title: Adverse childhood experiences of referred children exposed to intimate partner violence: consequences for their wellbeing.
abstract: OBJECTIVE
  This study investigated the relationships among Adverse Childhood Experiences (ACEs) in a high risk clinical sample of Dutch children whose mothers were abused by an intimate partner, and the severity of behavioral and emotional problems and trauma symptoms.
  
  
  METHODS
  The study population comprised 208 children (M=7.81 years, SD=2.39, range 2-12) who were referred to mental health and welfare institutions after reported Intimate Partner Violence (IPV). At intake, caregivers, children, and teachers completed questionnaires on Adverse Childhood Experiences, behavior and emotional problems, and trauma symptoms.
  
  
  RESULTS
  The results showed that child witnesses of IPV were also exposed to other adverse experiences, such as abuse, household dysfunction and neglect. The mean number of ACEs was 5.08 (range 2-9). Twenty percent of the children in this sample experienced seven ACEs or more. The number of ACEs children were exposed to was unrelated to the level of emotional and behavioral problems, except for trauma related symptoms reported by parents.
  
  
  CONCLUSIONS
  This study shows that children who witnessed Intimate Partner Violence were also exposed to other adverse experiences. The results of this study may imply that in this high-risk clinical sample of children exposed to IPV, additional adverse experiences have a limited relationship to psychological outcomes.
  
  
  CONCLUSIONS
  A thorough assessment and inclusion of all Adverse Childhood Experiences is necessary for a comprehensive treatment program.
authors.affiliation: Children's and Youth Trauma Centre, Haarlem, The Netherlands.
authors.forename: Francien
authors.initials: F
authors.lastname: Lamers-Winkelman
authors.forename: Agnes M
authors.initials: AM
authors.lastname: Willemen
authors.forename: Margreet
authors.initials: M
authors.lastname: Visser
mesh_terms: D002648:Child; D002667:Child Reactive Disorders / Q000523:psychology*; D002675:Child, Preschool; D017579:Domestic Violence / Q000523:psychology*; D005260:Female; D006240:Happiness; D006801:Humans; D008016:Life Change Events; D008297:Male; D009426:Netherlands; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology; D011795:Surveys and Questionnaires