Long-Term Consequences of Family Violence Victimization

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Matthias Burghart and Sophia Backhaus have just published their ‘umbrella review’ of the impact of family violence on mental health1. We are excited because this was partly supported by one of our first Seed Corn Grants.  It has been a while since the award – research takes a long time, and then you have to add some to see it through to publication. Good too that both Sophia and Matthias have progressed their careers and moved universities since starting on this.

So what is an umbrella review?  And what did they find? 

It has been apparent for a long time that various adverse experiences in childhood may not only hurt at the time, but also increase the risk of later disorders of health and behaviour. Early work tended to rely on retrospective accounts and, at the best of times, memories of childhood are often coloured by later events; few of us can sequence entirely accurately. Cathy Spatz Widom was one of the first to recognise this through research2 and take up prospective study in this field, initially examining violent offending as an outcome3, then developing the concept of the Cycle of Violence4. Mental health measures were added. The field has grown since then and it is important to make sense of the many publications that have followed.

An umbrella review is a special way of doing that. Here,  it is also indicative of just how much literature there is in this field.  It is a form of systematic review in that the method of review is so transparent that it could be replicated from its description in the paper. In addition,  this review was formally registered before starting it (with PROSPERO, www.crd.york.ac.uk/prospero/). The umbrella concept makes it a review of reviews, in that only systematic reviews above a quality threshold are included. Matthias and Sophia’s exclusively reviewed prospective studies. Systematic searches, sifting and selection yielded 18 published, unique meta-analyses, covering over 150 primary studies and more than 3 million individuals.

The harms studied were limited to actual physical violence to the child within the family. Other work suggests that witnessing violence or merely having a criminal parent may also have adverse outcomes5,6, but to add those here could have made this review over-complicated. As it is, increased risk of an extensive range of mental and physical disorders and of substance use and antisocial behaviours could be quantified. Matthias and Sophia conclude that that up to a quarter of cases of some psychiatric disorders can be attributed to family violence victimization.

Ideally, of course, that violence would be prevented. We need better knowledge  about how to achieve that, but also about how best to prevent the further harms when that violence does break through. There is still much research to do!     

  1. Burghart M and Backhaus S. (2024) The Long-Term Consequences of Family Violence Victimization: An Umbrella Review of Longitudinal Meta-Analyses on Child Maltreatment and Intimate Partner Violence. Journal of Family Violence https://doi.org/10.1007/s10896-024-00768-y
  2. Widom, C.S., and Shepard, R.L. (1996) Accuracy of adult recollections of childhood victimization: Part I: Childhood physical abuse. Psychological Assessment, 8(4): 412-421. https://doi:10.1037/1040-3590.8.4.412
  3. Widom CS and Maxfield MG (1996) A Prospective Examination of Risk for Violence among Abused and Neglected Children. Annals of the New York Academy of Sciences https://doi.org/10.1111/j.1749-6632.1996.tb32523.x
  4. Widom CS and Maxfield MG (2001)  An Update on the “Cycle of Violence”. US Department of Justice: Washington DC. https://www.ojp.gov/pdffiles1/nij/184894.pdf
  5. Ranu J, Kalebic N, Melendez-Torres GJ, Taylor PJ. (2023) Association Between Adverse Childhood Experiences and a Combination of Psychosis and Violence Among Adults: A Systematic Review and Meta-Analysis. Trauma Violence Abuse, 24(5): 2997-3013. https://doi.org/10.1177/15248380221122818
  6. Fazel S., Grann M., Carlström E., Lichtenstein P., Långström N. (2009). Risk factors for violent crime in schizophrenia: A national cohort study of 13,806 patients. The Journal of Clinical Psychiatry, 70(3), 362–369. doi: 10.4088/jcp.08m04274

Research can transform lives. We want to support discoveries about what helps people with mental disorder who have been victims of criminal behaviour, or perpetrators of criminal behaviour, and their families, and the clinicians and others who treat them and, indeed, the wider community when its members are in contact with these problems. More effective prevention is the ideal, when this is not possible, we need more effective, evidenced interventions for recovery and restoration of safety.

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