Time-Varying Risk Factors for Reassault Among Batterer Program Participants

This study uses longitudinal data to identify risk markers for reassault among batterer program participants. Data are from 308 men and their partners collected at five, 3-month intervals. Time-varying situational and behavioral risk factors, as well as time-invariant individual characteristics, are examined. The most influential risk markers, in terms of relative risk and level of statistical significance, were time-varying: 2 measures of the man's drunkenness during the follow-up interval in which the reassault occurred (OR: 3.5-16.3; p > .0005). Other included time-varying batterer characteristics had no significant effect on reassault. Two significant time-invariant batterer risk factors were (1) severe psychopathology and (2) a history of non-domestic-violence arrest, both measured at intake. Results suggest that batterers' drinking behavior after program intake may provide an important and easily observed marker for risk of reassault and that prediction of reassault with individual risk factors at program intake remains problematical.     

Assessing the Effect of Batterer Program Completion on Reassault: An Instrumental Variables Analysis

The main objective of this paper is to investigate the utility of using the instrumental variables (IV) method to estimate batterer program efficacy, i.e., the program effect among batterers who complete batterer programs. This method takes account of possible confounding due to unmeasured traits of compliers and non-compliers. A structural model is used to estimate the impact of program completion on reassault using instrumental variables (IV) regression. Data on 640 batterers enrolled at three batterer programs are used. Results obtained from IV regression are compared with those obtained from a more traditional regression analysis. The results indicate that usual regression methods yield estimates of program effect that may be biased due to confounding by unmeasured batterer characteristics. Unfortunately, IV estimates may be unreliable due to failure of some of the assumptions on which they are based. If equations are adequately identified by the non-linear functional form used to estimate them, then IV results indicate that among a very select group of batterers, program completion significantly reduces the probability of reassault. The implications of confounding due to program non-compliance, program non-enrollment and attrition for future evaluations of batterer programs are discussed.     

Predictors of Underreporting of Male Violence by Batterer Program Participants and Their Partners

Self-reports on domestic violence inventories remain the basis of court and clinical decision-making and program outcome evaluations, but previous research questions their reliability and validity. Accurate prediction of underreporting would help practitioners and researchers adjust batterer and victim self-reports. We develop prediction equations of underreporting on the Conflict Tactics Scale, using a multi-site database of men admitted to batterer programs and their female partners (n = 840). First we use variables measured at program intake to predict female and male underreporting of male violence at program intake. Second, we use variables measured at program intake, as well as measures of program participation, to predict male-female disagreement (male underreporting) at 12-month follow-up. Several variables were predictive of underreporting, both at intake and follow-up, but overall prediction was marginally better than chance. The findings suggest that men and women underreport based on situational factors (such as relationship characteristics) and rational reasons, rather than based on personality traits or social desirability. However, the ability to predict underreporting is too weak for adjustment of self-reports by clinicians and program evaluators.     

Stage of Change as a Predictor of Attrition Among Men in a Batterer Treatment Program

This study assessed the contribution of the men's stage of change to the prediction of attrition among men attending a batterer treatment program. As outlined by the transtheoretical model of change, men were classified into the precontemplation, contemplation, or action stage based on their level of change motivation and behavior. It was hypothesized that men in the precontemplation stage would dropout of treatment at higher rates than men in later stages of change. Participants were 308 men who enrolled in a batterer treatment program over the course of 1 year, 61.4% of whom dropped out of treatment. Counselor rated, but not self-rated stage of change significantly predicted treatment completion once traditionally used demographic, contextual, and personality variables were taken into account. Specifically, men identified by counselors as being in the precontemplation stage were 2.3 times as likely as men rated in the contemplation stage and 8.8 times as likely as men rated in the action stage to dropout of treatment. Referral source, age, and history of arrest also made significant contributions to the prediction of attrition. The best combination of predictors led to the successful classification of 72% of the cases, 98% of the dropouts but only 19% of the completers. Discussion focuses on the limitations of current findings and their implications for the use of the transtheoretical model to predict attrition from batterer treatment.     

Injuries and Health Care Use in Women with Partners in Batterer Intervention Programs

Objective:To characterize injury frequency, injury patterns, and health care seeking behavior in women with intimate partners enrolled in batterer intervention programs. Methods: A standardized telephone interview was conducted on a sample of women with male partners enrolled in batterer intervention programs in four U.S. cities. Information on prior injuries and the utilization of health care services was sought. Results: Four hundred and eighty eight of the 648 women (75.3%) reported a history of prior injury as a result of abuse. Contusions were the most common injury. Of the women reporting contusions, 233 (51.4%) reported contusions as their only injuries. Another 220 women (48.6%) reported other injuries in addition to contusions. In the majority of cases (63.2%) the contusions were to multiple body parts. When the contusion involved only one anatomical region, it was mostly to the face. A total of 192 of the 488 injured women (39.3%) reported ever seeking medical care for injuries caused by their intimate partner. Twenty-three women (4.7% of the injured cohort or 3.5% of the total cohort) reported having ever been hospitalized for injuries sustained from abuse.     

Consistency and Accuracy of Batterer Typology Identification

Researchers in the field of domestic violence have derived “typologies” to better conceptualize the differences found among batterers (e.g., Holtzworth-Monroe and Stuart [1994]. Psychol. Bull. 116: 476–497). Efforts have since been made to evaluate clinicians' accuracy in classifying batterers into subtypes (Langhinrichsen-Rohling, Huss, and Ramsey [2000]. J. Fam. Violence 15: 37–53). The present study investigated the accuracy and consistency with which experienced clinicians could sort profiles into an empirically derived MCMI-based batterer typology (Hamberger, Lohr, Bonge, and Tolin [1996] Violence Vict. 11: 277–292). Seven PhD level psychologists with experience in the field of domestic violence were asked to sort 36 MCMI profiles into three piles. Each pile was represented by each of the three prototypical cluster types described in Hamberger et al. (1996) using the Basic 8 MCMI subscales. Overall, expert raters were able to sort most profiles into the three clusters accurately. However, the expert raters had the most difficulty correctly sorting some of the “nonpathological” profiles, as 40% were placed into the antisocial cluster and (6%) were sorted into the negativistic-dependent cluster. There are a number of possible explanations for the lower accuracy in sorting the nonpathological cluster. Results suggest that psychologists with domestic violence training can accurately sort MCMI profiles of batterers into the main three subtypes derived from empirically-based typology research. Clinical implications for typology assessment are discussed.     

Child Abuse Potential: A Comparison of Subtypes of Maritally Violent Men and Nonviolent Men

Researchers have demonstrated an overlap between husband-to-wife violence and child abuse, but we know little about which maritally violent men are at greatest risk for engaging in child abuse. This study examined child abuse potential across 4 subtypes of maritally violent men (i.e., family only, low level antisocial, borderline/dysphoric, and generally violent/antisocial; Holtzworth-Munroe et al., and 2 comparison groups of nonviolent men (i.e., maritally distressed or not), using the Child Abuse Potential Inventory (CAP; J. S. Milner [1986])). The results revealed that the borderline/dysphoric batterer subtype had significantly higher child abuse potential scores than all of the other violent subtypes and the nonviolent comparison groups. Theoretical and clinical implications are briefly discussed.     

Outcomes from Referring Batterer Program Participants to Mental Health Treatment

A quasi-experimental study was conducted to investigate the impact of referral to supplemental mental health treatment for batterer program participants who screened positive for mental health problems. The principal outcome measure was re-assault reported during a periodic 12-month follow-up with female partners (n = 308). Batterer program completion and other abuse indicators were also considered. Mandatory court referral to mental health treatment produced no significant improvement in batterer program completion, re-assault and other abuse indicators. These results may be influenced by the low compliance to the referral, since the select number of men who did comply with a mental health evaluation (n = 48 of 148) and those who received treatment (n = 28 of 148) did better than those who did not. Simplified referral procedures or integrated treatment services might prove to be a more effective approach.

The Clinical Utility of Batterer Typologies

Domestic violence research has increasingly focused on the identification of batterer subgroups. Although typologies have been proposed using the utility of both empirical and theoretical methodologies, studies comparing empirically derived and theoretically based typology solutions have not been conducted. To what degree mental health practitioners can successfully classify batterers into subgroups is also not known. To address these questions, data were gathered from 49 male batterers who were treated for domestic violence in an outpatient mental health facility. A preliminary comparison of an empirically derived and a theoretically based typology solution revealed that many batterers were classified differently by the two strategies, although the overall grouping strategies were similar in content. Further, mental health professionals had substantial difficulty choosing which of the cluster analytically created subgroups into which to sort individual batterer's MMPI profile. Finally, different treatment efficacy indicators differentiated among the men in the two subtyping systems, suggesting that each system offers unique clinical information.The second author was supported as a predoctoral fellow by a NIMH Training grant     

No One Type of Intimate Partner Abuse: Exploring Physical and Non-Physical Abuse Among Intimate Partners

Although research into intimate partner abuse has expanded throughout the past several decades and increased our understanding of this multi-faceted phenomenon, the vast majority of empirical work is still focused almost exclusively on physical violence—against women in particular. Although a crucial issue in our society, physical violence against women is only one facet in an array of possible abusive behaviors toward an intimate partner. Researchers have long acknowledged the existence of multiple forms of non-physical abuse. These types of abuse have received little research attention, however, and are commonly lumped together simply as “non-physical” or “emotional” abuse. There is no reason to believe, however, that all forms of non-physical abuse are the same, whether in intensity, frequency, or co-existence with physical violence. The current study attempts to disentangle the multiple types of nonviolent abuse to examine prevalence, differences by sex, and its relationships to physical abuse. Using Tjaden and Thoennes’ (1998) survey data, this study examines the prevalence of different types of non-physical abuse, both in the general population and among those experiencing physical violence Findings indicate that non-physical partner abuse is more common than physical and that non-physical abuse does not show striking sex differences, as is commonly believed. There is strong evidence that some types of non-physical abuse serve as clear risk factors for physical abuse and may increase risk of more frequent violence among those already being abused. These relationships do not, however, differ by sex. Implications for future research are discussed.

Relationship to Perpetrator and Posttraumatic Symptomatology Among Sexual Abuse Survivors

This study investigated the association of several dimensions of relationship to perpetrator of childhood sexual abuse to posttraumatic symptomatology in adulthood. A structured clinical interview, the Impact of Event Scale, and the TSC-40 were administered to 67 women survivors seeking psychotherapy. The t-tests for significant differences indicated that subjects whose perpetrators were not caretakers experienced higher levels of posttraumatic symptomatology (PTS) in adulthood than those abused by caretakers. No significant differences were found in traumatic symptomatology between those whose perpetrators were family members and those whose perpetrators were not or between those abused by someone in the home and those abused by someone outside the household. Implications for future research and clinical practice are explored.     

Degrees of Memory of Childhood Sexual Abuse Among Women Survivors in Therapy

Past and current memory for childhood sexual abuse reported by a clinical sample of 160 women survivors was assessed utilizing a structured clinical interview. Response alternatives for memory were ordered along a continuum. To minimize treatment effects, participants were interviewed as early in therapy as possible. Fairly complete recollection both in the past and currently was reported by 26.3% of the sample, 36.9% apparently lost and subsequently recovered sexual abuse memories, and 36.9% endorsed intermediate degrees of memory. Only 2.5% indicated a decrease in degree of recollection over time. Age at onset was the only abuse characteristic found to differentiate participants with fairly complete memory from the rest of the sample. Findings are interpreted as illustrating that conclusions about memory for abuse are highly dependent on the way inquiries are conceptualized and worded.     

Group Treatment for Spouse Abuse: Are Women with PTSD Appropriate Participants?

Eighty four abused women seeking therapy with their husbands were accepted into a group treatment program for spouse abuse. In the current study, we evaluated the treatment outcome of those women (n = 27) diagnosed with Posttraumatic Stress Disorder (PTSD). PTSD diagnosis, itself, did not differentiate those women who dropped out of treatment. Results indicated, however, that across all women, avoidance symptomatology significantly differentiated treatment completers from dropouts. Although women with PTSD began treatment in worse condition (lower marital satisfaction, higher depressive symptomatology, greater fear of spouse), post-assessment revealed they achieved positive treatment gains parallel to those of women without PTSD. Women with PTSD improved on each outcome variable measured, including a reduction in fear of spouse. Women with PTSD also did not differentially drop out of either treatment condition (men's/women's versus conjoint groups) which lends support to the appropriateness of conjoint treatment for spouse abuse.     

Correlates of the Co-Occurrence of Wife Abuse and Child Abuse Among a Representative Sample

The co-occurrence of domestic violence and child abuse is well documented (Appel, A. E., & Holden, G. W. (1998). J. Fam. Psychol. 12: 578–599; Edleson, J. L. (1999). Violence Against Women 5: 134–154). However, little is known about the correlates of co-occurring wife and child abuse. Analyzing data from the 1985 National Family Violence Survey (subsample N = 2733), this study identified risk factors associated with the co-occurrence of wife and child abuse. One-way ANOVA and chi-square analyses were conducted to compare characteristics of parents, children, and households among subgroups of families reporting some form of abuse. Key differences emerged between the three types of homes compared (i.e., those with child abuse alone, wife abuse alone, or wife and child abuse), indicating possibly distinct etiologies and processes. In particular, the co-occurrence of wife and child abuse was marked by less education, worse health, increased reports of depression, and increased husband drug use. Findings may be useful to practitioners and researchers interested in risk factors for different forms of family violence.The total does not equal 100% because certain states report more than one form of maltreatment per child.     

An Integrated Theoretical Model of Sibling Violence and Abuse

Drawing on three theoretical perspectives (feminist, conflict, and social learning), an integrated analytical model of adolescence sibling violence and abuse is proposed. The model suggests that certain characteristics of the parents' relationship, various aspects of parent–child relations, and characteristics of the sibling relationship are major components in explaining sibling violence and abuse. These are mediated by individual sibling characteristics and sibling verbal conflict. The model should enable researchers to systematically examine, in a more holistic way, the factors related to violence and abuse, and to assess their relative importance in accounting for these phenomena.     

The Relationship Between Partner Abuse and Substance Use Among Women Mandated to Drug Treatment

This study investigates the relationship between substance use and partner abuse among women (N = 1,025) who entered drug-treatment programs through the criminal justice systems in New York City and Portland, Oregon. Self-report data on substance use and partner abuse indicate that although the rate of partner abuse in both cities is well above the national average, the less substance-involved women in Portland reported more abuse than their New York counterparts. Our analyses suggest that the relationship between partner abuse and substance use during conflicts varies within the population of women offenders who are heavily drug-involved, with women in Portland reporting a greater direct link between partner abuse and substance use. The findings indicate that there is a need for drug-treatment providers to understand their clients' victimization histories and the relationship between partner abuse and substance use in order to engage clients in the treatment process and help them learn how to avoid being victimized in the future.     

The Implications of Childhood Sexual Abuse on Adult Social Behavior

Research indicates that childhood sexual abuse creates many long-term psychological difficulties, which may impair social behavior. These problems include anxiety, fear, depression, self-hatred, alienation, and suicidal tendencies. It was hypothesized that childhood sexual abuse would produce impaired social behavior in adults sexually abused as children. Two hundred and twenty-two male and female introductory psychology students from the University of Manitoba completed the Rand Corporation's Social Health Battery amplpar1978amprpar;, Linn's Social Dysfunction Rating Scale (1969), and a shortened version of Finkelhor's Sexual Victimization Survey (1979). Participants who experienced childhood sexual abuse exhibited impaired social behavior, which included fewer friends and social contacts, and more social adjustment problems. The importance of early intervention for children who experienced sexual abuse was discussed.     

Relationship Between Childhood Sexual Abuse Characteristics and Dissociation Among Women in Therapy

This study investigated the relationship between 10 characteristics of childhood sexual abuse and dissociation in adulthood. A structured clinical interview, the Dissociative Experiences Scale, and the Dissociation Subscale of the Symptom Checklist 90 - Revised were administered to 118 women survivors seeking psychotherapy. Separate stepwise multiple regression analyses were conducted for each dissociation scale to determine which abuse characteristics were predictive of dissociation. In both analyses, the same four variables were significantly related to dissociation: age at onset, coercive sexual acts, objectifying sexual acts, and concurrent multiple perpetrators. Implications of findings for future research and clinical practice are explored.     

Collateral Damage: An Analysis of the Achievements and Unintended Consequences of Batterer Intervention Programs and Discourse

This paper reviews and critiques two prevailing program models for batterer intervention in order to highlight both their valuable achievements and attendant costs and consequences. We analyze these batterer intervention program models at 3 levels. First, we describe the historical development and basic program components of the intervention models. Second, we trace differences in the models to their grounding in different psychological assumptions and theories about behavior change, masculinity, and violence. Third, differences between the models are mapped onto contrasting approaches to the regulation of human deviance in the criminal justice and mental health systems. Based on this analysis, we conclude that further attention to structural and contextual factors, such as class, race, economic stress, and substance abuse in explanations of domestic violence is needed, together with alternative approaches to collaboration between victim advocates and batterer intervention providers.