and their family members, when compared with nonvictims. One exception, a study by Coyne et al. (1993), found that callers to a help line who had committed abuse had been providing care for a longer time and for more hours a day than nonabusers and had higher burden scores.

Intergenerational Transmission

Social learning theory gives rise to the hypothesis that when individuals experience violent behavior from parents or other role models in childhood, they tend to revert to these learned behaviors when provoked as adults. Indeed, it has by now become a commonplace that victims of child abuse may grow up to themselves become child abusers, a pattern often described as the “cycle of violence.” The cumulative research evidence supports this hypothesis, with experiencing violence from parents or witnessing violence between parents in childhood strongly related to perpetrating child or intimate partner abuse (See Newberger, 1998; Stark and Flitcraft, 1998).

Despite this evidence from other fields, the only two studies that have addressed this issue (Anetzberger et al., 1994; Wolf and Pillemer, 1989) found no evidence of intergenerational transmission of physical violence against elderly relatives. This issue, however, is worthy of further study, given the importance of childhood experience of aggression as a risk factor for other forms of interpersonal violence. The importance of early childhood experiences of perpetrators as risk factors for types of elder mistreatment other than physical violence should be explored. In addition, given that in the elder mistreatment field the victim and perpetrator have been in a long-standing personal relationship, as spouses or as parent and child, it may be more important to assess the type of relationship between the abuser and the victim as a risk factor for elder mistreatment.

ELDER MISTREATMENT IN INSTITUTIONAL SETTINGS

Despite the likelihood that elder mistreatment in nursing homes is equally or more prevalent than abuse in domestic settings, only one study has been conducted that specifically addressed risk factors. Pillemer and Bachman-Prehn (1991) analyzed data from a survey of staff regarding self-reported psychological and physical abuse. Predictors of psychological abuse were staff burnout, experiencing physical aggression from residents, negative attitudes toward residents, and age of the staff member, with younger staff more likely to engage in psychological abuse. Risk factors for physical abuse were again staff burnout and resident aggression, as well as the reported amount of conflict with residents. This study is limited by the self-report method used to assess the occurrence of elder mistreatment. Self-report may be subject to bias, especially since the staff would often



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