Examining Therapeutic Change Mechanisms in an Affect Regulation, Father-Focused Intervention for Reducing Family Violence and Associated Symptoms in Children

检查情感调节中的治疗改变机制，以父亲为中心的干预措施，以减少家庭暴力和儿童相关症状

• 批准号: 10733812
• 负责人: Damion Joseph Grasso
• 金额: $ 73.76万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10733812
• 关键词: 7 year old; Address; Affect; Aftercare; Aggressive behavior; Behavior; Caregivers; Child; Child Abuse and Neglect; Child Mental Health; Child Rearing; Child Welfare; Code; Complex; Data; Development; Diagnostic Factor; Emotional; Emotions; Exclusion; Exposure to; Family; Family Violence; Father-Child Relations; Fathers; Home; Impaired health; Impairment; Intervention; Knowledge; Masks; Mediating; Mental Health; Mental Health Associations; Meta-Analysis; Methods; Modeling; Motivation; Nature; Outcome; Parent-Child Relations; Parents; Patient Self-Report; Post-Traumatic Stress Disorders; Process; Psychopathology; Randomized; Randomized, Controlled Trials; Reaction; Recovery; Regulation; Research; Risk; Role; Sampling; Site; Source; Stress; Symptoms; Therapeutic; Time; Violence; Work; active control; associated symptom; care systems; child protective service; design; effective intervention; efficacy evaluation; emotion regulation; evidence base; experience; father child interaction; father role; fatherhood; improved; intervention program; intimate partner violence; men; multimodality; novel; physical abuse; pilot trial; psychosocial; therapeutic target; treatment effect; violence exposure

ABSTRACT Children’s exposure to intimate partner violence (IPV), often perpetrated by fathers, has been described as a gateway to other adversity, with more than a 50% co-occurrence of direct forms of child maltreatment (CM). IPV exposure can wreak havoc on children, with risk for psychosocial impairments, including posttraumatic stress disorder (PTSD), that can emerge early and cascade across development. Lacking are interventions that adequately address the complex nature of IPV in families, including fatherhood and coparenting. This gap reflects a bias towards excluding offending fathers from child-focused work and an overreliance on batterer intervention programs (BIPs), which have shown negligible effects in meta-analyses and fail to address the roots of offending behaviors in fathers. Consequently, IPV exposed children remain at risk and fathers’ personal and interpersonal functioning, including the father-child relationship, does not improve. In effect, there is an urgent need for effective interventions for fathers and their families. Fathers for Change (F4C) is a novel fatherhood-focused intervention with a dual focus on IPV and CM that focuses on identifying, understanding, and managing emotions to reduce aggression and improve partner and parent-child interactions. F4C has a growing evidence-base demonstrating significant reductions in family violence, improved father-child interactions, and in one open trial, improved child mental health. Proposed therapeutic mechanisms of F4C include reflective functioning (RF), the capacity for parents to understand their own and children’s actions as a function of underlying states and motivations, and emotion regulation (ER), the capacity to exert control over emotional states and reactions to threat. Poor RF and ER have been associated with increased family violence and stress-related psychopathology, suggesting key focal points for intervention. To date, there have been no empirical examinations of ER and RF as therapeutic change mechanisms for reducing family violence and improving father-child interactions and child mental health. Proposed is a dual-site, multi-modal examination of ER and RF in fathers (of children 4-7 y.o.) randomized to F4C (N=180) or the Duluth Model (N=180), a BIP serving as active control. In-session observational coding will assess adaptive and maladaptive ER and RF across treatment. Weekly self-ratings will assess at-home ER and RF. Aims will (1) assess efficacy of F4C compared to a standard BIP in reducing family violence and child mental health impairment, (2) identify and compare trajectories of therapeutic change targets across interventions, and (3) examine the mediating role of father’s ER and RF on child-related outcomes. This proposal will grow the evidence-base for F4C and advance our understanding of therapeutic mechanisms through which F4C exerts its effects.

摘要 儿童遭受亲密伴侣暴力（IPV），往往是由父亲实施的，被描述为一个严重的问题。 儿童虐待是通向其他逆境的门户，50%以上的儿童同时受到直接形式的虐待。 IPV暴露可能会对儿童造成严重破坏，并有心理社会障碍的风险，包括创伤后 应激障碍（PTSD），可能出现在早期，并在整个发展过程中级联。缺乏干预措施 这充分解决了家庭中IPV的复杂性，包括父亲和共同抚养。这一差距 反映了一种偏见，即把犯罪的父亲排除在以儿童为中心的工作之外，以及过度依赖殴打者。 干预计划（BIP），在荟萃分析中显示效果可以忽略不计， 父亲犯罪行为的根源因此，暴露于IPV的儿童仍然处于危险之中， 个人和人际交往功能，包括父子关系，没有改善。实际上， 迫切需要对父亲及其家庭采取有效的干预措施。Fathers for Change（F4C） 以父亲身份为中心的干预，双重关注IPV和CM，重点是识别，理解， 管理情绪，减少攻击性，改善伴侣和亲子互动。F4 C有一个 越来越多的证据表明家庭暴力显著减少， 互动，并在一项开放试验中，改善了儿童的心理健康。F4 C的治疗机制 包括反思功能（RF），父母理解自己和孩子的行为的能力， 潜在状态和动机的功能，以及情绪调节（ER），即控制 情绪状态和对威胁的反应。不良的RF和ER与家庭暴力的增加有关 和压力相关的精神病理学，建议干预的重点。到目前为止，还没有 ER和RF作为减少家庭暴力的治疗性改变机制的经验性检查， 改善父子互动和儿童心理健康。提出的是一个双站点，多模式的考试， 父亲的ER和RF（4-7岁儿童）随机分配至F4 C（N=180）或杜卢斯模型（N=180），BIP 作为主动控制。会话中观察编码将评估适应性和适应不良ER和RF 跨治疗。每周自我评定将评估在家ER和RF。目的是（1）评估F4 C的疗效 与标准的BIP相比，在减少家庭暴力和儿童心理健康损害方面，（2）识别和 比较干预措施中治疗变化目标的轨迹，以及（3）检查 父亲的ER和RF对儿童相关结果的影响。该提案将增加F4 C的证据基础， 我们对F4 C发挥作用的治疗机制的理解。