Husbands' marital violence and the adjustment problems of clinic-referred children

BEHAVIOR THERAPY 31,649-665,2000

Husbands' Marital Violence and the Adjustment Problems of Clinic-Referred Children

RENEE MCDONALD

ERNEST N. JOURILES

WILLIAM NORWOOD

HOLLY SHINN WARE

ELIZABETH EZELL

University of Houston

This research assessed the relation between husbands' marital violence and child problems in a sample of families seeking clinical services for their children's (4 to 7 years) oppositional, noncompliant behavior. We assessed whether husbands' marital violence was associated with increased levels of child problems after accounting for parental marital discord, parent-child aggression, and wives' acts of aggression toward husbands. We also assessed the contribution of data collected from fathers in evaluating the relation between husbands' marital violence and child problems. Ninety mothers and fathers each provided data on husbands' marital violence, their children's externalizing and internalizing problems, general marital discord, parental aggression toward children, and wives' aggression toward husbands. Husbands' marital violence was associated with child problems, even after accounting for general marital discord, parental aggression toward children, and wives' aggression toward husbands. The documented relations were more a function of fathers' than mothers' reports of child problems. In fact, relations between husbands' marital violence and child problems emerged only when fathers' data were included.

Husbands' marital violence (i.e., acts of physical aggression, such as pushes and hits committed by husbands toward their wives) may have important implications for the adjustment problems of clinic-referred children. Theory and experimental research suggest that such violence should be asso-

This research was supported by grants from the Hogg Foundation for Mental Health, the Texas Higher Education Coordinating Board, and Grant #53380 from the National Institute of Mental Health.

The authors wish to thank Wendy Buzy, Nanette Stephens, Paul Swank, and Tim Yerington for their helpful comments on drafts of this manuscript.

Address correspondence to Renee McDonald, Department of Psychology, University of Houston, 4800 Calhoun Road, Houston, TX 77204-5341 ; e-mail: [email protected].

649 005-7894/00/0649~366551.00/0 Copyright 2000 by Association for Advancement of Behavior Therapy

All rights for reproduction in any form reserved.

650 M C D O N A L D ET AL.

elated with child problems, even after accounting for nonviolent marital discord, and substantial data on children who have been exposed to husbands" marital violence indicate that such children are at risk for a variety of behavioral and emotional problems (see Margolin, 1998: Jouriles, Norwood, McDonald, & Peters, in press, for reviews). With a few exceptions, most of the research on children exposed to husbands' marital violence, however, has been based on samples of children residing in battered women's shelters. Such research provides only indirect evidence of a relation between husbands' marital violence and child problems among families of clinic-referred children. To date, there are no empirical studies that have directly evaluated this relation within child-clinical samples.

Identifying correlates of child problems within child-clinical samples is important for practitioners who work with clinic-referred children. High levels of externalizing problems and simultaneous elevations of both externalizing and internalizing problems at pretreatment have been found to predict poorer treatment outcomes (Webster-Stratton & Hammond, 1990; Zoccolillo, 1992). A better understanding of variables that account for such heightened levels of problems among clinic-referred children can thus inform clinical practice. In this paper, we briefly highlight theory suggesting that husbands' marital violence should be associated with child problems, even after accounting for nonviolent marital discord. We also describe some of the problems in generalizing findings from research on children of battered women to child-clinical samples. We then evaluate whether husbands' marital violence is associated with child problems within a child-clinical sample.

Theory Linking Husbands' Marital Violence to Child Problems Theory and related experimental research suggest that husbands" marital

violence should relate to child problems even after accounting for nonviolent marital discord. For example, exposure to physical aggression in general, and husbands' marital violence in particular, is hypothesized to convey strong mes- sages to children about the acceptability of such aggression and to increase the likelihood of child aggressive behavior (Bandura, 1973: Huesmann, 1988: Margolin, 1998; Wolfe, Wekerle, Reitzel, & Gough, 1995). Consistent with such theory, experimental studies have indicated that children's exposure to simulated adult conflict that includes physical aggression is more likely to result in aggressive behavior than is exposure to nonaggressive adult conflict (Cummings, Banard, & El-Sheikh, 1991). Some investigators have also con- ceptualized nonviolent marital conflict as a stressor for children that can result in fear, distress, and anger (Cummings & Davies, 1994). In this frame- work, physical violence between parents can be viewed as a more intense stressor than nonviolent marital conflict, and one that is perhaps more likely to result in negative affective states (Margolin). Experimental research consistent with such theory indicates that simulated adult conflict that includes physical aggression is likely to be perceived as more threatening and distress-

HUSBANDS' MARITAL VIOLENCE 651

ing to children than nonaggressive adult conflict (e.g., Cummings et al.; Grych & Fincham, 1993). In short, theory and experimental research converge to suggest that husbands' marital violence should be associated with child adjustment problems.

Limitations of Existing Research on Children Exposed to Husbands' Marital Violence

Virtually all of the current knowledge about the association between husbands' marital violence and children's adjustment stems from research with samples of children in battered women's shelters. This research indicates that children brought to women's shelters are at elevated risk for behavioral and emotional problems, particularly externalizing problems (e.g., aggression, noncompliance; see Jouriles et al., in press; Margolin, 1998, for reviews). For a number of reasons, however, the results from this research can not be readily applied to child-clinical samples. Perhaps the most obvious problem is that the violence that characterizes women's shelter samples is likely to differ both quantitatively and qualitatively from the violence in child-clinical samples. Families in women's shelters report an average of over 60 acts of husbands' marital violence per year, with approximately 80% of the children exposed to "wife beatings" and over one-half exposed to violence involving the threat or use of knives or guns (Jouriles, McDonald, Norwood, et al., 1998). In contrast, community survey research suggests that violent community families are characterized by no more than 6 acts of violence per year, with wives' as well as husbands' violence included among these 6 acts (Johnson, 1995; Straus, 1990a). "Wife beatings" and violence involving knives or guns are very rare in these samples. Although the nature of the violence that occurs in child-clinical samples is unclear (because it has not been studied), it seems reasonable to question the extent to which findings from women's shelter samples are directly applicable to child-clinical samples.

Methodological concerns also prevent drawing firm conclusions about the effects of husbands' marital violence on child problems. Specifically, most studies relating husbands' marital violence to child problems have not considered potentially important confounds of this relation. For example, shelter families are typically characterized by the presence of multiple risk factors for child problems such as nonviolent marital discord, parental aggression toward children, and poverty (Appel & Holden, 1998; Jouriles, McDonald, Stephens, et al., 1998; Margolin, Sibner, & Gleberman, 1988). These potentially confounding variables have not been addressed in most efforts linking husbands' marital violence with child adjustment. It could also be argued that the role of wives' aggression toward husbands is unclear; researchers have not yet examined the separate contributions of husbands' and wives' acts of aggression toward one another in efforts to understand how husbands' marital violence might influence child adjustment. Given the substantial debate about the nature and meaning of wives' aggression toward their husbands (Dobash,

652 MCDONALD ET AL.

Dobash, Wilson, & Daly, 1992; Straus, 1993), it may be an important variable to consider in attempting to understand the relation between husbands' marital violence and child problems. In the present research, we address these concerns by measuring and controlling for potentially important confounding variables.

The Present Research The primary aim of this research is to evaluate whether husbands' marital

violence is associated with increased levels of child externalizing and internalizing problems in a sample of families seeking clinical services for their children's oppositional, noncompliant behavior. To our knowledge, this is the first study evaluating whether husbands' marital violence is associated with child problems in a child-clinical sample. The relation between parental marital discord and child adjustment problems has been well-substantiated (see Cummings & Davies, 1994; Fincham, 1994, for reviews). Thus, we are particularly interested in whether husbands' marital violence increases risk for child problems over and above the risk associated with general marital discord. In addition, we consider the potential confounding variables of parental aggression toward children and family socioeconomic status. We also begin to evaluate the role of wives' aggression toward husbands in the relation between husbands' marital violence and child problems. Specifically, we evaluate whether wives' aggression toward husbands is associated with child problems and whether husbands' marital violence is associated with child problems after accounting for wives' aggression toward their husbands. Con- sistent with theory reviewed above, we expect husbands' marital violence to be positively associated with child externalizing and internalizing problems in a sample of families seeking clinical services for child oppositional, noncompliant behavior. We expect this relation to emerge even after controlling for the potential confounds of marital discord, parental aggression toward children, and family socioeconomic status. Although it is unclear whether wives' aggression toward their husbands will be associated with child problems, we believe a relation between husbands' marital violence and child problems will emerge after accounting for wives' aggression.

Within the context of this research, we also begin to evaluate the contribution of fathers" data (or the lack thereof) in research on husbands' marital violence and child problems. Very little research on wife abuse and child adjustment includes fathers as participants (see Jouriles, Murphy, & O'Leary, 1989; Sternberg et al., 1993, for exceptions). This is unfortunate given that men often report acts of violence that their wives do not, particularly in community samples and clinic samples seeking services for problems other than marital violence (Arias & Beach, 1987; Jouriles & O'Leary, 1985; Szinovacz, 1983). It is also well documented in the child-clinical literature that mothers and fathers provide different perspectives on their children's problems (Achenbach, 1997). We thus evaluate our hypotheses based on data obtained


from both parents and assess how our results would differ if we were limited to data obtained solely from mothers.

Method Participants

Participants were 90 consecutive dual-parent families seeking outpatient mental health services for a 4- to 7-year-old child's externalizing problems. Written descriptions of the study were provided to community service pro- viders and schools to elicit referrals. Families were also recruited through radio and newspaper announcements about the study. The age range of 4 to 7 was chosen because the relation between parents' marital discord and child adjustment problems appears to be particularly strong in samples of young clinic-referred children (Mahoney, Jouriles, & Scavone, 1997) and children in this age range appear to be among those at greatest risk for exposure to husbands' marital violence (Fantuzzo, Boruch, Beriama, Atkins, & Marcus, 1997; Wolf, 1999).

An advanced clinical psychology graduate student conducted a telephone screening interview with parents who contacted us about the research. Fami- lies were invited to participate if they indicated in the screening interview that (a) their child was exhibiting oppositional, noncompliant behaviors such as those characteristic of a DSM-III-R (American Psychiatric Association, 1987) diagnosis of oppositional defiant disorder (ODD), (b) neither the child nor the family was currently receiving treatment for child problems, (c) the child did not have a known history of mental retardation, autism, or significant head injury, and (d) both parents lived in the home with the child and both were willing to participate in treatment for their child's problems. Families who met these criteria were scheduled for an initial assessment at our university- based mental health clinic. The final sample was comprised of 70 boys and 20 girls. Husbands' average age was 35.8 years (SD = 6.5), and wives' average age was 33.4 (SD = 5.6). Mean family income was approximately $33,000, and the average length of marriage was 9.0 years (SD = 5.3). The ethnic distribution of the families was 79% Caucasian, 10% African Ameri- can, 10% Hispanic, and 1% "other."

Measures and Procedures

Mothers and fathers independently completed each of the following measures during their initial visit to our clinic. These measures were embedded in a larger assessment battery evaluating child and family functioning.

Conflict Tactics Scale (CTS; Straus, 1979). Husbands' violence toward wives was assessed using the Physical Aggression subscale of the CTS. The CTS, or slightly modified versions of this instrument, has been used in numerous studies on domestic violence, including oft-cited surveys on the prevalence and frequency of such violence (e.g., Magdol et al., 1997; O'Leary et al., 1989; Schafer, Caetano, & Clark, 1998; Straus & Gelles, 1990). The Physical

654 M C D O N A L D ET A E .

Aggression subscale includes eight items that tap physical violence: threw something at spouse; pushed, grabbed, or shoved spouse; slapped spouse; kicked, bit, or hit spouse with a list; hit or tried to hit spouse with something; beat spouse up; threatened spouse with a knife or gun; used a knife or fired a gun. Both the husband and wife reported the frequency with which the husband had committed each act in the past 12 months. Frequency was recorded on a 7-point scale, ranging from I (never occurred) to 7 (occurred more than 20 times). These items were also administered to assess husbands' and wives' reports of wives' acts of aggression toward husbands.

The conceptualization and operationalization of "violence" is both com- plex and controversial (Jouriles et al., in press; National Research Council, 1996), and the empirical literature on domestic violence includes many different operational definitions for husbands' marital violence. To facilitate comparability across studies, we opted to use one of the more common operational definitions of husbands' physical violence-- the commission of at least one of the eight acts of physical violence included on the Physical Aggression subscale of the CTS (e.g., Magdol et al., 1997; O 'Leary et al., 1989: Straus & Gelles, 1990). Couples classified as violent using the CTS and the above-described operational definition of violence have been found to differ from nonviolent spouses/families on a number of variables theoretically related to such violence (Straus & Gelles, 1990; Straus, Gelles, & Steinmetz, 1980).

Short Marital Adjustment Test (SMAT: ~ c k e & Wallace. 1959). The SMAT was used to measure general marital adjustment. This 15-item measure asks spouses to rate their level of marital satisfaction as well as how frequently they disagree on matters such as finances, social activity, intimacy, and self- disclosure. The SMAT has been shown to discriminate discordant from non- discordant couples consistently (O'Leary & Turkewitz, 1978), with a score of 100 recommended as the cutoff point for making such discriminations (Locke & Wallace). Lower scores indicate greater levels of marital discord. Scores on the SMAT relate to many factors theoretically associated with general marital distress (O'Leary & Turkewitz). In our sample, the Pearson correlation between spouses' reports on the SMAT was r = .38, p < .001.

Child Behavior Checklist (CBCL; Achenbach, 1991). T scores on the Externalizing and Internalizing Behavior Problem scales of the CBCL were used to assess child externalizing (aggression, noncompliance, and delin- quent behavior) and internalizing (anxiety, depression) problems. The 113- item CBCE asks parents to rate each problem behavior on a 3-point scale, including not true, sometimes or somewhat true, and always or often true. These scales are widely used in the child-clinical literature, have adequate internal consistency and test-retest reliability, and correlate with other measures of child problems (Achenbach). The Pearson correlation for spouses' reports of externalizing problems was r = .62, p < .01, and for internalizing problems was r = .48, p < .01.

Parent-Child Cot![fict Tactics Scales (PC-CTS; Straus, 1979). Similar to


the spousal CTS, the 8-item PC-CTS assesses physical aggression directed toward children by parents. Each mother and father reported on his or her own and his or her spouse's physical aggression toward the target child during the previous 12 months. PC-CTS items are rated for frequency of occurrence during the past 12 months on a 6-point scale that ranges from 0 (did not occur) to 5 (more than once a month). Reports of mothers' and fathers' aggression toward children were combined (yielding a measure of parental aggression), and such scores on the PC-CTS have been found to correlate with hypothesized outcomes of parent-child aggression (Jouriles, Barling, & O'Leary , 1987). In our sample, spousal reports of parental aggression were highly correlated, r = .77, p < .0001.

Considerations in Data Analysis and Data Reduction

Although obtaining data from multiple sources is often recommended to improve methodological rigor, it also complicates data analysis and data reduction. To include both husbands' and wives' reports of child adjustment problems in tests of hypotheses, we conducted multivariate analyses (with husbands' and wives' reports of child adjustment as dependent variables). Because of our interest in the specific contribution of fathers' data-- in addition to mothers' da ta- -we follow these multivariate analyses with univariate analyses for each parent's reports of child problems (Huberty & Morris, 1989). This strategy allows us to evaluate the extent to which overlap in mothers' and fathers' reports of child problems accounts for significant findings. Because we made directional hypotheses (i.e., husbands' marital violence would be positively associated with child problems), we conducted one-tailed tests of significance.

Reports from both husbands and wives were used to derive measures of husbands' marital violence and salient variables (e.g., parental marital discord, parental aggression toward children) that are important to consider in efforts to understand the relation between husbands' marital violence and child problems (e.g., potential confounds, covariates). Below we describe the considerations that guided our data reduction efforts.

Husbands' marital violence. Scores for husbands' marital violence on the CTS in nonclinical samples (i.e., samples not seeking or receiving services because of violence or marital difficulties) are often very low, and the distributions of scores are typically positively skewed (Johnson, 1995; Straus, 1990a). We expected a similar distribution of violence scores in our child- clinical sample and found that both husbands' and wives' reports of husbands' marital violence were very skewed (husbands' reports: M = 1.23, SD = .56, median = 1, skewness = 4.76; wives' reports: M = 1.23, SD = .61, median -- 1, skewness = 4.77). To minimize the effects of skewness, we evaluated our hypotheses by classifying families into violent and nonviolent groups.

As noted earlier, very few studies on domestic violence and child adjustment have included data obtained from fathers. Given that spousal discrepancies on reports of husbands' marital violence are common (Arias & Beach, 1987; Jouriles & O'Leary, 1985; Szinovacz, 1983), we considered husbands'


marital violence to be present if either the husband or the wile reported the occurrence of at least one of the CTS acts of husband-to-wilE physical aggression. Families in which neither spouse reported violence were classified as nonviolent. This strategy lk)r classifying families as "violent" or "'nonviolent" has been used in a number of reports on the prevalence of husbands' violence (e.g., Magdol et al., 1997: O'Leary et al., 1989: Schafer et al., 1998). The use of both spouses" reports, as opposed to relying on the report of a single spouse, yields slightly higher but arguably more accurate estimates of husbands' marital violence (O'Leary et al.; Schafer et al.).

Covariate scales. Ideal covariates are continuous measures, few in number, and maximally reliable (Tabachnick & Fidell, 1996). These guidelines governed our decisions about how to use fathers' and mothers' reports on measures of constructs (e.g., general marital discord, parent-child aggression) that could provide plausible alternative explanations for associations between husbands' marital violence and child problems. We averaged husbands' and wives' reports on measures used as covariates, thus increasing the reliability of measurement and allowing us to have one continuous measure for each covariate. Assumptions of homogeneity of regression of variables used as covariates were satisfied (i.e., there were no significant Covariate X Group Interaction terms in models evaluating group differences on the dependent variables).

Resu l t s

The prevalence of husbands" marital violence was 48% (43 out of 90 families) in our sample. In the violent group, the modal number of violent acts during the previous year was one. Thirteen of the women in the violent group were reported to have been kicked, bit, or hit with a fist by their husbands: 7 were reported to have been beaten up by their husbands; and 1 husband was reported to have used a knife or gun against his wife. Although not inconse- quential, this level of violence is low in comparison to the violence reported by women in battered women's shelters.

Preliminary Considerations

As indicated in the Method section, a family could be classified as violent on the basis of both spouses' reports of an occurrence of husbands' marital violence (n = 20), the wife's report only (n = 8), or the husband's report only (n = 15). It is possible that families in which both spouses report husbands' marital violence differ in meaningful ways from those in which only one spouse does so. To examine this possibility, we compared the 20 families in which both spouses reported husbands" marital violence to the 23 families in which only one spouse reported such violence on demographics, SMAT and parent-child aggression scores, and husbands' and wives' reports of child externalizing and internalizing problems. The groups did not differ on any of these variables. It may also be that families in which only husbands report violence differ from those in which only wives report violence or those in


which both partners do so. To evaluate this, we grouped families in which husbands' marital violence was reported to have occurred according to whether the husband, wife, or both reported the violence. These three groups did not differ on demographics or on reports of marital discord, parent-child aggression, or child externalizing and internalizing problems.

We also considered whether levels of child problems differed for boys and girls and whether the relation between husbands' marital violence and child problems differed for boys and girls. A 2 (Husbands' Marital Violence: present versus absent) × 2 (Child Gender: male, female) MANOVA with mothers ' and fathers' reports of child externalizing problems as the dependent variables revealed no child gender main effects or Husbands' Marital Violence X Child Gender interaction effects in the prediction of child externalizing problems. A similar MANOVA with mothers ' and fathers" reports of child internalizing problems as the dependent variables likewise revealed no child gender main effects or Husbands' Marital Violence × Child Gender interaction effects. On the basis of these results, we did not assess for gender differences in tests of our hypotheses.

Assessment of Alternative Plausible Explanatory Variables

We conducted a series of analyses to assess the need to control for potentially confounding variables. We first considered whether marital discord was associated with husbands' marital violence. As expected, an ANOVA indicated greater marital discord in the violent group (M = 87.8, SD = 23.4) than in the nonviolent group (M = 102.2, SD = 21.2), F(1,89) = 9.39,p = .002. We also examined whether parental marital discord was associated with child externalizing and internalizing problems. Marital discord was correlated in the expected direction with fathers' (r = - . 2 7 , p = .009) and mothers' (r = -.21~ p = .04) reports of child externalizing problems and with fathers' (r = - . 2 5 , p = .02) but not mothers ' (r = - . 1 2 , p = .25) reports of child internalizing problems. On the basis of these results, we statistically controlled for parents' marital discord in tests of our hypotheses.

We also evaluated whether parent-child aggression was associated with husbands' marital violence within our sample. An ANOVA indicated no differences between the violent (M = .62, SD = .37) and nonviolent (M = .68, SD = .43) groups on the amount of parental aggression directed toward children. To evaluate whether parent-child aggression was associated with child externalizing and internalizing problems, we examined the bivariate correla- tions. Parent-child aggression correlated in the expected direction with both mothers" (r = .28, p = .008) and fathers' (r = .33, p = .002) reports of child externalizing problems; consequently, we statistically controlled for parent- child aggression in tests of hypotheses regarding externalizing problems. Because parent-child aggression did not correlate significantly with either mothers ' (r = .08, p = .46) or fathers" (r = .13, p = .22) reports of child internalizing problems, we did not control for it in tests of hypotheses regarding internalizing problems.

658 MCDONALD ET AL.

Final ly , we examined whether soc iodemograph ic variables were associated with husbands ' marital v iolence and child problems. We cons idered mothers ' and lathers" age, educa t ion , e thnic i ty , and fami ly income. None o f these var iables d i s t ingu i shed the v iolent and nonvio lent g roups , nor were they assoc ia ted with e i ther mothe r s ' or fa thers ' reports o f chi ld ex te rna l iz ing or in terna l iz ing problems. Thus, we did not s tat is t ical ly control for them in tests of our hypotheses .

Assessing the Relation Between Husbands' Violence and Child Adjustment

Group means and standard devia t ions for child external iz ing and internalizing prob lems are presented in Table 1, and are comparab le to those reported in other chi ld-cl inical samples . To evaluate our hypotheses regarding group differences in child external iz ing problems, we conducted a mult ivariate analysis of covar iance ( M A N C O V A ) with husbands ' mari tal violence (violent, nonviolent) as the be tween-subjec ts factor, mothers ' and fathers ' reports of child external iz ing problems as the dependent variables , and parent-chi ld aggress ion and parental mari tal d iscord as covariates. Results indicated marginal differences between the violent group and the nonviolent group on parents ' reports of child externalizing problems, Wilks ' s Lambda = .96, F(2, 84) = 1.95, p = .07. Fol low-up ANCOVAs indicated mean differences between the Violent and Nonviolent groups in the expected direction for fathers ' , F(1,85) = 3.61, p = .03, but not mo the r s ' , F(1 ,85) = .26, p = ns, reports o f chi ld ex te rna l iz ing p rob lems , after cont ro l l ing for pa ren t -ch i ld aggress ion and mari ta l d iscord .

To evaluate whether there were group differences in internalizing problems, we conducted a M A N C O V A with group status (violent , nonviolent) as the be tween-subjec ts factor, mothers ' and fathers ' reports of child internalizing p rob lems as dependent variables , and parents ' mari tal d iscord as a covariate. The violent group differed from the nonviolent group, Wi lks ' s Lambda = .91, F(2 , 85) = 4.1, p < .05. Fol low-up ANCOVAs indicated that the groups

TABLE l GROUP MEANS AND STANDARD DEVIA|IONS FOR CHILD BEHAVIOR MEASURES

Nonviolent (n = 47) Violent (n - 43)

Variablc M S D M SD

CBCL externalizing Mother reports 69.3 7.2 70.7 7.4 Father reports 64.7 8.9 68.6 7.5

CBCL internalizing Mother reports 59.5 I 1.9 60.4 I 0.9 Father reports 54.3 9.9 59.5 9.0

Note. CBCL = Child Behavior Checklist. CBCL T scores are presented: higher scores on the CBCL indicate more problems.


again differed in the hypothesized direction on fathers', F(1,87) = 3.84, p = .03, but not mothers', F(1,87) = 0.00, p = ns, reports of child internalizing problems, after controlling for marital discord.

Does Method Variance Explain Our Pattern of Results?

Because more fathers than mothers reported the occurrence of husbands' marital violence (35 vs. 28) and because our findings emerged consistently for fathers' but not mothers' reports of child problems, we questioned the extent to which method variance might explain the results. We thus conducted additional analyses in which we examined associations between mothers' reports of their husbands' marital violence and fathers ' reports of child problems. Specifically, we reclassified families as violent (n = 28) or nonviolent 01 = 62) based only on mothers" reports of husbands' marital violence and assessed whether these families differed in the expected direction on fathers' reports of child externalizing and internalizing problems, after controlling for parental marital discord and parent-child aggression (for analysis of child externalizing problems). The ANCOVAs indicated marginal associations in the expected direction for both externalizing, F(I , 70) = 1.96, p = .08, and internalizing F(1,72) = 2.00,p = .08, problems.

Wives 'Aggression Toward Husbands

Similar to husbands' marital violence, the distributions of spouses' reports of wives' aggression were skewed (husbands' reports: M = 1.24, SD = .53, median = 1, skewness = 3.21; wives' reports: M = 1.20, SD = .39, median = 1, skewness = 2.71). To minimize the effects of skewness, we evaluated the relation between wives" aggression toward husbands and child problems by classifying families into groups (wife aggressive versus wife nonaggressive).

We considered wives' aggression toward husbands to be present if either the husband or the wife endorsed at least one of the CTS acts of wife-to-husband physical aggression. The prevalence of wives' aggression toward husbands was 50% (45 out of 90 families). In the families in which such aggression was present, the modal number of violent acts during the previous year was one; 17 of the husbands were reported to have been kicked, bit, or hit with a fist by their wives. There were three reports of husbands being beaten up by their wives and no reports of wives using a knife or gun against their husbands.

Wives' aggression toward husbands was associated with husbands' marital violence, X 2 (1, n = 90) = 16.08, p < .001. MANCOVAs indicated that wives' aggression toward husbands was marginally associated with child externalizing, Wilks's Lambda = .96, F(2, 84) = 1.73, p = .09, and internalizing problems, Wilks's Lambda = .95, F(2, 86) = 2.06, p = .07, after accounting for parental marital discord and parent-child aggression (for analysis of externalizing problems). However, ANCOVAs indicated that the wife aggressive and wife nonaggressive groups did not differ on either mothers', F(1,85) = .44, p = ns, or fathers', F(1,85) = 1.12, p = ns, reports of child externalizing problems, or mothers', F(I , 87) = 1.46, p = ns, or fathers',


F ( I , 87) = .74, p -- ;;s, reports of child internal izing problems. When husbands ' marital violence was added to the mult ivariate analyses as a covariate, wives" aggress ion toward husbands was not associated with internal izing problems, Wi lks ' s Lambda - .97, F(2, 85) = 1.26, p = ns, but it remained marginal ly associa ted with child external iz ing problems, Wi lks ' s L a m b d a = .96, F(2, 83) = 1.79, p = .09. Again , ANCOVAs indicated that the wife aggressive and wife nonaggress ive groups did not differ on ei ther mothers ' , F ( 1 , 8 4 ) = .58, p = ns, or l a thers ' , F ( I , 84) = .99, I? = ns, reports of child externalizing problems, nor did they differ on mothers ' , F (1 ,86 ) = .65,p = ns, or la thers ' , F ( I , 86) = .67, p = ns, reports of child internalizing problems.

To examine whether husbands ' marital v iolence remained associa ted with child behavior p roblems after control l ing fbr wives ' aggress ion toward husbands, we repeated the tests of our pr imary hypotheses , adding wives" aggression toward husbands into the models as an addit ional covariate. Hus- bands ' marital violence was not associated with child external iz ing problems, Wilks ' s Lambda = .97, F(2, 83) = 1.10, p = ns, but remained associated with child internalizing problems, Wilks ' s Lambda = .94, F(2, 85) = 2.61, p < .05. ANCOVAs indicated that husbands" marital violence was marginally associated with fathers ' , F ( 1 , 8 6 ) - 2.00, p = .08, but was not associated with mothers ' , F (1 ,86 ) = . 15, p = ns, reports of child externalizing problems. Husbands" marital violence was similarly associated with fathers ' , F ( I , 86) - 4 .78 ,p < .05, but not mothers ' , F (1 ,86) = . 16, p = ns, reports of child internalizing problems.

Wouht Our Results Have Been Di[l~rent If We Had Used Onh' Wives'Data?

To facilitate our understanding of the contribution of fathers" reports of marital and child funct ioning, we repeated the tests of our pr imary hypotheses (assessing the relation between husbands ' marital v iolence and child adjustment) using only mothers ' reports on each of the variables: husbands" mari tal v iolence, marital d iscord, parent-chi ld aggress ion, and child external iz ing and in terna l iz ing p rob lems . Firs t , when fami l ies were c lass i f ied as v iolent ( n - 28) or nonviolent (n = 62) based on wives ' reports of husbands" mari tal v io lence , the prevalence rate for husbands" marital v iolence was 31%. This contrasts with the 48% prevalence rate when both spouses" reports were considered. That is, 15 husbands had reported aggression toward their wives that their wives did not report. The 17% difference in prevalence rates resulting from these two different classif icat ion methods was stat is t ical ly significant, M c N e m a r ' s X:( l , n = 90) = 15.0,p < .01.

An ANCOVA with husbands ' marital violence (violent , nonviolent) as the be tween-subjec ts factor, mothers" reports of child external iz ing problems as the dependent variable, and mothers ' reports of parent-chi ld aggression and marital d iscord as covariates revealed no difference between the violent and nonviolent groups in child external iz ing problems, F(I, 88) = .23, p - ns. Similar ly . an ANCOVA with group status as the be tween-subjec ts factor and mothers ' reports of marital d iscord as a covariate indicated no between- groups differences in child internalizing problems, F(I, 89) = .(17, p = ns.


Discussion The primary aim of this research was to evaluate whether mothers" and

fathers' reports of husbands' marital violence are associated with their reports of child externalizing and internalizing problems in a sample of families seeking clinical services for their children's oppositional, noncompliant behavior. To our knowledge, this is the first attempt to document these associations within a child-clinical sample. It is also one of the first to include data from both parents in the evaluation of this relation. We found husbands' marital violence to be associated with child externalizing arid internalizing problems even after accounting for the potential confounds of parental marital discord, parental aggression toward children, and family demographic variables. We also found a relation between husbands' marital violence and child internalizing problems after controlling for wives' aggression toward husbands. Interestingly, these relations emerged only when we used data collected from fathers. We did not find a relation between wives' aggression toward husbands and child adjustment problems.

Our findings are consistent with theory suggesting that husbands' marital violence may be a precursor to or a maintaining factor for child externalizing and internalizing problems (e.g., Davies & Cummings, 1994; Margolin, 1998). It is important to note that the level of husbands' marital violence reported in our sample was low in comparison to the very frequent and severe violence reported by women in battered women's shelters (e.g., Jouriles et al., 1998). However, even at these relatively low levels, husbands' marital violence was related to child problems. Such findings are consistent with the notion that violence toward women--a t any level--should be of concern. In addition, our results, in conjunction with theory and data on the persistence of child problems (Webster-Stratton & Hammond, 1990; Zoccolillo, 1992), imply that husbands' marital violence may contribute to poor treatment outcomes with certain clinic-referred children. Of course, this hypothesis (husbands" marital violence contributes to the persistence of problems among clinic-referred children) is simply conjecture at this point. However, it is not difficult to imagine how husbands' marital violence might reduce the effec- tiveness of clinical services for child externalizing problems.

It is also noteworthy that 48% of the families reported at least one incident of husbands' marital violence in the previous year. This figure is comparable to the prevalence rate derived from another child-clinical sample (Stewart & deBlois, 1981). In addition, a wife was reported to have been "beaten up" by her husband in 16% of families; this highlights the magnitude of this particular family problem within child-clinical samples. In conjunction with the results described above, these prevalence estimates underscore the importance of carefully assessing for husbands' marital violence within child-clinical settings. Although many practitioners who work with clinic-referred children routinely assess for parental marital discord, direct or systematic assessment of husbands' marital violence is much less routine. Such assessment is desirable, however, for a number of reasons, including the identifica-

6 6 2 M C D O N A L D ET AL.

tion of family factors that may interfere with or otherwise reduce the effec- tiveness of treatment for child problems, and ensuring the safety of mothers and children who are presenting for services.

Participation of fathers in this research provided a unique opportunity to evaluate the role of their reports of child and family functioning to our understanding of the relation between husbands' marital violence and child problems. Fathers' data made an important contribution to this research. Specifi- cally, relations between husbands' marital violence and child problems emerged only when fathers" data were included, and the prevalence of husbands' marital violence was substantially higher when fathers' as well as mothers' reports were considered. Such findings are intriguing given the null results reported in previous studies that have evaluated relations between marital violence and child problems after accounting for general marital discord (e.g., Hershorn & Rosenbaum, 1985; Rosenbaum & O'Leary, 1981; Rossman & Rosenberg, 1992). Specifically, most of the studies that have evaluated this relation have relied solely on data collected from mothers, and many have failed to find a relation between marital violence and child problems after accounting for marital discord. In contrast, the one study that included mothers' and fathers' reports of violence and child problems found marital violence to be associated with child problems after accounting for general marital discord (Jouriles et al., 1989). Although it may not be feasible or appropriate to include fathers in some cases, such as in research with samples from battered women's shelters, the contribution of fathers' reports to this research (and perhaps to other research as well, e.g., Jouriles et al.), suggests that researchers and clinicians should attempt to collect data directly from fathers whenever possible. In fact, our findings underscore the importance of a multi-informant methodology in research on child and family problems.

It may also be important for researchers and clinicians to consider and examine the reasons for discrepancies in husbands" and wives' reports of family problems and the implications of these discrepancies. Although coun- terintuitive, it is not unusual for husbands to report more violence toward their wives than the wives report (Arias & Beach, 1987; Jouriles & O'Leary, 1985; Szinovacz, 1983). In this study, husbands' marital violence was associated with child adjustment problems after accounting for marital discord only when husbands were included as reporters of the violence; furthermore, the relation between husbands' marital violence and child adjustment emerged only for husbands' reports of child adjustment. These were unexpected results and are difficult to explain on the basis of our data, given the design of the current study. Because of the central role of fathers in the results of this research, however, replication appears warranted.

A few cautionary notes are in order regarding the interpretation of the present results. It is possible that characteristics of our sample influenced this pattern of results. Specifically, participating families were those who responded to referrals or advertisements for tree clinical services for children's behavior problems, and in which both parents were required to participate in order to


receive the services. The extent to which these families are representative of clinic-referred families in general is not clear; in particular, it is not clear how representative the fathers in our sample are of fathers of clinic-referred children. Interpretation of our results should also be limited to recent husbands' marital violence (i.e., within 12 months) as measured by the CTS, and limitations in the use of the CTS as a measure of domestic violence (Straus, 1990b) should be recognized. Perhaps a more comprehensive assessment of violence would have contributed to our understanding of the reasons for the associations documented in this research. It is also important to acknowledge that the cross-sectional design of this study does not permit us to determine the direction of effects.

In sum, this research is the first attempt to systematically examine relations between husbands' marital violence and child behavior problems within a child-clinical sample. It is also one of the only studies to formally consider potential confounds of this relation, and to include data obtained from fathers as well as mothers. Our results indicate that husbands' marital violence is associated with child externalizing and internalizing problems within a child-clinical sample. Our results also indicate that the inclusion of fathers in this research was essential for uncovering these associations. These findings and their potential implications highlight the need for additional exami- nation of the role of husbands' marital violence in the adjustment of clinic- referred children.

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Husbands' marital violence and the adjustment problems of clinic-referred children

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