Journal of Family Violence

, Volume 29, Issue 6, pp 681–692 | Cite as

Perceived Quality of Life and Health Complaints in Children Exposed to Intimate Partner Violence

  • Karin K. GripEmail author
  • Kjerstin Almqvist
  • Ulf Axberg
  • Anders G. Broberg


Children 9 to 13 years old exposed to intimate partner violence (IPV) reported on their violence exposure, attachment to both parents, temperament (negative emotionality and emotion regulation), perceived quality of life, and health complaints. Half of the children perceived their quality of life as good and did not have recurrent health complaints. When controlling for socioeconomic status, health complaints were associated with higher IPV exposure and negative emotionality, whereas quality of life was associated with attachment security, higher capacity for emotion regulation, and lower negative emotionality. These results underscore the importance of increasing and supporting the capacity of children exposed to IPV to handle and express their emotions, as well as making school nurses and other primary care practitioners more attentive to IPV as a possible background factor in children’s health complaints.


Intimate partner violence Subjective health Health complaints Quality of life Well-being Attachment Negative emotionality Emotion regulation 


  1. Ainsworth, M. D., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
  2. Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256(3), 174–186. doi: 10.1007/s00406-005-0624-4.PubMedCentralPubMedCrossRefGoogle Scholar
  3. Annerbäck, E. M., Wingren, G., Svedin, C. G., & Gustafsson, P. A. (2010). Prevalence and characteristics of child physical abuse in Sweden—findings from a population-based youth survey. Acta Paediatrica, 99(8), 1229–1236. doi: 10.1111/j.1651-2227.2010.01792.x.PubMedCrossRefGoogle Scholar
  4. Berntsson, L. T., Kohler, L., & Gustafsson, J. E. (2001). Psychosomatic complaints in schoolchildren: a Nordic comparison. Scandinavian Journal of Public Health, 29(1), 44–54. doi: 10.1177/14034948010290011001.PubMedCrossRefGoogle Scholar
  5. Bisegger, C., Cloetta, B., von Rueden, U., Abel, T., Ravens-Sieberer, U., & European Kidscreen, G. (2005). Health-related quality of life: gender differences in childhood and adolescence. Sozial- Und Praventivmedizin, 50(5), 281–291. doi: 10.1007/s00038-005-4094-2.PubMedCrossRefGoogle Scholar
  6. Bisegger, C., Fuhr, D. C., Abel, T. Kidscreen Group (2009). Age and gender differences in health-related quality of life of children and adolescents in Europe: a multilevel analysis. Quality of Life Research, 18(9), 1147–1157.Google Scholar
  7. Bretherton, I. (1991). Pouring new wines into old bottles:The social self as an internal working model. In M. Gunnar & L. A. Sroufe (Eds.), The Minnesota symposia on child psychology (Self-processes and development, Vol. 23, pp. 1–41). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
  8. Broberg, A. G., Almqvist, K., Almqvist, L., Cater, Å. K., Eriksson, M., Forssell, A., & Sharifi, U. (2011). Stöd till barn som upplevt våld mot mamma [Support services for children exposed to intimate partner violence]. Gothenburg: Department of Psychology, Gothenburg University.Google Scholar
  9. Cassidy, J., & Mohr, J. J. (2001). Unsolvable fear, trauma, and psychopathology: theory research, and clinical considerations related to disorganized attachment across the life span. Clinical Psychology: Science and Practice, 8(3), 275–298. doi: 10.1093/clipsy.8.3.275.CrossRefGoogle Scholar
  10. Chapman, D. P., Wheaton, A. G., Anda, R. F., Croft, J. B., Edwards, V. J., Liu, Y., & Perry, G. S. (2011). Adverse childhood experiences and sleep disturbances in adults. Sleep Medicine, 12(8), 773–779. doi: 10.1016/j.sleep.2011.03.013.PubMedCrossRefGoogle Scholar
  11. Clements, C. M., Oxtoby, C., & Ogle, R. L. (2008). Methodological issues in assessing psychological adjustment in child witnesses of intimate partner violence. Trauma, Violence & Abuse, 9(2), 114–127. doi: 10.1177/1524838008315870.CrossRefGoogle Scholar
  12. Currie, C., Hurrelman, K., Settertobulte, W., Smith, R., & Todd, J. (Eds). (2000). Health behaviour in school-aged children: a World Health Organization cross-national study (HBSC) international report. In: WHO Policy Series: Health policy for children and adolescents, Vol. 1. Copenhagen: WHO. Available at Accessed on August 20, 2012.
  13. De Bellis, M. D. (2001). Developmental traumatology: the psychobiological development of maltreated children and its implications for research, treatment, and policy. Development and Psychopathology, 13(3), 539–564. doi: 10.1017/s0954579401003078.PubMedCrossRefGoogle Scholar
  14. Dube, S. R., Anda, R. F., Felitti, V. J., Edwards, V. J., & Williamson, D. F. (2002). Exposure to abuse, neglect, and household dysfunction among adults who witnessed intimate partner violence as children: implications for health and social services. Violence Victims, 17(1), 3–17.PubMedCrossRefGoogle Scholar
  15. Edleson, J.L., Shin, N., & Armendariz, K. K. J. (2008). Measuring children’s exposure to domestic violence: The development and testing of the Child Exposure to Domestic Violence (CEDV) Scale. Children and Youth Services Review, 30(5), 502–521. doi: 10.1016/j.childyouth.2007.11.006.
  16. Eisenberg, N., Fabes, R. A., Guthrie, I. K., & Reiser, M. (2000). Dispositional emotionality and regulation: their role in predicting quality of social functioning. Journal of Personality and Social Psychology, 78(1), 136–157. doi: 10.1037/0022-3514.78.1.136.PubMedCrossRefGoogle Scholar
  17. Eisenberg, N., Spinrad, T. L., & Eggum, N. D. (2010). Emotion-related self-regulation and its relation to children’s maladjustment. Annual Review of Clinical Psychology, 6, 495–525.PubMedCentralPubMedCrossRefGoogle Scholar
  18. Eriksson, M., Biller, H., & Balkmar, D. (2006). Men’s violence against women and children’s experiences: interventions, knowledge, and issues for future development. Fritzes Stockholm. Google Scholar
  19. Erhart, M., Ottova, V., Gaspar, T., Jericek, H., Schnohr, C., Alikasifoglu, M., Ravens-Sieberer, U., & HBSC Positive Health Focus Group. (2009). Measuring mental health and well-being of school-children in 15 European countries using the KIDSCREEN-10 Index. International Journal of Public Health, 54, 160–166. doi: 10.1007/s00038-009-5407-7.PubMedCrossRefGoogle Scholar
  20. Fattore, T., Mason, J., & Watson, E. (2009). When children are asked about their well-being: towards a framework for guiding policy. Child Indicators Research, 2(1), 57–77. doi: 10.1007/s12187-008-9025-3.CrossRefGoogle Scholar
  21. Feldhaus, K. M., Koziol-McLain, J., Amsbury, H., Norton, I., Lowenstein, S., & Abbott, J. (1997). Accuracy of 3 brief screening questions for detecting partner violence in the emergency department. Journal of the American Medical Association, 277, 1357–1361. doi: 10.1001/jama.277.17.1357.PubMedCrossRefGoogle Scholar
  22. Flaherty, E. G., Thompson, R., Litrownik, A. J., Zolotor, A. J., Dubowitz, H., Runyan, D. K., English, D. J., & Everson, M. D. (2009). Adverse Childhood Exposures and Reported Child Health at Age 12. Academic Pediatrics, 9(3), 150–156.Google Scholar
  23. Ghasemi, M. (2009). Impact of domestic violence on the psychological wellbeing of children in Iran. Journal of Family Studies, 15(3), 284–295.CrossRefGoogle Scholar
  24. Gilbert, R., Widom, C. S., Browne, K., Fergusson, D., Webb, E., & Janson, S. (2009). Child maltreatment 1: burden and consequences of child maltreatment in high-income countries. Lancet, 373(9657), 68–81. doi: 10.1016/s0140-6736(08)61706-7.PubMedCrossRefGoogle Scholar
  25. Gross, J. J., & Munoz, R. F. (1995). Emotion regulation and mental-health. Clinical Psychology-Science and Practice, 2(2), 151–164.CrossRefGoogle Scholar
  26. Gunnar, M., & Quevedo, K. (2007). The neurobiology of stress and development. Annual Review of Psychology, 58, 145–173. doi: 10.1146/annurev.psych.58.110405.085605.PubMedCrossRefGoogle Scholar
  27. Hagquist, C., & Andrich, D. (2004). Measuring subjective health among adolescents in Sweden A Rasch-analysis of the HBSC-instrument. Social Indicators Research, 68(2), 201–220. doi: 10.1023/B:SOCI.0000025593.97559.7f.CrossRefGoogle Scholar
  28. Harding, L. (2001). Children’s quality of life assessments: a review of generic and health related quality of life measures completed by children and adolescents. Clinical Psychology & Psychotherapy, 8(2), 79–96. doi: 10.1002/cpp.275.CrossRefGoogle Scholar
  29. Haugland, S., & Wold, B. (2001). Subjective health complaints in adolescence: reliability and validity of survey methods. Journal of Adolescence, 24(5), 611–624. doi: 10.1006/jado.2000.0393.PubMedCrossRefGoogle Scholar
  30. Hetland, J., Torsheim, T., & Aaro, L. E. (2002). Subjective health complaints in adolescence: dimensional structure and variation across gender and age. Scandinavian Journal of Public Health, 30(3), 223–230. doi: 10.1080/140349402320290953.PubMedCrossRefGoogle Scholar
  31. Hilker, K. A., Murphy, M. A., & Kelley, M. L. (2005). Violence exposure, somatic complaints, and health care utilization in a pediatric sample. Childrens Health Care, 34(1), 35–46. doi: 10.1207/s15326888chc3401_3.CrossRefGoogle Scholar
  32. Hollingshead, A. B. (1975). The four factor index of social position. Unpublished manuscript available from the department of Sociology, Yale university New Haven, CT. Swedish translation and adaption Broberg, A. G. (1984/1992), Department of Psychology, Gothenborg.Google Scholar
  33. Hungerford, A., Ogle, R. L., & Clements, C. M. (2010). Children’s exposure to intimate partner violence: relations between parent–child concordance and Children’s adjustment. Violence and Victims, 25(2), 185–201. doi: 10.1891/0886-6708.25.2.185.PubMedCrossRefGoogle Scholar
  34. Jernbro, C., Svensson, B., Tindberg, Y., & Janson, S. (2012). Multiple psychosomatic symptoms can indicate child physical abuse—results from a study of Swedish schoolchildren. Acta Paediatrica, 101(3), 324–329. doi: 10.1111/j.1651-2227.2011.02518.x.PubMedCrossRefGoogle Scholar
  35. Kerns, K. A., Klepac, L., & Cole, A. K. (1996). Peer relationships and preadolescents’ perceptions of security in the child-mother relationship. Developmental Psychology, 32, 457–466.CrossRefGoogle Scholar
  36. Kerns, K. A., & Seibert, A. C. (Eds.). (In press). Finding your way through the thicket; Promising approaches to assessing attachment in middle childhood. New York: Guilford.Google Scholar
  37. Kim-Spoon, J, Cicchetti, D., & Rogosch, F. A. (2012). A longitudinal study of emotion regulation, emotion lability‐negativity, and internalizing symptomatology in maltreated and nonmaltreated children. Child Development, Article first published online: 3 OCT 2012. doi:  10.1111/j.1467-8624.2012.01857.x
  38. Kochanska, G, & Kim, S. (2012). Early Attachment Organization With Both Parents and Future Behavior Problems: From Infancy to Middle Childhood. Child Development, Article first published online: 24 SEP 2012. doi: 10.1111/j.1467-8624.2012.01852.x
  39. Lamers-Winkelman, F., De Schipper, J. C., & Oosterman, M. (2012). Children’s physical health complaints after exposure to intimate partner violence. British Journal of Health Psychology, 17, 771–784. doi: 10.1111/j.2044-8287.2012.02072.x.PubMedCrossRefGoogle Scholar
  40. Lengua, L. J. (2002). The contribution of emotionality and self-regulation to the understanding of children’s response to multiple risk. Child Development, 73(1), 144–161. doi: 10.1111/1467-8624.00397.PubMedCrossRefGoogle Scholar
  41. Levendosky, A. A., Huth-Bocks, A., & Semel, M. A. (2002). Adolescent peer relationships and mental health functioning in families with domestic violence. Journal of Clinical Child and Adolescent Psychology, 31(2), 206–218. doi: 10.1207/153744202753604485.PubMedCrossRefGoogle Scholar
  42. Little, R. J. A. (1988). A test of missing completely at random for multivariate data with missing values. Journal of the American Statistical Association, 83(404), 1198–1202. doi: 10.2307/2290157.CrossRefGoogle Scholar
  43. Martin, S. (2002). Children exposed to domestic violence: psychological considerations for health care practitioners. Holistic Nursing Practice, 16(3), 7–15.PubMedCrossRefGoogle Scholar
  44. Masten, A. S. (2011). Child development in the context of disaster, war and terrorism: pathways of risk and resilience. Annual Review of Psychology, 63, 18.11–18.31.Google Scholar
  45. Meltzer, H., Doos, L., Vostanis, P., Ford, T., & Goodman, R. (2009). The mental health of children who witness domestic violence. Child & Family Social Work, 14(4), 491–501. doi: 10.1111/j.1365-2206.2009.00633.x.CrossRefGoogle Scholar
  46. Michel, G., Bisegger, C., Fuhr, D. C., Abel, T., & KIDSCREEEN Group. (2009). Age and gender differences in health-related quality of life of children and adolescents in Europe: a multilevel analysis. Quality of Life Research, 18(9), 1147–1157. doi: 10.1007/s11136-009-9538-3.PubMedCrossRefGoogle Scholar
  47. Möller, J., & Pilman, N. (2010). Attachment in children and adolescents—a comparison between a clinical and a normal group. Göteborg: Department of Psychology.Google Scholar
  48. Nolen-Hoeksema, S. (2012). Emotion regulation and psychopathology: the role of gender. Annual Review of Clinical Psychology, 8, 2.1–2.27.CrossRefGoogle Scholar
  49. NSPCC. (2012). Child abuse and neglect in the UK today. London: NSPCC. Available at Accessed on June 1, 2012Google Scholar
  50. Olofsson, N., Lindqvist, K., Gadin, K. G., Braback, L., & Danielsson, I. (2011). Physical and psychological symptoms and learning difficulties in children of women exposed and non-exposed to violence: a population-based study. International Journal of Public Health, 56(1), 89–96. doi: 10.1007/s00038-010-0165-0.PubMedCrossRefGoogle Scholar
  51. Osofsky, J. D. (1999). The impact of violence on children. Future of Children, 9(3), 33–49.PubMedCrossRefGoogle Scholar
  52. Ostberg, V., Alfven, G., & Hjern, A. (2006). Living conditions and psychosomatic complaints in Swedish schoolchildren. Acta Paediatrica, 95(8), 929–934. doi: 10.1080/08035250600636545.PubMedCrossRefGoogle Scholar
  53. Ravens-Sieberer, U., Erhart, M., Gosch, A., Wille, N., & European KIDSCREEN Group. (2008a). Mental health of children and adolescents in 12 European countries—results from the European KIDSCREEN study. Clinical Psychology and Psychotherapy, 15, 154–163. doi: 10.1002/cpp.574.PubMedCrossRefGoogle Scholar
  54. Ravens-Sieberer, U., Erhart, M., Rajmil, L., Herdman, M., Auquier, P., Bruil, J., Kilroe, J., & European KIDSCREEN Group. (2010). Reliability, construct and criterion validity of the KIDSCREEN-10 score: a short measure for children and adolescents’ well-being and health-related quality of life. Quality of Life Research, 19(10), 1487–1500. doi: 10.1007/s11136-010-9706-5.PubMedCentralPubMedCrossRefGoogle Scholar
  55. Ravens-Sieberer, U., Erhart, M., Torsheim, T., Hetland, J., Freeman, J., Danielson, M., Thomas, C., & HBSC Positive Health Group. (2008b). An international scoring system for self-reported health complaints in adolescents. European Journal of Public Health, 18(3), 294–299. doi: 10.1093/eurpub/ckn001.PubMedCrossRefGoogle Scholar
  56. Ravens-Sieberer, U., Torsheim, T., Hetland, J., Volleberg, W., Cavallo, F., Jericek, H., Erhart, M., & HBSC Positive Health Focus Group. (2009). Subjective health, sympotm load and quality of life of children and adolescents in Europe. International Journal of Public Health, 54, 151–159. doi: 10.1007/s00038-009-5406-8.PubMedCrossRefGoogle Scholar
  57. Rivara, F. P., Anderson, M. L., Fishman, P., Bonomi, A. E., Reid, R. J., Carrell, D., & Thompson, R. S. (2007). Intimate partner violence and health care costs and utilization for children living in the home. Pediatrics, 120(6), 1270–1277. doi: 10.1542/peds.2007-1148.PubMedCrossRefGoogle Scholar
  58. Rosenberg, M., & Rossman, B. (Eds.). (1990). The child witness to marital violence. New York: Wiley.Google Scholar
  59. Rothbart, M., & Bates, J. (Eds.). (1998). Temperament (5th ed. Vol. 3). New York: Wiley.Google Scholar
  60. Rothbart, M., & Bates, J. (Eds.). (2006). Social, emotional, and personality development (6th ed. Vol. 3). Hoboken, NJ: Wiley.Google Scholar
  61. Rydell, A. M., Berlin, L., & Bohlin, G. (2003). Emotionality, emotion regulation and adaptation among 5- to 8-year-old children. Emotion, 3, 30–47. doi: 10.1037/1528-3542.3.1.30.PubMedCrossRefGoogle Scholar
  62. Rydell, A. M., Thorell, L. B., & Bohlin, G. (2007). Emotion regulation in relation to social functioning: an investigation of child self-reports. European Journal of Developmental Psychology, 4(3), 293–313. doi: 10.1080/17405620600783526.CrossRefGoogle Scholar
  63. Shiner, R. L., Buss, K. A., McClowry, S. G., Putnam, S. P., Saudino, K. J., & Zentner, M. (2012). What is temperament Now? assessing progress in temperament research on the twenty-fifth anniversary of goldsmith et al. (1987). Child Development Perspectives, 6(4), 436–444. doi: 10.1111/j.1750-8606.2012.00254.x.Google Scholar
  64. Sroufe, L. A. (1997). Psychopathology as an outcome of development. Development and Psychopathology, 9(2), 251–268.PubMedCrossRefGoogle Scholar
  65. Sroufe, L. A. (2005). Attachment and development: a prospective, longitudinal study from birth to adulthood. Attachment & Human Development, 7(4), 349–367. doi: 10.1080/14616730500365928.CrossRefGoogle Scholar
  66. Sroufe, L. A., Coffino, B., & Carlson, E. A. (2010). Conceptualizing the role of early experience: lessons from the Minnesota longitudinal study. Developmental Review, 30(1), 36–51. doi: 10.1016/j.dr.2009.12.002.PubMedCentralPubMedCrossRefGoogle Scholar
  67. Sternberg, K. J., Lamb, M., Guterman, E., Abbott, C., & Dawud-Noursi, S. (2005). Adolescents’ perceptions of attachments to their mothers and fathers in families with histories of domestic violence: a longitudinal perspective. Child Abuse & Neglect, 29, 853–869. doi: 10.1016/j.chiabu.2004.07.009.CrossRefGoogle Scholar
  68. Straus, M. A., Hamby, S. L., Boney-McCoy, S., & Sugarman, D. B. (1996). The revised conflict tactics scales (CTS2): development and preliminary psychometric data. Journal of Family Issues, 17(3), 283–316. doi: 10.1177/019251396017003001.CrossRefGoogle Scholar
  69. Suess, G. J., & Sroufe, J. (2005). Clinical implications of the development of the person. Attachment & Human Development, 7(4), 381–392. doi: 10.1080/14616730500365886.CrossRefGoogle Scholar
  70. Turner, H. A., Finkelhor, D., & Ormrod, R. (2010). Poly-victimization in a national sample of children and youth. American Journal of Preventive Medicine, 38(3), 323–330. doi: 10.1016/j.amepre.2009.11.012.PubMedCrossRefGoogle Scholar
  71. Vanaelst, B., De Vriendt, T., Ahrens, W., Bammann, K., Hadjigeorgiou, C., Konstabel, K., & De Henauw, S. (2012). Prevalence of psychosomatic and emotional symptoms in European school-aged children and its relationship with childhood adversities: results from the IDEFICS study. European Child & Adolescent Psychiatry, 21(5), 253–265. doi: 10.1007/s00787-012-0258-9.CrossRefGoogle Scholar
  72. Verschueren, K., & Marcoen, A. (2002). Perceptions of self and relationship with parents in aggressive and nonaggressive rejected children. Journal of School Psychology, 40(6), 501–522. doi: 10.1016/S0022-4405(02)00122-X.CrossRefGoogle Scholar
  73. Wilkins, A. J., O’Callaghan, M. J., Najman, J. M., Bor, W., Williams, G. M., & Shuttlewood, G. (2004). Early childhood factors influencing health-related quality of life in adolescents at 13 years. Journal of Paediatrics and Child Health, 40(3), 102–109. doi: 10.1111/j.1440-1754.2004.00309.x.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Karin K. Grip
    • 1
    Email author
  • Kjerstin Almqvist
    • 2
  • Ulf Axberg
    • 1
  • Anders G. Broberg
    • 1
  1. 1.Department of PsychologyGothenburg UniversityGothenburgSweden
  2. 2.Karlstad UniversityKarlstadSweden

Personalised recommendations