The Relationship Between Caregiver Intimate Partner Violence
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University of Central Florida STARS Electronic Theses and Dissertations, 2004-2019 2012 The Relationship Between Caregiver Intimate Partner Violence, Posttraumatic Stress, Child Cognitive Self-development, And Treatment Attrition Among Child Sexual Abuse Victims. Leigh de DeLorenzi University of Central Florida Part of the Counselor Education Commons, and the Education Commons Find similar works at: https://stars.library.ucf.edu/etd University of Central Florida Libraries http://library.ucf.edu This Doctoral Dissertation (Open Access) is brought to you for free and open access by STARS. It has been accepted for inclusion in Electronic Theses and Dissertations, 2004-2019 by an authorized administrator of STARS. For more information, please contact [email protected]. STARS Citation de DeLorenzi, Leigh, "The Relationship Between Caregiver Intimate Partner Violence, Posttraumatic Stress, Child Cognitive Self-development, And Treatment Attrition Among Child Sexual Abuse Victims." (2012). Electronic Theses and Dissertations, 2004-2019. 2191. https://stars.library.ucf.edu/etd/2191 THE RELATIONSHIP BETWEEN CAREGIVER INTIMATE PARTNER VIOLENCE, POSTTRAUMATIC STRESS, CHILD COGNITIVE SELF-DEVELOPMENT, AND TREATMENT ATTRITION AMONG CHILD SEXUAL ABUSE VICTIMS by LEIGH DE ARMAS DELORENZI B.S University of Miami, 2003 M.A. Rollins College, 2009 A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the College of Education at the University of Central Florida Summer Term 2012 Major Professor: Andrew P. Daire © 2012 Leigh de Armas DeLorenzi ii ABSTRACT Child sexual abuse (CSA) is a worldwide problem, with two-thirds of all cases going unreported. A wealth of research over the last 30 years demonstrates the negative emotional, cognitive, physical, spiritual, academic, and social effects of CSA. As a result, researchers and mental health professionals frequently attempt to measure the efficacy of treatment modalities in order to assess which treatments lead to better outcomes. However, in order to effectively study treatment outcomes, researchers must be able to track the status of child functioning and symptomology before, during, and after treatment. Because high levels of treatment attrition exist among CSA victims, researchers are unable to effectively study outcomes due to large losses in research participants, loss of statistical power, and threats to external validity (Kazdin, 1990). Moreover, due to the high prevalence of concurrent family violence, caregivers with intimate partner violence are more than twice as likely to have children who are also direct victims of abuse (Kazdin, 1996). Caregivers ultimately make the decisions regarding whether or not a child stays in treatment, and therefore, it is important to examine the influence of both parent factors (e.g., intimate partner violence) and child factors (e.g., traumatization and/or disturbances in cognitive self- development) on treatment attrition. This two-pronged approach of examining both child and family characteristics simultaneously with attrition patterns offers a more complete picture for the ways concurrent family violence influences treatment than looking at child and caregiver factors separately. The purpose of this study was to investigate the relationships between caregiver intimate partner violence, child posttraumatic stress (Trauma Symptom Checklist for Children [TSCC]; Briere, 1996), child cognitive self-development (Trauma and Attachment Belief Scale [TABS]; iii Pearlman, 2003), and treatment attrition. The statistical analyses in this study included (a) Logistic Regression, (b) Poisson Regression, and (c) Chi-square Test for Independence. Elevated TSCC subscale scores in posttraumatic stress predicted both an increased number of sessions attended and increased number of sessions missed. Elevated TABS subscale scores in self-trust predicted an increased number of sessions attended and decreased number of sessions missed. Elevated TABS subscale scores of other-intimacy and self-control predicted an increased number of sessions missed. Moreover, the presence of past or current caregiver intimate partner violence predicted a decrease in number of sessions attended. While no relationship existed between child posttraumatic stress or cognitive self-development and whether a child graduated or prematurely terminated from treatment, children with parents who confirmed past or current intimate partner violence were 2.5 times more likely to prematurely terminate from treatment. iv This dissertation is dedicated to the millions of brave women and children who survive abuse every day. May you be cloaked in the armor of love and steadfast courage on your journey toward peace and healing, and find comfort in words of Psalm 71:14 – “He shall redeem their soul from deceit and violence: and precious shall their blood be in his sight.” This work is also dedicated to my parents, who on the day of my baptism, prayed for, “…the eyes of my heart to be enlightened so that I may know the hope to which He has called me.” (Ephesians 1:18) v ACKNOWLEDGMENTS I give all glory to God for making this (and all things) possible, and thank Him for placing His protective hands over me during this very difficult dissertation year. On my very first day of dissertation writing, I received word that my 36-year-old sister, Blythe, was diagnosed with breast cancer. Six months later, my mother, Donna, was also diagnosed with breast cancer. I would like to thank these brave and beautiful women for teaching me, through their example, how to push through the paralysis of fear and anguish, one tiny step at a time. I would also like to thank my father and ―best dissertation buddy,‖ Nestor, for reminding me daily that I was not alone on my journey, and for his gentle nudging on the days I feared I was unable to keep going. Thank you, Daddy, for refusing to merely observe, and for stepping onto this roller coaster with me, strapping on your seatbelt, cheering with me, cursing with me, laughing with me, encouraging me, and never leaving my side for one minute. I would like to thank the smartest and hardest working man I know, Dr. Andrew Daire, for believing in me from the very first year of my doctoral program, for encouraging me to ―wear my badge‖ and pursue my dreams as a researcher of family trauma, and for inviting me to participate in the UCF Marriage and Family Research Institute‘s project to research and evaluate children exposed to abuse and family violence. Your work ethic and pursuit of excellence is, and always has been, hugely inspirational to me. I hope one day I can help someone turn their dreams into a reality, just as you have done for me. I will also never forget your genuine warmth, caring, and encouragement during the darkest and scariest moments of this crazy year. Thank you for being my dissertation chair. A heartfelt thank you goes out to the other esteemed members of my committee: Dr. Glenn Lambie, Dr. Mark Young, and Dr. Eileen Able. Thank you all for enriching this study vi with your wisdom. Dr. Lambie, thank you for your constant availability, kindness, and assistance regarding the trickier research methods utilized in this study. It was so much fun to learn alongside you! Dr. Young, thank you for your calming and compassionate presence, and for lending your time and energy to help make this project successful. Dr. Abel, thank you for your guidance, expertise, enthusiasm, and genuine excitement for my ideas, which motivated me tremendously during this process. I would also like to thank Nicole Brenenstuhl for her kindness, professionalism, and leadership during the 17-month data gathering process. To say it was an honor and a privilege to work with these individuals would be a colossal understatement. I would like to thank my other friends and family, specifically Anne, Paige, Liz, Gabe, Ray, Cathy, Polly, Nicole, Talia, Julie, Amanda, Stephanie, Sarah, Jenny, Lauren, Whitney, Lani, and Megan, for cheering me on from the sidelines, and for understanding why I had to be absent for so long from your lives. I would like to thank my cohort members, Matt, Ryan, Jennifer, Dallas, Emma, Yo-Sang, and John, for sharing in this experience with me. I am so lucky to learn from each of you and call you my friends. I would also like to acknowledge and thank my dear friend Amanda Bailey for her tireless efforts to help me gather and organize the ―trillions‖ of references utilized for this study, and for reminding me ―not to panic, but to plow through!‖ Most importantly, I want to thank my soul mate, best friend, and beloved husband, Anthony. I thank God for leading me to you the day we met on May 26, 2009, for joining us in marriage on March 5, 2011, and for every day that I get to wake up next to you. You have been my rock and my refuge during the hardest year of both of our lives, and have held me up more times than I can count. Your strength and tenderness have kept me safe, and your daily love and encouragement has fueled me to, ―Never, never, never give up!‖ I love you. vii TABLE OF CONTENTS LIST OF FIGURES ..................................................................................................................... xiii LIST OF TABLES ....................................................................................................................... xiv CHAPTER 1: INTRODUCTION ................................................................................................... 1 Problem Statement .....................................................................................................................