The Role of Co-Occurring Intimate Partner Violence, Substance Use, and Depression on Child Welfare-Involved Female Caregivers' Disciplinary Practices

Background and Purpose: Domestic violence (DV), alcohol/substance use, and depression are key risk factors for child welfare involvement. Taken together, they may have a concurring effect on child welfare-involved caregivers’ risk of using harmful disciplinary practices. However, to date, researchers studying this population have mainly studied these risk factors separately or conjointly with no investigation of their combined effect on child maltreatment risk. Our objective was to study the associations between DV, alcohol/substance use, and depression and self-reported disciplinary practices among a sample of child welfare-involved female caregivers, and the effect of co-occurrence of these factors on child disciplinary practices.

Methods: This analysis used data from the second round of the National Survey of Child and Adolescent Well-Being (NSCAW II). The sample included 923 female caregivers with children remaining in the home following a maltreatment investigation. Caregivers’ past-year physical DV victimization and child disciplinary practices were measured using different versions of the Conflict Tactic Scales. In addition, caregivers were determined as having an alcohol/substance use problem if either their caseworker reported so on the risk assessment or they met Alcohol Use Disorders Identification Test and/or Drug Abuse Screening Test criteria. Finally, caregivers were classified as having major depressive symptoms if they met Composite International Diagnostic Interview–Short Form criteria. Logistic regression analyses were conducted to test the independent associations between DV, alcohol/substance use, and depression and caregivers’ disciplinary practices, as well as the effect of co-occurrence on caregivers’ disciplinary practices.

Results: DV, alcohol/substance use and depression were co-occurring among caregivers in our sample. Only DV was independently associated with physical aggression disciplinary practices (p<.05); and DV and depression were independently associated with neglectful disciplinary practices (p< .05). Alcohol/substance use was not independently associated with any of the self-reported child disciplinary practices (p > .05). As the number of conditions caregivers had increased, so did their propensity for self-reporting neglectful disciplinary practices. Caregivers with one condition (OR 2.148, p = 0.017), two conditions (OR=3.767, p = 0.007), and three conditions (OR = 4.447, p = 0.009) reported using significantly more neglectful disciplinary practices than those with no potential co-occurring conditions. Neglect was the only disciplinary behavior significantly affected by co-occurring conditions.

Conclusions and Implications: Current child welfare policies mandate cross-system collaboration, however most child welfare collaborative efforts tend to focus only on one type of outcome (e.g., substance use versus mental health). Although our findings suggest that collaborations between child welfare and DV service providers may lead to decreased risk of physical child maltreatment, our findings strongly suggest that to effectively combat neglect - the most common type of child maltreatment in the United States- a multicomponent multi-level collaboration is necessary. Specifically, our model indicated that an integrated system of care focusing on child welfare-involved female caregivers’ risk of DV, alcohol/substance use, and depression might decrease risk of neglectful disciplinary practices. Thus, it is necessary for policymakers to shift thinking from interdisciplinary child welfare service efforts to a more a multidisciplinary approach.