Resolution of intimate partner violence and child behavior problems after investigation for suspected child maltreatment

Abstract

OBJECTIVE To describe longitudinal change in child behavior problems associated with resolution of intimate partner violence (IPV) after an investigation for suspected child maltreatment. DESIGN Retrospective cohort study. SETTING The National Survey of Child and Adolescent Well-Being, a nationally representative longitudinal sample of US households investigated for suspected child maltreatment. PARTICIPANTS The study included 320 school-aged subjects with caregiver-reported IPV in the year prior to baseline interview. Caregivers were interviewed an average of 3, 20, 36, and 81 months following investigation. MAIN EXPOSURE Resolution vs persistence of baseline IPV. Persistence was defined by report of IPV during any follow-up interview. MAIN OUTCOME MEASURES Clinically significant internalizing or externalizing child behavior problems. RESULTS In total, 44.6% of caregivers who reported IPV at the baseline interview reported persistent IPV. After adjusting for significant covariates, IPV resolution was associated with an 11.9% reduction in internalizing problems by 81 months (P = .03); IPV persistence was associated with persistence in baseline problems. Resolution of IPV was associated with an 18.5% reduction in externalizing problems by 20 months that was sustained at 36 and 81 months (all P < .05). Intimate partner violence persistence was associated with a steady but nonsignificant increase in externalizing behavior problems during 81 months (10.1%, P = .07). The adjusted relative risks for internalizing and externalizing behavior problems 81 months following a child protective services investigation for children exposed to persistent vs resolved IPV were 1.79 (95% CI, 0.91-3.52) and 1.88 (95% CI, 1.12-3.18), respectively. CONCLUSIONS Resolution of IPV after a child protective services investigation for suspected child maltreatment is associated with meaningful, sustained reductions in clinically significant child behavior problems.

Figure 1

Adjusted probability (%) and adjusted risk ratios (ARR) of clinically significant internalizing child behavior problems after a CPS investigation for suspected child maltreatment among children with and without persistence of caregiver-reported IPV

Figure 2

Adjusted probability (%) and adjusted risk ratio (ARR) of clinically significant externalizing child behavior problems after a CPS investigation for suspected child maltreatment among children with and without persistence of caregiver-reported IPV