PTSD as a predictor of treatment engagement and recidivism in partner abusive men.

Abstract

Objective: Past research has linked posttraumatic stress disorder (PTSD) symptoms to increased risk for intimate partner violence (IPV) perpetration. However, little is known about the impact that PTSD may have on treatment engagement or violence recidivism following treatment for IPV. The current study examined whether PTSD predicts treatment engagement and criminal recidivism in a 20-session, community-based, cognitive-behavioral abuse intervention program. Method: Participants (N ϭ 293) completed assessments of PTSD symptoms, depression, drug use, and alcohol problems during agency intake. These variables were examined as predictors of group treatment engagement (session attendance, working alliance, cognitive-behavioral therapy homework compliance, group cohesion, and task orientation) and criminal recidivism during the 2 years after scheduled completion of treatment. Results: Individuals with higher levels of PTSD symptoms at pretreatment had lower homework compliance during treatment. Further, individuals with probable PTSD reported lower task orientation and group cohesion later in treatment. Individuals with a probable PTSD diagnosis at pretreatment had 4 times higher odds of general violence recidivism than those without a probable PTSD diagnosis, and this association remained significant when controlling for substance use and depression. In addition, participants with probable PTSD were more likely to have intimate partner abuse recidivism compared with those without (adjusted odds ratio ϭ 2.5), although this effect was not statistically significant. Conclusions: Trauma symptoms affect violence cessation in IPV treatment, further highlighting the need to address unique clinical issues and underlying mechanisms associated with traumatic stress symptoms in treatments for this population.

Compared to What? A Meta-Analysis of Batterer Intervention Studies Using Nontreated Controls or Comparisons

“…Creech et al (2017) found that PTSD symptoms at baseline predicted both physical and psychologocal IPV perpetrations among a sample of male veterans, after controlling the effects of treatment condition, time, and number of sessions attended. Miles-McLean et al (2019) found that men with higher levels of PTSD symptoms at baseline had lower treatment engagement (e.g., homework compliance, group cohesion) in a community-based IPV intervention program. While there has been some work comparing trauma-informed care to other treatment (Taft, Murphy, & Creech, 2016), there has been a call for greater attention in this area (Voith, Logan-Greene, Strodthoff, & Bender, 2020), and future studies should further investigate how the changes occur, for example, whether PTSD symptoms mediate the relationship between a BIP intervention and men’s perpetration of IPV.…”

“…Other approaches may target risk factors that have spillover effects for IPV perpetration. This may include addressing issues related to offenders’ substance abuse (Lila, Gracia, & Catalá-Miñana, 2017) and/or mental health including trauma (Miles-McLean et al, 2019). For example, some studies have identified a siginficant association between post-traumatic stress disorder (PTSD) symptoms and trauma history in men’s IPV perpetration.…”

Trauma Exposure and PTSD Among Women Receiving Treatment for Intimate Partner Violence Perpetration

“…There were no significant differences in the responses to these time frames, so the estimates of drug use were treated as equivalent in calculating days of use in the past year. Past research has demonstrated associations of this drug use frequency indicator with other variables of clinical interest among men in IPV treatment, including alcohol use and PTSD symptoms (LaMotte, 2016;Miles-McLean et al, 2018;Semiatin et al, 2017).…”

Anger and Aggression: A New Beginning?

“…Research on IPV perpetrators suggests that many chronic offenders have significant levels of PTSD as compared to those who seemingly benefit from varied alternative treatment programs (Miles‐McLean et al, 2019). With the increasing acknowledgment of domestic violence as a significant public health and safety issue, (Miller & McCaw, 2019), court systems have begun examining traditional approaches to family violence more carefully.…”