Variability in Adjustment Outcomes Among Siblings Exposed to Intimate Partner Violence

Background:

Child exposure to intimate partner violence (IPV) is a significant problem, and is associated with poor behavioral and physical health outcomes across all stages of child development. While literature explores protective factors (individual, familial, contextual) that buffer children from the negative effects of childhood IPV exposure, few studies have investigated the role of sibling relationships. This systematic review aims to examine the current body of literature of siblings exposed to IPV and provide recommendations for future research. The two primary goals of this review are to assess how adjustment outcomes vary among siblings based on structural characteristics (birth order, age, gender), and how positive sibling relationship qualities (warmth, engagement, conflict resolution) promote resiliency.

Methods:

Five electronic databases (CINAHL, Medline PubMed, Medline Ebsco, PsychINFO, Social Science Citation Index) were searched for articles about IPV-exposed siblings published from January 1990 to February 2018. After de-duplication, 325 citations were identified for screening. Doctoral-level research assistants independently coded each article for inclusion to or exclusion from, and discrepant decisions were reconciled by a third coder. Inclusion criteria were as follows: (1) published in English; (2) children were exposed to at least one incident of any form of IPV (verbal, emotional, physical, sexual); (3) observational study; (4) included a focal child and at least one sibling; (5) at least one outcome addressed child behavioral or physical health, and is measured for both children; (6) published article or grey literature; (7) utilized validated/reliable scale or biological data; and (8) sample comprised of children ages 5-12 due to the salience of sibling relationships during middle childhood. Exclusion criteria were if studies were retrospective or focused exclusively on negative sibling relationship characteristics. Included articles were summarized and assessed for methodological quality.

Results:

Eight studies were identified for inclusion in this review. Seven out of eight studies investigated birth order, three studies considered age, and three studies considered gender. Across studies, differences in adjustment outcomes were consistently observed based on birth order, but findings observed for age and gender were less consistent. Positive sibling relationship quality was found to both mediate and moderate the relationship between exposure to IPV and adjustment outcomes. Siblings with relationships characterized by more warmth exhibited fewer poor adjustment outcomes as compared with siblings who engaged in more hostility. Quality assessments of studies found identified potential cofounders (e.g., child maltreatment, parental differential treatment), and possible performance and detection biases were present in studies with observational measures.   

Conclusions:

This review suggests that among siblings exposed to IPV (1) adjustment outcomes vary by sibling structural characteristics and (2) positive sibling relationships can be protective. Further research is needed to clarify the role of structural characteristics (birth order, age, gender) in predicting variability among outcomes of siblings exposed to IPV. Research is also needed to advance theoretical conceptualizations and measurement approaches of sibling relationships for future development of effective sibling interventions.