Resolution of Intimate Partner Violence and Child Behavior Problems After Investigation for Suspected Child Maltreatment

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. JAMA Pediatr. 2013;167(3):236-242. Published online January 14, 2013. doi:10.1001/2013.jamapediatrics.324