Child maltreatment: qualitative review of theoretical and methodological trends in intervention programs with an attachment perspective

Abstract. This review provides a qualitative comparative analysis of theoretical and methodological aspects of 27 studies in which the results of the implementation of programs involved in child maltreatment are presented with an attachment perspective. The studies were examined following the Scottish Intercollegiate Guidelines Network. It was found that the programs promote the development of maternal sensitivity, mentalization or reflective functioning and empathy, however, the underlying mechanisms are not differentiated according to the type of abuse to intervene. Likewise, it was found that despite the recognition of the mother's violent childhood experiences as one of the main predisposing factors for child abuse, it is a variable that is scarcely considered in the programs examined. These findings indicate the importance of developing intervention programs that consider a cumulative ecological risk perspective.

El consumo abusivo de alcohol en inmigrantes latinoamericanos participantes en programas de intervención para maltratadores: importancia de la adherencia al tratamiento / Alcohol Abuse in Latin American Immigrants Participating in Intervention Programs for Abusers: the Import ance of Adherence to Treatment

En este estudio, se analizan las tasas de abandono del tratamiento en hombres inmigrantes latinoamericanos con problemas de consumo de alcohol (PCA) derivados a programas de intervención con maltratadores, y se explora si aquellos que consiguen finalizar la intervención se diferencian de los que no tienen PCA en variables resultado de la intervención. La muestra la componen 107 hombres latinoamericanos condenados por violencia contra la mujer. Al contrario de lo esperado, no se confirman mayores tasas de abandono entre los participantes con PCA. Independientemente de tener o no PCA, los participantes que finalizaron el programa mostraron mejoría en todas las variables objetivo de la intervención analizadas, incluida la reducción del consumo de alcohol entre aquellos participantes con PCA.

This study analyzes dropout rates among Latin-American immigrants with alcohol abuse problems (AAP) participating in a batterer intervention program, and whether those perpetrators who finalize the intervention benefit the same as those participants without AAP in a number of program outcomes. The sample was 107 Latin-American immigrants convicted for intimate partner violence perpetration. Contrary to what was expected, there were not higher dropout rates among participants with AAP. Participants who finalized the intervention program, however, showed improvements in all outcomes variables explored regardless of whether they had AAP, including a reduction of alcohol abuse among participants with AAP.

El desafío de incorporar las redes institucionales y comunitarias en la intervención con adolescentes infractores: una investigación-acción en tres regiones del sur de Chile / The Challenge of Incorporating the Institutional and Community Networks in the Intervention with Juvenile Offenders: An Action Research in Three Southern Regions of Chile

Se reportan los resultados obtenidos a partir de una investigación-acción con componentes participativos, orientada a fortalecer el funcionamiento de redes institucionales y comunitarias para la intervención con adolescentes infractores de ley. El artículo da cuenta de los principales resultados obtenidos a partir de este proceso, centrando su análisis en un conjunto de dimensiones que permiten tener una panorámica acerca de los avances y desafíos que presentan los programas involucrados en el estudio. Los resultados reportan las dificultades de los equipos para incluir de modo eficiente los recursos de las redes interinstitucionales dada la fragmentación de la política pública destinada a este grupo de adolescentes, así como las barreras para integrar la dimensión comunitaria en el trabajo con los jóvenes, producto del formato de intervención así como las modalidades de financiamiento de los programas. Igualmente, se evidencian mejoras en la comprensión e integración de estos componentes, por parte de los equipos de los programas durante el proceso, articulándose redes interinstitucionales con mejores grados de continuidad y complementariedad en su quehacer y una incorporación paulatina, aunque parcial, de la dimensión comunitaria en la intervención.

The results of a participatory action research aiming the empowerment of institutional and community networks in the field of the intervention on youth offenders are presented. This paper focuses the analysis on several dimensions allowing us to have a broader perspective on the advances and challenges faced by intervention programmes on youth offenders. The results show the obstacles faced by these interventors in order to achieve efficiency in the use of resources within these networks. This is due to the fragmentation of public policies targeting these young offenders. It is also due to some barriers related to the inclusion of the community dimension within these programmes and also related to the mechanisms in place in order to provide funding. Some improvements in the understanding and integration of these dimensions by the interventors are also highlighted. Improvements in the continuity and complementarity of the work of these networks in order to increase the integration of the community level within the intervention are also found.

Una perspectiva crítica de las prácticas psicosociales en violencia de género: caso Barranquilla / A critical perspective of psychosocial practices in gender violence: case Barranquilla

Se aborda la problemática de la violencia contra la mujer, considerada por la OMS como un problema de salud pública frente al cual las ciencias sociales y humanas deben dar respuestas, en su comprensión e intervención, a fin de erradicarla, tal como lo propone el tercer Objetivo del Milenio. Desde un estudio de casos de corte analítico, se abordan ocho programas de intervención psicosocial en violencia de género (VBG) implementados en la ciudad de Barranquilla, Colombia, cuya comparación permite establecer cómo operan estos programas, para finalmente brindar una serie de propuestas a tener en cuenta frente al ejercicio de intervención en esta problemática. Los resultados resaltan a la mujer como la principal usuaria en los programas; y al taller como la técnica de intervención más implementada. Los contenidos se estructuran en torno a la mujer y defensa de sus derechos, la violencia de pareja e intrafamiliar y el empoderamiento femenino.

The problem of violence against women is approached, which is considered by the World Health Organization a public health issue in the face of which social and human sciences should give answers in their understanding and intervention in order to eradicate it, as the third objective of the Millennium proposes. From an analytic case study, a total of eight programs of psychosocial intervention in gender violence GV are approached - implemented in the city of Barranquilla, Colombia- which when compared permits to establish how they operate, to finally provide a series of proposals to be taken into account towards the exercise of intervention in this issue. The results highlight women as the main user in the programs; and the workshop as the most widely deployed technical intervention. The contents are structured around women and defend their rights, intimate partner violence and domestic violence and women empowerment.

The current practices of intervention with batterers / Uma revisão das práticas atuais na intervenção com agressores conjugais

Background: Since the 70s there was a proliferation of intervention programs for batterers; however the results remain controversial. Objectives: This study aims to analyse the literature published between the years of 2000 and 2013 about the effectiveness of the intervention with batterers. Methods: A review of papers about intervention with batterers published during this period (2000-2013) was conducted. Social sciences databases were checked. Papers about programs for a specific public or programs with a broad intervention focus, and with female and homosexual offenders were excluded. Results Thirty-six studies that described 37 intervention programs fulfilled the inclusion criteria. In general, the analysed programs adopted a group format (70.3%) and a cognitive-behavioural (56.8%) or psychoeducational (18.9%) intervention model (32.4% assumed to adopt a Duluth model). Concerning the effectiveness, results showed success rates of 39.4%-97%, dropout rates of 10%-58% and recidivism rates of 0%-65.9%. Discussion: The effectiveness of intervention with batterers remains controversial, which seems to be due to the different methodologies used in the studies. Despite the inconsistencies, programs for perpetrators are an important way to reduce intimate partner violence recidivism...

Contexto: Desde os anos 1970, assiste-se a uma proliferação dos programas de intervenção para agressores conjugais, no entanto os resultados mantêm-se controversos. Objetivos: Este estudo visa analisar a literatura publicada entre os anos de 2000 e 2013 acerca da eficácia da intervenção com agressores conjugais. Métodos: Para o efeito, realizou-se uma revisão de artigos publicados durante esse período (2000-2013) a respeito da intervenção com agressores conjugais. Foram consultadas bases de dados de referência na área das ciências sociais. Excluíram-se da análise artigos que versavam sobre programas destinados a um público-alvo ou com um foco de intervenção demasiadamente amplo, agressoras do sexo feminino e agressores homossexuais. Resultados: Trinta e seis estudos que descreviam 37 programas de intervenção dirigidos a agressores conjugais preencheram os critérios de inclusão definidos. Na generalidade, os programas analisados adotaram um formato grupal (70.3%) e um modelo de intervenção cognitivo-comportamental (56,8%) e/ou psicoeducativo (18,9%), e uma parte se assumiu como assente no modelo Duluth (32,4%). No que diz respeito à eficácia da intervenção, os resultados dos diferentes estudos revelaram-se ambíguos, com taxas de sucesso entre os 39,4% e os 97%, taxas de abandono entre os 10% e os 58% e taxas de reincidência entre os 0% e os 65,9%. Conclusão: Em suma, a eficácia da intervenção com agressores conjugais mantém-se controversa, o que parece relacionar-se essencialmente com as diferentes metodologias utilizadas nos estudos. Não obstante tais inconsistências, os programas para agressores revelam-se uma importante medida na redução da reincidência na violência doméstica...

Tipología de hombres condenados por violencia de género en un contexto de intervención psicológica en la comunidad / Typology of Men Convicted of Intimate Partner Violence in Psychological Treatment in a Community Setting

Este estudio analiza una muestra de 61 hombres que participaron en un programa de intervención psicológica en la comunidad dirigido a sujetos condenados por un delito de violencia de género. El objetivo es clasificar a los participantes en grupos homogéneos con el fin de detectar sus diferencias y semejanzas, y en particular determinar si valoran de manera distinta el programa de intervención. La información sobre los integrantes de la muestra ha sido obtenida a través de una entrevista semiestructurada, una valoración de sus expectativas ante el tratamiento y la utilidad de éste, y mediante la aplicación de los cuestionarios SCL-90-R, IRI, BDHI, IPDMV, MCMI-II y CTS-2. La clasificación de los sujetos se ha realizado mediante análisis clúster y los resultados evidencian la existencia de 2 grupos con una fuerte cohesión interna. Uno lo forman individuos más estables emocionalmente, con menor consumo de sustancias y una expresión de la violencia de menor intensidad. El otro lo constituyen sujetos que reconocen un mayor número de agresiones físicas menores (CTS-2) y que obtienen puntuaciones significativamente superiores en las escalas de personalidad antisocial, pasivo-agresiva y esquizotípica y en las de abuso de sustancias (MCMI-II). Sin embargo, no se observan diferencias significativas entre ambos grupos respecto a su valoración del programa de intervención psicológica.

This paper presents the study a sample of 61 convicted male batterers who participated in a psychological intervention program provided in the community. The aim is to classify the participants in homogeneous groups in order to detect their differences and similarities and, in particular, those concerning their evaluation of the intervention program. Data from the participants were collected by means of a semi-structured interview, an evaluation based on their expectations and the usefulness of the program, together with the administration of the following instruments: SCL-90-R, IRI, BDHI, IPDMV, MCMI-II and CTS-2. The batterers were classified using cluster analysis and the results suggest the existence of 2 clusters with a strong internal consistency. One cluster is composed by male batterers who are emotionally more stable, with lower drug use rates and a less intense expression of violence. The other group is composed by men who recognized a higher number of minor physical aggressions (CTS-2), with highest scores in the antisocial, passive-aggressive and schizotypal personality dimensions, and also the highest scores in drug use (MCMI-II). However, we have not found statistically significant differences between both clusters with respect to their assessment of the psychological intervention program.

Asunción de responsabilidad en hombres maltratadores: influencia de la autoestima, la personalidad narcisista y la personalidad antisocial / Responsibility assumption among male batterers: self-esteem, narcissistic and antisocial personality influence

El principal objetivo de este estudio es analizar la relación entre la asunción de responsabilidad de hombres condenados por violencia doméstica contra la mujer, la autoestima, la personalidad narcisista y la personalidad antisocial. Los participantes en este estudio fueron 177 hombres que participaban en un programa de intervención con maltratadores en medio abierto al que acudían por orden judicial. Se realizaron tres MANCOVAS para comprobar si existían diferencias en atribución de responsabilidad (culpabilización de la víctima, defensa propia y autoatribución de culpa), y minimización de los hechos, en función de la presencia de rasgos de personalidad narcisista y antisocial, y de la autoestima. En todos los casos se controló por la variable deseabilidad social. Únicamente se encontraron diferencias significativas entre los grupos de baja y alta autoestima en minimización. Los sujetos con baja autoestima tendían a minimizar en mayor medida los hechos por los que habían sido condenados. Se discuten los resultados relativos a la relación entre las dos variables de personalidad evaluadas y la atribución de responsabilidad y sus implicaciones para la intervención con maltratadores.

The main aim of this study was to analyze the relation between responsibility assumption among men convicted for domestic violence against women and self-esteem, narcissistic personality and antisocial personality. Participants in the study were 177 men participating in a court-ordered batterer intervention program in the community. Three MANCOVAS were performed to analyze differences in responsibility attributions (victim-blaming, self-defense, and self-attribution), and minimization as a function of narcissistic and antisocial personality traits presence, and levels of self-esteem. All analysis controlled for social desirability. Significant differences were found only between groups of low and high self-esteem in minimization. Subjects with low self-esteem showed higher levels of minimization of the violence for which they were convicted. These results implications of for batterers intervention programs are discussed.

Avaliação assistida em crianças com problemas de comunicação e de aprendizagem em contexto de intervenção / Dynamic assessment in children with communication problems and learning disabilities in intervention context / Avaluación asistida en niños con problemas de comunicación y aprendizaje en contexto de intervención

A inclusão escolar tem demandado novas formas de avaliar os processos de aprendizagem de crianças com necessidades educativas especiais ou dificuldades de aprendizagem (DA). As contribuições da avaliação assistida para essa área foram apresentadas neste trabalho que reuniu dados de dois estudos feitos com crianças de 8 a 12 anos de idade, sendo 7 com déficits (leve a severo) nas habilidades de linguagem e comunicação, usando-se o Children’s Analogical ThinkingModifiability Test (CATM) adaptado, antes e após intervenção com Sistema Computadorizado de Comunicação Alternativa e Ampliada (CAA), e 34 alunos com DA, pelo Jogo de Perguntas de Busca com Figuras Diversas (PBFD), antes e após programa de promoção da criatividade. Também foram aplicadas provas cognitivas psicométricas, observando-se baixo desempenho. Contudo, todas as crianças apresentaram ganhos entre o pré e pós-teste. Os dados mostram que a modalidade assistida de avaliação é prescritiva e sensível para avaliar os efeitos de programas para essa população.

Dynamic assessment in children with communication problems and learning disabilities in intervention contextThe school inclusion has required new ways of evaluating the learning processes of children with special educational needs or learning disabilities (LD). The contributions of dynamic assessment for this area were presented in this study that gathered data from two studies with children 8-12 years of age, 7 with deficits (mild to severe) in the skills of language and communication, using the Children’s Analogical Thinking Modifiability Test (CATM) adapted, before and after intervention with computerized system of Alternative and Augmentative Communication (AAC), and 34 students with LD, by the Constraint-Seeking Questions Game with Several Figures (CSQ-SF) before and after program to promote creativity. Also cognitive psychometric tests were applied, observing poor performance. However, all children showed gains between pre and post-test. The data show that the dynamic assessment is prescriptive and sensitive to evaluate the effects of programs for this population.

La inclusión escolar ha requerido nuevas maneras de evaluar los procesos de aprendizaje de los niños con necesidades especiales o dificultades de aprendizaje (DA). Las contribuciones de la evaluación asistida para esta área se presentaron en este estudio que recogió datos de dos estudios con niños de 8-12 años de edad, 7 con los déficit (de leve a grave) en las habilidades de lenguaje y comunicación, usando lo Children’s Analogical Thinking Modifiability Test (CATM) adaptado, antes y después de la intervención con el sistema computadorizado de Comunicación Aumentativa y Alternativa (CAA), y 34 estudiantes con el DA, con lo Juego de Preguntas de Busca con Figuras Diversas (PBFD) antes y después del programa de promoción de la creatividad. Pruebas psicométricas también cognitivas se aplicaron, y se observó un rendimiento deficiente. Sin embargo, todos los niños mostraron beneficios entre el pre y post-test. Los datos muestran que de la evaluación asistida es prescriptiva y sensible para evaluar los efectos de los programas para esta población.

Motivos, apoyo social y comportamientos de adhesión en personas con VIH: modelamiento con ecuaciones estructurales / Motives, social support, and adherence behaviors in HIV-patients: structural equation modeling

Se condujo un estudio transversal cuyo objetivo fue modelar con ecuaciones estructurales la influencia de variables psicológicas y sociales sobre comportamientos de adhesión en 69 personas con VIH. El modelo estructural final reveló la influencia de las variables motivos y apoyo social sobre los comportamientos de adhesión (x2/gl = 1.29; IBA = 0.91; IBAC = 0.84; RCMEA = 0.06; IAI = 0.96; IAC = 0.96), explicando 49% de la varianza; adicionalmente, se observó una influencia de los comportamientos de adhesión sobre los niveles de carga viral y de éstos sobre los linfocitos T-CD4. Este estudio contribuye a un mejor entendimiento de las variables que subyacen a la práctica eficiente de los comportamientos de adhesión en personas con VIH.

A cross-sectional study was carried out in order to assess the influence of a set of psychological and social variables on adherence behaviors in a sample of 69 persons with HIV, using a structural equations model. The final model revealed a strong influence of motives and social support on adherence behaviors, both explaining 49% of the total variance; also, an effect of adherence behaviors on viral load levels and of this one on T CD4+ cell counts were observed. The current study contributes to understand variables underlying adherence behaviors in a sample of persons with HIV, and therefore intervention programs directed to promote and/or to maintain these behaviors must to consider the specific weight of some psychological and social variables along the behavioral continuum.

Asociación entre variables psicológicas y sociales con la adhesión en personas con diabetes tipo 2 / Association between psychological and social variables with adherence among people with type 2 diabetes

Se presentan los resultados de un estudio transversal que contó con la participación de 334 personas adultas con diagnóstico de diabetes tipo 2 de la ciudad de Hermosillo, México, cuyo objetivo fue evaluar la asociación entre variables psicológicas y sociales con tres comportamientos de adhesión: ejercicio físico, dieta y consumo de medicamentos. Un análisis de regresión logística multivariada reveló asociaciones de éstos con bajos niveles de estrés vinculado con toma de decisiones y tolerancia a la frustración, así como con apoyo social percibido. Los resultados sugieren el peso diferenciado que esas variables tienen sobre tres comportamientos de adhesión a la terapéutica en personas con diagnóstico de diabetes tipo 2, aspecto que debe ser tenido en cuenta al momento de diseñar e instrumentar programas de intervención interdisciplinarias dirigidos a mejorar la práctica consistente y eficiente de los mencionados comportamientos.

We present the results of a cross-sectional study in which participated 334 adult persons with diagnosis of type 2 diabetes at Hermosillo city, México, with the main objective to assess the association between psychological and social variables with three adherence behaviors: physical exercise, diet, and medication consumption. A logistic regression analysis showed several associations for the analyzed behaviors with low stress-related to decision-making and tolerance to frustration, as well as with perceived social support The results of this study suggest a differential weight of these variables on adherence behaviors in persons with diagnosis of type 2 diabetes, aspect that must taken into account at time of designing and implementing interdisciplinary intervention programs directed to promote the consistently and efficiently practice of these behaviors.

Educar é punir?: Concepções e práticas educativas de pais agressores / Is educate punishing?: Parents' childrearing practices and conceptions

A violência física de pais contra filhos é um dos tipos de violência doméstica e constitui um problema de saúde pública. Buscando colaborar para a compreensão do problema e para estratégias de intervenção com famílias, este trabalho tem o objetivo de investigar concepções sobre o educar e as práticas educativas de pais denunciados. Os entrevistados são pais/mães denunciados ao Conselho Tutelar. Utilizou-se o modelo de entrevista “História de vida temática”, constituída pelo relato da história de vida do entrevistado, complementada por um conjunto de tópicos previamente definidos. Foram realizadas seis entrevistas, sendo gravadas, transcritas e analisadas qualitativamente. Os resultados apontam inconsistências entre concepções e práticas educativas, dificuldades em utilizar recursos alternativos à punição física para colocar limites; a falta de suporte em rede social como fatores de risco, e a necessidade de implementar programas de intervenção que promovam a integração entre suas concepções e práticas como educadores.

Domestic violence is a known public health problem. This research intends to investigate conceptions and childrearing practices of parents that use physical violence against their children. Interviews with three mothers and three fathers from different families were made. Qualitative methodology was used, through semi-structured interview called “Thematic Life History”, where participants expose their personal history since childhood, followed by a previously defined list of topics. Interviews were recorded, transcribed and qualitatively analyzed. Data analysis revealed that parent’s conceptions are not corresponding to their every day actions with their children; the difficulty of parents at using non-violent chidrearing practices and a cultural naturalization of physical punishment to establish limits. It also points out parents` low social and economical support as a risk factor, as well as the necessity of changes in intervention programs to offer possibilities of joining parents conceptions and practices, aiming the improvement of child`s positive global development.

Prevención de la depresión unipolar en España: realidad y futuro / Prevention of unipolar depression in Spain: current and future situation

La depresión unipolar es una de las patologías con mayor prevalencia en las sociedades occidentales. Los factores de riesgo son múltiples y muchos de ellos prevenibles. Sin embargo, en España no se toma demasiado en serio la planificación de la prevención primaria de la depresión. Concluimos que dicha situación tiene diversas motivaciones políticas y académicas. Las dos son superables, si se toma en serio la prevención de la depresión.

Unipolar depression is one of the most common illnesses in western society. There are multiple risk factors and many of them are preventable. However, planning of primary prevention of depression is not taken very seriously in Spain. We conclude that there are various political and academic reasons for this situation. They both can be overcome if we take prevention of depression more seriously.