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Children in the Crossfire: Child Custody Determinations Among Couples With a History of Intimate Partner Violence
Mary A. Kernic, Daphne J. Monary-Ernsdorff, Jennifer K. Koepsell and Victoria L. Holt Violence Against Women 2005 11: 991 DOI: 10.1177/1077801205278042 The online version of this article can be found at: http://vaw.sagepub.com/content/11/8/991

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VIOLENCE AGAINST WOMEN / Kernic August et al. 2005 / CHILDREN 10.1177/1077801205278042 IN THE CROSSFIRE

Children in the Crossfire

Child Custody Determinations Among Couples With a History of Intimate Partner Violence
MARY A. KERNIC DAPHNE J. MONARY-ERNSDORFF JENNIFER K. KOEPSELL VICTORIA L. HOLT
University of Washington

Although most states mandate considerations of intimate partner violence (IPV) in child custody proceedings, little is known about how often a preexisting history of IPV is effectively presented to the courts in dissolution cases and, when it is, what effect it has on child custody and visitation outcomes. This retrospective cohort study examined the effects of a history of IPV, further categorized by whether substantiation of that history existed and whether the court handling the custody proceedings knew of that history, on child custody and visitation outcomes. The findings from this study highlight several issues of concern regarding the reality of child custody among families with a history of IPV. These include two primary concerns: a lack of identification of IPV even among cases with a documented, substantiated history, and a lack of strong protections being ordered even among cases in which a history of substantiated IPV is known to exist. Keywords: child abuse; child custody; cohort studies; divorce; domestic violence visitation

Although most states mandate consideration of intimate partner violence in child custody proceedings, little is known about how often a preexisting history of intimate partner violence (IPV) is effectively presented to the courts in dissolution cases and, when it is, what effect it has on child custody and visitation outcomes.
AUTHORS NOTE: This project was supported by the History of Intimate Partner Violence and the Determination of Custody and Visitation Among Couples Petitioning for Dissolution of Marriage from the National Institute of Justice, Grant No. 2000-WT-VX0016. The views expressed herein represent those of the authors and do not purport to reflect the position of the National Institute of Justice or the U.S. Department of Justice.
VIOLENCE AGAINST WOMEN, Vol. 11 No. 8, August 2005 991-1021 DOI: 10.1177/1077801205278042 2005 Sage Publications

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More than 1 million children are the subjects of custody determinations in the United States annually (Clarke, 1995; Munson & Sutton, 2004), and it is likely that more than 150,000 of these children live in households experiencing IPV (Clarke, 1995; Holden, Geffner, & Jouriles, 1998). Custody determinations have the potential to significantly affect the future health and safety of victims of IPV and their children, yet, to date, there is little analytical research evaluating whether and how custody arrangements take into consideration a history of parental IPV. Two bodies of research provide evidence of why it is important to give heavy consideration to a history of parental IPV in child custody proceedings. One body of research has focused on the direct consequences of custody/visitation determinations or exchanges on female victims and their children. Focus group studies and case study reports suggest that joint custody or visitation arrangements often provide an opportunity for continued abuse of both the women and their children (Henderson, 1990; Shalansky, Ericksen, & Henderson, 1999; Susser, 2000). Ongoing threats, relinquishment of legal rights out of fear of their abusers, difficulty in having children returned on time from visitation, and continued physical and emotional abuse characterize the reports made by women who share children in common with, but no longer live with, their abusers (Henderson, 1990; Shalansky et al., 1999; Susser, 2000). Liss and Stahly (1993), in a study of custody problems experienced by clients served by domestic violence agencies in California, found that 25% of abusers verbally or emotionally abused their expartners, 10% physically abused them, and 34% threatened child kidnapping during child visitation. The authors also reported that 19% of abusers threatened contesting custody in an effort to force their victims to return to the abusive relationship. Disturbingly, 20% of clients reported returning to the abusive relationship because of their abusers threats to hurt or take the children. McMahon and Pence (1994) report that almost one third of violations of court orders occurring in Duluth, Minnesota, in 1988 occurred during child visitation exchanges. Hart (1990) described this in her review of this topic:
If the product of custody mediation locks the mother into compulsory consultation with the batterer about every aspect of the childrens lives, his continuing use of violence and terroristic controls

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will preclude the autonomy and safety she sought in leaving the relationship (p. 326).

A second body of research, which is far more developed, has focused on the profound and far-reaching effects of IPV on children growing up in these households. Children growing up in homes in which their mothers are being abused are at serious risk of behavioral disturbance (Cummings, Pepler, & Moore, 1999; Fantuzzo et al., 1991; Holden et al., 1998; Kernic, Holt, et al., 2002; Kernic, Wolf, et al., 2003; OKeefe, 1994; Wildin, Williamson, & Wilson, 1991), poor academic performance (Gleason, 1995; Jaffe, Wolfe, Wilson, & Zak, 1985, 1986; Wildin et al., 1991), child abuse (Ross, 1996; Rumm, Cummings, Krauss, Bell, & Rivara, 2000), and repeating the cycle of violence by becoming future perpetrators or victims of IPV (Ehrensaft et al., 2003; Fagan & Browne, 1994). Furthermore, research in the area of high-conflict marriages and divorce suggests that children who continue to be exposed to highly conflictual interactions between parents in joint custody arrangements or with frequent access to a noncustodial parent tend to have more behavioral problems both during childhood and into early adulthood (Hetherington & Stanley-Hagan, 1999; Johnston, 1994). Most states currently provide for the consideration of a history of IPV as a factor in making child custody determinations (Levin & Mills, 2003); the Model Code on Domestic and Family Violence established by the National Council of Juvenile and Family Court Judges (NCJFCJ) specifically recommends as a model statute that states go one step further to set a rebuttable presumption that it is in the best interests of the child that a spousally abusive parent not receive sole or joint custody of that child (NCJFCJ, 1994). This position has been supported by the United States Congress, the American Bar Association, and the American Medical Association among others (Drye, 1999; Lemon, 1999). A minority of states have yet to adopt this standard (Levin & Mills, 2003). Most states, including Washington State, allow or require courts to consider a history of IPV as one factor among many in adhering to the best interests of the child standard in the custody decision-making process, applying what is termed a factor test (Drye, 1999; Hart, 1991; Levin & Mills, 2003). Lemon (1999), in a recent review, defined the best interest of the child standard as the custody or

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visitation arrangement [that] will provide for the health, safety and general well-being of the child (p. 69). Problems associated with this approach with regard to IPV families have been widely described in the legal and social sciences literature. Among these issues are the failure of courts to screen for existing IPV; requiring that the burden of proof fall on the victim to provide objective evidence of an often private, nondisclosed crime; lack of education of court personnel in recognizing the traumatic effects of IPV on its victims; and questioning the victims credibility and their disclosure of abuse as fraudulent or exaggerated (Lemon & Jaffe, 1995; Matthews, 1999; McHardy & Hofford, 1999). The use of the factor test in child custody cases involving domestic violence has been criticized for leaving too much room for judicial discretion in its application, often at the expense of the safety of victims and their children (Cahn, 1991; Drye, 1999; Reihing, 1999; Susser, 2000). Additionally, the historical trend toward shared custody situations and friendly parent provisions that favor the parent who is more likely to encourage continued contact with the other parent is inherently biased against victims of IPV (Cahn, 1991). Few studies have evaluated the association between a history of IPV and child custody and visitation decisions (Drye, 1999; Lye, 1999; Sorensen et al., 1995). Sorensen et al. (1995) evaluated custody determinations among 60 custody dispute cases in Florida. At least one allegation of parental misconduct in the form of child abuse, spousal abuse, or substance abuse occurred in 83% of the cases. The authors found any allegation of parental unfitness to be associated with decreased likelihood of being awarded primary residential custody. Unfortunately, the authors did not have a sufficient sample size to report on spousal abuse allegations separately and relied on the select sample of cases in which custody was being contested. Another study evaluated custody determination among a random sample of all dissolution cases handled in Spokane County, Washington (Drye, 1999). In this study, IPV and child abuse histories were ascertained from case file data only. Custody decisions were compared between those couples with and without a reported history of either IPV or child abuse. That study found that the courts were more likely to appoint the nonabusing parent as the primary residential custodian and to order supervised visitation for abusing parents. However, the authors evaluated the

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presence of either spousal or child abuse jointly, so it is uncertain whether the custody determinations differed based on presence of spouse abuse alone. Additionally, the authors were limited to data available in the case file for the identification of a history of abuse. Furthermore, the authors note that although some restrictions were more likely to occur among those with a known history of IPV, a disturbing proportion of abusive partners were allowed free access to children. Case study reports express the concern and frustration of women who reported that their abusers received custody access directly after committing criminal acts of domestic violence (Shalansky et al., 1999). Although a strong consensus exists on the consideration of IPV as a factor in custody decision making, little research has been conducted to document the prevalence of IPV among couples undergoing custody determinations, or to note how often policeor court-reported IPV is actually documented in these cases, much less to determine the specifics of custody and visitation decisions among couples with a history of IPV. At the outset of this study, we hypothesized that the court system has not yet met the challenge of addressing custody determinations in IPV cases for a number of reasons. The dynamics of IPV tend to be counterintuitive and are often poorly understood by those without specific training. It is unclear to untrained individuals why victims have remained in the abusive relationship, why they have rarely sought help, and why they have little or no documentation of the abuse. Isolation tactics, limiting economic resources, and emotional abuse are consistently reported as tactics used by abusers both to control their victims and limit others knowledge of the abuse (Rose, Campbell, & Kub, 2000; Wolf, Holt, Kernic, & Rivara, 2000). IPV victims are often depressed and suffering from posttraumatic stress disorder, and as such, may perform poorly in their presentation to the court and on the psychological assessments that are sometimes conducted in custody disputes (Golding, 1999). The psychological aftermath of abuse may lead to the appearance that the batterer will make a more fit parent than the victim. Recent case studies involving court observations of judges and court personnel have found that trivialization of IPV relative to other criminal acts of violence, victim blaming, lack of education regarding the effects of IPV on children and victim mental health, and prioritization of the paternal rights of the

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abuser over those of the victim and her children are still current issues (Meier, 2003; Ptacek, 1999). Limitations within the court system itself may also contribute to the failure to identify IPV and the failure to offer sufficient protections to victims and children affected by IPV with regard to custody determinations. Courts may fail to identify a history of IPV for many reasons, including the lack of coordination of related family law and domestic violence cases, lack of access and coordination of existing law enforcement and legal records, and reliance on the victims voluntary self-disclosure (McHardy & Hofford, 1999). Evidentiary rules are such that the burden of proof is placed on victims rather than abusers, and spouse abuse is erroneously dismissed as irrelevant to a persons ability to parent (Jaffe & Geffner, 1998). Model codes acknowledge that a history of IPV is relevant to custody determinations in that batterers are much more likely than nonabusive partners to abuse their children (Ross, 1996; Rumm et al., 2000), and many adverse outcomes have been documented among children who witness their mothers abuse (Cummings et al., 1999; Fantuzzo et al., 1991; Gleason, 1995; Holden et al., 1998; Jaffe et al., 1985, 1986; Kernic, Holt, et al., 2002; Kernic, Wolf, et al., 2003; OKeefe, 1994; Wildin et al., 1991). The aim of this retrospective cohort study was to examine the relationship between a history of IPV and determination of child custody and visitation agreements among a population-based sample of couples undergoing dissolution of marriage. We examined this relationship through two related activities. First, we used data abstracted from court case files to determine specific custody and visitation outcomes among couples obtaining a marriage dissolution. Second, we compared the frequency of occurrence of each of these outcomes among couples with a history of IPV, categorized by whether the IPV was substantiated or not, and whether this history of IPV was known to the court handling the dissolution, to the frequency among couples without a history of IPV. This study allowed us to explore the hypothesis that IPV history is either discounted or not known to the court in the marriage dissolution process. Knowledge of which factor (lack of knowledge of the IPV history or discounting the known IPV history) is most prevalent can have important influence on custody determination policy. We used existing population-based data sources to calculate each of the outcomes of interest by IPV history. We chose

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to focus on the overall population of custody cases rather than restrict our focus to cases in which custody was being disputed. We chose this focus to best assess the overall impact of IPV on child custody outcomes regardless of differences in procedural complexity or court evaluative procedures. It is our goal, nonetheless, to address these separate matters in future research with these data. METHOD
SAMPLE

The study population consisted of Seattle couples with minor children petitioning for dissolution of marriage. A total of 2,796 couples with children under the age of 18 years and with at least one member listing a Seattle residence filed for marriage dissolution between January 1, 1998, and December 31, 1999. Of those 2,796 couples, 280 did not complete the dissolution process or were granted a change of venue outside the King County Court System and thus were ineligible for the study. The remaining 2,516 couples were merged to police- and court-reported sources of IPV data to determine whether a history of police- or courtreported male-perpetrated IPV existed. Upon merging, 142 cases were found to have police or court records of IPV following but not prior to filing for dissolution of marriage. These cases were excluded because our research questions involved examining the effect of preexisting IPV on child custody determinations. From the remaining 2,374 cases, sampling consisted of taking a 100% sample of couples with an identified history of IPV (n = 297) and a 33.8% random sample of those without an identified history of IPV (n = 703), for a total potential sample size of 1,000 (see Figure 1). Of the 297 cases with a history of IPV based on police and court order data, 40 cases were found to be ineligible once court dissolution records were obtained. Eleven eligible cases in the IPV-positive group were excluded for the following reasons: case file was missing (n = 2), no decree or final parenting plan could be located (n = 3), the child was kidnapped (n = 1), and the case was sealed (n = 5) and therefore unavailable to study staff. This left 246 IPV-positive cases for analysis (95.7% of eligible IPV-positive cases).

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Seattle Dissolutions involving Children January 1, 1998 to December 31, 1999 n = 2,516 142 excluded for IPV occurrences ONLY occurring post-dissolution filing n = 2,374 Initial IPV-positive sample: Initial IPV-negative sample:
(NO Police- or court-involved IPV history) n = 703 (33.8% sample of 2077 potential subjects) (Police- or court-involved IPV incident preceding the petition for dissolution) n = 297 (100% sample of 297 potential subjects) Found ineligible post-sampling: Eligible but excluded:
Reason excluded: Case file missing No decree/Final Parenting Plan Child kidnapped Case sealed Total 1 5 11 Reason ineligible: Child >=18 years at FPP Dismissed Duplicated case Children from prior relationship No children involved No jurisdiction over children Not in custody of parents Pre-1998 case Substantiated IPV by wife Total

Found ineligible post-sampling:

n 2 3

Eligible but excluded:

Reason excluded: Case file missing No decree/Final Parenting Plan Child kidnapped Case not abstracted Case sealed Total

n 6 2 n 22 25 1 3 3 11 3 1 11 80
1 1 3 13

Reason ineligible: Child >=18 years at FPP Dismissed Duplicated case Children from prior relationship No children involved No jurisdiction over children Not in custody of parents Pre-1998 case Substantiated IPV by wife Total

n 3 11 0 2 0 0 3 1 20 40

Final IPV-positive sample:

(Police- or court-involved IPV incident preceding the petition for dissolution) n = 246 (95.5% of eligible subjects)

Final IPV-negative sample:

(NO Police- or court-involved IPV history) n = 610 (97.9% of eligible subjects)

Figure 1: Study Sampling Overview NOTE: IPV = intimate partner violence; FPP = Final Parenting Plan.

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Of the 703 cases with no history of IPV based on police and court order data, 80 cases were found to be ineligible once court records were located. Thirteen eligible cases in the comparison (IPV negative) group were excluded for the following reasons: case file was missing (n = 6), no decree or final parenting plan could be located (n = 2), the child was kidnapped (n = 1), the case was inadvertently marked as having been abstracted when it was not (n = 1), and the case was sealed (n = 3) and therefore unavailable to study staff. This left 610 (97.9% of eligible cases) IPV-negative cases for final analyses. Following abstraction of study data from the case files, 16 cases initially classified as IPV negative, based on police and court order data, were found to have substantiated allegations of IPV by the husband against the wife documented in the dissolution case file. These 16 cases were transferred to the IPV-positive group. Additionally, 62 cases in the IPV-negative group had unsubstantiated allegations of IPV documented in the dissolution case file. These 62 cases were also transferred to the IPV-positive group. This yielded final sample sizes of 324 IPV-positive (262 substantiated and 62 unsubstantiated allegations) and 532 IPVnegative cases.
IPV EXPOSURE

The exposure of interest for this study was a preexisting history of IPV. Specifically, exposure was defined as either a history of Seattle police-reported IPV, court records denoting the filing of a civil protection order or criminal no contact order that preceded the filing of the petition for dissolution, or the notation of allegations or a substantiated history of IPV in the dissolution case file. King County Superior Court dissolution records for all potential participants were linked with incidents of IPV reported to the Seattle Police Department (SPD) between November 1994 (inception of the domestic violence-specific database) and the date the petition for dissolution was filed with King County Superior Court. Similarly, we linked all data on dissolutions to King County Courts records of civil protection order and criminal no contact order filings between July 1997 (the inception of this database) and the date the petition for dissolution was filed with King County Superior Court. Couples with a history of IPV identified

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from the SPD database, Superior Court protective order data, or dissolution case file comprised the overall exposed group. The exposed group was further classified according to presence of alleged versus substantiated IPV, and whether the history of IPV was documented in the dissolution case file, and therefore known to the court. Substantiation of IPV was defined as allegations of IPV that were supported by formal documentation including police reports, court reports, professional agency reports, or confession by the abusive partner. This classification scheme resulted in three IPV-exposed groups: those with substantiated IPV (based on police or court protective order data) that was not documented in the dissolution case file (and presumably unknown to the court; the SUC group); those with unsubstantiated allegations of IPV present in the dissolution case file (the unsubstantiated IPV allegations [AKC] group); and those with substantiated IPV (based on police data, court protective order data, or court case file data) that was documented in the dissolution case file (the SKC group). Because the disproportionate share of severe abuse is experienced by female victims of IPV (Tjaden & Thoennes, 2000), we limited our study to examining exposure to IPV involving female victims and male abusers. Therefore, couples with a history of IPV in which the husband was the victim and the wife was the abuser were excluded from the initial determination of IPV positivity (made by merging to police and court data). Similarly, those cases in which substantiated IPV perpetrated by the female member of the couple was identified from case file data were excluded. Cases in which substantiated IPV perpetrated by the female member of the couple was identified but additional documentation later confirmed the male partner of the couple as the primary aggressor were retained in the analyses. Because we focused on male-perpetrated IPV in this study, our outcomes of interest reflect restrictions placed on fathers. This was done specifically to compare outcomes reflective of restrictions placed on fathers who have a history of IPV perpetration relative to fathers without such a history. This in no way suggests that barring any other compelling factors, comparison group fathers warrant any restriction of their parental rights. The comparison group consisted of a random sample of couples with minor children petitioning for marriage dissolution with no history of police- or court-reported IPV and no evidence

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of either allegations of IPV or substantiated IPV in the dissolution case file. Specifically, those couples with neither a history of police-reported IPV since November 1994 nor a court protective order filing between July 1997 and the filing of the petition for dissolution comprised the pool from which the comparison group was sampled. Any comparison participants found to have either allegations of IPV or substantiated IPV based on data abstracted from the dissolution case file (examined after the sampling of study participants) were subsequently excluded from the comparison group and included in the IPV-exposed group.
REVIEW OF THE DISSOLUTION CASE FILE

The bulk of the data collected in the study was gathered through data abstraction from participants dissolution case files housed at the King County Superior Court Clerks Office. Court case files include all public filings related to court cases and are kept in paper format for cases filed during the study period. Case file data were captured on standardized abstraction coding sheets drawing data elements from pertinent court filings including the following: the original petition for dissolution; proposed and final parenting plans; confirmation of issues at the onset of the dissolution process; declarations by the wife or mother, husband or father, and third parties; protective court orders, family court services notification, involvement, and reports; other professional agency reports and evaluations, court orders for drug and alcohol services, supervised visitation, and appointment of court advocates and investigators; and family law motions, order of child support, and court findings of fact. All filings included in the case file, with the exception of documentation of financial assets and liabilities, were examined for the presence of information on IPV exposure, confounding factors, procedural variables, and custody outcomes of interest.
CHILD CUSTODY AND VISITATION OUTCOMES

The marriage dissolution process in Washington State for those couples who share children in common is described in this section. The process is initiated by one party filing with the regional Superior Court for dissolution of marriage (divorce) involving

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children. This filing is recorded and contained in the Washington State Justice Information System, a database collection comprised of civil, criminal, and juvenile court proceedings in Washington State Courts. In Washington State, all dissolutions involving dependent children require the development of a court-approved parenting plan. The purpose of the parenting plan is to establish a primary residential parent, to explicitly detail visitation arrangements and limitations and to establish shared or joint decisionmaking authority regarding the childrens affairs (Drye, 1999; Lye, 1999; Reihing, 1999; Rosenbaum, 1994). Following the filing of a petition for divorce, the spouse who did not file the petition is served with the petition and may choose to agree with the terms of the divorce (including a temporary parenting plan that may be served with the petition for divorce) or to disagree with the terms formally by submitting an answer to the petition with the court. Initial disagreement with the terms of the divorce requires mediation between the parties except in cases in which a history of domestic violence has been found. In these cases, mediation is waived, and an evaluation by a third party agency (Family Court Services, a Court Appointed Special Advocate, a Guardian Ad Litem, or a private agency) is recommended. For nonabusive couples, following mediation, if agreement is not reached on all issues, a process of changes is proposed by one party and responded to by the opposing party, and a hearing is set to establish a temporary parenting plan and to temporarily settle other immediate concerns. For couples with a history of abuse, following evaluation, a review of the evidence collected is examined by the court, and if agreement is reached between the parties, the divorce and the parenting plan are finalized. If agreement is not reached, a hearing is set to establish a temporary parenting plan and to temporarily settle other immediate concerns. The hearing process may be entered into repeatedly by couples with or without a history of abuse, in an attempt to reach agreement between the parties on all outstanding issues. If agreement is not reached through the hearing process, the parties proceed to either a settlement conference, which may serve as a last resort to reach an agreement before proceeding to a trial, or directly to trial. Each of these steps is documented in the docket of the dissolution case file and recorded into the court data system and subsequently into the Washington State Justice Information System.

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The study population was followed through resolution of the dissolution, which procedurally includes the courts approval of a final parenting plan (the child custody and visitation agreement). Custody outcomes for this study were those arrangements approved by the court at the time the dissolution was finalized. Appeals or modifications to the final parenting plan occurring after the issuance of the decree of dissolution were not examined. Outcomes of interest were abstracted from court data following case resolution and included the proportion of cases in which (a) the mother was assigned as the primary residential parent, (b) visitation was denied to the father, (c) any restriction (e.g., no overnight visits, no consumption of alcohol during visits, suspension of visitation upon any evidence of subsequent violent behavior) was placed on the fathers visitation with the child(ren), (d) the court ordered that visitation between the father and the child(ren) be supervised by a third party, (e) the court ordered restrictions on the fathers decision-making authority regarding the child(ren)s affairs, and (f) treatment program completion or other requirements (e.g., attend domestic violence classes, substance abuse classes, maintain sobriety) were made as a prerequisite or condition of the father s award of visitation.
POTENTIAL CONFOUNDERS

Potential confounding factors examined in the analyses included those factors statutorily mandated to result in restrictions of parental rights to custody or visitation (i.e., parent or someone that the parent resides with has sexually abused a child or committed another sex offense); factors that the court may consider in otherwise limiting a parents visitation time, parental decisionmaking authority, and future methods of dispute resolution (i.e., willful abandonment of child; refusal to perform parenting functions; physical, sexual, or pattern of emotional child abuse; committed an assault or sexual assault, which caused grievous bodily harm or the fear of such harm; committed a sex offense that does not result in complete restriction of child contact; long-term emotional impairment, physical impairment, or substance abuse problem that interferes with ability to perform parenting functions; absence of emotional ties between parent and child; abusive use of conflict that creates the danger of damage to the childs

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psychological development; withholding other parents access to child without good cause; and other factors related to the childs best interests; Washington State Parenting Act, 1987; see also NCJFCJ, 1994). Other factors not among those explicitly mentioned in Washington statutes as those to consider in the courts child custody decision-making process, but which nevertheless were considered as potential sources of influence in that process, were also examined as potential confounders (Wallace & Koerner, 2003). These factors included mothers and fathers ages, mothers and fathers legal representation in the dissolution process, which party filed for dissolution (i.e., petitioner status), mothers and fathers income, maternal and paternal failure to protect child from dangerous adults (other than the abusive father), maternal and paternal physical abuse of other parties (persons other than partner or child), maternal and paternal emotional abuse of other parties, maternal and paternal criminal history (including but not limited to sexual offenses), maternal and paternal failure to comply with court requirements, maternal and paternal mental health issues, concerns about ownership of or prior police confiscation of weapons, other measures of potential parental unfitness, opposition of one parent to mutual decision making (considered for decision-making outcome only), and a summary measure denoting the presence of any factor statutorily warranting consideration or mandatory restriction of custodial rights.
ANALYTIC METHOD

Multiple logistic regression was the primary statistical method employed in the analysis of study data (Rothman, 1986). Primary analyses involved comparing custody and visitation outcomes among couples in the IPV-exposed study groups relative to couples without a history of IPV. The effects of potentially confounding factors were evaluated for their singular and combined effects on the risk estimate. Comparison was made between the unadjusted risk estimate and that obtained following adjustment. A 10% change in the risk estimate was used as a minimal guideline for inclusion of confounders (Maldonado & Greenland, 1993; Rothman, 1986). Additionally, the following variables were assessed as potential effect modifiers of the IPV-custody outcome

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association: any paternal child abuse, current paternal substance abuse problem, any statutory restrictions against the father, and which party petitioned to dissolve the marriage. We performed significance testing of the inclusion of a multiplicative interaction term between the exposure of interest and the potential effect modifier to assess for meaningful effect modification of the IPVcustody outcome association. We did not find evidence of effect modification by any of these four factors. Therefore, we provide only unstratified summary estimates of the effect of IPV on each of the outcomes of interest. RESULTS
POLICE AND COURT ORDER IPV AND IPV DOCUMENTATION IN DISSOLUTION CASE FILES

Accounting for exclusions because of ineligibility found during the abstraction process, we estimate the total eligible dissolutions involving children during the study period to be 2,396. Of these 2,396 eligible dissolution filings, 257 (10.7%) cases had police incidents or court orders indicating a preexisting history of male-perpetrated IPV. In the 246 cases of the 257 that we were able to involve in the study, 117 (47.6%) had no mention of IPV in the dissolution case file; 71 (28.9%) had only unsubstantiated allegations of IPV documented in the dissolution case file (i.e., none of the prior police or court records were submitted as evidence); and only 58 (23.6%) cases had substantiated allegations of IPV documented in the dissolution case file. Of the 610 cases with no police incident or court order history of IPV, 62 (10.2%) cases had unsubstantiated allegations of IPV and 16 (2.6%) cases had substantiated allegations of IPV documented in the dissolution case file. Based on police incident, court order, and dissolution findings of substantiated male-perpetrated IPV, we estimate that at least 11.4% of Seattle dissolutions with dependent children involve a substantiated history of male-perpetrated IPV.
DEMOGRAPHIC CHARACTERISTICS OF STUDY GROUPS

Couples with a history of substantiated IPV known to the court (SKC) or substantiated IPV unknown to the court (SUC) differed

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significantly from the comparison group of nonabusive divorcing couples on several demographic variables (Table 1). On average, fathers in the two substantiated IPV groups had lower monthly incomes relative to comparison group fathers, and parents in these two groups were younger than the comparison group (IPV negative) parents. Mothers income was significantly lower in the SUC group relative to the comparison group. Fathers residence also differed significantly among the substantiated IPV groups relative to the comparison group, with more SUC and SKC fathers residing outside of Seattle or in jail or prison relative to comparison group fathers.
OTHER PARENTAL FACTORS

Additional group differences included greater prevalence of child abuse allegations, withholding other parents access to child, kidnapping or threats of kidnapping, lack of compliance with court requirements, mental illness, and substance abuse problems among IPV group parents relative to comparison group parents (data not shown).
CUSTODY OUTCOMES

Mother awarded custody. The analysis of the proportion of cases in which the mother received primary residential parent status (i.e., primary child custody) was limited to the 786 cases (91.8%) in which either the mother or father was awarded primary custody. Cases in which both parents were assigned as legal primary residential parent were excluded from the analysis. Note that in Washington State, even in custody arrangements in which the child spends an equal amount of time with both parents, one parent is typically assigned as the primary residential parent (legal custodial parent). Of those cases in which custody was awarded to either the mother or father, mothers were awarded custody in 86.5% of the IPV-negative cases, and 92.9%, 92.6%, and 91.2% of the SUC, AKC, and SKC cases, respectively. After adjusting for relevant confounders, mothers in the IPV-positive groups were no more likely than comparison group mothers to be awarded child custody (Table 2).
(text continues on page 1011)

TABLE 1 Characteristics of Study Population by History of IPV No IPV % (n = 532) Substantiated IPV Unknown to Court % (n = 117) IPV Allegations Substantiated IPV Known Known to Court % (n = 62) to Court % (n = 145)

26.5 21.6 21.1 19.4 11.5 25.2 20.9 21.1 19.0 13.9 25.0 37.6 33.9 3.5 15.9 38.2 37.0 8.1 33.0 47.8 14.8 3.5
a

9.4 12.8 29.1 30.8 18.0 9.4 18.8 23.9 29.9 18.0 47.4 41.4 8.6 2.6
a a

27.4 40.3 14.5 14.5 3.2 29.0 27.4 16.1 22.6 4.8 17.2 41.4 36.2 5.2 9.8 42.6 41.0 6.6

14.5 24.8 24.1 26.2 10.3

15.2 22.8 23.5 23.5 15.2 36.4a 44.1 19.6 0.0 19.6 50.4 27.3 2.8
b

Demographics Fathers gross monthly income More than $4,283 (highest quartile) $2,686 to $4,282 $1,800 to $2,685 Less than $1,800 (lowest quartile) Unknown Mothers gross monthly income More than $2,829 (highest quartile) $1,818 to $2,828 $1,225 to $1,817 Less than $1,225 (lowest quartile) Unknown Mothers age 20 to 29 years 30 to 39 years 40 to 49 years 50 to 59 years Fathers age 18 to 29 years 30 to 39 years 40 to 49 years 50 to 59 years

1007

(continued)

1008 TABLE 1 (continued) No IPV % (n = 532)

a

Substantiated IPV Unknown to Court % (n = 117)

IPV Allegations Substantiated IPV Known Known to Court % (n = 62) to Court % (n = 145)
d

Fathers residence Seattle Washington State (not Seattle) United States (not Washington State) Outside of United States Jail or prison Mothers residence Seattle Washington State (not Seattle) United States (not Washington State) Outside of United States 65.1 31.9 0.8 1.7 0.4 58.1 39.4 1.0 1.5 70.0 29.0 1.0 0.0 62.5 37.5 0.0 0.0 65.6 28.0 1.1 0.0 5.4 70.4 29.6 0.0 0.0 0.0

55.3 42.3 0.8 0.0 1.6

61.2 38.8 0.0 0.0

NOTE: IPV = intimate partner violence. a. Participants in this group differed significantly from the comparison group for this variable (p < .001); Fishers Exact used when an expected cell was less than n = 5. b. Participants in this group differed significantly from the comparison group for this variable (p < .01); Fishers Exact used when an expected cell was less than n = 5. c. Participants in this group differed significantly from the comparison group for this variable (p < .05); Fishers Exact used when an expected cell was less than n = 5. d. Participants in this group showed marginally significant differences from the comparison group for this variable (p = .05); Fishers Exact used when an expected cell was less than n = 5.

TABLE 2 Custody and Visitation Outcomes by IPV Status Proportion With Outcome
a

Outcome and IPV Group 86.5 92.9 92.6 91.2 4.6 6.7 0.0 16.8 17.5 40.0 46.0 71.2 9.6 12.4 30.0 51.2 4.6 10.5 6.0 25.6 1.0 2.1 3.6 1.6 1.0 1.1 0.0 3.2 1.0 2.2 2.2 4.6 1.0 0.8 0.9 2.1 1.0 0.9 1.1 2.3

OR

95% CI

0.9, 4.5 0.4, 31.7 0.5, 5.1 0.4, 3.0 c 0.0, 1.8 1.1, 9.4 1.3, 3.8 0.8, 5.9 2.3, 9.4

Mother awarded custody No IPV (n = 482) Substantiated IPV unknown to court (n = 113) IPV allegations known to court (n = 54) Substantiated IPV known to court (n = 137) b Father denied visitation No IPV (n = 417) Substantiated IPV unknown to court (n = 105) IPV allegations known to court (n = 50) Substantiated IPV known to court (n = 125) d Restrictions placed on time or conditions of fathers visitation No IPV (n = 417) Substantiated IPV unknown to court (n = 105) IPV allegations known to court (n = 50) Substantiated IPV known to court (n = 125) Court mandated treatment, counseling or other requirements as e a condition of or prior to fathers visitation No IPV (n = 417) Substantiated IPV unknown to court (n = 105) IPV allegations known to court (n = 50) Substantiated IPV known to court (n= 125) f Third-party supervision required of fathers visitation No IPV (n = 417) Substantiated IPV unknown to court (n = 105) IPV allegations known to court (n = 50) Substantiated IPV known to court (n = 125)

0.4, 1.8 0.3, 2.3 1.1, 4.1 0.4, 2.1 0.2, 5.0 0.9, 5.8 (continued)

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1010 TABLE 2 (continued) Proportion With Outcome

g

Outcome and IPV Group 15.4 41.0 22.0 60.8 1.0 3.1 0.6 3.8

OR

95% CI

Restrictions placed on fathers parental decision-making authority No IPV (n = 417) Substantiated IPV unknown to court (n = 105) IPV allegations known to court (n = 50) Substantiated IPV known to court (n = 125)

1.8, 5.2 0.2, 1.9 1.9, 7.6

NOTE: IPV = intimate partner violence; OR = odds ratio; CI = confidence interval. a. Adjusted for allegations of any child abuse by father, any child abuse by mother, current substance abuse by father, current substance abuse by mother, any statutorily restrictive factors against father, any statutorily restrictive factors against mother, legal representation of mother and petitioner status. b. Adjusted for allegations of any child abuse by father, any statutorily restrictive factors against mother, any abuse of others by father, noncompliance with court requirements by father, legal representation of father, and mothers age. c. Unadjusted and based on Fishers Exact chi-square. d. Adjusted for allegations of any child abuse by father, intimate partner violence by mother, other measures of parental unfitness against father, any statutorily restrictive factors by father, any statutorily restrictive factors by mother, legal representation of father, and mothers age. e. Adjusted for allegations of any child abuse by father, any statutorily restrictive factors by father, current substance abuse by father, any statutorily restrictive factors by mother, intimate partner violence by mother, other measures of parental unfitness against father, other measures of parental unfitness against mother, legal representation of mother, and mothers age; limited to cases in which the mother was awarded primary custody. f. Adjusted for allegations of any child abuse by father, any statutorily restrictive factors by father, current substance abuse by father, other measures of parental unfitness against father, other measures of parental unfitness against mother, legal representation of father, mothers age, and petitioners status. g. Adjusted for allegations of current substance abuse by father, current substance abuse by mother, intimate partner violence by mother, any statutorily restrictive factors relevant to decision making by father, mothers opposition to sharing decision making with father, and legal representation of father.

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Father denied visitation. The proportion of cases in which the father was denied visitation, as with each of the remaining study outcomes, was calculated among those cases in which the mother was awarded primary custody. This choice was made to evaluate how often these restrictions were imposed on fathers, specifically because of our focus on the effects of male-perpetrated IPV on custody determinations. Nineteen (4.6%) fathers in the comparison group were denied visitation compared to seven (6.7%) fathers in the SUC group and 21 (16.8%) fathers in the SKC group. None of the 62 fathers in the AKC group were denied child visitation. After adjustment for any child abuse by father, any statutorily restrictive factors against mother, any abuse of others by father, noncompliance with court requirements by father, legal representation of father, and mothers age, SKC fathers were significantly more likely than comparison group fathers to be denied child visitation (OR = 3.2; 95% CI: 1.1, 9.4). The SUC fathers and AKC fathers were no more likely than comparison group fathers to be denied child visitation. Restrictions placed on fathers visitation. Restriction in the time or conditions (e.g., no overnight visits, no consumption of alcohol during visits, suspension of visitation if any evidence of subsequent violent behavior) of fathers visitation was placed on 40.0% of SUC fathers, 46.0% of AKC fathers, and 71.2% of SKC fathers compared to 17.5% of fathers with no documented history of IPV. After adjusting for allegations of any child abuse by father, IPV by mother, any allegations against either parent of acts or behaviors for which statutory restrictions are mandated or suggested, allegations of other types of parental unfitness against the father, mothers age, and legal representation of father, fathers in both the SUC and the SKC cases were more likely than comparison group fathers to have restrictions placed on their child visitation (OR = 2.2, 95% CI: 1.3, 3.8 and OR = 4.6, 95% CI: 2.3, 9.4, respectively). The risk of visitation restrictions was nonsignificantly elevated for AKC group fathers (OR = 2.2, 95% CI: 0.8, 5.9). Treatment and other mandated requirements. Requirements (e.g., attend domestic violence classes, substance abuse classes, maintain sobriety) were ordered for 12.4% of SUC fathers, 30.0% of

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AKC fathers, and 51.2% of SKC fathers compared to 9.6% of fathers without a history of IPV. In multiple logistic regression analyses, after adjusting for allegations of any child abuse by father, fathers current substance abuse problem, IPV by mother, statutory restrictive allegations by either parent, other measure of parental unfitness by either parent, mothers legal representation, and mothers age, court mandated requirements were significantly more common only among SKC fathers relative to comparison group fathers (OR = 2.1; 95% CI: 1.1, 4.1). The SUC fathers and AKC fathers were no more likely than comparison group fathers to be ordered to meet specific court requirements prior to or as a condition of child visitation (OR = 0.8, 95% CI: 0.4, 1.8 and OR = 0.9, 95% CI: 0.3, 2.3, respectively; Table 2). Requirement of supervised visitation. Supervision of the fathers visitation was required of 10.5% of SUC fathers, 6.0% of AKC fathers, and 25.6% of SKC fathers compared to 4.6% of fathers with no documented history of IPV. Multiple logistic regression analyses revealed that supervised visitation was no more likely among SUC fathers nor among AKC fathers relative to fathers with no known history of IPV after adjusting for paternal child abuse, current paternal substance abuse problem, statutorily restrictive allegations against the father, allegations of other forms of parental unfitness against either parent, legal representation of father, petitioner status, and maternal age (OR = 0.9, 95% CI: 0.4, 2.1 and OR = 1.1, 95% CI: 0.2, 5.0, respectively). Risk of third party supervision was nonsignificantly elevated for the SKC group relative to comparison group fathers (OR = 2.3, 95% CI: 0.9, 5.8). Restrictions on fathers decision making. Restrictions on the fathers decision-making authority were placed on 41.0% of SUC fathers, 22.0% of AKC fathers, and 60.8% of SKC fathers compared to 15.4% of comparison group fathers. After adjustment for allegations of current substance abuse by father, current substance abuse by mother, IPV by mother, any statutorily restrictive factors relevant to decision making by father, mothers opposition to sharing decision making with father, and legal representation of father, restrictions of fathers parental decision-making authority were significantly more common among SUC fathers (OR = 3.1, 95% CI: 1.8, 5.2) and SKC fathers (OR = 3.8, 95% CI: 1.9,

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7.6) relative to comparison group fathers. Restriction of parental decision-making authority was comparable between AKC fathers and comparison group fathers (OR = 0.6, 95% CI: 0.2, 1.9). DISCUSSION This retrospective cohort study was designed to examine the frequency of documentation of a known history of IPV substantiated by police and court records in marriage dissolution proceedings involving dependent children and to examine that historys effect on child custody and visitation determinations. We found that 11.4% of Seattle marriage dissolutions involving children had a history of substantiated, male-perpetrated, police- or courtreported IPV. Assuming the rate in Seattle is an appropriate approximation for the United States, we estimate that 125,400 children from households with male-perpetrated police- or courtreported IPV are the subjects of custody actions in the United States each year (Clarke, 1995). This estimate is likely conservative in that it does not account for IPV not reported to the police or courts, and it does not account for the demographic characteristics of Seattle that would likely bias the prevalence of IPV downward. The findings from this study highlight several issues of concern regarding the reality of child custody among families with a history of IPV. These include two primary concerns: a lack of identification of IPV even among cases with a documented, substantiated history, and a lack of strong protections being ordered even among cases in which a history of substantiated IPV is known to exist. Jaffe and Geffner (1998), referring to their extensive history of conducting evaluations for child custody proceedings, noted that the nonidentification of domestic violence in divorce cases (p. 381) is a prevalent and problematic issue. Our findings provide strong support for this assertion. Almost one half of those cases with a history of police- or court-reported IPV had no mention of IPV whatsoever in the dissolution case file, and more than half of the remainder had documentation of allegations of IPV with no substantiation, although such evidence clearly existed. Several contributory factors have been recognized as obstacles to the effective presentation of IPV evidence to the court. One of these factors is the absence of or inadequate screening for IPV by family

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courts (Freedman, 2003; Jaffe & Geffner, 1998). A related factor is the lack of coordination of domestic violence services across different courts and the consequent failure to apply findings of IPV from other courts to the custody proceedings (McHardy & Hofford, 1999; Susser, 2000). The historically recent trend toward favoring custody outcomes that promote cooperative, shared physical and legal child custodial responsibilities between both parents and disfavoring a parents unwillingness to accommodate these aims has also resulted in the silencing of some victims of abuse (Jaffe & Geffner, 1998; Levin, 2000). Skepticism from untrained evaluators and attorneys as to the veracity or severity of the abuse history has also been shown to contribute to the failure of an effective presentation of a history of abuse to the court in custody cases (Ellis, 1990; Jaffe & Crooks, 2004; McHardy & Hofford, 1999). Finally, many divorce proceedings occur in the absence of legal counsel and formal evaluations (i.e., only 67 cases in our study were accompanied by a formal report or evaluation), thereby requiring the responsibility of effective disclosure to rest with the victim of abuse. We found that mothers with a history of IPV victimization were no more likely than comparison group mothers to be awarded child custody. As is true nationally, mothers in this study were, however, much more likely than fathers to be awarded custody, and our ability to detect group differences would be affected by the commonness of this outcome (Clarke, 1995). The movement historically toward friendly parent arrangements, based on the tenet that it is in the best interests of the child to have continuing involvement and care from both parents, has fostered strong policies both nationwide and in Washington State to prefer joint custody arrangements, meaning that there is at least some sharing of the physical custody and decision-making processes by both parents (Jaffe & Crooks, 2004; Levin, 2000; Washington State Parenting Act, 1987). Consistent with this policy, the fathers in this study were rarely denied child visitation. Also consistent with this policy but inconsistent with the aim of taking strong measures to protect victims and their children, fathers from two of the three groups with a history of IPV were no more likely than comparison group fathers to be denied child visitation. Although SKC fathers were 3 times more likely than comparison group fathers to be denied child visitation, this restriction was placed on only 16.8%

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of fathers from this group. In other words, 83.2% of fathers with a substantiated history of IPV that was known to the court were allowed child visitation. Third-party supervision of child visitation was no more likely to be required for fathers from any of the groups with a history of IPV than it was for comparison group fathers. The reluctance to order supervised visitation may be explained, in part, by the expense and limited availability of supervision services, especially services that use trained, objective professionals. Solender (1998), in a study of judges perspectives on domestic violence cases, for example, reported that judges she interviewed were indeed hesitant to order supervised visitation for this very reason. In effect, despite some advances in legislation and policy to offer protections for IPV victims and their children, there exists as Jaffe and Crooks (2004) describe, a gap between the spirit of the legislation and the practice in the field (p. 923) because of a lack of training and resources. Despite the relative absence of strong custody protections against spouse-abusing fathers, evidence was found that the courts were willing to order the less imposing restrictions on child visitation, such as limiting the time or conditions of child visitation and limiting parental decision-making authority. These outcomes were more common among fathers with a history of substantiated IPV, whether known to the court or not. The reluctance to impose the more restrictive outcomes on fathers with a history of abuse is likely an effect of a multitude of factors. It is unclear why the SUC group fathers would have more restrictions than comparison group fathers. One possible explanation is that not all disclosures of IPV that occur during the dissolution process are documented in the court case file. Another possibility is the recognition by the court of the higher prevalence of other forms of parental unfitness among this group. However, we examined, and, where appropriate, adjusted for an extensive set of confounding variables in our analysis. It, therefore, seems that lack of documentation of a known history of IPV is the more likely explanation for this finding. Requirement of some form of treatment or counseling as a condition of allowing child visitation by the father was a more common outcome among SKC fathers, but not among fathers from the other IPV groups, relative to comparison group fathers. Although

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this is an important acknowledgement by the court of the abusive history and the need for accountability by the abusive partner, the ability of such programs to effectively reduce future occurrences of partner abuse and harm to children remains unclear (Feder & Forde, 2000). Based on the findings from this study, AKC fathers were no more likely than comparison group fathers to have had their child custody and visitation limited with regard to the restrictions we examined. It is important to note that although we found no police or court records to substantiate the claims of these allegations, such evidence very well may have existed, for example, from nonlocal police or court sources or from medical records. It may prove useful for courts, legal advocates, attorneys, evaluators, and family court services personnel to better inform IPV victims of what evidence would assist in providing credibility to their allegations and therefore result in more appropriate action being taken in the determination of child custody and visitation. Attorneys and evaluators working with IPV victims would also be served by being better trained in this regard. Additionally, many victims of IPV will have no formal documentation of their abuse and pose a special challenge to establishing credibility with the court. Assistance in helping victims identify and provide less formal documentation, such as testimonies from parties who have witnessed the abuse directly or indirectly (e.g., witnessed the consequences of abuse such as bruising or other signs of injury) would be beneficial. The IPV group with the greatest level of restrictions, not surprisingly, was the group with a substantiated abuse history of which courts were made aware. Most evidence indicated that lack of court knowledge of IPV was a major issue; in fact, perhaps one of our most striking findings was that the court was made aware of less than one fourth of those cases with a substantiated history of IPV. It is clear that a court that remains uninformed about a history of partner abuse is severely disadvantaged in its power to protect victims and their children. In addition to the courts lack of knowledge about the history of IPV, we hypothesized that the courts lack of knowledge about the dynamics of IPV and disbelief in the victims credibility would lead to some disbelief of IPV allegations or at least to minimization of its seriousness and its impact on children. We found no association between any history

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of IPV and the more restrictive child custody outcomes and no association between a history of AKC and any of the child custody outcomes, suggesting support for this hypothesis as well. Unlike the findings of the Sorensen et al. (1995) and Drye (1999) studies, we did not find a history of IPV to significantly affect the assignment of custody or the requirement of third party supervision of the abusing parent during child visitation. This is likely explained, in part, by our ability to separate out a history of IPV from child abuse and other types of parental unfitness. Additionally, although we found numerous differences between families with a history of IPV and comparison families, we were able to thoroughly and exhaustively examine, and adjust for, as necessary, this rich set of confounding factors in our analyses. Also, unlike the Sorensen et al. (1995) study, we focused on a populationbased sample of all divorces involving children rather than the subsample of cases in which child custody was being contested. This study indicates that some progress has been made in recognizing the need to consider a history of IPV as a factor in child custody determinations. However, these findings also suggest that although some important restrictions are being placed on fathers with a history of IPV with regard to conditions of child visitation, these actions do not rise to the level of restrictions encouraged in the NCJFCJ model statute. According to the NCJFCJ model statute,
a determination by the court that domestic or family violence has occurred raises a rebuttable presumption that it is detrimental to the child and not in the best interest of the child to be placed in sole custody, joint legal custody, or joint physical custody with the perpetrator of family violence. (NCJFCJ, 1994)

Furthermore, although the goal in many states is to at least consider a history of IPV in adhering to the best interests of the child, the success of this approach hinges on the courts awareness of that history. As has been the concern of critics of this approach, we discovered that almost half of the couples with a history of substantiated IPV had no record of IPV in the dissolution case file, and less than one fourth of these cases had documentation of substantiated IPV in the case file. Changes in policy and procedures that would increase court awareness of an existing history of IPV should serve as one avenue for improvement in

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the handling of child custody and visitation determinations among this population. As noted by the NCJFCJ in 1999, future research should examine what types and levels of custody and visitation restrictions result in the greatest degree of safety and well-being of victims of IPV and their children (McHardy & Hofford, 1999). The results of this research will be instrumental in articulating custody and visitation plans that are most consistent with the intended aims of the NCJFCJ model statutes, namely, to legally establish guidelines to ensure protection for IPV survivors and their children. REFERENCES
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Mary A. Kernic is a research assistant professor of epidemiology at the University of Washington and the Harborview Injury Prevention and Research Center in Seattle, Washington. Her research focuses on the antecedents and consequences of intimate partner violence, the effect of parental intimate partner violence on children, and the psychiatric sequelae of abuse and trauma. Her recent projects include a randomized controlled trial examining the effect of a crisis intervention team

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approach to intimate partner violence and a study of the impact of spouse-abusing fathers involvement in child mental health. Daphne J. Monary-Ernsdorff is a research coordinator with the Harborview Injury Prevention and Research Center. She has more than a decades experience working in research with a focus on high-risk populations, with much of that time having been focused on research on intimate partner violence. Jennifer K. Koepsell worked as a research assistant for Dr. Mary Kernic while completing her masters degree in epidemiology at the University of Washington School of Public Health and Community Medicine. Her thesis focused on the examination of factors that influenced or deterred women from leaving abusive relationships following an episode of police-reported violence. She also worked with Dr. Kernic to establish a project evaluating the Seattle Police Departments Victim Support Team, a volunteer-run program designed to provide victims of abuse with counseling, emotional support, and information on available community resources. Victoria L. Holt is a professor of epidemiology at the University of Washington and faculty at the Harborview Injury Prevention and Research Center in Seattle, Washington. She has carried out research related to intimate partner violence (IPV) for nearly a decade. This research has included projects investigating associations between IPV and womens mental and physical health overall, the effects of IPV on the health of pregnant women and their infants, and the impact of obtaining a protection order on risk of subsequent IPV and injury. Currently, she is investigating the effect of the criminal justice systems response to reported IPV on a mans likelihood of repeat violence toward the same partner.