Adverse childhood experiences and intimate partner aggression in the US: sex differences and similarities in psychosocial mediation

Abstract

Six in ten people in the general population have been exposed to adverse childhood experiences (ACEs). Intimate partner violence (IPV) is a major public health problem in the US. The main objective of this study was to assess sex differences in the role of posttraumatic stress disorder (PTSD), substance abuse, and depression as mediators in the association between ACEs and intimate partner aggression. Data were obtained from Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Structural equation modeling was used to determine the mediational role of PTSD, substance abuse and depression in the association between ACE constructs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration/psychopathology) and intimate partner aggression. Among men, PTSD mediated the relationship between sexual abuse and intimate partner aggression. However, among men and women, substance abuse mediated the relationship between physical and psychological abuse and intimate partner aggression. IPV programs geared towards aggressors should address abuse (sexual, physical and psychological), which occurred during childhood and recent substance abuse and PTSD. These programs should be implemented for men and women. Programs aimed at preventing abuse of children may help to reduce rates of depression and PTSD in adulthood, and subsequent intimate partner aggression.

Keywords: Adverse childhood experiences; Depression; Intimate partner aggression; Mediation; Posttraumatic stress disorder; Structural equation modeling; Substance abuse.

Fig. 1

Mediational model showing indirect associations between adverse childhood experiences and intimate partner aggression. Abbreviations (from top to bottom, and left to right): Adverse Childhood Experiences: Unsupervised, Respondent was left alone or unsupervised before age 10; Things, Respondent went without things needed (clothes, supplies); Hungry, Respondent went hungry; Medical, Respondent failed to get medical treatment; Hurtful, Parent/Caregiver said insulted or said hurtful things to the respondent; Hit, Parent/Caregiver threatened to hit or throw something at the respondent; Hurt, Parent/Caregiver made respondent fear they would be physically hurt; Pushed, Parent/Caregiver pushed/grabbed/shoved/slapped or hit respondent; Injured, Parent/Caregiver hit respondent that caused marks/bruises/injury; Touched, Adult/Other person touched respondent sexually; Touch, Adult/Other person had respondent touched them sexually; Attempted, Adult/Other person attempted to have sex with respondent; Had Sex, Adult/Other person had sex with respondent; P_Pushed, Father/Other adult male push, grab, slap or throw something at mother; P_Hit, Father/Other adult male repeatedly hit mother for at least a few minutes; P_Fist, Father/Other adult male hit mother with a fist or something hard; P_Threat, Father/Other adult male threaten mother with a knife/gun or use it to hurt her; P_Drinker, Parent/Other adult living in the home was a problem drinker; P_Drugs, Parent/Other adult had problems with drugs; P_Incarc, respondent lived with a parent/other adult who was incarcerated; P_Mental, Parent/Other adult was treated/hospitalized for mental illness; P_AttSuic, Respondent lived with a parent/other adult who attempted suicide; P_CommSuic, respondent lived with a parent/other adult who committed suicide. Touch, Adult/Other person had respondent touched them sexually; Mediators: PTSD, post-traumatic stress disorder; Intimate Partner Aggression: Push, Respondent pushed/grabbed/shoved spouse/partner; Slap, Respondent slapped/Kicked/Bit/Hit spouse/partner; Threat, Respondent threatened spouse/partner with a weapon like a knife or gun; Cut, Respondent cut/bruise spouse or partner; Sex, Respondent force spouse/partner to have sex; Injury, Respondent injured spouse/partner enough that they needed medical care.