Development of Internalizing Behavior in Maltreated Children: Timing of Exposure to Intimate Partner Violence (IPV) and Sibling Structural Factors

Background and Purpose: Children experiencing maltreatment are at greater risk for exposure to intimate partner violence (IPV) and are at heightened risk of developing internalizing behavior problems (INT) than non-exposed children. Some IPV-exposed children continue to thrive and achieve optimal development, while some children are more vulnerable to the effects of IPV exposure. This study examined the heterogeneity in INT among children exposed to both IPV and child maltreatment by (1) identifying patterns of developmental trajectories of INT in maltreated children, (2) examining whether timing of IPV exposure was related to poorer outcomes, and (3) exploring whether sibling structural factors were related to resilient outcomes.

Method:  Cohort sequential growth mixture modeling (CS-GMM) estimated INT latent class trajectories for 1,770 children aged between 0-5 years at baseline from the National Survey of Child and Adolescent Well-Being (NSCAW). CS-GMM allows for the identification of the heterogeneity in the patterns of developmental trajectories of INT between birth to 10 years old. INT was assessed using the Child Behavior Checklist (CBCL) at 4 waves over 8 years. IPV exposure was female caregiver-reported using the Conflict Tactics Scale (CTS) physical assault subscale during three developmental stages: infancy/toddlerhood (birth to 2 years), preschool age (3-4 years), and school age (5-10 years). Sibling structure factors involved baseline sibship size and birth order. Covariates were included at the child-level (gender, race/ethnicity, substantiated child maltreatment, precious Child Protective Services involvement) and caregiver/family-level (income below poverty level, caregiver education, age). Using multinomial logistic regression, IPV exposure timing effects were estimated separately for the singleton (43%) and sibling (57%) samples, while considering covariates. Significance of sibling structure factors was estimated in the sibling sample.   

Results:  Half of children were exposed to IPV before they turned 11 years old. Nearly a third of children were exposed to IPV during infancy (29%), 24.5% were exposed during preschool age, and 12.1% were exposed during school age. Two resilient (low-stable, 23%; high-decreasing, 25%) and 2 non-resilient (high-stable, 41%; low-increasing, 11%) groups were identified. For the singleton sample, preschool-age IPV exposure (aOR = 2.61, p = .013) increased odds of being in the low-increasing group versus the low-stable group. For the sibling sample, school-age IPV exposure (aOR = 0.571, p = .032) decreased odds of being in the high-decreasing group versus the high-stable group. No sibling structural factors were significant.

Conclusions: Considering the diversity of outcomes for INT patterns, not all maltreated children develop maladaptive outcomes, and that some children exhibit resilient behavior over time. Interpreted within Bronfenbrenner’s bioecological framework, the presence of distinct patterns of development may indicate that children’s behaviors are constantly influenced by multiple levels of risk and protective factors surrounding the children. IPV exposure was associated with poorer outcomes over time among maltreated children. This study highlights the high rates of IPV exposure among children who also report child maltreatment, the increased risk of children who experience more forms of family violence exposure, and the need for rigorous assessment and intervention for children with dual-violence exposure.