Skip to main content Accessibility help

Preschooler witnesses of marital violence: Predictors and mediators of child behavior problems



This paper describes a conceptual approach to understanding the impact of marital violence on preschoolers, examines the predictors and mediators of child behavioral problems in a clinical sample of multiethnic preschoolers who witnessed their mothers' battering by their father figure, and presents empirical evidence supporting the use of relationship-based therapeutic modalities in treating preschoolers exposed to violence. We find that exposure to violence and maternal life stress are each predictive of child behavior problems, and that the impact of maternal life stress on child behavior problems is mediated by maternal psychopathology and the quality of the mother–child relationship.This research was funded by a grant from the National Institute of Mental Health (R21 MH 59661) and by grants from the Irving Harris Foundation and the Miriam and Peter Hass Fund. The authors thank the mothers and children who participated in the study and the assessors who conducted the interviews. We also thank Rachel Kimerling, PhD, and Chandra Ghosh Ippen, PhD, for their review of earlier versions of the manuscript.


Corresponding author

Address correspondence and reprint requests to: Alicia F. Lieberman, Child Trauma Research Project, San Francisco General Hospital, Building 20, Suite 2100, 1001 Potrero Avenue, San Francisco, CA 94110; E-mail:


Hide All


Achenbach, T. M. (1991a). Manual for the Child Behavior Checklist 4–18 and 1991 Profile. Burlington, VT: University of Vermont Department of Psychiatry.
Achenbach, T. M. (1991b). Manual for the Teacher's Report Form and 1991 Profile. Burlington, VT: University of Vermont Department of Psychiatry.
Achenbach, T. M., & Edelbrock, C. S. (1983). Manual for the Child Behavior Checklist and Revised Child Behavioral Profile. Burlington, VT: University of Vermont Department of Psychiatry.
Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A study of the Strange Situation. Hillsdale, NJ: Erlbaum.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Astin, M. C., Ogland–Hand, S. M., Coleman, E. M., & Foy, D. S. (1995). Posttraumatic stress disorder and childhood abuse in battered women: Comparisons with martially distressed women. Journal of Consulting and Clinical Psychology 63, 308312.
Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology 51, 11731182.
Blake, D. D., Weathers, F., Nagy, L., Kaloupek, D. G., Klauminzer, G., Charney, D., & Keane, T. M. (1990). Clinician administered PTSD scale. The Behavior Therapist 18, 1214.
Bowlby, J. (1969/1982). Attachment and loss: Vol. I. Attachment. New York: Basic Books.
Chamberlain, P., Reid, J. B., Ray, J., Capaldi, D., & Fisher, P. A. (1997). DSM-IV review for parent inadequate discipline (PID). In P. A. Widiger (Ed.), DSM-IV Sourcebook. New York: American Psychiatric Association.
Cicchetti, D., & Hinshaw, S. (2002). Editorial: Prevention and intervention science: Contributions to developmental theory. Development and Psychopathology 14, 667672.
Cicchetti, D., & Lynch, M. (1993). Toward an ecological/transactional model of community violence and child maltreatment: Consequences for children's development. Psychiatry 56, 96118.
Cicchetti, D., Toth, S. L., & Lynch, M. (1995). Bowlby's dream comes full circle: The application of attachment theory to risk and psychopathology. Advances in Clinical Child Psychology 17, 175.
Cicchetti, D., Toth, S. L., & Rogosch, F. A. (1999). The efficacy of toddler–parent psychotherapy to increase attachment security in offspring of depressed mothers. Attachment and Human Development 1, 3466.
Cummings, E. M., & Davies, P. T. (1994). Children and marital conflict: The impact of family dispute and resolution. New York: Guilford Press.
Davidson, T. (1978). Conjugal crime: Understanding and changing the wife beating pattern. New York: Hawthorne.
Dodge, K. A. (1980). Social cognition and children's aggressive behavior. Child Development 51, 162170.
Drell, M. J., Siegel, C. H., & Gaensbauer, T. J. (1993). Post-traumatic stress disorder. In C. H. Zeanah (Ed.), Handbook of infant mental health (pp. 291304). New York: Guilford Press.
Eth, S. E., & Pynoos, R. S. (1985). Post-traumatic stress disorder in children. Washington, DC: American Psychiatric Association Press.
Fantuzzo, J. W., & Lundquist, C. U. (1989). The effects of observing conjugal violence on children: A review and analysis of research methodology. Journal of Family Violence 4, 7794.
Fantuzzo, J. W., & Mohr, W. K. (1999). Prevalence and effects of child exposure to domestic violence. In Domestic violence and children: The future of children (Vol. 9, pp. 2132). Menlo Park, CA: The David and Lucile Packard Foundation.
Fraiberg, S. (1980). Clinical studies in infant mental health. New York: Basic Books.
Gaensbauer, T. J. (1994). Therapeutic work with a traumatized toddler. The Psychoanalytic Study of the Child 49, 412433.
George, C., & Solomon, J. (1996). Representational models of relationships: Links between caregiving and attachment. Infant Mental Health Journal 17, 198216.
Greenberg, M. T., Speltz, M. L., & DeKlyen, M. (1993). The role of attachment in the early development of disruptive behavior problems. Development and Psychopathology 5, 191213.
Groves, B. M. (2002). Children who see too much. Boston: Beacon Press.
Holden, G., Geffner, R. A., & Jouriles, E. N. (1998). Children exposed to marital violence: Theory, research, and applied issues. Washington, DC: American Psychiatric Association Press.
Holden, G. W., & Ritchie, K. L. (1991). Linking extreme marital discord, child rearing, and child behavior problems: Evidence from battered women. Child Development 62, 311327.
Jaffe, P. G., Wolfe, D. A., & Wilson, S. K. (1990). Children of battered women. Newbury Park, CA: Sage.
Jouriles, E. N., McDonald, R., Stephens, N., Norwood, W., Spiller, L. C., & Ware, H. S. (1998). Breaking the cycle of violence: Helping families departing from battered women's shelters. In G. W. Holden, R. Geffner, and E. N. Jouriles (Eds.), Children exposed to marital violence: Theory, research and applied issues (pp. 337370). Washington, DC: American Psychological Association.
Jouriles, E. N., & Norwood, W. D. (1995). Physical aggression toward boys and girls in families characterized by the battering of women. Journal of Family Psychology 9, 6978.
Jouriles, E. N., Norwood, W. D., McDonald, R., Vincent, J. P., & Mahoney, A. (1996). Physical violence and other forms of marital aggression: Links with children's behavior problems. Journal of Family Psychology 10, 223234.
Kagan, J. (1981). The second year: The emergence of self-awareness. Cambridge, MA: Harvard University Press.
Keane, T. M., Fairbank, J. A., Caddell, J. M., Zimering, R. T., Taylor, K. L., & Mora, C. A. (1989). Clinical evaluation of a measure to assess combat exposure. Psychological Assessment 1, 5355.
Kemp, A., Green, B. L., Hovanitz, C., & Rawlings, E. I. (1995). Incidence and correlates of posttraumatic stress disorder among battered women: Shelter and community samples. Journal of Interpersonal Violence 10, 4355.
Laor, N., Wolmer, L., & Cohen, D. J. (2001). Mothers' functioning and children's symptoms 5 years after a SCUD missile attack. American Journal of Psychiatry 158, 10201026.
Layzer, J. I., Goodson, B. D., & Delange, C. (1985). Children in shelters. Response 9, 25.
Levendosky, A. A., Huth–Bocks, A. C., Shapiro, D. L., & Semel, M. A. (2003). The impact of domestic violence on the maternal–child relationship and preschool-age children's functioning. Journal of Family Psychology 17, 275287.
Lieberman, A. F. (1991). Attachment theory and infant–parent psychotherapy: Some conceptual, clinical, and research considerations. In D. Cicchetti & S. Toth (Eds.) , Rochester Symposium on Developmental Psychopathology: Vol. 3. Models and Integrations (pp. 262287). Rochester, NY: University of Rochester Press.
Lieberman, A. F., & Van Horn, P. (1998). Attachment, trauma, and domestic violence: Implications for child custody. Child and Adolescent Psychiatric Clinics of North America 7, 423444.
Lieberman, A. F., Van Horn, P., Grandison, C. M., & Pekarsky, J. H. (1997). Mental health assessment of infants, toddlers and preschoolers in a service program and a treatment outcome research program. Infant Mental Health Journal 18, 158170.
Lieberman, A. F., Weston, D., & Pawl, J. H. (1991). Preventive intervention and outcome with anxiously attached dyads. Child Development 62, 199209.
Linares, L. O., Heeren, T., Bronfman, E., Zuckerman, B., Augustyn, M., & Tronick, E. (2001). A mediational model for the impact of exposure to community violence on early child behavior problems. Child Development 72, 639652.
Lynch, M., & Cicchetti, D. (1998). An ecological-transactional analysis of children and context: The longitudinal interplay among child maltreatment, community violence, and children's symptomatology. Development and Psychology 10, 23557.
Lyons–Ruth, K., & Block, D. (1996). The disturbed caregiving system: Relations among childhood trauma, maternal caregiving, and infant affect and attachment. Infant Mental Health Journal 17, 257275.
Lyons–Ruth, K., Bronfman, E., & Atwood, G. (1999). A relational diathesis model of hostile-helpless states of mind. In J. Solomon & C. George (Eds.), Attachment and disorganization (pp. 3569). New York: Guilford Press.
MacKinnon, D. P. (2000). Contrasts in multiple mediator models. In J. Rose, L. Chassin, C. C. Presson, & S. J. Sherman (Eds.), Multivariate applications in substance use research: New methods for new questions (pp. 141160). Mahwah, NJ: Erlbaum.
MacKinnon, D. P., Lockwood, C. M., Hoffman, J. M., West, S. G., & Sheets, V. (2002). A comparison of methods to test mediation and other intervening variable effects. Psychological Methods 7, 83104.
Marans, S., & Adelman, A. (1997). Experiencing violence in a developmental context. In J. Osofsky (Ed.), Children in a violent society (pp. 202222). New York: Guilford Press.
Margolin, G. (1998). Effects of domestic violence on children. In P. K. Trickett and C. J. Shellenbach (Eds.), Violence against children in the family and the community (pp. 57101). Washington, DC: American Psychological Association.
McDonald, R., & Jouriles, E. N. (1991). Marital aggression and child behavior problems: Research findings, mechanisms, and intervention strategies. Behavior Therapist 14, 189192.
Osofsky, J. D. (1997). Children in a violent society. New York: Guilford Press.
Osofsky, J. D. (1998). Children as invisible victims of domestic and community violence. In G. W. Holden, R. Geffner, & E. N. Jouriles (Eds.), Children exposed to marital violence: Theory, research, and applied issues (pp. 95117). Washington, DC: American Psychological Association.
Ozer, E. J., Best, S. R., Lipsey, T. L., & Weiss, D. S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychological Bulletin 129, 5273.
Parson, E. R. (1995). Post-traumatic stress and coping in an inner-city child: Traumatogenic witnessing of interparental violence and murder. The Psychoanalytic Study of the Child 50, 252271.
Peled, E., & Edleson, J. L. (1992). Multiple perspectives on groupwork with children of battered women. Violence and Victims 7, 327346.
Perrin, S., Van Hasselt, V. B., Basilio, I., & Hersen, M. (1996). Assessing the effects of violence on women in battering relationships with the Keanne MMPI-PTSD Scale. Journal of Traumatic Stress 9, 805816.
Pruett, K. D. (1979). Home treatment for two infants who witnessed their mother's murder. Journal of the American Academy of Child and Adolescent Psychiatry 18, 647657.
Pynoos, R. S. (1993). Traumatic stress and developmental psychopathology in children and adolescents. In J. M. Oldham, M. B. Riba, & A. Tasman (Eds.), American Psychiatric Press review of psychiatry (Vol. 12, pp. 205238).
Pynoos, R. S., & Eth, S. (Eds.). (1985). Post-traumatic stress disorder in children. Washington, DC: American Psychiatric Association Press.
Pynoos, R. S., & Nader, K. (1988). Children who witness the sexual assaults of their mothers. Journal of the American Academy of Child And Adolescent Psychiatry 27, 567572.
Pynoos, R. S., Steinberg, A. M., & Piacentini, J. C. (1999). A developmental psychopathology model of childhood traumatic stress and intersection with anxiety disorders. Biological Psychiatry 46, 15421554.
Pynoos, R. S., Steinberg, A. M., & Wraith, R. (1995). A developmental model of childhood traumatic stress. In D. Cicchetti & D. Cohen (Eds.), Manual of developmental psychopathology: Vol. 2. Risk, disorder, and adaptation (pp. 7295). New York: Wiley.
Reid, J. B., & Eddy, J. M. (1998). The prevention of antisocial behavior: Some considerations in the search for effective interventions. In D. M. Stoff, J. Breiling, & J. D. Maser (Eds.), Handbook of antisocial behavior (pp. 343356). New York: Wiley.
Richters, J. E., & Martinez, P. E. (1993). The NIMH Community Violence Project: Children as victims of and witnesses to violence. In D. Reiss, J. E. Richters, M. Radke–Yarrow, & D. Scharf (Eds.), Children and violence (pp. 721). New York: Guilford Press.
Rosenheck, R., & Fontana, A. (1998). Transgenerational effects of abusive violence on the children of Vietnam combat veterans. Journal of Traumatic Stress 11, 731742.
Rutter, M. (1994). Family discord and conduct disorder: Cause, consequence, or correlate? Journal of Family Psychology 8, 170186.
Rutter, M. (2000). Resilience reconsidered: Conceptual considerations, empirical findings, and policy implications. In Shonkoff, J. P. & Meisels, S. J. Handbook of early childhood intervention. Cambridge: Cambridge University Press, 651682.
Rutter, M., & Sroufe, L. A. (2000). Developmental psychopathology: Concepts and challenges. Development and Psychopathology 12, 265296.
Sameroff, A. J. (2000). Developmental systems and psychopathology. Development and Psychopathology 12, 297312.
Sameroff, A., & Emde, R. N. (Eds.). (1989). Relationship disturbances in early childhood: A developmental approach. New York: Basic Books.
Scheeringa, M. S., & Zeanah, C. (1995). Symptom expression and trauma variables in children under 48 months of age. Infant Mental Health Journal 16, 259270.
Shaw, D. S., & Winslow, E. B. (1997). Precursors and correlates of antisocial behavior from infancy to preschool. In D. M. Stoff, J. Breiling, & J. D. Maser (Eds.), Handbook of antisocial behavior (pp. 148158). New York: Wiley.
Solomon, Z., Kotler, M., & Mikulincer, M. (1988). Combat-related posttraumatic stress disorder among 2nd generation Holocaust survivors—Preliminary findings. American Journal of Psychiatry 145, 865868.
Straus, M. A. (1979). Measuring intrafamily conflict and violence: The Conflict Tactics (CT) Scales. Journal of Marriage and the Family 41, 7588.
Straus, M. A., Hamby, S. L., Boney–McCoy, S., & Sugarman, D. B. (1996). The revised Conflict Tactics Scales (CTS2): Development and preliminary psychometric data. Journal of Family Issues, 17 (3), 283316.
Terr, L. C. (1981). Forbidden games: Post-traumatic child's play. Journal of the American Academy of Child and Adolescent Psychiatry 20, 740759.
Toth, S. L., Maughan, A., Manly, J. T., Spagnola, M., & Cicchetti, D. (2002). The relative efficacy of two interventions in altering maltreated preschool children's representational models: Implications for attachment theory. Development and Psychopathology 14(4), 877908.
van der Kolk, B. (1987). Psychological trauma. Washington, DC: American Psychiatric Press.
van Ijzendoorn, M. H., Bakermans–Kranenburg, M. J., & Sagi–Schwartz, A. (2003). Are children of Holocaust survivors less well-adapted? A meta-analytic investigation of secondary traumatization. Journal of Traumatic Stress 16, 459469.
Weathers, F. W., & Litz, B. T. (1994). Psychometric properties of the Clinician-Administered PTSD Scale, CAPS-1. PTSD Research Quarterly 5, 26.
Wolfe, D. A., Jaffe, P., Wilson, S. K., & Zak, L. (1985). Children of battered women: The relation of child behavior to family violence and maternal stress. Journal of Consulting and Clinical Psychology 53, 657665.
Wolfe, J. W., & Kimerling, R. (1997). Gender issues in the assessment of posttraumatic stress disorder. In J. P. Wilson & T. P. Keane (Eds.), Assessing psychological trauma and Posttraumatic Stress Disorder (pp. 192238). New York: Guilford Press.
Wolfe, J. W., Kimerling, R., Brown, P. J., Chrestman, K. R., & Levin, K. (1996). Psychometric review of The Life Stressor Checklist—Revised. In B. H. Stamm (Ed.), Measurement of stress, trauma, and adaptation. Lutherville, MD: Sidran Press.
Zero to Three, National Center for Clinical Infant Programs. (1994). Diagnostic classification: 0–3. Diagnostic classification of mental health and developmental disorders of infancy and early childhood. Washington, DC: Author.
Zilberfein, F. (1996). Children of Holocaust survivors: Separation obstacles, attachments, and anxiety. Social Work in Health Care 23, 3555.

Related content

Powered by UNSILO

Preschooler witnesses of marital violence: Predictors and mediators of child behavior problems



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.