Neglect and abuse are types of childhood maltreatment and represent traumatic experiences with complex long-lasting effects for the person’s neurobiological, emotional and psychological development (Nemeroff, 2016). Neglect is understood as a recurrent failure to meet a child’s basic needs: physical, educational, emotional and medical (Horwath, 2007). The National Society for the Prevention of Cruelty to Children (NSPCC) defines abuse as any damaging and harmful act against a child; be it sexual, physical, verbal, emotional or psychological (NSPCC, 2017).

Within the literature and Criminal Justice System there is a consensus on the association between childhood maltreatment and subsequent offending in adulthood (including aggressive behaviours in general). However, possible gender differences in the cycle of violence are still showing mixed results.

Some research suggests that maltreatment is slightly more predictive of female incarceration compared to males (Roos et al., 2016). This could be related to the fact that more women, in general, and imprisoned women, particularly, have more diagnoses of mental health issues when compared to men, which could be due to the increased risks of abuse, especially sexual, which women face (Karlsson & Zielinski, 2018; Fazel et al., 2016). Moreover, substance abuse due to maltreatment-mediated mental health issues is more foretelling of criminal trajectories for women than for males (Chang et al., 2015). Noteworthy, there is an inaccurate belief that girls and women internalise their emotions instead of ‘acting out’ through antisocial behaviours (Widom, 2017), which results in women being consistently overlooked in research regarding childhood maltreatment and subsequent violent acts in adulthood. These gender differences deserve more research as it can inform treatment and policy-making to reduce reoffending and incarceration lengths.

As such, the paper discussed below, by Augsburger and colleagues (2019), investigated the current theory and research regarding the underlying mechanisms of the female cycle of violence and its relationship with childhood maltreatment. They looked at:

• whether there is support for an overall association between childhood maltreatment and aggression,
• whether different types of past childhood maltreatment affected subsequent aggression differently, and
• the possible moderators of the proposed cycle of violence.

Methods

The question-led meta-analysis included 34 peer-reviewed quantitative studies which consisted of varied samples of adult women. The literature searching strategy included creating several search terms (e.g gender, pathways, gender differences, abuse, PTSD, trauma) generally related to gender, types of childhood maltreatment and antisocial behaviours. These terms were then combined in different search strings. These were imputed into online academic databases, and the titles and abstracts of the found papers were scanned to see if they fit the inclusion criteria. The papers needed to: 1) be peer-reviewed; 2) specifically investigate the associations between childhood maltreatment, lifetime traumatic experiences, or PTSD, and subsequent aggression; 3) directly measure and report on potential childhood maltreatment predictors and subsequent aggression; 4) have adequate control groups; 5) have adult women as samples (min. age 18 years old). Various types of childhood maltreatment and aggressive behaviours were taken into account. Selected studies were retrieved in full and then coded and synthesised. The analysis strategy involved creating several effect models using multi-level meta-analyses differing in complexity, as well as a sensitivity analysis regarding the design quality of the studies included.

Results

• Results in support of a cycle of violence determined by past maltreatment and exposure to adversities appear to be consistent across study designs, samples, and cultural setting.
• A small but significant effect (Cohen’s d = 0.30) was found in support of an association between having experienced childhood maltreatment and subsequent aggressive behaviours. They showed a heterogenous risk of aggression due to past childhood maltreatment, irrespective of the investigated sample of adult women (e.g. general population, clinical samples, child welfare beneficiaries, offenders).
• Research which assessed the frequency of aggressive behaviour, rather than simply their incidence, found greater correlations with past childhood maltreatment, especially in those studies which tested it over longer periods of time.
• Studies on populations exposed to conflicts (e.g. war) found more support for childhood maltreatment as a determinant of aggressive behaviours in adulthood. This is possibly due to people facing conflicts being exposed to a cumulus of various maltreatment, rather than just one type of childhood maltreatment.
• Moderators of the cycle of violence, from child victim of maltreatment to adult perpetrator, remain unclear. So far, the data shows that childhood maltreatment is associated with more mental health issues, more substance abuse, and possible neurobiological alterations in the brain. These can moderate further aggressive behaviours.
• No differences were found between types of maltreatment (e.g. psychological abuse, physical abuse) and aggressive behaviour in adulthood. They appear to have a similar weighting.
• It appears that female victims of childhood maltreatment might be more prone to further perpetrating physical and psychological aggression in adulthood. In terms of perpetrating sexual aggression, current results cannot be conclusive, as, apart from one included study, all investigated intimate partner violence (with no associations found), which is inherently dependent on various factors to happen, such as partner, marital status, relationship type etc.
• Limited results point towards the idea that the children of previously maltreated females may be more at risk of receiving aggression from their mothers.

Conclusions

The authors conclude that:

This meta-analysis provides evidence for a robust cycle of violence for women, arising from exposure to childhood adversities, yet with a small effect size. (p. 1784).

Moderators and mechanisms of this cycle are less understood and under-researched. All types of maltreatment appear to be associated with further aggression.

Past research has shown that adult aggression and violence, particularly crime engagement, is a process caused by, not one, but several aspects of the person’s life. It is not straightforward, but instead it is generated and constantly affected by an interplay between various familial, individual and social factors. childhood maltreatment and cumulated maltreatment, specifically, all affect the person’s social, emotional, psychological, and neurobiological development.

As past literature has shown (Beckley et al., 2018), it is possible that through the moderating effect of mental health, including substance abuse, risky-behaviour/relationships engagement, personality, and other socioeconomic determinants, childhood maltreatment can lead to aggression, and especially crime involvement. However, the relationship is not straightforward, but rather complex. Unfortunately, there is a consistent lack of research with females, and adult females especially.

Strengths and limitations

Strengths

• Adds to a limited understanding of a female cycle of violence
• Focuses on adult women, which are poorly understood in terms of aggression
• Takes into account various samples and cultural contexts, as well as study designs and methodologies
• Discusses priorities for further research, such as the possible effects of different neglect and abuse types on different types of aggressive behaviours.

Limitations

• Shows general associations, but no specific mechanisms. Could be due to lack of studies on this matter, possibly combined with a faulty search process
• There is a lack of in-depth discussion regarding the females’ aggressive behaviours and their context, as well as consequences on their overall life quality
• No definite conclusions can be drawn.

Implications for practice

Gender differences in childhood maltreatment and violence/aggression are poorly studied, especially in recent research. Certain types of abuse and neglect may impact on females and males differently, such as consequences on wellbeing, social life, education engagement, or type and severity of crime/aggressive behaviour committed. Knowing this could inform better interventions to reduce crime, recidivism, and violence overall. It could also indicate who is more at risk (e.g., children of childhood maltreatment victims) and reduce chances of further victimisation.

Given the ongoing struggle of the prison system to reduce re-offending rates (Ministry of Justice, 2019), questions remain about the validity and usefulness of current trauma-centred interventions. Thus, understanding the complexity of the adult criminal behaviour, and female criminal behaviour especially, is vital for policy-making within the Criminal Justice System. It informs therapy programmes in the community and in prisons, as well as early on programmes with at-risk children or families.

The meta-analysis discussed above has added important information to this ongoing debate. It has also minimised the unfortunate consistent lack of research on adult females’ aggression, violence, and criminal offending. Nonetheless, women’s cycle of violence remains under researched and overlooked in the wider society.

Statement of interests

No conflict of interest to be reported.

Links:

Primary paper:

Augsburger, M., Basler, K., & Maercker, A. (2019). Is there a female cycle of violence after exposure to childhood maltreatment? A meta-analysis. Psychological Medicine, 49(11), 1776-1786. DOI:10.1017/S0033291719000680

Other references

Beckley, A. L., Caspi, A., Arseneault, L., Barnes, J. C., Fisher, H. L., Harrington, H., … & Moffitt, T. E. (2018). The developmental nature of the victim-offender overlap. Journal of developmental and life-course criminology, 4(1), 24-49. https://doi.org/10.1007/s40865-017-0068-3

Chang, Z., Larsson, H., Lichtenstein, P., & Fazel, S. (2015). Psychiatric disorders and violent reoffending: a national cohort study of convicted prisoners in Sweden. The Lancet Psychiatry, 2(10), 891-900. https://doi.org/10.1016/S2215-0366(15)00234-5

Fazel, S., Wolf, A., Chang, Z., Larsson, H., Goodwin, G. M., & Lichtenstein, P. (2015). Depression and violence: a Swedish population study. The Lancet Psychiatry, 2(3), 224-232. https://doi.org/10.1016/S2215-0366(14)00128-X

Horwath, J. (2007). Child neglect: Identification and assessment. Macmillan International Higher Education.

Karlsson, M. E., & Zielinski, M. J. (2018). Sexual victimization and mental illness prevalence rates among incarcerated women: A literature review. Trauma, Violence, & Abuse. https://doi.org/10.1177/1524838018767933

Ministry of Justice (2019). Proven Reoffending Statistics Quarterly Bulletin, January 2017 to March 2017.

Nemeroff, C. B. (2016). Paradise lost: the neurobiological and clinical consequences of child abuse and neglect. Neuron, 89(5), 892-909. https://doi.org/10.1016/j.neuron.2016.01.019

NSPCC (2017). Definitions and signs of child abuse.

Roos, L. E., Afifi, T. O., Martin, C. G., Pietrzak, R. H., Tsai, J., & Sareen, J. (2016). Linking typologies of childhood adversity to adult incarceration: Findings from a nationally representative sample. American Journal of Orthopsychiatry, 86(5), 584-593. http://dx.doi.org/10.1037/ort0000144

Widom, C. S. (2017). Long‐term impact of childhood abuse and neglect on crime and violence. Clinical Psychology: Science and Practice, 24(2), 186–202. https://doi.org/10.1111/cpsp.12194

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