Carla Smith Stover

The Child and Family Traumatic Stress Intervention: secondary prevention for youth at risk of developing PTSD.

OBJECTIVE This pilot study evaluated the effectiveness of a four-session, caregiver-child Intervention, the Child and Family Traumatic Stress Intervention (CFTSI), to prevent the development of chronic posttraumatic stress disorder (PTSD) provided within 30 days of exposure to a potentially traumatic event (PTE). METHOD One-hundred seventy-six 7 to 17-year-old youth were recruited through telephone screening based on report of one new distressing posttraumatic stress symptom after a PTE. Of those, 106 youth were randomly assigned to the Intervention (n = 53) or a four-session supportive Comparison condition (N = 53). Group differences in symptom severity were assessed using repeated measures with mixed effects models of intervention group, time, and the interaction of intervention and time. Logistic regression analyses were performed to assess treatment condition and any subsequent traumas experienced as predictors for full and partial PTSD diagnosis at 3-month follow-up. An exploratory chi-square analysis was performed to examine the differences in PTSD symptom criteria B, C, and D at follow-up. RESULTS At baseline, youth in both groups had similar demographics, past trauma exposures and symptom severity. At follow-up, the Intervention group demonstrated significantly fewer full and partial PTSD diagnoses than the Comparison group on a standardized diagnostic measure of PTSD. Also, there was a significant group by time interaction for Trauma Symptom Checklist for Childrens Posttraumatic Stress and Anxiety Indices as the CFTSI group had significantly lower posttraumatic and anxiety scores than the Comparison group. CONCLUSIONS The results suggest that a caregiver-youth, brief preventative early intervention for youth exposed to a PTE is a promising approach to preventing chronic PTSD.

Research Review: The relationship between childhood violence exposure and juvenile antisocial behavior: a meta-analytic review

BACKGROUND The connection between childhood violence exposure and antisocial behavior in adolescence has received much attention and has important implications for understanding and preventing criminal behavior. However, there are a limited number of well-designed prospective studies that can suggest a causal relationship, and little is known about the magnitude of the relationship. METHODS This meta-analysis provides a quantitative comparison of 18 studies (N = 18,245) assessing the relationship between childhood (before age 12) violence exposure and adolescent antisocial behavior. An overall effect size (Cohens d) was calculated for each study, an average for the 18 studies, and averages for subsets of analyses within studies. RESULTS Results indicated a small effect from prospective studies (d = .31) and a large effect from cross-sectional studies (d = .88). The effect for victimization (d = .61) was larger than for witnessing violence (d = .15). CONCLUSIONS Effect size varied across studies employing different methodologies, populations, and conceptualizations of violence exposure and antisocial behavior. These findings do not support a simple, direct link from early violence exposure to antisocial behavior but suggest that many factors influence this relationship.

Domestic Violence Research: What Have We Learned and Where Do We Go From Here?

Domestic violence has been an intense area of study in recent decades. Early studies helped with the understanding of the nature of perpetration, the cycle of violence, and the effect of family violence on children. More recently, studies have focused on beginning to evaluate domestic violence interventions and their effects on recidivism. This article acknowledges the importance of what we have learned about the prevalence and impact of domestic violence and explores the need for more focused effort to pinpoint interventions that are effective with perpetrators and victims. Methodological issues relevant to past intervention studies are also discussed and future research directions are outlined.

The Effects of Father Visitation on Preschool-Aged Witnesses of Domestic Violence

Fifty preschool children with varying amounts of visitation with their previously violent fathers were studied to determine if the amount of father visitation was related to their behavioral functioning. The possible association of the severity of violence witnessed and the quality of the mother-child relationship on child behaviors was also assessed. There was a significant negative relationship between internalizing and externalizing behaviors, as measured by the Child Behavior Checklist, and frequency of father visitation. Children who saw their fathers less frequently evidenced higher internalizing and externalizing scores. More severe levels of violence perpetrated by the father significantly predicted increased externalizing behavior scores but not internalizing scores. Severity of violence was more predictive of externalizing behaviors than frequency of father visitation.

Fathers entering substance abuse treatment: An examination of substance abuse, trauma symptoms and parenting behaviors

OBJECTIVE The relationship between fatherhood and both psychiatric distress and severity of substance abuse (SA) among men entering SA treatment has not been well explored. This study was designed to (a) examine differences in symptoms of men presenting for SA assessment based on fatherhood status and (b) determine how posttraumatic stress disorder (PTSD) symptoms and severity of SA were associated with parenting for men who were fathers. METHODS PTSD symptoms, severity of SA, and parenting data reported on structured questionnaires were collected from 126 men presenting for an SA evaluation at a forensic drug diversion clinic. RESULTS There were no differences in severity of alcohol or drug use between fathers and nonfathers; however, fathers with more PTSD symptoms reported greater severity of alcohol and drug use. Among the fathers, PTSD symptoms correlated significantly and positively with negative parenting behaviors, whereas SA did not. Fathers with more significant PTSD symptoms were more likely to want help with parenting. CONCLUSIONS Further exploration of the impact of trauma-related symptoms on the parenting behaviors of substance-abusing men is warranted.

The Efficacy of a Police-Advocacy Intervention for Victims of Domestic Violence: 12 Month Follow-Up Data

The Domestic Violence Home Visit Intervention (DVHVI) provides advocate/police officer team home visits following a domestic dispute. Women (52 DVHVI and 55 controls) were interviewed at 1, 6, and 12 months following a police reported domestic incident to assess repeat violence, service utilization, and symptoms. Women who received the DVHVI were more satisfied with the police and likely to call them to report a nonphysical domestic dispute in the 12 months following the initial incident than women in the comparison group. DVHVI participants were significantly more likely to use court-based services and seek mental health treatment for their children.

Parenting of Men With Co-Occurring Intimate Partner Violence and Substance Abuse

No studies to date have compared parenting behaviors of men with co-occurring intimate partner violence (IPV) and substance abuse (SA) with community controls. This study was designed to document mediators of differences in parenting behavior of fathers and the emotional-behavioral problems of their children for men with co-occurring SA and IPV. The self-reported parenting (negative, positive and coparenting behaviors) and the child emotional-behavioral problems of 43 fathers with children aged 2 to 6 years with a recent history of SA + IPV were compared to a sample of 43 community control fathers with the same socioeconomic and cultural backgrounds. Fathers completed measures on their parenting behavior with a target child, coparenting behavior with the child’s mother, emotion regulation, romantic attachment, psychiatric symptoms, and the behavior of the target child. Men with co-occurring SA + IPV had significantly less positive coparenting and more negative parenting behaviors than community control fathers. Negative parenting and coparenting were mediated by the fathers’ avoidant attachment problems. SA + IPV fathers also reported more emotional and behavioral problems in their children. These poor child outcome differences between groups were mediated by the negative parenting behaviors of the fathers. These results suggest areas of potential focus in interventions with fathers who have co-occurring SA + IPV issues. Focus on attachment difficulties with his coparent, which may include affect regulation, coping with emotions, and communication skills training related to coparenting, may yield significant changes in parenting behaviors and ultimately child functioning.

Intimate Partner Violence: The Role of the Relationship Between Perpetrators and Children Who Witness Violence

The issue of the father—child relationship has been greatly ignored in the domestic violence research literature. This study investigated whether intimate partner violence (IPV) perpetrated by biological fathers resulted in higher levels of posttraumatic stress symptoms and behavior problems than violence perpetrated by nonbiological fathers and whether children who witnessed violence perpetrated by multiple father figures had increased levels of posttraumatic stress disorder and behavioral symptoms. Eighty mothers who experienced domestic incidents completed the Child Behavior Checklist (CBCL) and the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (PTSD-RI) for their children aged 2 to 18. Children with multiple violent father figures had significantly more symptoms on the CBCL than children in the other two research groups while controlling for maternal symptoms and trauma history. There were no significant differences between the biological and nonbiological father groups or among the three groups on the PTSD-RI.

Depression as a Mediator of the Association between Substance Abuse and Negative Parenting of Fathers

Objective: The role of substance abuse (SA) and depression on paternal parenting has recently gained attention in the research literature. Both SA and depression have been associated with negative parenting in fathers, but studies to date have not examined the mediating role that depression may play in the association of SA and fathering. Methods: SA, depression, and parenting data were reported by 87 fathers presenting for SA evaluation. Bootstrap mediation modeling was conducted to determine the role of depression on the association between SA and negative parenting. Results: Depression is a significant mediator of the relationship between the severity of fathers’ drug use and hostile-aggressive parenting behaviors. Fathers who had concerns about parenting or wanted help to improve the parent–child relationship had significantly higher symptoms of depression. Conclusions: Depressive symptoms in fathers entering SA treatment have implications for both the severity of drug abuse and negative parenting behaviors.

Factors Associated With Engagement in a Police-Advocacy Home-Visit Intervention to Prevent Domestic Violence:

This study examines factors related to engagement in the services offered by police officer–advocate teams on the basis of police and clinical records for 301 female victims referred to the Domestic Violence Home Visit Intervention (DVHVI) program. The authors find that the severity of intimate partner violence charges and ethnicity of the victim, advocate, and police officer are all significantly related to engagement in the DVHVI, with Hispanic women served by Hispanic advocate–officer teams more engaged in services than African American or Caucasian women. The data suggest that this intervention model may be particularly beneficial for Hispanic victims of intimate partner violence when implemented by a Spanish-speaking officer–advocate team.