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Kennedy E, O'Nions E, Pulford BD, Bursnall S, Germuska J, Senior R. The Tavistock First-Time Parent Study: a pilot randomised controlled feasibility trial of a brief couple-focused perinatal intervention to reduce inter-parental discord. Eur Child Adolesc Psychiatry 2023; 32:451-462. [PMID: 34546408 DOI: 10.1007/s00787-021-01862-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 08/13/2021] [Indexed: 10/20/2022]
Abstract
Numerous studies report that some first-time parents experience a decline in relationship quality and an increase in conflict after the birth of a first baby. Inter-parental discord that is frequent, intense, and poorly resolved increases the likelihood of relationship breakdown and adversely impacts child development. We investigated the feasibility of a brief preventative couple-focused psychotherapeutic intervention in the perinatal period in a general population sample. Sixty couples expecting their first baby were recruited from the Royal Free Hospital, London. Thirty were randomly assigned to treatment (TMT, a newly developed five-session couple-focused intervention), and 30 to usual care (TAU). Outcomes were collected at 28 weeks into pregnancy, 6-8 weeks after birth, and when the baby was 6 months old. The intervention was feasible and acceptable, evidenced by 100% attendance. However, no change in relationship quality or inter-parental discord was detected in either TMT or TAU groups across the transition to parenthood. The intervention did not improve outcomes vs. TAU. Depression assessed by the Hospital Anxiety and Depression Scale increased across the cohort and mood symptoms assessed by the Edinburgh Postnatal Depression Scale decreased in mothers but not fathers. The absence of a decline in relationship quality could reflect sample attributes: couples were older than average UK first-time parents, had high levels of educational qualifications, and low discord. Even in this low-risk sample, only 20 out of 30 TAU couples completed all three assessments, vs. 29 out of 30 TMT couples. Larger-scale RCTs of perinatal couple-focused psychosocial interventions may be hampered by selection effects and attrition. They may benefit from co-design with stakeholders and active control conditions.Trial registration: ISRCTN12258825; 1st May 2020 (retrospectively registered).
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Affiliation(s)
- Eilis Kennedy
- Research and Development Unit, The Tavistock and Portman NHS Foundation Trust, 120 Belsize Lane, London, NW3 5BA, UK.
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
| | - Elizabeth O'Nions
- Research and Development Unit, The Tavistock and Portman NHS Foundation Trust, 120 Belsize Lane, London, NW3 5BA, UK
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Briony D Pulford
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Sam Bursnall
- Research and Development Unit, The Tavistock and Portman NHS Foundation Trust, 120 Belsize Lane, London, NW3 5BA, UK
| | - Judit Germuska
- University College London, Great Ormond Street Institute of Child Health, London, UK
| | - Rob Senior
- Research and Development Unit, The Tavistock and Portman NHS Foundation Trust, 120 Belsize Lane, London, NW3 5BA, UK
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Shorey RC, Strauss C, Elmquist J, Anderson S, Cornelius TL, Stuart GL. Distress Tolerance and Intimate Partner Violence among Men in Substance Use Treatment. JOURNAL OF FAMILY VIOLENCE 2017; 32:317-324. [PMID: 28366983 PMCID: PMC5373090 DOI: 10.1007/s10896-016-9843-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Intimate partner violence (IPV) is overrepresented among men in substance use treatment. Individuals who relapse following substance use treatment report greater IPV perpetration relative to individuals who remain remitted. In addition, distress tolerance has been shown to be an important treatment target in substance use treatment, with distress tolerance predicting relapse following treatment. However, we are unaware of any research that has examined the relationship between distress tolerance and IPV among men in substance use treatment, which may hold important treatment implications. The current study therefore examined this relationship in a sample of men in substance use treatment (N = 138). Results demonstrated that distress tolerance was negatively associated with physical and psychological IPV perpetration. After controlling for age and substance use and problems, distress tolerance remained associated with psychological, but not physical, IPV perpetration. These findings suggest that distress tolerance may be an important component of treatments for IPV, particularly for psychological aggression. Substance use treatment programs that target distress tolerance may concurrently reduce the risk for relapse to substance use and IPV perpetration.
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Shorey RC, Elmquist J, Strauss C, Anderson SE, Stuart GL. Research Reactions Following Participation in Intimate Partner Violence Research: An Examination With Men in Substance Use Treatment. JOURNAL OF INTERPERSONAL VIOLENCE 2016; 31:3196-3210. [PMID: 25944831 DOI: 10.1177/0886260515584345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
There has been increased attention in recent years related to the research reactions of individuals who participate in intimate partner violence (IPV) research. Existing studies demonstrate that participating in IPV research is not emotionally upsetting for the vast majority of participants and that many participants perceive benefit from their research participation. However, almost all of the existing research has utilized non-clinical samples or battered women, failing to examine the research reactions of a clinical sample of men. Thus, the present study examined the research reactions of men in substance use treatment ( N = 138) who completed a self-report measure of IPV perpetration and victimization. We also examined whether distress tolerance moderated the relationship between reports of IPV and negative emotional research reactions. Consistent with previous research, after accounting for distress tolerance, substance use, and demographic control variables, IPV was unrelated to negative emotional research reactions. Distress tolerance did not moderate the association between IPV and research reactions. Findings add to a growing body of literature suggesting that IPV research meets Institutional Review Board (IRB) requirements for minimal risk research.
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Brasfield H, Morean ME, Febres J, Shorey RC, Moore TM, Zuckosky Zapor H, Elmquist J, Wolford-Clevenger C, Labrecque L, Plasencia M, Stuart GL. Alcohol Use, Alcohol-Related Outcome Expectancies, and Partner Aggression Among Males Court-Mandated to Batterer Intervention Programs: A Brief Report. JOURNAL OF INTERPERSONAL VIOLENCE 2016; 31:245-256. [PMID: 25519237 PMCID: PMC4469639 DOI: 10.1177/0886260514555366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Additional work is needed to determine how and/or why the relationship between alcohol use and increased risk of partner aggression (PA) exists. Researchers have begun to examine whether alcohol-related outcome expectancies (i.e., beliefs about the cognitive and behavioral effects of alcohol) are associated with PA irrespective of alcohol use. We examined the relationship between alcohol use, alcohol expectancies, and PA among 360 males arrested for a domestic violence offense and court-mandated to treatment. Results indicate that certain alcohol expectancies do play a role in the relationship between alcohol use and some forms of PA.
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Affiliation(s)
| | - Meghan E Morean
- Oberlin College, Oberlin, OH, USA Yale University, New Haven, CT, USA
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Faulkner B, Goldstein AL, Wekerle C. Pathways from childhood maltreatment to emerging adulthood: investigating trauma-mediated substance use and dating violence outcomes among child protective services-involved youth. CHILD MALTREATMENT 2014; 19:219-232. [PMID: 25287053 DOI: 10.1177/1077559514551944] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Longitudinal survey data were used to examine the relationship between two types of childhood maltreatment, abuse/neglect and exposure to intimate partner violence (IPV), and two outcomes, substance use and dating violence, within the past year. Participants were youth (N = 158, aged 16-19 at Time 3) involved with child protective services (CPS). A parallel multiple mediator model was used to test the hypothesis that trauma symptoms would mediate the relationship between both types of maltreatment and dating violence, marijuana, and alcohol use outcomes. Although both types of maltreatment were not directly associated with dating violence and substance use outcomes, the indirect effects of anxiety, anger, and dissociation on the relationship between maltreatment and substance use/dating violence were significant. Direct effects of both types of maltreatment on past year use of dating violence + alcohol use and dating violence + marijuana use were not significant, but results demonstrated a significant indirect effect for anger on the relationship between exposure to IPV and past year dating violence + marijuana use. No other indirect effects were significant. Findings highlight the negative effects of exposure to IPV and have implications for the development of prevention programming for youth transitioning out of CPS.
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Stuart GL, McGeary J, Shorey RC, Knopik V, Beaucage K, Temple JR. Genetic associations with intimate partner violence in a sample of hazardous drinking men in batterer intervention programs. Violence Against Women 2014; 20:385-400. [PMID: 24759925 PMCID: PMC4000529 DOI: 10.1177/1077801214528587] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The etiology of intimate partner violence (IPV) is multifactorial. However, etiological theories of IPV have rarely included potential genetic factors. The purpose of the present study was to examine whether a cumulative genetic score (CGS) containing the monoamine oxidase A (MAOA) and the human serotonin transporter gene linked polymorphism (5-HTTLPR) was associated with IPV perpetration after accounting for the effects of alcohol problems, drug problems, age, and length of relationship. We obtained DNA from 97 men in batterer intervention programs in the state of Rhode Island. In the full sample, the CGS was significantly associated with physical and psychological aggression and injuries caused to one's partner, even after controlling for the effects of alcohol problems, drug problems, age, and length of relationship. Two of the men in the sample likely had Klinefelter's syndrome, and analyses were repeated excluding these two individuals, leading to similar results. The implications of the genetic findings for the etiology and treatment of IPV among men in batterer intervention programs are briefly discussed.
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Affiliation(s)
- Gregory L. Stuart
- University of Tennessee-Knoxville & Alpert Medical School of Brown University & Butler Hospital
| | - John McGeary
- Division of Behavioral Genetics, Rhode Island Hospital & Alpert Medical School of Brown University
- Providence VA Medical Center
| | | | - Valerie Knopik
- Division of Behavioral Genetics, Rhode Island Hospital & Alpert Medical School of Brown University
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Brasfield H, Febres J, Shorey R, Strong D, Ninnemann A, Elmquist J, Andersen SM, Bucossi M, Schonbrun YC, Temple JR, Stuart GL. Male batterers' alcohol use and gambling behavior. J Gambl Stud 2012; 28:77-88. [PMID: 21516369 PMCID: PMC3382076 DOI: 10.1007/s10899-011-9246-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Little work has examined the interrelations among intimate partner violence (IPV), alcohol use, and gambling behavior, and no studies have examined these relationships among males court-ordered to batterer intervention programs (BIPs). The aim of the current investigation was to explore the associations between IPV, alcohol use, and gambling behavior among 341 males court-mandated to attend BIPs utilizing self-report measures. Voluntary, anonymous questionnaires were administered and completed during regularly scheduled BIP sessions. Compared to the general population, a higher percentage of the sample met criteria for pathological gambling (9%), and problem gambling (17%). Further, males exhibiting pathological gambling were more likely to be hazardous drinkers, and hazardous drinkers were more likely to exhibit pathological gambling. Additionally, pathological gamblers were at an increased risk for the perpetration of both physical and sexual aggression. Finally, gambling behavior uniquely predicted the perpetration of sexual aggression above and beyond alcohol use, impulsivity, and relationship satisfaction. The implications of these results for future research and intervention are discussed.
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Affiliation(s)
- Hope Brasfield
- Department of Psychology, The University of Tennessee, Knoxville, TN, USA.
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Rothman EF, Stuart GL, Greenbaum PE, Heeren T, Bowen DJ, Vinci R, Baughman AL, Bernstein J. Drinking style and dating violence in a sample of urban, alcohol-using youth. J Stud Alcohol Drugs 2012; 72:555-66. [PMID: 21683037 DOI: 10.15288/jsad.2011.72.555] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study examined childhood abuse, problem behavior, drinking style, and dating violence (DV). Our goal was to assess whether (a) alcohol use-related beliefs and behaviors ("drinking style") would be associated with DV perpetration and victimization, (b) drinking style would mediate the relationship between childhood abuse and DV, and (c) the drinking style-DV relationship would be attributable to propensity for problem behavior. METHOD Cross-sectional survey data were collected from 456 youth ages 14-21 years who were patients in an urban emergency department. Participants were eligible if they were unmarried and reported past-month alcohol use and dating in the past year. By design, the sample was 50% female. Data were analyzed using structural equation modeling. RESULTS For both males and females, past-year DV was associated with a more risky drinking style, characterized by more frequent alcohol use, alcohol-aggression expectancies, drinking to cope, and beliefs that alcohol is disinhibiting and that being drunk provides a "time-out" from behavioral expectations. Drinking style mediated the childhood victimization-DV relationship for males and females. However, when propensity for problem behavior was included in the model, the effect of drinking style on DV was no longer significant. Substantial path differences for males and females were observed. CONCLUSIONS The current study examined adolescent drinking style as a potential mediator between childhood victimization and DV. Drinking style was associated with DV for males and females and mediated the relationship between childhood victimization and DV. The relationship between drinking style and DV appeared to reflect adolescents' propensity for problem behavior. Variations in males' and females' pathways to DV were observed. The implications of these findings are discussed.
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Affiliation(s)
- Emily F Rothman
- Department of Community Health Sciences, Boston University School of Public Health, Massachusetts 02118, USA.
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Rothman EF, Johnson RM, Azrael D, Hall DM, Weinberg J. Perpetration of physical assault against dating partners, peers, and siblings among a locally representative sample of high school students in Boston, Massachusetts. ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE 2010; 164:1118-24. [PMID: 21135340 PMCID: PMC3381649 DOI: 10.1001/archpediatrics.2010.229] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To assess the co-occurrence of past-month physical assault of a dating partner and violence against peers and siblings among a locally representative sample of high school students and to explore correlates of dating violence (DV) perpetration. DESIGN Cross-sectional survey design. SETTING Twenty-two public high schools in Boston, Massachusetts. PARTICIPANTS A sample of urban high school students (n = 1398) who participated in the Boston Youth Survey, implemented January through April of 2008. MAIN OUTCOMES MEASURES Self-reported physical DV in the month before the survey, defined as pushing, shoving, slapping, hitting, punching, kicking, or choking a dating partner 1 or more times. RESULTS Among the respondents, 18.7%, 41.2%, and 31.2% of students reported past-month perpetration of physical DV, peer violence, and sibling violence, respectively. Among violence perpetrators, the perpetration of DV only was rare (7.9%). Controlling for age and school, the association between sibling violence and DV was strong for boys (adjusted prevalence ratio, 3.81; 95% confidence interval, 2.07-6.99) and for girls (1.83; 1.44-2.31), and the association between peer violence and DV perpetration was strong for boys (5.13; 3.15-8.35) and for girls (2.57; 1.87-3.52). Dating violence perpetration was also associated with substance use, knife carrying, delinquency, and exposure to community violence. CONCLUSIONS Adolescents who perpetrated physical DV were also likely to have perpetrated peer and/or sibling violence. Dating violence is likely one of many co-occurring adolescent problem behaviors, including sibling and peer violence perpetration, substance use, weapon carrying, and academic problems.
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Affiliation(s)
- Emily F Rothman
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA 02118, USA.
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Schumm JA, O'Farrell TJ, Murphy CM, Fals-Stewart W. Partner violence before and after couples-based alcoholism treatment for female alcoholic patients. J Consult Clin Psychol 2009; 77:1136-46. [PMID: 19968389 PMCID: PMC2819228 DOI: 10.1037/a0017389] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined partner violence before and in the 1st and 2nd year after behavioral couples therapy (BCT) for 103 married or cohabiting women seeking alcohol dependence treatment and their male partners; it used a demographically matched nonalcoholic comparison sample. The treatment sample received M = 16.7 BCT sessions over 5-6 months. Follow-up rates for the treatment sample at Years 1 and 2 were 88% and 83%, respectively. In the year before BCT, 68% of female alcoholic patients had been violent toward their male partner, nearly 5 times the comparison sample rate of 15%. In the year after BCT, violence prevalence decreased significantly to 31% of the treatment sample. Women were classified as remitted after treatment if they demonstrated abstinence or minimal substance use and no serious consequences related to substance use. In Year 1 following BCT, 45% were classified as remitted, and 49% were classified as remitted in Year 2. Among remitted patients in the year after BCT, violence prevalence of 22% did not differ from the comparison sample and was significantly lower than the rate among relapsed patients (38%). Results for male-perpetrated violence and for the 2nd year after BCT were similar to the 1st year. Results supported predictions that partner violence would decrease after BCT and that clinically significant violence reductions to the level of a nonalcoholic comparison sample would occur for patients whose alcoholism was remitted after BCT. These findings replicate previous research among men with alcoholism.
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Affiliation(s)
- Jeremiah A Schumm
- Families and Addiction Program, Department of Psychiatry, Harvard Medical School, USA
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