Identifying experiences of physical and psychological violence in childhood that jeopardize mental health in adulthood

Abstract

Objective

This study examined associations between profiles of physical and psychological violence in childhood from parents and two dimensions of mental health in adulthood (negative affect and psychological well-being). Profiles were distinguished by the types of violence retrospectively self-reported (only physical, only psychological, or both psychological and physical violence), as well as by the frequency at which each type of violence reportedly occurred (never, rarely, or frequently).

Methods

Multivariate regression models were estimated using data from the National Survey of Midlife in the U.S. (MIDUS). An adapted version of the Conflict Tactics Scales (CTS) was used to collect respondents’ reports of physical and psychological violence in childhood from each parent. Respondents also reported on current experiences of negative affect and psychological well-being.

Results

Regarding violence from mothers, reports of frequent psychological violence—even when coupled with never or rarely having experienced physical violence—were associated with more negative affect and less psychological well-being in adulthood. Nearly all profiles of violence in childhood from fathers—with the exception of reports of rare physical violence only—were associated with poorer adult mental health.

Conclusions

Results provide evidence that frequent experiences of psychological violence from parents—even in the absence of physical violence and regardless of whether such violence is from mothers or fathers—can place individuals’ long-term mental health at risk. Moreover, frequent physical violence from fathers—even in the absence of psychological violence—also serves as a risk factor for poorer adult mental health.

Practice implications

Findings provide additional empirical support for the importance of prevention and intervention efforts directed toward children who experience physical and psychological violence from parents, as well as among adults who reportedly experienced in childhood only one type of violence and especially psychological violence at high levels of frequency.

Introduction

Recognizing that children who experience one type of violence are likely to experience other types of violence as well, scholars have noted an important gap in the literature on the long-term psychological consequences of childhood abuse (e.g., Higgins and McCabe, 2000, Kessler et al., 1997): many studies have focused on single types of violence without accounting for individuals potentially having experienced other types of violence as well. Recent empirical work increasingly has addressed this gap, in part, by examining associations between the number of types of maltreatment that individuals report having experienced in childhood and adult mental health (e.g., Arata et al., 2005, Clemmons et al., 2003, Clemmons et al., 2007, Higgins and McCabe, 2000). This approach, however, does not allow for examining whether specific types of violence—experienced alone or in combination with other particular types of violence—are differentially associated with poorer adult mental health. Also, although some studies have considered the independent and cumulative effects of physical and sexual abuse specifically (e.g., Arnow et al., 2000, Diaz et al., 2002, Sachs-Ericsson et al., 2006), few studies have examined psychological violence as a potentially distinct or co-occurring type of violence (for exceptions, see Chapman et al., 2004, Kessler et al., 1997, Schneider et al., 2007). Furthermore, much of the previous work that has considered linkages between multiple types of violence in childhood and adult mental health has used data from college students (e.g., Clemmons et al., 2007) or samples of women only (e.g., Mullen et al., 1996, Schneider et al., 2007). Expanded population work in this area is necessary to examine the mental health consequences of various, yet specific, types of childhood family violence within a broader population of adults.

This study aimed to address these gaps by using data from the National Survey of Midlife in the U.S. (MIDUS). We compared levels of mental health among adults reporting distinct profiles of physical and/or psychological violence in childhood from mothers and fathers. Profiles were distinguished by the types of violence reported (only physical, only psychological, or both physical and psychological), as well as by the frequency level at which each type of violence reportedly occurred (never, rarely, or frequently). We also examined whether associations between profiles of physical and psychological violence in childhood and adult mental health differed for men and women.

Although psychological violence is recognized as an important type of violence in its own right (e.g., National Center on Child Abuse and Neglect Clearinghouse, 2003), controversy regarding how to distinguish psychological violence from other types of violence remains (see Barnett, Miller-Perrin, & Perrin, 2005, for a discussion). Recognizing variation in approaches to defining psychological violence, McGee and Wolfe (1991) suggested that physical and psychological violence can be distinguished from each other along two dimensions: first, by whether or not the act of violence itself is physical or nonphysical/psychological, and second, by whether or not the consequences of the act are physical and/or nonphysical/psychological. This conceptualization recognizes that acts that are purely physical can have psychological consequences and that violence, overall, includes acts that are nonphysical/psychological. Recognition of physical and psychological violence as related-yet-distinct phenomena suggests the importance of examining the long-term psychological consequences of physical and nonphysical/psychological acts both in conjunction and independently from each other.

Research on the long-term effects of psychological violence—alone or in combination with physical violence—has lagged behind research on the long-term effects of other types of violence (Yates & Wekerle, 2009). Nevertheless, several studies have used population data to examine the long-term mental health consequences of physical and psychological violence in childhood (Chapman et al., 2004, Kessler et al., 1997, Schneider et al., 2007). These studies provide evidence for physical and psychological violence in childhood as independent risk factors for poorer adult mental health. This study aimed to expand population work on linkages between physical and psychological violence in childhood and adult mental health in three ways: (1) by considering the frequency level at which physical and/or psychological violence reportedly occurred, (2) by testing for gender differences in associations, and (3) by examining two related, yet distinct, dimensions of mental health.

Scholars have posited that long-lasting experiences of violence can more profoundly damage a child's healthy development by creating cumulative problems at various developmental stages (Manly, Cicchetti, & Barnett, 1994). Also, infrequent episodes of violence are more likely to result from transient family challenges, whereas chronic violence is more likely to result from and contribute to more enduring problematic patterns in family functioning that can undermine optimal child development (Cicchetti & Rizley, 1981).

Despite this theorizing on frequency as an important dimension for specifying experiences of violence in childhood, population-based studies on the long-term mental health effects of childhood family violence largely have categorized respondents into dichotomous groups indicating whether or not respondents report histories of childhood family violence, thereby not accounting for potential gradations in the frequency at which childhood violence reportedly occurred. For example, some scholars have coded respondents as having active histories of childhood family violence only if they reported violence having occurred at relatively high levels of frequency (e.g., Edwards et al., 2003, Irving and Ferraro, 2006), thereby not addressing whether linkages of risk are also present at lower levels of frequency as well. This gap in previous research suggests the importance for population-based studies on the long-term mental health effects of children's experiences of violence to account for differential frequency levels of various types of violence that respondents reportedly experienced in childhood.

Theorists have posited several processes through which women might be more vulnerable to the negative psychological effects of interpersonal violence than men, such as women's more intense feelings of self-blame for being the target of violence and women's greater likelihood of responding to negative moods through rumination (Cutler & Nolen-Hoeksema, 1991). Despite this theorizing, few studies have explicitly tested gender differences in associations, in large part because of limited samples that do not include data from both men and women (see Higgins & McCabe, 2000, for a review). Nevertheless, while results from some studies that have drawn on data from mixed-gender samples indicate that the associations between childhood family violence and adult mental health are stronger for women than for men (e.g., MacMillan et al., 2001), results from other studies have failed to find gender differences (e.g., Brems, Johnson, Neal, & Freemon, 2004). Inconsistencies in these findings suggest the importance of additional research on gender differences in linkages between childhood family violence and adult mental health.

Much of the extant research on the long-term mental health effects of childhood family violence has focused on negative states of emotional well-being in adulthood, such as depressive symptoms, anxiety, and symptoms of post-traumatic stress (see Springer, Sheridan, Kuo, & Carnes, 2003, for a review). Recent conceptualizations of mental health, however, suggest that mental ill-being is not synonymous with mental well-being (Keyes, 2002). Furthermore, approaches to mental health as a multi-dimensional construct also suggest that optimal mental health goes beyond maximum experiences of pleasure and minimal levels of pain; psychological well-being also involves positive psychosocial functioning and full engagement with life (Ryan & Deci, 2001), which may or may not be accompanied by particular emotional states.

Guided by a multi-dimensional approach to mental health, this study examined linkages between diverse profiles of childhood family violence and two theoretically derived and empirically validated aspects of adult mental health, including negative affect and psychological well-being (Keyes, Shmotkin, & Ryff, 2002). Negative affect involves experiences of negative moods and emotions (Mroczek & Kolarz, 1998) and has been importantly linked to depression and poorer health in adulthood (Charles and Almeida, 2006, Payton, 2009). Psychological well-being indicates positive functioning and engagement with life, such as feelings of purpose in life and perceptions of positive relationships with others (Ryff & Keyes, 1995), and has been increasingly understood as a distinct predictor of adult health outcomes (for a discussion, see Ryff et al., 2004a, Ryff et al., 2004b).

In brief, based on the extant literature, this study aimed to extend understanding of linkages between experiences of physical and psychological violence in childhood and adult by using U.S. population data to (1) differentiate among diverse histories of childhood family violence from parents by examining physical and psychological violence as potentially independent or co-occurring types of violence, (2) differentiate among histories of violence by considering the frequency level at which each type of violence (i.e., physical and psychological) reportedly occurred, (3) examine gender differences in associations between diverse experiences of physical and psychological violence in childhood and adult mental health, and (4) examine the psychological consequences of childhood family violence in terms of two theoretically informed and empirically validated dimensions of mental health—negative affect and psychological well-being. Overall, we addressed the following research questions: Which patterns of physical and/or psychological violence from mothers and fathers during childhood are associated with poorer mental health in adulthood? Do these patterns of association vary by gender?