Childhood Exposure to Intimate Partner Violence and Mental Health Problems: A Three-Level Meta-Analysis

Background and Purpose: Childhood exposure to intimate partner violence (IPV) is a pervasive form of child maltreatment, yet findings on its association with mental health outcomes have been inconsistent. Existing meta-analyses are dated and have largely overlooked outcomes beyond childhood. This study employed a three-level meta-analysis to clarify the overall magnitude of the association between childhood IPV exposure and mental health problems, examine differential effects across outcome types, and explore potential moderators.

Methods: A systematic search of seven databases yielded 36 eligible studies (79 effect sizes; total N = 50,229). A three-level random-effects meta-analysis was conducted using Fisher’s Z-transformed correlations. Moderator analyses examined literature quality, sample size, IPV measurement type, and participant age, with subgroup analyses for internalizing problems, depressive symptoms, and PTSD-related symptoms. Publication bias and sensitivity were assessed via Egger’s test and leave-one-out procedures.

Results: Childhood IPV exposure showed a significant moderate overall association with mental health problems (r = 0.257, 95% CI [0.203, 0.310], p < 0.001). Significant associations emerged across internalizing problems (r = 0.245), depressive symptoms (r = 0.234), and PTSD-related symptoms (r = 0.300), with the largest effect for PTSD. Higher study quality (β = -0.025) and larger sample sizes (≥500: r = 0.177 vs. <500: r = 0.328) were associated with smaller effect sizes. Older age (β = 0.010) and use of the Conflict Tactics Scale (CTS: r = 0.327 vs. self-developed: r = 0.170) were associated with larger effects. Publication bias was not significant, and sensitivity analyses confirmed robustness.

Conclusions and Implications: Childhood IPV exposure confers significant and lasting mental health risks across internalizing, depressive, and PTSD-related domains. The moderating role of study quality, sample size, age, and measurement tools underscores the need for rigorous methodological standards in future research. Practically, these findings call for trauma-informed prevention and intervention efforts that extend beyond early childhood, as significant effects were also observed among older cohort. Policies should prioritize early family education and parenting training to reduce children’s IPV exposure, while interventions such as trauma-focused cognitive behavioral therapy may help mitigate long-term psychological harm.