Can a Parenting Intervention to Prevent Early Conduct Problems Interrupt Girls' Risk for Intimate Partner Violence 10 Years Later?

This study tests whether a parenting intervention for families of preschoolers at risk for conduct problems can prevent later risk for intimate partner violence (IPV). Ninety-nine preschoolers at familial risk for conduct problems were randomly assigned to intervention or control conditions. Ten years later, 45 preschoolers and 43 of their siblings completed an assessment of their romantic relationships, including measures of physical and psychological IPV. The study focuses on the 54 females, including targets (n = 27) and siblings (n = 27) who participated in a 10-year follow-up (M age = 16.5, SD = 5.2, range = 10-28). Using an intent-to-treat (ITT) design, multivariate regressions suggest that females from families randomly assigned to intervention in early childhood scored lower than those in the control condition on perceptions of dating violence as normative, beliefs about IPV prevalence, exposure to IPV in their own peer group, and expected sanction behaviors for IPV perpetration and victimization. Findings suggest that early parenting intervention may reduce association of high-risk females with aggressive peers and partners in adolescence.

Web-Based Prevention of Parenting Difficulties in Young, Urban Mothers Enrolled in Post-Secondary Education.

Research consistently indicates that young mothers are at elevated risk for adverse social and economic risks. Recent attention has been paid to the value of maternal educational attainment for their children's economic and social outcomes. Pursuit of post-secondary education requires mothers to balance multiple roles, potentially stressing the parent-child relationship. Yet, almost no studies have addressed parenting and associated stress in young mothers enrolled in post-secondary education, and no preventive intervention trials have been conducted. We screened young mothers (<25 years at child's birth) pursuing post-secondary education in an urban, inner city college for study inclusion based on elevated parenting stress, and participated in a randomized controlled trial to assess the efficacy of a web-based parenting intervention (Triple P Online) in reducing parenting stress and dysfunctional discipline (N = 52). Mothers were randomly assigned to the web-based parenting program condition or to a waitlist control condition. Mothers who completed at least the first four core modules of the online program had lower scores on the Parenting Scale's subscales (Overreactivity, Verbosity, and Laxness), compared to those who did not complete four or more modules. No intervention effects were obtained for parenting stress. The current study provides preliminary evidence of the efficacy of this online parenting program for reducing risk for dysfunctional discipline in student mothers. Future research is warranted to replicate these findings, and to test whether provision of supplemental support for implementation, or briefer program formats may promote both program compliance and outcomes related to reducing parenting stress.

A safety app to respond to dating violence for college women and their friends: the MyPlan study randomized controlled trial protocol.

BACKGROUND: Research demonstrates high rates of physical and sexual victimization of women by intimate partners on college campuses (Black et al. 2001). College women in abusive relationships must weigh complex factors (health, academics, economics, and social stigma) during critical decision-making regarding the relationship. Rather than access formal support systems (e.g., campus security, administrators, counselors), research indicates abused college women most often turn to informal networks; specifically friends (Perspect Psychiatr Care 41:162-171, 2005), who often lack the knowledge or resources to provide effective support (Nurs Res 54(4):235-242, 2005). Decision aids have been shown to assist with health-related decisions by improving knowledge, creating realistic expectations, and resolving decisional conflict (Cochrane Database Syst Rev 1:1-332, 2014). METHODS/DESIGN: This study is a randomized controlled trial testing the effectiveness of an interactive safety decision aid web-based and smartphone application (App) for abused college women and their friends. Three hundred female college students experiencing abuse and three hundred friends of female college students experiencing abuse will be recruited in Maryland and Oregon and randomized to either the intervention safety decision aid, accessible by website or smartphone App, or a usual safety planning control website/App. The intervention App allows users to enter information on: a) relationship health; b) safety priorities; and c) severity of violence/danger in relationship. The App uses this information to provide personalized safety planning information and resources. Self-reported outcome measures for abused college women on safety seeking behaviors, decisional conflict, IPV exposure and mental health will be collected at baseline, six, and 12-months post-baseline via the study App/website. Outcomes measured for friends are IPV awareness, confidence to intervene, supportive behaviors and decisional conflict. Protocols for safely recruiting, retaining and collecting data from abused women via web/App are discussed. DISCUSSION: This trial may provide important information on the impact of an App and web-based safety planning tool on college women's decisional conflict and safety behavior use when making difficult safety decisions. This study is the first, to our knowledge, to test an intervention that engages friends of abused college women. The trial may also inform researchers on the feasibility of safely conducting research with abused women using online recruitment and enrollment methods and collecting data via an App or website. TRIAL REGISTRATION: Clinicaltrials.gov ID: NCT02236663.

Contribution of family violence to the intergenerational transmission of externalizing behavior.

Research finds that early antisocial behavior is a risk for later intimate partner violence (IPV) perpetration and victimization, and that children's exposure to their parents' IPV is a risk for subsequent behavior problems. This study tests whether intimate violence (IPV) between partners contributes independently to the intergenerational transmission of antisocial behavior, using the Children in the Community Study, a representative sample (N = 821) followed for over 25 years in 6 assessments. The present study includes a subsample of parents (N = 678) and their offspring (N = 396). We test the role of three mechanisms by which IPV may influence child antisocial behavior-parental psychopathology, parenting practices, and child self-regulation. Results suggest that IPV independently increased the risk for offspring externalizing problems, net of the effects of parental history of antisocial behavior and family violence. IPV also increased the risk for parental post traumatic stress disorder (PTSD) and alcohol use disorder 2 years later, but not for major depressive disorder. Alcohol use disorder independently increased the risk for offspring externalizing behavior, but IPV continued to predict offspring externalizing net of parental alcohol use. Parenting, particularly low satisfaction with the child, was significantly associated with both IPV and externalizing behavior, but did not mediate the effects of IPV on externalizing. IPV predicted higher levels of emotional expressivity, aggression and hostile reactivity, and depressive mood in offspring. Implications for future research and prevention are discussed.

Early maternal separation and the trajectory of borderline personality disorder symptoms.

Extended maternal separations before age 5 were evaluated as a predictor of long-term risk for offspring borderline personality disorder (BPD) symptoms in longitudinal data from a large random community sample. Early separations from mother predicted elevations in BPD symptoms assessed repeatedly from early adolescence to middle adulthood. Early separations also predicted a slower than normal rate of decline in symptoms with age. Other theoretically grounded risks were examined and shown to predict elevated BPD symptoms over the developmental trajectory. Long-term effects of early separations were largely independent of childhood temperament, child abuse, maternal problems, and parenting risks. These data provide the first prospectively collected data on the developmental course of BPD symptoms and suggest a series of environmental and other influences on these very disabling problems.

Is domestic violence followed by an increased risk of psychiatric disorders among women but not among men? A longitudinal cohort study.

OBJECTIVE: The association between violence between intimate partners and psychiatric disorders is assumed to reflect a causal link. This assumption is now questioned because several longitudinal studies have documented that adolescents with psychiatric disorders grow up to be overrepresented among adults involved in partner violence. METHOD: The study followed a representative birth cohort prospectively. Adolescent mental disorders were diagnosed at age 18 years. Between ages 24 and 26 years, the authors identified individuals involved in nonabusive relationships versus those involved in clinically abusive relationships (i.e., resulting in injury and/or official intervention). At age 26 years, mental disorders were again diagnosed. RESULTS: Male and female adolescents with psychiatric disorders were at greatest risk of becoming involved in abusive adult relationships. After the authors controlled for earlier psychiatric history, women who were involved in abusive relationships, but not men, had an increased risk of adult psychiatric morbidity. CONCLUSIONS: 1) Psychiatric disorders pose risk for involvement in abusive relationships for both sexes; 2) partner abuse is a contributing source of psychiatric disorders among women but not among men.

Development of personality disorder symptoms and the risk for partner violence.

In a community sample (N = 543) followed over 20 years, the authors studied associations among childhood family violence exposure, personality disorder (PD) symptoms, and adult partner violence. PD symptoms (DSM-III-R Clusters A, B, and C) in early adulthood partially mediated the effect of earlier childhood risks on the odds of perpetrating partner violence. The authors tested whether stability of PD symptoms from adolescence to the early 20s differs for individuals who later perpetrated partner violence. Cluster A ("Odd/Eccentric") symptoms declined less with age among partner violent versus nonviolent men and women. Cluster B ("Dramatic/Erratic") symptoms were more stable through late adolescence in partner violent men, compared with nonviolent men and violent women. Cluster C ("Anxious") symptoms were most stable among partner violent men.

Associations of parental personality disorders and axis I disorders with childrearing behavior.

Data from the Children in the Community Study, a community-based longitudinal investigation, were used to investigate the associations of parental anxiety, depressive, substance use, and personality disorders with parental child rearing behavior. Comprehensive psychosocial interviews, including assessments of child rearing, were conducted with 224 women and 153 men (mean age = 33 years; mean off- spring age = 8 years). Findings indicated that parental personality disorders were associated with parental possessiveness, inconsistent parental discipline, low parental communication, and low parental praise and encouragement. These associations remained significant when parental gender, offspring gender, and co-occurring parental disorders were controlled statistically. Parental anxiety disorders were independently associated with parental possessiveness. Parents with personality disorders were substantially more likely than parents without personality disorders to report engaging in multiple problematic child rearing behaviors. This association was not moderated by co-occurring parental disorders. These findings suggest that the presence of a parental personality disorder may be associated with an elevated likelihood of problematic parenting behavior during the child rearing years.

Interpersonal relationships and sex differences in the development of conduct problems.

This article investigates the role of interpersonal relationships in shaping sex differences in the manifestation, etiology, and developmental course of conduct problems and their treatment needs. The review examines whether: (1) Girls' conduct problems are more likely than boys' to manifest as a function of disrupted relationships with caretakers and peers; (2) For girls more than for boys, the outcomes of conduct problems in adolescence and adulthood, and related treatment needs, are more likely to be a consequence of the quality of interpersonal relationships with others, particularly opposite-sex peers and partners. Evidence reviewed suggests that boys and girls share many similarities in their expression of conduct problems, but that a relational perspective does unify important differences. There is fair evidence that girls with conduct problems are more likely to come to the attention of authorities because of chaotic, unstable family relationships, and to express antisocial behavior in the context of close relationships; there is stronger evidence that the course and outcomes of conduct problems in females versus males pertain to interpersonal relationship impairments. Those sex differences map onto specific differences in treatment needs. Further empirical testing of the proposed relational model is indicated.

Intergenerational transmission of partner violence: a 20-year prospective study.

An unselected sample of 543 children was followed over 20 years to test the independent effects of parenting, exposure to domestic violence between parents (ETDV), maltreatment, adolescent disruptive behavior disorders, and emerging adult substance abuse disorders (SUDs) on the risk of violence to and from an adult partner. Conduct disorder (CD) was the strongest risk for perpetrating partner violence for both sexes, followed by ETDV, and power assertive punishment. The effect of child abuse was attributable to these 3 risks. ETDV conferred the greatest risk of receiving partner violence; CD increased the odds of receiving partner violence but did not mediate this effect. Child physical abuse and CD in adolescence were strong independent risks for injury to a partner. SUD mediated the effect of adolescent CD on injury to a partner but not on injury by a partner. Prevention implications are highlighted.

Clinically abusive relationships in an unselected birth cohort: men's and women's participation and developmental antecedents.

In an unselected birth cohort (N=980, age 24-26 years), individuals in abusive relationships causing injury and/or official intervention (9% prevalence) were compared with participants reporting physical abuse without clinical consequences and with control participants who reported no abuse, on current characteristics and prospective developmental risks. In nonclinically abusive relationships, perpetrators were primarily women. In clinically abusive relationships, men and women used physical abuse, although more women needed medical treatment for injury. Women in clinically abusive relationships had childhood family adversity, adolescent conduct problems, and aggressive personality; men had disinhibitory psychopathology since childhood and extensive personality deviance. These findings counter the hibitory assumption that if clinical abuse was ascertained in epidemiological samples, it would be primarily man-to-woman, explained by patriarchy rather than psychopathology.

Exposure to intimate partner violence, peer relations, and risk for internalizing behaviors: a prospective longitudinal study.

The present study examines the quality of peer relations as a mediator between exposure to IPV (intimate partner violence) and internalizing behaviors in a sample of 129 preadolescents and adolescents (ages 10-18), who were interviewed via telephone as part of a multigenerational, prospective, longitudinal study. Relational victimization is also examined as a moderator of IPV exposure on internalizing behaviors. Results demonstrate a significant association of exposure to severe IPV and internalizing behaviors. Relational victimization is found to moderate the effects of exposure to severe IPV on internalizing behaviors. The present findings suggest that the effects of exposure to IPV had a particularly important effect on the risk for internalizing problems if the adolescent also experienced relational victimization. Conversely, the receipt of prosocial behaviors buffer against the effects of IPV exposure on internalizing symptoms in teen girls.

Direct and indirect transmission of relationship functioning across generations.

Relationship functioning is assumed to propagate across subsequent generations, but most studies have lacked appropriate methodologies to test this assumption prospectively. In a randomly selected sample of youth (N = 821) followed prospectively for over 25 years across multiple generations, we examined the association of romantic engagement (i.e., emotional involvement and closeness) between parents with offspring romantic relationship quality. We tested two developmental pathways linking parents' romantic engagement with offspring adult romantic relationship quality, the first operating via parenting practices, and the second operating via adolescent depression. Parents' romantic engagement predicted offspring romantic relationship quality a mean of 17 years later, net age and socioeconomic status. Results supported a developmental pathway from parents' romantic engagement at offspring mean age 14, to parenting at offspring mean age 16, to offspring socioemotional functioning at mean age 22, and offspring romantic relationship quality at mean age 33. However, the influence of parents' romantic engagement on offsprings' adult romantic relationship quality does not appear to operate via a pathway of adolescent depression. Implications for prevention are discussed.

Improving parenting in families referred for child maltreatment: a randomized controlled trial examining effects of Project Support.

Project Support is an intervention designed to decrease coercive patterns of aggressive discipline and increase positive parenting. This research evaluates Project Support in a sample of families reported to Children's Protective Services (CPS) for allegations of physical abuse or neglect; 35 families with a child between 3- and 8-years-old participated. In all families, CPS allowed the children to remain in the family home while the family received services. Families were randomly assigned to receive either Project Support or services as usual, which were provided by CPS or CPS-contracted service providers. To evaluate intervention effects, a multimethod, multi-informant assessment strategy was used that included data from mothers' reports, direct observation of parents' behavior, and review of CPS records for re-referrals for child maltreatment. Families who received Project Support services showed greater decreases than families who received services as usual in the following areas: mothers' perceived inability to manage childrearing responsibilities, mothers' reports of harsh parenting, and observations of ineffective parenting practices. Only 5.9% of families in the Project Support condition had a subsequent referral to CPS for child maltreatment, compared with 27.7% of families in the comparison condition. The results suggest that Project Support may be a promising intervention for reducing child maltreatment among families in which it has occurred.