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.

抽象的 儿童遭受亲密伴侣暴力（IPV）（通常由父亲实施）被描述为一种 通往其他逆境的门户，超过 50% 的直接形式的儿童虐待 (CM) 同时发生。 IPV 暴露会对儿童造成严重破坏，并有造成社会心理障碍的风险，包括创伤后 应激障碍（PTSD）可能会在早期出现并在整个发育过程中连锁反应，但缺乏干预措施。 充分解决家庭中 IPV 的复杂性，包括父亲身份和共同养育子女。 一种偏见，反映出将冒犯父亲排除在以儿童为中心的工作之外以及对施虐者的过度依赖 干预计划（BIP），在荟萃分析中显示出的效果可以忽略不计，并且未能解决 对父亲犯罪行为的根源进行了检查，暴露于 IPV 的儿童仍然面临风险，而父亲的行为也面临风险。 个人和人际功能，包括父子关系，实际上并没有改善。 父亲及其家庭迫切需要有效的干预措施，《父亲变革》（F4C）是一本小说。 以父亲为中心的干预，双重关注 IPV 和 CM，重点是识别、理解、 管理情绪以减少攻击性并改善伴侣和亲子互动。 越来越多的证据表明家庭暴力显着减少，父子关系得到改善 F4C 的拟议治疗机制。 包括反思功能（RF），即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），即对事物施加控制的能力 情绪状态和对威胁的反应不良与家庭暴力增加有关。 和压力相关的精神病理学，表明迄今为止还没有干预的关键焦点。 对 ER 和 RF 作为减少家庭暴力的治疗改变机制的实证检验 改善父子互动和儿童心理健康。建议进行双地点、多模式检查。 父亲（4-7 岁儿童）的 ER 和 RF 随机分配至 F4C (N=180) 或德卢斯模型 (N=180)（BIP） 作为主动控制，会话中的观察编码将评估适应性和适应不良的 ER 和 RF。 每周自我评估将评估家庭 ER 和 RF 目标将 (1) 评估 F4C 的疗效。 与标准 BIP 相比，在减少家庭暴力和儿童心理健康损害方面，(2) 确定并 比较不同干预措施的治疗改变目标的轨迹，以及（3）检查以下因素的中介作用： 父亲关于儿童相关结果的 ER 和 RF 该提案将扩大 F4C 的证据基础并推进。 我们对 F4C 发挥作用的治疗机制的理解。