This thesis presents a program of research investigating the role of parental attributions in the management of parents with anger management problems who are atrisk of child maltreatment. Child maltreatment is a major social and health issue that is associated with significant costs for the individual child, his or her family and society. In Australia, all major indicators of child abuse have increased each year for the past six years, including child abuse notifications; substantiated abuse cases; children on care and protection orders; and the number of children in out-of-home care (AIHW, 2005). There is increasing focus on furthering our understanding of the aetiology connected with child maltreatment and on reducing risk factors associated with child maltreatment. Parental anger and parental dysfunctional attributions associated with parentchild interactions have been implicated as important risk factors for child maltreatment. These dysfunctional attributions for child behaviour and negative parenting behaviour and their affects on parental anger and parenting behaviour are the focus of this thesis. The present research aimed to (a) identify and assess the types of parental attributions that may intensify and perpetuate parental anger and anger-related behaviour; (b) examine the differences in the attributions clinically angry and at-risk of child maltreatment (CA) parents, and non-angry, not at-risk of child maltreatment (NA) parents make for parent-child interactions; and (c) evaluate the effectiveness of an enhanced behavioural family intervention, Pathways Triple P that aimed to reduce CA parents maladaptive attributions, anger and other key risk factors for child maltreatment, compared to a standard behavioural family intervention, Group Triple P. This program of research employed an attributional-behavioural model of child maltreatment to identify key risk factors involved in the precipitation, exacerbation and perpetuation of parents' anger and anger-related behaviour. This attributional-behavioural model of child maltreatment hypothesised that the types of attributions parents make during parent-child interactions intensify their anger and justify their negative parenting behaviour. Two attribution measures were developed for this research to assess parents' anger-intensifying and anger justifying attributions. Study 1 examined the differences between the attributions CA parents and NA parents make for parent-child interactions, and the differences between other key risk factors associated with child maltreatment, including parental adjustment, parenting practices, and perceptions of disruptive child behaviour problems. The 82 families with a child aged between 2-7 years who participated consisted of 41 CA mothers and 41 NA mothers. As predicted, there were significant differences between the CA and NA mothers' anger-intensifying attributional style for both negative and ambiguous negative child behaviour, with the CA mothers reporting an elevated level of anger-intensifying attributional style. In accordance with predictions CA mothers, compared to NA mothers, reported being more likely to attribute blame to their child for their own negative parenting behaviour and that the reason for their behaviour was unlikely to change. The study revealed significant group differences on all remaining key risk factors with CA mothers compared to NA mothers reporting significantly higher levels of negative affect, use of dysfunctional parenting practices, and more problem child behaviours. Study 2 examined the efficacy of an enhanced behavioural intervention, Pathways Triple P with CA mothers. Ninety-three CA parents with a child-aged 2-7 years were randomly assigned to either an enhanced group-administered behavioural family intervention program based on the Triple P - Positive Parenting Program that incorporated attributional retraining and anger management, Pathways Triple P, or a standard behavioural family intervention program, Group Triple P, that provided training in parenting skills alone. This Study revealed that both the Group Triple P program and the Pathways Triple P program were powerful tools for change in the selected population of families at-risk for child maltreatment. At post-intervention and follow-up both conditions were associated with lower levels of observed and parent-reported disruptive child behaviour, lower levels of parent-reported dysfunctional parenting, improvement in parental anger, adjustment, unrealistic expectations and potential for child abuse. Families receiving the enhanced behavioural family intervention showed significantly greater improvements on two key indicators of abuse potential both in the short and long term. Mothers who received the Pathways Triple P showed a significant reduction in their level of anger-intensifying attributional style for both negative and ambiguous negative child behaviour and significantly lower child-blame attributions for negative parenting behaviour from pre to post intervention, with evidence of maintenance to follow-up. The specific targeting of parents' attributions was successful in reducing mothers' anger-intensifying and anger-justifying attributions for parent-child interactions. Mothers in the EBFI group not only reported a significant decrease in the tendency to blame and attribute malintent to children for negative child behaviour but also reported a significant decrease in the tendency to blame children for negative parenting behaviour. This generalised shift for mothers to make more benign attributions for their children's negative and ambiguous negative behaviours and to make less child blaming attributions for negative parenting behaviour showed that the cognitive mechanism hypothesised to shift in angry parents did change in the predicted direction. Participants in both conditions reported comparably high levels of consumer satisfaction with their respective interventions. However, mothers in the EBFI group reported that the attributional retraining session as the most useful of the 12 sessions in the EBFI intervention. Contrary to prediction, only one family in the SBFI condition received contact with child protection services for notification for child maltreatment in the follow-up period. Previous research into interventions for parents at-risk of child maltreatment has indicated that standard behavioural family interventions might not sufficiently meet the complex needs of these families. The results of this present study support this assertion to some degree. As has been noted previously, the EBFI condition was associated with significantly greater improvements on key risk factor for child maltreatment, namely measures of anger-intensifying and anger-justifying attributions for parent-child interactions compared with SBFI. Although at post-intervention SBFI families had also improved significantly on many measures, the differences between conditions on the attributional measures were maintained from post-intervention to follow-up. This thesis provides important new information regarding the differences in clinically angry parents at-risk of child maltreatment (CA) and non-angry parents not atrisk of child maltreatment (NA) attributional processes for child negative behaviour and negative parenting behaviour. It represents an important contribution in the development of two attributional measures the PACBM and the PAM that discriminate between CA and NA parents. This present thesis also extends the limited empirical base of BFI as an intervention for child maltreatment (Wekerle & Wolfe, 1993) and provides evidence for two variants of BFI (Group Triple P and Pathways Triple P) being associated with a range of positive changes in parental risk factors linked to child maltreatment. An important finding was that the Pathways Triple P intervention produced more changes more expeditiously and more consistently across the full spectrum of child measures, parents' cognitive, affective and parenting behaviour measures. A strength of the present study was the utilisation of a robust, standard-care comparison condition which provided not only a creditable test for the additive benefits of the enhanced intervention but also provided the CA mothers immediate intervention with a credible treatment.
| Identifer | oai:union.ndltd.org:ADTP/289050 |
| Creators | Pidgeon, Aileen Mary |
| Source Sets | Australiasian Digital Theses Program |
| Detected Language | English |
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