The Damage Done - Children Exposed to Intimate Partner Violence and their Mothers: Towards empirically based interventions in order to reduce negative health effects in children

Violence in intimate relationships occurs in all societies, and intimate partner violence (IPV) is a prevalent and serious social problem. Mothers of young children are particularly often victims of IPV, the consequences of which often have long-lasting effects. Research has convincingly brought to light the detrimental effects of IPV on women’s psychological and physical health. Too many children are raised in homes where IPV occurs. There is now a substantial body of research of the harm that IPV exposure can inflict on children’s health and development. Nationally and internationally there have been calls for research evaluating support services for children and their mothers in the aftermath of IPV. Since 2007, the Social Services Act has prescribed the responsibility of social services for ensuring that children who witness violence receive the support and help they need. International knowledge is limited about the effectiveness of most methods developed within and outside social services to support children who have witnessed violence against their mothers. In Sweden, empirically based knowledge is almost nonexistent. The data presented in this thesis comes from a national project evaluating the support available to children exposed to IPV and to their mothers, and from an earlier pilot project. After receiving support, children (9 to 13 years of age) in the national evaluation study reported reduced symptom levels of post-traumatic stress and general psychological problems, and their mothers reported significant reductions in the children’s behavioral problems. However, despite the statistically significant results, the majority of children were unchanged following support, and many children with clinical levels of problems at study entry continued to have elevated symptoms following support. The same pattern, with significant treatment effects at the group level of analysis, but more modest results at the individual level of analysis, were found for the self-rated mental health of mothers subjected to IPV and their perceptions of their children’s behavioral problems after they and their children attended concurrent 15-week group support programs. The treatment results point to the need to monitor treatment progress in order to detect those who are unchanged or even worsened during treatment. As a group, children 9 to 13 years old who were exposed to IPV evidenced lower quality of life and more recurrent health complaints than other Swedish children in the same age range. However, there was great variability among the children, and a large proportion of the children rated their quality of life to be as good as other children of the same age and did not have recurrent symptoms of headache, stomach-ache, or difficulties sleeping. Higher quality of life in children was associated with higher attachment security to both parents, better capacity for emotion regulation, and lower negative emotionality, whereas more ii recurrent health complaints were associated with higher exposure to IPV and higher negative emotionality. These results point up the importance of looking at the individual characteristics of children to better understand their adjustment after exposure to IPV, and to determine the best factors to target in individual interventions.