This study examined the associations between childhood ACEs (exposure to violence and witnessing IPV) and adult experiences of IPV and other violence among community and university women in rural Limpopo, RSA. This is the first study investigating the prevalence of and relationship between specific childhood ACEs and adulthood IPV victimization and perpetration among women from this area of South Africa. Results partially supported hypotheses that ACEs (exposure to violence and witnessing IPV in childhood) are related to adult IPV perpetration and victimization. The primary contributions of this study are that witnessing IPV during girlhood and exposure to violence as a girl can negatively affect adult women and their partners in intimate relationships and that women from the community who witnessed IPV during childhood were nearly five times more likely to perpetrate severe physical assault than university women.
Minor acts of psychological aggression were the most prevalent IPV perpetration and victimization reported by women from the university and community. Previous research indicated that psychological aggression is the most common form of aggression in intimate partner relationships (Follingstad et al., 2005; Murphy & Hoover, 1999; Shorey et al., 2012). Prior studies indicated that men are typically more violent than women (United Nations Office on Drugs and Crime, 2014; Denson, O’Dean, Blake, & Beames, 2018) and are the main perpetrators of psychological aggression (Johnson, 2006; Stark, 2012). Our study shows that women also perpetrate psychological aggression towards their partners (Archer & Coyne, 2005; Spencer, Haffejee, Candy, & Kaseke, 2016). While women display these behaviors more frequently than other forms of IPV, they tend to be minor and less direct (Archer & Coyne, 2005), but any form of IPV perpetration by anyone is unacceptable.
We found that women from the community who witnessed IPV during childhood were nearly five times more likely to perpetrate severe physical assault than university women. Women perpetrate violence against their partners for numerous reasons. For some women, witnessing IPV as a girl without exposure to positive ways of solving intimate partner conflicts could teach her that handling conflicts violently is appropriate or normal (Caldwell, Swan, Allen, Sullivan, & Snow, 2009). In intimate partner relationships, women perpetrate violence for reasons such as self-defense, poor management of negative emotions, yearning for control, jealousy, and to appear strong (Caldwell et al., 2009; Stewart, Gabora, Allegri, & Slavin-Stewart, 2014). Some women who perpetrated physical assault and other IPV behaviors report that they had been longtime victims of IPV and eventually used violence in retaliation (Dugan, Rosenfeld, & Nagin, 2003). Girls exposed to IPV are a priority population to receive interventions that provide role modeling and practice more appropriate ways to handle conflicts in their future relationships. Interventions that focus on communication and interpersonal skills can prevent women from behaving violently in relationships and help them avoid consequences such as incarceration (Caldwell et al., 2009; Stewart et al., 2014).
People who experience ACEs are at risk for mental health disorders that can be detrimental to their health (Center for Disease Control and Prevention, 2021b). Children exposed to violence and witnessed IPV between parents were at an increased risk for developing depression (Lövestad, Löve, Vaez, & Krantz, 2017). Women who are victims of psychological aggression could also develop depression (Nathanson, Shorey, Tirone, & Rhatigan, 2012; Ouellet & Morin, 2004). Disorders such as depression can hinder healthy relationships and impair socialization activities with others (Dillon, Hussain, Loxton, & Rahman, 2013). Younger women from the community and female university students who are victims of psychological aggression and other forms of IPV could benefit from positive social support resources, which can aid women in handling their depression (Ellsberg, Jansen, Heise, Watts, & Garcia-Moreno, 2008; Landstedt, Gustafsson, Johansson, & Hammarström, 2016). With positive support, resources, and mental health treatment, young women may be better positioned to foster healthy relationships with partners and others, ending the vicious cycle of experiencing then re-enacting perpetration as adults.
In addition to depression, IPV victimization reduces students' ability to focus in school. Female students with depression or psychological aggression victimization can have difficulties concentrating, falling asleep, and tiredness daily (Lövestad et al., 2017). We found that women from the community who did not attend a university are at an increased risk for IPV victimization, consistent with previous findings that women with ACEs, substance use as adults, and low educational attainment are more likely to be victims of IPV (Spencer et al., 2016). Poverty also places community women at an increased risk for physical assault victimization. Unemployed women may be at risk for physical and psychological abuse due to depending on their partners for financial benefits (Banwell, 2010). Women with low educational attainment who live in poverty should be a priority for interventions. These women could benefit from safe spaces to report abuse and receive assistance to reduce the risk of further abuse and IPV.
While IPV victimization can affect women from the community and university students differently, they also face similar risk factors. They were living in a low to a middle-income country such as South Africa, experiencing poverty, unemployment, and being of a younger age all place both groups of women at an increased risk for depression (Capaldi, Knoble, Shortt, & Kim, 2012; Iverson et al., 2013; Lövestad et al., 2017). Special attention should also be given to parents in abusive relationships with children in the home, as witnessing IPV places that child at risk for future IPV victimization or perpetuation (“Child Maltreatment and Polyvictimization as Predictors of Intimate Partner Violence in Women From the General Population of Quebec - Audrey Brassard, Marc Tourigny, Caroline Dugal, Yvan Lussier, Stéphane Sabourin, Natacha Godbout, 2020,” n.d.; Shields, Tonmyr, Hovdestad, Gonzalez, & MacMillan, 2020; Yan & Karatzias, 2020). IPV experiences can also affect future family generations as behaviors and practices are passed on from one generation to another (Islam, Tareque, Tiedt, & Hoque, 2014). Therefore, interventions must target parents, couples, children, and even young adults (Spencer et al., 2016). Additionally, we recommend that interventions for girls who witness IPV should consider screening for physical, sexual, and psychological well-being and promote education and awareness about violence and IPV. Those who screen positive for ACEs should receive family conflict resolution skills training.
Further, access to psychological services, health care providers, and resources should be expanded for families to promote optimal health outcomes and limit the harmful effects of exposure to IPV. Interventions should be provided to girls as soon as the screening indicates exposure to IPV. Screening should be implemented in outpatient and in-patient settings, schools, community centers, classrooms, and clinics across childhood and into high school and college years when intimate partner relationships are forming(Agency for Healthcare Research and Quality, n.d.).
Strengths and Limitations
This was the first study to investigate the relationship between childhood exposure to violence and IPV and adulthood experience with IPV victimization and perpetration in Limpopo Province, Republic of South Africa. An important strength of this study was including both university and community women to understand who experienced ACEs and s who are experiencing adulthood violence and IPV.. An additional strength was that the study investigated women as victims and perpetrators, rather than assuming that women had roles only as victims.
A potential limitation of this study was its focus on one gender and one location, which limits generalizability. However, this study provides information that could inform future studies with a larger sample to understand how ACEs influence IPV during adulthood. Findings from this study replicate many other studies showing the negative impact of ACEs on adults but are more specifically focused on resulting adult victimization and perpetration. University and community leaders in Limpopo Province can use information from this study to develop and implement interventions to prevent children from being exposed to violence and provide support for behavior change for victims and perpetrators of IPV.