The Damage Done - Children Exposed to Intimate Partner Violence and their Mothers: Towards empirically based interventions in order to reduce negative health effects in children

Sammanfattning: Abstract Title: The Damage Done, Children Exposed to Intimate Partner Violence and their Mothers - Towards empirically based interventions in order to reduce negative health effects in children. Author: Karin Grip Key words: Intimate partner violence (IPV), evaluation, clinical significance, children, mothers Distribution: University of Gothenburg, Dept.of psychology, Box 500, S-405 30 Gothenburg. ISBN: 978-91-628-8527-4 ISSN: 1101-718X ISRN: GU/PSYK/AVH--265-SE Electronic: http://hdl.handle.net/2077/30153 The data presented in this thesis comes from a national project evaluating the support available to children exposed to IPV and to their mothers, and from an earlier pilot project. Client-focused research is lacking in the evaluation of interventions for children exposed to IPV and their mothers. Hence, the primary aim of the three evaluation studies was to measure the clinical significance of the service provided. A related aim was to explore possible factors related to outcome effects. The majority of studies with children exposed to IPV have primarily focused on pathogenic reactions and children’s perceived quality of life and its possible associated factors were therefore another area of interest in the thesis. Paper I: Effects of a group-based intervention on psychological health and perceived parenting capacity among mothers exposed to intimate partner violence (IPV): A preliminary study. This study examined the self-rated mental health and perceived parenting capacity of mothers subjected to IPV after they attended 15-week group support program. At the group level of analysis mothers improved their mental health, but not their perceived parenting capacity following support. At the individual level of analysis (clinical significance), the treatment effects were more uncertain since many mothers with clinical levels of trauma and mental health symptoms were unchanged. Paper II: Maternal report on child outcome after a community-based program following intimate partner violence, evinced reduced behavioral problems in children after they and their children attended concurrent 15-week group support programs. The effects were not related to the amount of IPV exposure or the mothers’ changes in trauma symptoms following support. At the individual level of analysis the effects were more modest and point to the need to monitor treatment progress in order to detect those who are unchanged or even worsened during treatment. Paper III: Children exposed to IPV and the reported effects of psychosocial interventions. Using a repeated measures design post-traumatic stress, psychological and behavioral problems significantly decreased following intervention in children exposed to intimate partner violence, with use of traditional group analyses. Analyses using the Reliable Change Index, however, revealed that few children were improved or recovered. Positive changes in children’s behavioral problems were related to the mother’s improvement of their own mental health. Direct victimization by the perpetrator was not associated with treatment changes, but with higher symptom levels at study entry. Paper IV: Attachment, emotion regulation, and emotionality: health and quality of life in children exposed to intimate partner violence. Children evinced low attachment security to mothers and fathers, high levels of recurrent health complaints, and low quality of life. However, there was great variability among children. When controlled for socioeconomic status recurrent health complaints were associated with higher IPV exposure and negative emotionality, whereas quality of life was associated with attachment security, higher capacity for emotion regulation, and lower negative emotionality.