Clinical trial NCT06783231: Identification With the Aggressor (IWA)
Official title: Implications of Identification With the Aggressor (IWA) : a Randomized Control Trial
Study type: INTERVENTIONAL
Overall status: ENROLLING_BY_INVITATION
Phase: NA
Conditions: Female
Abuse Neglect
Abuse Physical
Abuse, Child
Keywords: identification with the aggressor
abuse
trauma
Lead sponsor: Tel Aviv University
Sponsor class: OTHER
Collaborators: name: Bar-Ilan University, Israel
First posted: 2025-01-20
Enrollment: 300
Sex: FEMALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: 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.
Primary purpose: PREVENTION

Brief summary: 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.

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.

Primary outcomes:
measure: International Trauma Questionnaire (ITQ)
timeFrame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)
measure: PTSD Checklist for DSM-5 (PCL-5)
timeFrame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)
measure: Patient Health Questionnaire-9 (PHQ-9)
timeFrame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)
measure: Identification with the Aggressor Scale (IAS)
timeFrame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)
measure: The Interpersonal Trauma Doubt Scale (ITDS)
timeFrame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)
measure: Difficulties in Emotion Regulation Scale (DERS-18)
timeFrame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)
measure: Maudsley Violence Questionnaire (MVQ)
timeFrame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)
measure: Reading the Mind in the Eye Test (RMET)
timeFrame: T2: (immediately after the manipulation= The IWA lab task)
measure: Implicit Association Test (IAT) - new version attitudes towards the characters of the IWA task
timeFrame: T2: (immediately after the manipulation= The IWA lab task)
measure: Implicit Association Test (IAT) - new version attitudes regarding harm/violent behavior
timeFrame: T2: (immediately after the manipulation= The IWA lab task)
measure: Dissociative Experiences Scale-II (DES-II)
timeFrame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)
measure: The Selflessness scale (SS)
timeFrame: Change between T1 and T2: (48 hours before and immediately after the manipulation= The IWA lab task)
measure: 7. Sense of Body Boundaries Survey (BBS)
timeFrame: T2: (immediately after the manipulation= The IWA lab task)
Secondary outcomes:
measure: Manipulation check questions
timeFrame: T2: (immediately after the manipulation= The IWA lab task)
measure: The short form of the Childhood Trauma Questionnaire (CTQ-SF)
timeFrame: Baseline ( screening phase)
measure: Characteristics of the assault
timeFrame: Baseline ( screening phase)
measure: Open questions
timeFrame: T2: (immediately after the manipulation= The IWA lab task)
measure: Background questionnaire
timeFrame: Baseline ( screening phase)
Other outcomes:
Locations:
Study officials:
affiliation: Tel Aviv University
name: Yael Lahav, Phd
role: PRINCIPAL_INVESTIGATOR
affiliation: Bar Ilan University
name: Danny Horesh, Phd
role: PRINCIPAL_INVESTIGATOR
References: