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In recent years, researchers have focused on acquiring a better understanding of the development of posttraumatic stress disorder (PTSD) in children under the age of six following exposure to chronic trauma, such as intimate partner violence (IPV). Despite a number of empirical studies on early childhood PTSD, few have examined how children differ in the clinical presentation of PTSD symptomatology. There may be wide variability in the presentation of symptoms within the four clusters of PTSD symptoms: re-experiencing, alterations in physiological arousal, negative alterations in cognitions and mood, and avoidance. Symptoms of physiological arousal may be particularly difficult for parents and therapists to identify and report on because many of these symptoms are internal sensations (e.g. racing heart beat), and they are most often evaluated out of context (e.g. in reports of past behaviour). Thus, little is known about the presentation of these symptoms in preschoolers. To better identify physiological arousal symptoms as they occur, this study examined therapists' qualitative reports on the presentation of physiological symptoms of 56 young children exposed to IPV while they participated in an intervention programme. Results indicated that children were most likely to exhibit emotion dysregulation, behavioural outbursts, mood swings and temper tantrums when physiologically aroused. The presence of temper tantrums as a component of arousal and reactivity is consistent with recent "Diagnostic and Statistical Manual of Mental Disorders" (fifth edition) changes, which include these elements as new criteria for PTSD in children aged six and younger. Behavioural examples are described and implications discussed for clinical intervention.

Although intimate partner violence (IPV) is a particularly prevalent public health concern among Latina populations, the evidence-based treatment options for Latinas who experience IPV are limited. The present study tested the efficacy of the Moms' Empowerment Program (MEP), an intervention for Spanish-speaking Latina mothers who had recently experienced IPV. Participants (N = 95) were assigned to a Treatment (n = 55) or a waitlist Control (n = 40) condition, and those in the Treatment group completed a 10-week intervention designed to address the problems associated with IPV. Intent-to-treat analyses using multiple regression revealed that Latinas' participation in the MEP was associated with reductions in IPV exposure. These findings provide preliminary evidence that the MEP may reduce exposure to physical violence among Spanish-speaking Latinas., Author(s): Hannah M. Clark [sup.1] , Andrew Grogan-Kaylor [sup.2] , Maria M. Galano [sup.1] , Sara F. Stein [sup.1] , Nora Montalvo-Liendo [sup.3] , Sandra Graham-Bermann [sup.1] Author Affiliations: (Aff1) [...]

Post-traumatic stress disorder (PTSD) is a serious problem for children exposed to intimate partner violence (IPV). Recent changes to diagnostic criteria for PTSD include a reduction in avoidance symptom criteria from three to one and the separation of emotional numbing from avoidance symptoms, thus creating a need to better understand how avoidance symptoms of PTSD present themselves in young children. This study evaluated 56 children aged four to six as they participated in an intervention for mothers and children exposed to IPV. Therapists documented behaviours indicative of avoidance symptoms during group sessions. Data were analysed and coded into symptom categories and thematically emergent domains. Results demonstrated that avoidance symptoms fell into three separate categories: physical avoidance, emotional avoidance, and changing topics. Additionally, the data support the "Diagnostic and Statistical Manual of Mental Disorders" (5th edition) change to remove emotional numbing from the avoidance symptom category. These results give insight into how to develop more targeted treatments for PTSD as well as improve the assessment and diagnosis of PTSD symptoms in preschoolers.

Childhood exposure to intimate partner violence (IPV) can have lasting effects on well-being. Children also display resilience following IPV exposure. Yet, little research has prospectively followed changes in both maladaptive and adaptive outcomes in children who experience IPV in early life. The goal of the current study was to investigate how child factors (irritability), trauma history (severity of IPV exposure), maternal factors (mental health, parenting), and early intervention relate to trajectories of behavior problems (internalizing and externalizing problems) and resilience (prosocial behavior, emotion regulation), over 8 years. One hundred twenty mother-child dyads participated in a community-based randomized controlled trial of an intervention for IPV-exposed children and their mothers. Families completed follow-up assessments 6–8 months (N = 71) and 6–8 years (N = 68) later. Although intention-to-treat analyses did not reveal significant intervention effects, per-protocol analyses suggested that participants receiving an effective dose (eight sessions) of the treatment had fewer internalizing problems over time. Child irritability and maternal parenting were associated with both behavior problems and resilience. Maternal mental health was uniquely associated with child behavior problems, whereas maternal positive parenting was uniquely associated with child resilience. Results support the need for a dyadic perspective on child adjustment following IPV exposure. [ABSTRACT FROM AUTHOR]

Executive functioning (EF), or a set of related cognitive skills that facilitate goal-oriented behavior, is a critical aspect of adaptive development. Mounting research indicates that exposure to environmental threats during the preschool years jeopardizes EF; however, the extent and mechanisms through which early exposure to intimate partner violence (IPV) influences children's EF are unknown. Using data from an eight-year longitudinal investigation of mothers who had experienced IPV and their preschool-aged children (N = 120), this study examined the relative influence of recent and remote IPV exposure on speeded control—a component of EF influenced by processing speed—in late childhood. Results indicated that preschoolers' IPV exposure had a significant negative impact on their speeded control eight years later, and this relation was mediated by the remote effects of IPV on their mothers. Specifically, IPV was positively associated with maternal depression, which in turn contributed to greater use of negative parenting strategies when children were of preschool age. Children's IPV exposure during late childhood was not predictive of their concurrent speeded control. These findings lend further evidence to the notion that the preschool years are a sensitive period for the mastery of EF skills and that IPV exposure is a distinct risk factor that can have protracted effects on children's cognitive development. Further, this study points to modifiable environmental risk factors, which, through targeted prevention and intervention efforts, could promote EF across the lifespan. [ABSTRACT FROM AUTHOR]

Mothers experiencing intimate partner violence (IPV) have been found to have negative long-term parenting outcomes, such as reduced maternal involvement and greater use of physical punishment, which represent potential pathways by which IPV negatively affects children. Factors influencing these parenting practices have not been examined in IPV-exposed Latinas. The aim of this study is to understand the factors that affect maternal involvement and spanking by Latinas to contribute to culturally-informed intervention development and refinement. A total of 93 Spanish-speaking Latinas who had experienced IPV completed standardized measures of maternal involvement, spanking, IPV, depression, and posttraumatic stress (PTS) and provided demographic information. Slightly over half of the women participated in an intervention program. Longitudinal multilevel modeling (MLM) demonstrated that higher levels of maternal depression predicted lower levels of involvement over time. PTS reexperiencing symptoms were positively related to involvement, such that mothers with higher levels of reexperiencing reported higher levels of involvement. An independent longitudinal MLM revealed that higher amounts of IPV exposure and higher levels of PTS arousal symptoms were associated with higher levels of spanking, while maternal employment was associated with lower levels of this same parenting behavior. Maternal involvement increased over time, where there was no significant change in spanking over time, and no effect of the intervention program on either parenting practice. Results suggest clinical interventions should target reductions in depression and specific PTS symptom subdomains as pathways to improving parenting in IPV-exposed Latinas. Continued study is needed to understand the relationship between reexperiencing and maternal involvement. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a pervasive social issue with broad physical and mental health implications. Although 35%-56% of women report IPV victimization with more than one violent partner, few studies have identified factors that increase the risk of experiencing IPV across multiple partners (i.e., IPV reengagement). In the current study, multilevel modeling was used to examine the roles of trauma exposure, mental health, and sociodemographic factors in the risk for reengagement in a sample of women (N=120) with IPV victimization. Participants were drawn from a randomized control trial of an intervention for mothers who had experienced IPV. The results revealed that more psychological but less sexual IPV was associated with increased reengagement. Higher degrees of posttraumatic reexperiencing symptoms were associated with less reengagement. Depressive symptoms were also significantly associated with reengagement such that lower levels of positive affect and increased somatic symptoms were associated with increased reengagement. Higher income levels and less housing instability were associated with more reengagement, βrange = -.13-.16. Finally, compared to the control condition, participation in the intervention program was significantly associated with lower levels of reengagement at 8-year follow-up, β=-.75, p = .001. These findings suggest that it is not what happened (i.e., experiences of abuse) but rather a woman's posttraumatic experience (i.e., posttraumatic stress and depressive symptoms) that creates risk for reengagement. The findings support the long-term effectiveness of a brief intervention in reducing reengagement. [ABSTRACT FROM AUTHOR]

Childhood exposure to intimate partner violence (IPV) is associated with a host of problems, including the development of posttraumatic stress symptoms (PTSS). PTSS include a wide range of unique symptomatology and as a result, clinical presentations of PTSS can vary in both distribution and overall number of symptoms. Work in child and adolescent samples has largely focused on factors predicting the total number of symptoms (i.e., symptom severity), with less work focused on both patterns of symptom number and distribution. Furthermore, few studies have examined how functional impairment varies in relation to PTSS presentation. The goal of the current study is to (a) document patterns of PTSS severity and distribution in children with histories of witnessing IPV, (b) examine the factors that predict different PTSS presentations, and (c) investigate how PTSS presentation is associated with functional impairment. Data for this study were drawn from a sample of 236 children between the ages of 4 and 12 years and their mothers who had experienced recent IPV. Families reported high levels of IPV in the past year, and children reported moderate levels of PTSS. A latent profile analysis of PTSS revealed that three profiles were the best-fitting model for the data. The three profiles were differentiated between low, moderate, and high levels of PTSS, and membership in the profiles varied by children's age and trauma history. The results of this study give important information about the potential development of PTSS as well as clinically useful information about the relationship between children's PTSS and their functioning following exposure to IPV. [ABSTRACT FROM AUTHOR]

Millions of children witness intimate partner violence (IPV) each year, and the effects of these experiences are substantial. One of the more common sequelae of exposure to IPV is the development of posttraumatic stress symptoms (PTSS). Given the chronic nature of both IPV and PTSS, there is a need for prospective research on long-term mental health outcomes following IPV exposure in childhood. This study prospectively examines trajectories of PTSS over an 8-year period, beginning from the preschool period. This study also investigates factors that may be associated with these trajectories, including intervention participation, continued IPV exposure, and the caregiving environment. A total of 120 mother–child dyads participated in four study waves over an 8-year period, beginning when children were between the ages of 4 and 6. Mothers and children participated in an intervention between baseline and Time 2. At the onset of the study, all mothers reported experiencing IPV over the previous year. Findings demonstrate that, in general, children experienced worsening of their PTSS over the 8-year trajectory, and few factors were significantly associated with this trajectory. There were no associations between intervention participation, parenting behaviors, and long-term child PTSS outcomes; however, there were significant associations between amount of IPV exposure, mother's level of PTSS, and children's PTSS outcomes. These results underscore the need to better understand the impact of early-life exposure to IPV, as well as the need for interventions tailored to this developmental period. Furthermore, these findings highlight the long-term negative associations between chronic exposure to IPV and child well-being, as well as the significant connections between caregiver and child mental health. [ABSTRACT FROM AUTHOR]

Limited psychometric information is available to guide best practices for measuring youth irritability. This report compares performance of irritability measures using item response theory (IRT). Study 1 used a sample of 482 early adolescents and compared the parent- and youth-report affective reactivity index (ARI) and irritability factors derived from the parent-report Child Behavior Checklist (CBCL) and clinician-administered Kiddie Schedule for Affective Disorders (K-SADS). Study 2 combined data from three childhood samples (N = 811) and compared performance of the parent-report ARI and CBCL and the clinician-administered Preschool Age Psychiatric Assessment (PAPA). The ARI emerged as the best measure of childhood irritability across the developmental periods, while the CBCL and K-SADS provided an adequate amount of information in early adolescents. No measure reliably assessed irritability at modest severity levels. Using IRT across large pools of developmental samples and measures is needed to guide the field in the measurement of youth irritability. [ABSTRACT FROM AUTHOR]

Although one in four women in the United States experience severe intimate partner violence (IPV) in their lifetimes and are at greater risk for homelessness and housing insecurity than women who have not experienced IPV, the factors increasing the vulnerability of women with an IPV history to housing instability have not been examined. This cross-sectional study utilized baseline data from interviews with 218 IPV-exposed women from diverse ethnoracial backgrounds participating with their children in the Kids' Club and the Mom's Empowerment Program, joint interventions designed to improve outcomes in families who have experienced IPV. Multiple regression was used to examine the predictors associated with housing instability, quantified as the number of times a participant had moved in the past 4 years. Demographic information was collected and exposure to violence was measured with the Conflict Tactics Scale (CTS); severity and prevalence of PTSD and depression symptoms were measured with the Posttraumatic Diagnostic Scale (PDS) and the Center for Epidemiologic Studies Depression Scale (CES-D), respectively. Results showed that level of education was positively associated with housing instability, while age of the participant, average monthly income, and increased severity of PTSD symptoms were negatively associated. Neither the participant's race nor the extent of reported violence significantly predicted participants' housing instability. The findings of this study may serve to better identify those who have experienced IPV that are most at risk of experiencing housing instability, and to inform future interventions and policy aiming to support their needs. In addition, these results further emphasize the importance of providing housing resources in addition to interventions designed to improve physical and psychosocial health in enabling women that have experienced IPV to gain independence from an abuser. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a significant social and public health problem that includes physical violence, sexual violence, threats of physical or sexual violence, stalking, and psychological aggression by an intimate partner. Estimates suggest that 35% of Latinas living in the United States experience IPV in their lifetime, with known severe negative outcomes. One mental health consequence of concern is depression, which disproportionately affects IPV-exposed Latinas. The present study tested the effectiveness of the Moms' Empowerment Program (MEP), a culturally adapted intervention to reduce depressive symptoms among IPV-exposed Spanish-speaking Latina mothers. Additional psychosocial predictors of levels of depressed affect over time are examined, including levels of post-traumatic stress, IPV exposure, positive parenting, parental acceptance of children's negative emotions, and maternal employment. Participants (N = 72) were assigned to a treatment or a wait-list comparison condition, and those in the treatment group completed a 10-week group intervention addressing the unique problems associated with IPV exposure, mental health, and parenting among Spanish-speaking Latinas. Results of multilevel modeling revealed that participation in the MEP was associated with significant reductions in depressed affect. Lower levels of post-traumatic stress and higher levels of positive parenting, maternal acceptance of children's negative emotions, and maternal employment predicted lower levels of depressed affect. The amount of total IPV exposure was not significantly associated with the extent of depressed affect. The MEP represents a culturally tailored, evidence-based intervention to reduce depressed affect among Spanish-speaking Latinas. The clinical implications of the additional predictors of levels of depressed affect are discussed. [ABSTRACT FROM AUTHOR]

Objective: The Moms' Empowerment Program (MEP) provides affordable services to address the effects of women experiencing intimate partner violence (IPV) and to enhance their mental health. In past evaluations with mothers of school-age children this ten-session program was successful in reducing women's symptoms of posttraumatic stress. Method: A new efficacy trial compares outcomes for women with preschool-age children who received the MEP to those randomly assigned to a waitlist comparison condition. Women with young children (N = 120) who had experienced IPV living in Southeast Michigan and Ontario, Canada, were assessed at baseline, 5 weeks later (at post-intervention) and at approximately 8-month follow-up. Using standardized measures, this evaluation compared rates of change in women's symptoms of posttraumatic stress. Results: Approximately 46% of the women were diagnosed with posttraumatic stress disorder (PTSD); 94% reported re-experiencing symptoms, 85% physiological arousal symptoms, and 69% avoidance/numbing symptoms. Hierarchical Linear Modeling (HLM) results showed that the MEP was somewhat successful in reducing women's symptoms of posttraumatic stress symptoms. However, the extent of improvement was related to both age and the number of sessions attended during the program. Conclusion: This finding indicates that mothers with young children, who have experienced IPV and who are significantly distressed, may be successfully treated by attending this group intervention designed specifically to address their unique experiences and needs. Clinical impact: High rates of traumatic stress and PTSD are found in women who experience intimate partner violence. A comparison study showed that a 10-session group intervention, the MEP, was success in reducing their traumatic stress. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a serious public health problem with known negative physical and mental health outcomes for women exposed. Studies have shown that with increased violence exposure, there are increased risks of negative outcomes for women. Likewise, chronicity of IPV across multiple partners is linked to more profound psychological suffering than acute exposure. However, little is known about the social- and individual-level characteristics of women that are correlated with engagement with multiple abusive partners. The current study (N = 164) identifies the characteristics of women that are associated with the number of violent partners with which they have been involved, with 35% of the sample reporting multiple IPV relationships. Participants reported on the number of violent partners, demographic characteristics, trauma history, current trauma and depressive symptoms, and exposure to IPV, including physical, sexual, and psychological violence. Results of multiple regression analysis indicate that trauma history (childhood sexual abuse, being held hostage, and torture) and current psychological violence were associated with women's engagement with multiple violent partners. Additional findings reveal that identification as African American and White was associated with greater re-engagement compared with identification as Latina. Finally, current exposure to sexual violence was associated with fewer violent partners. The clinical implications of these findings for treatment for women at risk for engagement with multiple partners in IPV relationships are discussed. [ABSTRACT FROM AUTHOR]