The Role of Control in Intimate Partner Violence: A Study in Dutch Forensic Outpatients.

Johnson argued that coercive control is crucial in explaining heterogeneity in intimate partner violence, with such violence being more frequent, less reciprocal, and more often male-to-female aggression when it serves to exercise control over the partner. We assessed 280 Dutch forensic outpatients who had recently engaged in intimate partner violence on nonaggressive coercive control. Control showed significant, small to moderate, associations with more frequent past year acts of psychological aggression, physical assault, and sexual coercion and more frequently resulted in partner injury. Control was unrelated to reciprocity of partner violence. High controlling violence was enacted mostly, but not exclusively by men. Overall, while perhaps not having a uniquely strong association, our findings provide partial support for the role of coercive control in intimate partner violence and suggest it may benefit intimate partner violence risk assessment.

The Impact of ADHD Treatment on Intimate Partner Violence in a Forensic Psychiatry Setting.

Objective: The current longitudinal impact of treatment of ADHD on intimate partner violence (ITAP) study aims to investigate whether decrease of ADHD symptoms is associated with reduction of intimate partner violence (IPV) frequency in IPV offenders with ADHD in a forensic psychiatry setting. Method: Of n = 209 offenders of IPV with ADHD, frequency of IPV and ADHD symptoms were assessed at the 8th, 16th, 24th, and 52nd weeks of their combined treatment for ADHD and IPV. Results: We observed a significant decrease of self-reported ADHD symptoms (large effect size, d ≥ 0.80) and all IPV outcomes (small, d > 0.20, to large, d > 0.80, effect sizes). The decrease in IPV was mainly associated with the decrease in ADHD symptoms. Conclusion: As IPV treatment alone is not effective in the reduction of IPV in forensic psychiatry, we now have strong indications that the combined treatment of adult ADHD and IPV is more effective in offenders with ADHD.

ADHD in Childhood and/or Adulthood as a Risk Factor for Domestic Violence or Intimate Partner Violence: A Systematic Review.

Objective: To date, treatment programs for adult domestic violence (DV) or intimate partner violence (IPV) have had minimal impact. To make treatment more effective, programs should be adjusted to psychopathology of the offender. As emotional lability and poor emotional self-regulation and self-control are common features of ADHD, it may play a pivotal role as a predictor for adult DV/IPV. Method: This systematic review synthesizes the available evidence for childhood and/or adult ADHD being a risk factor for DV/IPV. Results: Four case control studies and three cohort studies were included in the review. Although three case control studies showed positive associations between childhood and/or adult ADHD and adult DV/IPV, two did insufficiently control for the presence of comorbid Conduct Disorder (CD) or Antisocial Personality Disorder (ASPD). Conclusion: Cohort studies identified hyperactive, impulsive, and inattention symptoms as risk factors for adult IPV. CD and ASPD were regarded as mediators in three studies.

ADHD Undetected in Criminal Adults.

OBJECTIVE: The objective of this study was to assess whether adults with ADHD in a forensic sample had received the diagnosis earlier and to investigate reasons for missing the diagnosis earlier. METHOD: From December 1, 2007 until March 5, 2009, all patients from an outpatient clinic for forensic mental health care who were suspected of having ADHD were seen by a psychiatrist who assessed presence and severity of ADHD symptoms and other psychiatric disorders in a standardized way. RESULTS: ADHD diagnosis was missed previously in life in 59 of 106 male adults (56%). ADHD diagnosis was missed more often in older men, in those with hyperactive/impulsive or combined subtype of ADHD, in those who reported fewer symptoms of ADHD in childhood or adolescence, in those with a comorbid mood disorder in adulthood, and in those who had never received mental health care before. Even in those who had previously received mental health care, the diagnosis had been missed in 42% of the cases. Prior contacts with police or court also predicted missing the diagnosis, an effect that was mediated by a lower chance to be referred to mental health care. CONCLUSION: General and forensic mental health care workers should be alert for the fact that ADHD is missed very often in individuals who have problems with delinquency and should realize that ADHD may be masked by various factors.

Impact of treatment of ADHD on intimate partner violence (ITAP), a study protocol.

BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) in adults is one of the predictive and treatable risk factors for delinquency, including intimate partner violence (IPV). Effective treatment of IPV needs to address personal dynamic risk factors, offender typology, and dynamics of the domestic violence. It is unknown whether treatment of ADHD symptoms contributes to a decrease in IPV. The ITAP study aims to investigate the relationship between treatment of ADHD symptoms and IPV in patients in forensic mental health care. Moreover, this study examines the role of comorbid psychopathology, subtype of the offender, and dynamics of the domestic violence. METHODS/DESIGN: The ITAP study is a longitudinal observational study. Participants are followed one year through various assessments: one before starting treatment (t0), and four during treatment (8, 16, 24 and 52 weeks after start of the treatment). All participants receive treatment for IPV, ADHD, and comorbid psychopathology, if present. The primary outcome measure is the change in severity of IPV; the primary predictive variable is the change in severity of ADHD symptoms. The secondary outcome measure is the observation of the therapist about change in the offender's general violent behaviour, within and outside the partner relationship. Data are analysed in a multiple regression model with change in severity of IPV as the dependent variable and change in severity of ADHD symptoms as the primary predictor. Other predictive variables taken into account in the analyses are presence of comorbid psychopathology and personality disorder, subtype of the offender, and dynamics of the domestic violence. In addition, compliance with treatment and content of the treatment are documented. DISCUSSION: Research on the treatment process of IPV offenders and victims is complicated by many factors. This observational design will not allow inferences about causality but may reveal clinically important factors that contribute to more effective treatment of IPV. TRIAL REGISTRATION: The Netherlands National Trial Register (NTR), trial ID NTR3887 .