Rosamund Thorpe

Intermittent explosive disorder amongst women in conflict affected Timor-Leste: associations with human rights trauma, ongoing violence, poverty, and injustice.

Introduction Women in conflict-affected countries are at risk of mental disorders such as posttraumatic stress disorder and depression. No studies have investigated the association between experiences of abuse and injustice and explosive anger amongst women in these settings, and the impact of anger on womens health, family relationships and ability to participate in development. Methods A mixed methods study including an epidemiological survey (n = 1513, 92.6% response) and qualitative interviews (n = 77) was conducted in Timor-Leste. The indices measured included Intermittent Explosive Disorder, posttraumatic stress disorder; severe distress; days out of role (the number of days that the person was unable to undertake normal activities); gender-specific trauma; conflict/violence; poverty; and preoccupations with injustice. Results Women with Intermittent Explosive Disorder (n = 184, 12.2%) were more disabled than those without the disorder (for >5 days out of role, 40.8% versus 31.5%, X2 (2)  = 12.93 p = 0.0016). Multivariable associations with Intermittent Explosive Disorder, controlling for the presence of PTSD, psychological distress and other predictors in the model, included the sense of being sick (OR 1.73; 95% CI 1.08–2.77); victimization as a result of helping the resistance movement (OR 2.33, 95% CI 1.48–3.68); war-related trauma specific to being a woman (OR 1.95, 95%, CI 1.09–3.50); ongoing family violence and community conflict (OR 1.88, 95% CI 1.27–2.77); extreme poverty (OR 1.23, 95%, CI 1.08–1.39); and distressing preoccupations with injustice (relating to 2/3 historical periods, OR 2.10, 95% CI 1.35–3.28). In the qualitative study, women elaborated on the determinants of anger and its impact on their health, family and community functioning, child-rearing, and capacity to engage in development. Women reflected on the strategies that might help them overcome their anger. Conclusions Intermittent Explosive Disorder is prevalent and disabling amongst women in conflict-affected Timor-Leste, impacting on their health, child-rearing and ability to participate fully in socio-economic development.

Testing a cycle of family violence model in conflict-affected, low-income countries: a qualitative study from Timor-Leste

The present study examines key aspects of an emerging cycle of violence model as applied to conflict-affected countries. We focus specifically on the roles of intimate partner violence (IPV), consequent experiences of explosive anger amongst women, and associated patterns of harsh parenting. Between 2010 and 2011, we conducted a women-centred and culturally sensitive qualitative inquiry with 77 mothers drawn consecutively from a data-base of all adults residing in two villages in Timor-Leste. We over-sampled women who in the preceding whole of household survey met criteria for Intermittent Explosive Disorder (IED). Our methodology included in-depth qualitative interviews followed by a focus group with a comprehensive array of service providers. We used the NVivo software package to manage and analyse data. Our findings provide support for a link between IPV and experiences of explosive anger amongst Timorese mothers. Furthermore, women commonly reported that experiences of explosive anger were accompanied by harsh parenting directed at their children. Women identified the role of patriarchy in legitimizing and perpetuating IPV. Our findings suggest that empowering women to address IPV and poverty may allow them to overcome or manage feelings of anger in a manner that will reduce risk of associated harsh parenting. A fuller examination of the cycle of violence model will need to take into account wider contributing factors at the macro-level (historical, conflict-related, political), the meso-level (community-wide adherence to patriarchal norms affecting the rights and roles of women), and the micro-level (family interactions and gendered role expectations, individual psychological responses, and parenting). Longitudinal studies in post-conflict settings are needed to examine whether the sequence of male violence against women, mothers experience of explosive anger, and consequent harsh parenting contributes to risk of aggression and mental disorder in offspring, both in childhood and adulthood.

Attachment Style of Foster Carers and Caregiving Role Performance

This study assessed the adult attachment styles of 111 male and female foster carers of children who have been abused and neglected in the Mackay/Whitsunday region of Queensland, Australia. It was hypothesised that those foster carers with secure attachment or with “earned” secure attachment status are better able to cope with the challenges of caring for children who have been abused and neglected, or have attachment difficulties. The Attachment Style Questionnaire was used to categorise foster carers in terms of relationships as secondary, confidence, need for approval, discomfort with closeness, or preoccupation. The research findings were explored in relation to attachment style of foster carers, role performance as assessed by senior foster care professionals in the region, and life experiences leading to secure or “earned” secure adult attachment. Many of the foster carers had overcome early disadvantage through their adult attachment relationships. Attachment style of foster carers as measured by the Attachment Style Questionnaire was not found to be related to the quality of care provided to children. The findings have implications for the selection of foster carers, and for the specialised support of those carers with unresolved attachment issues.

Selecting and foster carers : could personnel psychology improve outcomes?

Foster care services are struggling in a context of decreasing community interest in providing care and increases in the demand for placements, the proportion of children with special needs requiring care and placement breakdowns. As Sinclairs recent (2005) overview emphasises, improving carer selection could reduce pressure on services by selecting those applicants best suited to the demands of the task. Research and practice from personnel psychology has long been used by employers seeking to identify the most suitable employees for a particular job, but this approach appears not to have been applied to selecting foster carers. In recent years, in personnel psychology, there has been increased recognition of the impact of personal characteristics on work performance satisfaction and retention. Barbara Kennedy and Rosamund Thorpe explore the utility of one such test, the Hogan Personality Inventory (HPI), in predicting foster carer suitability and subsequent retention among Australian carers. Both group and case-study analysis suggests potential worthy of further investigation.

Associations between bride price obligations and women's anger, symptoms of mental distress, poverty, spouse and family conflict and preoccupations with injustice in conflict-affected Timor-Leste

Objectives Bride price is a widespread custom in many parts of the world, including in most countries in sub-Saharan Africa and parts of Asia. We hypothesised that problems relating to the obligatory ongoing remittances made by the husband and his family to the brides family may be a source of mental disturbance (in the form of explosive anger and severe mental distress) among women. In addition, we postulated that problems arising with bride price would be associated with conflict with the spouse and family, poverty and womens preoccupations with injustice. Design A mixed-methods study comprising a total community household survey and semistructured qualitative interviews. Setting Two villages, one urban, the other rural, in Timor-Leste. Participants 1193 married women participated in the household survey and a structured subsample of 77 women participated in qualitative interviews. Results Problems with bride price showed a consistent dose–effect relationship with sudden episodes of explosive anger, excessive anger and severe psychological distress. Women with the most severe problems with bride price had twice the poverty scores as those with no problems with the custom. Women with the most severe problems with bride price also reported a threefold increase in conflict with their spouse and a fivefold increase in conflict with family. They also reported heightened preoccupations with injustice. Conclusions Our study is the first to show consistent associations between problems with bride price obligations and mental distress, poverty, conflict with spouse and family and preoccupations with injustice among women in a low-income, postconflict country.