Exploring patterns of child-to-parent violence and abuse from caregivers’ perspectives: parental experiences, correlates and support-seeking behaviour

Background: Child-to-parent violence and abuse (CPVA) is recognised as a form of domestic violence (DV). However, little is known about its prevalence, associations with other types of DV, or how caregivers cope with this behaviour. Aims: The aims of this thesis were to: 1) explore caregivers’ lived experiences and coping responses to CPVA; 2) develop a conceptual model to explain patterns of caregiver coping responses; 3) investigate the occurrence and association between lifetime incidence of CPVA and other types of DV within a UK community sample; and 4) understand family and situational characteristics which influence levels of CPVA and support accessed. Method: In order to investigate aims 1) and 2), a qualitative systematic review and thematic synthesis were conducted. Studies were quality appraised using the CASP checklist, and data were extracted and inductively coded. Confidence in review findings was assessed using the GRADE-CERQual approach. Aims 3) and 4) were explored via a cross-sectional anonymous online survey of UK caregivers with a child or young person (CYP) aged six to 24 years old. Participants completed an adapted version of the Child-to-Mother Violence Scale (Edenborough, 2007) and the Composite Abuse Scale (CAS; Hegarty, 2007), a measure of previous intimate partner violence (IPV) victimisation. Before the survey was carried out, the CAS was critiqued in relation to its psychometric properties, and was employed in the current study due to its broad coverage of IPV subtypes that align with UK cross-governmental definitions of DV. Results: 1) The review identified a range of psychological and behavioural coping responses. 2) Coping responses appeared to be mediated by caregivers’ appraisals of CPVA (e.g. how they made sense of the abuse), how it impacted them emotionally and relationally (e.g. level of fear; impact on the family system), and views about the responsiveness of formal and informal support networks. 3) 412 UK caregivers (94% female) completed the online survey; 65% reported at least one lifetime incidence of CPVA, and 21% reported ongoing abuse. Strongest associations were found between history of emotional (rather than physical) IPV victimisation and lifetime experience of CPVA, whilst CYPs previously witnessing or experiencing violence did not predict levels of CPVA. 4) Female participants experiencing at least one occasional lifetime incidence of CPVA generally reported on male CYPs (60%), who were aged 7 to 9 years old when the CPVA started, and 10 to 12 years old when it was worst. CYPs being threatening to other family members (mainly siblings), and longer duration of CPVA were associated with higher levels of CPVA, whilst higher levels of CPVA and antecedents positively predicted level of support accessed. Contrary to the systematic review’s hypotheses, caregivers feeling afraid, normalising the CYP’s behaviours, and endorsing barriers to support seeking were not associated with level of support accessed. Conclusions: The systematic review is the first known synthesis of qualitative evidence concerning CPVA, and identifies testable hypotheses concerning caregiver coping responses. The thesis provides preliminary evidence on the rate of CPVA in a UK community sample, its levels of co-occurrence with IPV and sibling directed aggression, and gaps in service access and provision