Risk Factors Associated with the Co-Occurrence

Key Talking Points
  • Co-occurring child maltreatment and domestic violence often exist in the presence of other risk factors such as poverty, parental unemployment, substance abuse, mental illness, crime, financial or parenting stress, poor health, and lower education.
  • Caution must be used when drawing conclusions about the existence of these risk factors in families with co-occurring violence. These studies show associations between variables, not cause-effect relationships. 

Families experiencing the co-occurrence of child maltreatment and exposure to domestic violence also are more likely to face numerous other risk factors for adverse outcomes later in life. Research suggests that children experiencing violence in the home are at greater risk of experiencing additional problems that place them at increased risk for adverse outcomes later in life.

For example, Fantuzzo and colleagues (1997) conducted a very large secondary analysis of police arrest data in five U.S. cities (Atlanta, Charlotte, Miami, Milwaukee, and Omaha). They found that, in households in which an arrest for misdemeanor domestic violence against an adult female partner occurred, stress factors including poverty, parental unemployment, and lower levels of education among primary care providers also were more common. The youngest children in these households also were more likely to be exposed to multiple incidents of domestic violence against their mothers and substance abuse in the home associated with the domestic violence.

Similarly, Dong et al.’s (2004) large retrospective study of adverse childhood experiences among 8,600 adult members of a health plan in San Diego, California found that among those who reported child maltreatment and/or prior domestic violence exposure, the prevalence of substance use, mental illness, and crime in the family also was higher. For example, among those who reported witnessing domestic violence as children, 65 percent also reported growing up with substance abuse in the household. Among those who did not report witnessing domestic violence as children, about 23 percent reported growing up with substance abuse in the household. 

Hartley’s (2002) cross-sectional study of 519 confirmed child maltreatment reports in Cedar Rapids, Iowa found that the co-occurrence of domestic violence and physical child abuse was associated with fathers’ use of alcohol or drugs and fathers’ arrest, conviction, or incarceration for criminal offenses other than domestic violence. In Tajima’s (2004) reanalysis of data from the 1985 National Family Violence Survey, she also found an association between domestic violence exposure, child abuse, and substance use within the family. Other factors related to the co-occurrence of child abuse and exposure to domestic violence included lower income and depression in the family (Tajima, 2004).

In their study of 219 six- to seven-year old children who were identified as at-risk when they were newborns, Lee and colleagues (2004) found that, among caregivers who received welfare, the occurrence of physical domestic violence was associated with a four-fold increase in the probability of child maltreatment (8.5 percent vs. 35.73 percent). This pattern was not observed among caregivers who did not receive welfare. In those caregivers, the incidence of maltreatment reports was almost the same (10.6 percent among those who experienced physical domestic violence vs. 10.06 percent among those who did not experience physical domestic violence). Findings from this study also suggested that, in households experiencing physical domestic violence, social supports such as the availability of a helpful grandparent or church community may protect children from maltreatment.

Herrenkohl and colleagues (2008) described the results of their longitudinal study of 457 preschool- and elementary-aged children in which parent caregivers were asked about the presence of 39 stressors within and outside the household. These stressors included poverty, unemployment, mental illness, substance abuse, parental criminality, lack of social support, housing problems, problems with neighbors, and community crime and violence. These variables then were combined into three measures: family conflict, personal problems, and external constraints. The relationship between these three measures and indicators of child maltreatment and exposure to domestic violence then were examined. Physical child abuse and a child’s exposure to domestic violence were found to be positively correlated. The correlations of physical child abuse and family conflict, personal problems, and external constraints also were found to be significant. Similar results were demonstrated for exposure to domestic violence and family conflict, personal problems, and external constraints.

Caution must be used when drawing conclusions from the studies described here. These studies all show associations between variables, not cause-effect relationships. In other words, these studies reveal an association between the variables examined without predicting that one variable causes the other to occur or vice versa.


Dong, M., Anda, R.F., Felitti, V.J., Dube, S.R., Williamson, D.F., Thompson, T.J., et al. (2004). The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child Abuse & Neglect, 28, 771-784.

Fantuzzo, J., Boruch, R., Beriama, A., Atkins, M., & Marcus, S. (1997). Domestic violence and children: Prevalence and risk in five major U.S. cities. Journal of the American Academy of Child and Adolescent Psychiatry, 36(1), 116-122.

Hartley, C.C. (2002). The co-occurrence of child maltreatment and domestic violence: Examining both neglect and child physical abuse, Child Maltreatment, 7(4), 349-358.

Herrenkohl, T.I., Sousa, C., Tajima, E.A., Herrenkohl, R.C., & Moylan, C.A. (2008). Intersection of child abuse and children’s exposure to domestic violence.  Trauma, Violence, & Abuse, 9(2), 84-99.

 Lee, L.C., Kotch, J.B., & Cox, C.E. (2004). Child maltreatment in families experiencing domestic violence, Violence and Victims, 19(5), 573-591.

Tajima, E.A., (2004). Correlates of the co-occurrence of wife abuse and child abuse among a representative sample. Journal of Family Violence, 19(6), 399-410.


Resource Center on Domestic Violence: Child Protection and Custody.


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