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Intimate partner violence: Childhood exposure

Kathleen M Franchek-Roa, MD
Section Editors
Jan E Drutz, MD
Marilyn Augustyn, MD
Deputy Editor
Mary M Torchia, MD


Intimate partner violence is a common form of violence against women and men. The epidemiology, effects, and treatment of children who are exposed to intimate partner violence and some aspects of diagnosing, screening, and counseling caregivers for intimate partner violence are reviewed here. A more thorough discussion of diagnosing, screening, and counseling women for intimate partner violence is provided separately. (See "Intimate partner violence: Intervention and patient management" and "Intimate partner violence: Diagnosis and screening".)


Women between the ages of 20 and 34 are at the greatest risk for intimate partner violence [1,2] and because many of these women are mothers, millions of children are exposed to intimate partner violence [3-5]. Exposure to such violence is a major threat to children's health and well-being [6-11]. It has deleterious effects on a child's developing brain resulting in long-term adverse consequences [11-13]. Data from the Adverse Childhood Experiences (ACE) studies indicate that adverse childhood experiences, such as exposure to intimate partner violence, dramatically affect adult mental and physical health and mortality [14-16]. (See 'Effects' below.)

The American Academy of Pediatrics (AAP) encourages health care professionals to use an ecobiodevelopmental framework to understand how exposure to toxic stress (eg, domestic or community violence, maternal depression, parental substance abuse, food scarcity, poor social connectedness) during childhood can lead to permanent changes in learning, behavior, and physiology [11,17]. Chronic toxic stress in childhood causes physiologic changes that lead to stress-related chronic illness and unhealthy lifestyles in adulthood.

Family violence has a significant impact on an individual's health, as well as community health and health care resources [18,19]. Intimate partner violence frequently remains undiagnosed because victims may conceal that they are in abusive relationships, and the clues pointing to abuse may be subtle or absent. Pediatricians are well-placed to identify maternal intimate partner violence because victims of intimate partner violence seek health care for their children, even if they do not for themselves [20-22].


Intimate partner violence is a pattern of coercive behaviors that may include repeated sexual and physical violence, psychological abuse, progressive social isolation, deprivation, intimidation, stalking, and reproductive coercion. These behaviors are perpetrated by someone who is or was involved in an intimate relationship with the victim and are used to establish power and control over the victim [23-25]. Abusive relationships are characterized by episodic, unpredictable outbursts by the abuser that often begin as verbal and emotional abuse but, over time, tend to become physical. As the abusive relationship continues, the victim begins to live in a state of constant fear, terrified about when the next episode of abuse will occur.

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Literature review current through: Nov 2017. | This topic last updated: Apr 04, 2017.
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