Journal of Child & Adolescent Trauma

, Volume 8, Issue 4, pp 245–251 | Cite as

Understanding How Intimate Partner Violence Impacts School Age Children’s Internalizing and Externalizing Problem Behaviors: a Secondary Analysis of Hawaii Healthy Start Program Evaluation Data

  • Megan H. Bair-MerrittEmail author
  • Sharon R. Ghazarian
  • Lori Burrell
  • Sarah Shea Crowne
  • Elizabeth McFarlane
  • Anne K. Duggan
Original Article


We examined the role of maternal depression and parenting stress in the relationship between intimate partner violence (IPV) and child internalizing and externalizing problems, and explored whether child gender modified these pathways. This secondary analysis used data from the Hawaii Healthy Start Program. Logistic regression models examined the associations between IPV in 1st grade and child internalizing and externalizing behaviors in 1st, 2nd, and 3rd grades. Mediation models used bootstrapping methodology and stratified models examined effect modification. Adjusted models with 214 mothers demonstrated associations between IPV and internalizing (adjusted odds ratios (aOR) = 2.62; 95 % CI 1.11, 6.21) and externalizing (aOR = 4.16; 95 % CI 1.55, 11.19) behaviors. The association with externalizing behaviors was mediated by maternal depression and parenting stress, while internalizing behaviors was mediated by depression only. Stratified models found the association between IPV and externalizing behaviors was significant for girls only. Our results support the importance of multicomponent maternal IPV interventions.


Intimate partner violence Child behavior Mediation Depression Parenting stress 



Dr Bair-Merritt is funded by a Career Development Award (K23HD057180) sponsored by the National Institute of Child Health and Human Development. The parent study, evaluation of the Hawaii Healthy Start Program, was supported in part by the Federal Maternal and Child Health Bureau (R40MC00029 (formerly MCJ 240637) and R40 MC 00123 (formerly MCJ 240838); The Robert Wood Johnson Foundation (18303); The Annie E. Casey Foundation (94–4041); The David and Lucile Packard Foundation (93–6051, 94–7957, 97–8058, and 98–3448); the Hawaii State Department of Health (99-29-J); and the National Institute of Mental Health, Epidemiological Center for Early Risk Behaviors, P30MH38725.

Compliance with Ethical Standards

Conflict of Interest

None of the authors have any conflicts of interest to disclose.


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Copyright information

© Springer International Publishing 2015

Authors and Affiliations

  • Megan H. Bair-Merritt
    • 1
    Email author
  • Sharon R. Ghazarian
    • 2
  • Lori Burrell
    • 3
  • Sarah Shea Crowne
    • 3
  • Elizabeth McFarlane
    • 3
  • Anne K. Duggan
    • 3
  1. 1.Division of General PediatricsBoston University School of MedicineBostonUSA
  2. 2.Johns Hopkins School of NursingBaltimoreUSA
  3. 3.Johns Hopkins Bloomberg School of Public HealthBaltimoreUSA

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