Maternal Intergenerational Transmission of Childhood Multitype Maltreatment

PLEASE SCROLL DOWN FOR ARTICLE

This article was downloaded by: [Cort, Natalie A.]On: 13 January 2011Access details: Access Details: [subscription number 932380146]Publisher RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

Journal of Aggression, Maltreatment & TraumaPublication details, including instructions for authors and subscription information:http://www.informaworld.com/smpp/title~content=t792303964

Maternal Intergenerational Transmission of Childhood MultitypeMaltreatmentNatalie A. Corta; Sheree L. Tothb; Catherine Cerullia; Fred Rogoschb

a University of Rochester Medical Center, Rochester, New York, USA b University of Rochester,Rochester, New York, USA

Online publication date: 13 January 2011

To cite this Article Cort, Natalie A. , Toth, Sheree L. , Cerulli, Catherine and Rogosch, Fred(2011) 'MaternalIntergenerational Transmission of Childhood Multitype Maltreatment', Journal of Aggression, Maltreatment & Trauma,20: 1, 19 — 38To link to this Article: DOI: 10.1080/10926771.2011.537740URL: http://dx.doi.org/10.1080/10926771.2011.537740

Full terms and conditions of use: http://www.informaworld.com/terms-and-conditions-of-access.pdf

This article may be used for research, teaching and private study purposes. Any substantial orsystematic reproduction, re-distribution, re-selling, loan or sub-licensing, systematic supply ordistribution in any form to anyone is expressly forbidden.

The publisher does not give any warranty express or implied or make any representation that the contentswill be complete or accurate or up to date. The accuracy of any instructions, formulae and drug dosesshould be independently verified with primary sources. The publisher shall not be liable for any loss,actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directlyor indirectly in connection with or arising out of the use of this material.

Journal of Aggression, Maltreatment & Trauma, 20:19–38, 2011Copyright © Taylor & Francis Group, LLCISSN: 1092-6771 print/1545-083X onlineDOI: 10.1080/10926771.2011.537740

Maternal Intergenerational Transmissionof Childhood Multitype Maltreatment

NATALIE A. CORTUniversity of Rochester Medical Center, Rochester, New York, USA

SHEREE L. TOTHUniversity of Rochester, Rochester, New York, USA

CATHERINE CERULLIUniversity of Rochester Medical Center, Rochester, New York, USA

FRED ROGOSCHUniversity of Rochester, Rochester, New York, USA

Previous research suggests that child maltreatment is transmit-ted across familial generations. However, extant studies focusedexclusively on single maltreatment subtypes, instead of the morecommon experience of multitype maltreatment. This limitation isaddressed in the first known study to examine the maternal inter-generational transmission of childhood multitype maltreatmentamong 104 mothers and their children. Findings demonstratedthat mothers’ childhood multitype maltreatment directly predictedtheir children’s multitype maltreatment, instead of having indi-rect effects through maternal romantic attachment dimension,intimate partner violence, and psychological distress. Mothers’childhood multitype maltreatment was also related to intimatepartner violence and anxious romantic attachment but unre-lated to psychological distress. Our findings highlight the need forclinical attention to the long-term generational effects of diversechildhood traumas.

Submitted 28 October 2009; revised 27 January 2010; accepted 28 January 2010.We extend gratitude to the women and children who were study participants, Mt. Hope

Family Center staff, the Laboratory of Interpersonal Violence and Victimization, and theInterventions Research Group, who helped to make this project successful.

Address correspondence to Natalie A. Cort, Department of Psychiatry, Universityof Rochester Medical Center, 300 Crittenden Boulevard, Rochester, NY 14642. E-mail:[email protected]

19

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

20 N. A. Cort et al.

KEYWORDS intergenerational transmission, multitype maltreat-ment, partner violence

Victims of child maltreatment are often subjected to multiple, co-occurringforms (i.e., neglect, sexual, physical, and emotional abuse) of maltreat-ment, referred to as multitype maltreatment (Briere & Runtz, 1990; Finkelhor,Ormond, & Turner, 2007; Higgins & McCabe, 2000a; Ney, Fung, & Wickett,1994; Trickett & McBride-Chang, 1995). However, maltreatment researchers(e.g., Banyard, 1997; Brayden, Deitrich-MacLean, Dietrich, & Sherrod, 1995;DiLillo & Damashek, 2003; Schuetze & Das Eiden, 2005) typically examineatypical single maltreatment experiences and therefore fail to cogently dif-ferentiate the effects of childhood multitype maltreatment on psychologicalhealth, interpersonal well-being, and the intergenerational transmission ofmaltreatment (Carlson, McNutt, Choi, & Rose, 2002; Kinard, 1994).

The intergenerational transmission of childhood maltreatment, whichoccurs when maltreated children become maltreating parents, has beenrobustly demonstrated in numerous studies (Heyman & Slep, 2002; Kaufman& Zigler, 1987; Leifer, Kilbane, Jacobsen, & Grossman, 2004; Pears & Capaldi,2001; Zuravin, McMillen, DePanfilis, & Risley-Curtis, 1996). However, mostresearchers have examined the continuity of single maltreatment typesacross successive generations. The purpose of this study is to facilitate aparadigm shift and improve the ecological validity of empirical examinationsof child maltreatment by studying the previously unstudied intergener-ational transmission of childhood multitype maltreatment. A number ofcomplex research literatures are drawn together to examine the utility ofthree intervening mechanisms (i.e., maternal romantic attachment, intimatepartner violence [IPV] victimization, and psychological distress, specificallydepressive and posttraumatic stress disorder symptoms), through whichthe intergenerational transmission of childhood multitype maltreatment canoccur.

CHILDHOOD MALTREATMENT, ADULT PSYCHOLOGICALDISTRESS, AND PARENTING

A consensus has emerged indicating that many of the approximately 1.5 mil-lion children maltreated annually (Sedlak, 1988) experience deleterious andsustained psychological difficulties as a consequence. Retrospective and lon-gitudinal studies have demonstrated that childhood multitype maltreatmentis associated with adult experiences of depression, aggression, anxiety, andposttraumatic stress disorder (PTSD; Breslau, Chilcoat, Kessler, & Davis,1999; Gross & Keller, 1992; Higgins & McCabe, 2001; Silverman, Reinherz, &

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

Maternal Intergenerational Transmission 21

Giaconia, 1996; Vranceanu, Hobfoll, & Johnson, 2007; Widom, 1999). Giventhe discovery of these significant associations, this study examines the under-lying influence of depressive and PTSD symptoms on the transmission ofchildhood multitype maltreatment.

Mothers’ impaired psychological functioning might also have directinfluences on their abilities to provide appropriate care to their children.Researchers have found that mothers experiencing PTSD are covertly hos-tile and intrusive when interacting with infants (Lyons-Ruth & Block,1996). Although maternal depression has been significantly associated withincreased child maltreatment risk (Kotch et al., 1995), Zuravin (1989) foundthat mothers with moderate depression were more likely to engage inaggressive behaviors toward their children, in comparison to mothers withmild, severe, or no depressive symptoms, after controlling for education,race, and Child Protective Services (CPS) status. Thus, research suggestsPTSD and depressive symptoms, related to childhood trauma in some cases,increase the potential for mothers to maltreat their children. However, thepotential for psychological difficulties to mediate the relationship betweenmothers’ childhood multitype maltreatment and their children’s multitypemaltreatment remains largely unexplored.

Dubowitz et al. (2001) found that the combined experience of maternalchildhood sexual and physical abuse was related to mothers’ use of harsherparenting methods, compared to childhood sexual abuse alone or no experi-ence of childhood abuse. Dubowitz et al. suggested there are no significantspecific effects directly attributable to either childhood physical or sexualabuse. Instead, it is the experience of childhood multitype maltreatment thatcontributes to aversive parenting. A majority of individuals who experiencechildhood violence successfully break the cycle of abuse and do not maltreattheir own children (Kaufman & Zigler, 1987). However, this study identifies asmaller but important cluster of individuals, in this case mothers, who mightbe at increased risk of continuing a familial pattern of childhood multitypemaltreatment.

CHILDHOOD MALTREATMENT, ATTACHMENT, AND ADULTINTIMATE PARTNER VIOLENCE

Childhood multitype maltreatment can also negatively affect the formationof healthy attachment styles and intimate relationships (Cicchetti & Toth,1995; Colman & Widom, 2004). Research indicates that attachment pat-terns shaped in childhood are moderately manifested in adult relationshipswith partners and children (Fivush & McDermott-Sales, 2006; Fraley, 2002;Hazan & Zeifman, 1994; Volling, Notaro, & Larsen, 1998). Reder and Duncan(2001) suggested that parents with avoidant attachment styles might become

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

22 N. A. Cort et al.

physically assaultive to control their children and avoid responding to theirattachment demands. In contrast, parents with ambivalent attachment stylesmight be more likely to perceive their children as controlling and engage inuse of threats of abandonment as a mechanism of parental control.

Although only two previous studies have extended this line of researchto examine the roles of romantic attachment styles on parenting behaviors(Edelstein et al., 2004; Rholes, Simpson, & Friedman, 2006), there appear tobe noteworthy associations between these constructs, indicating the needfor further study. Edelstein et al. (2004) found parents’ avoidant romanticattachment style was related to unsupportive, withdrawn, and unrespon-sive parenting behaviors toward distressed children. Rholes et al. (2006)also found that individuals with an avoidant attachment style reported lessinterest in becoming parents and tended to describe parenting as stressfuland unsatisfying. Additionally, researchers have begun exploring connec-tions between attachment styles and IPV. The preoccupied attachment style,in particular, has been shown to be more related to IPV, in comparison toother attachment styles (Henderson, Bartholomew, Trinke, & Kwong, 2005).The pressing needs for intimacy and conflicting fear of abandonment, repre-sented by this style, might increase vulnerabilities to maintaining emotionallyand interpersonally complex abusive relationships.

Research reveals that IPV is reported by women with childhood mal-treatment experiences (Banyard, Arnold, & Smith, 2000; Briere & Elliott,2003; Ornduff, Kelsey, & O’Leary, 2001) more often than women withoutsimilar histories. Renner and Slack (2006) found that, after controlling forfamily of origin characteristics, experiences of childhood sexual and phys-ical abuse were significantly related to adult IPV. IPV might also portendchildren’s risk of being maltreated. IPV occurring in a home results in riskof child abuse increasing by three to nine times (Moffitt & Caspi, 1998).Tajima (2000) also found that IPV during a 12-month period was related toa 70% chance of a child being physically abused. Higgins (2004) concludedthat “children who experience family environments characterized by inter-parental conflict or lack of affection, or in which familial relationships arerigid and distant, are at greater risk of being subjected to multiple sub-typesof child abuse and neglect” (p. 52).

In contrast to elevated risk of child maltreatment attributed to IPV pres-ence, mothers’ involvement in healthy intimate relationships might resultin a reduction of risk. In a prospective study of mothers with childhoodabuse histories, Egeland, Jacobvitz, and Papatola (1987) found that motherswho discontinued the transmission of abuse were more likely to describetheir adult intimate relationships as secure and fulfilling. They were alsosignificantly less likely to describe their partners as physically abusive. Theintegration of the aforementioned research literatures suggests interlinked,potentially causal, associations among childhood maltreatment, attachmentorganization, and adult victimization in intimate relationships.

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

Maternal Intergenerational Transmission 23

STUDY HYPOTHESES

To our knowledge, this is the first study to examine maternal intergener-ational transmission of multiple types of maltreatment. Vondra and Toth(1989) suggested that it is the emotional pain of maltreatment that istransmitted through generations. Therefore, it is important that researchaddress more general experiences of maltreatment and not exclusivelyfocus on child sexual or physical abuse (Herzberger, 1990). This study alsosupplements the extant literature by utilizing independently coded ChildProtective Services (CPS) reports and Department of Human Services (DHS)preventive records, as well as standardized methods of classifying child mal-treatment subtypes (Barnett, Manly, & Cicchetti, 1993; Manly, Kim, Rogosch,& Cicchetti, 2001).

The literature review indicates that mothers’ experiences of childhoodmultitype maltreatment might negatively impact adult psychological andinterpersonal well-being as well as capacities to suitably care for theirchildren. This study simultaneously examines the direct pathway betweenmothers’ and their children’s multitype maltreatment and indirect pathwaysthrough mediating adult experiences; that is, romantic attachment dimen-sion, IPV, and psychological distress. Depicted in the path model (shownin Figure 1), mothers’ childhood multitype maltreatment was hypothesizedto be directly related to their children’s multitype maltreatment (Path A).However, we also expected that (a) elevated psychological distress (depres-sion and PTSD symptoms; Paths B and C), (b) high levels of insecureromantic attachment (i.e., doubts about partners’ dependability [Dependsubscale], intimacy anxiety [Anxiety subscale], and/or abandonment anxiety

MATERNAL Psychological

Distress

MATERNALRomantic

AttachmentDimension

MATERNALIntimate

Partner Violence

CHILDMulti-type

Maltreatment

MATERNALChildhoodMulti-type

Maltreatment

B

D

A

GF

C

E

FIGURE 1 Hypothesized path model. All paths to be examined are labeled alphabetically.

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

24 N. A. Cort et al.

[Close subscale]; Paths D and E), and (c) high levels of IPV (Paths F and G)would mediate the association between mothers’ and their children’s mul-titype maltreatment experiences. Separate path models with each romanticattachment dimension in combination with each measure of psychologi-cal distress (i.e., PTSD and depression symptoms) were computed. Finally,significant correlations among the predictor, outcome, and three interveningvariables were examined.

METHOD

Participants

Data were collected from 104 mothers of children, ages 10 to 12, whoattended a summer camp program designed for maltreated and nonmal-treated children (Cicchetti & Manly, 1990). Caregivers provided informedconsent and permission to access the Department of Human Services (DHS)registry to confirm maltreatment statuses. Families without CPS reportswere recruited from the Temporary Assistance to Needy Families pro-gram, the Aid to Families with Dependent Children program, and lowerincome neighborhoods demographically similar to those with identified mal-treating families. The recruitment strategy of the camp program involvesdeliberate recruitment of 50% maltreating families and 50% nonmaltreat-ing families. This study’s data set originally consisted of 168 caregivers(e.g., parents, grandparents, relatives). However, data from paternal andnonparental caregivers were excluded. Consequently, the remaining dataset consisted of 64 (61.5%) families without maltreatment histories and 40(38.5%) with maltreatment histories.

Procedure

Mothers completed the individual interviews during home and center-basedresearch sessions. All measures were administered by trained graduatestudents and research assistants. The Institutional Review Board at theUniversity of Rochester approved the study protocol.

Measures

MATERNAL CHILDHOOD MULTITYPE MALTREATMENT

The Childhood Trauma Questionnaire (Bernstein & Fink, 1998) is a 60-item self-report questionnaire measuring childhood maltreatment severity.The subscales, which demonstrated moderate to high internal consistency inthis study, were emotional neglect defined by caregivers’ lack of provisionof basic emotional support (α = .89); physical abuse defined by physical

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

Maternal Intergenerational Transmission 25

assaults that pose a risk of injury (α = .89); emotional abuse defined byverbally assaultive, demeaning behavior (α = .89); sexual abuse definedby sexual coercion, contact, or conduct between a child and adult (α =.96); and physical neglect defined by lack of provision of basic physicalcare (α = .66). A total aggregated score representing the experience ofchildhood multitype maltreatment was computed by incorporating severityand frequency ratings then summing across the five scales.

MATERNAL ROMANTIC ATTACHMENT DIMENSION

The Adult Attachment Scale (AAS; Collins, 1996; Collins & Read, 1990) mea-sures three dimensions of attachment to intimate partners. High scores onthe Depend subscale indicate a lack of confidence in partners’ availabil-ity and dependability. High scores on the Close subscale indicate anxietyor discomfort with intimacy. On the Anxiety subscale, high scores indicateanxiety about being abandoned and unloved. According to Collins and Read(1990), individuals with secure attachment styles are comfortable with inti-macy, depending on intimate partners, and confident about being loved.Avoidant individuals are apprehensive about intimacy, uncertain of part-ners’ availability, and unconcerned about being abandoned. Finally, anxiousindividuals are comfortable with intimacy, moderately certain of their part-ners’ availability, but very concerned about being abandoned and unloved.The Cronbach’s alphas were .70 for the Depend subscale, .53 for the Closesubscale, and .62 for the Anxiety subscale.

MATERNAL INTIMATE PARTNER VIOLENCE VICTIMIZATION

The Conflict Tactics Scales–Form N (Straus, 1979; Straus & Gelles, 1986) isa well-validated 18-item scale that has been used in many studies of familyviolence as a measure of the frequency and intensity of violence of malestoward female intimate partners. Cumulative verbal aggression and violencesubscales scores were averaged into a single measurement of IPV in the pastyear. The Cronbach’s alpha was .88, indicating high internal consistency.

MATERNAL PSYCHOLOGICAL DISTRESS

The Beck Depression Inventory–II (Beck, Steer, & Brown, 1996; Steer, Ball,Ranieri, & Beck, 1999) is a widely used, valid, and reliable 21-item self-reportmeasure of the severity of depressive symptoms during the two weeks priorto administration. A total depression score is calculated by summing theresponses of all 21 items and scores range from 0 to 63, with higher scoresindicating more depressive symptomatology. In this study, the Cronbach’salpha was .90.

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

26 N. A. Cort et al.

The Parent Version–Survey of Children’s Distress Symptoms (Martinez& Richters, 1993; Richters & Martinez, 1990) is 28-item measure used toassess parental experience of adult PTSD symptoms. Higher scores indicateincreased frequency of PTSD symptoms. The Cronbach’s alpha was .92,indicating high internal consistency.

CHILD MULTITYPE MALTREATMENT

The Maltreatment Classification System (MCS; Barnett et al., 1993) was uti-lized to code CPS and DHS records. It has been shown to be reliable andvalid (weighted kappa statistics = .78–1.00) in categorizing maltreatmentsubtypes (Bolger & Patterson, 2001; Manly et al., 2001; Stouthamer-Loeber,Loeber, Homish, & Wei, 2001). The child maltreatment subtypes were phys-ical neglect, emotional maltreatment, physical abuse, and sexual abuse.Physical neglect involved failure to provide basic physical needs andsupervision. Emotional maltreatment involved inability or unwillingnessto provide psychological support, security, and comfort. Physical abuseincluded deliberate acts that inflict physical injury. Finally, the definitionof sexual abuse included sexual contact between child and adult in behav-iors ranging from exposure to adult sexual activity. A total aggregated scoreof multitype maltreatment was computed by incorporating severity andfrequency ratings then summing across the subtypes.

RESULTS

The racial and ethnic makeup of the mothers in the sample was 60.6%(n = 63) African American, 32.7% (n = 34) Caucasian, 4.9% (n = 5) Hispanic,and 1.9% (n = 2) other. Mothers’ average age was 31.29 (SD = 5.7). Mostmothers were unmarried (72.1%, n = 75), receiving public assistance (75%,n = 78), high school graduates (64.5%, n = 67), and employed full-timeor part-time (50%, n = 52). Mothers had an average of three biologicalchildren and had an approximate average total income of $21,000. Mothersin maltreating and nonmaltreating families shared many demographic char-acteristics. However, mothers in maltreating families (M = 3.4, SD = 1.7)differed from mothers in nonmaltreating families (M = 2.8, SD = 1.3) in thatthey had more biological children, F(1, 102) = 4.09, p < .05.

The percentages of mothers reporting childhood histories of emotionalabuse, physical abuse, sexual abuse, emotional neglect, and physical neglectexperiences were 51.9% (n = 54), 40.4% (n = 42), 46.2 % (n = 48), 53.8%(n = 56), and 42.3% (n = 44), respectively. A small portion of mothers,29 (27.9%), reported no childhood experiences of victimization. However,9.6% (n = 10) of mothers experienced one type of maltreatment, 20.2%(n = 21) experienced two maltreatment subtypes, 6.7% (n = 7) experienced

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

Maternal Intergenerational Transmission 27

TABLE 1 Maternal Childhood Multitype Maltreatment and Their Children’s ChildProtective Services Reported Multitype Maltreatment Cross-Tabulations

No CPS reportedmultitype

maltreatment history

CPS reportedmultitype

maltreatmenthistory Total

No maternal childhoodmultitype maltreatmenthistory

22 (75.9%) 7 (24.1%) 29

Maternal childhood multitypemaltreatment history

40 (53.3%) 35 (46.7%) 75

Total 62 42 104

Note.CPS = Child Protective Services.

three maltreatment subtypes, 13.5% (n = 14) experienced four maltreat-ment subtypes, and 22.1% (n = 23) experienced five maltreatment subtypes.Although the majority (62.5%, n = 65) of mothers reported childhood mul-titype maltreatment, only 28.9% (n = 30) of their children reported to CPShad multitype maltreatment experiences.

A chi-square test of independence demonstrated a statistically significantrelationship between mothers’ and their children’s multitype maltreatmentexperiences, χ2(1, N = 104) = 4.41, p < .05. Mothers with childhood mul-titype maltreatment histories were more likely to have children reported toCPS with multitype maltreatment experiences than mothers without thesehistories (see Table 1). The majority (78.4%) of perpetrators of maltreatment,as documented by CPS, were mothers. The intergenerational transmissionof childhood multitype maltreatment was 46.7% (n = 35). However, a slimmajority of mothers with childhood multitype maltreatment (53.3%, n = 40)had not continued the cycle of abuse and neglect. Of the mothers withoutchildhood multitype maltreatment, 75.9% (n = 22) did not have childrenreported to CPS. Correlation coefficients are presented in Table 2.

On average, mothers reported minor IPV (M = 1.52, SD = .94) duringthe 12 months prior to study involvement. They reported minimal depres-sive symptoms (M = 9.35, SD = 8.90) and infrequent PTSD (M = 40.93,SD = 17.30) symptoms. Mothers moderately endorsed the close (intimacyanxiety; M = 4.96, SD = 2.23) and anxiety (abandonment anxiety; M =8.50, SD = 3.38) attachment dimensions. However, they reported high lev-els of uncertainty about partners’ availability and dependability (dependattachment dimension; M = 8.95, SD = 3.11).

Path Analysis

Path analysis was used to simultaneously analyze direct and indirect effectsbetween variables. Preliminary data screening indicated that the assumption

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

TAB

LE2

Pea

rson

Corr

elat

ions

bet

wee

nSt

udy

Var

iable

s

Mat

ernal

multi

type

mal

tx

Child

multi

type

mal

txIP

VPTSD

sym

pto

ms

Dep

ress

ive

sym

pto

ms

Anxi

ous

atta

chm

ent

Dep

end

atta

chm

ent

Clo

seat

tach

men

t

Mat

ernal

multi

type

mal

tx

1.00

Child

multi

type

mal

tx.3

5∗∗1.

00

IPV

.34∗∗

.27∗∗

1.00

PTSD sy

mpto

ms

.23∗

.06

.25∗∗

1.00

Dep

ress

ive

sym

pto

ms

.07

−.04

.18

.45∗∗

1.00

Anxi

ous

atta

chm

ent

.21∗

.12

.04

.24∗

.06

1.00

Dep

end

atta

chm

ent

−.04

−.13

.02

.14

.00

.29∗∗

1.00

Clo

seat

tach

men

t.1

1−.

07−.

08.1

2−.

08.4

8∗∗.4

5∗∗1.

00

Not

e.M

altx

=m

altrea

tmen

t;IP

V=

intim

ate

par

tner

viole

nce

;PTSD

=post

trau

mat

icst

ress

dis

ord

er.

∗ p<

.05.

∗∗p

<.0

1.

28

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

Maternal Intergenerational Transmission 29

of multivariate normality was met by the data. In addition, the sample sizewas adequate for testing the proposed models (with 12 parameters in eachmodel, we had a 9:1 ratio of participants to parameters) with the roman-tic attachment dimensions analyzed separately with PTSD then depressionsymptoms. The goodness of fit of the model was examined using thecomparative fit index (CFI), the root mean square error of approximation(RMSEA) and the chi-square. However, due to the poor fits of the proposedmodels and to improve the fit and stability, paths with nonsignificant pathcoefficients (Paths B, C, and E) were trimmed in a step-by-step manner(Kline, 2005). As a result, there was no evidence that psychological dis-tress (depression, PTSD, or both) served as a mediator. The modified model(see Figure 2) was significantly improved and demonstrated very good fit,χ2(2, N = 104) = 5.00, p = .78, RMSEA = .00 (CI = .00–.13), CFI = 1.00.Medium direct effects were found, indicating that mothers’ childhood mul-titype maltreatment was positively related to their children’s experience ofmultitype maltreatment (Path A; ß = .29, p < .01), as well as anxious roman-tic attachment dimension (Path D; ß = .21, p < .05) and IPV (Path F; ß = .34,p < .001). Finally, in the modified model, an indirect intervening effect of IPVwas not found in the intergenerational transmission of childhood multitypemaltreatment.

e1

CHILDMulti-type

Maltreatment

MATERNALChildhood Multi-type

Maltreatment

.15

MATERNALAnxious Romantic

Attachment Dimension

MATERNALIntimate

Partner Violence

.21* .17ns.34***

.12 .04

e3 e2

.29**

FIGURE 2 Modified, best fitting path model with standardized regression weights.

Note: ∗p < .05; ∗∗p < .01; ns = not significant.

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

30 N. A. Cort et al.

DISCUSSION

To our knowledge, this is the first study to examine the utility of a modelof intergenerational transmission of childhood multitype maltreatment frommothers to their children, integrating IPV, romantic attachment dimensions,and psychological distress. The study’s main finding extends the child mal-treatment research field by demonstrating that mothers who have sustainedchildhood multitype maltreatment are at risk of either directly perpetratingmultiple types of victimization on their offspring or of fostering unsafeenvironments, which increase their children’s potential to also experiencemultitype maltreatment. Mothers’ early foundational, traumatic experiencesappear to detrimentally affect their provision of emotional security and phys-ical safety to their children, over and above the influence of attachmentdimensions, IPV, and trauma-related psychological symptoms.

The study was unable to confirm that mothers’ current depressive andPTSD symptoms were related to childhood victimization and their children’sCPS-reported multitype maltreatment. These findings were unexpectedgiven the robust associations established in multiple studies indicating thatchildhood maltreatment predicted adult depression and PTSD (Banyard &Williams, 1996; Cicchetti & Valentino, 2006; DiLillo, Tremblay, & Peterson,2000; Silverman et al., 1996; Widom, 1999). It is possible that, due in partto shame and stigma, some women with childhood maltreatment historiesmight minimize the severity of the psychological consequences of earlytrauma (Baumann & Kolko, 2002). Psychological minimization of emotionalpain might also be an artifact of the mothers’ cultural or ethnic identities.Most mothers (60.6%) in the study were African American, and due tochronic exposure to stress identified in samples of African American women(McEwen & Seeman, 1999), they might have less awareness of psychologi-cal distress (Beauboeuf-Lafontant, 2007; Harris-Lacewell, 2001). Additionally,fear of stigma might result in denial (Beauboeuf-Lafontant, 2007; Nghe &Mahalik, 2001) of depressive or PTSD symptoms, especially when assessedin a time-limited fashion (e.g., past 2 weeks or 6 months).

In addition to the possibility of minimization being partly responsiblefor psychological distress being unrelated to either maternal childhood multi-type maltreatment or child multitype maltreatment, there might be additionalissues to consider. The relatively low levels of IPV present in the samplecould account for the proximally related minimal depressive and infre-quent PTSD symptoms in adulthood. Mothers’ negligible distress suggeststhat there might be insufficient variability among the constructs in this pri-marily low-income sample. Future research should therefore examine theseassociations with a more diverse and representative sample of mothers.

Research utilizing attachment theory to examine childhood maltreat-ment has been prolific. However, even though in adulthood attach-ment organization in romantic and parental relationships share common

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

Maternal Intergenerational Transmission 31

characteristics (Fraley, 2002), less attention has been directed toward theinfluence of romantic attachment on parenting (Edelstein et al., 2004; Fivush& McDermott-Sales, 2006; Volling et al., 1998). In this study, mothers’ child-hood multitype maltreatment was significantly associated with endorsementof anxious attachment to intimate partners. This finding indicates that, as aconsequence of childhood traumas, some mothers might be fearful of theirpartners’ abandonment, uncertain of their love and dependability in timesof need, and desirous of emotional intimacy.

Mothers’ childhood multitype maltreatment was directly related to theirvictimization in adult romantic relationships. This finding supports previousliterature and signifies the importance of childhood experiences in influenc-ing women’s vulnerability to continued victimization in later developmentalperiods (Banyard et al., 2000; Briere & Elliott, 2003; Ornduff et al., 2001;Renner & Slack, 2006). Mothers’ histories of maltreatment in physical, sex-ual, and emotional domains might result in an internalized universal senseof insecurity and interpersonal powerlessness.

The findings also support previous research indicating that maltreatedchildren usually experience multiple forms of abuse and neglect (Higgins& McCabe, 2000b; Trickett & McBride-Chang, 1995). The majority of moth-ers reported histories of childhood multitype maltreatment and a significantportion of their children who had been reported to CPS had been victims ofmultitype maltreatment. In this study, the rate of intergenerational transmis-sion of childhood multitype maltreatment was 46.7% and therefore higherthan the often reported intergenerational child maltreatment transmissionrate of 30% ± 5 (Kaufman & Zigler, 1987). Our inclusion of multiple mal-treatment subtypes might have resulted in an elevated rate. It should benoted that intergenerational transmission rates can vary depending on sam-ple differences (i.e., identified abusers vs. high-risk participants) and studydesign (i.e., retrospective vs. prospective). In this study, maltreated and non-maltreated children were identified and their mothers’ retrospective reportsof childhood multitype maltreatment were obtained. Additionally, the inclu-sion of nonmaltreated children in the study sample might have lessened thelikelihood that the rate found in the study is a spurious estimation.

However, it is acknowledged that the current intergenerational trans-mission of maltreatment rate could be an artifact of the demographics of thestudy sample. The mothers were predominantly single, with limited financialresources and educational backgrounds. Socioeconomic factors, includingreliance on social services and unemployment, might exacerbate existingvulnerabilities to perpetrating and experiencing maltreatment (Egeland etal., 1987; Egeland, Jacobvitz, & Sroufe, 1988; Hall, Sachs, & Rayens, 1998).Egeland et al. (1988) suggested that high concentrations of poverty and stressmight amplify rates of intergenerational maltreatment continuity.

Despite positive contributions of this investigation, a number of impor-tant limitations need to be considered. A limitation of this study is the use of

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

32 N. A. Cort et al.

Collins and Read’s (1990) AAS given that two subscales (Close and Anxiety)demonstrated poor internal consistency (DeVellis, 1991). AAS scores werestandardized and normed on primarily nonminority, college-educated, andmarried middle-class individuals. Therefore, the AAS might have decreasedreliability in a sample consisting primarily of African American women fromlow socioeconomic backgrounds.

Given the cross-sectional design, we could not claim temporal asso-ciations among or between the variables. The concurrent collection ofchildhood maltreatment and adult IPV data are potentially confoundedbecause current IPV might distort recollections of childhood experiences(Colman & Widom, 2004). Egeland et al. (1988) also suggested abusiveparents might misrepresent childhood experiences to gain sympathy fromothers or to find justification for their own abusive behaviors. We didnot compare individual, independent effects of single maltreatment sub-types to combinations of other subtypes. Therefore, we have not ruledout that a single subtype might have more intergenerational influencethan multiple types. However, Arata, Langhinrichsen-Rohling, Bowers, andO’Farril-Swails’s (2005) study findings indicated that compared to singlesubtypes, multitype maltreatment experiences were significantly more asso-ciated with negative psychological consequences. Although their findingssupport our contention that multitype maltreatment experiences are morecritical, further empirical comparative examinations are needed to clarifythese associations. Additionally, child maltreatment reports in our studypertain only to families detected and reported to CPS. It is also possiblethat children without CPS reports, at the time of the study, could havebeen maltreated after their study involvement. Therefore, it is likely thatthe rates of child maltreatment experiences are an underestimation of theactual phenomenon.

CONCLUSION

This first, comprehensive empirical examination of the generational conti-nuity of maternal childhood multitype maltreatment highlights the potentialfor mothers’ maltreatment across multiple domains to increase the riskof their children’s multitype maltreatment. Examinations of single mal-treatment experiences cannot decisively identify unique and interrelatedlong-term consequences of childhood traumas (Higgins & McCabe, 2000a).It is therefore imperative that the child welfare system and maltreatmentresearchers attend to maternal multitype maltreatment, especially given thepotential vulnerabilities to partner abuse and children’s increased multitypemaltreatment risk.

The study results suggest that there might be a need for further con-sideration of social policies addressing child maltreatment and IPV. Somestates have adopted policies that encourage CPS involvement when children

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

Maternal Intergenerational Transmission 33

are exposed to repeated parental IPV (Child Welfare Information Gateway,2007; Clark, Burt, Schulte, & Maguire, 1996; Edleson, Gassman-Pines, & Hill,2006; Magen, 1999; Nilsen & Cerulli, 2007). Although uncommon, these poli-cies have resulted in the substantiation of CPS cases against abused mothersfor failure to protect their children. However, our findings indicate that,for mothers with infrequent IPV experiences, distal childhood multitypemaltreatment might have a more salient impact on their children’s risk ofmultitype maltreatment compared to IPV exposure. Nevertheless, we notethat these particular findings might not generalize to mothers experienc-ing frequent and severe IPV. Therefore, further comparative examinationsof IPV versus childhood multitype maltreatment are needed to determineunique contributions to children’s multitype maltreatment risk.

Study findings also highlight the need for increased and sustained pub-lic health support of early intervention and clinical treatment programs formaltreated children. Egeland et al.’s (1988) examination of factors distin-guishing mothers with childhood maltreatment histories who continue ordiscontinue the abuse cycle demonstrated that the receipt of psychologi-cal treatment is a crucial factor in arresting potentially negative generationaltrajectories. In conclusion, the painful and traumatic experiences of child-hood multitype maltreatment give rise to global interpersonal turmoil. Theseexperiences can disrupt a variety of hierarchical stage-salient develop-mental processes, resulting in further generational continuity of multitypemaltreatment (Cicchetti & Toth, 1995). This study demonstrates that, forsome mothers, the impact of childhood multitype maltreatment is significantenough to be sustained over a subsequent generation.

REFERENCES

Arata, C., Langhinrichsen-Rohling, J., Bowers, D., & O’Farril-Swails, L. (2005). Singleversus multi-type maltreatment: An examination of the long-term effects of childabuse. Journal of Aggression, Maltreatment & Trauma, 11(4), 29–52.

Banyard, V. L. (1997). The impact of childhood sexual abuse and family functioningon four dimensions of women’s later parenting. Child Abuse & Neglect, 21,1095–1107.

Banyard, V. L., Arnold, S., & Smith, J. (2000). Childhood sexual abuse and datingexperiences of undergraduate women. Child Maltreatment, 5(1), 39–48.

Banyard, V. L., & Williams, L. M. (1996). Characteristics of child sexual abuse ascorrelates of women’s adjustment: A prospective study. Journal of Marriageand the Family, 58, 853–865.

Barnett, D., Manly, J. T., & Cicchetti, D. (1993). Defining child maltreatment: Theinterface between policy and research. In D. Cicchetti & S. L. Toth (Eds.), Childabuse, child development, and social policy (pp. 7–73). Norwood, NJ: Ablex.

Baumann, B. L., & Kolko, D. J. (2002). A comparison of abusive and nonabusivemothers of abused children. Child Maltreatment, 7 , 369–376.

Beauboeuf-Lafontant, T. (2007). You have to show strength: An exploration ofgender, race, and depression. Gender & Society, 21(1), 28–51.

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

34 N. A. Cort et al.

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck DepressionInventory–II . San Antonio, TX: Psychological Corporation.

Bernstein, D. P., & Fink, L. (1998). Childhood Trauma Questionnaire: A retrospectiveself-report manual. San Antonio, TX: Psychological Corporation.

Bolger, K. E., & Patterson, C. J. (2001). Developmental pathways from childmaltreatment to peer rejection. Child Development, 72, 549–568.

Brayden, R. M., Deitrich-MacLean, G., Dietrich, M. S., & Sherrod, K. B. (1995).Evidence for specific effects of childhood sexual abuse on mental well-beingand physical self-esteem. Child Abuse & Neglect, 19, 1255–1262.

Breslau, N., Chilcoat, H. D., Kessler, R. C., & Davis, G. C. (1999). Prior traumaand the issue of sensitization in posttraumatic stress disorder: Results from theDetroit Area Survey of Trauma. American Journal of Psychiatry, 156 , 902–907.

Briere, J., & Elliott, D. M. (2003). Prevalence and psychological sequelae of self-reported childhood physical and sexual abuse in a general population sampleof men and women. Child Abuse & Neglect, 27 , 1205–1222.

Briere, J., & Runtz, M. (1990). Differential adult symptomatology associated withthree types of child abuse histories. Child Abuse & Neglect, 14, 357–364.

Carlson, B. E., McNutt, L., Choi, D. Y., & Rose, I. M. (2002). Intimate partner abuseand mental health: The role of social support and other protective factors.Violence Against Women, 8, 720–745.

Child Welfare Information Gateway. (2007). Child witnesses to domestic violence:Summary of state laws. Retrieved from www.childwelfare.gov/systemwide/laws_policies/statutes/witnessdv.cfm

Cicchetti, D., & Manly, J. T. (1990). A personal perspective on conducting researchwith maltreating families: Problems and solutions. In G. Brody & I. Sigel (Eds.),Methods of family research: Vol. 2. Families at risk (pp. 87–133). Hillsdale, NJ:Lawrence Erlbaum Associates.

Cicchetti, D., & Toth, S. L. (1995). A developmental psychopathology perspectiveon child abuse and neglect. Journal of the American Academy of Child andAdolescent Psychiatry, 34, 541–565.

Cicchetti, D., & Valentino, K. (2006). An ecological transactional perspective on childmaltreatment: Failure of the average expectable environment and its influenceupon child development. In D. Cicchetti & D. J. Cohen (Eds.), Developmentalpsychopathology: Risk, disorder, and adaptation (2nd ed., Vol. 3, pp. 129–201).New York, NY: Wiley.

Clark, S. J., Burt, M. R., Schulte, M. M., & Maguire, K. (1996). Coordinatedcommunity responses to domestic violence in six communities: Beyond the jus-tice system. A full report (Prepared for the U.S. Department of Health andHuman Services, Office of the Assistant Secretary for Planning and Evaluation).Washington, DC: Urban Institute.

Collins, N. L. (1996). Working models of attachment: Implications for explana-tion, emotion, and behavior. Journal of Personality and Social Psychology, 71,810–832.

Collins, N. L., & Read, S. J. (1990). Adult attachment, working models, and relation-ship quality in dating couples. Journal of Personality and Social Psychology,58, 644–663.

Colman, R. A., & Widom, C. S. (2004). Childhood abuse and neglect andadult intimate relationships: A prospective study. Child Abuse & Neglect, 28,1133–1151.

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

Maternal Intergenerational Transmission 35

DeVellis, R. F. (1991). Scale development: Theory and applications. Newbury Park,CA: Sage.

DiLillo, D., & Damashek, A. (2003). Parenting characteristics of women reporting ahistory of childhood sexual abuse. Child Maltreatment, 8, 319–333.

DiLillo, D., Tremblay, G. C., & Peterson, L. (2000). Linking childhood sexual abuseand abusive parenting: The mediating role of maternal anger. Child Abuse &Neglect, 24, 767–779.

Dubowitz, H., Black, M. M., Kerr, M. A., Hussey, J. M., Morrel, T. M., Everson, M.D., et al. (2001). Type and timing of mothers’ victimization: Effects on mothersand children. Pediatrics, 107 , 728–735.

Edelstein, R. S., Weede-Alexander, K., Shaver, P. R., Schaaf, J. M., Quas, J. A., Lovas,G. S., et al. (2004). Adult attachment style and parental responsiveness duringa stressful event. Attachment and Human Development, 6(1), 31–52.

Edleson, J. L., Gassman-Pines, J., & Hill, M. B. (2006). Defining child exposure todomestic violence as neglect: Minnesota’s difficult experience. Social Work, 51,167–174.

Egeland, B., Jacobvitz, D., & Papatola, K. (1987). Intergenerational continuity ofabuse. In R. J. Gelles & J. B. Lancaster (Eds.), Child abuse and neglect: Biosocialdimensions (pp. 255–276). New York, NY: Aldine de Gruyter.

Egeland, B., Jacobvitz, D., & Sroufe, A. L. (1988). Breaking the cycle of abuse. ChildDevelopment, 59, 1080–1088.

Finkelhor, D., Ormond, R. K., & Turner, H. A. (2007). Poly-victimization: A neglectedcomponent in child victimization. Child Abuse & Neglect, 31, 7–26.

Fivush, R., & McDermott-Sales, J. (2006). Coping, attachment, and mother–childnarratives of stressful events. Merrill-Palmer Quarterly, 52(1), 125–150.

Fraley, R. C. (2002). Attachment stability from infancy to adulthood: Meta-analysisand dynamic modeling of developmental mechanism. Personality and SocialPsychology Review, 6(2), 123–151.

Gross, A. B., & Keller, H. R. (1992). Long-term consequences of childhood physicaland psychological maltreatment. Aggressive Behavior, 18, 171–185.

Hall, L. A., Sachs, B., & Rayens, M. (1998). Mothers’ potential for child abuse: Theroles of childhood abuse and social resources. Nursing Research, 47(2), 87–95.

Harris-Lacewell, M. (2001). No place to rest: African American political attitudes andthe myth of Black women’s strength. Women and Politics, 23(3), 1–33.

Hazan, C., & Zeifman, D. (1994). Sex and the psychological tether. In D. Perlman& K. Bartholomew (Eds.), Advances in personal relationships (pp. 151–180).London, England: Jessica Kingsley.

Henderson, A. J. Z., Bartholomew, K., Trinke, S. J., & Kwong, M. J. (2005). Whenloving means hurting: An exploration of attachment and intimate abuse in acommunity sample. Journal of Family Violence, 20, 219–230.

Herzberger, S. D. (1990). The cyclical pattern of child abuse: A study of researchmethodology. American Behavioral Scientist, 33, 529–545.

Heyman, R. E., & Slep, A. M. (2002). Do child abuse and interparental violence leadto adulthood family violence? Journal of Marriage and Family, 64, 864–870.

Higgins, D. J. (2004). The importance of degree versus type of maltreatment: Acluster analysis of child abuse types. The Journal of Psychology, 138, 303–324.

Higgins, D. J., & McCabe, M. P. (2000a). Multi-type maltreatment and the long-termadjustment of adults. Child Abuse Review, 9(1), 6–18.

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

36 N. A. Cort et al.

Higgins, D. J., & McCabe, M. P. (2000b). Relationships between different typesof maltreatment during childhood and adjustment in adulthood. ChildMaltreatment, 5, 261–272.

Higgins, D. J., & McCabe, M. P. (2001). Multiple forms of child abuse andneglect: Adult retrospective reports. Aggression and Violent Behaviour, 6 ,547–578.

Kaufman, J., & Zigler, E. (1987). Do abused children become abusive parents?American Journal of Orthopsychiatry, 57 , 186–192.

Kinard, E. M. (1994). Methodological issues and practical problems in con-ducting research on maltreated children. Child Abuse & Neglect, 18,654–656.

Kline, R. B. (2005). Principles and practice of structural equation modeling (2nded.). New York, NY: Guilford.

Kotch, J. B., Browne, D. C., Ringwalt, C. L., Stewart, P. W., Ruina, E., Holt, K., et al.(1995). Risk of child abuse or neglect in a cohort of low-income children. ChildAbuse & Neglect, 19, 1115–1130.

Leifer, M., Kilbane, T., Jacobsen, T., & Grossman, G. (2004). A three-generationalstudy of transmission of risk for sexual abuse. Journal of Clinical Child andAdolescent Psychology, 33, 662–679.

Lyons-Ruth, K., & Block, D. (1996). The disturbed caregiving system: Relationsamong childhood trauma, maternal caregiving, infant affect and attachment.Infant Mental Health Journal, 179, 257–275.

Magen, R. H. (1999). In the best interests of battered women: Reconceptualizingallegations of failure to protect. Child Maltreatment, 4, 127–135.

Manly, J. T., Kim, J. E., Rogosch, F. A., & Cicchetti, D. (2001). Dimensions of childmaltreatment and children’s adjustment: Contributions of developmental timingand subtype. Development and Psychopathology, 13, 759–782.

Martinez, P., & Richters, J. E. (1993). The NIMH community violence project: II.Children’s distress symptoms associated with violence exposure. Psychiatry,56 , 22–35.

McEwen, B. S., & Seeman, T. (1999). Protective and damaging effects of mediatorsof stress: Elaborating and testing the concepts of allostasis and allostatic load.Annals of New York Academy of Sciences, 896 , 30–47.

Moffitt, T. E., & Caspi, A. (1998). Annotation: Implications of violence betweenintimate partners for child psychologists and psychiatrists. Journal of ChildPsychology and Psychiatry, 39, 137–144.

Ney, P. G., Fung, T., & Wickett, A. R. (1994). The worst combinations of child abuseand neglect. Child Abuse & Neglect, 18, 705–714.

Nghe, L. T., & Mahalik, J. R. (2001). Examining racial identity statuses as predic-tors of psychological defenses in African American college students. Journal ofCounseling Psychology, 48(1), 10–16.

Nilsen, W., & Cerulli, C. (2007, July). Child witnessing legislation: Trends over time.Paper presented at The International Family Violence and Child VictimizationResearch Conference, Portsmouth, NH.

Ornduff, S. R., Kelsey, R. M., & O’Leary, K. D. (2001). Childhood physical abuse,personality, and adult relationship violence: A model of vulnerability tovictimization. American Journal of Orthopsychiatry, 71, 322–331.

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

Maternal Intergenerational Transmission 37

Pears, K. C., & Capaldi, D. M. (2001). Intergenerational transmission of abuse: A twogenerational prospective study of an at-risk sample. Child Abuse & Neglect, 25,1439–1461.

Reder, P., & Duncan, S. (2001). Abusive relationships, care and control conflicts, andinsecure attachments. Child Abuse Review, 10, 411–427.

Renner, L. M., & Slack, K. S. (2006). Intimate partner violence and child maltreat-ment: Understanding intra- and intergenerational connections. Child Abuse &Neglect, 30, 599–617.

Rholes, W. R., Simpson, J. A., & Friedman, M. (2006). Avoidant attachment andthe experience of parenting. Personality and Social Psychology Bulletin, 32,275–285.

Richters, J. E., & Martinez, P. (1990). Checklist of child distress symptoms: Parentreport. Rockville, MD: National Institute of Mental Health.

Schuetze, P., & Das Eiden, R. (2005). The relationship between sexual abuse duringchildhood and parenting outcomes: Modeling direct and indirect pathways.Child Abuse & Neglect, 29, 645–659.

Sedlak, A. (1988). Study findings: Study of the national incidence and prevalenceof child abuse and neglect: 1986 . Washington, DC: U.S. Department of Healthand Human Services.

Silverman, A. B., Reinherz, H. Z., & Giaconia, R. M. (1996). The long-term sequelaeof child and adolescent abuse: A longitudinal community study. Child Abuse &Neglect, 20, 709–722.

Steer, R. A., Ball, R., Ranieri, W. F., & Beck, A. T. (1999). Dimensions of the BeckDepression Inventory–II in clinically depressed outpatients. Journal of ClinicalPsychology, 55(1), 117–128.

Stouthamer-Loeber, M., Loeber, R., Homish, D. L., & Wei, E. (2001). Maltreatment ofboys and the development of disruptive and delinquent behavior. Developmentand Psychopathology, 13, 941–955.

Straus, M. A. (1979). Measuring intrafamily conflict and violence: The conflict tactics(CT) scales. Journal of Marriage and the Family, 41(1), 75–88.

Straus, M. A., & Gelles, R. J. (1986). Societal change and change in family violencefrom 1975 to 1985 as revealed by two national surveys. Journal of Marriageand the Family, 48, 465–479.

Tajima, E. A. (2000). The relative importance of wife abuse as a risk factor forviolence against children. Child Abuse & Neglect, 24, 1383–1398.

Trickett, P. K., & McBride-Chang, C. (1995). The developmental impact of differentforms of child abuse and neglect. Developmental Review, 15, 311–337.

Volling, B. L., Notaro, P. C., & Larsen, J. J. (1998). Adult attachment styles: Relationswith emotional well-being, marriage, and parenting. Family Relations, 47 ,355–367.

Vondra, J. I., & Toth, S. L. (1989). Ecological perspectives on child maltreatment:Research and intervention. Early Child Development and Care, 42, 11–29.

Vranceanu, A., Hobfoll, S. E., & Johnson, R. J. (2007). Child multi-type maltreatmentand associated depression and PTSD symptoms: The role of social support andstress. Child Abuse & Neglect, 31(1), 71–84.

Widom, C. S. (1999). Posttraumatic stress disorder in abused and neglected childrengrown up. American Journal of Psychiatry, 156 , 1223–1229.

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011

38 N. A. Cort et al.

Zuravin, S. J. (1989). Severity of maternal depression and three types of mother-to-child aggression. American Journal of Orthopsychiatry, 59, 377–389.

Zuravin, S. J., McMillen, C., DePanfilis, D., & Risley-Curtis, C. (1996). The intergen-erational cycle of child maltreatment: Continuity versus discontinuity. Journalof Interpersonal Violence, 11, 315–334.

Downloaded By: [Cort, Natalie A.] At: 23:16 13 January 2011