of 54 antecedents and 57 reinforcing or nonreinforcing consequences that is designed to assess contingencies based on self-report data and potentially assist in the behavior modification of domestic violence perpetrators and victims. The voluntary participants were 70 male and 3 female perpetrators of ...
Untangling the concept of coercive control: Theorizing domestic violent
Domestic violence is an important form of coercion; a serious violent crime; and a cause and consequence of gender inequality. Frustrated with the limitations of the traditional approach to crime, a new field has emerged that treats domestic violence as if it has a distinctive aetiology, developing new concepts, including that of 'coercive control'.
Women living with domestic violence: Ecological framework-guided
Domestic violence, particularly intimate partner violence, remains a major health problem and a violation of human rights ... The studies adopted the following designs - descriptive qualitative (n = 18), grounded theory (n = 5), phenomenological approach (n = 8), exploratory (n = 4), consensual (n = 1), and mixed methods (n = 1). The ...
The Development of Attitudes Toward Intimate Partner Violence: An
Social learning theory remains one of the leading explanations of intimate partner violence (IPV). Research on attitudes toward IPV represents a logical extension of the social learning tradition, as it is intuitive to expect that individuals exposed to violence in the family of origin may internalize behavioral scripts for violence and adopt attitudes accepting of IPV.
Empowerment and intimate partner violence: Domestic abuse when
Intimate partner violence (IPV) is the most common form of violence against women, and approximately one third of all women worldwide have been exposed to physical or sexual abuse by an intimate partner (Devries et al., 2013). One prominent policy response to domestic abuse is the implementation of projects that aim to promote women's ...
Domestic Violence in Families: Theory, Effects, and Intervention
The effects of child abuse and exposure to domestic violence on adolescent internalizing and externalizing behavior problems. Journal of Family Violence, (25), 53-63. doi: 10.1007/s10896-009-9269-9. Richards, K. (2011). Children's exposure to domestic violence in Australia. Trends and Issues in crime and criminal justice, (419), 1-5.
Domestic Violence and Its Effects on Women, Children, and Families
Abstract. Men and women experience severe domestic violence (DV) and intimate partner violence (IPV); however, women and children remain especially vulnerable. Violence along the DV/IPV continuum has been recognized as a type of child maltreatment and a child's awareness that a caregiver is being harmed or at risk of harm is sufficient to ...
A multitheoretical perspective for addressing domestic and family
Domestic and family violence remains a significant challenge to family wellbeing. The risk of serious harm from domestic and family violence is disproportionally carried by women and children, yet often the complex reality of family life means that many families have ongoing contact with their abusers.
A review of "Understanding Domestic Violence: Theories, Challenges and
These factors alone are not the bases for therapy alone that are effective in reducing the risk of domestic violence in clients. Herron and Javier (Chapter 5) offer an in-depth look at the psychodynamic theory of domestic violence, offering the reader a means to look at how the past influences feelings and behaviors in the present.
Evolutionary Approaches to Domestic Violence
Definition. Domestic violence is physical, psychological, or sexual abuse between intimate partners, offspring, parents, and siblings within a family structure. Evolutionary approaches illuminate the psychological mechanisms that underpin these behaviors. Partner abuse has been explained as a male mate guarding strategy.
Understanding domestic violence against women: using evolutionary
According to this hypothesis, domestic violence varies with women's reproductive value or expected future reproduction, declining steeply as women age. We tested this hypothesis with a sample of 3,969 cases of male-perpetrated partner-abuse reported to a single police precinct in a large urban area over a 14-year period. Results show that (a ...
Long-Term Impact of Domestic Violence on Individuals—An Empirical Study
Domestic violence includes not only physical violence but also mental violence with regard to neglect, emotional abuse, etc. Therefore, this study estimates a domestic violence index from the four aspects of injury from violence, negligent care, emotional abuse and witnessing domestic violence, and then takes the CHARLS (2011, 2013, 2015, 2018 ...
PDF THE "CYCLE OF VIOLENCE"
oppressions and vulnerabilities to injustice".10 The impact and prevalence of domestic violence can be higher when domestic violence is layered with forms of oppression in race, gender, sexuality, and class.11 In addition, In addition, the response to domestic violence from service systems is not equal. Victims may also face
Sociological Theories of Intimate Partner Violence
Family violence theories (including systems theory, ecological theory, exchange/social control theory, resource theory, and the subculture-of-violence theory) view intimate partner violence as an expression of conflict within the family that can best be understood through examination of social structures contributing to the use of violence.
A qualitative quantitative mixed methods study of domestic violence
Violence against women is one of the most widespread, persistent and detrimental violations of human rights in today's world, which has not been reported in most cases due to impunity, silence, stigma and shame, even in the age of social communication. Domestic violence against women harms individuals, families, and society. The objective of this study was to investigate the prevalence and ...
PDF Causes and Theories of Domestic Violence
domestic violence. Learning Objectives: Facilitator: At the end of this session, participants will be able to: - Identify and evaluate different theories of domestic violence. - Explain how the theory of violence used dictates the response to domestic violence. - Identify domestic violence as intentional, learned behavior designed to achieve
Social-Cognitive Mechanisms in the Cycle of Violence: Cognitive and
Exposure to emotional abuse (on the CECA, or above the validated CTQ threshold) and domestic violence (on the VEX-R interview or PTSD-RI trauma screen) was determined based on child report only. A total of 76 children (30.9%) reported experiencing emotional abuse and 94 (38.2%) reported witnessing domestic violence.
Representing Three Discourses on the Roots of
Violence frighteningly gly prevalent against prevalent throughout women the world. throughout Estimates by their domestic the world. partners Estimates is of the prevalence of violent domestic relationships range from l-in-5 to nearly 8-in-10, depending on country (Heise 1995). The health impact of violence greatly exceeds the daily log of.
Hochul Unveils Plan to Fight Gun Violence, Domestic Terrorism After
Hochul Unveils Plan to Fight Gun Violence, Domestic Terrorism After Buffalo Shooting Authorities allege that an 18-year-old, white gunman committed the massacre at the Tops Friendly Market-- a ...

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Theories of Domestic Violence:

Cycle of Violence

Exchange Theory

Identity Theory

Social Learning Theory

Victim-Blaming Theory

Lauren Isaac, MSW

Domestic Violence in Families: Theory, Effects, and Intervention

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A review of "Understanding Domestic Violence: Theories, Challenges and Remedies," edited by Rafael Art. Javier and William G. Herron

Evolutionary Approaches to Domestic Violence

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Understanding domestic violence against women: using evolutionary psychology to extend the feminist functional analysis

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A qualitative quantitative mixed methods study of domestic violence against women

Conclusions

Qualitative method

Quantitative method

Qualitative results

Husband’s criminal record

Inappropriate age for marriage

Overdependence

Bitter memories

Lack of commitment to different roles

Fear and silence

Shame from society

Hope and trust

Efforts for children

Child-bearing thoughts

Lack of effective communication

Harm to children

After divorce

Social harm

Non-acceptance in the family

Emotional harm

Inappropriate family support

Inefficiency of social systems

Undesired training and advice

Quantitative results

Limitations

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BMC Women's Health

Social-Cognitive Mechanisms in the Cycle of Violence: Cognitive and Affective Theory of Mind, and Externalizing Psychopathology in Children and Adolescents

Katie A. McLaughlin

Associated Data

Maltreatment Exposure.

Externalizing Psychopathology.

Deprivation.

Statistical Analysis

Descriptive Statistics

Interpersonal Violence Exposure and Externalizing Psychopathology

Interpersonal Violence Exposure and Theory of Mind

Affective theory of mind.

Theory of Mind and Externalizing Psychopathology

Indirect Effects

Sensitivity Analyses