Objective: Living in a home where violence is present places young children at great risk for developing emotional, behavioral, cognitive, and health problems. While many studies have examined direct relationships between violence exposure and adjustment, fewer have considered how children's mental health problems may interact over time. The primary aim of the current study is to more fully explicate the complex relationships between children's mental health difficulties following exposure to violence. Methods: The current study examines 120 preschool-aged children who had been exposed to intimate partner violence in the past 2 years. Results: Results show that the relationship between violence exposure and adjustment problems was mediated by children's posttraumatic stress symptoms related to witnessing the violence. Posttraumatic stress symptoms fully mediated the relationship between violence and Internalizing behavior and total adjustment problems, and partially mediated the relationship between violence and Externalizing behavior problems. Conclusions: This indicates that posttraumatic stress and behavioral adjustment are related but distinct reactions following exposure to violence. Clinically, a thorough assessment of posttraumatic stress symptoms is recommended for this population, as these symptoms require specific intervention techniques that may otherwise be overlooked in the course of therapy. (Contains 1 table.)