Intimate partner violence, parental substance misuse and the mental health of parents & children - a retrospective open birth cohort

Date of Approval
Application Number
Lay Summary
Almost one in four children and young adults in England have experienced domestic violence or abuse at home, which we refer to below as 'intimate partner violence’ or IPV. IPV tends to co-occur with parental mental health problems, substance abuse, and mental conditions in children and adolescents. Given that half of mental health problems occur by adolescence, it is imperative to determine how IPV, parental substance abuse, and parental mental health affect children and young people's mental health. We have little understanding of how these relationships operate.

The purpose of this project is to gain a better understanding of how IPV, substance abuse and parental and child mental health are related. For instance, whether families experiencing all three parental adversities, tend to be first identified in medical records as experiencing IPV, substance misuse or mental health problems. We will also compare the mental health of children exposed to parental IPV, substance abuse, and mental ill-health (and their combination) and those who were not exposed.

We will achieve this by creating a cohort of parents and their children followed over time, based on primary and secondary care records. By assessing variation in presentations related to IPV, substance misuse and mental health in parents and children’s routine health records, our research will guide GPs’ questioning about health within the family, checking the health of family members through the GP record household link, and follow up appointments. Our research will also guide the development of family-focused interventions that use existing general practice data.
Technical Summary
Intimate partner violence tends to co-occur with parental mental health problems and substance misuse having a strong relationship with child and young people’s mental health problems. However, there is a dearth of studies that explicitly examined the directionality of the relationship between these adverse parental experiences, and their association with children and young people’s mental health. The main objective of our study will be to better understand the longitudinal interrelationships between intimate parental violence, substance misuse and parental mental health in general practice and how these problems relate to child and young people’s mental health and child maltreatment. Findings will inform early detection and intervention for families at risk of these problems in primary care. We will aim to address this objective in the routine data records.

The clinical sample will include a birth cohort of mothers, fathers and children (born 1987 – 2021) from CPRD linked data using the CPRD mother-baby link. Children will be followed from birth to the latest available data point and linked to the Hospital Episode Statistics and Office for National Statistics for mortality data.

The interrelationship between intimate parental violence, parental substance misuse, parental mental health and child and young people’s mental health will be investigated by applying cross-lagged panel models. These are a type of structural equation modelling allowing for studying two or more variables measured repeatedly at one or more points in time. Cross-lagged models are typically used with longitudinal datasets to describe directional influences or reciprocal relationships between variables over time.

Findings will help us to better understand which of the parental adversities (parental intimate partner violence, parental substance misuse, parental mental health) tends to be recorded first in medical records, how strongly these events are inter-related over time, and how they influence children and young people’s mental health.
Health Outcomes to be Measured
Incidence of mental health problems among children and young people; incidence of child maltreatment.

Ruth Gilbert - Chief Investigator - University College London ( UCL )

Dawid Gondek - Corresponding Applicant - University College London ( UCL )

gene feder - Collaborator - University of Bristol

Laura Howe - Collaborator - University of Bristol

Linda Wijlaars - Collaborator - University College London ( UCL )

Pia Hardelid - Collaborator - University College London ( UCL )

Rebecca Lacey - Collaborator - University College London ( UCL )

Stephen Morris - Collaborator - University of Cambridge

CPRD Mother-Baby Link;HES Accident and Emergency;HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation