Citation: Novaco, Raymond and Taylor, John (2008) Anger and assaultiveness of male forensic ...

46 Pages·2016·0.31 MB·English

Citation: Novaco, Raymond and Taylor, John (2008) Anger and assaultiveness of male
forensic patients with developmental disabilities : links to volatile parents. Aggressive
Behavior, 34 (4). pp. 380-393. ISSN 0096-140X
Published by: Wiley-Blackwell
URL: http://dx.doi.org/10.1002/ab.20254 <http://dx.doi.org/10.1002/ab.20254>
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RunningHead:VOLATILEPARENTSAND FORENSIC PATIENTS'ANGER
Angerand AssaultivenessofMaleForensicPatientswith
DevelopmentalDisabilities:LinkstoVolatileParents
Raymond W. Novaco
UniversityofCalifornia, Irvine
John L.Taylor
NorthumbriaUniversity
Northumberland,Tyne& Wear NHSTrust
AggressiveBehavior,34,380-393
Correspondence:
Raymond W.Novaco, Ph.D.
Departmentof Psychologyand SocialBehavior
UniversityofCalifornia, Irvine
Irvine,CA 92697-7085
[email protected]
VolatileParents 2
Abstract
This studywith107maleforensicpatientswithdevelopmentaldisabilitiesinvestigated
whetherexposuretoparentalangerand aggressionwas relatedtoangerand assaultivenessin
hospital,controllingforbackgroundvariables. Patientangerand aggressionwasassessedby
self-report,staff-ratings,andarchivalrecords. Exposuretoparentalanger/aggression,assessed
byclinicalinterview,wassignificantlyrelatedto patientself-reportedanger,staff-rated anger
andaggression, andphysicalassaults inhospital,controllingforage, IQ,lengthofhospitalstay,
violentoffensehistory,andchildhoodphysicalabuse. Results areconsonantwithprevious
findings concerningdetrimentaleffects ofwitnessingparentalviolenceand withtheoryon
acquisitionofcognitivescripts foraggression. Implicationsforclinicalassessmentandcognitive
restructuringinangertreatment arediscussed.
Keywords: anger,aggression,parentalviolence,hospitalpatients,developmentaldisabilities
VolatileParents 3
AngerandAssaultivenessofMaleForensicPatients withDevelopmentalDisabilities:
LinkstoVolatileParents
Fromchildhoodonward, thelifecircumstancesandpsychosocialexperiencesofpeople
withdevelopmentaldisabilities1areconducivetotheactivationofangerandaggressive
behavior. Recurrentthwartingofphysical,emotional,andinterpersonalneeds,aswellas
cognitivefunctioningdeficits,impairtheirpsychosocialadjustment,particularlythosewho
resideincustodialsettings.Thepresentstudyexamineswhethertheangerandaggressive
behaviorofhospitalized maleoffenderswithdevelopmentaldisabilitiesarerelatedtochildhood
experiencesofparentalangerandparentalfighting,as wellastoabusevictimization. We pursue
thisresearchquestionwithaneyetowarditsbroadertheoreticalrelevanceforangerand
aggression,aswellasitsimplicationsconcerningassessmentandtreatment.
Epidemiologicalstudies onthreecontinents concerningpeoplewithdevelopment
disabilities havefoundhighratesof“challengingbehaviour”,inwhich aggressionfeatures
prominently(Harris,1993;Hill&Bruininks,1984;Sigafoos,Elkins, Kerr, &Attwood,1994;
Smith,Branford,Collacott,Cooper,&McGrother,1996).Theprevalenceofphysicalaggression
inthesestudiesis 35%orhigher forpersonsininstitutionalsettings,and,forthemalepatientsin
thepredominantlyforensicfacilityinvolvedinthepresentstudy,NovacoandTaylor(2004)
foundphysicallyassaultivebehaviorpost-admissiontobe46.5%. Importantly,thelatterstudy
foundthatthenumberof assaultswassignificantlyrelatedtoanger,controllingforage,lengthof
stay,IQ,violentoffensehistory,andpersonalityvariables. Therelevance ofangerand
aggressionforpersonswithdevelopmentaldisabilitiesisreviewedinTaylorandNovaco(2005).
Here, weexaminefamilybackgroundvariablesthatmightaccountfor angerdispositionand
aggressivebehavioramongthoseinthis clinicalpopulation.
VolatileParents 4
InterparentalVolatilityandChildAdjustment
Thewitnessingofinterparentalangerorinteradultdomesticviolencehas consistently
beenfoundtobedetrimentaltochildren’s well-being.Cummings andhiscolleagueshaveshown
repeatedlyinlab experimentalstudiesthatchildrendisplayheightenedsensitivityand emotional
distresstoangryadultinteractions,especiallywhenthereisinteradultphysicalaggression(e.g.,
Cummings,Ballard, &El-Sheikh,1991;Cummings,Zahn-Waxler, &Radke-Yarrow,1981;
Davies,Myers,Cummings, &Heindel,1999;El-Sheikh,Cummings, &Goetsch,1989). In a
home-baseddiarystudy,Cummings,Goeke-Morey, Papp,and Dukewich (2002)foundthat,in
responseto maritalconflictepisodes,childangerwassignificantlyrelated tobothmothers’and
fathers’anger,particularlythatoffathers. Substantialfieldresearchconcerningchildren who
havewitnessed familyviolencehas identifiedassociatedpsychological maladjustment,including
posttraumaticstresssymptoms (Fantuzzo etal.,1991; Kilpatrick& Williams,1998;Jarvis,
Gordon,&Novaco,2005;McCloskey& Walker, 2000; O'Keefe,1994;Rossman &Ho,2000;
Silvaetal.,2000)andbehaviorproblems(Grych etal.,2000;Jarvisetal.,2005;Jarvis&
Novaco,2006; Litrownik,Newton,Hunter,English,&Everson,2003;Mathias,Merton,&
Murray,1995). Witnessingadultangryconflictitself(separatefromwitnessingviolencetoward
afamilymember)presentsriskforchildadjustmentproblems,asshownin alargesamplestudy
concerningtoddlers(McDonald,Jouriles,Briggs-Gowan,Rosenfield, &Carter,2007).
Interparentalaggression andparentalaggressiontowardchildrenoftenco-occurin
families(cf.O’Leary,Slep,&O’Leary,2000).The Kitzmann,Gaylord, Holt,andKenny(2003)
meta-analysis foundnodifferencesineffectsizes foroverallpsychologicaladjustmentbetween
witness-onlychildren,abused-onlychildren,and abused-witnesses,butseveralstudieshave
reportedthat childrenwhoarebothwitnessestoanddirecttargetsofabuse faresignificantly
VolatileParents 5
worsethanchildrenwho aresolelywitnesses (e.g.,Grychetal.,2000; Mathiasetal.,1995;
McCloskey& Walker,2000). Inaddition,exposuretomoresevereinteradultabusehasbeen
associatedwithhigherlevels ofchildbehavioralproblems andtraumasymptoms(Fantuzzo et
al.,1991;Jarvis,etal.,2005;O’Keefe,1994;Rossman &Ho,2000). Ina longitudinalstudy
withmultipleinformantsthatcontrolledforchildabuseandneglect(as wellaschild IQ,
householdSES,andfamilylifestress),Yates, Dodds,Sroufe,andEgeland(2003)foundthat
exposuretopartnerviolenceduringpreschool yearswasassociatedwithexternalizingproblems
forboys inadolescence.
Strickler(2001)asserted thatpersons withintellectualdisabilityhavehigherriskforchild
abuseanddomesticviolenceexposure.Compared topersons withaveragegeneralintellectual
functioning,theirhigherdependency,frequentdenialofrights,moreisolatedlivingconditions,
communicationproblems,lackof knowledgeaboutappropriatebehavior,physicalimpairments,
andlackof economicindependenceheightenstheirvulnerability. Epidemiologicalresearchon
twinpairs (sampledfrom1994and1995birthcohorts inEngland)byKoenen,Moffitt,Caspi,
Taylor,and Purcell(2003)demonstratedthatdomesticviolencewas uniquelyassociatedwith IQ
suppressionindose-responserelationship.Thus,domesticviolenceexposuremayexacerbate
cognitivefunctioningimpairmentpresentatbirth. HuesmannandEron(1984),inworkthat
presagedthesocialinformationprocessingconstructwediscusslater, foundthatdiminished
intellectualcompetencewasassociatedwiththeearlyadoptionofaggressivestrategiesas achild
thatpersistovertimeand arepredictiveoflowerintellectualfunctioningas anadult.
Thefamilyenvironmentrootsofangerandaggressivebehaviorhavebeen aresearch
psychologytopicsincetheclassicworkofGoodenough(1931),Sears,Maccoby, and Levin
(1957),and McCord, McCord,andHoward(1961,1963).Thelatter authorsconcludedthat
VolatileParents 6
aggressiveboyswere raisedbyparentswho wererejectingandpunitive,weremodelsofdeviant,
aggressivebehavior,and wereofteninvolvedinintenseinterparentalconflict. Similarly,in
Farrington’s(1989)longitudinalresearch,adult males convictedofviolentoffenseshad, atage8,
parents characterizedbycruelattitudes,harshdiscipline,andinterparentalconflict. Parental
disharmonyduringadolescence wasalsopredictiveofconvictions forviolence,as waslowIQ.
Takentogether,thisbodyofresearchindicates that children’s exposuretointerparental
angerand aggressioncanbeexpectedtoincreasetheirriskofhavingadjustmentdifficulties.
AcquisitionofaDispositionfor Anger andAggression
SociallearningmodelsfromBandura(1973)tothoseofDodgeandhis colleagues (e.g.,
Crick&Dodge,1994,1996;Dodge&Coie,1987;Dodge,Pettit,Bates,&Valente,1995)andof
Huesmann(1988,1998) providefortheconjecturethatdisplaysofangerandaggressionby
parents wouldinculcateangerandaggressionamongtheiroffspring. Prospectiveintergeneration
studiesofthe“cycleofviolence”areindeedrare. However,Conger,Neppl,Kim,and
Scaramella (2003)found intergenerationalcontinuitiesfromangry, aggressiveparentingtothe
angry,aggressivebehaviorofchildren andadolescents. Thosecontinuities werediscoveredin
directlyobservedbehaviorandwerenotexplainedbydisadvantagedsocialconditions. Parents'
hostility,angrycoercion, andantisocialbehaviortowardachildwerelinkedtothatchild'sangry
andaggressivebehaviortowardasiblingandtothenextgeneration'saggressivenesstowardtheir
parents.This isconsistentwithPatterson's(1998) viewthatchildrearingapproachesshape
continuitiesinaggressivebehavioracross generations,withcomplementarycontributionsfrom
biology. "Oncetheprocessisunderway,theindividualsselectsettings,persons,andbehaviors
thatmaintainalimitedsetofsocialskills andanoverwhelmingpatternofdeviantbehaviors"
(Patterson,1998,p.1266). As well, LeungandSlep's (2006)foundthatparentalangerwas
VolatileParents 7
directlyassociated withoverreactiveparenting:"Themorefrequentlyparentsactouttheiranger
in general,themoreoverreactivetheytendtobewhentheydisciplinetheirchildren"(p.531).
TheintergenerationalcontinuityfoundbyCongeretal.(2003),whodidnotoffer
explanatorymechanisms,canbeaccountedforbysociallearningtheoryandsocialinformation
processing(SIP) models. Bandura(1973,1983)emphasizedobservationallearningin the
acquisitionofaggressivebehavior,andidentifiedattention,memoryrepresentation,andthe
symbolizationofexperienceasimportantcognitivecomponents.ForBandura,aprominent
originofaggressionand ofitsactivationbyangeristhrough modelingand reinforcementinthe
family.Various SIPmodels havebeenputforwardtoaccountfor aggressivebehavior,including
Holtzworth-Munroe’s(1992)conceptionof maritalviolence--influenced byMcFall’s(1982)
approachtosocialskills, aswasDodge and Coie(1987). Theadventofformal SIPmodelsof
thedevelopmentofhabitualaggressivebehavioroccurredinparallelbyHuesmann’s(1988)and
byDodgeandhis colleagues (cf.Crick&Dodge, 1994). Huesmannemphasizedcognitive
scripts,acquired and maintainedthroughobservationalandenactivelearning,thatarestoredin
memory,serve as guides forsocialbehavior,and areresistanttochange. Theperspectiveof
Dodgeandcolleaguessprangfromtheidentificationofhostileattributionalbiasinaggressive
boys(Dodge &Coie,1987;Dodge& Frame,1982).Bothmodelsincludetheinterpretationand
encodingofsituationalcues,memorysearchforbehavioralguides,theinterplayofemotion,
evaluationandselectionofresponses, andbehavioralenactment. Huesmann’s (1988,1998)
modelfeatures aggressivescripts,normativebeliefs,andrehearsal,whileDodge’s model
highlights hostileattributionalbiasincueinterpretationandpeerresponses thatinfluence
decisionheuristics. Huesmann(1998)provides asummaryofbothperspectivesandoffers a
unifiedmodel. As thepresentstudydoesnottestsuchmodels,this encapsulationmustsuffice.
VolatileParents 8
PresentStudyContext
Angerhas enormousrelevancetothewelfareofhospitalizedpatients,nottheleastof
whichpertains toitsassociationwithviolence. Angerhasbeenfoundtobepredictiveof
physicalaggressionbypsychiatrichospitalpatients priortoadmission(McNeil,Eisner,&
Binder,2003),duringhospitalization(Doyle&Dolan,2006a;Novaco,1994;Novaco &Taylor,
2004;Wang& Diamond,1999)andinthecommunityafterdischarge(Doyle&Dolan,2006b;
Monahanetal.,2001).Withinapsychiatrichospital,angerand aggressionincuragreatcostboth
interms ofstaffinjuries andoperational management(e.g.,Bensleyetal.,1997;Carmel&
Hunter,1989;NationalAuditOffice,2003). Inforensicfacilities entrustedwithprovidingboth
securityandrehabilitation,patientangerandaggressionrequires therapeuticintervention
enlightenedbyknowledgeofsources ofangerdysregulationinthebackgroundsofpatients.
Regardingthecontextofthepresentstudy,conductedinaforensichospital forpersons
havingdevelopmentaldisabilities,ourprevious researchhasdemonstrated thatpatients’anger
canbereliablyandvalidlyassessedandthatcognitive-behavioralangertreatmentproduces
significantgainsinpatientcare(Novaco&Taylor,2004;Taylor&Novaco,2005;Taylor,
Novaco,Gillmer,Robertson,&Thorne,2005;Taylor,Novaco,Gillmer,& Thorne,2002;
Taylor,Novaco,Guinan, &Street,2004). Wehereseektoascertainwhetherreportedexposure
toparentalangerand aggressionisrelatedtothepatients’angerandaggressiondispositions,as
thatcouldinformclinicalassessmentandtreatmentprocedures.Inexaminingthathypothetical
linkage,ouranalyseswillcontrolforpatients’age,IQ,violenceoffensehistory,lengthofstayin
hospital,andforthepatienthavingbeenphysicallyabusedathomeas achild. Givenvarious
studyresultsdiscussed earlier(e.g.,Congeretal,2003;Yates etal.2003),wehypothesizedthat
patients’childhoodphysicalabusewouldbesignificantlyrelatedtotheir angerandaggressive
VolatileParents 9
behaviorinthehospital. Aftertestingforthatprediction,wethentestfortheincrementaleffect
ofexposuretoparental angerandaggression.
Method
Setting
Thestudywas conducted inthehospitalforensicserviceoftheNationalHealthService
(NHS)TrustinEnglandthatprovidesspecialistservicestopeoplewithdevelopmental
disabilities.Thehospitalprovidesinpatientservicesonalocal,regionalandnationalbasisto
patientsreferredtoitsforensicservices viastatutoryHealthAuthorities,the court,andprison
services. Theforensicservicehassevenunitsprovidingmediumsecure,lowsecure,and
rehabilitationfacilitiesfor159patients,22(14%) ofwhomarewomen;all unitsaresinglesex.
Participants
Allfemalepatients wereexcludedfromthestudy, astherewasnoroutinepsychological
servicesavailabletothewomen’sunitatthetime. Malepatientswhowereabouttobe
dischargedortransferred werenotincluded.Thisleft129patients,allCaucasian,who
participatedinthestudyrepresenting94%ofthetotalpopulation(N =137)ofthemen’sforensic
serviceinthehospitalatthetime. Theaverageageoftheparticipants was 33.2 years(Mdn=
30.1; SD= 11.6),theiraveragelengthofstaywas 3.7 years(Mdn= 3.0; SD= 3.5),andaverage
WAIS-R FullScaleIQwas67.5(Mdn= 69.0;SD= 8.0).Furtherinformationabouttheir
background,cognitive,personality, andangerpsychometriccharacteristics is giveninNovaco
andTaylor(2004).
Onehundred andtwenty-onepatients(94%) wereformallydetainedunder sectionsofthe
Englandand Wales MentalHealthAct1983,andeight(6%)were‘informal’orvoluntary
patientsnotdetainedunderanystatutoryact. Approximately36%ofthepatients hadprevious