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Conduct disorder symptoms in pre-school
children exposed to intimate partner violence:
Gender differences in risk and resilience
Erica Bowen
International Family Violence and Child Victimization Research Conference,
Portsmouth, NH July 11th
2016
Previous literature
• Pre-school children vulnerable to IPV (Fantuzzo & Fusco, 2007)
• Few studies of pre-schoolers (Howell, 2011)
• IPV leads to increased CD in children (Moylan et al, 2010)
• Potential sex differences (Moffitt, 2001)
• Predictor of future criminality and IPV (Fang et al, 2010; Moffitt, 2003)
• Not all children adversely affected by IPV (Kitzman et al, 2003)
• Gender may moderate effects
• Boys not shielded from aggression (Hetherington et al, 1989)
• Sex-role socialisation of IPV (Kerig et al, 1993)
• Sex-role socialisation of coping (Zahn-Waxler, 1993)
• Potential predictors of resilience
• Lower IPV (Grych et al, 2000)
• Perceiving IPV as less serios (Graham-Bermann et al, 2009
Previous literature
Potential predictors of resilience
• Lower IPV (Grych et al, 2000)
• Perceiving IPV as less serious (Graham-Bermann et al, 2009; Grych et al, 2000)
• Higher social support (boys only; Kolbo, 1996)
• Low maternal mental health problems (Kolbo, 1996)
• Better quality parenting (Kolbo, 1996)
• Low maternal depression (Graham-Bermann et al, 2009; Martinez-Torteya et al, 2009)
• Easy child temperament (Martinez-Torteya et al, 2009)
• More effective family problem solving abilities (Graham-Bermann et al, 2009)
BUT
• Studies typically cross sectional (Except Martinez-Torteya et al, 2009)
• Small samples
• Sex differences not examined (except Grych et al, 2000 who found none)
• Attachment not examined
Study aims
1.A group of IPV-exposed children would be identified as resilient and that boys
will be less likely than girls to be resilient to conduct disorder symptoms due to
previous findings that boys are more likely to exhibit externalizing behavior problems
when exposed to IPV.
2.In addition, IPV-exposed children are expected to have higher levels of conduct
disorder symptoms than non-IPV exposed children, and that the highest levels would
be identified in boys exposed to IPV.
3.Family and child characteristics, specifically attachment, parental involvement,
and easy temperament will predict resilience, whereas non-resilience was expected to
be predicted by higher levels of maternal depression and maternal life events.
• To examine profiles of adaptation to IPV focusing on CD
symptoms in community based cohort of pre-school children
• To examine gender differences in predictors of adaptation
Hypotheses
Method
13,617 mother-child pairs
14,541 mothers enrolled
14,676 foetuses
14,062 live births
13,988 alive at year 1
7,743 (51.6% boys)
Complete data Birth – 4 years
Included cases: Education Non-White DV victimisation
Method
Measures
IPV: 8, 21, 33 months
Child conduct disorder symptoms: SDQ (Goodman, 1997) 47 months
Child temperament:
•Carey Temperament Scales (Carey & McdDevitt, 1977) 6 months, 24 months
•Emotionality, Activity Sociability scales (Buss & Plomin, 1984) 38 months
Social development: Denver Developmental Screening Test (Frankenburg et al, 1992) 6 & 24 months
Attachment: 3 item reunion warmth scale; 42 months
Parental involvement: 9 item scale 6, 24, 42 months
Maternal mental health: Edinburgh Postnatal Depression Scale (Cox et al, 1987), 8, 21, 33 months
Maternal life events: Life events scale, 8, 21, 33 months
Findings 1
Adaptation categorisation
c.f. Masten, 2001; Martinez-Torteya et al (2009)
17.7% IPV exposure: 18.4% girls, 17.0% boys
IPV experienced (yes/no) x conduct disorder symptoms (yes/no)
Resilient = IPV + NO CD 16%: 15.3% boys, 16.7% girls
Non-resilient = IPV + CD 1.7%: 1.7% boys, 1.7% girls
Vulnerable = NO IPV + CD 3.1%: 3.8% boys, 2.4% girls
Competent = NO IPV + NO CD 79.2%: 79.2% boys, 79.2% girls
Findings 2: Resilient vs. Non-resilient
BOYS
Logistic regression: Nagelkerke R2
= .14
•Maternal education (low vs. high) = OR 2.24 (2.08 4.64)*
•Emotionality = OR .88 (.82-.94)*
•Activity = OR .86 (.76-.91)*
•Shyness = OR 1.03 (.95 – 1.12)*
GIRLS
Logistic regression: Nagelkerke R2
= .14
•Maternal education (low vs. high) = OR 2.71 (1.27 – 5.76)*
•Shyness = OR 1.09 (1.00 – 1.18)*
•Attachment to mother = OR 1.46 (1.01 – 2.10)*
•Maternal involvement = OR 1.12 (1.02 – 1.22)*
•Social development = OR .90 (.83 - .99)*
•Emotionality = OR .92 (.86 - .98)*
•Activity = OR .86 (.79 - .99)*
Findings 3: Resilient vs. Vulnerable
BOYS
Logistic regression: Nagelkerke R2
= .19
•Mood = OR .94 (.90-0.98)*
•Emotionality = OR .93 (.89-.98)*
•Activity = OR .93 (.86 – 1.00)*
•Maternal involvement = OR 1.14 (1.06 – 1.21)*
•Paternal involvement = OR .93 (.89 - .96)*
•Maternal depression = OR 1.06 (1.01-1.12)*
•Maternal life events = OR 1.07 (1.03-1.15)*
GIRLS
Logistic regression: Nagelkerke R2
= .20
•Maternal education (low vs high) 2.14 (1.12 – 4.11)*
•Emotionality = OR .90 (.85 - .95)*
•Shyness = OR 1.05 (.98 – 1.13)*
•Sociability = OR .96 (.87 – 1.04)*
•Paternal involvement = OR .91 (.87 - .95)*
•Maternal life events = OR 1.07 (1.03-1.12)*
Findings 4: Resilient vs. Competent
BOYS
Logistic regression: Nagelkerke R2
= .28
•Paternal involvement = OR .89 (.88-.91)*
•Maternal depression = OR 1.15 (1.11-1.18)*
•Maternal life events = OR 1.10 (1.08-1.12)*
GIRLS
Logistic regression: Nagelkerke R2
= .29
•Maternal involvement = OR 1.05 (1.04 – 1.04)*
•Paternal involvement = OR .87 (.85 - .89)*
•Maternal depression = OR 1.11 (1.08-1.14)*
•Maternal life events = OR 1.11 (1.09-1.13)*
Summary and interpretation
• IPV impact heterogeneous; boys less likely to be resilient, majority of children resilient
however.
• Different resilience processes for boys and girls
• Resilient (relative to non-resilience) predicted by:
• High Maternal education, low emotionality and low activity for all children
• High attachment to mother, high involvement by mother, lower social development for
girls only.
• Resilient (relative to vulnerable) predicted by:
• Low emotionality, low paternal involvement, higher life events for all children
• Low mood, high maternal involvement, high maternal depression for boys
• High maternal education, high shyness, low sociability for girls
• Resilient (relative to competent) predicted by
• Low paternal involvement, high maternal depression, high life events for all children
• High maternal involvement for girls
• Suggests potential gender differences in sex role socialisation and coping (c.f. Zahn-Waxler,
1993)
Limitations and implications
Limitations
• Ethnicity under-specified
• Cohort attrition
• Operationalization of IPV
• Reliance on mothers as respondents
Implications
Intervention design: differences for boys and girls:
• Boys: focus on social skills and emotion regulation training
• Girls: focus on maternal parenting
Research
• Need to more clearly unpack impact of maternal education
• Multi-informant methods needed
Acknowledgements
We are extremely grateful to all the families who took part in this study, the
midwives for their help in recruiting them, and the whole ALSPAC team, which
includes interviewers, computer and laboratory technicians, clerical workers,
research scientists, volunteers, managers, receptionists and nurses.
The UK Medical Research Council (Grant ref: 74882) the Wellcome Trust (Grant
ref: 076467) and the University of Bristol provide core support for ALSPAC.
Any Questions?

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Wekerle CIHR Team - Conduct Disorder Symptoms in Pre-school Children Exposed to Intimate Partner Violence: Gender Differences in Risk and Resilience

  • 1. Conduct disorder symptoms in pre-school children exposed to intimate partner violence: Gender differences in risk and resilience Erica Bowen International Family Violence and Child Victimization Research Conference, Portsmouth, NH July 11th 2016
  • 2. Previous literature • Pre-school children vulnerable to IPV (Fantuzzo & Fusco, 2007) • Few studies of pre-schoolers (Howell, 2011) • IPV leads to increased CD in children (Moylan et al, 2010) • Potential sex differences (Moffitt, 2001) • Predictor of future criminality and IPV (Fang et al, 2010; Moffitt, 2003) • Not all children adversely affected by IPV (Kitzman et al, 2003) • Gender may moderate effects • Boys not shielded from aggression (Hetherington et al, 1989) • Sex-role socialisation of IPV (Kerig et al, 1993) • Sex-role socialisation of coping (Zahn-Waxler, 1993) • Potential predictors of resilience • Lower IPV (Grych et al, 2000) • Perceiving IPV as less serios (Graham-Bermann et al, 2009
  • 3. Previous literature Potential predictors of resilience • Lower IPV (Grych et al, 2000) • Perceiving IPV as less serious (Graham-Bermann et al, 2009; Grych et al, 2000) • Higher social support (boys only; Kolbo, 1996) • Low maternal mental health problems (Kolbo, 1996) • Better quality parenting (Kolbo, 1996) • Low maternal depression (Graham-Bermann et al, 2009; Martinez-Torteya et al, 2009) • Easy child temperament (Martinez-Torteya et al, 2009) • More effective family problem solving abilities (Graham-Bermann et al, 2009) BUT • Studies typically cross sectional (Except Martinez-Torteya et al, 2009) • Small samples • Sex differences not examined (except Grych et al, 2000 who found none) • Attachment not examined
  • 4. Study aims 1.A group of IPV-exposed children would be identified as resilient and that boys will be less likely than girls to be resilient to conduct disorder symptoms due to previous findings that boys are more likely to exhibit externalizing behavior problems when exposed to IPV. 2.In addition, IPV-exposed children are expected to have higher levels of conduct disorder symptoms than non-IPV exposed children, and that the highest levels would be identified in boys exposed to IPV. 3.Family and child characteristics, specifically attachment, parental involvement, and easy temperament will predict resilience, whereas non-resilience was expected to be predicted by higher levels of maternal depression and maternal life events. • To examine profiles of adaptation to IPV focusing on CD symptoms in community based cohort of pre-school children • To examine gender differences in predictors of adaptation Hypotheses
  • 5. Method 13,617 mother-child pairs 14,541 mothers enrolled 14,676 foetuses 14,062 live births 13,988 alive at year 1 7,743 (51.6% boys) Complete data Birth – 4 years Included cases: Education Non-White DV victimisation
  • 6. Method Measures IPV: 8, 21, 33 months Child conduct disorder symptoms: SDQ (Goodman, 1997) 47 months Child temperament: •Carey Temperament Scales (Carey & McdDevitt, 1977) 6 months, 24 months •Emotionality, Activity Sociability scales (Buss & Plomin, 1984) 38 months Social development: Denver Developmental Screening Test (Frankenburg et al, 1992) 6 & 24 months Attachment: 3 item reunion warmth scale; 42 months Parental involvement: 9 item scale 6, 24, 42 months Maternal mental health: Edinburgh Postnatal Depression Scale (Cox et al, 1987), 8, 21, 33 months Maternal life events: Life events scale, 8, 21, 33 months
  • 7. Findings 1 Adaptation categorisation c.f. Masten, 2001; Martinez-Torteya et al (2009) 17.7% IPV exposure: 18.4% girls, 17.0% boys IPV experienced (yes/no) x conduct disorder symptoms (yes/no) Resilient = IPV + NO CD 16%: 15.3% boys, 16.7% girls Non-resilient = IPV + CD 1.7%: 1.7% boys, 1.7% girls Vulnerable = NO IPV + CD 3.1%: 3.8% boys, 2.4% girls Competent = NO IPV + NO CD 79.2%: 79.2% boys, 79.2% girls
  • 8. Findings 2: Resilient vs. Non-resilient BOYS Logistic regression: Nagelkerke R2 = .14 •Maternal education (low vs. high) = OR 2.24 (2.08 4.64)* •Emotionality = OR .88 (.82-.94)* •Activity = OR .86 (.76-.91)* •Shyness = OR 1.03 (.95 – 1.12)* GIRLS Logistic regression: Nagelkerke R2 = .14 •Maternal education (low vs. high) = OR 2.71 (1.27 – 5.76)* •Shyness = OR 1.09 (1.00 – 1.18)* •Attachment to mother = OR 1.46 (1.01 – 2.10)* •Maternal involvement = OR 1.12 (1.02 – 1.22)* •Social development = OR .90 (.83 - .99)* •Emotionality = OR .92 (.86 - .98)* •Activity = OR .86 (.79 - .99)*
  • 9. Findings 3: Resilient vs. Vulnerable BOYS Logistic regression: Nagelkerke R2 = .19 •Mood = OR .94 (.90-0.98)* •Emotionality = OR .93 (.89-.98)* •Activity = OR .93 (.86 – 1.00)* •Maternal involvement = OR 1.14 (1.06 – 1.21)* •Paternal involvement = OR .93 (.89 - .96)* •Maternal depression = OR 1.06 (1.01-1.12)* •Maternal life events = OR 1.07 (1.03-1.15)* GIRLS Logistic regression: Nagelkerke R2 = .20 •Maternal education (low vs high) 2.14 (1.12 – 4.11)* •Emotionality = OR .90 (.85 - .95)* •Shyness = OR 1.05 (.98 – 1.13)* •Sociability = OR .96 (.87 – 1.04)* •Paternal involvement = OR .91 (.87 - .95)* •Maternal life events = OR 1.07 (1.03-1.12)*
  • 10. Findings 4: Resilient vs. Competent BOYS Logistic regression: Nagelkerke R2 = .28 •Paternal involvement = OR .89 (.88-.91)* •Maternal depression = OR 1.15 (1.11-1.18)* •Maternal life events = OR 1.10 (1.08-1.12)* GIRLS Logistic regression: Nagelkerke R2 = .29 •Maternal involvement = OR 1.05 (1.04 – 1.04)* •Paternal involvement = OR .87 (.85 - .89)* •Maternal depression = OR 1.11 (1.08-1.14)* •Maternal life events = OR 1.11 (1.09-1.13)*
  • 11. Summary and interpretation • IPV impact heterogeneous; boys less likely to be resilient, majority of children resilient however. • Different resilience processes for boys and girls • Resilient (relative to non-resilience) predicted by: • High Maternal education, low emotionality and low activity for all children • High attachment to mother, high involvement by mother, lower social development for girls only. • Resilient (relative to vulnerable) predicted by: • Low emotionality, low paternal involvement, higher life events for all children • Low mood, high maternal involvement, high maternal depression for boys • High maternal education, high shyness, low sociability for girls • Resilient (relative to competent) predicted by • Low paternal involvement, high maternal depression, high life events for all children • High maternal involvement for girls • Suggests potential gender differences in sex role socialisation and coping (c.f. Zahn-Waxler, 1993)
  • 12. Limitations and implications Limitations • Ethnicity under-specified • Cohort attrition • Operationalization of IPV • Reliance on mothers as respondents Implications Intervention design: differences for boys and girls: • Boys: focus on social skills and emotion regulation training • Girls: focus on maternal parenting Research • Need to more clearly unpack impact of maternal education • Multi-informant methods needed
  • 13. Acknowledgements We are extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists and nurses. The UK Medical Research Council (Grant ref: 74882) the Wellcome Trust (Grant ref: 076467) and the University of Bristol provide core support for ALSPAC.