From the Mother to the Child: The Intergenerational Transmission of Experiences of Violence in Mother–Child Dyads Exposed to Intimate Partner Violence in Cameroon

Abstract

Intimate partner violence (IPV) is a widespread social problem with serious consequences for the health of both women and their children. However, little is known about the combined effect of maternal childhood abuse and current exposure to IPV with respect to the psychopathological symptoms of the mother–child dyad. In a Cameroonian cultural setting, where IPV affects more than half of women, we aimed to better understand how mother’s childhood abuse and current IPV co-occur to lead to psychopathological symptoms in the mother–child dyad. With the help of a non-governmental organization in Cameroon, we recruited 49 mother–child dyads exposed to IPV, along with 25 mother–child dyads who had not been exposed, and who functioned as a control group. All mothers completed a set of questionnaires, including the Revised Conflict Tactics Scale to assess IPV; the Child Trauma Questionnaire to examine their childhood trauma; the Child Behavior Checklist to assess their children’s psychopathological traits; the Hospital Anxiety and Depression Scale; and the Symptom Checklist. We found that physical abuse experienced by mothers during childhood was associated with IPV in adulthood, and specifically sexual abuse, p = .001. In addition, we found that the accumulation of maternal childhood abuse and current IPV was related to anxiety and depression symptoms in mothers, all R² ≥ .18, all ps ≤ .015, as well as to externalized symptoms in children, all R² ≥ .27, all ps ≤ .017. Our results suggest the intergenerational transmission of experiences of childhood abuse and current IPV, which calls for the development of interventions and care strategies for the mother–child dyad.

Keywords

traumatic stress child abuse domestic violence intergenerational transmission of trauma

Introduction

Global estimates of intimate partner violence (IPV) indicate that about one third of women (35%) worldwide have experienced either physical and/or sexual IPV or non-partner sexual violence in their lifetime (World Health Organization, 2013). Some of the highest global prevalence rates of IPV are in Africa (Hausmann et al., 2009; McCloskey et al., 2016). In Cameroon, this situation is particularly dramatic, with an increase from 49% in 2004 to 53% in 2015 (Institut National de la Statistique [INS], 2015). According to the INS (2015), more than half of women aged 15 to 49 years currently in or out of union (55%) have experienced physical violence since the age of 15 years, mainly from their current or most recent husband/partner; furthermore, 43% have had injuries (such as fractures, wounds, sprains, strains, dislocations, and concussions) as a result of IPV. However, the majority of female victims of IPV do not report it (INS et ICF International, 2012).

Bride price (also called dowry) is a common cultural practice in many African societies. It is a payment from the groom and/or the groom’s family to the bride’s family at the time of marriage, and is a prerequisite to officially hand over the bride to the groom (Forkuor et al., 2018; Lowes & Nunn, 2018; Ngutor, 2013). Thus, it is difficult to wed without going through the dowry process (Kamdem Kamgno & Mvondo Mengue, 2014). Dowry is a widespread practice in Cameroon that is sometimes used by men to justify acts of domestic violence. Growing evidence (Anderson, 2007; Kaye et al., 2005; Rees et al., 2017) confirms that high bride prices have serious implications for marital stability and further increase the possibility of IPV. Expensive dowries reinforce the myth that women are property bought at high prices (Bopda, 1997; Nkouendjin-Yotnda, 1977; Tsala Tsala, 2009) and may trap women within their marriages because of their families’ inability to refund the bride price in case of divorce (Lowes & Nunn, 2017). This specific cultural context, as harsh as it is hidden, is particularly well-suited to the investigation of intergenerational aspects of violence against women.

The effects of IPV on women or their children have been well-documented in recent decades. Campbell (2002) reported increased health problems in women exposed to IPV, such as injury; chronic pain; gastrointestinal issues; and gynecological signs, including sexually transmitted diseases, depression, and post-traumatic stress disorder. According to a recent meta-analysis, IPV during pregnancy is associated with low child birth weight and preterm birth (Hill et al., 2016). A further meta-analysis (Evans et al., 2008) suggested a strong relationship between exposure to IPV after birth and the child’s internalizing and externalizing symptoms as well as a relationship between IPV and childhood trauma symptoms. However, little is known about the combined effect of women’s early traumatic experiences and current exposure to IPV on psychopathological symptoms in the mother–child dyad.

Some research has focused on the effect of current IPV on the mother’s and child’s psychopathology. For instance, McFarlane et al. (2014) provided evidence of a direct relationship among current IPV experienced by the mother, maternal psychopathology, and child behavioral (dys)functioning in a clinical population of 300 abused women in Texas.

Recent research shows that trauma experienced during childhood is likely to create an accumulative effect with the current IPV, with severe enhanced psychopathological consequences for the mother and the child. For example, Lünnemann et al. (2019) studied a clinical population of 426 maltreated children in the Netherlands, and reported that childhood abuse and neglect by both mothers and fathers were related to their current trauma symptoms. They also found that this association was mediated by IPV, but only for mothers. In addition, they showed that trauma symptoms in both fathers and mothers were related to child post-traumatic stress disorder (PTSD) symptoms, but that this effect was not mediated by the child’s current abuse and neglect. Gartland et al. (2019) showed that maternal childhood abuse, current maternal IPV, and poor maternal physical or mental health were associated with higher odds of emotional/behavioral difficulties of the child in a pregnancy cohort (N = 1,507), followed up to 4 years postpartum in Australia. However, none of these studies examined the effect of cumulative patterns of childhood abuse and current IPV on the mother’s and the child’s psychopathology. Previous studies relied primarily on the evaluation of intergenerational effects using a cross-sectional design with no control group.

The present study aims to better understand the intergenerational transmission of the experiences of violence in mother–child dyads exposed to IPV in a non-Western context. It is important to examine the patterns of IPV in sub-Saharan Africa, given that it affects 36% of the population (McCloskey et al., 2016). We would examine whether—and, if so, to what extent—cumulative and/or co-occurring patterns of mother’schildhood abuse (including physical abuse, sexual abuse, emotional abuse, and neglect) and current IPV lead to psychopathological symptoms for mother–child dyads in Cameroon. Using a cross-sectional research design with an exposed and a control group, we investigate (a) how exposure to childhood abuse is associated with current experience of IPV in mothers, (b) how a mother’s psychopathological symptoms correlate with her child’s psychopathological symptoms, (c) if and how maternal childhood abuse and current IPV predict the mother’s and child’s psychopathological symptoms, and (d) whether maternal protective factors can mediate the link between childhood abuse/current IPV and psychopathological symptoms of the mother and child.

Based on our hypothetical model (see Figure 1) postulating that the accumulation of maternal childhood abuse and current IPV may predict psychopathological symptoms in mothers as well in children, and on previous findings (Gartland et al., 2019; McFarlane et al., 2014), we expect (a) mother’s childhood abuse will positively correlate with and statistically predict current IPV; (b) mother’s psychopathological symptoms will significantly correlate with her child’s psychopathological symptoms; (c) mother’s childhood abuse and current IPV will predict psychopathological symptoms of that mother and her child; and finally, (d) maternal protective factors can mediate the link between childhood abuse/current IPV and psychopathological symptoms of the mother and child.

Figure 1.

Schematic illustration of the hypothetical model for the effects of mother’s childhood abuse and mother’s current IPV on mother’s and child’s psychopathological scores.

Method

Participants

We recruited 49 mother–child dyads exposed to IPV and 25 mother–child dyads as a control group.

All exposed women had consulted the Association for the Fight against Domestic Violence (ALVF) in the 12 months preceding the study. The ALVF is a nonprofit organization based in Cameroon, which provides free legal advice, guidance, and support to female victims of IPV. We recruited exposed participants through telephone calls from ALVF records. Several women had either changed their phone numbers or did not have phones at the time of the study. To get in touch with them, we worked with community agents of ALVF, who performed a door-to-door sensitization and awareness campaign for our study. These agents are popular people, who are aware of what happens in their neighborhoods and know most of the inhabitants. They serve as information relays for ALVF in the field. Our inclusion criteria for the exposed mothers were that each mother had to (a) have been a victim of IPV in the past 12 months, (b) have a child aged 2 to 18 years, and (c) be able to express herself in French or English.

The control group was also recruited with the help of community agents. Inclusion criteria for mothers in this group were that each member had to (a) have not been a victim of IPV, (b) have a child aged 2 to 18 years, and (c) be able to express herself in French or English. We excluded mothers who did not know either French or English, and mothers of children above 18 years.

A total of 82 mothers came to ALVF after a phone call or door-to-door sensitization. Of the 82 mothers, four (4.9%) entirely refused to participate, three (3.7%) were excluded because of a language barrier, one (1.2%) agreed to participate but did not provide any information, and 74 (90.2%) agreed to participate and completed the questionnaire. The final sample consisted of 74 mother–child dyads. Mothers were aged between 22 and 58 years (M = 37.66, SD = 7.78) and children between 2 and 18 years (M = 10.0, SD = 4.33). Most of the women (46.9%) were homemakers, and more than half had a primary education (51.0%). The sociodemographic information of the sample is summarized in Table 1.

Table 1.

Demographic Characteristics and Psychopathological Scores of the Mother and the Child, and Mann–Whitney Analysis Comparing the Exposed and the Control Group.

Demographic Characteristics and Psychopathological Scores	Exposed Group		Control Group		Mann–Whitney Analysis
Demographic Characteristics and Psychopathological Scores	N	%	N	%	U	p
Mother’s age, M (SD, minimum–maximum)	37.86 (±9.14, 22–58)		37.28 (±4.08, 26–44)		586	.732
Child’s age, M (SD, minimum–maximum)	10.71 (±4.47, 2–18)		8.64 (±3.76, 2–15)		494	.137
Mother’s level of education
Primary education	25	51.0	11	44.0	450.5	.170
Secondary education	15	30.6	8	32.0
University level	4	8.2	6	24.0
Mother’s matrimonial status
Married
Not in the process of separation	15	30.6	20	80.0	294	.000*
In the process of separation	11	22.4	1	4.0
Single	13	26.5	3	12.0
Divorced	4	8.2	0	0
Widow	2	4.1	1	4.0
Cohabitation	3	6.1	0	80.0
Mother’s profession
Teacher	3	6.1	7	28.0	553.5	.486
Business	1	2.0	0	20.0
Secretary	3	6.1	0	12.0
Homemakers	23	46.9	5	12.0
Trader	10	20.4	3	8.0
Cultivator	2	4.1	0	4.0
Hairdresser	3	6.1	3	4.0
Student	1	2.0	2	8.0
Hotelkeeper	1	2.0	0	4.0
Laundress	1	2.0	0	28.0
Accountant	0	2.0	1	20.0
Pastor	0	6.1	1	12.0
Seamstress	1	2.0	2	12.0
Nurse	0	6.1	1	8.0
Mother’s psychological resources
GSES scores	30 (±7.81)		34 (±4.36)		366	.049*
EES scores	27.71 (±5.05)		27.20 (±2.58)		423.5	.376
CTS2 scores
Negotiation skills	72.07 (±49.06)		124.96 (±20.26)		210	.000*
Psychological abuse	66.53 (±47.58)		49.96 (±22.89)		360	.189
Physical abuse	75.38 (±70.64)		10.17 (±13.31)		156.5	.000*
Sexual abuse	37.86 (±33.78)		7.56 (±16.79)		186.5	.000*
Injuries	9.77 (±18.24)		0.12 (±0.33)		340.5	.001*
CTQ scores
Emotional abuse	11.20 (±5.13)		9.40 (±4.32)		435.5	.118
Physical abuse	2.84 (±2.13)		1.21 (±1.86)		264	.001*
Sexual abuse	7.67 (±4.52)		5.56 (±1.26)		427.5	.047*
Emotional neglect	17.09 (±4.85)		18.64 (±3.71)		439	.209
Physical neglect	13.33 (±3.06)		12.48 (±2.18)		434	.113
CBCL scores
Internalized symptoms	17.29 (±8.46)		6.30 (±3.60)		57	.000*
Externalized symptoms	15.31 (±10.80)		8.32 (±5.74)		145	.001*
HADS scores
Anxiety symptoms	11.21 (±3.17)		5.32 (±3.63)		117	.000*
Depression symptoms	8.93 (±3.78)		5.48 (±2.38)		243.5	.000*
SCL-27 plus scores
Depression symptoms	11.83 (±5.13)		6.83 (±2.18)		201.5	.000*
Vegetative symptoms	12.59 (±4.69)		9.12 (±2.95)		247	.004
Agoraphobic symptoms	9.13 (±3.77)		4.54 (±1.31)		116.5	.000*
Social phobic symptoms	11.16 (±4.18)		7.50 (±3.07)		247	.000*
Pain symptoms	18.85 (±5.73)		13.71 (±3.79)		220.5	.000*

Note.p = p-value; SD = standard deviation; U = Mann-Whitney coefficient, M (SD, Min-Max) = Mean (standard deviation, minimum-maximum); N = frequency; % = percentage; * = significant values; GSES = General Self-Efficacy Scale; EES = Self-Esteem Scale; CTS2 = Conflict Tactics Scale; CTQ = Child Trauma Questionnaire; CBCL = Child Behavior Checklist; HADS = Hospital Anxiety and Depression Scale; SCL-27 plus = Symptom Checklist.

Procedure

The Ethical Committee of Cameroon approved the study—No. 2019/02/1141/CE/CNERSH/SP. After phones calls and door-to-door sensitization, an appointment in the ALVF’s premises was scheduled according to each participant’s availability. After being given oral and written information about the study, all adult participants signed an informed consent form. Written informed consents were also asked from mothers on behalf of their minor children involved in this study. The mothers completed questionnaires that included demographic information, a child behavior checklist, the mother’s own childhood experience, their current experience of IPV, maternal health problems including depression and anxiety, maternal psychological resources, and a symptom checklist.

Measures

Sociodemographic characteristics were assessed using a brief questionnaire on the mother’s age, level of education, marital status and profession, and on the child’s age.

IPV

To assess IPV, we used the Revised Conflict Tactics Scale (CTS2; Straus et al., 1996; French version by Lussier, 1997). The CTS2 scale has been widely used in sub-Saharan Africa (Goodman et al., 2019; McClintock et al., 2019) and was chosen to allow comparisons with previous studies in this field. The CTS2 was administered to all mothers (N = 74), regardless of whether or not they had been victims of domestic violence. The CTS2 consists of 78 items exploring conflict and violence between the mother and her partner in the past 12 months. Respondents are asked to rate how frequently they have been victim of verbal and nonverbal aggressive acts, physical abuse, sexual abuse, or physical injuries. The CTS2 examines the various manifestations of IPV over five scales: physical abuse (e.g., “pushed, kicked, burned, scalded or slapped me”), injuries (e.g., “felt pain, needed to see a doctor because of a fight”), psychological abuse (e.g., “insulted, stomped out of room or threatened to hit me”), sexual abuse (e.g., “used force, used threats . . . to make me have sex”), and negotiation (e.g., “I explained my side or suggested a compromise”). The CTS2 is scored by adding the midpoints for the response categories chosen by the participant. The midpoints were zero for 0 time, one for 1 time, two for 2 times, four for 3 to 5 times, eight for 6 to 10 times, fifteen for 11 to 20 times, and twenty-five for more than 20 times (Straus et al., 2003). Cronbach’s alpha coefficient for the CTS2 in the current sample was .88.

Mother’s Childhood Trauma

To examine mother’s childhood trauma, we used the Child Trauma Questionnaire (CTQ; Bernstein et al., 2003), which is the most widely used and standardized instrument for assessing negative childhood experiences, to make comparisons with previous studies. The CTQ was used to measure physical abuse, sexual abuse, emotional abuse, and neglect. The CTQ consists of 28 items and assesses five types of adversity experienced during childhood or adolescence: physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect. Each item was rated as 1 = Never, 2 = Rarely, 3 = Sometimes, 4 = Often, or 5 = Very often. The sum of the five items for each subscale ranged from 5 to 25. Cronbach’s alpha coefficients ranged from .74 to .89 for the subscales and .52 for the global scale, respectively. Due to the poor internal consistency of the global score, we performed our analysis with only the subscale scores.

Child Psychopathology

Children’s psychopathological traits were assessed using the Child Behavior Checklist (CBCL; Achenbach, 1991; French version by Vermeersch & Fombonne, 1997). Completed by each mother, the CBCL comprises 113 items scored as 0 = Not true, 1 = Sometimes true, and 2 = Very true. All items were grouped in two broad scales: (a) internalized symptoms calculated as the sum of anxious/depressed, attention problems, somatic complaints, social problems, thought problems, and withdrawn/depressed scores; and (b) externalized symptoms consisting of rule-breaking behavior and aggressive behavior. Cronbach’s alpha coefficients were .84 for internalized symptoms and .89 for externalized symptoms.

Mother’s Psychological Resources

Mother’s psychological resources were measured using the General Self-Efficacy Scale and the Self-Esteem Scale.

Mothers evaluated their perceived self-efficacy with the General Self-Efficacy Scale (GSES; Jerusalem & Schwarzer, 1992; French version by Dumont et al., 2000). This scale is a self-report measure of self-efficacy in coping with a variety of stressful life events or challenging demands. There are 10 items rated on a 4-point Likert-type scale going from 1 = Not at all true to 4 = Exactly true. A higher score indicates better general self-efficacy. In the present study, the total scores ranged from 10 to 40. Cronbach’s alpha coefficient was .88.

Self-esteem was assessed with the Rosenberg’s Self-Esteem Scale (EES; Rosenberg, 1965; French version by Vallieres & Vallerand, 1990). The EES is composed of 10 items that measure self-esteem, that is, positive and negative feelings about the self. Items are rated on a 4-point Likert-type scale, from “strongly disagree” to “strongly agree.” Higher scores indicate higher levels of self-esteem. In this study, the total scores ranged from 10 to 40. Cronbach’s alpha coefficient was .60.

Mother’s Psychopathology

We used the Hospital Anxiety and Depression Scale (HADS; Zigmond & Snaith, 1983; French version by Lepine et al., 1985) to examine current patterns of anxiety and depression. The HADS is composed of 14 items rated from zero to three, with seven questions related to anxiety and seven others related to depression. Two scores are obtained, with a minimum of zero and a maximum of 21. Higher scores indicate higher levels of anxiety and depression, respectively. Cronbach’s alpha coefficient for the global scale was .80.

To detect maternal health problems, we used the French version of the Symptom Checklist (SCL-27-plus; Hardt, 2008). The SCL-27-plus is a screening instrument for psychopathological symptoms, composed of 27 items rated on a 5-point Likert-type scale. With it, we examined screening questions for suicidality; a lifetime assessment for depressive symptoms; and current issues such as depressive, vegetative, agoraphobic, social phobic, and pain symptoms. Cronbach’s alpha coefficient of the SCL-27-plus mean score was .89.

Data Analysis

The IBM SPSS 25 was used for data analysis. Missing data were less than 5% for all the scales, and therefore inconsequential, according to Schafer (1999). The level of statistical significance was set at 5%. A Shapiro–Wilk test (Shapiro & Wilk, 1965) and a visual inspection of their histograms, normal Q-Q plots, and box plots showed that almost all variables were not normally distributed, all ps < .05. The exceptions were the anxiety and depression scores on HADS, the emotional neglect and physical neglect scores on the CTQ, and the pain score on the SCL-27-plus, all ps > .05. Hence, for correlation and differences between groups, we performed nonparametric tests, including Spearman’s correlation and the Mann–Whitney test. For regression analysis, we tested the assumption of normally distributed residuals and homoscedasticity according to Field (2013), and found that our residuals were normally distributed, with a mean of zero; the variance of the residuals was constant.

To control whether our two groups were significantly different in terms of experience of IPV as well as of trauma during childhood—that is, whether control participants really did not experience childhood abuse or IPV—we compared mean CTQ and CTS2 scores for the two groups. In addition, we compared mean scores of mothers and children with regard to psychopathological symptoms in both groups. To test our first hypothesis, that mother’s childhood abuse correlates positively with and statistically predicts current IPV, we first calculated correlation coefficients between the subscales of the CTQ and CTS2. Second, we performed a linear regression to test whether childhood abuse predicts the experience of IPV. To test our second hypothesis, that mother’s psychopathological symptoms will significantly correlate with her child’s psychopathological symptoms, we calculated a correlation coefficient between the mother’s anxiety and depression scores on HADS and her child’s internalized and externalized symptoms as assessed with the CBCL as well as current maternal symptoms on the SCL-27 plus and the child’s internalized and externalized symptoms. For our third hypothesis, we proceeded by stepwise regression. First, we tested the effects of childhood abuse on the mother’s and child’s psychopathological scores separately. To do this, we performed a linear regression with the mother’s childhood abuse as the predictor variable and the mother’s and child’s psychopathological scores as the outcome variables. Second, we examined the effects of current IPV on the mother’s and child’s psychopathological scores independently by performing a linear regression with current IPV as the predictor variable and the mother’s and child’s psychopathological scores as the outcome variables. To show the cumulative effects on the mother’s and child’s psychopathological symptoms, we carried out multiple linear regression using a stepwise method, with the mother’s childhood abuse as the first predictor and current IPV as the second predictor. We did so only for significant relationships. Finally, we compared the self-efficacy and the self-esteem scores of both groups. In addition, we performed a correlation analysis between measures of protective factors and measures of maternal childhood trauma (CTQ)/current IPV (CTS2) as well as between protective factors and measures of mother’s (HADS, SCL-27 plus) and children’s psychopathological symptoms. This was a condition for performing mediation analysis.

Results

Control Measures: Differences Between Groups

The results of the Mann–Whitney test showed highly significant differences between groups on the CTS2 for negotiation skills, U = 210, z = −4.24, p < .001; physical abuse, U = 156.5, z = −4.26, p < .001; sexual abuse, U = 186.5, z = −4.60, p < .001; and injuries, U = 340.5, z = −3.4, p = .001, with higher mean scores for physical abuse, sexual abuse, and injuries in the exposed group, and lower mean scores for negotiation skills in the exposed group. The difference for psychological abuse was not significant, U = 360, z = −1.31, p = .189. With regard to the CTQ, the results of the Mann–Whitney test showed significant differences for physical abuse, U = 264, z = −3.44, p = .001; and sexual abuse, U = 427.5, z = −1.98, p = .047, with higher mean scores in the exposed group. The differences in emotional abuse, emotional neglect, or physical neglect between our groups were not significant, p ≥ .113 for all.

Looking at the child’s and mother’s psychopathology, the results of the Mann–Whitney test showed significant differences on the CBCL for internalized symptoms, U = 57, z = −4.67, p < .001, and for externalized symptoms, U = 145, z = −3.31, p = .001, with mean scores higher in the exposed group than in the control group. Furthermore, the results of the Mann–Whitney test showed highly significant differences in mean scores on the HADS for the anxiety scale, U = 117, z = −5.30, p < .001, and depression scale, U = 243.5, z = −3.75, p < .001, with mean scores higher in the exposed group than in the control group. Finally, with regard to the SCL-27 plus, the results of the Mann–Whitney test indicated highly significant differences among the groups for depression, U = 201.5, z = −4.36, p < .001; vegetative symptoms, U = 247, z = −2.91, p = .004; agoraphobia, U = 116.5, z = −5.51, p < .001; social phobia, U = 247, z = −3.63, p < .001; and pain symptoms, U = 220.5, z = −3.51, p < .001, with mean scores higher in the exposed group than in the control group (see Figure 1).

Association Between Childhood Abuse and Experience of IPV

Spearman’s rho correlation test showed that physical abuse during childhood, as measured with the CTQ, positively and significantly correlated with current sexual abuse as measured by the CTS2, r_s = .27, p = .03. The results of the linear regression indicated that a mother’s childhood physical abuse significantly predicted her current sexual abuse, β = 5.68, t = 3.40, p = .001, and explained 16% of the variance, R² = .16, F(1, 61) = 11.58, p = .001. No other significant correlation was found between CTQ dimension—that is, the mother’s traumatic childhood experience—and current IPV, p ≥ .073 for all.

Correlations Between Mother’s Psychopathological Symptoms and Child’s Psychopathological Symptoms

The results of Spearman’s rho correlation coefficients indicated that internalized and externalized symptoms in children strongly correlated with mother’s anxiety and depression symptoms (internalized symptoms: mother’s anxiety, r_s = .74, p < .001, and mother’s depression, r_s = .53, p < .001; externalized symptoms: mother’s anxiety, r_s = .61, p < .001; and mother’s depression, r_s = .29, p = .043). Spearman’s rho correlation test showed children’s internalized symptoms on the CBCL strongly correlated with mother’s depression on the SCL-27, r_s = .55, p < .001; mother’s agoraphobic symptoms, r_s = .72, p < .001; mother’s social phobic symptoms, r_s = .58, p < .001; and mother’s pain symptoms, r_s = .55, p < .001; and moderately correlated with mother’s vegetative symptoms, r_s = .48, p = .001. Children’s externalized symptoms also significantly correlated with mother’s depression, r_s = .50, p < .001; mother’s vegetative symptoms, r_s = .43, p = .003; mother’s agoraphobic symptoms, r_s = .59, p < .001; mother’s social phobic symptoms, r_s = .54, p < .001; and mother’s pain symptoms, r_s = .49, p = .001.

Effects of Childhood Abuse and Current IPV on Mother’s and Children’s Psychopathological Scores

To describe the relationship between mother’s childhood abuse, current IPV, and their psychopathological scores, as well as the relationship between mother’s childhood abuse and current IPV and their children’s psychopathological scores, we present all the significant correlations in Table 2.

Table 2.

Results of the Correlations Analyses Between Mother’s Childhood Abuse Resp. Current IPV and Mother’s Psychopathological Scores Resp. Child’s Psychopathological Scores.

Mother’s and child’s Psychopathological Scores	Exposed Group					Control Group
	CTQ Scores		CTS2 Scores			CTQ Scores		CTS2 Scores
	Physical Abuse	Sexual Abuse	Physical Abuse	Psychological Abuse	Injuries	Physical Abuse	Sexual Abuse	Physical Abuse	Psychological Abuse	Injuries
Child
CBCL externalized scores	r = .422 p = .022*	r = .429 p = .006*	r = −.097 p = .660	ns	ns	r = .481 p = .027*	r = .041 p = .858	r = .488 p = .025*	ns	ns
CBCL internalized scores	ns	ns	r = −.475 p = .026*	ns	ns	ns	ns	r = .423 p = .488	ns	ns
Mother
Anxiety scores	ns	ns	r = .430 p = .011*	ns	ns	ns	ns	r = .094 p = .664	ns	ns
Depression on SCL-27 plus	r = .473 p = .002*	ns	r = −.355 p = .031*	ns	r = .515 p = .000*	r = .265 p = .222	ns	r = −.210 p = .326	ns	r = .045 p = .835
Agoraphobic scores	r = .374 p = .016*	ns	ns	r = −.07 p = .686	ns	r = .110 p = .616	ns	ns	r = −.479 p = .018*	ns
Vegetative scores	r = .290 p = .102	ns	r = .374 p = .042*	ns	r = .377 p = .000*	r = .523 p = .011*	ns	r = .269 p = .215	ns	r = .078 p = .719
Social phobic scores	r = .089 p = .586	r = .172 p = .277	ns	ns	ns	r = .442 p = .035*	r = .438 p = .032*	ns	ns	ns

Note.p = p-value; r = Spearman correlation coefficient; ns = nonsignificant; * = significant; IPV = Intimate Partner Violence; CTQ = Child Trauma Questionnaire; CTS2 = Conflict Tactics Scale; CBCL = Child Behavior Checklist; SCL-27 plus = Symptom Checklist.

Effects of Mother’s Childhood Abuse on Children’s Psychopathological Scores

The results of the linear regression indicated that mother’s childhood emotional abuse significantly predicted children’s externalized symptoms in the exposed group, β = 0.94, t = 2.51, p = .015, and in the control group, β = 0.58, t = 2.33, p = .030, and explained 19.6% of the variance for the exposed group, R² = .196, F(1, 26) = 6.34, p = .018%, and 21.4% of the variance for the control group, R² = .214, F(1, 20) = 5.45, p = .030. Equally, the results of the linear regression indicated that in the exposed group, mother’s experience of physical abuse during childhood significantly predicted children’s externalized symptoms, β = 2.92, t = 4.11, p < .001, and explained 38.5% of the variance, R² = .385, F(1, 27) = 16.93, p < .001. The results of the linear regression in the control group were not significant (see Table 3).

Table 3.

Results of the Regression Analysis for the Effects of Childhood Abuse and Current IPV on Mother and Child Psychopathological Scores.

Effects of Childhood Abuse and Current IPV on Mother and Child Psychopathological Scores	Exposed Group					Control Group
	R ²	F(df)	β	t	p	R ²	F(df)	β	t	p
Child’s CBCL scores and CTQ scores
Child externalized symptoms and emotional abuse	.196	F(1, 26) = 6.34	0.94	2.51	.018	.214	F(1, 20) = 5.45	0.58	2.33	.030
Child externalized symptoms and physical abuse	.385	F(1, 27) = 16.93	2.92	4.11	.000	.122	F(1, 19) = 2.64	1.05	1.62	.121
Child’s CBCL scores and CTS2 scores
Child externalized symptoms and sexual abuse	.202	F(1, 27) = 6.81	0.14	2.61	.015	.003	F(1, 20) = 0.05	−0.01	−0.23	.816
Mother’s HADS scores and SCL-27 plus scores and CTQ scores
Anxiety and sexual abuse on CTQ	.163	F(1, 38) = 7.40	0.35	2.72	.010	.202	F(1, 23) = 5.83	1.29	2.41	.024
Depression (on SCL-27 plus) and emotional abuse	.100	F(1, 41) = 4.55	0.31	2.13	.039	.089	F(1, 22) = 2.15	0.14	1.46	.157
Depression (on SCL-27 plus) and physical abuse	.243	F(1, 39) = 12.53	1.22	3.54	.001	.251	F(1, 21) = 7.04	0.58	2.65	.015
Depression (on SCL-27 plus) and sexual abuse	.102	F(1, 40) = 4.53	0.35	2.12	.040	.151	F(1, 22) = 3.92	0.80	1.98	.060
Vegetative and physical abuse	.154	F(1, 31) = 5.62	0.82	2.37	.024	.075	F(1, 21) = 1.70	0.43	1.30	.206
Agoraphobic and emotional abuse	.160	F(1, 40) = 7.64	0.29	2.76	.009	.036	F(1, 22) = 0.816	0.057	0.903	.376
Agoraphobic and physical abuse	.271	F(1, 39) = 14.48	0.91	3.80	.000	.227	F(1, 21) = 6.18	0.33	2.48	.021
Social phobic and sexual abuse	.103	F(1, 40) = 4.61	0.29	2.14	.038	.194	F(1, 22) = 5.29	1.05	2.30	.031
Mother’s HADS scores and SCL-27 plus scores and CTS2 scores
Anxiety and physical abuse on CTS2	.169	F(1, 32) = 6.50	−0.02	−2.55	.016	.004	F(1, 22) = 0.09	0.01	0.30	.764
Depression (on SCL-27 plus) and injuries	.092	F(1, 44) = 4.46	−0.08	−2.11	.040	.014	F(1, 22) = 0.30	−0.90	−0.55	.584
Vegetative and physical abuse	.160	F(1, 28) = 5.34	−0.02	−2.31	.028	.028	F(1, 21) = 0.61	0.03	0.78	.442
Vegetative and injuries	.109	F(1, 28) = 4.29	−0.08	−2.07	.046	.000	F(1, 22) = 0.004	−0.13	−0.06	.952
Effects of childhood abuse and current IPV on mother’s psychopathological scores
Sexual abuse (1) and physical abuse (2) on anxiety	.317	F(2, 29) = 6.72 c = 10.26	β1 = 0.376, p1 = .025 β2 = −0.021, p2 = .011		.004	.202	F(2, 21) = 2.66 c = −1.960	β1 = 1.285, p1 = .033 β2 = 0.016, p2 = .776		.093
Emotional abuse (1) and injuries (2) on depression (on SCL-27 plus)	.188	F(2, 40) = 4.63 c = 9.54	β1 = 0.307, p1 = .034 β2 = −0.094, p2 = .044		.015	.014	F(1, 22) = 0.309 c = 6.90	β1 = −0.909, p1 = .584 β2 = 0.289, p2 = .180		.584
Sexual abuse (1) and injuries (2) on depression (on SCL-27 plus)	.202	F(2, 39) = 4.93 c = 10.49	β1 = 0.354, p1 = 0.033 β2 = −0.100, p2 = .033		.012	.014	F(1, 22) = 0.309 c = 6.90	β1 = 0.909, p1 = .584 β2 = 3.80, p2 = .074		.584
Effects of childhood abuse and current IPV on child’s psychopathological scores
Emotional (1) and sexual abuse (2) on externalized symptoms	.279	F(2, 25) = 4.82 c = 4.128	β1 = 0.644, p1 = .125 β2 = 0.104, p2 = 0.103		.017	.215	F(1, 19) = 2.59 c = 2.55	β1 = 0.594, p1 = .035 β2 = 0.007, p2 = .912		.101
Physical abuse (1) and sexual abuse (2) on externalized symptoms	.448	F(2, 26) = 10.56 c = 5.15	β1 = 2.496, p1 = .002 β2 = 0.086, p2 = .097		.000	.002	F(1, 19) = 0.048 c = 8.43	β1 = 0.016, p1 = .830 β2 = 0.349, p2 = .132		.830

Note. 1 = first predictor; 2 = second predictor; c = constant; p = p-value; R² = proportion of variation in the outcome variable that can be explained by the model; F(df) = F-Ratio (degree of freedom); β = Beta coefficient or slope; t = t-test coefiicient; CBCL = Child Behavior Checklist; CTQ = Child Trauma Questionnaire; CTS2 = Conflict Tactics Scale; HADS = Hospital Anxiety and Depression Scale; SCL-27 plus = Symptom Checklist; IPV = Intimate Partner Violence.

Effects of Mother’s Current IPV on Children’s Psychopathological Scores

With regard to current IPV, the results of the linear regression showed that in the exposed group, mother’s current sexual abuse significantly predicted children’s externalized symptoms, β = 0.14, t = 2.61, p = .015, and explained 20.2% of the variance, R² = .202, F(1, 27) = 6.81, p = .015. The results of the linear regression in the control group were not significant for children’s externalized symptoms, and current IPV was not found to have any significant effect on their internalized symptoms.

Effects of Mother’s Childhood Abuse on Mother’s Psychopathological Scores

The results of the linear regression showed that mother’s childhood sexual abuse significantly predicted anxiety symptoms in the exposed group, β = 0.35, t = 2.72, p = .010, and in the control group, β = 1.29, t = 2.41, p = .024; and explained 16.3% of the variance for the exposed group, R² = .163, F(1, 38) = 7.40, p = .010, and 20.2% of the variance for the control group, R² = .202, F(1, 23) = 5.83, p = .024. Equally, the results of the linear regression demonstrated that, in the exposed group, mother’s experience of emotional abuse significantly predicted depression symptoms on the SCL-27 plus, β = 0.31, t = 2.13, p = .039, and explained 10% of the variance, R² = .100, F(1, 41) = 4.55, p = .039. Furthermore, the results of the linear regression indicated that mother’s childhood physical abuse significantly predicted depression symptoms on the SCL-27 plus in the exposed group, β = .1.22, t = 3.54, p = .001, and in the control group, β = 0.58, t = 2.65, p = .015, and explained 24.3% of the variance for the exposed group, R² = .243, F(1, 39) = 12.53, p = .001, and 25.1% of the variance for the control group, R² = .251, F(1, 21) = 7.04, p = .015. Similarly, the results of the linear regression indicated that in the exposed group, mother’s experience of sexual abuse significantly predicted depression symptoms on the SCL-27 plus, β = 0.35, t = 2.12, p = .040, and explained 10.2% of the variance, R² = .102, F(1, 40) = 4.53, p = .040. In addition, the results of the linear regression evidenced that in the exposed group, mother’s physical abuse significantly predicted vegetative symptoms on the SCL-27 plus, β = −.82, t = 2.37, p = .024, and explained 15.4% of the variance, R² = .154, F(1, 31) = 5.62, p = .024. The results of the linear regression showed that in the exposed group, mother’s experiences of emotional abuse significantly predicted agoraphobic symptoms on the SCL-27 plus, β = −0.29, t = 2.76, p = .009, and explained 16% of the variance, R² = .160, F(1, 40) = 7.64, p = .009. Likewise, the results of the linear regression evidenced that mother’s childhood physical abuse significantly predicted agoraphobic symptoms on the SCL-27 plus in the exposed group, β = 0.91, t = 3.80, p = .000, and in the control group, β = 0.33, t = 2.48, p = .021; and explained 27.1% of the variance for the exposed group, R² = .271, F(1, 39) = 14.48, p = .000, and 22.7% of the variance for the control group, R² = .227, F(1, 21) = 6.18, p = .021. Finally, the results of the linear regression showed that mother’s childhood sexual abuse significantly predicted social phobic symptoms on SCL-27 plus in the exposed group, β = 0.29, t = 2.14, p = .038, and in the control group, β = 1.05, t = 2.30, p = .031; and explained 10.3% of the variance for the exposed group, R² = .103, F(1, 40) = 4.61, p = .038, and 19.4% of the variance for the control group, R² = .194, F(1, 22) = 5.29, p = .031.

Effects of IPV on Mother’s Psychopathological Scores

With regard to current IPV, the results of the linear regression showed that in the exposed group, mother’s current experience of physical abuse significantly predicted anxiety symptoms, β = −2.55, t = .016, p = .004, and explained 16.9% of the variance, R² = .169, F(1, 32) = 6.50, p = .004. Furthermore, the results of the linear regression indicated that in the exposed group, mother’s injuries significantly predicted depression symptoms on the SCL-27 plus, β = −2.11, t = .04, p = .014, and explained 9.2% of the variance, R² = .092, F(1, 44) = 4.46, p = .014. The results of the linear regression indicated that in the exposed group, mother’s experience of physical abuse significantly predicted vegetative symptoms on the SCL-27 plus, β = −0.02, t = 2.31, p = .028, and explained 16% of the variance, R² = .160, F(1, 28) = 5.34, p = .028. Finally, the results of the linear regression evidenced that in the exposed group, mother’s injuries significantly predicted vegetative symptoms on the SCL-27 plus, β = −0.08, t = −2.07, p = .046, and explained 10.9% of the variance, R² = .109, F(1, 28) = 4.29, p = .046.

Effects of Mother’s Childhood Abuse and Current IPV on Child’s Psychopathological Scores

Figure 2 shows the results of the regression analysis for the effects of mother’s childhood abuse and current IPV on children’s psychopathological scores. A significant overall regression model was found for the effects of both the emotional abuse mothers experienced during childhood and mother’s current sexual abuse on externalized symptoms in the exposed group, R² = .27.9, F(2, 25) = 4.82, p = .004. However, the test for each predictor at alpha = .05 did not show significant p-values for mother’s emotional abuse, β1 = 0.644, p1 = .125, or sexual abuse, β2 = 0.104, p2 = .103. In the control group, the results of the multiple linear regression were not significant, R² = .215, F(1, 19) = 2.59, p = .101. Finally, the overall regression model demonstrated that mother’s physical abuse during childhood and mother’s current sexual abuse had highly significant effects on externalized symptoms in the exposed group, R² = .448, F(2, 26) = 10.56, p < .001. However, as the coefficient table indicates, the test for each predictor at alpha = .05, was significant for mother’s childhood physical abuse, β1 = 2.49, p1 = .002, but was not significant for mother’s sexual abuse, β2 = 0.086, p2 = .097. In the control group, the results of the multiple linear regression were not significant, R² = .002, F(1, 19) = 0.048, p = .830.

Figure 2.

Results of the effects of mother childhood abuse and current IPV on mother and child psychopathological scores. (A) Mother psychopathology: A significant overall regression model was found for the effects of mothers’ emotional abuse during childhood and mother’scurrent injuries on mother’s depression symptoms in the exposed group with no significant results in the control group. Furthermore, a significant overall regression model was found for the effects of mother’s sexual abuse during childhood and mother’s current physical abuse on mother anxiety symptoms. Finally, a significant overall regression model was found for the effects of mother’s sexual abuse during childhood and mother’s current injuries on mother’s depression symptoms. (B) Child psychopathology: A significant overall regression model was found for the effects of mother’s emotional abuse during childhood and mother’s current sexual abuse on externalized symptoms in the exposed group with no significant results in the control group. Finally, the overall regression model was highly significant for the effects of mother’s physical abuse during childhood and mother’s current sexual abuse on externalized symptoms.

Effects of Mother’s Childhood Abuse and Current IPV on Mother’s Psychopathological Scores

In Figure 2, a highly significant regression model was found for the effects of mother’s childhood abuse and current IPV on mother’s anxiety in the exposed group, R² = .317, F(2, 29) = 6.72, p = .004. The tests for each predictor showed significant results for sexual abuse, β1 = 0.376, p1 = .025, and for physical abuse, β2 = 0.021, p2 = .011. The results of the overall multiple linear regression in the control group were not significant, R² = .202, F(2, 21) = 2.66, p = .093. However, the test for sexual abuse as a predictor was statistically significant, β1 = 1.285, p1 = .033. A significant regression model was also found for the effects of emotional abuse and injuries on depression measured with SCL-27 plus in the exposed group, R² = .188, F(2, 40) = 4.63, p = .015. The tests for each predictor showed significant results for emotional abuse, β1 = 0.307, p1 = .034, and for injuries, β2 = −0.094, p2 = .044. The results of the overall multiple linear regression in the control group was not significant, R² = .014, F(1, 22) = 0.309, p = .584. Finally, a significant regression model was found for the effects of sexual abuse and injuries on depression measured with the SCL-27 in the exposed group, R² = .202, F(2, 39) = 4.93, p = .012. The tests for each predictor showed significant results for sexual abuse, β1 = 0.354, p1 = .033, and for injuries, β2 = −0.100, p2 = .033. The results of the multiple linear regression in the control group showed no significant results, R² = .012, F(1, 22) = 0.309, p = .584.

Mediating Role of Protective Factors

The results of the Mann–Whitney test showed a significant difference between groups on the General Self-Efficacy Scale, U = 366, z = −1.96, p = .049, but no significant difference for Self-Esteem Scale, U = 423.5, z = −.886, p = .376. We found no significant correlation between our protective factors, that is general self-efficacy and self-esteem, and maternal childhood abuse and current IPV, all ps > .05. However, our results showed a significant correlation between self-esteem and pain (on SCL-27 plus) in the exposed group, r_s = .364, p = .04. There was no significant correlation in the control group, r_s = .141, p = .512. A significant correlation was equally found between general self-efficacy and depression (on HADS), r_s = .356, p = .022, in the exposed group, but not in the control group, r_s = .192, p = .380. Finally, no significant correlation was found between the maternal protective factors and children’s psychopathological symptoms, all ps > .05.

Discussion

The aim of this research was to provide evidence of the intergenerational transmission of experiences of violence in mother–child dyads exposed to IPV in Cameroon. One of our main findings was that physical abuse experienced by mothers during childhood was associated with IPV in adulthood, and specifically with sexual abuse. In addition, we found that the accumulation of maternal childhood abuse and current IPV was related to anxiety and depression symptoms in mothers as well as to externalized symptoms in children.

Our first hypothesis, stating that mother’s childhood abuse will positively correlate with and statistically predict current IPV, was supported by the finding that a positive and significant correlation exists between mother’s experience of childhood abuse and current IPV. Particularly, we found that physical abuse experienced by mothers during childhood was associated with current IPV, specifically sexual abuse. This result suggests that women abused during their childhood have an increased likelihood of being re-victimized in their intimate partner relationships. Remarkably, on one hand, the accumulation of physical abuse during childhood predicts anxiety and depression symptoms in mothers as well as poor negotiation skills (positive strategies used by a couple to reach a compromise). In fact, our results show that physical abuse during childhood and current sexual IPV negatively correlate with negotiation skills. On the other hand, the accumulation of experiences of violence by mothers increases the risk of their children developing externalized symptoms. This is in line with the results from a large prospective cohort study by Gartland et al. (2019), which indicated that mother’s physical and sexual childhood abuse increases the risk of IPV, as well as of poor physical and mental health, for both the mother and her child. Specifically, Gartland et al. (2019) found emotional/behavioral difficulties in children, while, in our study, we found externalized symptoms including rule-breaking behavior and aggressive behavior.

Interestingly, the analyses conducted to test our second hypothesis that mother’s psychopathological symptoms will significantly correlate with her child’s psychopathological symptoms, showed a significant link between mother’s psychopathological symptoms and her child’s psychopathological symptoms. Better still, the child’s internalized and externalized symptoms strongly correlate with the mother’s anxiety and depression symptoms as measured by two scales (HADS and SCL-27-plus) as well as with the mother’s psychological and physical symptoms assessed by the SCL-27 plus. Our results provide evidence of a relationship between a mother’s psychopathology and her child’s psychopathology. This finding is in line with a previous study (McFarlane et al., 2014).

As for the third hypothesis, that mother’s childhood abuse and current IPV will predict psychopathological symptoms in the mother–child dyad, our results indicate that mother’s childhood abuse and current IPV have a significant impact on mother and child’s psychopathological scores. For mothers, our findings showed, on one hand, that their childhood abuse was associated with their anxiety and depression and, on the other hand, that current IPV was related to their anxiety and depression. The accumulation of the two traumatic experiences explained a higher percentage of the variance in the equation model. This confirms the hypothesis of a certain accumulation of trauma over time advanced by Briere and Jordan (2009). For children, their mother’s childhood abuse was also associated with their own externalized symptoms, as the current IPV was related to children’s externalized symptoms. The accumulation of mothers’ traumatic experiences was associated with children’s externalized symptoms and explained a higher percentage of the variance in the general equation model. Nevertheless, the individual effect of each predictor in the general equation model was not significant for children. Perhaps, our predictors were correlated with each other to such a degree that none of them offered a significant amount of unique variance in explaining the outcome variable. However, our result suggests an accumulative effect that explains a higher percentage of the variance for both mother’s and children’s symptoms.

This study included a control group and provided control measures that showed that the control and the exposed group differed significantly at the level of the experience of IPV and CTQ, as well as at the level of psychopathological symptoms, with mean scores higher in the exposed group than in the control group. Remarkably, the exposed group had a lower mean score for negotiation skills than the control group. This indicates that negotiation skills could be a positive strategy used in the control group to prevent crisis or to manage conflicts. This result is similar to that of Kalokhe et al. (2018), who found that good negotiation skills help prevent the occurrence of IPV. Significant differences in psychopathological symptoms were also observed among the two groups, with means scores higher in the exposed group than in the control group. In addition, the groups differed in terms of sociodemographic variables, especially in terms of mother’s professions and levels of education. This sociodemographic characteristic may help explain why women in the exposed group were more likely to be victims. Compared with the control group, most women in the exposed group were economically dependent on their husbands. The majority of them were homemakers with a primary level of education. Our findings support studies suggesting that unemployment and lower levels of education increase the risk of IPV (Almiş et al., 2018; Capaldi et al., 2012), or that secondary education and high socioeconomic status offer protection (Abramsky et al., 2011), as was the case in our control group. However, we did not find evidence that formal marriage offered protection, as shown by Abramsky et al. (2011), as a large proportion of women in the exposed group were married, with almost half of them in the process of separation. This control measure showed the validity of the choice of our groups.

When looking at mother’s internal resources or coping strategies, we were unable to perform a mediation analysis because we found no link between maternal protective factors and maternal childhood abuse/current IPV. Perhaps, there are other protective factors in this cultural context that may play a role, such as social support, which we did not measure. However, we found an association between self-esteem and pain as well as between self-efficacy and depression. This result is consistent with studies that explain that low levels of self-efficacy are associated with higher levels of depressive symptoms, particularly in a negative environment such as the situation of partner abuse (Hammen, 2005). It has also been argued that many people who live with pain experience gradual changes in the way they perceive themselves (Hegarty, 2014).

Taken together, the results of this study provide evidence for an intergenerational transmission of experience of childhood abuse and current IPV in the Cameroonian cultural setting. On one hand, mother’s experience of childhood abuse partly explains the psychopathological symptoms in both her and her child. On the other hand, her current experience of IPV also explains her psychopathological symptoms and those of her child. The accumulation of these traumatic experiences was associated with anxiety and depression symptoms in mothers as well as to externalized symptoms in children and explains a large part of the variance. This is consistent with recent findings on the accumulation model of trauma by Dunn et al. (2018), who argue that child’s psychopathology symptoms are primarily explained by accumulation models. This understanding of the intergenerational transmission of experiences of violence is a prerequisite for and calls for the development of interventions and care strategies for the mother–child dyad.

Limitations

Our study has some limitation that need to be taken into consideration. The relatively small sample of 74 mother–child dyads limits the statistical power of our analyses as well as the findings’ representativeness. One further limitation is the recruitment strategy or the motivation to participate. We do not know whether women only participated because the community agents persuaded them or because they truly desired to participate in the study. We also do not know how many declined or what their reasons for declining were. In addition, the use of a cross-sectional design based on retrospective data is subject to bias. In fact, the variability in the duration and in time since the last exposure to abuse may affect the recall of the experience. Furthermore, in some cases the researcher had to explain or reformulate some of the items, and in doing so could have introduced some additional bias. Similarly, cultural bias related to interpretation and meaning of words may have occurred, thus posing the question of the cultural validity of the questionnaires. However, Cronbach’s alphas in our sample were similar to those of the original versions, suggesting the comparable reliability of the versions used in our study.

Another limitation is that we did not include fathers in the study, and as a result, we cannot tell whether children’s psychopathology is due to mother’s or father’s mental health problems, or both. It is possible that not only maternal trauma symptoms, but also paternal trauma symptoms, are important to understanding the trauma symptoms of their children, as reported by Lünnemann et al. (2019). However, in this particular context, it was dangerous and ethically impossible to include the male partners because (a) the women were recruited through an NGO that aims to protect them from their abusive partners; (b) during data collection, some women were molested by their partner because they participated in the study; and (c) the ALVF personnel, together with some community agents and the researcher, received several threats from the partners. Furthermore, we used the CTS2 to measure current IPV. The abuse of women is a multidimensional problem, and the use of several tools is required to enhance the reliability and validity of conclusions about it. Therefore, we may have under- or over-reported the abuse and ignored some other very important facts in this study. Finally, we addressed childhood trauma with the CTQ, which does not report child’s exposure to IPV.

However, our study has several strengths. It adds to the literature on IPV in sub-Saharan Africa, and especially in Cameroon, where more than half of women are affected by that phenomenon. To date, very few studies on IPV in non-Western contexts have been conducted. We believe this study adds important elements to the existing body of research, particularly by focusing on a cultural context in which dowry practices are still widely practiced, IPV is considered justifiable (Cools & Kotsadam, 2017) or individual acts of domestic violence are supported overtly or tacitly by cultural and social norms (Johnson et al., 2008). The study provides a unique insight from Cameroon into the intergenerational transmission of violence in mother–child dyads. In addition, the relationship between maternal traumatic experiences during childhood and current IPV and the psychopathological symptoms of mothers and children exposed to IPV, has been understudied, especially in this context. Other relevant contributions of our study to the existing literature are (a) the use of a design with an exposed and a control group; (b) the control measures for differences in the experience of childhood abuse, current IPV and mother’s and children’s psychopathological scores between the control and the exposed group; (c) the consistency of results across the scales; and (d) the administration of self-rating instruments by a trained clinical psychologist.

Implications

This research indicates that mother’s experience of physical abuse during her childhood is associated with current IPV, and specifically with sexual abuse. Based on the current findings and further evidence from longitudinal studies (Gartland et al., 2019), it might be useful for personnel running intervention programs in Cameroon to keep in mind that IPV and childhood abuse commonly co-occur. Therefore, therapeutic interventions in IPV cases can be more effective if they address not only current IPV, but also childhood trauma. Increased public awareness of the impact of child maltreatment and current IPV is equally necessary; however, it can be extremely difficult in this cultural context to promote such awareness due to gender-related attitudes, customary and cultural norms, and the beliefs and values of both women and men. Intervention programs should therefore include education to address attitudes, beliefs, and cultural norms. Furthermore, this study can inform community-based interventions about the importance of women’s literacy and girl’s education, as well as on the need for women’s economic empowerment in the fight against IPV. More importantly, our study helps increase understanding of the significant correlation between mother’s and children’s psychopathological well-being. Therefore, management and intervention strategies should focus on both a mother and her child, as the consequences of the accumulation of childhood abuse and current IPV are visible in both generations.

Conclusion

This study throws some light on the intergenerational transmission of traumatic experiences of violence. It provides evidence that trauma experienced by a mother during her childhood increases the probability for her to experience IPV. Moreover, the accumulation of mother’s traumatic experiences is associated with anxiety and depression symptoms in them, but with equally externalized symptoms in their children. Further research is needed to assess the mechanisms underlying this intergenerational transmission. It would be interesting to see, for example, how biological correlates or epigenetic alterations can help to explain it.

Footnotes

Acknowledgements

The authors express gratitude to the Association for the Fight against Domestic Violence (ALVF) in Cameroon, which facilitated the recruitment of participants, as well as to each one of the mother–child dyads who agreed to participate in this study. The authors thank Ian Law, Madeleine Viviany, and Chia Oliver Ankiambom for correcting and editing the text.

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: This work was funded by a grant to the author from the Swiss Confederation and by the research funds of the University of Fribourg (TE-40505 Project 734 Epigenetic and psychological factors). This study was also supported by the IReach Lab, Unit of Clinical and Health Psychology, University of Fribourg.

ORCID iD

Dany Laure Wadji

Author Biographies

Dany Laure Wadji, MSc, is a PhD student at the Department of Psychology, University of Fribourg, Switzerland. She is interested in the effects of earlylife adversity, including child maltreatment and exposure to intimate partner violence, with a focus on psychopathological, biological, and epigenetic factors.

Germain Jean Magloire Ketcha Wanda, PhD, is an associate professor of Physiology, Neurophysiology and Psychopharmacology at the Department of Psychology, University of Yaoundé I, Cameroon. His research focuses on neuropsychology. He is interested in diseases such as anxiety, insomnia, convulsions, and depression.

Chantal Wicky, PhD, is a molecular biologist and senior researcher at the Department of Biology, University Fribourg, Switzerland. She is particularly specialized in genetic and epigenetic analyses in animals. Her main research interest is on the chromatin function and associated epigenetic mechanisms.

Naser Morina, PhD, is a senior research associate at the Department of Psychiatry and Psychotherapy, University Hospital Zurich, Switzerland. He is interested in mental health and health care in traumatized refugees. He aims at developing psychotherapeutic mini-interventions for traumatized refugees.

Chantal Martin-Soelch, PhD, is a professor of Clinical Psychology at the University Fribourg, Switzerland. She does research in biological psychology, neuropsychology, and clinical psychology. She is interested in psychopathological symptoms in several vulnerable populations, including offspring of depressed individuals, patients with chronic somatic diseases, and relatives of individuals with mental disorders.

References

Abramsky

Watts

C. H.

Garcia-Moreno

Devries

Kiss

Ellsberg

. . . Heise

(2011). What factors are associated with recent intimate partner violence? Findings from the WHO multi-country study on women’s health and domestic violence. BMC Public Health, 11, Article 109. https://doi.org/10.1186/1471-2458-11-109

Achenbach

T. M.

(1991). Manual for the Child Behavior Checklist/4-18 and 1991 profile. Department of Psychiatry, University of Vermont.

Almiş

B. H.

Kütük

E. K.

Gümüştaş

Çelik

(2018). Risk factors for domestic violence in women and predictors of development of mental disorders in these women. Nöro Psikiyatri Arşivi, 55(1), 67–72. https://doi.org/10.29399/npa.19355

Anderson

(2007). The economics of dowry and brideprice. Journal of Economic Perspectives, 21(4), 151–174. https://doi.org/10.1257/jep.21.4.151

Bernstein

D. P.

Stein

J. A.

Newcomb

M. D.

Walker

Pogge

Ahluvalia

. . . Zule

(2003). Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse & Neglect, 27(2), 169–190. https://doi.org/10.1016/S0145-2134(02)00541-0

Bopda

(1997). Etude sociologique du phénomène de violences conjugales sur les femmes à Yaoundé [Mémoire de Maîtrise en Sociologie]. Université de Yaoundé I.

Briere

Jordan

C. E.

(2009). Childhood maltreatment, intervening variables, and adult psychological difficulties in women: An overview. Trauma, Violence & Abuse, 10(4), 375–388. https://doi.org/10.1177/1524838009339757

Campbell

J. C.

(2002). Health consequences of intimate partner violence. Lancet, 359(9314), 1331–1336. https://doi.org/10.1016/S0140-6736(02)08336-8

Capaldi

D. M.

Knoble

N. B.

Shortt

J. W.

Kim

H. K.

(2012). A systematic review of risk factors for intimate partner violence. Partner Abuse, 3(2), 231–280. https://doi.org/10.1891/1946-6560.3.2.231

10.

Cools

Kotsadam

(2017). Resources and intimate partner violence in Sub-Saharan Africa. World Development, 95, 211–230. https://doi.org/10.1016/j.worlddev.2017.02.027

11.

Dumont

Schwarzer

Jerusalem

(2000). French adaptation of the General Self-Efficacy Scale. http://userpage.fu-berlin.de/~health/french.htm

12.

Dunn

E. C.

Soare

T. W.

Raffeld

M. R.

Busso

D. S.

Crawford

K. M.

Davis

K. A.

. . . Susser

E. S.

(2018). What life course theoretical models best explain the relationship between exposure to childhood adversity and psychopathology symptoms: Recency, accumulation, or sensitive periods?Psychological Medicine, 48(15), 2562–2572. https://doi.org/10.1017/S0033291718000181

13.

Evans

S. E.

Davies

DiLillo

(2008). Exposure to domestic violence: A meta-analysis of child and adolescent outcomes. Aggression and Violent Behavior, 13(2), 131–140. https://doi.org/10.1016/j.avb.2008.02.005

14.

Field

A. P.

(2013). Discovering statistics using IBM SPSS statistics: And sex and drugs and rock “n” roll (4th ed.). SAGE.

15.

Forkuor

J. B.

Kanwetuu

V. D. P.

Ganee

E. M.

Ndemole

I. K.

(2018). Bride price and the state of marriage in North-West Ghana. International Journal of Social Science Studies, 6(9), 34. https://doi.org/10.11114/ijsss.v6i9.3439

16.

Gartland

Giallo

Woolhouse

Mensah

Brown

S. J.

(2019). Intergenerational impacts of family violence: Mothers and children in a large prospective pregnancy cohort study. EClinicalMedicine, 15, 51–61. https://doi.org/10.1016/j.eclinm.2019.08.008

17.

Goodman

Wangamati

S. A.

Maranga

F. K. N.

Gitari

Seidel

Keiser

(2019). Childhood experiences and intimate partner violence among Kenyan males: Mediation by self-esteem and impulsivity. Journal of Interpersonal Violence. https://doi.org/10.1177/0886260519862278

18.

Hammen

(2005). Stress and depression. Annual Review of Clinical Psychology, 1, 293–319. https://doi.org/10.1146/annurev.clinpsy.1.102803.143938

19.

Hardt

(2008). The Symptom Checklist-27-Plus (SCL-27-plus): A modern conceptualization of a traditional screening instrument. GMS Psycho-Social Medicine, 5, Doc08.

20.

Hausmann

Tyson

L. D.

Zahidi

(2009). The global gender gap report 2009. World Economic Forum.

21.

Hegarty

D. A.

(2014). Prevalence of stigmatization and poor self-esteem in chronic pain patients. Journal of Pain & Relief, 3(2), 136. https://doi.org/10.4172/2167-0846.1000136

22.

Hill

Pallitto

McCleary-Sills

Garcia-Moreno

(2016). A systematic review and meta-analysis of intimate partner violence during pregnancy and selected birth outcomes. International Journal of Gynecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics, 133(3), 269–276. https://doi.org/10.1016/j.ijgo.2015.10.023

23.

Institut National de la Statistique. (2015). Multiple Indicator Cluster Survey (MICS5), 2014, Final Report. Yaoundé, Cameroon.

24.

Institut National de la Statistique et ICF International. (2012). Demographic and Health and Multiple Indicator Cluster Survey (EDS-MICS 2011). Calverton, Maryland, USA.

25.

Jerusalem

Schwarzer

(1992). Self-efficacy as a resource factor in stress appraisal processes. In Schwarzer

(Ed.), Self-efficacy: Thought control of action (pp. 195–213). Hemisphere.

26.

Johnson

Ollus

Nevala

(2008). Violence against women. Springer. https://doi.org/10.1007/978-0-387-73204-6

27.

Kalokhe

A. S.

Iyer

S. R.

Kolhe

A. R.

Dhayarkar

Paranjape

Del Rio

. . . Sahay

(2018). Correlates of domestic violence experience among recently-married women residing in slums in Pune, India. PLOS ONE, 13(4), e0195152. https://doi.org/10.1371/journal.pone.0195152

28.

Kamdem Kamgno

Mvondo Mengue

C. E

. (2014). Rise of unofficial marriages in Cameroon: Economic or socio-demographic response?American International Journal of Social Science, 3, 55–66.

29.

Kaye

D. K.

Mirembe

Ekstrom

A. M.

Kyomuhendo

G. B.

Johansson

(2005). Implications of bride price on domestic violence and reproductive health in Wakiso District, Uganda. African Health Sciences, 5(4), 300–303.

30.

Lepine

J. P.

Godchau

Brun

(1985). Anxiety and depression in inpatients. The Lancet, 326(8469–8470), 1425–1426. https://doi.org/10.1016/S0140-6736(85)92589-9

31.

Lowes

Nunn

(2017). Bride price and the wellbeing of women (WIDER working paper: 2017, 131). World Institute for Development Economics Research, United Nations University. https://www.wider.unu.edu/publication/bride-price-and-wellbeing-women

32.

Lowes

Nunn

(2018). Bride price and the well-being of women (Vol. 1). Oxford University Press. https://doi.org/10.1093/oso/9780198829591.003.0006

33.

Lünnemann

M. K. M.

van der Horst

F. C. P.

Prinzie

Luijk

M. P. C. M.

Steketee

(2019). The intergenerational impact of trauma and family violence on parents and their children. Child Abuse & Neglect, 96, 104134. https://doi.org/10.1016/j.chiabu.2019.104134

34.

Lussier

(1997). Questionnaire on the resolution of marital conflicts. Université du Québec à Trois-Rivières, Canada.

35.

McClintock

H. F.

Trego

M. L.

Wang

E. M.

(2019). Controlling behavior and lifetime physical, sexual, and emotional violence in Sub-Saharan Africa. Journal of Interpersonal Violence. https://doi.org/10.1177/0886260519835878

36.

McCloskey

L. A.

Boonzaier

Steinbrenner

S. Y.

Hunter

(2016). Determinants of intimate partner violence in Sub-Saharan Africa: A review of prevention and intervention programs. Partner Abuse, 7(3), 277–315. https://doi.org/10.1891/1946-6560.7.3.277

37.

McFarlane

Symes

Binder

B. K.

Maddoux

Paulson

(2014). Maternal-child dyads of functioning: The intergenerational impact of violence against women on children. Maternal and Child Health Journal, 18(9), 2236–2243. https://doi.org/10.1007/s10995-014-1473-4

38.

Ngutor

(2013). The effects of high bride-price on marital stability. IOSR Journal of Humanities and Social Science, 17(5), 65–70. https://doi.org/10.9790/0837-1756570

39.

Nkouendjin-Yotnda

(1977). About the right to “punch” his wife. Penant: Revue De Droit Des Pays D’afrique, 86(755), 5–9.

40.

Rees

Mohsin

Tay

A. K.

Soares

Tam

da Costa

. . . Silove

(2017). Associations between bride price stress and intimate partner violence amongst pregnant women in Timor-Leste. Globalization and Health, 13(1), Article 66. https://doi.org/10.1186/s12992-017-0291-z

41.

Rosenberg

(1965). Society and the adolescent self-image. Princeton University Press.

42.

Schafer

J. L.

(1999). Multiple imputation: A primer. Statistical Methods in Medical Research, 8(1), 3–15. https://doi.org/10.1177/096228029900800102

43.

Shapiro

S. S.

Wilk

M. B.

(1965). An analysis of variance test for normality (complete samples). Biometrika, 52, 591–611.

44.

Straus

M. A.

Hamby

S. L.

Boney-McCoy

Sugarman

D. B.

(1996). The revised Conflict Tactics Scales (CTS2): Development and preliminary psychometric data. Journal of Family Issues, 17(3), 283–316.

45.

Straus

M. A.

Hamby

S. L.

Warren

W. L.

(2003). The Conflict Tactics Scales handbook. Western Psychological Services.

46.

Tsala Tsala

J.-P

. (2009). Violences faites aux épouses et angoisse masculine chez les époux camerounais. Le Divan Familial, 23(2), 169–181. https://doi.org/10.3917/difa.023.0169

47.

Vallieres

E. F.

Vallerand

R. J.

(1990). Traduction et Validation Canadienne-Française de L’échelle de L’estime de Soi de Rosenberg. International Journal of Psychology, 25(2), 305–316. https://doi.org/10.1080/00207599008247865

48.

Vermeersch

Fombonne

(1997). Le child behavior Checklist: Resultats preliminaires de la standardisation de la version Francaise. Neuropsychiatrie de L’enfance et de L’adolescence, 45(10), 615–620.

49.

World Health Organization. (2013). Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence.

50.

Zigmond

A. S.

Snaith

R. P.

(1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x