Abstract
The presence of threat and self-blame in children exposed to violence in the home has been linked to a number of negative behavioral and emotional consequences across developmental periods. Little research, however, has examined self-reported attributions of threat and self-blame in children under the age of 6. The current study evaluated the developmental trajectories of appraisals of threat and self-blame in preschool-aged children recently exposed to intimate partner violence. It was hypothesized that (a) children’s appraisals of threat and self-blame would naturally decrease over time and (b) there would be a main effect of child sex on appraisals of self-blame but not threat, such that girls would report higher levels of self-blame than boys. Participants included 68 preschool-aged children (ages 4-6) who were interviewed at two time points over the course of 1 year. Multilevel modeling was employed to examine the effects of violence exposure, child age, and child sex over time. Children’s attributions of threat were stable over the course of 1 year, but greater child age was related to lower appraisals of threat. Children’s appraisals of self-blame increased over time, and there was a trend for girls to report more self-blame than did boys. It appears that without intervention, young children may be at risk of developing relatively stable maladaptive cognitive patterns, thereby heightening their risk of subsequent developmental psychopathology. Furthermore, girls may need additional intervention targeted at addressing attributions of self-blame.
Intimate partner violence (IPV) is defined by the Centers for Disease Control and Prevention (CDC) as threatened or completed acts of physical, sexual, or psychological aggression against a partner (2006). An estimated 275 million children worldwide are exposed to IPV each year (UNICEF, 2005), and some research indicates that children under the age of 6 are at the highest risk of exposure (Fantuzzo & Fusco, 2007; Finkelhor, Ormrod, Turner, & Hamby, 2005). Not only are these children at risk of the emotional trauma of being an eye-witness to such violence, but they are frequently victimized themselves—either due to co-occurring physical abuse by a family member, harsh physical punishment, or accidental injuries occurring during the course of their parents’ violent altercations (Graham-Bermann & Perkins, 2010; Zolotor, Theodore, Coyne-Beasley, & Runyan, 2007). A large number of studies have documented the relationship between this violence exposure and children’s emotional, behavioral, health, social, and cognitive problems (Graham-Bermann, Gruber, Howell & Girz, 2009; Graham-Bermann, Howell, Miller, Kwek, & Lilly, 2010; Kennedy, Bybee, Sullivan, & Greeson, 2010; Onyskiw, 2003).
In addition to establishing the direct links between violence exposure and child developmental psychopathology, research has increasingly looked to mediating and moderating factors as a way of understanding how and why these negative outcomes unfold across development (e.g., Miller, Howell, & Graham-Bermann, 2012a; Kennedy et al., 2010; Shelton & Harold, 2008). One specific line of research on mediating factors has focused on children’s cognitive interpretation, or appraisal, of the conflict they witness. Such research was originally pioneered with late childhood and early adolescent populations, focusing on families with nonviolent conflict (Grych, Fincham, Jouriles, & McDonald, 2000). The measure designed to assess these attributions, the Children’s Perception of Interparental Conflict Scale (CPIC; Grych, Seid, & Fincham, 1992) evaluates appraisals of threat and self-blame, the presence of which were predicted to relate to increased adjustment problems in children following interparental conflict (Grych & Fincham, 1990). Threat is defined as children’s report of fearfulness and inability to cope with threatening stimuli, whereas self-blame is defined as the extent to which children blame themselves for adverse experiences.
Extensive research on these constructs with children living in nonviolent families has produced a consistent mediating effect of maladaptive cognitive appraisals on internalizing behavior problems in children ranging in age from 5 to 14 (e.g., Ablow, Measelle, Cowan, & Cowan, 2009; Grych et al., 2000; McDonald & Grych, 2006). A study by Grych and colleagues (2000) also included a sample of 10- to 12-year-old children drawn from battered women’s shelters and found that appraisals of threat also mediated the relationship between exposure to conflict and children’s internalizing symptoms. While types of conflict that can occur in relationships range from marital disputes to severe physical assaults, the mediating effect was found for violent and nonviolent couples’ conflicts. Another study conducted on 8- to 12-year-old children exposed to IPV did not report on the relationship between child exposure and children’s self-reports of interparental conflict, making it difficult to draw conclusions about appraisals as they relate to chronically violent contexts (Jouriles, Spiller, Stephens, McDonald, & Swank, 2000).
Despite the relatively consistent relationship between cognitive appraisals and child adjustment, the examination of gender differences in these studies has shown more mixed results. No studies have discovered gender differences in children’s perceptions of threat in any age range (e.g., Grych et al., 1992; McDonald & Grych, 2006; McDonald, Jouriles, Tart, & Minze, 2009). However, children’s reports of self-blame have shown somewhat different results—with a few studies reporting higher levels of self-blame appraisals in girls (e.g., Miller, Howell & Graham-Bermann, 2012b; Kerig, Fedorowicz, Brown, Patenaude, & Warren, 1999), and some reporting higher self-blame in boys (Dadds et al., 1999; Richmond & Stocker, 2007). When examining children exposed to violence, there is evidence that girls may be more vulnerable than boys to the negative effects of IPV (Georgsson, Almqvist, & Broberg, 2011), perhaps due to the inherent gender-imbalance in rates of IPV perpetration and victimization (Langhinrichsen-Rohling, Misra, Selwyn, & Rohling, 2012). Thus, it is especially important to examine gender differences in the appraisals of children exposed to interparental violence, as young girls may identify with their same-sex parent, who is often the victim of partner abuse. Therefore, although gender findings in cognitive appraisals are mixed in children living in homes with nonviolent conflict, there is reason to expect that this may not hold in young children witnessing IPV.
In addition to differences in appraisals by gender, there is evidence that children’s appraisals may further vary by age. This assertion is relatively tenuous given that the majority of research on cognitive appraisals of violence has been cross-sectional. One study examining 8- to 12-year-old children found that younger children (8-10) reported higher levels of threat and self-blame than did older children (10-12; Jouriles et al., 2000). However, the association between appraisals and adjustment problems was stronger in older children, leading Jouriles and colleagues (2000) to conclude that while younger children report higher levels of maladaptive cognitions, these cognitions may be a less potent predictor of adjustment problems. One longitudinal study assessing the effects of age on children’s appraisals (8-19 years) in nonviolent families has been conducted (Richmond & Stocker, 2007). The results of this study indicated that children’s appraisals of threat decrease rapidly between childhood and early adolescence, but children’s appraisals of self-blame are relatively unchanged over time. Although there has been little longitudinal research on appraisals and even less on very young children, available studies suggest a general decline in maladaptive cognitive appraisals over time. The present study empirically evaluates the appraisals of preschool children because this age group experiences unique vulnerabilities (e.g., less contact with individuals outside of the home, lack of support through academic or peer outlets) that could provide insight into distinct developmental variations in cognitive appraisals.
Given the relative consistency of findings on appraisals in children exposed to nonviolent conflict, researchers have recently prompted others to focus on cognitive appraisals in children exposed to more severe levels of interparental conflict or IPV (Fosco, DeBoard, & Grych, 2007). Some robust research has been conducted on older children exposed to violence (Grych et al., 2000; Jouriles et al., 2000), but only one study has examined children most at risk of violence exposure—those under the age of 6 years (author Miller et al., 2012b). This is, perhaps, in part related to the reluctance of researchers to glean self-report data on the cognitions of very young children due to doubts about their linguistic and cognitive development. One previous study, however, has examined preschool-aged children’s appraisals of threat and self-blame for those living in violent families (Miller et al., 2012b). This study provided preliminary evidence that the majority of children were able to meet cognitive cut-offs identified as minimum requirements for valid responding and also found that children’s appraisals of threat were related to their reports of conflict between their parents. Such findings reinforce the validity of preschool children’s self-reports. This study also found that children’s appraisals of threat were negatively related to child age, but the extent to which this previous study is able to describe developmental changes in threat and self-blame in the preschool years is limited by its cross-sectional design.
The Current Study
The present study, therefore, proposes to expand current knowledge on the development of cognitive appraisals in the early childhood years by examining 4- to 6-year-old children who have been recently exposed to IPV. To provide essential information about the development of these appraisals over time, the current study will employ a longitudinal design, thereby building on existing knowledge available in this age group.
Aims and Hypotheses
Due to the lack of research on preschool children’s appraisals of threat and self-blame, the current study aims to examine how appraisals naturally develop over time. For each of the below hypotheses, change will be examined across two time points (baseline, 6- to 8-month follow-up). It is hypothesized that
No gender differences in child appraisals of threat are hypothesized.
Method
Participants
The study included 68 preschool-aged children exposed to severe IPV in the past 2 years. Children ranged in age from 4 to 6 years (M = 4.93, SD = 0.82). There were 37 boys and 31 girls. Forty-four percent of the children were European American, 32% were African American, 18% were Biracial, and 6% were Hispanic American.
Drop analyses
At baseline, 68 children were interviewed, with some attrition at follow-up. At 6- to 8-month follow-up, 36 children completed the interview (attrition of 47%). Preliminary analyses were conducted to verify that there were no differences based on drop out status. At 6- to 8-month follow-up, children in the drop-out group were significantly more likely to report higher levels of threat at baseline than children in the non-drop group, t(47) = 2.08, p < .05. There were no other significant differences between drops and nondrops.
Inclusion protocol
Interviewed children were required to meet a set of inclusion criteria based on previous use of the CPIC with preschool-aged children. These criteria were enforced to eliminate possible random responses due to insufficient cognitive and linguistic development (Miller, et al, 2012). As such, children who fulfilled any of the three following criteria were dropped from the analyses: (a) an interviewer rating of “no understanding” regarding comprehension of interview material, (b) a verbal ability score in the extremely low range (Scaled Score <5), and (c) measure completion rate of less than 40%. Of the 68 children interviewed at baseline, 10 of these children’s interviews were dropped based on the above criteria. Compared with children who met inclusion criteria for valid responding, children who were dropped from the analyses were younger—age in months, t(66) = −2.70, p < .05—and had less housing instability—moves in the past 4 years, t(53.44) = −3.53, p < .01. At 6- to 8-month follow-up, 2 of the 36 interviewed children were dropped. These two children had mothers who reported significantly less psychological aggression in their intimate relationships at baseline, t(34) = 2.64, p < .05, but there were no differences in total violence exposure. The final sample included 58 children at baseline and 34 children at 6- to 8-month follow-up.
Procedures
The data for this study were derived in part from a larger, ongoing study of the efficacy of an intervention program for preschool-aged children exposed to IPV (Graham-Bermann 2006-2011). To identify patterns in the development of children’s cognitive appraisals, only children who did not receive the intervention were included in the current study. All study materials and procedures were approved by the Institutional Review Board of the University of Michigan. Mothers and their preschool-aged children were recruited using advertisements posted in a variety of cooperating public agencies, such as county legal, medical, and mental health services. After contacting the study coordinator, the mothers completed a brief phone screen to determine whether she had experienced severe IPV in the past 2 years and had a 4- to 6-year-old child living in the home. If mothers and their children met these criteria for inclusion and were interested in participating, they were scheduled for an initial interview. The study coordinator scheduled this interview at a location that was convenient for the mother and maintained the health and safety of all participants and interviewers. If there was no abuser living in the home, mothers were given the option of completing the interview at home. If there was an abusive partner living in the home, however, mothers were offered the opportunity to meet at the research lab, a women’s shelter, or at another location of their choosing (e.g., a public library).
Following informed consent, mothers and children completed the interviews, which lasted approximately 1.5 hr for mothers and 30 min for children. Mothers received $25 for their participation and children received a toy valued at approximately $4. At the conclusion of the baseline interview, each mother provided interviewers with updated contact information. Each mother also provided signed consent to contact other close family members and friends to obtain the mother’s contact information in case the family moved or had a phone number change between interviews. Mothers who were interested in obtaining support (including intervention) were provided with community resources for housing, mental health, and legal services. Mothers and children participated in an identical set of interview protocol at 6- to 8-month follow-up.
Measures
Demographics
Mothers completed a questionnaire to gather basic background information such as mother’s age, the age of her child, income, ethnicity, educational attainment, housing history and relationship status.
IPV
Family violence was assessed with the Revised Conflict Tactics Scales (CTS2; Straus, Hamby, Boney-McCoy, & Sugarman, 1996). The CTS2 is a 78-item instrument measuring the severity and frequency of Psychological Aggression, Physical Assault, Injury, Sexual Coercion, and Negotiation over the past year in a couple’s relationship. Only the 39 questions addressing violence victimization were administered in this study. For each item, mothers were asked to estimate the frequency with which their partner had used different violence tactics toward them within the past year. At baseline, mothers reported on the violence they had experience in the past year. At 6- to 8-month follow-up, mothers reported only on violence experienced since their baseline interview, that is, over the past 6 to 8 months. The CTS2 has been shown to be reliable, with subscales ranging from α = .79 to α = .95 (Straus et al., 1996). The reliabilities for the CTS2 at each time point (baseline and 6- to 8-month follow-up) were Psychological Aggression (α = .60, not used at follow-up), Physical Assault (α = .72, .87), Sexual Coercion (α = .80, .82), and Injury (α = .62, .47).
Children’s appraisals of interparental conflict
Appraisals were assessed using the Children’s Perception of Interparental Conflict Scale (CPIC; Grych et al., 1992), a 48-item measure of school-aged children’s appraisals that has three subscales: Conflict Properties, Self-Blame, and Threat. The Conflict Properties subscale includes Frequency, Intensity, and Resolution. The Self-Blame subscale includes Content and Self-Blame. The Threat subscale includes Threat and Coping Efficacy. For each item, children can choose whether it is true (2), sometimes true (1) or not true (0) of their families. The CPIC was originally designed for use with older children (Grych et al., 1992), and a current version exists that has been evaluated for use in 7- to 9-year-olds (McDonald & Grych, 2006). However, due to data collection for the current study having begun prior to the release of this measure, a number of accommodations were made to best reflect changes in the administration and structure of the scale in concordance with available research. Interviewers first taught children hand gestures that would help them express their answers (e.g., spreading their arms wide for “true,” more narrowly for “sometimes true,” and crossing their hands over their chest for “not true”). To ensure that children were cognizant of possible responses, interviewers then guided children through a series of “practice” questions wherein they responded with the prescribed response set to a series of statements (e.g., “I like ice cream”). This measure has been used in a number of studies with test–retest reliability ranging from .68 to .76 (Grych et al., 1992).
In addition to methodological accommodations, an item analysis was conducted to evaluate concerns about difficulties with the length of the CPIC measure and the ability of preschool-aged children to respond to negatively worded statements. Here, items that failed to provide factor loadings of at least (<.40) were removed. With regard to the Threat subscale, the following items were removed: “When my parents argue I can do something to make myself feel better,” “When my parents argue or disagree I can usually help make things better,” and “When my parents argue, I worry they might get divorced.” Items removed from the Self-Blame subscale were: “I’m not to blame when my parents have arguments” and “Usually it’s not my fault when my parents have arguments.” Finally, items removed from the Conflict Properties subscales were: “I never see my parents arguing or disagreeing,” “My parents hardly ever yell when there is a disagreement,” and “My parents still act mean after they have an argument.” It should be noted that removed items were primarily items that were negatively worded or were at the end of the measure, as hypothesized by other research (McDonald & Grych, 2006). Scale reliabilities for the current study can be found in Table 1.
Descriptive Analyses for Children Perceptions of Interparental Conflict Omnibus Scales and Subscales.
Note. Descriptives are reported on nonimputed data.
Analytic Protocol
Study hypotheses were analyzed using multilevel models in STATA 12. To account for multiply imputed data, the “mi estimate” procedure was used, which adjusts the coefficients and standard errors for variability across the 20 imputations. The creation of 20 datasets is a recent estimate of the number of datasets required to create stable estimates with minimal bias and maximum power (Graham, Olchowski, & Gilreath, 2007). The specific imputation procedure employed was multivariate normal, which is recommended for repeated measures data, as it takes into account the clustering of responses within each individual, and recognizes that these are related over time (Allison, 2002). That is, this specific procedure acknowledges that the best predictor of a person’s score at one time point is their score at other time points (Engels & Diehr, 2003).
Data were modeled using full maximum likelihood estimation. For both dependent variables (self-blame and threat, noted here as yit), the following model was fitted:
Time was included in each model as a continuous variable, measured in weeks since baseline interview. Child age was measured in months.
Results
Violence Exposure
All children in the current study had exposure to IPV in the past 2 years, per inclusion criteria. Of these families, only 2.5% reported no IPV of any kind in the year immediately previous to the study. On average, mothers reported that in the past year, there had been 184 incidents of violence (SD = 129.23). Specifically, mothers reported an average of 93 acts of psychological aggression (SD = 49.33), 51 acts of physical assault (SD = 54.06), 25 acts of sexual coercion (SD = 39.31), and 14 injuries sustained from the violence (SD = 14.17) within the last year. Notably, violence had decreased significantly at the follow-up interview, with mothers reporting an average of 59 events of physical violence, sexual violence, or injury (SD = 88.42).
Threat and Self-Blame Analyses
Descriptive analyses of the CPIC scales and subscales can be found in Table 1. Children’s appraisals of threat ranged from 0 to 18, with an average relatively mid-range (See Table 1). Appraisals of self-blame, however, were quite high. On a scale ranging from 0 to 14, children scored an average of 10 to 11 (see Table 1), indicating that they nearly always blamed themselves for the violence that occurred.
Prior to conducting multilevel analyses, direct relationships between study variables were examined to determine model construction. Correlational analyses can be found in Table 2. Each model tested for the fixed effects of child age, child sex, and violence exposure, with random intercepts.
Correlation Analyses of Study Variables.
Note. Descriptives are reported on nonimputed data. CTS = conflict tactics scales.
p<.10 *p < .05. **p < .01. ***p < .001.
Threat
Multilevel modeling with random intercepts was employed to test changes in children’s appraisals of threat over time, controlling for child age in months and for exposure to violence (by child and maternal reports). No significant between-group differences were found, indicating no differences in growth trajectories based on child sex. However, children’s perception of threat was significantly related to their own reports of the intensity of the conflicts they witnessed (β = .72, t = 4.79, p < .001). Specifically, increased reports of parental conflict intensity over time were related to increases in appraisals of threat. Contrary to the first hypothesis, child reports of threat appraisals did not decrease over time in the study, but older children had signifcantly lower appraisals of threat (β = −.12, t = −2.54, p < .05). The full model is presented in Table 3.
Multilevel Models for Threat and Self-Blame.
Note. Calculated using multiply imputed data. CTS = conflict tactics scales. CI = confidence interval.
p < .10. *p < .05. **p < .01. ***p < .001.
Self-blame
Multilevel modeling with random intercepts was also used to assess trajectories in children’s appraisals of self-blame over time (See Table 3). Children’s perceptions of self-blame did change in relation to their appraisals of parental resolution of conflict, with children reporting greater self-blame when parents were more effective in resolving conflict (β = −.33, t = −2.45, p < .05). Children’s appraisals of self-blame significantly increased over time (β = .03, t = 2.13, p < .05) and were not significantly influenced by the child’s age. Girls reported higher levels of self-blame than did boys (β = −1.61, t = −2.00, p < .05), providing support for the second hypothesis.
Discussion
The results of the current study provide longitudinal data on preschooler’s cognitive appraisals of threat and self-blame, indicating a generally static or worsening of cognitions about IPV over the period of 6 to 8 months. The first hypothesis, that postulated young children’s appraisals of threat and self-blame would naturally decrease over time, was not supported by the data. However, children’s appraisals of threat were related to child age, indicating that there may be some developmental changes in appraisals of threat across 4- to 6-year-olds, but that a 6- to 8-month time span is not long enough to identify these changes. This finding is consistent with previous literature that shows stability in perceptions of threat and self-blame across the period of 1 year in 5- to 6-year-old children (Ablow et al., 2009). This finding also indicates that much more research needs to be done to examine the timing and course of these developmental changes, such as a multimethod assessment of threat that includes physiological and observational measures. Using longer assessment time periods, as well as a multimethod assessment of threat, may help identify nuanced differences in children’s perceptions of threat over time, as have been found in studies of older children (e.g., Richmond & Stocker, 2007).
The current study found that there were no changes in appraisals of threat over time, and increases in appraisals of self-blame. While this is a relatively limited time span, the failure of these appraisals to decrease may indicate a high need for intervention with this young population. This finding is especially notable because violence decreased over time, yet the cognitive appraisals of threat and self-blame remained stable. Many research studies have linked the presence of threat and self-blame to negative mental health outcomes for children at all stages of development (e.g., Dodd, Hudson, Morris, & Wise, 2012; Kiel & Buss, 2011; McDonald & Grych, 2006). In fact, in one study of preschoolers exposed to violence, increased vigilance toward threatening stimuli increased vulnerability for PTSD (Swartz, Graham-Bermann, Mogg, Bradley & Monk, 2011). Most of these studies have been cross-sectional and have therefore not differentiated children who are experiencing cross-sectionally heightened self-blame/threat from those with prolonged maladaptive attributions. Given research that shows that the stability of depressed cognitions in children places them at high risk of perpetuation of negative mood states (e.g., Cole et al., 2011), one would expect that the stability of these maladaptive appraisals of IPV may place children at especially at even greater risk of developmental psychopathology.
The second hypothesis was partially supported by the data. First, there were no differences in threat appraisal by child sex. This finding supports the large body of research on threat appraisal across developmental periods, which consistently shows no differences by child sex (e.g., Grych et al., 1992; McDonald & Grych, 2006). There were, however, differences in children’s appraisals of self-blame by child sex, providing support for cross-sectional research in preschoolers exposed to IPV, which shows higher rates of self-blame in girls (Miller et al., 2012b). This finding supports other research in child development that shows higher rates of self-blame, shame, and guilt in girls—a gender difference that first arises in the preschool years (Kochanska, De Vet, Goldman, Murray, & Putnam, 1994).
One notable (and unexpected) finding of the current study is that preschoolers’ appraisal of threat and self-blame was higher when they reported greater conflict resolution between their parents (e.g., “When my parents have an argument, they usually work it out”). One potential explanation for this finding is that children exposed to IPV are at high risk of violence exposure and victimization (e.g., Finkelhor et al., 2005). Unlike children living in nonviolent families, where resolution could enhance emotional security in the parental relationship and foster positive adjustment (Davies, Harold, Goeke-Morey, & Cummings, 2002), resolution between couples in chronically violent relationships may extend the length of violence exposure and thereby heighten the risk of child victimization. It may be that these young children perceive a continued sense of insecurity and fear of victimization following parental resolutions, thereby increasing the presence of maladaptive cognitions about their parents’ violence.
Limitations
Despite the contributions of this study, it is important to remember that it represents a selected sample of children exposed to severe IPV drawn from a specific region. As such, the results may not generalize to other populations. More notably, the data collected from these children had inconsistent reliability over time, indicating that the factor structure of the CPIC scale for this population may be weaker than it is for older children. It could be that the CPIC constructs have different functional meaning in children exposed to high levels of violence, as evidenced by the unique finding on the conflict resolution subscale.
Although differences in drop/nondrop and included/excluded participants were statistically controlled for in the modeling, it is important to recognize that the resulting sample are generally those children who have better cognitive functioning and may be exposed to lower levels of certain types of violence (i.e., psychological aggression). It is therefore possible that children who are at the highest-level of risk within this violence exposed group may have unique needs that are not captured by the methods and analyses used in the current study.
It should also be noted that only one type of violence exposure was measured in the current study. This is important to recognize as there is significant overlap between children’s exposure to IPV and other types of maltreatment, such as child abuse (Zolotor et al., 2007). Exposure to other types of violence, in addition to exposure to IPV, may have important and complex effects on children’s appraisals of threat and self-blame.
Finally, the current study used children’s self-report data on a single measure of cognitive appraisal that was originally designed for older children (Grych et al., 1992). Due to concerns about its use in younger populations, updated and modified versions of this measure are now available (e.g., CPIC-Y for use in 7- to 9-year-olds, McDonald & Grych, 2006; BPI for use in 5- to 6-year-olds, Ablow et al., 2009). Because data collection for the current study preceded the development of these measures, they were unavailable for use. However, it should be noted that the current study took a number of measures to promote valid responding that are similar to the accommodations in later measures. These changes include the removal of some negatively worded items (e.g., CPIC-Y, McDonald & Grych, 2006) and the increased emphasis on kinesthetics as a way of mediating verbal tasks (e.g., BPI, Ablow et al., 2009). While it is recommended that future research make use of the most recent measures available for assessment of threat and self-blame, there is evidence that the administrative and statistical accommodations of the current study assist in enhancing its valid use in preschool populations.
Clinical Implications
Fortunately, the limitations of the current study do not compromise the clinical utility of the results. It appears that children’s maladaptive attributions of threat and self-blame were either unchanging (threat) or increasing (self-blame) over the time period assessed, though there is a children’s appraisals were lower in older children. The perpetually heightened presence of maladaptive cognitive attributions during a key period of cognitive, emotional, social, and behavioral development may place these children at particular risk of developmental psychopathology. Because of this, it is essential that clinicians monitor and provide appropriate intervention to address maladaptive attributions. This should be done only in conjunction with relevant safety skills training and psychoeducation to prevent any possible physical risk that may be posed to children by restructuring possible threat appraisals that are realistic in import. That is, children’s appraisals of threat, especially in populations exposed to high levels of violence, are likely to be based in a realistic threat assessment. However, it is important to note that studies on vigilance to threat show that this heightened attenuation has significant implications on children’s mental health (e.g., Dodd et al., 2012). As such, clinicians should work to decrease appraisals that represent distorted views of threat and risk while maintaining appropriate cognitive appraisals that serve a protective function for children and enhance resilient coping. Furthermore, assistance to the child’s family should include ways of reducing the violence and threat to the child.
Future Directions
Future research should examine the development of these appraisals over a longer time period, so as to more completely determine periods of relative stability versus times of change. These trajectories would be even more clearly specified with the inclusion of a non-IPV exposed comparison group. It may also be helpful to incorporate other measures of threat and self-blame to provide better validation for these cognitive evaluations and determine if construct instability is due to true developmental change in the meaning of these constructs or whether children have difficulty in the reliability of these reports over time. The incorporation of other types of measurement may be especially beneficial for the preschool age group, as there do appear to be a number (albeit a minority) of children who are not able to respond to these types of cognitive measures. The incorporation of longitudinal modeling techniques in the complex interplay between individual, family, and community level variables will continue to be an important way of delineating the unique needs of preschoolers exposed to chronic violence.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Research costs were generally supported by the University of Michigan Office of the Vice President for Research, University of Michigan Rackham Graduate School, and the Blue Cross Blue Shield of Michigan.
