Social Learning Theory and Family Violence Research Paper

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Social learning theory is one of the most popular explanatory perspectives in the marital violence literature. Often conceptualized as the ‘‘cycle of violence’’ or ‘‘intergenerational transmission theory’’ when applied to the family, the theory states that people model behavior that they have been exposed to as children. Violence is learned through role models provided by the family (parents, siblings, relatives, and boyfriends/girlfriends), either directly or indirectly (i.e., witnessing violence), is reinforced in childhood, and continues in adulthood as a coping response to stress or as a method of conflict resolution (Bandura 1973).

During childhood and adolescence, observations of how parents and significant others behave in intimate relationships provide an initial learning of behavioral alternatives which are ‘‘appropriate’’ for these relationships. Children infer rules or principles through repeated exposure to a particular style of parenting. If the family of origin handled stresses and frustrations with anger and aggression, the child who has grown up in such an environment is at greater risk for exhibiting those same behaviors, witnessed or experienced, as an adult. Gelles (1972) states that ‘‘not only does the family expose individuals to violence and techniques of violence, the family teaches approval for the use of violence.’’ Children learn that violence is acceptable within the home and is an effective method for solving problems or changing the behavior of others.

The primary hypothesis for the intergenerational cycle of violence is that violent and abusive adults learned this behavior as a result of being the victims of or witnesses of aggressive and abusive behavior as children. If children are abused by their parents, they may internalize beliefs and patterns of behaviors that lead them to abuse their own children; if children observe parents who hit each other, they may develop a greater propensity toward abusing their own spouses. Transmission of violent behavior occurs through processes ofmodeling, failure to learn appropriate ways to manage conflict, and reinforcement for violent behavior. Normal coping mechanisms may not be learned or may become impaired, leading to violence as the ultimate resource.

Outline

I. Research Supporting the Intergenerational ‘‘Cycle of Violence’’ Theory

II. Intergenerational Transmission and Gender

III. Sex-Role Theory

IV. Is Aggression Generalizable?

V. Mediators of Childhood Exposure to Violence and Intimate Partner Violence

VI. Summary

VII. Prevention Implications

I. Research Supporting the Intergenerational ‘‘Cycle of Violence’’ Theory

There are numerous studies that support the cycle of violence theory, showing that the experience of violence in childhood is associated with general patterns of violent behavior (Widom 1989), as well as later violence in one’s intimate relationships (Browne 1980; Burgess, Hartman, and McCormack 1987; Fagan, Stewart, and Hansen 1983; Gelles 1972; McCord 1988; Roy 1982; Steinmetz 1977; Straus, Gelles, and Steinmetz 1980; Walker 1984). Early support for the cycle of violence was buttressed by two reviews of the literature. A review of findings from six studies (Okun 1986) indicated that 23 to 40 percent of battered women witnessed violence between their parents, while in four studies 10 to 33 percent of battered women were also abused as children. Hotaling and Sugarman (1986) reviewed fifty-two case comparison studies of marital violence, finding that witnessing violence between parents was a consistent risk marker for spouse abuse among both males and females. Although not a consistent risk marker, the majority of studies also found an association between being a victim of childhood violence and spouse abuse.

Much of the early work on intergenerational transmission was derived from small cross-sectional studies of distinctive populations, such as clinical populations and children of battered women in shelters. Appropriate control group comparisons were often missing, making it difficult to establish cause and effect. Results from these studies have generally supported the association between witnessing or experiencing violence in childhood with later negative outcomes, such as partner violence. The linkage is somewhat less pronounced in nonreferred, community samples (Margolin 1998; Stith et al. 2000). This may be a result of the less severe nature of most violence that occurs or a result of better controls. Women in shelters report an average of sixty-five to sixty-eight assaults per year, which is about eleven times greater than the average of six assaults per year reported by abused women in the National Family Violence Survey (Straus 1990a). Other limitations of the early studies included the use of retrospective data. Retrospective assessments rely on long recall periods, with the possibility of selective recall biases and memory reconstruction problems. Discrepant findings using retrospective versus prospective designs have been documented. For instance, a study that examined whether childhood victimization increased the risk for drug abuse in young adulthood found increased risk with retrospective self-reports, but no risk when prospective data was used (Widom, Weiler, and Cottler 1999). A better approach for studying the linkage between early exposure to violence and later partner violence is to utilize longitudinal studies.

Overcoming the issues of retrospection and lack of comparison groups, White and Widom (2003) used a prospective study to trace long-term outcomes for men and women with official records of child abuse and/or neglect prior to age twelve, and a control group of nonabused matched cases. Both groups (n = 939) were interviewed twenty years later to discover that the abused and neglected children were slightly more likely than controls to ever hit their partners (53 vs. 41 percent). This difference held for both males and females.

Another twenty-year prospective study using a randomly selected sample of youth and their mothers residing in two upstate New York counties in 1975 followed 543 children to test the independent effects of parenting, exposure to domestic violence between parents, maltreatment, adolescent disruptive behavior disorders, and emerging adult substance abuse disorders on the risk of violence to and from an adult partner (Ehrensaft et al. 2003). Consistent with social learning theory, observing violence between parents, childhood powerassertive punishment by the mother, and adolescent conduct disorder (which appeared to mediate the effects of childhood physical abuse) were predictors of later perpetration of partner violence. Observing parental violence also predicted later victimization by a partner. Childhood physical abuse significantly predicted injury by a partner, as well as injury to a partner.

Support for the theory that direct or indirect (i.e., witnessing) childhood exposure to parental violence is related to engaging in later partner violence is also supported by nationally representative samples, such as the 1975 and 1985 National Family Violence Surveys (Straus 1990b; Straus et al. 1980). Relying on retrospective data, Straus found that males and females who endured more (i.e., higher frequency) ordinary physical punishment as children had higher rates of both ordinary and severe marital violence as adults. They also reported higher rates of ordinary physical punishment and child abuse toward their own children. Men and women who had witnessed parents hit each other were three times more likely to abuse their own partners compared with those who had not. Respondents with the experience of being both abused as children and witnessing parental violence— the ‘‘double whammy’’—had a one in three chance of encountering marital violence in the study year, double the overall rate for annual marital violence. Subsequent analyses confirmed that dually exposed, compared with singly exposed, women had significantly increased risk for adult perpetration of child abuse and for partner abuse perpetration and victimization. Similarly, men exposed to both forms, rather than one form, of family-of-origin violence had double the risk of partner abuse victimization. Men’s risk for perpetration of child abuse or partner abuse was elevated by exposure to any form of family-of-origin violence but was not increased by exposure to multiple forms of family-of-origin violence.

As evidence mounted in support of the cycle of violence theory, a new criticism arose that studies failed to separate witnessing violence from experiencing violence. These two types of exposure to violence may differentially affect the learning of marital violence. Kalmuss (1984) explored the relationship between childhood family aggression (by those children who directly experienced violence and those who only witnessed it in their families) and severe marital aggression in the next generation, using data from 2,143 adults in the 1975 National Family Violence Survey. In this retrospective study, she found that severe marital aggression was more likely when respondents, males and females, observed hitting between their parents than when they were hit as teens by their parents, although both forms of first-generation violence resulted in increased levels of second-generation marital aggression. Exposure to both types of childhood aggression led to a dramatic increase in the probability of marital aggression.

Recent support for the intergenerational cycle of violence theory comes from meta-analysis, which is a systematic review of the relevant literature allowing for statistical aggregation of results that can be reported as an average effect size. A meta-analysis of thirty-nine studies that examined the relationship between witnessing or experiencing family violence in childhood and receiving or perpetrating violence in an adult heterosexual cohabiting or marital relationship demonstrated that growing up in an abusive family is positively related to becoming involved in a violent marital relationship (Stith et al. 2000). The relationship is weak to moderate, with r values ranging from .08 to .35, depending upon the relationship examined.

II. Intergenerational Transmission and Gender

Although boys and girls rely on both parents as a relevant source of information in constructing their own beliefs and behaviors, a major question has been the degree to which the process of intergenerational transmission operates differently for males and females. Are boys and girls vulnerable to the same degree (i.e., does childhood exposure to marital violence have the same effects on males and females)? Bandura’s (1973) social learning theory states that the ability to influence through modeling depends upon the degree to which the child identifies with the model. This suggests another research question: Do gender differences exist in the modeling of behavior? e.g., are boys more likely to imitate their fathers and girls their mothers?

A community sample of adolescents, some with histories of childhood maltreatment, sheds some light on the first question. The maltreated adolescents, compared with nonmaltreated youths, showed differential patterns of adjustment problems and dating violence. Female adolescents with maltreatment histories reported considerable emotional distress (such as anger, depression, and anxiety), posttraumatic stress–related symptoms, and acts of violent and nonviolent delinquency compared with girls without such histories. Male adolescents with maltreatment histories reported fewer symptoms of emotional turmoil and delinquent behavior but were significantly more likely to be abusive toward their dating partners than boys without a maltreatment history (Wolfe et al. 2001).

Overall, the study of gender effects has produced mixed findings (Stith et al. 2000), with some studies showing that direct and/or indirect exposure to violence in childhood is more salient for females (Forsstrom and Rosenbaum 1985), some studies showing stronger effects among males (Rosenbaum and O’Leary 1981), some showing a same-gender modeling effect (Heyman and Slep 2002), and some showing no sex-specific differentiation (Cappell and Heiner 1990). A review of eight recent studies (Cummings, Pepler, and Moore 1999) examining the impact of interparental violence on children ranging in age from four to sixteen showed that girls exposed to interparental violence displayed higher internalizing scores than did exposed boys in the six studies that reported on internalizing outcomes. Of the five studies that reported externalizing scores, three studies reported higher scores for girls and two for boys. These studies suggest that the social context of the home may be more salient for girls than for boys. Data from the National Youth Survey also support the premise that prior experiences with violence may be more salient for females than for males. In this study, which examined both witnessing parental violence and experiencing child abuse, only witnessing violence had an effect on later violence and only for females. However, this effect was not direct and operated through other variables, such as marital satisfaction (Mihalic and Elliott 1997). A longitudinal study of parenting practices experienced in three distinct developmental periods while growing up also provides evidence of intergenerational transmission for females only (Belsky et al. 2005).

In contrast, Rosenbaum and O’Leary (1981) found that the effects of witnessing parental violence as children on later violent behavior were especially strong for males. Women who were victims of physical marital violence were no more likely than women in two control groups (composed of women who had suffered no physical abuse; one group claimed to have satisfactory marriages and the other group discordant marriages) to have witnessed spouse abuse between their parents. However, abusive husbands were much more likely to have come from families characterized by marital violence than husbands in the two control groups.

Others theorize that modeling of marital aggression is not sex specific, but is role specific. The 1975 National Family Violence Survey examined this perspective, finding that females who had observed fathers hitting mothers were just as likely to be the perpetrators of violence as the victims, and males were as likely to be the victims as well as perpetrators of marital violence. Kalmuss (1984) concluded that the intergenerational transmission of aggression involves both generalizable and specific models. Generalized models increase the likelihood of any form of family aggression in the next generation, and specific models increase the likelihood of particular types of family aggression (e.g., children who observe aggressive acts between their parents are more likely to model aggressive behavior in their own marriages) (see also Seltzer and Kalmuss 1988). A later analysis using the 1975 National Family Violence Survey also found evidence that the existence of spousal violence in the family of origin increased the likelihood that the respondent, whether husband or wife, would be the target of aggression, but no evidence was found for sex-specific acquisition of the perpetrator role (Cappell and Heiner 1990). Findings from the 1975 National Family Violence Survey are in direct contrast to the 1985 National Family Violence Survey, which provided support for a same-gender modeling effect for perpetration of violence toward partners and children. Men’s risk was increased by exposure to father-to-mother violence, and women’s risk was increased by exposure to mother-to-father violence (Heyman and Slep 2002).

III. Sex-Role Theory

A subtype of social learning, sex-role theory suggests that early sex-role socialization teaches boys to be the dominant partner, major wage earner, and head of the household, while women are socialized to accept male dominant relationships and taught to meet the needs of others through their main roles as wives and mothers. These roles may leave males and females vulnerable to becoming offenders and victims of marital violence. Most empirical studies have failed to validate a sex-role interpretation of marital violence (Hotaling and Sugarman 1986; Mihalic and Elliott 1997). Walker (1984), contrary to her original supposition, found no evidence in a clinical sample that battered women had traditional sex-role attitudes. Instead, they perceived themselves as more liberal; however, they perceived their mates as traditional. Her research suggested that the discordance in perceived sex roles might lead to conflict within the marriage and hence to marital violence. This hypothesis was tested by Coleman and Straus (1986), who found that equalitarian couples had the lowest rates of conflict and violence, while male- or female-dominant couples had the highest rates. Consensus about the legitimacy of the power structure reduced the rate of conflict and violence in male- or female-dominated families, but when conflict did occur in these families, it was associated with a much higher risk of violence than that of equalitarian families encountering the same level of conflict. This suggests that disagreement over sexrole orientations may be a bigger factor in marital aggression than the actual orientation held.

IV. Is Aggression Generalizable?

A key element of social learning theory concerns its generalizability. Is violence learned in one context generalizable to other contexts? Social learning theory predicts a generalized pattern of learned aggression that may be modeled in both family and nonfamily relationships. Bandura (1971, 1973) proposes that aggressive models transmit general lessons, as well as specific ones, and that observers learn general aggressive strategies that go well beyond the specific modeled examples. The perspective of generalized modeling has much empirical support in both the family violence literature and the delinquency literature (McCloskey and Lichter 2003; Mihalic and Elliott 1997; Thornberry 1994). A review of twenty-three articles on the effects of observing parent aggression provided evidence that children observers are at risk for a variety of externalizing behaviors, including increased aggression at home and school and in the community (Fantuzzo and Lindquist 1989). The effects on child witnesses of domestic violence are not confined only to behavioral development, but also affect emotional development, although meta-analyses suggest that these links may be weak (Kitzman et al. 2003).

Data from the 1975 and 1985 National Family Violence Surveys and a 1972 university student survey demonstrated that children assaulted by parents were more violent toward brothers, sisters, parents, and persons outside the family. They were also more likely to be involved in property crimes and with the police (Hotaling, Straus, and Lincoln 1990). This study also found that adult offenders and victims of family assault had higher rates of violent and nonviolent crime outside the family. The relationship existed even with controls for socioeconomic class, gender, and severity of violence, although the relationship was, in general, stronger for males and blue-collar families. These authors suggest that it is not just the direct experience of being assaulted that leads to violence, but the experience of living in a multi-assaultive family (i.e., the highest rates of outside family violence were reported by those respondents who were from families where they witnessed violence between their parents and were directly assaulted by a parent). These findings suggest that there are common links in all types of violence.

A prospective sample of 299 children, ages six to twelve, were interviewed with their mothers in 1991 to examine gender differences in adolescent delinquency five years later against a backdrop of witnessing marital violence and being a victim of child abuse (Herrera and McCloskey 2001). This study indicated that 31 percent of children who experienced abuse and 33 percent who witnessed marital violence, compared with 18 percent of those children without abuse in their childhoods, were referred to juvenile court at least once. Additionally, 17 percent of abused children and 17 percent of those who witnessed violence were referred for a violent offense, compared with 5 percent without a family background of violence. Being a victim simultaneously of both forms of abuse failed to predict delinquency above and beyond that of either of the other two categories. There was an interaction between sex and child abuse, with girls at higher risk of arrest for violence if they had a prior history of physical child abuse.

Evidence that exposure to violence in childhood is related to antisocial behavior outside the home also comes from longitudinal delinquency surveys. The Rochester Youth Development Study, which tracks 1,000 seventh- and eighth-grade students in the Rochester public school system, found that a history of substantiated cases of physical or sexual abuse or neglect prior to age twelve increased the chances of youth violence by 24 percent. Adolescents growing up in homes with partner violence or a family climate of hostility also exhibited higher rates of self-reported violence. Exposure to multiple forms of family violence doubled the risk of self-reported youth violence. These analyses controlled for gender, race/ethnicity, family structure, and social class (Thornberry 1994). In the National Youth Survey, females who witnessed marital violence had higher rates of minor adolescent violence and felony assault (Mihalic and Elliott 1997).

Another study followed 1,575 cases from childhood through young adulthood, comparing 908 substantiated cases of childhood abuse or neglect with a group of 667 matched children not officially recorded as abused or neglected. Being abused as a child increased the likelihood of arrest as a juvenile by 59 percent, as an adult by 28 percent, and for a violent crime by 30 percent (Widom and Maxfield 2001).

A question that arises is whether there is a threshold in one’s early experience of violence that must be surpassed before the aggressive lessons become salient. To answer this question, a national representative sample was used to compare the effects of minimal, moderate, and frequent spanking on children’s physical aggression against siblings and parents. A linear relationship for preschoolers, preadolescents, and adolescents was found for all levels of spanking. This supports the idea that ‘‘violence begets violence’’ and that any punishment that uses violent means may be harmful. It is important to note that the degree to which the parent reasoned with the child moderated the effect in several models (Larzelere 1986).

The cycle of violence theory assumes that if physically aggressive parents end up with aggressive children, it is because the child has learned a patterned response to violence. An alternative explanation is that the child has a predisposition toward aggressive behavior and that the punitive parental behavior is a response to the child. Parents often cite child misbehaviors as leading to greater use of severe corporal punishment. Thus, corporal punishment may be a response to aggressive child behavior, rather than its cause. A test of the social learning model against the temperament model provided support for the social learning model, which suggests that temperament does not adequately explain the process by which corporal punishment is passed on intergenerationally (Muller, Hunter, and Stollak 1995).

While there appears to be support for a link between family violence and youth violence, others have argued that the claim that child maltreatment is the leading cause of delinquency relies upon methodologically flawed studies and that the few rigorous studies are inconclusive or offer only a weak connection, which often disappears when other variables are controlled in the analyses (Schwartz, Rendon, and Hsieh 1994).

V. Mediators of Childhood Exposure to Violence and Intimate Partner Violence

A large problem with the intergenerational violence studies is that too much emphasis is often given to the simple association found, even if weak, and people assume that everyone who had a violent childhood will be violent to their own spouses and children. In fact, researchers have identified both child and spouse abusers who came from nonviolent families and nonviolent individuals who came from violent families. Kaufman and Zigler (1987) reviewed the literature cited to support the intergenerational theory of violence and postulated that the best estimate of the rate of intergenerational transmission was about 30 percent, plus or minus 5 percent. Thus, while approximately one-third of those who have suffered physical or sexual abuse or neglect as children will subject their own children to some form of abuse, two-thirds will not.

Researchers know little about why the majority of abused children do not become violent. Most studies reflect only the linkages between observations of violence and direct experiences with violence during childhood and later behavioral outcomes in adulthood and have not incorporated the intervening variables which ultimately may be responsible for determining whether a person will perform a learned behavior. According to Bandura (1969), exposure to violence does not ensure observational learning. A comprehensive theory of observational learning includes four component processes that influence its nature and degree: attentional processes, retention processes, motor production processes, and incentive and motivational processes. Some people fail to learn the essential features of the model’s behavior, memories may be lost or altered with the passage of time, physical capabilities may restrict performance of a learned observation, and a learned behavior may not be expressed if it holds no functional value for the person or if the behavior is not reinforced. Breakdowns in any of the above processes may result in a failure to translate observational learning to behavior.

Hotaling and Sugarman (1990) updated their earlier review of the literature on intergenerational transmission using multivariate statistics from a national probability sample and could find no link between current marital violence and earlier family-of-origin violence. They now conclude that the relationship that is typically found between current and past childhood violence disappears when other risk factors are controlled, such as socioeconomic status and marital conflict.

There are several potentially confounding social, family, and contextual factors that may be associated with both childhood exposure to violence and increased risks of later adjustment problems or intimate partner violence. Families who experience intimate violence often experience other mental health risks, such as unemployment, drug and alcohol abuse, divorce, incarceration, and other family stressors. Other variables that might mediate the relationship include frequency and duration of exposure, severity of childhood violence, age, gender, perceived legitimacy of violence in family relations, quality of attachment with caregivers, maternal stress, family disadvantage, marital discord, and other stressful life events (Kolbo, Blakely, and Engleman 1996). Other mediators include elevated depression (McCloskey and Lichter 2003) and childhood neglect (Andrews and Brown 1988).

The extent to which confounding factors such as parental criminality, alcoholism, drug use, and adverse life events might explain the relationship between interparental violence in childhood and psychosocial adjustment in young adulthood was examined in a 1977 New Zealand birth cohort of 1,265 children who were followed into adulthood (Fergusson and Horwood 1998). At age eighteen, retrospective reports of interparental violence were obtained. A substantial amount of the association appeared to reflect these social and familial contextual factors. Statistical control of family context was sufficient to explain all or most of several outcomes, including depression, suicide attempts, substance abuse (other than alcohol), nicotine dependence, and violent crime. Associations persisted for anxiety, conduct disorder, alcohol abuse/dependence, and property crime.

It has been suggested that child abuse affects later intimate aggression by enhancing the development of a problem syndrome in adolescence and young adulthood. Using a longitudinal community study, a direct effect between harsh physical punishment in childhood and perpetration of violence against an intimate partner later in life was found. Over half of the effect was indirect through problem behaviors in adolescence and young adulthood (Swinford et al. 2000). In contrast, Mihalic and Elliott (1997) found no direct or indirect effects between self-reported child abuse (‘‘beaten as a child’’) and partner violence later in life.

Path models have demonstrated an indirect path between observing violence as a child and later severe marital violence via sex-role egalitarianism and approval of marital violence, both of which directly influenced the use of severe violence (Stith and Farley 1993). As egalitarianism decreased and approval of marital violence increased, the level of severe violence increased. In this same study, observation of parental violence was also related to decreased self-esteem, which increased the level of alcoholism and marital stress, both of which had an effect on the approval of marital violence. The variables in this study were not measured in temporal sequence; hence no conclusions regarding causality can be made. A national longitudinal study that provided temporal sequencing showed that the path between witnessing parent violence and later partner violence among females was mediated by the development of adolescent delinquency, which resulted in lower marital satisfaction. There was no direct or indirect path between witnessing violence and later partner violence for males (Mihalic and Elliott 1997). Other path models have demonstrated that antisocial personality disorder mediated the effects of abuse/neglect on inter-partner violence for men and women, and hostility and alcohol problems also mediated the effects for abused and neglected women (White and Widom 2003).

A review of the mediating factors that diminish the likelihood of abuse being transmitted across generations suggests that the cycle of violence is less likely to repeat itself if as a child one had the love and support of at least one parent; a loving, supportive relationship as an adult; fewer stressful events in life; and acknowledgment of the childhood abuse and determination not to repeat it (Kaufman and Zigler 1987). Past or current life stresses or supports are influential in determining whether or not the cycle of violence is repeated. Respondents who were not physically abused as children but who abused their own children reported more neglect, more stresses, and less nurturance in the family of origin than those who did not abuse their own children. Abused respondents who did not abuse their children reported fewer stresses in their families of origin than those abused respondents who had abused their own children (Herrenkohl, Herrenkohl, and Toedter 1983).

VI. Summary

This research paper provides a complex picture of the role of social learning during childhood in explaining later intimate partner violence. While many of the earliest studies show associations between childhood exposure to violence (either as a witness or as a victim), most of these studies have methodological weaknesses, such as the use of clinic or shelter samples (which generally show a stronger relationship between early and later violence), small samples, lack of comparison groups, and use of retrospective data and analyses. The relationship, however, is also supported in the stronger studies employing national samples. However, more sophisticated analyses, using multivariate statistics, have commonly demonstrated that the relationship between parental violence in childhood and later intimate partner violence could be explained by other social, family, and contextual factors.

The preponderance of evidence suggests that while social learning is a viable explanation for intimate partner violence, its explanatory power is weak to moderate, and the mechanisms for intergenerational transmission of abusive parenting are complex and remain unspecified.

VII. Prevention Implications

There are many reasons for preventing child abuse and child exposure to violence—one reason is some moderate potential to reduce intimate partner violence in later adulthood. Early intervention may restore normal developmental processes, such as empathy and self-control, that promote healthy nonviolent relationships. Since the family provides a context for early learning of violence, programs that intervene with the family should have farreaching effects. Children are especially vulnerable to the effects of harsh, permissive, and inconsistent parenting. High levels of parental negative affect and hostility are disruptive to children’s ability to regulate their emotional responses and manage conflict appropriately. Patterson, Reid, and Dishion (1992) use social learning theory to describe an interactive pattern of behavior between parent and child, the ‘‘coercive process,’’ whereby children learn to escape or avoid parental criticism by escalating their negative behaviors. This, in turn, leads to increasingly aversive parent interactions and escalating dysregulation on the part of the child. These negative parent responses directly model and reinforce the child’s deviant behaviors. This suggests the need to teach parent skills that emphasize changing negative parenting practices, such as coercive discipline and punishment, and that teach parents how to handle conflict, maintain self-control, and problem-solve to effectively manage children. Clinical experience indicates that coercive discipline patterns among parents are difficult to change as children reach adolescence; thus families should be targeted before the children reach late childhood and before patterns of physical abuse become entrenched in the child and reproduced in later relationships.

There are several selected (secondary prevention) evidence-based parent training programs that target high-risk families. The Nurse-Family Partnership (Olds et al. 1998) is an effective method of reducing child abuse and neglect and later antisocial and criminal behavior on the part of children. It provides supports for first-time and other high-risk mothers during pregnancy and through the child’s second birthday. Parents are provided educational content, supports, and skills designed to improve pregnancy outcomes, improve the child’s health and development, and improve the mother’s own personal development. The Incredible Years Parent, Teacher, and Child Training Series (Webster- Stratton et al. 2001) is designed to promote emotional and social competence in young children, ages two to eight, at risk for or presenting with conduct problems. The program for parents imparts skills such as how to play with children, ways to help children learn, effective praise and use of incentives, and effective limit-setting and strategies for handling misbehavior. In the advanced program, parents are also taught interpersonal skills such as effective communication, anger management, and problem-solving between adults. The Child Program intervenes with children who exhibit particular behaviors that place them at risk for later adolescent and adult violence. Although the program has not been tested to determine its effects on child abuse, the skills that parents gain and the reduction in conduct disorders among children may ultimately impact child abuse.

There is also evidence that a well-developed capacity for empathy inhibits or prevents aggression, suggesting that programs that work with children to develop social and emotional competencies may have long-term benefits. Promoting Alternative Thinking Strategies (PATHS) is a universal (primary prevention) school program for children in kindergarten through grade 5 that teaches empathy and behavioral regulation to prevent initiation of aggressive behavior (Greenberg, Kusche, and Mihalic 2002).

Indicated (tertiary prevention) programs target populations already exhibiting the problem, such as domestic violence perpetrators and victims. Although numerous treatment options for batterers (e.g., cognitive-behavioral therapy, individual and group counseling, mandated arrest) have been evaluated, there is little empirical support that any of these treatment modalities stop the violence. Few studies have evaluated advocacy studies for victims, but at least two studies show promise for this approach (Goodman and Epstein 2005; Stover 2005). Until programs can be found that have demonstrated effects working with adult perpetrators and victims, early intervention models appear the most promising.