Adverse experiences and mental health problems in perpetrators of intimate partner violence in Northern Ireland: A latent class analysis.

BACKGROUND: Trauma and adverse experiences among perpetrators of intimate partner violence (IPV) have been associated with more serious patterns of offending. OBJECTIVE: To examine 1) how traumatic and adverse experiences cluster together and co-occur among IPV perpetrators, and 2) whether different patterns of trauma exposure are associated with specific mental health problems. PARTICIPANTS AND SETTING: The sample consisted of 405 convicted IPV perpetrators from Northern Ireland. METHODS: Data was collected between 2018 and 2019. Latent class analysis identified typologies of exposure to traumatic and adverse experiences. A series of binary logistic regression analyses explored associations between the identified classes and five categories of probable mental health problems. RESULTS: Three adversity classes were identified: a baseline class (59.2%), characterised by relatively low levels of exposure to most types of adversity; a 'childhood adversity' class (32.9%), with high levels of childhood adversity; and a 'community violence and disadvantage' class (7.9%), which had high probabilities of endorsing adversities related to economic hardship and community violence. Regression analyses showed that the childhood adversity class was significantly associated with increased likelihood of all categories of mental health problems, except for neurodevelopmental disorders (ORs = 1.77-3.25). The community violence and disadvantage class was significantly associated with probable mood and anxiety disorder (ORs 3.92 and 8.42, respectively). CONCLUSIONS: Different patterns of exposure to adversities were associated with distinct mental health problems in the present sample. Early intervention to prevent poly-victimisation, the clustering of adversities in childhood and the resulting accumulation of risk may be a useful component of preventive responses for IPV in Northern Ireland.

Trauma Exposure and Domestic Violence Offending Severity in a Probation Sample From Post-conflict Northern Ireland.

Domestic violence is more common in post-conflict settings such as Northern Ireland. However, the extent to which trauma and related mental health problems are associated with domestic violence perpetration in the region has not yet been quantitatively assessed. The present study examines relationships between multiple traumas, mental health problems, and five indicators of domestic violence perpetration severity (causing injury, use of a weapon, breach of nonmolestation order, sexual violence, and previous police involvement). The unique risk associated with distinct types of trauma (i.e., childhood maltreatment or conflict related) was also investigated. Perpetrators' case file data (n = 405) were analyzed using hierarchical logistic regression. The rates of recorded trauma exposure and mental health difficulties were 72.3% and 63.5%, respectively. The first logistic regression analyses showed that exposure to multiple traumas was associated with increased likelihood of perpetrating injurious and sexual violence, when controlling for the covariates (odds ratios [ORs] = 1.24-1.28). The second logistic regression analyses showed that childhood maltreatment was the only trauma type to confer unique risk, a relationship that was significant only for the outcome of perpetrating injurious violence (OR = 3.06). Substance misuse was also significantly associated with perpetration of injurious violence, use of weapons, and having past police involvement (ORs = 2.49-3.50). The accumulation of traumatic experiences and substance abuse appear to act as risk factors for some indicators of offending severity. Childhood maltreatment appears to confer particularly strong risk. The findings may support a focus on trauma and substance abuse as intervention targets in post-conflict settings.

Assessing Personality Pathology Response Sets in Perpetrators of Intimate Partner Violence.

Self-report personality inventories may be useful in directing perpetrators of intimate partner violence (IPV) to appropriate intervention programs. They may also have predictive capabilities in assessing the likelihood of desistance or persistence of IPV. However, validity problems are inherent in self-report clinical tools, particularly in forensic settings. Scores of the modifying indices (subsections of the scale designed to detect biases in responding) of the Millon Clinical Multiaxial Inventory-III (MCMI-III) often are not reported in research. This study analyses the response sets of a sample of 492 IPV perpetrators at intake to a Danish perpetrator program. Profiles were grouped into levels of severity, and the proportion of exaggerated or minimized profiles at each severity level was analyzed. Findings suggested that 30% of the present sample were severely disturbed or exaggerating their symptoms. As expected, there were significant levels of exaggerated profiles present in the severe pathology group and significant levels of minimized profiles in the low pathology group. Self-referred participants were more likely to exaggerate their pathology, but minimization was not associated with referral status. Nor was there an association between gender and the modifying indices. It is suggested that so-called "fake good" or "fake bad" profiles should not necessarily be treated as invalid, but that elevations in the modifying indices can be interpreted as clinically and forensically relevant information in their own right and should be reported on in research.

The effectiveness of interventions to prevent recidivism in perpetrators of intimate partner violence: A systematic review and meta-analysis.

BACKGROUND: Previous reviews of interventions to prevent recidivistic intimate partner violence (IPV) have cited minimal benefits and have been critical of interventions adopting a 'one-size-fits-all' approach to a heterogenous category of offenders. The present systematic review and meta-analysis assesses evidence for interventions situated in a risk-need-responsivity framework, in comparison with the more traditional 'one-size-fits-all' intervention approach. METHOD: Six databases (PsycINFO, Web of Science, PubMed, EMBASE, SCOPUS, PILOTS) were searched for studies examining effectiveness of IPV interventions. RESULTS: Thirty-one studies met the inclusion criteria. Studies were analysed separately depending on whether they compared two treatments (n = 17) or used a no-treatment control group (n = 14). In the meta-analysis, overall effect sizes were OR = 0.52, 95% CI [0.35-0.78] for interventions with follow-up of ≤ one year (p < 0.001) and OR = 0.60, 95% CI [0.46-0.78] for interventions with follow-up between one and two years (p < 0.001). The pooled effects from the studies using follow-up of greater than two years did not reach statistical significance. Subgroup analyses suggested that effect sizes differed across treatment types, with risk-need-responsivity treatments performing well against other modalities. CONCLUSIONS: Risk-need-responsivity treatments showed promise in the short-to-medium term, but the challenge of sustaining effects into the longer term remains.

Revealing what is distinct by recognising what is common: distinguishing between complex PTSD and Borderline Personality Disorder symptoms using bifactor modelling.

Background: Despite concerns of conceptual similarity, increasing evidence supports the discriminant validity of Complex Posttraumatic Stress Disorder (CPTSD) and Borderline Personality Disorder (BPD). However, all studies to date have assumed a categorical model of psychopathology. In contrast, dimensional models of psychopathology, such as the Hierarchical Taxonomy of Psychopathology model (i.e. HiTOP model), recognise shared vulnerability across supposedly discrete disorders. Accounting for shared vulnerability between CPTSD and BPD symptoms may help to better reveal what is unique about these constructs. Objective: To identify the distinct and shared features of CPTSD and BPD via the application of dimensional modelling procedures. Method: Confirmatory bifactor and confirmatory factor analysis were employed to identify the optimal latent structure of CPTSD and BPD symptoms amongst a convenience sample of Israeli adults (N = 617). Additionally, structural equation modelling was used to identify risk factors associated with these constructs. Results: The latent structure of CPTSD and BPD symptoms was best explained by a bifactor model including one 'general' factor (i.e. vulnerability to all symptoms) and three 'specific' correlated factors (i.e. vulnerability to PTSD, DSO, and BPD symptoms, respectively). CPTSD symptoms were more readily distinguished from the general factor whereas BPD symptoms were not as easily distinguished from the general factor. CPTSD symptoms reflecting a negative self-concept and BPD symptoms reflecting an alternating self-concept were the most distinctive features of CPTSD and BPD relative to the general factor, respectively. Most of the risk factors were associated with the general vulnerability factor, consistent with the predictions of dimensional models of psychopathology regarding shared risk across supposedly distinct psychiatric constructs. Conclusion: Consistent with a dimensional model of psychopathology, CPTSD and BPD shared a common latent structure but were still distinguishable. CPTSD and BPD symptoms may be most effectively distinguished based on the phenomenology of self-concept symptoms.

Antecedentes: A pesar de las consideraciones sobre la similitud conceptual, cada vez hay más pruebas que respaldan la validez para diferenciar el trastorno de estrés postraumático complejo (TEPT-C) del trastorno límite de personalidad (TLP). Sin embargo, todos los estudios hasta la fecha han asumido un modelo categórico de psicopatología. Por el contrario, los modelos dimensionales de psicopatología, como el modelo de taxonomía jerárquica de psicopatología (el modelo HiTOP), reconocen la vulnerabilidad compartida entre trastornos supuestamente distintos. Tener en cuenta la vulnerabilidad compartida entre los síntomas de TEPT-C y TLP puede ayudar a revelar mejor qué es lo particular de estos constructos.Objetivo: Identificar las características distintivas y compartidas de TEPT-C y TPL mediante la aplicación de procedimientos de modelado dimensional.Método: Se emplearon análisis de factores confirmatorios y bifactoriales para identificar la estructura latente óptima de los síntomas de TEPT-C y TLP entre una muestra por conveniencia de adultos israelíes (N = 617). Además, se utilizó el modelado de ecuaciones estructurales para identificar los factores de riesgo asociados con estos constructos.Resultados: La estructura latente de los síntomas de TEPT-C y TLP se explicó mejor mediante un modelo bifactorial que incluye un factor 'general' (es decir, vulnerabilidad a todos los síntomas) y tres factores correlacionados 'específicos' (es decir, vulnerabilidad a los síntomas de TEPT, DSO y TLP respectivamente). Los síntomas de TEPT-C se distinguieron más fácilmente del factor general, mientras que los síntomas de TLP no se distinguieron tan fácilmente del factor general. Los síntomas de TEPT-C que reflejan un autoconcepto negativo y los síntomas de TLP que reflejan un autoconcepto alterno fueron las características más distintivas de TEPT-C y TLP en relación con el factor general, respectivamente. La mayoría de los factores de riesgo se asociaron con el factor de vulnerabilidad general, en consonancia con las predicciones de los modelos dimensionales de psicopatología con respecto al riesgo compartido entre constructos psiquiátricos supuestamente distintos.Conclusión: De acuerdo con un modelo dimensional de psicopatología, el TEPT-C y el TLP compartían una estructura latente común, pero aún eran distinguibles. Los síntomas de TEPT-C y TLP se pueden distinguir de manera más efectiva según la fenomenología de los síntomas del autoconcepto.

Childhood trauma as a predictor of reoffending in a Northern Irish probation sample.

BACKGROUND: It is well-documented that there is a high prevalence rate of childhood trauma experiences among the prison population, and studies have found a link between childhood trauma and later acts of violence. OBJECTIVE: The aim of the current study was to investigate whether childhood trauma (i.e., physical, sexual, emotional abuse and physical neglect) among offenders who have served a life sentence in Northern Ireland was associated with general and violent reoffending patterns. The study also explored the relationship between childhood trauma resulting from the sectarian conflict "The Troubles" in the region and its impact on reoffending. METHOD: The casefiles of 100 offenders were coded for trauma experiences and official reoffending data was extracted. Logistic regression analysis was performed to explore the relationship between trauma and reoffending. RESULTS: The most common form of childhood trauma were emotional abuse and/or emotional neglect (n = 43), conflict-related trauma (n = 43) and physical abuse (n = 40). Only age (OR .91) and conflict-related trauma (OR 5.57) emerged as significant predictors (p < .05) of general reoffending at any time post release. Similarly, only age (OR .92) and conflict-related trauma (OR 4.57) emerged as significant predictors (p < .05) of violent reoffending. Although it did not reach significance (p =  .09), childhood physical abuse was related to an increase in the odds of violently reoffending, of a large magnitude (OR 4.09). CONCLUSIONS: Conflict-related trauma significantly predicted general and violent reoffending among offenders with previous violent convictions.

Youth Responses to School Shootings: a Review.

PURPOSE OF REVIEW: This paper aims to synthesize research relating to youth responses to school shootings between 2014 and 2017. The main questions it addresses are how such events impact young people psychologically, and what risk or protective factors may contribute to different trajectories of recovery? RECENT FINDINGS: Recent research suggests that most young people exposed to school shootings demonstrate resilience, exhibiting no long-term dysfunction. However, a minority will experience severe and chronic symptoms. The likelihood of experiencing clinically significant reactions is influenced by pre-trauma functioning as well as peri-traumatic and post-traumatic factors. These include proximity to the trauma, peri-traumatic dissociation, post-traumatic emotional regulation difficulties, social support, and flexibility of coping styles. Research that separates the distinguishing features of young people with differing recovery styles is vital to tailor intervention. But methodological and design issues associated with such research necessitates caution in drawing conclusions. Variation in definitions and measures and the self-report nature of many of the studies are potential sources of bias. Greater uniformity across designs would enhance confidence and allow for improved evidence-based intervention.

Training the next generation of psychotraumatologists: COllaborative Network for Training and EXcellence in psychoTraumatology (CONTEXT).

In this paper we present a description of the Horizon2020, Marie Sklodowska-Curie Action funded, research and training programme CONTEXT: COllaborative Network for Training and EXcellence in psychoTraumatology. The three objectives of the programme are put forward, each of which refers to a key component of the CONTEXT programme. First, we summarize the 12 individual research projects that will take place across three priority populations: (i) refugees and asylum seekers, (ii) first responders, and (iii) perpetrators and survivors of childhood and gender-based violence. Second, we detail the mentoring and training programme central to CONTEXT. Finally, we describe how the research, together with the training, will contribute towards better policy, guidelines, and practice within the field of psychotraumatology.

En este artículo presentamos una descripción de un nuevo programa de investigación y formación, Horizon2020, con fondos de Marie Sklodowska-Curie Action, llamado CONTEXT o 'Red coordinadora para la formación y la excelencia en psicotraumatología'. Se presentan los tres objetivos del programa y cada uno de los cuales hace referencia a un componente clave del programa CONTEXT. Primero, resumimos los doce proyectos individuales de investigación que se llevarán a cabo en tres poblaciones prioritarias: (i) refugiados y solicitantes de asilo, (ii) personal de respuesta en emergencias y (iii) perpetradores y sobrevivientes de violencia infantil y de género. En segundo lugar, detallamos el programa de tutoría y formación, eje central de CONTEXT. Finalmente, describimos cómo la investigación, junto con la formación, contribuirá a una mejor política, directrices y práctica en el campo de la psicoterapia.

Prospective cohort study of the relationship between neuro-cognition, social cognition and violence in forensic patients with schizophrenia and schizoaffective disorder.

BACKGROUND: There is a broad literature suggesting that cognitive difficulties are associated with violence across a variety of groups. Although neurocognitive and social cognitive deficits are core features of schizophrenia, evidence of a relationship between cognitive impairments and violence within this patient population has been mixed. METHODS: We prospectively examined whether neurocognition and social cognition predicted inpatient violence amongst patients with schizophrenia and schizoaffective disorder (n = 89; 10 violent) over a 12 month period. Neurocognition and social cognition were assessed using the MATRICS Consensus Cognitive Battery (MCCB). RESULTS: Using multivariate analysis neurocognition and social cognition variables could account for 34 % of the variance in violent incidents after controlling for age and gender. Scores on a social cognitive reasoning task (MSCEIT) were significantly lower for the violent compared to nonviolent group and produced the largest effect size. Mediation analysis showed that the relationship between neurocognition and violence was completely mediated by each of the following variables independently: social cognition (MSCEIT), symptoms (PANSS Total Score), social functioning (SOFAS) and violence proneness (HCR-20 Total Score). There was no evidence of a serial pathway between neurocognition and multiple mediators and violence, and only social cognition and violence proneness operated in parallel as significant mediators accounting for 46 % of the variance in violent incidents. There was also no evidence that neurocogniton mediated the relationship between any of these variables and violence. CONCLUSIONS: Of all the predictors examined, neurocognition was the only variable whose effects on violence consistently showed evidence of mediation. Neurocognition operates as a distal risk factor mediated through more proximal factors. Social cognition in contrast has a direct effect on violence independent of neurocognition, violence proneness and symptom severity. The neurocognitive impairment experienced by patients with schizophrenia spectrum disorders may create the foundation for the emergence of a range of risk factors for violence including deficits in social reasoning, symptoms, social functioning, and HCR-20 risk items, which in turn are causally related to violence.