What is the study about?

Children from domestically violent homes are at-risk for a variety of negative developmental
outcomes, including but not limited to anxiety, depression, externalizing problems, and general
difficulty with emotion regulation and expression. This study focused on determining if parents in
domestically violent homes could effectively assist their children with emotion regulation,
otherwise referred to as emotion coaching.

Emotion coaching, or teaching children how to identify, express, and manage their emotions, has
been linked to positive outcomes related to overall child adjustment. Additionally, there is
increasing evidence that children learn how to regulate their emotions through parent-child
interactions. However, because parents residing in households where domestic violence is
prevalent may experience difficulty with their own emotion regulation, researchers predicted that
these parents would have difficulty teaching emotion regulation skills to their children.

The study also examined whether parents experiencing domestic violence had difficulty coaching
their children with specific emotions based on their status as either the perpetrator or victim of the
domestic violence. For example, it was hypothesized that parent victims of domestic violence
would have difficulty coaching their children with the regulation of fear, as they may find it difficult
to manage their own fear. Similarly, parent perpetrators of domestic violence would have difficulty
coaching their children in anger management, as they have difficulty managing their own anger.

Finally, researchers assessed whether parental emotion coaching moderated the relationship
between children’s exposure to domestic violence and subsequent child behavior problems.
Based on previous research in parental meta-emotion philosophy, they hypothesized that poor
parental emotion coaching would result in a strong relationship between exposure to domestic
violence and child behavior problems. Alternatively, effective parental emotion coaching would
result in a weak or perhaps nonexistent relationship between exposure to domestic violence and
child behavior problems.

A community-based sample of 130 nuclear families with pre-school aged (4-5 year-old) children
was recruited for this study. Each parent was administered a meta-emotion interview, in addition
to completing selected self-report measures of domestic violence, marital satisfaction, children’s
behavior problems, and family income.

What did the study find?

Results of the study failed to yield a statistically significant relationship between domestic
violence and a general deficit in parental emotion coaching, though a marginal association was
observed between domestic violence perpetrated by mothers and less emotion coaching.
However, results did reveal an association between domestic violence and less parental emotion
coaching of anger and fear based on parental status as either the perpetrator or victim of the
domestic violence. Furthermore, the study indicated that emotion coaching moderated the
relationship between children’s exposure to domestic violence and subsequent child behavior
problems. Specifically, mothers’ emotion coaching moderated the relationship between children’s
exposure to domestic violence and children’s aggression, withdrawal, and depression-anxiety,
whereas fathers’ emotion coaching moderated the relationship between children’s exposure to
domestic violence and children’s withdrawal.

How does this relate to the ACT Against Violence program?

As this study suggests, children are particularly vulnerable to domestic violence, and continued
exposure may have a long-lasting psychological impact on their developmental trajectory.
Children learn to regulate and express their emotions through parent-child interactions and
observations of parental behavior. The ACT program underscores the need for parents to learn
and implement constructive and effective anger management and conflict-resolution strategies at
home. The program helps parents learn to set a positive example for their children by modeling
non-violent behaviors.

Now we know that violence in the home is very frequent. More than 4 million American women a
year are physically attacked by their male partners; violence can also happen in same sex
relationships, and some men are beaten in heterosexual relationships, although what is most
common is that women are battered by men. Some of these assaults are severe. From 1990
through 1994 the deaths of nearly 11,000 people age 18 and over resulted from one partner
killing another, with women almost twice as likely to be victims of such fatal partner violence as
men. Violence between partners happens in all groups in society. No group is immune. If your
intimate partner has beaten you, you are not alone.

Back to Top

How do I know if I?m at risk?

Violence in a relationship is never okay and never justified. A "little slap" is violence. So is
pushing, shoving, throwing things, threatening violence, or forcing a partner to engage in sexual
activities against her or his will. All of these things, along with punching, kicking, biting choking,
burning, and injury with weapons have happened to victims of partner violence. If violence or a
threat of violence of any kind has happened more than once or twice, it is extremely likely to
happen again. It may get more frequent or more severe. If this describes you and your
relationship, you are at risk.

Back to Top

Am I overreacting?

Very often abusers will tell victims that they are overreacting and causing the batterer to become
violent. You are not overreacting or causing the violence. It is normal to feel frightened and angry
when your spouse or partner is violent with you. Your reactions to earlier abuse are no excuse for
someone to be violent toward you.

Back to Top

Why don?t I just leave?

This is a common question that people ask about victims and victims ask of themselves. It is
almost always more complicated than just leaving. Sometimes the batterer will not allow you to
leave and may threaten to kill you or other family members if you do. These are not always idle
threats. Research tells us that women are more likely to be killed by their battering mates at the
time these women try to leave. You may be afraid to be alone and on your own. You may worry
about how to support yourself and your children without the batterer. You may blame yourself,
wrongly, for causing the violence and feel ashamed and afraid of exposing yourself. It may be
against your religious or other beliefs to end a marriage or committed relationship. It?s important
for you to get help in learning how to resolve these issues for yourself.
Back to Top

What can I do?

If you are the victim of violence:

Begin to think about how you can plan for your own safety and happiness. Waiting for abusers to
change and trying harder to please them will not work. Find out what resources are available in
your area for victims of partner abuse. At a safe time, when the abuser is not around, call a local
battered women?s shelter or domestic violence hotline. Tell them what has happened; ask them
what your choices are to protect yourself and to end the violence. Think about the answers to
your questions and call again if you need to know more.

If you are considering leaving your abuser, make safety plans before you talk about separation.
Discuss the abuser?s pattern of violence with someone at a shelter or crisis line and think about
what risks there might be if you talk about leaving. Try to keep enough money in a protected
place to use when you need it to get to safety. Some victims find it best to go to a shelter where
they can be safe before they tell the abuser that they are leaving.

If you can do this safely, encourage the abuser to go to a group for batterers. There are now
many such groups for men who batter their partners. Some large cities also have groups for gay
men and lesbians who batter their partners and for people from particular ethnic or religious
groups. In such a group, batterers can get help from experts specially trained to treat violent
people and may learn to change their beliefs and behaviors. You may still need to live apart from
the batterer while that person is in the group. Changing patterns of violence can take a long time.
(Call the Domestic Abuse Hotline for information on groups in your area).

If you think you are in immediate danger, you probably are. You are an expert at sensing when
things are getting really bad. Flee at once to a safe location or call the police if you can. When
police arrive, ask what legal protections are available to you, and use whatever you need to be
sure you are safe. Don?t let the police leave you alone with the abuser once they?ve arrived. If
you are hurt, ask for medical help. Be sure that the doctor or nurse makes a record of your
injuries and notes that those injuries were the result of an assault, not falling down stairs or
bumping into a door.

Back to Top<P< p>

If you are an abuser:

Get help to end your violent behavior. Hurting the people you love will cost you their trust and
respect and your own self-respect as well. You may lose your loved ones permanently. No one
likes to be violent or to get hurt.

Realize that you can change. Others have gone through this and found ways to stop their
patterns of violence. Their lives and relationships with those they love have gotten better. Call a
state or local domestic violence hotline (you don?t have to give your name to get information) and
ask for referrals to a batterer?s group or to expert therapists in your area. Be honest with the
people running the group or with an individual therapist about your history of violence. Tell the
leader or therapist that your violent behaviors are the ones you want to change. Don?t wait until a
judge requires you to go to treatment.

Back to Top

If you are a friend or a family member:

You can do something. Encourage the victim to get to safety and help keep that person safe.
Confront the abuser if you can do it safely (you may want to have someone else with you when
you do this). Don?t accept excuses for violence from people you love.

Call the National Domestic Abuse Hotline or a local hotline and gather information about local
resources and support services. Advise the victim about her options and assistance available to
her and her children.

Call the police if the victim cannot. Sometimes this can help stop or reduce the violence.

Back to Top

For Anyone:

Become knowledgeable about violence between partners. Support local initiatives to reduce

If you need help now:

You can call the National Domestic Violence Hotline at 1-800-799-SAFE (1-800-787-3224 TDD)
24 hours per day, 365 days per year. If you have access to the Internet you may reach their web
site at http://www.ndvh.org/ or send and e-mail message to ndvh@inetport.com. The hotline
provides support counseling and links to 2500 local support services, such as emergency
shelters, legal advocacy and assistance programs, and social service programs for abused
women and their children. The hotline also offers counseling programs and links to local support
services for abusers.

Of the 74 million children and adolescents in the United States, 30 percent to 50

percent will experience at least one traumatic event by their 18th birthdays. Such
events include sexual abuse, physical abuse, domestic violence, community and
school violence, medical trauma, motor vehicle accidents, acts of terrorism, natural
disasters, suicides and other traumatic losses. Typically, children are exposed to
more than a single traumatic event. Prevalence rates of post-traumatic stress
disorder among youth vary, with increased rates in urban neighborhoods with high
levels of poverty and crime. As many as 85 percent of children in poor, urban
neighborhoods have witnessed violence, and up to 66 percent have been hurt
personally. Although seldom reported, children probably comprise a substantial
proportion of the nearly 2.5 billion people affected worldwide by natural disasters in
the past decade alone.

Almost all children and adolescents express some kind of distress or behavioral
change in the acute phase of recovery from a traumatic event. Reactions include
feelings of horror, terror, and helplessness, development of new fears, separation
anxiety, sleep disturbance, sadness, loss of interest in normal activities, reduced
concentration and decline in schoolwork. Most children and adolescents who develop
trauma-related psychological symptoms are not identified, and consequently do not
receive any help. Research on PTSD and trauma among youth is relatively new but
has increased markedly in the past 20 years. However, many treatments for
traumatized children have not been empirically studied. Ethnically and culturally
informed and sensitive interventions that consider contexts, identity and traditions
have also received little attention (see "The smallest survivors").
To begin addressing these issues, I formed a Presidential Task Force on PTSD and
Trauma of Children and Adolescents to:

• Identify the key contributions psychological science has made to our understanding
of PTSD in youth.

• Identify what we know and need to know regarding the development, treatment
and prevention of PTSD.

• Make recommendations to guide future research, practice and public policy.

• Plan for the dissemination of materials to the public, caregivers, policy-makers and
government agencies.

We were extraordinarily fortunate to have a dream team of task force members who
have made major contributions to the topic including: Chair Annette M. La Greca,
PhD, of the University of Miami; Beth Boyd, PhD, of the University of South Dakota;
Lisa H. Jaycox, PhD, of the RAND Corporation; Anthony P. Mannarino, PhD, of
Allegheny General Hospital; Nancy Kassam-Adams, PhD, of Children's Hospital of
Philadelphia; Wendy K. Silverman, PhD, of Florida International University; Farris
Tuma, ScD, of NIMH; and Marleen Wong, PhD, of the University of Southern
California. APA staff, including Mary Campbell, Efua Andoh, Diane Elmore, PhD, MPH,
and Nancy Smith-Crawford, optimized the productivity and innovativeness of the
group.

The task force is generating products for multiple audiences. For the public, it is
creating a booklet detailing issues surrounding trauma and PTSD in children and
adolescents. To help APA staff educate policy-makers, the task force is drafting a
briefing sheet on the impact PTSD has on children and the importance of funding for
research, services, education and training. For the media and policy-makers, the
task force is preparing a list of PTSD experts who can respond to media queries,
testify at congressional hearings and participate in federal agency briefings. For
psychologists, the group will develop a one-page summary of tips for working with
children and adolescents after trauma. And, to promote further PTSD research, APA
has issued a call for empirical papers and scholarly reviews that identify next steps
for research, prevention and treatment. Papers that clear the review process will be
published in a special section of the Journal of Consulting and Clinical Psychology.
(To submit a paper, visit www.apa.org/journals/ccp/papercall-ptsd.html.) The task
force will meet this month to incorporate feedback from many APA members, finalize
products and develop dissemination strategies so our message will reach a broad,
multidisciplinary audience worldwide.
PRESIDENT'S COLUMN
Trauma in children: How can we
communicate what we know?
Print version: page 5

PTSD and trauma among children, adolescents and adults are

global problems; few receive any treatment, and ethnically and
culturally informed and evidence-based treatments are especially
rare. The task force's accomplishments are not only significant in
their own right but also could serve as a valuable base for
international partnerships to address a global problem, ensuring a
broad relevance of psychological work across nations, cultures and
contexts, and making a palpable difference in the lives of children
everywhere.
 Making Welfare to Work
Really Work

Domestic Violence

Poor Women Are Often Battered Women

Women attempting to get off welfare and become economically independent face numerous
obstacles. One of the most devastating is violence from intimate partners. Research increasingly
and dramatically documents the pervasiveness of abuse against all women and the increased
incidence among poor women, including welfare recipients. Violence, research shows, has a
direct impact in keeping welfare recipients from holding jobs and becoming self-sufficient. For
example, a recent study of a representative sample of welfare recipients in Massachusetts found
that 65 percent were victims of violence by a current or former boyfriend or husband, and one-fifth
had been victimized in the past 12 months (Colten & Allard, 1997). Similar results were found in a
survey of welfare recipients in Washington State. There, 55 percent of the recipients reported
being physically or sexually abused by a spouse or boyfriend (Roper & Weeks, 1993). Another
study of 436 homeless and low-income housed mothers found that 63 percent reported assaults
by intimate male partners (Bassuk, Browne, & Buckner, 1996a; Brooks & Buckner, 1996). This
rate of intimate violence is substantially higher than that suffered by women in the general
population, according to the National Crime Victimization Survey (Bachman & Saltzman, 1995).

Violence Is An Obstacle to Work

Job training providers report that a high proportion of women in welfare-to-work programs are
being abused by their intimate partners. This abuse may take many forms, ranging from
administering beatings to failing to fulfill child care responsibilities so that women cannot go to
work (NOW Legal Defense and Education Fund, 1997; Raphael, 1996). Disruptive and
threatening actions by their intimate partners may sabotage women's efforts at financial
independence, perhaps out of the partner's fear that the woman will leave the relationship or form
other relationships at work (NOW Legal and Defense Fund, 1997). A 1997 study on intimate
violence and Black women's health found that rates of severe partner violence are higher for low-
income Black women than for higher income Black women. Black women who have unemployed
husbands experience particularly high rates of severe violence (Russo, Denious, Keita, & Koss,
1997).

Violence interferes with work, job training, and education and thus undermines women's attempts
at economic independence. In addition, pervasive violence may also leave women with physical
injuries and psychological consequences that make work difficult. Posttraumatic stress disorder
(PTSD) and severe depression are common among victims of domestic violence (Koss,
Goodman, Browne, Fitzgerald, Keita, & Russo, 1994; T.L. Weaver & Clum, 1995; Woods &
Campbell, 1993). PTSD sufferers may feel helpless and terrified, experiencing flashbacks of the
original trauma in recurrent and/or intrusive thoughts or dreams, have trouble sleeping and be
unable to concentrate. Both physically and verbally abused women may experience PTSD; the
more extensive the abuse, the greater the risk of PTSD (Kemp, Green, Hovanitz, & Rawlings,
1995).

Psychological control by the batterer, coupled with the demands of parenting and often by life in a
dangerous neighborhood, isolates many victims of abuse (Bassuk et al., 1996a), leaving them
without social and material support that could mitigate the psychological consequences of
battering and could facilitate employment. Women need a range of psychological, medical, and
social and legal services as they remove themselves from abusive relationships. Even after
finding a safe environment, they need continuing psychological help to repair the damage to their
self-esteem and to prepare them for job training and employment.
Some women may be unwilling to voluntarily identify themselves as victims. The Family Violence
Option allows states to take the initiative to do the necessary screening. This initiative can save
the lives of battered women, can help preserve their families, and can help them keep jobs and
gain self-sufficiency.

Recommendations

1. States should adopt the Family Violence Option to the federal welfare law, which allows
states to (a) screen welfare recipients for a history of domestic violence; (b) refer these
individuals to counseling and support services; and (c) exempt individuals from certain
requirements for as long as necessary when compliance would make it more difficult to
escape a violent situation (Davis, 1996; Swarns, 1997).
2. States should grant extensions or temporary exemptions from time limits to welfare
recipients who have experienced a history of domestic violence.
3. States should administer "good cause" exceptions which define domestic violence
broadly without increasing the burden of proof upon the victim of abuse.
4. States should exempt young mothers living in abusive home environments from
requirements that they live at home.
5. States should eliminate the two-tiered benefit system for welfare recipients who have
relocated from other states to escape their abusers.
6. States should train job and employment staff to recognize domestic abuse among women
applicants and should offer psychological services to women applicants identified as
battered; this assistance is needed to support the efforts of these women to get training
and to find and keep jobs.
7. States should protect battered women from benefit cuts as a result of reporting abuse by
a live-in partner. This will mean a waiver of the rule attributing income of the man to the
welfare recipient in states in which welfare benefits are available only to single-parent
families.
8. States should establish "good cause" exemptions to requirements that paternity be
established or child support enforced in situations in which it is likely to increase violence
by or provoke retaliation from abusers.