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Department of Preventive Medicine Lisa Klesges, Ph.D. May 20, 1998 Current Research Projects | Pending Research Projects | Faculty | Bibliography | Top
INTRODUCTION We have recently organized a Violence Prevention Research Group in the Department of Preventive Medicine at the University of Tennessee, Memphis. Our research group has multidisciplinary training and expertise in psychology, statistics, research methodology, epidemiology, and public health as well as specific experience in surveillance methods, complex data analysis, and prevention and control of violence. We are currently working with multiple community groups including the Memphis Police Department, the District Attorney General’s Office, the Memphis/Shelby Crime Commission, the Shelby County Domestic Violence Council, the Partnership for Women’s and Children’s Health, and other health care and social services providers. In the past year our research group has initiated numerous projects in the areas of prediction, prevention, and control of violence. These research investigations focus not only on individual factors related to violent behavior but seek to improve our understanding of individual behavior in the context of family, community and cultural environment. Projects are wide-ranging in scope from investigations of psychobiologic relationships between exposure to conflict and health-related outcomes to developing information surveillance systems in the criminal justice system. Our goal is to conduct and promote research and evaluation projects to control and prevent violence in our community.
Individual Interventions and Evaluation 1) Family Conflict as a Predictor of Cardiovascular Reactivity in Youth Biobehavioral models of stress-disease relationships have a long history in biomedical, psychological, and sociological research especially as a model for cardiovascular disease. Current stress-illness models related to cardiovascular responses have shifted investigation from single risk factor models to those of frequent and naturally occurring chronic stressors. For children, two such salient chronic stressors include the processes of exposure to family conflict and community violence. The current research project is assessing approximately 200 adolescent children to investigate longitudinal relationships between exposure to family conflict and violence and cardiovascular reactivity. These family and environmental stress measures will be related to psychological functioning and physiologic functioning after considering potential moderators of temperament, coping, and social support variables.
2) Children’s Psychosocial Functioning Following Physical and Sexual Abuse National statistics estimate that over 2 million reports of child abuse are made each year. In Shelby County alone, estimates of child abuse reports are approximately 12,000 cases annually. Recognition of the psychological harm to children who experience abuse is widespread (APA, 1996). However, while programs have been developed to ameliorate the effects of abuse on children both in the immediate aftermath and for the long term, they have generally not been carefully evaluated. The aims of this evaluation study are to assess prospective changes in the psychological and behavioral functioning of physically and/or sexually abused children receiving intervention at Le Bonheur Center for Children in Crisis. Children are assessed at baseline and approximately 12 weeks after receiving therapy. Intervention goals and psychosocial assessments include: 1) reducing post-traumatic stress, 2) decreasing anxiety and depression, 3) increasing coping and resiliency skills, 4) increasing appropriate conflict resolution skills, and 5) reducing problem behaviors and increasing appropriate responses. Such efforts are considered primary prevention for preventing mental illness, health-related problems, and the transmission of violence. 3) Responsible Fatherhood Program Up to 28% of children in the U.S. currently live with a single parent; in the vast majority of these cases the absent parent is the father. Research over the last 25 years indicates that lack of parental involvement is related to early developmental difficulties and later psychological, social, and behavioral maladjustment for children. However, of particular concern to our research group is the greater risk for juvenile delinquency among children reared without paternal involvement. The currently funded investigation will evaluate the development and feasibility of a responsible fatherhood intervention (RFP) for minority men who father children with unmarried teenage mothers. The intervention is implemented by the Le Bonheur Center for Children in Crisis (LBCCC). The goal of the intervention is to encourage fathers in the parenting of their children and the provision of support to mothers. Methods for achieving these results will include counseling sessions where fathers learn parenting and relationship skills, work to achieve stability in their lives, and become more involved with their children.
4) Witnesses of Family Violence: Evaluation of a Children’s Intervention Recognition of the psychological harm to children who witness and experience family violence has grown considerably over the past 15 years. The accumulated evidence also indicates a strong transmission of family violence across generations. There is a great need, therefore, for efficacious prevention programs to help children break the cycle of violence. Few of the interventions that have been developed to prevent marital violence, however, have been empirically validated. This funded study is designed to evaluate a psychoeducational intervention that provides group therapy to children who have witnessed violence in their families. The specific aims of this study are to evaluate changes in the emotional and behavioral functioning of children witnessing family violence after participating in the intervention program at the Exchange Club Family. Intervention goals being evaluated are: 1) reducing self-blame and increasing self-esteem, 2) improving interpersonal relationships with parents and peers, 3) increasing coping and resiliency skills, 4) reducing anxiety and depression, and 5) reducing problem behaviors. Funding Source: Partnership for Women’s & Children’s Health (R07323673) 5) Needs Assessment of an Exchange Center for Supervised Family Visitation At the request of the Women’s and Children’s Committee of the Shelby County Domestic Violence Council, we are conducting a needs assessment to develop a supervised center for exchange and visitation of children in dangerous or court-mandated cases. Because batterer’s in domestic violence cases often use the children to manipulate their victims, it would allow third-party accountability and supervision of child visitation. Key informant interviews and a survey of victims are being conducted to make recommendations for the interest in and the feasibility of such an exchange center. Local-Area Surveillance System of Domestic Violence Introduction. Recommendations for local-area surveillance and data systems for violent and abusive behavior are prevalent. Various agencies have identified improvement in community statistical information as a priority area of research including Healthy People 2000 (DHHS, 1987), Understanding Violence Against Women (NRC, 1996), and the report Domestic and Sexual Violence Data Collection (NIJ, 1996). Among other benefits, local surveillance information allows investigation of the prevalence and predictors of violence in the community. Additionally, surveillance information introduces potential policy and intervention initiatives to target improvements in identification and screening efforts and prevention of further violence. The projects outlined below are in specific response to these recommendations and address the lack of information infrastructure in our community. 1) Memphis Police Department & Shelby County Pretrial Surveillance System In conjunction with the Memphis PD, Pretrial Services and Citizens’ Dispute offices, we have developed a data surveillance system to enrich the amount and quality of information available concerning domestic violence in our community. Currently collected information includes: victim offender relationship; standardized measures of physical, verbal and psychological abuse; the presence and extent of the involvement of children in the domestic dispute; receipt of medical and social services by victims and children; use and ownership of weapons, and history of alcohol and drug abuse of the offender as well as other pertinent description. The uses for this surveillance system are many. For example, when linked to information from treatment providers, the surveillance system will provide "pre-test" or baseline data to evaluate services for victims and batterers. Geographic mapping of domestic violence incidents will allow us to examine neighborhood contextual variables linked to domestic violence. Additionally, these GIS maps will be of great help to agencies interested in developing community interventions for domestic violence.
2) Shelby County Domestic Violence Assessment Center We have proposed the development of a Domestic Violence Assessment Center that will serve as the primary evaluation center for all court-referred domestic violence cases in the city of Memphis. Domestic violence offenders would be required to complete a comprehensive psychological assessment at the Center prior to attending one of the batterer’s intervention programs. This information would serve as a baseline to judge improvement in attitudes, beliefs and behavior as a result of completing court-mandated treatment program(s). Additionally, the information will be used for program evaluation of treatment interventions, for research on psychological typologies of batterer’s to target interventions, and for assessing treatment compliance. The data will address policy questions of the effectiveness of various batterers’ intervention strategies such as concomitant treatment for drug or alcohol use. Increased knowledge about domestic violence offenders and treatment outcomes will provide a means to modify current practices and policies.
3) Structured Follow-up Interview of Domestic Violence Victims In cooperation with the Shelby County Victims Assistance Center, the YWCA Abused Women's Center, and the Shelby County Domestic Violence Court, we have submitted to the State Justice Institute a proposal to develop and implement a structured follow-up interview for victims of domestic violence. The development of such a program is needed to evaluate the responsiveness of the courts, law enforcement, victim’s advocates, and batterer’s intervention providers. Results of the study will be available to local agencies in the form of a technical report and recommendations for current and future programs. 4) Unreported Domestic Violence and Normative Attitudes of Violence While the National Crime Victimization Survey and the National Family Violence Survey provide national estimates of violence against women, they offer little in understanding the extent of DV in its local context. We have proposed to conduct a computer-assisted phone survey in Memphis, Tennessee to address the following questions: 1) What are the prevalence and predictors of violence against women in our local area? 2) To whom, besides law enforcement, do women disclose acts of DV? 3) What are individual and contextual characteristics of women who disclose DV? Specifically, to what extent do severity of violence, normative perceptions of DV, fear of retaliation, and attitudes towards authorities in addition to household, cultural and social characteristics relate to disclosure of violence? 4) Considering severity of violence, what are individual and contextual differences of women reflected in the criminal justice surveillance system as compared to those in the community survey? The proposed investigation will allow local-area estimation of the occurrence of DV, will explore contextual explanations for disclosure of violence such as victims’ normative views of DV, cultural differences, fear of harm to self or children, and general reluctance to be identified and will provide a baseline and secular trend to evaluate targeted community interventions.
Current Research Projects | Pending Research Projects | Faculty | Bibliography | Top
We are providing evaluation and statistical consultation to the Child Advocacy Center (Nancy Williams, Director) to analyze the prevalence, predictors, intervention outcomes, and long-term dispensation of child victims of severe physical or sexual abuse. Specific projects are being developed for submission to the LHS (Le Bonheur Health Systems) Foundation.
Current Research Projects | Pending Research Projects | Faculty | Bibliography | Top
Lisa M. Klesges, Ph.D. Dr. Lisa Klesges is an Assistant Professor of Preventive at the University of Tennessee, Adjunct Professor of Psychology at the University of Memphis, and Co-Director of the Memphis Alliance for Public Health Research. A behavioral epidemiologist with extensive experience in funded research, Dr. Klesges has published articles on smoking prevention and cessation, nutrition, and a range of women’s and children’s health issues. Her currently funded projects include an evaluation of a psychosocial intervention for children witnessing family violence and evaluation of women’s and children’s community health promotion and surveillance projects. Her experience in research design, measurement methods, and community health promotion will contribute to the success of the surveillance, evaluation, and community intervention portions of programmatic research in violence prevention. Dr. Klesges is actively involved with local domestic violence efforts as chair of the Shelby County Domestic Violence Council Research Committee and as a member of the Executive Committee. Kris Henning, Ph.D. Dr. Henning is a licensed clinical psychologist and Assistant Professor in the Department of Preventive Medicine at the University of Tennessee, Memphis. Dr. Henning has extensive research training with specific expertise in measurement methodology. His background and publications in the areas of violent offenders and psychosocial adjustment to experiences of violence and child abuse will contribute significantly to the design of intervention projects and his experience with surveillance projects in motor vehicle accidents are relevant to the design of information systems to enumerate and geocode violent incidents. Currently, Dr. Henning is directing the evaluation of a psychoeducational intervention for children witnessing domestic violence and is co-investigator of the evaluation of a responsible fatherhood program. He is actively involved with the Oversight and Monitoring Committee and the Research Committee of the Shelby County Domestic Violence Council. Andrew J. Bush, Ph.D. Dr. Andrew Bush is an Associate Professor of Biostatistics & Epidemiology in the Department of Preventive Medicine at the University of Tennessee, Memphis. He currently also holds a joint appointment as Associate Professor in the Department of Physical Therapy. A respected statistician in both the academic and private sector, Dr. Bush has written many professional articles as well as a widely used text on the analysis of experimental data. His professional experience includes 10 years as a university professor and 13 as a researcher and department head in one of the largest private hospitals. Currently, his funded research interests include studying the impact of bicycle patrolling on police officer health in Memphis as well as the effectiveness of local jail diversion programs for the mentally ill. Formerly, Dr. Bush was a certified police officer in the state of Ohio where his action received commendation from the Federal Bureau of Investigation. Grant Somes, Ph.D. Dr. Somes is a Professor of Preventive Medicine at the University of Tennessee, Memphis, where he is Chief of the Division of Biostatistics and Epidemiology and Co-Director of the Memphis Alliance for Public Health Research. He has been working in the area of intentional injuries since 1982 with specific emphasis on gun ownership and subsequent violence. Dr. Somes' research interests include smoking cessation, domestic violence, and innovative techniques for statistical data analysis.
Current Research Projects | Pending Research Projects | Faculty | Bibliography | Top
Somes, G. W., Klesges, L. M., Henning, K., et al. (in preparation). The social context of handgun violence. To be submitted to, Journal of the American Medical Association. Coffey, P., Leitenberg, H., Henning, K., & Turner, T. (in press). Dating violence: Psychological adjustment and methods of coping. Violence and Victims. Klesges, L. M., Henning, K. R., Powell, W., & Mosley, J. (1998). Prevalence and predictors of child witnesses of domestic violence: Results from a criminal justice surveillance system in Shelby County, Tennessee. Submitted to, 4th International Conference on Children Exposed to Family Violence; San Diego, CA. Henning, K. R. & Klesges, L. M. (1998). Enhancing interventions for domestic violence through the use of GIS mapping technology. Submitted to, 4th International Conference on Children Exposed to Family Violence; San Diego, CA. Henning, K. R., Klesges, L. M., Gooch, M., Holdford, R, Epstein, A., & Brookoff, D. (1998). Children’s perceptions of severity, threat, and self-blame from interparental conflicts: relationships with child and parent characteristics. Submitted to, 4th International Conference on Children Exposed to Family Violence; San Diego, CA. Henning, K. R., Klesges, L. M., & Powell, W. (1998). Development of a court-based surveillance system for victims of domestic violence. To be presented at: Program Evaluation and Family Violence Research: An International Conference; Durham, New Hampshire. Bailey, J. E., Lee, M. D., Somes, G. W., Graham, R. L. (1997). Risk factors for violent deaths of women in the home. Archives of Internal Medicine, 157, 777-82. Rivara, F.P., Mueller, B. A., Somes, G. W., Mendoza, C. T., Rushforth N. B., Kellermann, A. L. (1997). Alcohol and illicit drug abuse and the risk of violent death in the home. Journal of the American Medical Association, 278(7), 569-575. Frueh, C., Henning, K., & Pellegrin, K. (1997). Anger and combat-related PTSD: Further psychometric evidence of an interrelationship. Journal of Clinical Psychology, 53, 871-878. Henning, K., & Frueh, C. (1997). Combat-related guilt: measurement and relationship to PTSD. Journal of Clinical Psychology, 53, 801-808. Henning, K., Leitenberg, H., Coffey, P., Bennett, T., & Jankowski, M. (1997). Long-term psychological adjustment to witnessing interparental physical conflict during childhood. Child Abuse & Neglect, 21, 501-515. Kellermann, A. L., Rivara, F. P., lee R. K., Banton, J. G., Cummings, P., Hackman, B. B. Somes, G. W. (1996). Injuries due to firearms in three cities. New England Journal of Medicine, 1438-1444. Coffey, P., Leitenberg, H., Henning, K., & Bennett, T. (1996). The relation between methods of coping during adulthood with a history of childhood sexual abuse and psychological adjustment. Journal of Consulting and Clinical Psychology, 64, 1090-1093. Coffey, P., Leitenberg, H., Henning, K., & Turner, T. (1996). Mediators of the long-term impact of child sexual abuse: Perceived stigma, betrayal, powerlessness, and self-blame. Child Abuse & Neglect, 20, 447-455. Henning, K. & Frueh, C. (1996). Cognitive behavioral treatment of incarcerated offenders. Criminal Justice and Behavior, 23, 523-541. Henning, K., Leitenberg, H., Coffey, P., Turner, T., & Bennett, T. (1996). Long-term psychological and social adjustment of adults who witnessed interparental physical conflicts as children. Journal of Interpersonal Violence, 11, 35-51. Henning, K., & Frueh, B. (1996). Assessment of guilt in veterans with PTSD. Poster presented at the Society for Personality Assessment, Annual Mid-Winter Meeting, Denver, CO. (Accepted for presentation). Kellermann, A. L., Hackmann, B. B., Somes, G. W. et al. (1993). Gun ownership as a risk factor for homicide in the home. New England Journal of Medicine, 329, 1084-1091. Kellermann, A. L., Rivara, F. P., Somes, G. W., Reay, D. T. et al. Suicide in the home in relation to gun ownership. New England Journal of Medicine, 327, 467-472.
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