The Assessment of Impulsivity and Aggression and Their Contribution to Risk in Domestic Abuse

Identifying those at risk of harm is a critical issue in safeguarding victims and their children from domestic abuse. Research shows that aggression and impulsivity relate to domestic abuse perpetration, however there is a gap in the literature in how those constructs could be applied to victim-perception risk assessments. Furthermore, considering the high numbers of children that are present within families experiencing domestic abuse, there is a gap regarding the potential contribution these children could make in risk assessment procedures, particularly to ensure their voices are included. The aim of this project was to provide an original contribution to knowledge by exploring these gaps with a view to informing the risk assessment literature and practice in the UK. Through use of mixed methods, this project conducted three phases of study. Analysis from the first study revealed a complexity of domestic abuse lived experience via five superordinate themes, within them showing participants could recognise their abusive partners’ aggressive and impulsive behaviours, as well as revealing that they could recall an array of risk management techniques they used in order to minimise risk, these recollections were more tangible than recalling their feelings of risk. The second phase of study measured impulsivity using the Barratt Impulsiveness Scale (BIS-11) and aggression levels, using the Buss-Perry Aggression Questionnaire (BPAQ) and the Aggressive Acts Questionnaire (AAQ; Barratt, Stanford, Dowdy, Liebman, & Kent, 1999) in 113 participants’ self-reports and their reports on their partners. Important differences were found, with those who experienced domestic abuse measuring their abusers as significantly higher on the BIS-11, the BPAQ and the AAQ, than those who had not experienced domestic abuse. The family case study phase revealed powerful themes regarding a family’s shared experience of domestic abuse. The use of sand tray and art-based play with children, aided by rapport building techniques, provided them with the tools they needed to explore their experiences and talk about them in a non-direct and non-intrusive way. This resulted in their disclosures of witnessing abuse between their parents, as well as internalising and externalising behaviours being apparent. Taken together, the findings from the three phases of study expand our knowledge of domestic abuse victims’ perceptions of risk, impulsivity and aggression in their abusive partners. It is suggested that victim-perception risk assessments would benefit from the addition of impulsivity and aggression items, as well as rapport building and play techniques being an ideal method for practitioners to elicit important risk assessment information from children

A never-before opportunity to strengthen investment and action on adolescent contraception, and what we must do to make full use of it

Abstract Background Increasingly, the health and rights of adolescents are being recognized and prioritized on the global agenda. This presents us with a “never-before” opportunity to address adolescent contraception. This is timely, as there are enormous numbers of adolescents who are currently unable to obtain and use contraceptives. From research evidence and programmatic experience, it is clear that we need to do things differently to meet their needs/fulfil their rights. Main body In this commentary, we call for action in several key areas to address adolescents’ persistent inability to obtain and use contraceptives. We must move away from one-size-fits-all approaches, from a ‘condoms-only’ mind set, from separate services for adolescents, from ignoring the appeal of pharmacies and shops, and from one-off-training to make health workers adolescent friendly. Our efforts to expand access to quality contraceptive services to adolescents must be combined with efforts to build their desire and ability to use them, and to do so consistently. In order for these changes to be made, action must be taken on several levels. This includes the formulation of sound national policies and strategies, robust programme implementation with monitoring, regular programmatic reviews, and implementation research. Further, high-quality collection, analysis, and dissemination of data must underlie all of our efforts. As we move ahead, we must also recognize and draw lessons from positive examples of large scale and sustained programmes in countries that have led the way in increasing contraceptive use by adolescents. Conclusion This unprecedented moment in history gives us a real opportunity to bring about transformational change, particularly when there is so much at stake