Male and Female Perpetrated Partner Abuse: Testing a Diathesis-Stress Model 
by Reena Sommer


Table of Contents

Chapter 2 Part 1

Chapter 4


                           CHAPTER 3

                THE WINNIPEG HEALTH AND DRINKING 
                        SURVEY - WAVE 1

     The research conducted in this study was based on data derived
     from the Winnipeg Health and Drinking Survey (WHADS) (Barnes &
     Murray, 1989).  This survey was designed to examine the prevalence of
     alcohol consumption in a general population sample of Winnipeg,
     Manitoba by exploring the socio- demographic and personality
     variables associated with its occurrence. The survey followed a
     longitudinal panel design and includes two waves of data.  The survey
     attempted to capture a wide range of information on people's drinking
     and lifestyle practices across three age groups over a two year time
     period.

          Partner abuse data have been previously analyzed for Wave 1 of
     the WHADS.  A brief description of the overall sampling strategy
     involved the WHADS, the response rate for Wave 1 data, the format for
     the Wave 1 partner abuse data analyses as well as summaries of its
     major findings follows.  This chapter concludes with:

          1) a discussion of the results and limitations of Wave 1 partner
          abuse data,

          2) a presentation of an alternative theoretical model used in
          this research that attempts to overcome the methodological
          weaknesses of Wave 1,

          3) a list of the objectives and assumptions of Wave 2, and

          4) a list of the research hypotheses tested in this research.

     A discussion of the measures included in both waves of this research
     is provided in the chapter on methodology.
 
 

                Sample Selection and Description

     A random sample of adult residents of Winnipeg, Manitoba between
     the ages of 18 and 65 years who were not institutionalized was
     provided for use by the Manitoba Health Services Commission, the
     provincial medicare agency.  The initial sample was stratified by age
     and sex into the following categories for males: (a) 18-34 years, (b)
     35-49 years, and (c) 50-65 years; and females: (a) 18-34 years, (b)
     35-49 years, and (c) 50-65 years. For each sex/age cell, there were
     667 randomly selected names of Winnipeg residents. From this initial
     sample, a total of 2761 introductory letters were mailed (See
     Appendix A). Data collection for Wave 1 began during the summer of
     1989 and was completed by the fall of 1990.
 

              Procedure for Data Collection

     In both phases of the project, respondents participated in a 90
     minute face-to-face interview which involved completing a structured
     interview schedule as well as a self-administered questionnaire. The
     interviews were conducted by graduate students from the departments
     of Psychology, Sociology, and Family Studies at the University of
     Manitoba who received training during a full day workshop.

          Each personal interview was preceded by approximately one week
     by a letter describing the purpose of the project. Respondents were
     invited to call the project office should they have any questions or
     concerns.  A telephone appointment was made prior to the interview.
     Interviews were schedules to take place at the subject's home (unless
     otherwise arranged).  The interviews were conducted at a time most
     convenient to the subject.  At least five attempts were made to
     contact each individual to arrange for a suitable interview time.
 

                     Response Rate

     The response rates to be described are based on the entire
     sample. Of the initial sampling base, 366 persons were deemed
     ineligible, 722 refused to be interviewed and 336 could not be
     contacted. The number of completed interviews was 1257 (615 males and
     642 females) and provided an overall response rate of 63.5%. Data
     analyzed in this research were drawn from a subsample of 447 males
     and 452 females who were married or remarried. Table 1 provides a
     summary of the demographic characteristics for this subsample.
 

  Table 1. Demographic characteristics of the married and cohabiting 
           sample based on Wave 1 data (Barnes et al., 1992).

                                   Males                    Females
          Category                 N    %                   N    %
 

     Mean Age                      46.1 Years               43.5 Years

     Age Groups
          18-34 years              104  23.3                145  32.1
          35-49 years              155  34.7                150  33.2
          50 years +               188  42.1                157  34.7
                    Total          447 100.0                452 100.0

     Marital Status
          Married                  429  96.0                443  98.0
          Married, but previously   18   4.0                  9   2.0
               divorced
                    Total          447 100.0                452 100.0

     Educational Status
          Grade school              27   6.0                128  26.1
          Some high school          93  20.0                110  24.1
          High school completed     88  19.7                115  25.4
          Some college or          110  24.6                 79  17.5
               technical diploma
          University graduate       88  19.7                 17   3.8
          Post university education 41   9.2                 13   2.9
                    Total          447 100.0                452 100.0

                                                  Table 1. cont'd.                        Table 1 (continued)
 

          Category                    Males                 Females
                                   N       %                N      %

     Current Employment Status
          Working full time        365  81.7                172  38.1
          Working part time         12   2.7                108  23.9
          Unemployed                11   2.5                 10   2.2
          Student                    2    .4                 10   2.2
          Housewife                ___   ___                116  25.7
          Retired                   43  10.1                 31   6.9
          Other                     14   2.6                 10   2.2
                    Total*         447 100.0                457 101.5

     Income
          < $10,000/yr.              5   1.1                  4    .9
          $10,000 - $20,000/yr.     16   3.6                 34   7.5
          $20,000 - $35,000/yr.     88  19.7                 88  19.5
          $35,000 - $50,000/yr.    127  28.4                117  25.9
          > $50,000/yr             196  43.8                161  35.6
                    Total*         432  96.6                404  89.4
 

     Religious Preference
          Catholic                 117  26.7                143  31.6
          Protestant               197  44.1                205  45.4
          Jewish                    14   3.1                 11   2.4
          Other                     51  11.4                 47  10.4
          No religious preference   67  15.0                 46  10.2
                    Total*         446  99.3                452 100.0

     Race
          White                    417  93.3                417  92.3
          Non white                 30   6.7                 35   7.7
                    Total          447 100.0                452 100.0
 
 

* Note: Not all totals will equal 447 or 452 (100%) due to missing
       data or multiple categories.
 
 

                       Data Analysis

     Data in this phase of the research were analyzed with the
     Statistical Package for the Social Sciences, version X (SPSSx) and
     the Statistical Analysis Systems (SAS). The following represents the
     general format of data analyses for this phase of the research:

          1. Frequency analyses (using percentages and means) were
          conducted to describe the frequency and severity of perpetrated
          partner abuse as well as the demographic variables that define
          the sample.  At this stage of the analysis, it was also possible
          to test for scale outliers, skewness, normality, linearity and
          homoscedasticity and to conduct appropriate transformations when
          necessary.  Although the CTS (Straus, 1979) was found to be
          skewed, the criteria set by Cleary and Angel (1984) suggested
          the use of linear multiple regression was an appropriate
          statistical approach to analyze these data.  Finally,
          examination of the distributions of the alcohol dependence
          measures established their high/low cutpoints and facilitated
          the construction of the Alcohol Dependence Index.

          2.Pearson Correlations were computed to determine the bivariate
          relationships among continuous or dummy coded variables.  As
          noted previously, correlational analyses determined the measures
          needed to be included in the Neuroticism Index.  In addition,
          zero order relationships between the dependent measure, partner
          abuse and the independent measures, socio-demographic,
          personality, alcohol measures were determined.

          3. A number of standard regression models testing both main and
          interaction effects were performed on continuous and dummy coded
          variables.  These involved examining both the individual and
          combined effects of the independent variables against the
          dependent variable (i.e., six items taken from the CTS).
          Through this procedures, it was possible to ascertain which
          variables were most salient in their explanation of partner
          abuse.
 
 

                       Major Findings

     The following represents a summary of the results of the
     analyses conducted on the male and female data from Wave 1 of this
     research.
 

     Male Data

          1. The prevalence of male perpetrated abuse was 26.3 percent
     with the most common abuse tactic being "pushing, grabbing and
     shoving" (Barnes, Sommer, Murray & Patton, 1994) (See Table 2).
 
 

     Table 2. Male perpetrated violence (Wave 1 data) (Barnes et al., 
             1994).

                                             Number of
     Type of violence                        occurrences         %

     Minor violence acts
          Threw or smashed something              79            15.8
          (not at partner)
          Threatened to throw something           42             7.3
          (not at partner)
          Threw something at partner              30             4.6
          Pushed, grabbed or shoved               85            17.2
     Severe violence acts
          Hit partner                             42             7.3
          Hit partner with something hard         14              .9
     Violence Indexes
          Minor Violence                         128            25.9
          Severe Violence                         43             7.6
          Overall Violence                       125            26.3

     There were 10 missing cases. Overall violence scale statistics:
          Mean = 6.63, S.D. = 1.48 and range = 6-20

          2. Partner abuse by male respondents was significantly predicted
     by being nonwhite, unemployed and alcohol dependent, and by a low
     score on Eysenck's Lie Scale and a high score on the Neuroticism
     Index.  In addition, an interaction effect was found for high alcohol
     consumption and high scores on the Neuroticism Index. This
     interaction effect was found to be the strongest predictor of male
     perpetrated partner abuse.  Table 3 illustrates the results of a
     standard regression model testing both main and interaction effects.
 
 

   Table 3. Standard multiple regression predicting male perpetrated 
              partner abuse (Wave 1 data) (Sommer et al., 1991).

     Predictor                          r         Beta           R2

     Income                           -0.08       0.04
     White                            -0.09*     -0.14**
     Age                              -0.10*     -0.05
     Unemployment                     -0.25***   -0.23***
     Years of education               -0.08      -0.09
     Catholic                         -0.04      -0.06
     Protestant                       -0.04       0.02
     Ethanol                           0.13*      0.11
     Alcohol dependence                0.26***    0.16**
     MacAndrew Scale                   0.14*      0.12
     EPQP                              0.17**    -0.12
     EPQE                              0.07       0.04
     EPQL                             -0.22**    -0.22**
     Neuroticism Index                 0.23***    0.23***
     Alcohol consumption & Mac         0.16*     -0.38
     Alcohol consumption &
          Neuroticism  Index           0.32***    0.25**
     Alcohol consumption & EPQL       -0.32***   -0.06
     Alcohol consumption & EPQE        0.11       0.07
     Alcohol consumption & EPQP        0.27***    0.25
          Equation                                            .26

     * p<.05, ** p<.01, *** p<.001, F(19,311) = 5.92, p<.001,
          adj. R2 = .22
 
 

     Female Data

          1. The prevalence of female perpetrated partner abuse was 39.1
     percent with the most common abuse tactic also being "throwing or
     smashing something (but not directly at partner)" (23.6%). See Table
     4.
 

   Table 4. Female perpetrated violence  (Wave 1 data) (Sommer et al., 
              1992).

                                        Number of
     Type of violence                   occurrences          %

     Minor violence acts
          Threw or smashed something         108            23.6
          (not at partner)
          Threatened to throw something       69            14.9
          (not at partner)
          Threw something at partner          75            16.2
          Pushed, grabbed or shoved           92            19.8
     Severe violence acts
          Hit partner                         73            15.8
          Hit partner with something hard     16             3.1
     Violence indexes
          Minor violence                     173            38.0
          Severe violence                     75            16.2
          Overall violence                   178            39.1

     Note: There are 2 missing cases. Overall violence scale statistics:
           Mean = 7.38, S.D. = 3.37, and range = 6-28.

          2. Partner abuse by female respondents was significantly
     predicted by being young in age and having high scores on Esyenck's
     Psychoticism Scale (EPQ-R), the Neuroticism Index and the MacAndrew
     Scale.  An interaction effect was found between alcohol consumption
     and the EPQ-P.  The strongest predictor of partner abuse by women was
     the main effect of having high scores on the EPQ-P.  Table 5
     illustrates the results of a standard multiple regression model
     testing both main and interaction effects.
 

   Table 5: Standard multiple regression analyses predicting female 
              perpetrated partner abuse (Sommer et al., 1992).

     Predictor                          r         Beta           R2

     Age                             -0.23***     -0.21***
     Years of education              -0.07        -0.02
     Unemployment                     0.05         0.03
     Income                          -0.14**      -0.06
     Catholic                        -0.01        -0.03
     Protestant                       0.00         0.04
     White                            0.10*       -0.003
     Ethanol                          0.001        0.14
     Alcohol dependence               0.02        -0.07
     EPQP                             0.39***      0.30***
     EPQE                             0.10*       -0.003
     EPQL                            -0.17**      -0.03
     Neuroticism Index                0.32***      0.35***
     MacAndrew Scale                  0.16**       0.16*
     Alcohol consumption & EPQP      -0.001       -0.38*
     Alcohol consumption &
          Neuroticism Index           0.20***     -0.13
     Alcohol consumption & EPQE      -0.001        0.19
     Alcohol consumption & EPQL      -0.03        -0.15
     Alcohol consumption & Mac       -0.004        0.08
          Equation                                            .28

     Note: * p < .05, ** p < .01, *** p <.001
           F(19,240)=4.87, p < .001, adj. R2 =0.22.
 
 
 

              Limitations of Wave 1 Partner 
                       Abuse Data

     Wave 1 research has made an important contribution to the family
     violence literature because it is one of the first general population
     studies to investigate the prevalence of partner abuse by including
     both socio-demographic and individual variables in its analyses.
     Yet, in spite of the findings provided by this research, a number of
     theoretical and empirical questions have been raised. A discussion of
     Wave 1 results and its subsequent limitations follows.

          Wave 1 data provides support for the role of both
     socio-demographic and individual risk factors in the perpetration of
     partner abuse.  As might be expected, the regression analyses yielded
     abuser profiles that differed for males and females.  The one common
     predictor, however, is the finding that both male and female abusers
     are most likely to score high on the Neuroticism Index.

          Results demonstrated that male and female partner abusers can be
     distinguished in terms of how alcohol abuse influences the likelihood
     of perpetration.  Whereas alcohol dependence and the consumption of
     alcohol (as it interacted with Neuroticism) were found to be salient
     factors in the prediction of male perpetrated violence, the same did
     not hold true in the prediction of female perpetrated violence.
     Although the interaction between Eysenck's P Scale and alcohol
     consumption was found to be a weak predictor for female abusers, it
     appears that the role of alcohol in partner abuse is experienced
     differently by males and females.

          In an attempt to explain this sex difference, our article on
     female perpetrated spouse abuse (Sommer et al., 1992) relied upon
     Frieze and Schafer's (1984) cognitive model.  According to this
     model, "a drinker's reactions will depend upon the social context in
     which drinking occurs and the prior expectations of the person about
     how the alcohol will affect him or her" (p.277). We suggested that
     "the effects of alcohol consumption are thought to be dependent upon
     an individual's cognitive interpretation of the physiological arousal
     experienced in a manner that is consistent with prior sex-role
     socialization" (Sommer et al., 1992, p. 1321). For women, the
     physiological effects associated with alcohol consumption may be
     interpreted as emotional warmth, whereas for men, it may be
     interpreted as power.

          The contextual role of alcohol abuse in the perpetration of
     partner abuse is an issue that has arisen from this research.
     Specifically, the question "Is alcohol consumed during an abuse
     episode?" is in need of being answered.  In doing so, it will be
     possible to determine whether it is the reaction to the immediate
     effects of alcohol consumption, or merely the alcoholic lifestyle,
     that is most influential in the perpetration of partner abuse.

          The socio-demographic risk factors found to be significant for
     male (i.e., unemployment, nonwhite) and female abusers (i.e., young
     age) are also consistent with the findings of other general
     population surveys on partner abuse.

     Contrary to those derived from clinical data (Gondolf et al., 1990),
     abusers in this, and other general population based research, were
     not necessarily defined as being of low SES backgrounds even though
     the male data demonstrated that being unemployed was a risk factor.
     Further, the finding that being nonwhite was also a salient factor in
     the prediction of male perpetrated spouse abuse, needs to be
     considered cautiously since our male sample was 93.3 percent white.
     Finally, the finding that female abusers are most likely to be young
     in age is consistent with other research (Kennedy & Dutton, 1989;
     Shupe & Stacey, 1987; Stacey & Shupe, 1983; Straus et al., 1980), as
     well as with the profile of the deviance prone individual (Sommer et
     al., 1992).

          Although Wave 1 data included the socio-demographic variables
     most often used to define a sample, several other variables commonly
     investigated in family violence research were omitted.  For example,
     the effects of violence in the family and life stress events were not
     considered in the analysis of Wave 1 data.  In view of the extensive
     literature suggesting that each of these factors are important
     correlates of partner abuse, it is thought that they too, may add to
     the explanatory power of a regression model.

          Finally, with respect to the prevalence of perpetrated partner
     abuse, Wave 1 data demonstrated that 26.3 percent of males and 39.1
     percent of females in this random sample of adult Winnipeg residents
     acknowledged at least one incident of partner abuse during the course
     of their relationship with their current partner.  While the
     prevalence rates of partner abuse reported are consistent with Straus
     et al.'s (1980) findings, explanations regarding a significant sex
     difference (Sommer et al., 1991) in its occurrence remain a matter of
     speculation.

          The recency of the partner abuse was also not examined.
     Establishing whether the abuse reported is part of a well established
     pattern or behaviour, or simply an isolated event, possibly occurring
     early on in the relationship is a matter that remains unresolved.
     Contextual issues (i.e., the perpetration of abuse occurring in self
     defence), as well as the consequences of partner abuse (i.e.,
     partner's need for medical attention following a partner abuse
     episode) were not examined, and remain a challenge for future
     research.

          The limitations just described indicate that the study of abuse
     between intimate partners like any other area of research is not
     without its problems. It was the goal of this study to be sensitive
     to these issues and to attempt to overcome them by way of the methods
     outlined in the following chapter.  In so doing, some of the
     uncertainty regarding the dynamics underlying both male and female
     perpetrated partner abuse was clarified.
 
 

                     Diathesis Stress Model

     In order to address both the socio-demographic and psychological
     variables represented in this research, and in order to provide a
     more definitive explanation of partner abuse, a diathesis stress
     model was selected for those purposes.  This approach "considers the
     often subtle interaction between a predisposition toward disease (or
     disorders) - the diathesis - and the environmental, or life events
     disturbing people - the stress" (p. 55, Davison & Neale, 1990).
     According to Davison and Neale (1990), an important tenet of this
     perspective is that both the diathesis and stress are necessary
     conditions in the development of a particular state.  Often used to
     describe the development of schizophrenia (Buskist & Gerbing, 1990),
     this conceptual framework can also be extended to a number of
     phenomena whose underpinnings are thought to involve both
     biologically and environmentally based vulnerabilities.  According to
     Graff (1993), vulnerability factors are thought to be relatively
     stable, whereas stressors may be experienced as acute or chronic.
 

     The Present Study: Application to Partner Abuse

     The diathesis-stress model was thought to be particularly well
     suited toward explaining the problem of partner abuse.  Our earlier
     research on courtship violence employed this conceptual framework
     (Barnes et al., 1991) and demonstrated that the inclusion of an
     interaction term (i.e., personality and alcohol consumption) in the
     diathesis-stress regression model increased the amount of variance
     explained over the amount explained by the main effects by seven
     percent.  Previously, theories that have guided research
     demonstrating associations between a number of socio-demographic
     variables, personality, alcohol consumption, and the perpetration of
     abuse between intimate partners have not been successful in providing
     a complete explanation of this phenomenon.  The application of a
     diathesis-stress model allowed for the integration of principles from
     a number of the theories previously discussed.

          In this research, by conceptualizing personality, alcohol
     dependence, socio-demographic variables (i.e., age, employment
     status, income, education, religion and race), family background and
     past partner abuse as the diathesis, and life stress events (i.e.,
     job loss, job change, change in financial situation, change in
     residence, birth of a child, retirement, start or finish school,
     change in marital status, spouse's job loss, spouse's job change) and
     recent alcohol consumption as the stress, an examination of their
     individual and combined effects in the prediction of partner abuse
     was attempted.  In the presence of both constitutional and
     environmental risk factors, the likelihood for partner abuse was
     expected to increase.  It was expected that the application of a
     diathesis-stress model to the issue of partner abuse would improve
     upon the explanatory value of previously advanced models.  Figure 1
     illustrates the model tested in this research.
 

     Figure 1.

    [Will be shown here when the graphics file becomes available. --WHS]

          Assumptions Underlying the Research Project

     This research project assumed that references to partner abuse
     were made within the context of heterosexual relationships. Although
     it is recognized that there is a growing body of literature on gay
     and lesbian partner abuse, it was deemed to be beyond the scope of
     this research to explore the perpetration of partner abuse within
     this population.
 
 

                        Objectives

     The objectives of this project were as follows:
 

     Primary:

          1) Examine the longitudinal relationships among
             socio-demographic variables, alcohol consumption and
             dependence, personality and partner abuse.
 

     Secondary:

          1) Identify the incidence and prevalence of partner abuse in a
             large urban Canadian sample.

          2) Compare the rates of partner abuse between males and females.

          3) Compare these rates of partner abuse with those of other
             Canadian and U.S. urban samples.

          4) Examine the stability of partner abuse during the course of
             the research project.

          5) Examine whether the abuse perpetrated occurred in self defence.

          6) Examine the consequences of partner abuse episodes based on
             whether medical treatment was sought.

          7) Examine whether the consumption of alcohol was a factor at
             the time of an abuse episode.

          8) Examine whether the relationship between the amount of
             alcohol consumed and the occurrence of partner abuse is
             linear (i.e., such that the likelihood for abuse increases
             with the amount consumed).

          9) Examine the relationship between observing violence in the
             family of origin and the perpetration of partner abuse.

          10) Examine the relationship between recent life stress events
              (i.e., those occurring during the past two years) and the
              perpetration of partner abuse.
 
 

                       Research Hypotheses

     The empirical literature and the diathesis-stress model as
     applied to abuse between intimate partners suggest several testable
     hypotheses.  A description of the hypotheses tested in this research
     are as follows:

          Descriptive statistics and correlational analyses were expected to
     reveal that:

          1. The incidence rates of male and female perpetrated partner
             abuse (i.e., abuse that has occurred during the past
             year) as measured in Wave 2 will be consistent with those
             reported in the literature (i.e., 10-14 percent).

          2. The pattern of partner abuse (i.e., frequency, severity, most
             common abuse tactics and sex differences) found in Wave 1
             of this research will also hold true for Wave 2 data.

          3. Partner abuse scores will be significantly higher among
             respondents who had witnessed their parents' abuse of each
             other (as measured in Wave 2).

          4. Partner abuse scores will be significantly higher among
             respondents who had reported having experienced life stress
             events (as measured in Wave 2).

          5. The relationship between the consumption of alcohol and the
             perpetration of partnerabuse will be curvilinear whereby
             individuals who consume moderate amounts of alcohol will have
             higher mean partner abuse scores than those who consume low
             and high amounts of alcohol (as measured in Wave 1 and Wave
             2).

     The main hypotheses, related to the diathesis-stress model were
     assessed by way of logistic regression analyses and included measures
     drawn from Wave 1 and Wave 2.  The individual and combined main
     effects of the independent measures on current perpetrated partner
     abuse (as measured in Wave 2) as well as their interactive
     contributions to its prediction were evaluated for the following:

          6. For males, witnessing mother's and father's abuse of each
             other, consuming alcohol (measured in Wave 2), being
             unemployed, perpetrating past partner abuse, having low
             scores on social conformity and having high scores on alcohol
             dependence, the Neuroticism Index, (measured in Wave 1) and
             stress (measured in Wave 2) will significantly predict
             current perpetrated partner abuse in Wave 2.

          7. For females, witnessing mother's and father's abuse of each
             other (measured in Wave 2) being young in age, perpetrating
             past partner and having high scores on Esyenck's Psychoticism
             Scale (EPQ-R), the Neuroticism Index, the MacAndrew Scale
             (measured in Wave 1) and stress (measured in Wave 2) will
             significantly predict current perpetrated partner abuse in
             Wave 2.

     Finally, based on the findings emerging from the literature reviewed,
     the following two hypotheses were derived:

          8. For males, the interaction between the following diathesis
             and stress factors will   significantly predict current
             perpetrated partner abuse in Wave 2 and add to the
             explanatory power of the main effects model:

               a) deviance prone personality (i.e. high scores on the
                  neuroticism index) and high recent alcohol consumption,

               b) deviance prone personality (i.e., high scores on the
                  neuroticism index) and life stress,

               c) past environmental contributions (i.e. past partner
                  abuse and violence in the family of origin) and high
                  recent alcohol consumption,

               d) past environmental contributions (i.e., past partner
                  abuse and violence in the family of origin) and life
                  stress, and

               e) alcohol dependence and life stress.

          9. For females, the interaction between the following diathesis
             and stress factors will significantly predict current
             perpetrated partner abuse in Wave 2 and improve upon the
             explanatory power of the main effects model.

               a) high scores on deviance prone personality (i.e.,
                  neuroticism index and psychoticism scale) and past
                  partner abuse,

               b) high scores on deviance prone personality (i.e.,
                  neuroticism index and psychoticism scale) and life
                  stress events,

               c) high scores on deviance prone personality (i.e.,
                  neuroticism index and psychoticism scale) and high
                  recent alcohol consumption, and,

               d) past environmental contributions (i.e., violence in the
                  family of origin and past abuse) and life stress.
 

Next:  Chapter 4



 

Table of Contents

Chapter 2 Part 1

Chapter 4

References



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Children need Both Parents -- Once a Parent, a Parent for Life
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