Dissociative Symptoms in Women with Histories of Intimate Partner Victimization: A Focus on Coercive Control.

Identifying and contrasting different patterns of intimate partner violence (IPV) (e.g. situational couple violence, coercive controlling violence) is useful for understanding IPV and its connections with health. Applying this approach to dissociation may be fruitful, given theoretical perspectives that predict a specific connection between coercive controlling violence and dissociative symptoms. To address this, community women with divorce histories (N = 188) completed measures to identify patterns of IPV victimization in prior relationships (no direct violence, situational couple violence, coercive controlling violence), and to quantify recent dissociative symptoms and number of depressed days, for comparison. Contrary to predictions, the predicted odds of recent dissociative symptoms did not differ between women who experienced situational couple violence versus coercive controlling violence. However, the latter group had greater odds of recent dissociative symptoms, but not depressed days, compared to women with no histories of direct violence. Further, a continuous measure of coercive control was uniquely associated with increased odds of dissociative symptoms. This study provides preliminary empirical support for a connection between coercive controlling violence and dissociative symptoms, compared to women without histories of direct violence. This deserves further attention given the strong theoretical rationale for this link, and the importance of dissociation for mental health.

Thinking under fire: Mentalization-based couple therapy for high conflict and domestically abusive couples'.

BACKGROUND: The question of working psychotherapeutically with high conflict and domestically abusive couples is one that continues to raise anxieties within the field. AIMS: Embracing a relational approach offers an alternative perspective to the more familiar individual-based treatment interventions. MATERIALS AND METHODS: Drawing on my therapy with a married couple who presented in a crisis following an abusive incident, I will outline how I approached the assessment, my understanding of their presenting problem and the basis on which the therapy was conducted. RESULTS: During the eight months of treatment, the couple had frequent breakdowns in communication, and I found myself drawing on a range of mentalization-based techniques that supported and maintained the working alliance. DISCUSSION: Helping the couple break the damaging effects of the abuse, which was seriously affecting them and impacting their children, provides a particular focus for this submission. CONCLUSION: The rationale for undertaking couple therapy in situations of domestic violence and abuse was examined. The dynamic elements of theory underpinning practice, together with mentalization-based techniques designed to tackle disregulated states of mind that may lead to violent and abusive exchanges, were considered through the presentation of a case example.

EFT and Intimate Partner Violence: A Roadmap to De-escalating Violent Patterns.

This article aimed to extend and refine the existing roadmap of emotionally focused therapy (EFT) in cases of situational couple violence (SCV). SCV is a common problem with couples who seek out couple therapy. Based on attachment theory, academic research, EFT, and our clinical experience, we argue that SCV can be safely treated using EFT. Through a detailed case description of stage 1 of EFT with a violent couple, we demonstrate how EFT can help to reduce violence. We also discuss safety-related matters, specific therapeutic interventions, and potential limitations of the proposed method.

Este artículo tiene como finalidad ampliar y perfeccionar la hoja de ruta actual de la terapia centrada en emociones (TCE) en casos de violencia situacional de pareja (VSP). La VSP es un problema común en las parejas que buscan terapia de pareja. Sobre la base de la teoría del apego, la investigación académica, la TCE y nuestra experiencia clínica, sostenemos que la VSP puede tratarse de manera segura usando la TCE. Mediante una descripción detallada de un caso de etapa 1 de TCE con una pareja violenta, demostramos cómo la TCE puede contribuir a reducir la violencia. También comentamos asuntos relacionados con la seguridad, las intervenciones terapéuticas específicas y las posibles limitaciones del método propuesto.

Preventing intimate partner violence via the Internet: A randomized controlled trial of emotion-regulation and conflict-management training for individuals with aggression problems.

OBJECTIVE: The aim of this randomized controlled trial was to investigate the effect of an Internet-delivered cognitive behaviour therapy (iCBT), which incorporated emotion-regulation and conflict-resolution techniques, on intimate partner violence (IPV). Another aim was to test the theoretical underpinnings of the treatment model using mediation analysis. METHOD: Sixty-five participants with aggression problems in intimate adult relationships were recruited from the community and were randomly assigned to iCBT or to a monitored waitlist control. Participants were assessed with standardized self-report measures of IPV or aggression (Multidimensional Measure of Emotional Abuse, Revised Conflict Tactics Scale, and Aggression Questionnaire), relationship quality (Dyadic Adjustment Scale), anxiety or depression symptomatology (Patient Health Questionnaire; Generalized Anxiety Disorder Screener), at pretreatment, posttreatment (8 weeks), and 1-year follow-up. Process variables (subscales of Dysfunctional and Emotional Regulation Scale and Anger Rumination Scale) were assessed weekly over the active treatment phase. RESULTS: Robust linear regression analysis of all randomized participants showed significant treatment effects on emotional abuse relative to control at postassessment. Mediation analysis using growth curve modeling revealed that the treatment effect was partially mediated by changes in emotion-regulation ability. Controlled effects on secondary outcomes were also observed. Analyses of uncontrolled effects indicted that gains on IPV were maintained at 1-year follow-up. CONCLUSIONS: iCBT focusing on enhancing conflict-resolution skills and emotion-regulation ability has the potential to reduce IPV among self-recruited individuals with mild forms of abusive behaviour in intimate relationships. Emotion-regulation ability is potentially a key therapeutic process of change. KEY PRACTITIONER MESSAGE: Internet-delivered clinician-guided cognitive behaviour therapy is a viable treatment option for reducing intimate partner violence among self-recruited individuals with mild forms of abusive behaviour. For persons who display patterns of frequent and severe violence, other treatments are most likely needed. Emotion-regulation training is potentially a key therapeutic component that ought to be incorporated in interventions targeting IPV.

Evaluating Measures of Intimate Partner Violence Using Consensus-Based Standards of Validity.

The assessment of intimate partner violence (IPV) by mental health, medical, and criminal justice practitioners occurs routinely. The validity of the assessment instrument they use impacts practitioners' ability to judge ongoing risk, establish the type of IPV occurring, protect potential victims, and intervene effectively. Yet, there is no known compendium of existing assessment measures. The purpose of this article is threefold: (1) to present a systematic review of measures used to identify or predict IPV, (2) to determine which of these measures have psychometric evidence to support their use, and (3) to determine whether any existing measure is capable of differentiating between situational couple violence and intimate terrorism. A systematic search was conducted using PsycINFO, PsycARTICLES, PubMed, and MEDLINE. Studies on the reliability or validity of specific measures of IPV were included, regardless of format, length, discipline, or type of IPV assessed. A total of 222 studies, on the psychometric properties of 87 unique measures, met our a priori criteria and were included in the review. We described the reliability and validity of the 87 measures. We rated the measures based on the Consensus-based Standards for the Selection of Health Measurement Instruments-revised criteria and other established validity criteria, which allowed us to generate a list of recommended measures. We also discussed measures designed to differentiate IPV types. We conclude by describing the strengths and weaknesses of existing measures and by suggesting new avenues for researchers to enhance the assessment of IPV.

Perpetrator Risk Markers for Intimate Terrorism and Situational Couple Violence: A Meta-Analysis.

Johnson developed a typology of intimate partner violence (IPV) which includes two different categories of violence: situational couple violence (SCV) and intimate terrorism (IT). Johnson proposed that IT is more likely to be found in clinical samples (e.g., batterer intervention programs or domestic violence shelters) compared to nonclinical (general population) samples. This meta-analysis (n = 149 studies; k = 216 effect sizes) examines differences in the strengths of IPV risk markers in clinical and nonclinical samples of male perpetrators and female victims. All variables (communication and conflict resolution, demand-withdraw patterns, relationship dissatisfaction, controlling behaviors, jealousy, patriarchal beliefs, power in the relationship, and stalking) were expected to be significantly related to IPV for both clinical and nonclinical populations. However, specific variables indicative of IT (control, jealousy, patriarchal beliefs, power, and stalking) were expected to be more strongly associated with clinical samples compared to nonclinical samples. As expected, most variables were significant for clinical and nonclinical populations, and IT risk markers (control, power, jealousy, and patriarchal beliefs) were significantly stronger risk markers for IPV in clinical samples. These results indicate that Johnson's typology may be conceptualized as representing a continuum of violence, with IT being more severe due to the controlling nature of the violence. Sample type needs to be considered when research about IPV is disseminated, as different degrees of IPV (IT vs. SCV) may be present depending on sample type. Implications from this study include the need to differentiate the level of violence and to tailor intervention for IPV appropriately.

Exploring Variations Within Situational Couple Violence and Comparisons With Coercive Controlling Violence and No Violence/No Control.

We examined variations within situational couple violence among 23 divorcing mothers and compared them with mothers with coercive controlling violence and no violence/no control. Situational couple violence had great variability in frequency and severity of violence, fear, harassment, and protective strategies. In some cases, situational couple violence was frequent and severe and resembled coercive controlling violence in its consequences. The dynamics of fear and harassment in situational couple violence and in the divorce process in general warrant attention. Finally, mothers reported mental health symptoms that did not differ by group, which is likely due to the stresses of divorce.

Intimate terrorism and situational couple violence in general surveys: ex-spouses required.

In this article, we argue that past efforts to distinguish among types of intimate partner violence in general survey data have committed a critical error--using data on current spouses to develop operationalizations of intimate terrorism and situational couple violence. We use ex-spouse data from the National Violence Against Women Survey (NVAWS) to develop new operationalizations. We then demonstrate that NVAWS current spouse data contain little intimate terrorism; we argue that this is likely to be the case for all general surveys. In addition, the ex-spouse data confirm past findings regarding a variety of differences between intimate terrorism and situational couple violence, including those predicted by feminist theories.