Inter-parental conflict, domestic violence and children's psychological adjustment : the role of children's perceptions of parental behaviour

The research presented in this thesis applies a process-orientated perspective to understanding children's emotional and behavioural adjustment in the context of hostile and violent inter-parental conflict. The studies presented examined the relationship between inter-parental conflict and the quality of parent-child relations, and the role that dysfunction in these family relationships may play in determining children's psychological adaptation. In particular, the primary focus of this research was concerned with children's perceptions, or social cognitive processing, of these family relationships as a primary mechanism through which exposure to inter-parental conflict ranging in severity, influences children's psychological wellbeing. Using data from three separate samples of children and parents drawn from community and clinical settings in the United Kingdom, a set of four interlocking studies was conducted. First, using a sample of over 200 children and parents, the quality of parent-child relations was found to play a mediating role in the relationship between parents' reports of marital conflict and children's immediate and longer term externalising behaviour. Recognising the need to examine the interrelationships between the marital and parent-child relationship from the child's perspective, the second study considered the joint role'played by children's appraisals of both inter- parental conflict and parent-child relationship quality in explaining children's adaptation in the context of varying levels of conflict. Children's appraisals of both relationships were found to be important in conveying effects to children's psychological adaptation across the spectrum of inter-parental behaviour, although there was some variation in processes underpinning children's development as a function of conflict severity and the index of adjustment considered (internalising symptoms, externalising problems). Next, the role of younger children's appraisals of family relationships was examined. Children's appraisals were found to play an intervening role in the relationship between hostile inter-parental conflict and adjustment, although children's internalising symptoms were found to be affected directly through children's appraisals of threat relating to parents' marital conflict, whereas children's externalising problems were found to be affected indirectly, through children's respective appraisals of both the inter-parental and parent-child relationships. Finally, children's appraisals of multiple family relationships were examined as a mechanism through which very hostile forms of inter-parental conflict influenced children's concurrent adjustment. Broad agreement was found with the previous studies, where children's appraisals of the inter-parental relationship seemed to be particularly important in accounting for children's internalising symptoms in the context of high inter-parental conflict, whereas children's views on the quality of relations with parents were more important in accounting for children's externalising problems. Collectively, these studies represent a process-orientated account of how inter- parental conflict across the spectrum of severity affects children's adjustment, and in particular locates children's understanding of family relationships as a primary mechanism through which hostile and violent inter-parental conflict impacts on children's psychological functioning. These findings are of relevance to researchers, practitioners and policy makers seeking to understand how interparental conflict and domestic violence affects children.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Inter-parental conflict, domestic violence and children's psychological adjustment: The role of children's perceptions of parental behaviour

The research presented in this thesis applies a process-orientated perspective to understanding children's emotional and behavioural adjustment in the context of hostile and violent inter-parental conflict. The studies presented examined the relationship between inter-parental conflict and the quality of parent-child relations, and the role that dysfunction in these family relationships may play in determining children's psychological adaptation. In particular, the primary focus of this research was concerned with children's perceptions, or social cognitive processing, of these family relationships as a primary mechanism through which exposure to inter-parental conflict ranging in severity, influences children's psychological wellbeing. Using data from three separate samples of children and parents drawn from community and clinical settings in the United Kingdom, a set of four interlocking studies was conducted. First, using a sample of over 200 children and parents, the quality of parent-child relations was found to play a mediating role in the relationship between parents' reports of marital conflict and children's immediate and longer term externalising behaviour. Recognising the need to examine the interrelationships between the marital and parent-child relationship from the child's perspective, the second study considered the joint role'played by children's appraisals of both inter- parental conflict and parent-child relationship quality in explaining children's adaptation in the context of varying levels of conflict. Children's appraisals of both relationships were found to be important in conveying effects to children's psychological adaptation across the spectrum of inter-parental behaviour, although there was some variation in processes underpinning children's development as a function of conflict severity and the index of adjustment considered (internalising symptoms, externalising problems). Next, the role of younger children's appraisals of family relationships was examined. Children's appraisals were found to play an intervening role in the relationship between hostile inter-parental conflict and adjustment, although children's internalising symptoms were found to be affected directly through children's appraisals of threat relating to parents' marital conflict, whereas children's externalising problems were found to be affected indirectly, through children's respective appraisals of both the inter-parental and parent-child relationships. Finally, children's appraisals of multiple family relationships were examined as a mechanism through which very hostile forms of inter-parental conflict influenced children's concurrent adjustment. Broad agreement was found with the previous studies, where children's appraisals of the inter-parental relationship seemed to be particularly important in accounting for children's internalising symptoms in the context of high inter-parental conflict, whereas children's views on the quality of relations with parents were more important in accounting for children's externalising problems. Collectively, these studies represent a process-orientated account of how inter- parental conflict across the spectrum of severity affects children's adjustment, and in particular locates children's understanding of family relationships as a primary mechanism through which hostile and violent inter-parental conflict impacts on children's psychological functioning. These findings are of relevance to researchers, practitioners and policy makers seeking to understand how interparental conflict and domestic violence affects children

Child maltreatment and parental domestic violence and abuse, co-occurrence and the effect on lifetime outcomes in the Avon Longitudinal Study of Parents and Children (ALSPAC)

Exposure to child maltreatment (CM), and parental domestic violence and abuse (DVA), impose considerable adverse life outcomes in both the short and long term, yet, the extent and effects of their co-occurrence on outcomes have not been comprehensively quantified. This study describes the analysis of data from the Avon Longitudinal Study of Parents and Children, quantifying the prevalence of CM, parental DVA, co-occurrence rates, and the impact of different combinations of childhood exposures on life outcomes (health, economic, and likelihood of perpetrating intimate partner violence as a young person). Childhood exposure prevalences were estimated at 41.7% for any form of CM, 19.3% for parental DVA, and 49.0% for exposure to at least one form of CM and/or parental DVA. Co-occurring parental DVA was reported in 21%-42% of CM-exposed households. Sexual abuse was reported in 2% of parental DVA-exposed households, whilst co-occurrence of other forms of CM ranged between 19% and 41%. Co-occurring CM and parental DVA exposures were associated with increased risks of drug use, anxiety, depression, smoking, unemployment, social welfare use, and perpetration of intimate partner violence as a young person - highlighting the intergenerational effects of exposure. Increased risks across a wider range of adverse outcomes were associated with child-reported awareness of parental DVA, compared to parent-reported DVA exposure. The high cumulative prevalence of childhood exposure to CM and/or parental DVA, and the scale of the resulting adverse impacts emphasise the need for policies and family interventions sensitive to the possibility of co-occurring forms of abuse

Association of Interparental Violence and Maternal Depression With Depression Among Adolescents at the Population and Individual Level

Importance: Parental intimate partner violence (IPV) and maternal depression are associated with increased risk of depression in children at the population level. However, it is not known whether having information about these experiences can accurately identify individual children at higher risk of depression. Objective: To examine the extent to which experiencing parental IPV and/or maternal depression before age 12 years is associated with depression at age 18 years at the population and individual level. Design, Setting, and Participants: This cohort study used data from the Avon Longitudinal Study of Parents and Children, a UK population-based birth cohort, which initially recruited pregnant mothers with estimated due dates in 1991 and 1992. Data used in this study were collected from 1991 to 2009. Data analysis was performed from February to March 2022. Exposures Mother-reported parental IPV was assessed on 8 occasions (child age, 1-11 years). Maternal depression was assessed via the Edinburgh Postnatal Depression Scale or by the mother taking medication for depression, as reported by the mother on 8 occasions (child age, 2-12 years). Main Outcomes and Measures: Depressive symptoms were measured with the Short Mood and Feelings Questionnaire (SMFQ) and Clinical Interview Schedule–Revised (CIS-R) when the child was aged 18 years. Binary indicators of a case of depression were derived the cutoff point of 11 points or above for the SMFQ and 12 points or above for the CIS-R. Results The study included 5029 children (2862 girls [56.9%]; 2167 boys [43.1%]) with a measure of depressive symptoms at age 18 years. IPV only was associated with a 24% (adjusted risk ratio, 1.24; 95% CI, 0.97-1.59) higher risk of depression at age 18 years, exposure to maternal depression only was associated with a 35% (adjusted risk ratio, 1.35; 95% CI, 1.11-1.64) higher risk, and exposure to both IPV and maternal depression was associated with a 68% (adjusted risk ratio, 1.68; 95% CI, 1.34-2.10) higher risk. At the individual level, the area under the receiver operating characteristic curve was 0.58 (95% CI, 0.55-0.60) for depression according to the SMFQ and 0.59 (95% CI, 0.55-0.62) for the CIS-R, indicating a 58% to 59% probability (ie, 8%-9% above chance) that a random participant with depression at age 18 years had been exposed to IPV and/or maternal depression compared with a random participant who did not have depression. Conclusions and Relevance: In this cohort study, parental IPV and maternal depression were associated with depression in adolescence at the population level. However, estimation of an individual developing depression in adolescence based only on information about IPV or maternal depression is poor. Screening children for maternal depression and IPV to target interventions to prevent adolescent depression will fail to identify many children who might benefit and may unnecessarily target many others who do not develop depression

Child and family-focused interventions for child maltreatment and domestic abuse:Development of core outcome sets

BACKGROUND: The current evidence for child maltreatment (CM) and domestic violence and abuse (DVA) interventions is limited by the diversity of outcomes evaluated and the variety of measures used. The result is studies that are difficult to compare and lack focus on outcomes reflecting service user or provider priorities. OBJECTIVE: To develop core outcome sets (COSs) for evaluations of child and family-focused interventions for: (1) CM and (2) DVA. DESIGN: We conducted a two-stage consensus process. Stage 1: a long list of candidate outcomes across CM and DVA was developed through rapid systematic reviews of intervention studies, qualitative and grey literature; stakeholder workshops; survivor interviews. Stage 2: three-panel, three-round e-Delphi surveys for CM and DVA with consensus meetings to agree with the final COSs. PARTICIPANTS: 287 stakeholders participated in at least one stage of the process (ie, either CM or DVA COS development): workshops (n=76), two e-Delphi surveys (n=170) and consensus meetings (n=43). Stakeholders included CM and DVA survivors, practitioners, commissioners, policymakers and researchers. RESULTS: Stage 1 identified 335 outcomes categorised into 9 areas and 39 domains. Following stage 2, the final five outcomes included in the CM-COS were: child emotional health and well-being; child’s trusted relationships; feelings of safety; child abuse and neglect; service harms. The final five outcomes in the DVA-COS were: child emotional health and well-being; caregiver emotional health and well-being; family relationships; freedom to go about daily life; feelings of safety. CONCLUSIONS: We developed two COSs for CM and DVA with two common outcomes (child emotional health and well-being; feelings of safety). The COSs reflect shared priorities among service users, providers and researchers. Use of these COSs across trials and service evaluations for children and families affected by CM and DVA will make outcome selection more consistent and help harmonise research and practice

Police referrals for domestic abuse before and during the first COVID-19 lockdown: An analysis of routine data from one specialist service in South Wales.

BACKGROUND: COVID-19 lockdown measures may have led to more, and increasingly severe, domestic abuse. This study examines police referrals to a specialist domestic abuse service in Wales, UK before and during the first lockdown. METHODS: Routine data relating to 2292 police referrals for female adult victim-survivors from December 2019 until July 2020 were analysed and presented in the form of descriptive statistics to monitor changes in referral rates and the profile of those referrals. RESULTS: There was little increase in the overall volume of police referrals during lockdown, but the proportion assessed as high risk increased, and children became the primary source of third-party referrals, with a higher proportion of reports made by other third parties as restrictions eased. Police reports for cases of Child/Adolescent to Parent Violence (C/APV) occurred almost exclusively during lockdown. CONCLUSIONS: The increase in risk level despite less clear increase in volume may suggest unmet need, with victims less likely to seek help during lockdown other than for more severe instances. Increased reports by children suggest increased exposure of children to domestic abuse during school closure. Unmet need for women and children may have been made visible to services, and acquaintances, as measures began to ease.National Institute for Health Research via the Public Health Research funding committee (NIHR127793)

A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): a pragmatic randomised controlled trial

Background More young people are going to university, but there is concern about an increasing demand for student mental health services. We designed a pragmatic randomised controlled trial to test the hypothesis that providing mindfulness courses to university students would promote their resilience to stress. Methods University of Cambridge students without severe mental illness or crisis (self-assessed) were remotely randomised to join an 8-week mindfulness course adapted for university students (MSS), or to mental health support as usual (SAU). The primary outcome was self-reported psychological distress during the examination period measured using the Clinical Outcomes in Routine Evaluation Outcome Measure. Main outcome intention-to-treat analysis was masked to allocation. Trial registration: ACTRN12615001160527 (complete). Findings In total, 616 students were randomised (circa 3% of all students; 309 to MSS, 307 to SAU); 74% completed the primary outcome measure; 65% of the MSS arm participants completed at least half of the MSS course. MSS reduced distress scores during the exam period compared with SAU (β=-0.44, 95%CI -0.60 to -0.29; p < 0.0001); 57% of SAU participants had distress scores above an accepted clinical threshold level compared with 37% of MSS participants. On average, six students needed to be offered the MSS course to prevent one from experiencing clinical levels of distress (number needed to treat 6, 95%CI 4 to 10). SAU distress worsened over the year whereas MSS scores improved after the course and were maintained during exams. Active monitoring revealed no adverse reactions related to self-harm, suicidality or harm to others. Interpretation The main limitation of this trial is the lack of control for non-specific effects. However, the provision of mindfulness training appears an effective component of a wider student mental health strategy. Funding University of Cambridge and NIHR Collaboration for Leadership in Applied Health Research and Care East of England.University of Cambridge and National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England