Affective Awareness in Parenting of Fathers with Co-Occurring Substance Abuse and Intimate Partner Violence

Virtual reality for the rehabilitation and prevention of intimate partner violence - From brain to behavior: A narrative review

Rehabilitation and prevention strategies to reduce intimate partner violence (IPV) have limited effectiveness in terms of improving key risk factors and reducing occurrence. Accumulated experimental evidence demonstrates that virtual embodiment, which results in the illusion of owning a virtual body, has a large impact on people's emotional, cognitive, and behavioral responses. This narrative review discusses work that has investigated how embodied perspective - taking in virtual reality has been used as a tool to reduce bias, to enhance recognition of the emotional state of another, and to reduce violent behaviors, in particular in the realm of IPV. Some of the potential neurological mechanisms behind these affective and behavioral changes are also discussed. The process of rehabilitation and prevention is complex and not always effective, but the integration of neuroscience-inspired and validated state-of-the-art technology into the rehabilitation process can make a positive contribution.

Self-reported reflective functioning and father-child interactions in a sample of fathers who have used intimate partner violence

Reflective functioning (RF) has been found to be associated with mother-child interactions, but less is known about the association of fathers' self and child-focused RF and father-child relationships.  Fathers who have histories of intimate partner violence (IPV) are known to have poor RF, which may impact their father-child interactions.  The current study was designed to examine how types of RF are associated with father-child relationships.  Pretreatment assessments and recorded, coded father-child play interactions were used to examine associations among fathers' history of adverse childhood experiences (ACES), RF and coded father-child play interactions in a sample of 47 fathers with a history of IPV use in the last 6 months with their coparent.  Fathers' ACES and their child's mental states (CM) were associated with father-child dyadic play interactions.  Fathers with greater ACES and higher scores on CM had the most dyadic tension and constriction during play interactions.  Those with high ACES but low CM had scores similar to those with low ACES and low CM.  These results indicate that fathers who have used IPV and have a history of significant adversity may benefit from interventions to increase their child-focused RF and further improve their interactions with their children.

Domestic Violence From a Child Perspective: Impact of an Immersive Virtual Reality Experience on Men With a History of Intimate Partner Violent Behavior

Domestic violence has long-term negative consequences on children. In this study, men with a history of partner aggression and a control group of non-offenders were embodied in a child's body from a first-person perspective in virtual reality (VR). From this perspective, participants witnessed a scene of domestic violence where a male avatar assaulted a female avatar. We evaluated the impact of the experience on emotion recognition skills and heart rate deceleration responses. We found that the experience mainly impacted the recognition of angry facial expressions. The results also indicate that males with a history of partner aggression had larger physiological responses during an explicit violent event (when the virtual abuser threw a telephone) compared with controls, while their physiological reactions were less pronounced when the virtual abuser invaded the victim's personal space. We show that embodiment from a child's perspective during a conflict situation in VR impacts emotion recognition, physiological reactions, and attitudes towards violence. We provide initial evidence of the potential of VR in the rehabilitation and neuropsychological assessment of males with a history of domestic violence, especially in relation to children.

The Parents under Pressure parenting programme for families with fathers receiving treatment for opioid dependence: the PuP4Dads feasibility study

Background

The impact of parental drug use on children is a major public health problem. However, opioid-dependent fathers have been largely ignored in parenting research.

Objective

To implement and test the feasibility and acceptability of the Parents under Pressure programme (PuP4Dads) for opioid-dependent fathers and their families, and to determine whether or not a full-scale evaluation could be conducted.

Design

A mixed-methods feasibility study.

Setting

Two non-NHS family support services for parents who use drugs in Scotland.

Participants

Fathers prescribed opioid substitution therapy (n = 25), their partners (n = 17) and children, as well as practitioners, supervisors, service managers and referrers.

Intervention

A home-visiting programme, including an integrated theoretical framework, case formulation, collaborative goal-setting and modules designed to improve parenting, the caregiving environment and child welfare. The programme was delivered flexibly over 6 months by accredited practitioners.

Main outcome measures

Feasibility progression criteria included the recruitment target (n = 24 fathers), acceptability of PuP4Dads, father engagement in the study (including a minimum of 66% of fathers completing PuP and a minimum of 10 fathers completing baseline and post-treatment research interviews), engagement in qualitative interviews (including a minimum of 10 fathers and 90% practitioner uptake and 80% manager uptake), focus groups (with a minimum of 80% referrer uptake), adequate fidelity and no adverse events.

Data sources

The following researcher-administered validated questionnaires were used: the Brief Child Abuse Potential Inventory, the Parenting Sense of Competence Scale, the Difficulties in Emotion Regulation Scale, the Paternal Antenatal Attachment Scale, the Maternal Antenatal Attachment Scale, the Emotional Availability Scale, the Brief Infant Toddler Social and Emotional Assessment, the Strengths and Difficulties Questionnaire, the Conflict Tactics Scale, Treatment Outcome Profile and the EuroQol-5 Dimensions, five-level version. Other sources included parent-completed service use (an economic measure), social work child protection data, NHS opioid substitution therapy prescription data and practitioner-reported attendance data. We also conducted interviews with fathers (n = 23), mothers (n = 14), practitioners (n = 8), supervisors (n = 2) and service managers (n = 7); conducted focus groups with referrers (n = 28); and held an ‘expert event’ with stakeholders (n = 39).

Results

The PuP4Dads was successfully delivered within non-NHS settings and was considered acceptable and suitable for the study population. Referrals (n = 44) resulted in 38 (86%) eligible fathers, of whom 25 (66%) fathers and 17 partners/mothers consented to participate. Most fathers reported no previous parenting support. A total of 248 sessions was delivered to the 20 fathers and 14 mothers who started the intervention. Fourteen fathers (and 10 mothers) completed ≥ 6 sessions and six fathers (and four mothers) completed ≤ 5 sessions. Father and mother attendance rates were equal (mean 71%). Median length of engagement for fathers was 26 weeks and for mothers it was 30 weeks. Twenty-three fathers completed interviews at baseline, 16 fathers completed interviews at follow-up 1 and 13 fathers completed interviews at follow-up 2. Outcome measures were well tolerated; however, the suitability of some measures was dependent on family circumstances. The researcher-administered questionnaires had few missing data. The perceived benefits of PuP4Dads reported by parents, practitioners and managers included the following: the therapeutic focus on fathers improved parental emotion regulation, there was improved understanding and responding to child’s needs, there was better multiagency working and the programme was a good fit with practice ‘ethos’ and policy agenda. Learning highlighted the importance of service-wide adoption and implementation support, strategies to improve recruitment and retention of fathers, managing complex needs of both parents concurrently, understanding contextual factors affecting programme delivery and variables affecting intervention engagement and outcomes.

Limitations

Lack of emotional availability and economic (service use) data.

Conclusions

A larger evaluation of PuP4Dads is feasible.

Future work

Further work is required to demonstrate the effectiveness of PuP4Dads and the cost implications. A better understanding is needed of how the intervention works, for whom, under what circumstances and why.

Trial registration

Current Controlled Trials ISRCTN43209618.

Funding

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 3. See the NIHR Journals Library website for further project information.

The Relationship between Health-promoting Lifestyle and Suicidal Ideation in Addicted Women

Background

Addiction is one of the most important problems of the present century that can be the basis of many social and family problems. Addiction severely affects the physical and mental health and lifestyle of addicted people and sometimes leads to suicide. The aim of this study was to investigate the relationship between health-promoting lifestyle and suicidal ideation in addicted women.

Methods

In this descriptive-correlational study, the statistical population included all addicted women who referred to psychiatric hospitals in Kerman, Iran, in 2020, among whom 118 people were selected using convenience sampling method. Data were collected using Beck Depression Inventory (BDI) (1974) and were analyzed using Spearman's correlation coefficient test.

Findings

44.9% of women had no suicidal ideation, 23.7% were ready to commit suicide, and 30.5% attempted suicide. There was a significant inverse relationship between health-promoting lifestyle and its components (nutrition, physical activity, health responsibility, stress management, interpersonal relationships, and spiritual growth) with suicidal ideation.

Conclusion

The results of this study can have important applications in the care and rehabilitation of addicted people and reduce suicidal ideation among them. In the rehabilitation of addicted people, one of the important goals should be improving the quality of life (QOL) and lifestyle of these people.

How domestically violent Fathers impact children's social-emotional development: Fathers' psychological functioning, parenting, and coparenting

BACKGROUND

Most children exposed to father-perpetrated domestic violence (DV) continue to have contact or live with fathers, yet there is little research on the impact of fathering in the context of domestic violence.

OBJECTIVE

This paper aimed to identify pathways from children's exposure to father-perpetrated DV to compromised social-emotional outcomes. Based on extant literature on fathering and domestic violence, psychological, parenting, and coparenting features in DV fathers were identified as potential mediators of the relationship between child exposure to DV and their social-emotional outcomes.

PARTICIPANTS AND SETTING

Participants were 123 fathers with confirmed histories of DV perpetration and 101 comparison fathers without such histories.

METHODS

Fathers completed self-report measures during two assessment sessions held at the university. Simple mediation analyses were used to examine pathways between fathers' DV perpetration and child internalizing and externalizing difficulties through potential mediators.

RESULTS

Paternal depression, hostility, and coparenting difficulties significantly mediated the relationship between child exposure to DV and child internalizing and externalizing difficulties. Low paternal warmth was associated with child externalizing difficulties but did not function as a mediator. Paternal over-reactivity and laxness, in contrast, were not significantly correlated with DV perpetration or with child internalizing or externalizing outcomes.

CONCLUSIONS

This study suggests that fathers' emotion regulation and coparenting difficulties are important correlates of his DV perpetration and of their children's psychological symptoms and should be considered as potential foci for parenting intervention with this population.

Fathers and substance misuse: a literature review

Purpose

The purpose of this paper is to review the following research questions from the available literature: What evidence is there to suggest that substance misuse specifically by fathers (including alcohol and other drugs) causes wider harms, including child welfare concerns? substance misuse, recovery, parents, fathers, fathering, drugs/ alcohol services. How do professionals respond specifically to substance misuse by fathers? Do interventions aimed at parental substance misuse (particularly in the UK) include both mothers and fathers and if so how?

Design/methodology/approach

A scoping literature review was conducted which identified 34 papers (including scoping reviews published in 2006 and 2008, covering the period 1990-2005) and 26 additional studies published between 2002 and 2020.

Findings

The review in this paper is organised into six themes: Negative impact of men’s substance misuse problems on their parenting behaviours; quality of the relationship between parents affected by substance misuse of the fathers, in turn affecting the parenting behaviour and outcomes for children; importance to fathers of their fathering role (for example, as a financial provider); difficulties fathers may face in developing their fathering role; sidelining of the fathering role in substance misuse services; and professionals tending to focus on the mother’s role in parenting inventions and services.

Originality/value

This paper focusses on fathers and substance misuse, which is an under-researched field within the wider contexts of fathering research and research into parental substance misuse.

Coparenting of fathers in residential substance use treatment

Purpose

Few studies have examined coparenting characteristics and experiences of fathers who use substances and are aggressive with their partners. The purpose of this paper is to use quantitative and qualitative measures to increase knowledge of coparenting of fathers with co-occurring substance use disorders and histories of intimate partner violence (IPV) to inform intervention efforts with this population.

Design/methodology/approach

Baseline interviews were used from 62 fathers in a residential treatment center who participated in a longitudinal research study about interventions for substance-misusing fathers. Coparenting-related themes were identified through qualitatively analyzing transcripts of fathers’ responses to the Articulated Thoughts in Simulated Situations (ATSS) task. Fathers completed the Coparenting Relationship Scale (CRS), Conflict Tactics Scale Revised and the Child Trauma Questionnaire. Correlations were examined to determine if themes generated from the ATSS task were associated with IPV severity or coparenting relationship.

Findings

Qualitative analysis of transcripts revealed six themes: hostility, dismissiveness, non-confrontational, child-focused, feeling undermined and being active or non-active in the ATSS task. Qualitative themes were not significantly correlated with self-reported coparenting on the CRS except coded dismissive responses were positively associated with self-reported undermining by their coparent. Self-reported physical and psychological aggression were significantly positively associated with self-reported coparent undermining but were not significantly associated with qualitative themes.

Originality/value

This study is the first to use qualitative analysis of responses to coparenting situations to understand ways fathers in substance misuse treatment with histories of IPV think about coparenting to guide interventions.

Fathers' perpetration of intimate partner violence and parenting during early childhood: Results from the Fragile Families and Child Wellbeing Study

BACKGROUND

Experiences of intimate partner violence (IPV) victimization negatively impact maternal parenting. However, little is known about the association between fathers' perpetration of IPV and paternal parenting.

OBJECTIVE

To examine associations between fathers' IPV perpetration against the child's mother and fathers' stimulation and spanking practices with their young child.

PARTICIPANTS AND SETTING

We used two waves of data from the Fragile Families and Child Wellbeing Study in the United States. The analytic sample comprised of 2,257 biological fathers who had been in a romantic relationship with the child's mother.

METHODS

Fathers' IPV perpetration at year 1 and 3 was measured based on maternal report. Fathers were categorized into: never perpetrators (no IPV at either year), persisters (IPV at both years), desisters (IPV at year 1 only), and emergers (IPV at year 3 only). Fathers' parenting at year 3 was measured based on self-reported stimulation (e.g., reading books, playing games, telling stories) and spanking.

RESULTS

Approximately one-third of fathers never perpetrated IPV, 35.8% were persisters, 14.4% were desisters, and 16.9% were emergers. For stimulation, persisters (β=-0.16, 95% CI: -0.25, -0.06) and emergers (β=-0.25, 95% CI: -0.36, -0.14), but not desisters (β=-0.02, 95% CI: -0.14, 0.11), were less engaged in stimulation than fathers who never perpetrated IPV. However, for spanking, there were no differences in the associations by father IPV profiles.

CONCLUSIONS

Findings suggest that fathers' perpetration of IPV is related to their stimulation practices. Partner-abusive men and their children may benefit from parenting programs that promote engagement in stimulation and improve the quality of parent-child relationships.

A randomized pilot trial of two parenting interventions for fathers in residential substance use disorder treatment

Residential substance misuse treatment programs for men typically do not integrate treatment for intimate partner violence (IPV) or parenting despite significant overlap between substance misuse, IPV and child maltreatment. A randomized trial compared two fatherhood focused interventions in 6-month residential substance misuse treatment programs. Fathers for Change (F4C) is an integrated intervention targeting IPV and child maltreatment. Dads 'n' Kids (DNK) is a psychoeducational intervention focused on child development and behavioral parenting skills. Sixty-two fathers were randomly assigned to F4C or DNK. They received 12 weeks of individual treatment while in the residential facility and were offered 4 aftercare sessions following discharge. They were assessed prior to treatment, at the time of residential discharge, following completion of the intervention booster sessions, and 3 months following intervention. Overall, both groups showed significant reductions in affect dysregulation, anger, and IPV. F4C fathers showed significantly greater decreases in affect dysregulation problems. There were no significant differences between groups on IPV but men who received F4C may have been less likely to use substances after leaving residential treatment. Integration of fatherhood focused interventions were possible and welcomed by residents at the facilities. F4C showed some benefit over DNK in terms of affect dysregulation symptoms and substance use relapse.

Relationship between adaptation and self-esteem in addicted female prisoners in the south east of Iran

Background Reduction of the adaptation and self-esteem can be the consequence of opium addiction and imprisonment. Drug use causes inappropriate behaviors in women, which are quite different from those in men. Social deviations, prostitution, high-risk sexual behaviors, abortion, divorce and imprisonment followed by loss of self-esteem are the consequences of women's addiction. The present study was conducted to assess the relationship between adaptation and self-esteem in addicted female prisoners. Methods In this descriptive analytical study, 130 addicted female prisoners were selected from a prison in the south east of Iran using census sampling. The data were collected by a demographic questionnaire, the Rosenberg's self-esteem scale and the bell adjustment inventory (BAI). Results According to the results, women's adaptation fell into the 'very unsatisfactory' range. The highest mean was related to the emotional dimension, while the lowest mean was in terms of the health dimension. In total, 96.4% of the participating women had low adaptation. The mean total self-esteem fell into the low range; in fact, 84.6% of the women had a low self-esteem. The results showed no significant relationships between adaptation and self-esteem in these women; however, self-esteem was significantly and inversely related to health and emotional adaptation. Conclusion The findings showed that the majority of the women had unsatisfactory adaptation as well as poor self-esteem. No significant relationships were observed between adaptation and self-esteem in the addicted female prisoners.

Intimate partner violence, fatherhood, and co-parenting of men in residential substance misuse treatment

Purpose

The purpose of this paper is to examine the role of co-parenting, childhood experiences, and satisfaction with fathering in a sample of men in a long-term residential drug rehabilitation program.

Design/methodology/approach

A paper and pencil survey was completed by 128 men between the ages of 18 and 68 (M age=30.42 years) in a court ordered residential rehabilitation center for drug misuse. Of the 128 respondents, 40.625 percent (n=52) were fathers and completed a longer survey to assess their co-parenting relationships.

Findings

The percentage of men with positive role models did not differ between the fathers and non-fathers, with 40.4 percent of fathers having had a positive role model growing up, χ2(1, n=127)=0.54, p=0.816. Fathers were more likely to report witnessing IPV between their parents during childhood than non-fathers, χ2(1, n=125)=4.7888, p=0.029. Linear regression models examining factors associated with co-parenting agreement and exposure to conflict were significant, but witnessing IPV as a child was the only significant individual predictor.

Practical implications

Exposure to IPV in childhood was a common experience for fathers in residential treatment for substance misuse. Fathers reported significant problems in their co-parenting relationships indicating a need for fatherhood and co-parenting focused services available within residential treatment programs.

Originality/value

There is little research about fathers with co-occurring histories of substance misuse and IPV in residential treatment. This paper is the first to examine co-parenting in this specific population.

Parental reflective functioning in fathers who use intimate partner violence: Findings from a Norwegian clinical sample

Few studies have examined fathering in an intimate partner violence (IPV) context outside the US. The present study included 36 Norwegian men who were voluntarily participating in therapy after perpetrating acts of IPV. They were interviewed with the revised Parent Development Interview, which is designed to assess parental reflective functioning (parental RF), and screened for alcohol- and substance-use habits and trauma history. At the group level, participants exhibited poor parental RF, high relational trauma scores, and elevated alcohol intake. Parental RF did not correlate with education level, alcohol or substance use, or compound measures of trauma history. There was a moderate negative relationship between having experienced physical abuse in childhood and parental RF.

Relationship of Physical Intimate Partner Violence with Mental Health Diagnoses in the Nationwide Emergency Department Sample

OBJECTIVES

We examined associations of physical intimate partner violence (PIPV) with selected mental health disorders using a nationally representative sample of emergency department (ED) discharges corresponding to men and women (18-64 years) from the 2010 Nationwide Emergency Department Sample.

METHODS

PIPV was determined using International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) external cause of injury code E967.3 (battering by spouse or partner). ICD-9-CM clinical classification of discharge diagnoses was used to identify mental health disorders. Multivariable logistic regression models were constructed to estimate adjusted odds ratios (OR_adj) and their 95% confidence intervals (CIs).

RESULTS

PIPV prevalence was estimated at 0.36 per 1000 ED discharges. The strongest correlates of PIPV were alcohol-related (OR_adj = 3.02, 95% CI: 2.62-3.50), adjustment (OR_adj = 2.37, 95% CI: 1.56-3.58), intentional self-harm (OR_adj = 1.41, 95% CI: 1.05-1.89), anxiety (OR_adj = 1.23, 95% CI: 1.07-1.40), drug-related (OR_adj = 1.22, 95% CI: 1.01-1.47), and mood (OR_adj = 1.16, 95% CI: 1.04-1.31) disorders. PIPV's association with alcohol-related disorders was stronger among women (OR_adj = 3.22, 95% CI: 2.79-3.72) versus men (OR_adj = 1.98, 95% CI: 1.42-2.77). Similarly, drug-related disorders were stronger correlates of PIPV among women (OR_adj = 1.32, 95% CI: 1.09-1.60) versus men (OR_adj = 0.59, 95% CI: 0.31-1.16).

CONCLUSIONS

In EDs, PIPV was linked to several mental health disorders, with women experiencing comorbid PIPV and substance use more frequently than men.

Fathers' experiences of being in change during pregnancy and early parenthood in a context of intimate partner violence

OBJECTIVE

Intimate partner violence (IPV) is a large public health problem with far-reaching consequences for those involved. The aim of this study was to explore fathers' experiences of change during pregnancy and early parenthood in the context of IPV.

METHODS

The methodological approach in this interview study was hermeneutics, based on a lifeworld perspective. Ten men, who had subjected their partners to violence during the childbearing period, and had become fathers within the previous 6 years, participated.

RESULTS

The analysis revealed four themes: beginning to acknowledge that you are inflicting violence, receiving confirmation that you are more than just a perpetrator of violence, becoming aware of the child, and the desire to receive support in the process of learning how to become a father. Levinas' concept "the face of the other" is used to interpret the findings.

CONCLUSION

This study contributes to a more nuanced and expanded picture of IPV. It shows that men who inflict violence want to be and learn how to be fathers. We need more knowledge about how to stop violent acts and support these men in the process of fatherhood.

The Relationship of Reflective Functioning to Parent Child Interactions in a Sample of Fathers With Concurrent Intimate Partner Violence Perpetration and Substance Abuse Problems

This study is the first to examine reflective functioning (RF) and direct parent-child interactions of fathers with concurrent intimate partner violence (IPV) perpetration and substance abuse (SA) problems. Twenty-four fathers, with children between the age of one and seven, completed a structured interview to assess RF, self-report measures of hostile-aggressive parenting behaviors, IPV perpetration severity, SA severity, and a coded play session with their children. Results of three simultaneous multiple regressions revealed that RF in fathers was not associated significantly with observed parenting behaviors. However, fathers' SA severity emerged as a significant predictor for child avoidant behavior and dyadic tension, and fathers' IPV perpetration severity contributed unique variance to child avoidant behavior and dyadic constriction. These results suggest that fathers' SA severity and IPV perpetration behaviors may be more salient factors in predicting their father-child interactions than paternal RF.

Parenting of men with co-occurring intimate partner violence and substance abuse

No studies to date have compared parenting behaviors of men with co-occurring intimate partner violence (IPV) and substance abuse (SA) with community controls. This study was designed to document mediators of differences in parenting behavior of fathers and the emotional-behavioral problems of their children for men with co-occurring SA and IPV. The self-reported parenting (negative, positive and coparenting behaviors) and the child emotional-behavioral problems of 43 fathers with children aged 2 to 6 years with a recent history of SA + IPV were compared to a sample of 43 community control fathers with the same socioeconomic and cultural backgrounds. Fathers completed measures on their parenting behavior with a target child, coparenting behavior with the child's mother, emotion regulation, romantic attachment, psychiatric symptoms, and the behavior of the target child. Men with co-occurring SA + IPV had significantly less positive coparenting and more negative parenting behaviors than community control fathers. Negative parenting and coparenting were mediated by the fathers' avoidant attachment problems. SA + IPV fathers also reported more emotional and behavioral problems in their children. These poor child outcome differences between groups were mediated by the negative parenting behaviors of the fathers. These results suggest areas of potential focus in interventions with fathers who have co-occurring SA + IPV issues. Focus on attachment difficulties with his coparent, which may include affect regulation, coping with emotions, and communication skills training related to coparenting, may yield significant changes in parenting behaviors and ultimately child functioning.

Fathers for change: a new approach to working with fathers who perpetrate intimate partner violence

Legal and social service systems rarely acknowledge the status of men as fathers in the conceptualization and delivery of interventions for intimate partner violence (IPV). Large percentages of men who are arrested and mandated to intervention programs for IPV are fathers who continue to live with or have consistent contact with their young children despite aggression and substance use. There are currently no evidence-based treatments that address co-morbid substance abuse and domestic violence perpetration with emphasis on paternal parenting for fathers. This article will describe the components of a new intervention, Fathers for Change, which addresses the co-morbidity of substance abuse, domestic violence, and poor parenting in fathers of young children. Fathers for Change is unique in its focus on the paternal role throughout treatment. A case example and initial feasibility of the intervention will be described to provide an understanding of the key ingredients and the gap this intervention could fill in the field once tested in efficacy trials.