Identification With the Aggressor (IWA)

Official title

Implications of Identification With the Aggressor (IWA) : a Randomized Control Trial

Overview

This is a randomized control study, comprising of 2 assessments :before (T1) and after (T2) the identification with the aggressor (IWA) lab task.

Detailed description

Background: Abuse is a severe trauma that has multiple psychological implications. One of the most paradoxical effects of CA is the identification with the aggressor (IWA) phenomenon. Research to date has indicated associations between IWA and various negative outcomes, such as PTSD, dissociation, guilt, suicidality, and increased likelihood of returning to abusive relationships . Nonetheless, these studies were based on a cross-sectional design, and thus excluded the possibility of establishing causality or shedding light on the complex dynamics of IWA. In addition, to the best of our knowledge, no experimental research has been conducted on IWA thus far. This type of study is required to examine causal relationships between IWA and potential outcomes. In an attempt to bridge this gap, the current study will serve as a pilot study examining the efficacy of a new lab task designed to ethically but validly manipulate a state of IWA among women with and without a history of abuse. Developing a tool that experimentally manipulates IWA under laboratory conditions will allow examining the influences of IWA, while controlling for other consequences of the abuse, trauma, or life circumstances. In order to test the effectiveness of our lab task, the investigators will compare measurements of relevant outcomes before and after the task in the process.

Methods:

This is a randomized controlled trial comprising of 2 assessments :before (T1) and after (T2) experimental manipulation. Participants with and without history of interpersonal abuse will be randomly allocated to one of three study conditions and will receive different instructions before listening to the audio recording of the identification with the aggressor (IWA) lab task: (1) The 'identification with the aggressor' group will be asked to try to identify, understand and adopt the point of view of the perpetrator; (2) The 'identification with the victim' group will be asked to try to identify, understand and adopt the point of view of with the victim; (3) The control group will be asked to pay attention to the story's details and to try and remember as much details as they can.

Population: the investigators will recruit 300 female adults with and without history of interpersonal abuse. Participants with a history of interpersonal abuse will be identified via questionnaires during screening. The sample size was calculated based on power analyses via G\*Power 3 software derived from p-value of .05 and statistical power of .80.

Tools: outcome measures will be consist self-report questionnaires as well as Reading the Mind in the Eye Test (RMET; Baron-Cohen et al., 2001) and two new versions of Implicit Association Tests (IAT; Greenwald, McGhee \& Schwartz, 1998) created for the purpose of the present study. The experimental manipulation will comprise of the identification with the aggressor (IWA) lab task.

Expected Results: Findings may advance the understanding both mechanisms at the basis of IWA as well as its effects, and in this way may contribute to developing preventative measures for IWA among abuse survivors.

Interventions

• Behavioral Identifying with the aggressor
  The IWA lab task consists 10 min audio recorded story, portraying a romantic relationship between two women (Lori and Sophia), in which one of them (Lori - the perpetrator) is being aggressive towards the other (Sophia - the victim). The story was carefully designed to align with ethical considerations - it is non-graphic, contains no severe acts of violence, and mostly describes a romantic power dynamic which may be considered abusive or toxic. The three groups of participants will receive diff
• Behavioral Identifying with the victim
  The IWA lab task consists 10 min audio recorded story, portraying a romantic relationship between two women (Lori and Sophia), in which one of them (Lori - the perpetrator) is being aggressive towards the other (Sophia - the victim). The story was carefully designed to align with ethical considerations - it is non-graphic, contains no severe acts of violence, and mostly describes a romantic power dynamic which may be considered abusive or toxic. The three groups of participants will receive diff
• Behavioral Neutral
  The IWA lab task consists 10 min audio recorded story, portraying a romantic relationship between two women (Lori and Sophia), in which one of them (Lori - the perpetrator) is being aggressive towards the other (Sophia - the victim). The story was carefully designed to align with ethical considerations - it is non-graphic, contains no severe acts of violence, and mostly describes a romantic power dynamic which may be considered abusive or toxic. The three groups of participants will receive diff

Primary outcome measures

• International Trauma Questionnaire (ITQ) [Time frame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)]
• PTSD Checklist for DSM-5 (PCL-5) [Time frame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)]
• Patient Health Questionnaire-9 (PHQ-9) [Time frame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)]
• Identification with the Aggressor Scale (IAS) [Time frame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)]
• The Interpersonal Trauma Doubt Scale (ITDS) [Time frame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)]
• Difficulties in Emotion Regulation Scale (DERS-18) [Time frame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)]
• Maudsley Violence Questionnaire (MVQ) [Time frame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)]
• Reading the Mind in the Eye Test (RMET) [Time frame: T2: (immediately after the manipulation= The IWA lab task)]
• Implicit Association Test (IAT) - new version attitudes towards the characters of the IWA task [Time frame: T2: (immediately after the manipulation= The IWA lab task)]
• Implicit Association Test (IAT) - new version attitudes regarding harm/violent behavior [Time frame: T2: (immediately after the manipulation= The IWA lab task)]

Secondary outcome measures (5)

• Manipulation check questions [Time frame: T2: (immediately after the manipulation= The IWA lab task)]
• The short form of the Childhood Trauma Questionnaire (CTQ-SF) [Time frame: Baseline ( screening phase)]
• Characteristics of the assault [Time frame: Baseline ( screening phase)]
• Open questions [Time frame: T2: (immediately after the manipulation= The IWA lab task)]
• Background questionnaire [Time frame: Baseline ( screening phase)]

Eligibility criteria

Inclusion criteria

• Good command of Hebrew language
• Age 18 or older

Exclusion criteria

• Diagnosis of dissociative identity disorder
• Persistent drug use
• Diagnosis of autism spectrum disorder.
• Hearing or vision difficulties (that may impair the experimental manipulation and participants' ability to complete the Reading the Mind in the Eyes and the IAT tasks).
• Being currently subjected to abuse
• Suicidal risk, as assessed by a clinical interview.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Prevention

Study locations

Center list to be confirmed — check the primary protocol.

Identifiers

NCT: NCT06783231 · 0009390-2

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗