Children’s exposure to intimate partner violence: an overview

ABSTRACT

Children’s exposure to intimate partner violence (IPV) is associated with significant emotional impairment and other harmful effects. It is increasingly recognized as a type of child maltreatment, with outcomes similar to other types of abuse and neglect. Children can experience harm from exposure to IPV, even when not directly involved in, or a witness to, the violence between caregivers. This review, based on a synthesis of best available evidence, addresses the epidemiology of children’s exposure to IPV, including prevalence, risk and protective factors, and associated impairment, as well as strategies for identification, and interventions for prevention of exposure and impairment. Strategies for ensuring children’s safety are also discussed. The article concludes with guidance specific to mental health clinicians.     

How do attachment style and social support contribute to women's psychopathology following intimate partner violence? Examining clinician ratings versus self-report

Concurrent associations between attachment style and social support in posttraumatic stress disorder, depression, and generalized anxiety disorder were explored using regression analyses in a sample of 108 victims of intimate partner violence. To examine whether assessment modality influenced findings, self-report and clinician ratings of psychopathology were compared. Both lower perceived social support and higher attachment anxiety were significantly associated with higher self-reported PTSD; however, only lower social support was significantly associated with clinician assessed PTSD. Lower social support, higher attachment anxiety, and lower attachment closeness were related with higher self-reported depression; however, only lower social support was related to clinician assessed depression. Lastly, only higher attachment anxiety was associated with self-reported GAD, whereas lower attachment dependency showed the only significant association in clinician assessed GAD. Possible explanations for discrepancies between assessment modalities are discussed, with emphasis on application to intimate partner violence and suggestions for future research.     

The effect of maternal psychopathology on parent–child agreement of child anxiety symptoms: A hierarchical linear modeling approach

The current study examined the effects of maternal anxiety, worry, depression, child age and gender on mother and child reports of child anxiety using hierarchical linear modeling. Participants were 73 mother–child dyads with children between the ages of 7 and 10 years. Reports of child anxiety symptoms, including symptoms of specific disorders (e.g., social phobia) were obtained using concordant versions of the Screen for Anxiety and Related Emotional Disorders (SCARED). Children reported significantly higher levels of anxiety symptoms relative to their mothers. Maternal worry and depression predicted for significantly lower levels of maternal-reported child anxiety and increasing discrepant reports. Maternal anxiety predicted for higher levels of maternal-reported child anxiety and decreasing discrepant reports. Maternal depression was associated with increased child-reported child anxiety symptoms. No significant effect of child age or gender was observed. Findings may inform inconsistencies in previous studies on reporter discrepancies. Implications and future directions are discussed.     

The color of touch: A case of tactile–visual synaesthesia

We report a single-case study, EB, who experiences synaesthetic sensations of color from tactile stimulation. Developmental synaesthesia is typically characterized by the consistency of synaesthetic pairings over time, in that stimuli tend to generate the same synaesthetic responses on different occasions. Here we demonstrate that EB's touch–color associations are significantly more consistent over time compared to a group of non-synaesthete controls, but that this comes in the face of surprisingly high consistency among non-synaesthetes themselves, for certain tactile stimuli. We show, too, that EB's touch–color correspondences are guided by an implicit rule system, and that this system is shared by non-synaesthetes. Both synaesthetes and non-synaesthetes are sensitive to tactile qualities such as smoothness and softness, and these qualities are systematically related to the luminance and chroma of associated colors.     

The classification of depression: are we still confused?

Recent developments in the classification of major depressive disorder are reviewed in light of the predictions made by Kendell in the 1970s. Particularly, the institution of operational diagnoses along with the contentious issues of subdividing major depressive disorder and its characterisation on a dimensional as opposed to a categorical scale.     

The role of intergenerational similarity and parenting in adolescent self-criticism: An actor–partner interdependence model

Research investigating the development of adolescent self-criticism has typically focused on the role of either parental self-criticism or parenting. This study used an actor–partner interdependence model to examine an integrated theoretical model in which achievement-oriented psychological control has an intervening role in the relation between parental and adolescent self-criticism. Additionally, the relative contribution of both parents and the moderating role of adolescent gender were examined. Participants were 284 adolescents (M = 14 years, range = 12–16 years) and their parents (M = 46 years, range = 32–63 years). Results showed that only maternal self-criticism was directly related to adolescent self-criticism. However, both parents' achievement-oriented psychological control had an intervening role in the relation between parent and adolescent self-criticism in both boys and girls. Moreover, one parent's achievement-oriented psychological control was not predicted by the self-criticism of the other parent.     

A review of: “The rush to fill the void”

Abstract

Lance E. Trexler (Ed.) Cognitive Rehabilitation: Conceptualization and Intervention. New York: Plenum Press, 280 pp. 1982. $ 37.50.     

Action–perception coupling in kinesthesia: A new approach

According to recent findings, intentional motor actions are controlled by resetting the referent position, R, at which neuromuscular elements, including reflexes, begin to act. It is suggested that somatosensory afferents inform the brain about the deviation (P) of body segments from the centrally set referent position. To perceive the actual position (Q) of body segments and form the position sense (PS), the central and afferent signals are combined: Q=R+P. In previous studies, the R has been shown to remain invariant during involuntary changes in the wrist position elicited by sudden unloading of muscles, suggesting that only the afferent component is responsible for the PS during this reflex. In contrast, the central PS component, R, is predominantly responsible for PS during intentional motion in isotonic conditions. We tested the hypothesis that the R and P are interchangeable PS components such that involuntary changes in wrist position elicited by the unloading reflex can easily be reproduced by making intentional changes in wrist position in isotonic conditions, in the absence of vision. The PS rule also suggests that PS is independent of sense of effort, which was tested by asking subjects to reproduce elbow joint angles under different constant loads. We also tested the hypothesis that tendon vibration may elicit motion that may not be perceived by subjects (no-motion illusion). These hypotheses were confirmed in three experiments. It is concluded that the R and P are additive components of PS and that, contrary to the conventional view, PS is independent of the sense of effort or efference copy. The PS rule also explains kinesthetic illusions and the phantom limb phenomenon. This study advances the understanding of action–perception coupling in kinesthesia.     

Client accounts of personal change in process–experiential psychotherapy: A methodologically pluralistic approach

Abstract

Client changes in psychotherapy can be studied using a range of qualitative and quantitative research methods. Despite the availability of these various methods, therapy outcomes research is traditionally conducted with only a single-method approach. In the current study, the authors break from this single-genre research and present a pluralistic approach for examining qualitative accounts of personal change for a naturalistic sample of clients who engaged in process-experiential therapy. Open-coding analysis of changes indicated two broad categories: Changes Within the Self and Changes in Life Situation. Content analysis found that changes in experiential processing were more often reported at the end of treatment. Analyses of quantitative outcome measures indicated substantial pre–post therapy change. Brief case studies of two clients with contrasting outcomes illustrated limitations of the other methods and identified range and manner of expression of reported changes as directions for further research. In addition to demonstrating the array of information gained from applying different research methods, the pluralistic approach was also used to make comparisons between results.

Zusammenfassung

Klientenberichte persönlicher Änderungen in prozess-erfahrungsorientierter Psychotherapie: Ein methodologisch pluralistischer Ansatz

Klientenveränderungen in der Psychotherapie können mit einer Reihe von qualitativen und quantitativen Forschungsmethoden untersucht werden. Obwohl verschiedene Methoden zur Verfügung stehen, wird Therapieergebnisforschung traditioneller Weise nur auf eine Methode beschränkt. In der vorliegenden Untersuchung brechen die Autoren mit dieser Tradition und stellen einen pluralistischen Ansatz zur Prüfung qualitativer persönlicher Veränderungsberichte bei einer in einer Klientenstichprobe in prozess-erfahrungsorientierter Psychotherapie vor. Eine Kodierungsanalyse von Veränderungen erbrachte zwei breite Kategorien: Veränderungen des Selbst und Veränderungen in den Lebensumständen. Eine Inhaltsanalyse ergab, dass Veränderungen im Erfahrungsprozess öfters am Ende der Behandlung berichtet werden. Analysen von quantitativen Ergebnismassen zeigten substantielle Veränderungen im Vergleich des Zeitpunkts vor der Therapie zum Zeitpunkt nach der Therapie auf. Kurze Fallstudien von zwei Klienten mit entgegengesetzten Ergebnissen beleuchten die Beschränkungen der anderen Methoden und stellen den stellen den Spielraum und die Art der Veränderungsausdrucksweisen als Leitlinien für die weitere Forschung dar. Zusätzlich zum Aufzeigen des Informationsbereichs, der durch die Anwendung verschiedener Forschungsmethoden erzielt werden kann, erlaubte uns der pluralistische Ansatz auch einen Vergleich der erzielten Ergebnisse.

Résumé

Le compte-rendu par le client du changement personnel en psychothérapie processus-expérientielle?: une approche méthodologique pluraliste.

Les changements des clients en psychothérapie peuvent être étudiés par toute une gamme de méthodes de recherche qualitatives et quantitatives. Malgré la disponibilité de ces méthodes variées, la recherche des résultats thérapeutiques est traditionnellement conduite avec une approche basée sur une seule méthode. Dans la présente étude, les auteurs rompent avec cette recherche à genre unique et présentent une approche pluraliste pour examiner des récits qualitatifs de changements personnels dans un échantillon naturaliste de clients engagés dans une thérapie processus-expérientielle. L'analyse par codage ouvert a indiqué 2 catégories larges?: des changements dans le Soi et des changements dans la situation de vie. L'analyse du contenu a établi que des changements du traitement expérientiel étaient rapportés plus fréquemment en fin de thérapie. L'analyse des mesures de résultats quantitatives indiquait un changement pré-post substantiel. Des études de cas brèves de 2 clients avec des résultats contrastants ont illustré les limitations des autres méthodes et identifié l’éventail et la manière des changements rapportés en tant que directions pour de futures recherches. En plus de démontrer la panoplie d'informations gagnées par l'emploi de méthodes de recherche variées, l'approche pluraliste nous a aussi permis de faire des comparaisons entre les résultats.

Resumen

Testimonios de clientes sobre cambio personal en psicoterapia proceso-experiencial: un enfoque metodológicamente pluralista.

Los cambios del cliente en psicoterapia pueden estudiarse usando una gama de métodos de investigación cuali y cuantitativos. A pesar de la disponibilidad de estos diversos métodos, las investigaciones de los resultados de la terapia están conducidas, tradicionalmente, con un solo enfoque metodológico. En este estudio, los autores se apartan de este tipo de género único de investigación y presentan un enfoque pluralista para examinar testimonios cualitativos de cambio personal en una muestra naturalista de clientes que se involucraron en una terapia proceso-experiencial. El análisis de codificación abierta de los cambios indicó dos amplias categorías: cambios en el self y cambios en la situación vital. El análisis de contenido descubrió que los cambios en el procesamiento experiencial se reportaron más frecuentemente al final del tratamiento. Los análisis de las mediciones cuantitativas de resultado indicaron cambios substanciales pre y post terapia. Estudios breves de caso de dos clientes con resultados contrastantes ilustraron las limitaciones de los otros métodos e identificaron el rango y forma de expresión de los cambios reportados como direcciones para futuras investigaciones. Además de demostrar el cúmulo de información ganada por la aplicación de diferentes métodos de investigación, el enfoque pluralista también nos permitió comparar resultados.

Resumo

Os Relatos dos Clientes da Mudança Pessoal na Psicoterapia Processo-Experiencial: uma Abordagem Metodológica Pluralista

As mudanças dos clientes em psicoterapia podem ser estudadas usando vários métodos de investigação qualitativa e quantitativa. Apesar da disponibilidade destes vários métodos, a investigação dos resultados terapêuticos é tradicionalmente conduzida com uma única abordagem metodológica. No presente estudo, os autores distanciam-se de uma abordagem de investigação de tipo único e apresentam uma abordagem pluralista para analisar os relatos pessoais qualitativos da mudança de uma amostra naturalista de clientes envolvidos em terapia processo-experiencial. As análises de codificação aberta (Open-coding analysis) das mudanças indicaram duas categorias gerais: mudanças do self e mudanças nas situações de vida. Uma análise de conteúdo encontrou que as mudanças no processamento experiencial eram mais frequentemente relatadas no final do tratamento. As análises quantitativas das medidas dos resultados terapêuticos indicaram uma mudança substancial pré-pós terapia. Estudos de caso breves com dois clientes com resultados terapêuticos contrastantes ilustraram as limitações dos outros métodos e identificaram a amplitude e a forma de expressão das mudanças relatadas como directrizes para futuras investigações. Além disso, a diversidade de informação obtida ao aplicar diferentes métodos de investigação e a abordagem pluralista permitiu-nos também fazer comparações entre os resultados.

Sommario

I resoconti dei clienti sul cambiamento personale nella psicoterapia processo-esperienziale: un approccio metodologicamente pluralistico

I cambiamenti del cliente in psicoterapia possono essere studiati usando una gamma di metodi di ricerca qualitativi e quantitativi.

Malgrado la disponibilità di questi vari metodi, la ricerca sugli esiti terapeutici è tradizionalmente condotta solo con un approccio che usa un metodo singolo.

Nel presente studio, gli autori si distaccano da questo approccio e presentano un approccio pluralistico per esaminare i resoconti qualitativi del cambiamento personale di un campione naturalistico di clienti in terapia processo-esperienziale.

Le analisi dei cambiamenti a codificazione aperta hanno indicato due ampie categorie: cambiamenti all'interno del sé e cambiamenti nella situazione di vita.

Le analisi del contenuto hanno trovato che i cambiamenti nel processo esperienziale erano più spesso riportati alla fine del trattamento.

Le analisi delle misure quantitative di esito hanno indicato un cambiamento sostanziale pre-post terapia.

Brevi studi di caso di due clienti con esiti contrastanti hanno illustrato le limitazioni degli altri metodi ed hanno identificato l'intervallo ed il modo di espressione dei cambiamenti segnalati come indicatori per la ricerca futura.

Oltre che dimostrare la mole d'informazione acquisita nell'applicare metodi differenti di ricerca, l'approccio pluralistico ci ha permesso di fare confronti tra i risultati.

     

The compensatory ‘rebound’ of reactive astrogliosis: glial fibrillary acidic protein immunohistochemical analysis of reactive astrogliosis after a puncture wound to the brain of rats with portocaval anastomosis

Summary This study was designed to compare the degree of reactive astrogliosis occurring around a puncture wound in the brain of normal rats and at different intervals after a similar puncture wound in rats with a portocaval anastomosis. The gliosis was evaluated by the number of astrocytes, the thickness of their processes and the intensity of the glial fibrillary acidic protein immunoreactivity. After the puncture wound in the brain of rats with a portocaval anastomosis, the gliosis varied at different intervals being: (1) decreased at 10 days, (2) markedly increased at 5 weeks and (3) significantly decreased at 8, 12, and 16 weeks. These findings suggest that 5 weeks after portocaval anastomosis, an active proliferation of the metabolically altered astrocytes occurs with heightened synthesis of glial fibrillary acidic protein in the period of adaptive compensation, the so-called compensatory rebound. At 8 weeks or more after portocaval anastomosis, these altered astrocytes were considered to be in the phase of decompensation and incapable of maintaining the reactive response which occurred in normal rats. The compensatory rebound and decompensatory decline illustrate the dynamic plasticity of the reactive astrogliosis.Supported by grant from the National Foundation of Natural Sciences No. 386-0956. This paper was read at the XIth International Congress of Neuropathology, September 7, 1990 in Kyoto, Japan     

The crossover approach to switching antipsychotics: what is the evidence?

Clinicians frequently use a crossover approach in switching antipsychotics, although historically there has been a lack of data addressing the question of switch strategies. To establish if there is now empiric evidence that may guide clinicians in this regard, a MEDLINE search to April 2004 was carried out to identify published, randomized and controlled trials that have addressed this topic. A total of 404 articles were identified in the search, which resulted in the identification of four reports meeting the criteria. The four studies evaluated switching strategies to one of three atypical antipsychotics: aripiprazole, olanzapine (two reports), and ziprasidone. The switching process itself could be subdivided as follows: discontinuation (abrupt vs. gradual); and, replacement (abrupt vs. gradual). Meta-analyses confirmed a lack of difference in outcome, regardless of approach. While a crossover approach does not appear to increase adverse events, the available empiric evidence does not support its clinical superiority on various outcome measures. The existing data therefore argue against the position that a crossover approach in switching antipsychotics represents a 'safer' means of preventing clinical deterioration during the switch.     

A translational research approach to poor treatment response in patients with schizophrenia: clozapine–antipsychotic polypharmacy

Poor treatment response in patients with schizophrenia is an important clinical problem, and one possible strategy is concurrent treatment with more than one antipsychotic (polypharmacy). We analyzed the evidence base for this strategy using a translational research model focused on clozapine–antipsychotic polypharmacy (CAP). We considered 3 aspects of the existing knowledge base and translational research: the link between basic science and clinical studies of efficacy, the evidence for effectiveness in clinical research and the implications of research for the health care delivery system. Although a rationale for CAP can be developed from receptor pharmacology, there is little available preclinical research testing these concepts in animal models. Randomized clinical trials of CAP show minimal or no benefit for overall severity of symptoms. Most studies at the level of health services are limited to estimates of CAP prevalence and some suggestion of increased costs. Increasing use of antipsychotic polypharmacy in general may be a factor contributing to the under-utilization of clozapine and long delays in initiating clozapine monotherapy. Translational research models can be applied to clinical questions such as the value of CAP. Better linkage between the components of translational research may improve the appropriate use of medications such as clozapine in psychiatric practice.     

Early adolescents' motivations to defend victims in school bullying and their perceptions of student–teacher relationships: A self-determination theory approach

The aim of this study was to investigate whether various dimensions of student–teacher relationships were associated with different types of motivation to defend victims in bullying and to determine the association between these types of motivations and various bystander behaviors in bullying situations among early adolescents in Italy. Data were collected from 405 Italian adolescents who completed a survey in their classroom. Results showed that warm student–teacher relationships were positively associated with defending victims and with autonomous motivation to defend victims. In contrast, conflictual student–teacher relationships were positively associated with passive bystanding and with extrinsic motivation to defend victims. Different forms of motivation to defend were found to be mediators between student–teacher relationship qualities and bystander behaviors in school bullying. Our findings suggest that teachers should build warm and caring student–teacher relationships to enhance students' autonomous motivation to defend victims of bullying as well as their inclination to defend the victims in practice.     

Self-reported traumatic brain injury in male young offenders: A risk factor for re-offending,poor mental health and violence?

Adolescence is a risk period for offending and for traumatic brain injury (TBI) and TBI is a risk factor for poor mental health and for offending. TBI has been largely neglected from guidance on managing the mental health needs of young offenders. We sought to determine the rate of self-reported TBI, of various severities, in a male, adolescent youth offending population. We also aimed to explore whether TBI was associated with number of convictions, violent offending, mental health problems and drug misuse. Young male offenders aged 11 to 19 years were recruited from a Young Offender Institute, a Youth Offending Team and a special needs school. A total of 197 participants were approached and 186 (94.4%) completed the study. They completed self-reports on TBI, crime history, mental health and drug use. TBI with loss of consciousness (LOC) was reported by 46% of the sample. LOC consistent with mild TBI was reported by 29.6%, and 16.6% reported LOC consistent with moderate to severe TBI. Possible TBI was reported by a further 19.1%. Repeat injury was common – with 32% reporting more than one LOC. Frequency of self-reported TBI was associated with more convictions. Three or more self-reported TBIs were associated with greater violence in offences. Those with self-reported TBI were also at risk of greater mental health problems and of misuse of cannabis. TBI may be associated with offending behaviour and worse mental health outcomes. Addressing TBI within adolescent offenders with neurorehabilitative input may be important for improving well-being and reducing re-offending.     

The disposition of mentally disordered offenders in Australia: ‘Out of mind,out of sight’ revisited

The author surveys developments in the disposition of mentally disordered offenders since 1976. He focusses upon persons found mentally disordered or incompetent at or before trial, persons acquitted by reason of insanity and persons who become or are found mentally disordered after sentence. He concludes that the law in these areas remains in flux with different jurisdictions developing diverse initiatives resulting in major inconsistencies and in detainees seeking to avail themselves of international law.