Aggression by Children Exposed to IPV: Exploring the Role of Child Depressive Symptoms, Trauma-Related Symptoms, & Warmth in Family Relationships.

Multi-informant reports of aggression by siblings in families with and without a history of IPV were compared. Associations between aggressive behavior and child depressive and trauma-related symptoms, as well as maternal and sibling warmth were also explored. Mothers, observers and the siblings themselves reported on aggressive behaviour. Mothers reported on child trauma-related symptoms while children provided self-report on depressive symptoms and mother-child and sibling warmth. The frequency of observed aggression did not differ across groups on average, although more sibling dyads exposed to IPV engaged in aggression than those not exposed. Child reports of sibling aggression did not differ across groups but mothers reported significantly less aggressive behavior by children exposed to IPV than those not exposed. Regression results indicated that depressive and trauma-related symptoms were significant risk factors for aggression, while the role of mother-child and sibling warmth was more complex. Results were discussed within a developmental psychopathology framework.

The Hans Kai trial: study protocol of a mixed methods randomized controlled trial evaluating a peer-led health promotion program for adults with or without noncommunicable diseases.

BACKGROUND: A significant proportion of Canadian adults is impacted by chronic noncommunicable diseases. These conditions may be improved by peer-led health promotion interventions that target modifiable risk factors; however, to date, there is mixed evidence on the effectiveness of these interventions. Unlike other health promotion programs, Hans Kai is grounded in a holistic model of health that simultaneously addresses multiple determinants of health at different levels of human ecology. In Hans Kai, a set of informational sessions that are delivered in a group setting by healthcare professionals are followed by regular peer-led group meetings in a self-governed support group setting that is designed to promote implementation of newly learned health competences. The Hans Kai trial described here aims to evaluate the efficacy of the Hans Kai program in promoting the health and wellbeing of its participants and investigate the experiences of the Hans Kai participants and facilitators. METHODS: This research will involve a mixed methods trial combining an experimental component with a qualitative component. The experimental component will involve a 6-month 2-group parallel superiority randomized controlled trial (RCT) in which 105 participants will be randomly assigned to two conditions, an intervention group (n = 70) that will participate in the Hans Kai program and a control group (n = 35) that will have access to standard care using a computer-generated random sequence; blinding will not occur. The RCT will test the impact of the program on several health outcomes and will be followed by a 12-18-month observational follow-up study that will provide data on the long-term durability of the 6-month RCT health outcomes. The qualitative component will investigate the experiences of program participants (n = 30) and facilitators (n = 15) to identify the main strengths and limitations of Hans Kai, uncover potential implementation issues, and elucidate the mechanisms through which the program works. The population of interest will include adults aged 18 + with or without chronic health conditions who self-report an interest in taking control of their own health and improving their lifestyle. In the RCT, all outcomes of interest will be measured using a multi-method approach, involving self-report questionnaires and objective indicators, and within-subject mean changes in outcomes over time between the two groups will be compared to address the RCT aims. Similarly, in the qualitative component, a multi-method approach, involving in-depth individual interviews, photovoice, and online surveys, will be used to reach a deeper and more nuanced understanding of the program strengths, how the program works, and for which people it is more effective. Adaptable components of the program will also be investigated and modified according to the feedback provided by the RCT participants. In the mixed methods integration of evidence, the qualitative findings will be used to explain the quantitative RCT results. DISCUSSION: The RCT findings will help support the further development and use of Hans Kai as well as other peer-led health promotion interventions. TRIAL REGISTRATION: United Stated Clinical Trial Registry ClinicalTrials.gov (registration# NCT03949725; Protocol version 2, June 22nd, 2022).

Investigating adjustment profiles in children exposed to intimate partner violence using a biopsychosocial resilience framework: A Canadian population-based study.

BACKGROUND: The variability observed across different profiles of adjustment in children exposed to intimate partner violence (IPV) and the factors associated with resilience in this population are not yet well understood. OBJECTIVE: Within a biopsychosocial framework, this study aimed to identify and describe profiles of adjustment in a cohort of children who had previously experienced IPV exposure, as well as the specific risk and promotive factors that significantly predicted membership in the identified adjustment profiles. The moderating effect of children's biological sex was also tested. PARTICIPANTS AND SETTING: Population-based administrative data on all residents of the Province of Manitoba (Canada) over a 12-year period (2006-2017) were used to create a cohort of 3886 children aged 6-11 years who experienced IPV exposure and to extract information on these children and their mothers. METHOD: Within a retrospective cohort study design, all study variables were extracted by linking multiple administrative health, social and justice datasets that were available in the Manitoba Population Research Data Repository. RESULTS: Person-centered latent class analysis revealed four distinct adjustment profiles in the cohort of children, which differed for boys and girls. These included a resilient profile in which children showed no adjustment problems, as well as three profiles showing different combinations of children's externalizing problems and physical health problems. Positive maternal mental and physical health were the strongest predictors of resilient profile membership in both boys and girls. CONCLUSIONS: Study results suggest interconnectedness among biological, psychological and social domains in shaping the adjustment of children exposed to IPV and corroborate existing evidence on the key role that mothers play in promoting the resilience of these children. Thus, future resilience research with this group and resilience-promoting programming for IPV-affected families would benefit from adopting a multisystemic biopsychosocial resilience framework that simultaneously accounts for factors at all levels of human ecologies.

Changes in the quality of life of persons with profound intellectual and multiple disabilities following community transition: A Canadian study.

BACKGROUND: The goal of this research study was to measure changes in the quality of life (QoL) of adults with profound intellectual and multiple disabilities (PIMD) and complex care needs following their transition from a large institutional residence to smaller community homes in Central Canada. METHOD: A pre- post-transition quasi-experimental time-series longitudinal study design was implemented to measure the impact of community transition on the QoL of study participants. QoL was assessed in eight domains (self-determination; emotional, physical, and material wellbeing; rights; personal development; social inclusion; and interpersonal relations) by proxy at two time points (Time 1: pre-transition and Time 2: at least 6 months post-transition) using the standardized tool San Martin Scale. The study group included 33 persons with PIMD and complex care needs (20 men [60%] and 13 women [40%]) aged 24-55 years (M = 42.52; SD = 8.07). Paired-samples t-test was conducted to determine significant changes in the QoL of study participants following their community transition. RESULTS: Between pre- and post-transition, study participants experienced significant improvements in all the eight domains of QoL evaluated as well as in global QoL. Mean differences ranged from 5.67 (SD = 5.16, t(32) = 6.31, p = .001) for rights to 1.73 (SD = 3.10, t(32) = 3.19, p = .003) for physical wellbeing. Mean global QoL improved significantly from 99.97 (SD = 16.54) pre-transition to 120.42 (SD = 10.54) post-transition (Mdiff = 17.55, t(32) = 6.69, p = .001). CONCLUSIONS: This longitudinal study provides evidence of improved QoL for persons with PIMD following deinstitutionalization.

Understanding the Mechanisms through Which Family Risk Affects Adolescent Mental Health: A Model of Multisystemic Resilience in Context.

There is substantial evidence that exposure to family adversity significantly and negatively impacts positive adolescent development by placing adolescents at increased risk of experiencing developmental difficulties, including conduct problems. Although the mechanisms responsible for these effects are still largely unknown, a novel line of inquiry in the resilience field conceptualizes positive adaptation, following exposure to atypical adversity, as resulting from complex interactions of systems at multiple ecological levels. The purpose of the present analysis was to apply this multisystemic resilience framework to the study of positive adaptation following exposure to family adversity in a sample of Canadian adolescents (n = 230; mean age 16.16, SD = 1.38) and South African adolescents (n = 421; mean age = 15.97, SD = 1.19) living in economically volatile communities dependent on the oil and gas industry. Cross-sectional survey data were used to investigate the mechanisms through which family adversity exercises its impact on adolescent conduct problems by accounting for their caregiving, peer, and community resources. Results of two moderated mediation analyses showed that family adversity impacts adolescent externalizing mental health negatively, via disrupted caregiving, when other resources are also considered. For the Canadian adolescents, these negative impacts were protectively moderated by peer support, but not moderated by appreciation for community traditions. In contrast, peer support showed no significant protective effect for the South African sample, while a strong appreciation for community traditions was positively and significantly associated with conduct difficulties. Contextual dynamics (e.g., social unrest) provide a plausible explanation for the discrepant results and bring attention to the importance of theorizing resilience in context.

Aggression in Children Exposed to Intimate Partner Violence: A Comparison of Maternal, Sibling, and Observer Perspectives.

The negative effects of exposure to intimate partner violence (IPV) on children have been well documented, including externalizing difficulties such as aggression. Although aggressive behavior is a common concern for these children, sibling aggression in children exposed to IPV has rarely been studied. Our purpose was to investigate similarities and differences in multiple informant reports of aggression by siblings exposed to IPV, and to examine how exposure to IPV was linked to these differing perspectives. Forty-seven sibling dyads and their mothers were recruited from the community. Aggression was assessed by observers, by mothers, and by the siblings themselves, whereas IPV was assessed by both maternal and child report. Informants had very differing views on aggression. Regression results indicated that children's reports of their own exposure to IPV accounted for significant variance in observed aggression between siblings, as well as in the maternal reports of aggression by both siblings. Aggression did not vary by sibling age, sex, or age spacing. Results were discussed within a risk and resilience framework.

Linking a History of Childhood Abuse to Adult Health among Canadians: A Structural Equation Modelling Analysis.

A history of childhood abuse has been linked to serious and long-lasting problems in adulthood. We developed two theoretical models concerning how early adverse experiences affect health in adulthood, and we tested the empirical fit of the two models in a population-based representative sample of Canadian adults (N = 25,113) using a structural equation modelling (SEM) technique, path analysis. The first model included direct pathways by which a history of three types of childhood abuse-exposure to intimate partner violence, physical abuse, and sexual abuse-affected adult physical and mental health, as well as indirect pathways by which perceived social support and everyday life stress acted as mediators of these associations. The second model included only indirect pathways and tested mediating effects. Global statistics indicated that both models were a good fit to the data, and local statistics supported the hypothesized associations between independent, dependent, and mediator variables.

Self-Esteem in Children Exposed to Intimate Partner Violence: a Critical Review of the Role of Sibling Relationships and Agenda for Future Research.

This paper provides a critical analysis of research on self-esteem in children exposed to intimate partner violence (IPV), with particular emphasis on the role of sibling relationships. Over 100 empirical and review articles published from 2000 to 2015 examining self-esteem in children exposed to IPV, the role of sibling relationships in the development of self-esteem, and the sibling relationships of children exposed to IPV, were reviewed. Research findings show that self-esteem is an important component of understanding children's positive adjustment and their adjustment difficulties. A substantial research literature also documents that siblings significantly influence one another's self-esteem; however, the potential risk or protective function of sibling relationships in the development of self-esteem in children and adolescents exposed to IPV has only been minimally investigated. This is a serious gap in the literature, as this information has significant potential for informing prevention and intervention programming. Recommendations for future research were provided.