Dropout from Court-Mandated Intervention Programs for Intimate Partner Violence Offenders: The Relevance of Alcohol Misuse and Cognitive Impairments

A Systematic Review of the Quality of Perpetrator Programs' Outcome Studies: Toward A New Model of Outcome Measurement

This systematic review assessed whether studies on the outcomes of perpetrator programs comply with the model recommendations for outcome evaluation. Three databases (PsycINFO, Medline, and Scopus) were used to identify perpetrator program outcome studies from 1988 to 2021. The inclusion criteria were as follows: empirical studies with no time restriction; published in English or Spanish; evaluated interventions aimed at male perpetrators of any type of abuse toward women; evaluated the effectiveness of the intervention in a follow-up post-intervention; and provided an indicator of recidivism. The search and selection process resulted in 46 original studies. The results showed that studies did not include a thorough description of the study sample. Many approaches to psychological intervention are used, with cognitive behavioral therapy being the most widely used. Most studies did not describe the program content. Dropout rates varied greatly from one study to another (from 0% to 64%) and only eight studies provided dropout rates specified by each type of perpetrator. The follow-up period ranged from 3 months to 9 years. The recidivism rates (ranging from 5% to 72.5%), and their assessments were also very different. Only 12 of the 46 studies (26.1%) used more than one source to obtain recidivism rates. In terms of outcomes, few studies considered (ex-) partner accounts. Some studies had other measures of outcome, whereas a few included a pretest-posttest. In summary, these studies do not follow the recommendations of the model.

Intervention Program Dropout Among Perpetrators of Intimate Partner Violence: A Meta-Analysis of Correlated Variables

Dropout in perpetrator intervention programs (PIPs) is extensively documented in the literature, yet findings across various studies exhibit global inconsistency. This meta-analysis aimed to identify dropout rates among individuals attending PIPs and examine sociodemographic, violence-related, intrapersonal, interpersonal, and external variables related to dropout. A search was conducted across six databases, encompassing studies published between 2010 and 2022 in English, Spanish, or Portuguese. Thirty manuscripts, comprising data from 31 independent samples, were included. Dropout rates varied from 9% to 67%. Bivariate analysis results indicated that younger age (OR = 0.69), non-White ethnicity (OR = 1.54), unemployment (OR = 1.78), offender typology other than family only (OR = 2.45), substance abuse (OR = 1.78), presenting a personality disorder (OR = 1.21), engaging in problematic leisure activities (OR = 1.28), possessing a greater criminal history (OR = 1.47), and experiencing more adversity in childhood (OR = 1.44) were significantly correlated with dropout. Additionally, the inclusion of motivational strategies in treatment (OR = 0.44) significantly decreased the likelihood of dropout. Results from multivariate analyses revealed that younger age (OR = 0.63), presenting a personality disorder (OR = 1.73), and experiencing more adversity in childhood (OR = 2.16) were significantly associated with dropout. Notably, intimate partner violence characteristics established a significant negative relation with dropout (OR = 0.59). Findings indicate that variables associated with dropout align with those related to general and intimate partner violence recidivism, suggesting that individuals requiring more intensive intervention are those who derive less benefit from it.

Strengths and Weaknesses of Inviting Men to a Voluntary-Based Domestic Violence Intervention

This study examines the factors motivating domestic violence perpetrators to participate in a voluntary-based intervention program. The experiences and determining factors around men's positive and negative responses to this invitation were examined through semi-structured interviews with professionals, observations, and reflexive notes during the first meeting with 29 men. Two major themes emerged from the thematic analysis: the factors making men more likely to attend the first meeting or resisting the group intervention. These findings can help professionals recognize the challenges of inviting perpetrators to interventions, especially in countries with insufficient laws for mandated domestic violence perpetrator programs. The paper discusses the importance during the first meeting of building rapport and trust and recognizing complex family histories to encourage voluntary attendance and intervention engagement.

Participants in Court-mandated Intervention Programs for Intimate Partner Violence Perpetrators with Substance Use Problems: A Systematic Review of Specific Risk Factors

Men with alcohol and/or other drug use problems (ADUPs) court-mandated to attend intervention programs for intimate partner violence (IPV) perpetrators have been identified as a high-risk, highly resistant group of IPV perpetrators, as they present lower treatment adherence and higher dropout and recidivism rates. Previous research suggests that IPV perpetrators with ADUPs may require tailored interventions to address their specific risk factors. The present systematic review was conducted using PRISMA guidelines to identify the specific risk factors in men with and without ADUPs on entry to court-mandated perpetrator programs. The following databases were searched from inception to November 2021: Web of Science, PsycINFO, and Scopus. There was a screening of 3,995 records, and 29 quantitative studies were included in the review. Risk factors present in males court-mandated to perpetrator programs were grouped into four categories: sociodemographic risk factors, personality disorders and psychological adjustment, social-relational risk factors, and risk factors related to attitudes towards women. Results indicated that the main risk factors in IPV perpetrators with ADUPs, compared to those without, were higher clinical symptomatology (e.g., anger and impulsivity), personality disorders, poorer executive functions, having experienced more stressful life events, higher exposure to childhood trauma, lower intimate social support, and higher responsibility attributed to the offenders' personal context. These results contribute to a deeper understanding of the complex phenomenon of IPV and ADUPs, and could help to inform key targets for perpetrator programs that may improve the well-being of their (ex)partners and increase the effectiveness of intervention programs for IPV perpetrators.

Prevention interventions for interpersonal violence occurring under the influence of alcohol: A mixed method systematic review

AIMS

To (a) explore risk indicators related to interpersonal violence occurring under the influence of alcohol and to (b) search for interventions addressed towards violence perpetrators to prevent violence occurring under the influence of alcohol.

DESIGN

Mixed method systematic review. This study has been registered in the International Prospective Register of Systematic Reviews with register number CRD42021217848.

DATA SOURCES

A systematic search was conducted on PubMed, CINAHL, PsycINFO and Scopus in October 2021.

REVIEW METHODS

Two researchers independently examined 1076 papers following the inclusion criteria. After three rounds of selection (title, abstract and full text), the quality and bias assessments were conducted independently by two reviewers. The data were analysed with inductive and deductive content analyses.

RESULTS

Of the 1076 papers retrieved, 16 papers were eligible for inclusion, addressing 13 different interventions. Interventions were divided into three types (individual-, group- and family-level) and were constructed on several background frameworks, with cognitive behavioural therapy being the most common framework. Family-level interventions seemed to yield the most effective results. Violence occurring under the influence of alcohol was mostly researched as men being the perpetrators and women being the victims of violence. Several indicators that increased the risk of violence victimization or perpetration, such as trait jealousy and disparity in education, were identified.

CONCLUSION

Interventions emerging from the systematic review were heterogenous, and the outcomes of the interventions were versatile. The disparity between interventions and outcome measures made it challenging to reliably compare the effectiveness between interventions. Using standardized outcome measure instruments and unifying research on interventions are needed to reliably assess the effectiveness of different interventions.

Dropout and recidivism are partly explained by emotional decoding and perspective taking deficits of intimate partner violence perpetrators

Professionals and researchers have dedicated important efforts to understanding the underlying factors that explain the failure to complete interventions (dropout) and the recidivism of men convicted of intimate partner violence (IPV) against their female partners. There is a growing interest in measuring emotional decoding and empathic deficits in IPV perpetrators to better understand dropout and recidivism proneness, due to their direct impact on behavioral regulation. In the current study, we first aimed to examine whether the emotional decoding abilities of facial expressions and empathic abilities (cognitive and emotional), as well as their interrelationships in IPV perpetrators (n = 561), would explain dropout, treatment attendance, and recidivism (risk and official) once treatment ended. Our results allowed us to conclude that emotional decoding abilities and perspective taking (cognitive empathy) were significantly and negatively associated with dropout and recidivism. Two moderation models were significant. On the one hand, participants with low emotional decoding abilities presented lower intervention doses the lower their perspective taking. Furthermore, the percentage of participants that reoffended was higher among individuals with low and moderate perspective taking who dropped out. Therefore, our study highlights the importance of conducting emotional decoding and empathic assessments during the initial stages of intervention programs to clearly outline the therapeutic needs of IPV perpetrators. This would allow designing coadjuvant and complementary training programs that can support the main interventions by increasing treatment adherence and, in turn, reducing the risk of recidivism.

Cognitive Flexibility and Reaction Time Improvements After Cognitive Training Designed for Men Perpetrators of Intimate Partner Violence: Results of a Pilot Randomized Controlled Trial

Purpose Current interventions for intimate partner violence (IPV) perpetrators are designed to reduce IPV recidivism by treating risk factors and increasing protective factors. However, these interventions pay less attention to cognitive functioning in IPV perpetrators and how these variables interfere with the future risk of recidivism. Therefore, the main objective of this research was to compare the effectiveness of Standard Intervention Programs for men who perpetrate IPV [SIP] + cognitive training vs SIP + placebo training in promoting cognitive improvements and reducing recidivism. Furthermore, we also aimed to assess whether changes in the risk of recidivism would be related to cognitive changes after the intervention. Method IPV perpetrators who agreed to participate were randomly allocated to receive SIP + cognitive training or SIP + placebo training. Several cognitive variables were assessed before and after the interventions with a complete battery of neuropsychological tests assessing processing speed, memory, attention, executive functions, and emotion decoding abilities. Moreover, we also assessed the risk of recidivism. Results Our data pointed out that only the IPV perpetrators who received the SIP + cognitive training improved their processing speed and cognitive flexibility after this intervention. Furthermore, these participants presented the lowest risk of recidivism after the intervention. Nonetheless, cognitive improvements and reductions in the risk of recidivism after the intervention were unrelated. Conclusions Our study reinforces the importance of implementing cognitive training to reduce risk of recidivism after SIP. Hence, these results might encourage professionals to incorporate neuropsychological variables in IPV intervention programs.

Differential psychopathological profile of male intimate partner violence perpetrators depending on Problematic alcohol use

OBJECTIVE

This study explored the differential psychopathological profile between male perpetrators of intimate partner violence (IPV) with and without problematic alcohol use (PAU).

METHOD

A sample of 981 men was recruited from a specialized IPV perpetrators treatment programme. All of them were assessed with the Symptom Checklist-90-Revised (SCL-90-R), the State-Trait Anger Expression Inventory-2 (STAXI-2), and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Comparisons between perpetrators with (n = 125) and without (n = 856) PAU on all the variables studied were carried out.

RESULTS

Perpetrators with PAU were less frequently employed and had higher rates of previous psychiatric history and childhood family violence. Moreover, they presented with higher levels of cognitive biases about women and violence. On a psychopathological level, participants with PAU reported significantly higher scores on the SCL-90-R, on the STAXI-2, and on almost all the MCMI-III scales than did those without PAU. The multivariate logistic regression analyses showed that the main variables related to PAU were as follows: higher levels of previous psychiatric history, distorted thoughts about women, depression, drug dependence, and various personality disorders (bipolar, dysthymia, antisocial, avoidant, borderline, and schizotypal); and lower scores on internal control, anger reaction, paranoid ideation, and schizoid personality disorders.

DISCUSSION

IPV perpetrators with PAU have a more severe psychopathological profile than those without PAU. Additionally, several variables along with PAU may have contributed to the development of IPV. Therefore, tailored interventions should be developed for those perpetrators with PAU.

Long-Term Drug Misuse Increases the Risk of Cognitive Dysfunctions in Intimate Partner Violence Perpetrators: Key Intervention Targets for Reducing Dropout and Reoffending

Intimate partner violence against women (IPVAW) is a major public health problem, with an important mortality rate in women across the world. In this regard, it has been well-established that drug misuse explains (at least in part) an increased risk of IPVAW perpetration. Even though alcohol is the most widely studied drug underlying IPVAW, other drugs, such as cannabis and cocaine also seem to be significant indicators of this type of violence. Nonetheless, little is known about mediators, such as cognitive domains that facilitate proneness to violence after drug consumption. Therefore, the primary objective of the present study was to compare drug misuse patterns and cognitive performance in a carefully selected sample of IPVAW perpetrators (n = 63) and a group of non-violent men (control group; n = 39). Second, we also aimed to study the association between different patterns of drug misuse and cognitive performance and several facets of IPVAW perpetration (i.e., severity of injuries and type of aggression). Our results revealed that IPVAW perpetrators showed considerably higher levels of sustained drug misuse (alcohol, cannabis, cocaine, and heroin) for years and worse cognitive performance than controls. Moreover, the highest drug misuse sustained over time was related to the worst cognitive performance and the highest IPVAW severity. Finally, alcohol and cocaine seemed to be related to IPVAW and risk of reoffending. Whereas, cannabis, heroin, and MDMA were related to the existence of a previous criminal record (delinquency without violence). Hence, research in this field would help to develop coadjutant treatments and intervention packages to reduce drug misuse in the initial stages, which in turn would reduce cognitive impairments in IPVAW perpetrators. These expected improvements might produce an increase in treatment adherence and a decrease in the risk of future IPVAW reoffending.