Participants in Court-mandated Intervention Programs for Intimate Partner Violence Perpetrators with Substance Use Problems: A Systematic Review of Specific Risk Factors

Abstract

Men with alcohol and/or other drug use problems (ADUPs) court-mandated to attend intervention programs for intimate partner violence (IPV) perpetrators have been identified as a high-risk, highly resistant group of IPV perpetrators, as they present lower treatment adherence and higher dropout and recidivism rates. Previous research suggests that IPV perpetrators with ADUPs may require tailored interventions to address their specific risk factors. The present systematic review was conducted using PRISMA guidelines to identify the specific risk factors in men with and without ADUPs on entry to court-mandated perpetrator programs. The following databases were searched from inception to November 2021: Web of Science, PsycINFO, and Scopus. There was a screening of 3,995 records, and 29 quantitative studies were included in the review. Risk factors present in males court-mandated to perpetrator programs were grouped into four categories: sociodemographic risk factors, personality disorders and psychological adjustment, social-relational risk factors, and risk factors related to attitudes towards women. Results indicated that the main risk factors in IPV perpetrators with ADUPs, compared to those without, were higher clinical symptomatology (e.g., anger and impulsivity), personality disorders, poorer executive functions, having experienced more stressful life events, higher exposure to childhood trauma, lower intimate social support, and higher responsibility attributed to the offenders’ personal context. These results contribute to a deeper understanding of the complex phenomenon of IPV and ADUPs, and could help to inform key targets for perpetrator programs that may improve the well-being of their (ex)partners and increase the effectiveness of intervention programs for IPV perpetrators.

Adapting the ADVANCE group program for digitally-supported delivery to reduce intimate partner violence by men in substance use treatment: a feasibility study

“…Establishing individualized participant retention plans using various strategies to maximize retention (e.g., via phone, email, through emergency and service provider contacts) and ensuring researchers build rapport and maintain relationships for the duration of the study (e.g., same researcher completes all contacts and interviews where possible), may help to increase retention in longitudinal research with hard-to-reach participants ( 99 ). Substance use is a significant predictor of drop-out ( 14 , 17 , 100 ), with one trial reporting higher drop-out rates among men with alcohol abuse problems (36%) than those without (23%) ( 101 ). Research suggests around 20–80% of perpetrators drop out of programs ( 17 , 98 , 102 , 103 ), however there is a lack of standard definition of program attrition, making cross-study comparison problematic ( 104 ).…”

“…Given that men who use substances are underserved in perpetrator programs and are also most likely to drop out of standard perpetrator programs ( 14 , 23 , 24 ), alternative approaches that address their specific needs and risks, such as ADVANCE-D are required. We were able to adapt the ADVANCE face-to-face group program to reduce IPV by men in substance use treatment for blended digitally-supported delivery based on available evidence of best practice with input from key stakeholders and people with lived experience.…”

“…Multiple risk factors contribute and interact at individual, relationship, community, and societal levels to increase the likelihood of IPV perpetration, including substance use, mental health problems, adverse childhood experiences, anger, hostility, poor executive function, low empathy, relationship conflicts, and holding sexist attitudes ( 8–12 ). Many risk factors are elevated among men who have substance use problems ( 13 , 14 ), potentially explaining the higher prevalence of IPV perpetration among this group compared to the general population ( 8 , 14–16 ) and highlighting that targeted perpetrator programs are needed ( 14 , 17 , 18 ). Limited evidence shows what works to reduce IPV perpetration by men who use substances ( 19 ), but programs that include trauma and substance use components show promising results and/or greater reductions in perpetration ( 20 , 21 ).…”

“…Regardless, men in substance use treatment are underserved by perpetrator programs ( 22 , 23 ) and often considered unsuitable for such programs due to their substance use ( 24 ). Men who use substances are also most likely to drop out of perpetrator programs ( 14 , 23 , 24 ), suggesting alternative and tailored approaches are required. We developed the ADVANCE perpetrator group program ( 25–27 ) to address the complex interplay between substance use and IPV perpetration in the context of intoxication, withdrawal, craving and acquiring substances ( 28–30 ), neglected in other programs.…”

The role of intimate partner violence perpetrators' resting state functional connectivity in treatment compliance and recidivism

“…The estimated prevalence of intimate partner violence (IPV) across 161 countries indicates that approximately 27% of women, aged 15–49, have experienced some form of physical and/or sexual IPV, mostly from their male partner, throughout their lives 1 . Many factors have been identified as risks for IPV perpetration, such as personality disorders, executive dysfunctions, emotional dysregulation, drug misuse, emotional processing dysfunctions, and childhood trauma, among others 2 , 3 . However, much of this research is based on self-reports and/or qualitative interviews.…”