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Siobhan Morris: Hello and welcome to Disruptive Voices from UCL Grand Challenges. I'm Siobhan Morris, your host and assistant director of UCL's Grand Challenge of Mental Health and Wellbeing. In this episode we are exploring promoting safe adolescent relationships, a cross disciplinary co produced approach. A project taking a serious look at adolescent intimate partner violence. It's a widespread and often overlooked factor that can have a profound impact on young people's mental health and well being.
Research shows just how concerning this issue is. In a survey of more than 10,000 UK teenagers, 27% said they'd been in a romantic relationship in the past year and almost half of those reported experiencing violent or controlling behaviours.
What makes this project particularly innovative is its blend of behavioural genetics, psychology and co production, bringing together researchers, young people and educators both to co create solutions, not just study the problem. So today our experts will explore why adolescent relationship violence is such a crucial issue for mental health prevention, how cross disciplinary approaches can help uncover new insights and what co produced methods can bring to create meaningful and lasting change.
I'm joined by two brilliant guests today. Dr. Patrizia Pezzoli project co lead and lecturer at the UCL Division of Psychology and Language Sciences and Professor Rochelle Burgess, project co lead and professor of Global Mental Health and social justice at UCL's Institute for Global Health. Thank you both very much for joining me.
So Patrizia let's start with you. Could you give us a bit of background on the project, what's it all about, why it matters and what you hope to achieve.
Dr Patrizia Pezzoli: Thanks so much for having us Siobhan. Um, so as you said in, intimate partner violence affects sadly a large number of young people with potential serious consequences. And the project is really all about understanding how we can do a better job of preventing intimate partner violence among young people um, and in turn protect their mental health. So one approach to preventing intimate partner violence among young people is school based relationship education. And this is of course very important. But when we look at the evidence, uh, that the effects on actually uh, preventing intimate partner violence from happening, especially in the long term, are often quite modest.
And based on our research we think that part of the problem, part of the reason why this is, is that relationship education tends to take a one size fit all approach, so delivering the same content to all young people. However, young people vary greatly in how they navigate relationships and why they might be at ah, greater or lesser risk, uh, including how they respond to contextual influences such as the norms and expect embedded in their environments.
And my broader research focuses on understanding these individual differences. And one factor that's really central to these individual differences is personality. So there's now quite robust evidence of a link between personality and intimate partner violence. And this link runs in both directions. So exposure to intimate partner violence can affect personality of development, uh, but also personality. So things like how impulsive someone is can influence the risk of experiencing uh, and engaging in intimate partner violence. Um, and here it's important to stress that this is about risk and probability. It's not determinism. So these are tendencies and they can be addressed by intervention. And in fact there is evidence from the field of substance use prevention that school based education that is tailored to different personality profiles, um, can show remarkable effects in reducing substance use rates. So these interventions are not aimed at changing someone's personality, but rather young people are grouped by their personality style and the content used in the intervention is matched to this so that young people discuss scenarios that they're more likely to encounter, uh, also because of their personality. So building on all of this evidence, our project is essentially the foundational cross disciplinary research that is needed to explore whether this kind of approach could work better for preventing intimate partner violence among young people.
So what we're doing is we're systematically studying how personality shapes, um, what young people think is or isn't okay to do within romantic relationships, um, and what behaviours might put them at risk, um, as well as validating this link between personality and intimate partner violence, um, over and above the risk factors, both genetic and environmental, that are common to these traits and experiences. Exposure to intimate partner violence, especially early in life, can have a host of detrimental consequences. We know that intimate partner violence can almost double the risk of developing a mental disorder. We know that then in turn having a mental disorder can impact somebody's functioning in their lives, uh, in many different ways. We know that there are sort of social welfare and justice implications of involvement in intimate partner violence. So especially for a young person, the consequences can be really devastating. And so the focus on prevention is uh, hopefully to buffer against all of those consequences. So preventing someone from experiencing intimate partner violence early in life could really change a trajectory for that person, um, and help them develop safe and uh, healthy relationships and also succeed uh, in their education, in their professional lives, uh, as well as in their social lives. So the potential ripple effects of successful prevention are uh, many and are long term.
Siobhan Morris: thank you. So how has the project progressed so far? And also looking ahead, what are the bigger picture goals once you've gathered and analysed the findings.
Dr Patrizia Pezzoli: We're really pleased with how the project is going. Um, so the project includes three interrelated trends. The first trend is a secondary data analysis of existing UK based, um, cohort datasets, including the Avian Longitudinal Study of Parents and Children, or alspac, and the Twins Early Development Study, or teds. Uh, and we're using behavioural genetic methods, um, to look at how personality vulnerability in childhood and adolescence relates to intimate partner violence in young adulthood.
And it's early days, but we're already seeing support for the idea that both internalising vulnerabilities or things like emotional distress and externalising vulnerabilities like, uh, conduct problems, relate to future involvement in intimate partner violence. The second strand is a school based mixed methods data collection where we are asking young people, people age 14 to 15 from schools in England, uh, to complete questionnaires and to take part in interviews which focus on their attitudes towards, uh, intimate partner violence and how they might differ by personality. And the third strand, which really runs through everything, is co production. Um, so we're collaborating with teachers from partner schools, um, with mental health professionals from charities that support young people with experience of intimate partner violence and with young people themselves. Um, and this collaboration is really shaping how we do things, such as the way we've designed questionnaires and the language we use when talking about the project and the lived experience. Input will be absolutely central also to how we communicate the findings of the project. Uh, and in terms of the bigger picture goals, um, once we have the full picture from the different strands, uh, the goal is to move towards developing a manualised prevention programme that is personality tailored and which we would want to properly evaluate, um, with a mechanistic trial. So the grand challenges are really allowing us to do the essential groundwork for a more targeted and hopefully more effective, uh, prevention programme.
Siobhan Morris: Great, thank you. Rochelle, if I may turn to you now. So, Patrizia already touched on the role of co production in the project and how the project places a really strong emphasis on co production. Could I ask what does that look like in practice and why is it so important in this kind of research?
Professor Rochelle Burgess: Thanks, Siobhan. I, um, mean, I think Patrizia has done a beautiful job of talking about a project that is in a very, uh, simple and clear way that is actually incredibly complicated. I think actually when you start to think about, and actually engage people in thinking and talking about personality and how that sort of shapes the way we are in the world, there's a bit of tension there. And one of the biggest things that co production really contributes to and supports in this project is the opportunity to sort of like pick apart what that actually means in practise for people. So in essence, when we're talking about, you know, personality, it's very much about thinking about what are the things that sort of shape the way we go through the world. And so it would totally make sense that those sort of dynamics and um, factors would shape all of our encounters, whether they be positive or negative ones, that put us at more risk. Um, and so then if you're sort of trying to really get at sort of how people have this sort of lived experience that shapes the way they engage with environments and the world around them, then co production to me is really the only way that projects like that should be done because it keeps you really close to how people actually make sense of what that means.
Um, so in this project, what it looks like in practice, um, is, and I think that's the beauty of what the Grand Challenges Project has allowed us to do. It's sort of given us space to really sort of bring people along in the journey with us and thinking through what these big ideas mean for sort of practical interventions to impact the lives of young people. Um, so it's about pausing and thinking through and talking through and having sort of deep dialogue about sort of big ideas in the, in the intervention, um, or not the intervention. Sorry, I'm an interventionist, so I use that word far too often. We're not at intervention stage yet, um, but essentially working with people who the intervention would be for talking through these sort of big different concepts of what ideas mean. What are the best ways to talk to young people about intimate partner violence? What, what is the language, the best language to use in ways that is inclusive and, and safe for people? Um, what does it mean to work with people with lived experience who have experienced such a traumatic life event? How do we do that safely? What are the parameters for that? And taking time to really think through what that means in the real world.
So co production is for me and in this project in particular, really about a slowing down, about how we do research. Slowing down to give space to think about some of these deep conceptual ideas that sometimes get taken for granted, I think by science. As we sort of move ahead to try and respond to real world challenges and sort of just to take our time with them so that when you do produce this outcome and you know, we will build an intervention out of this, that intervention will make sense to everybody. Who it's for, people who would be delivering it, where it'll be located, how young people engage with it. And not so. Not just in a sense of um, sort of this idea and the big concepts of personality and IPV, but actually the pragmatics of it and sort of how that gets delivered. Um, so, yeah, I guess in practice what that means is it's this slowing down, this rethinking about time and how we sort of engage in research, creating space to have conversations, um, that you know, sometimes are about big things but the importance and the value of dialogue. I can hear my nose getting more and more stuffed with every phrase. Um, and you, Siobhan, I think you're just being very gentle and wonderful with us as we're both sort of suffering from colds. But uh, um. I hope the passion for what we're doing is still coming across because it is such a beautiful project that Patrizia has come up with and I'm really just along for the ride and feel very honoured that she's asked me to come along the ride with her. It's been great.
Siobhan Morris: Thank you, Rochelle. It's so interesting, the idea of slowing down in research and not rushing to the intervention, but making sure that that uh, intervention will work from multiple different communities. It's a really interesting concept and not one that is often in the endless cycle of research grants and funding streams. Not often do you have that time, I guess, to slow down. So really interesting to hear how co production can be done in a much more gradual and iterative way.
Dr Patrizia Pezzoli: Can I add something about timing as well? So something that has required a lot more groundwork understandably, is involving young people with experience of intimate partner violence in the project. Um, and this has taken far longer than we had planned. But I think it's very understandable if you keep in mind, uh, then sort of the partners that need to be involved to make that happen. So we're trying to work with the charity, we're working with the charities that support young people with experience of intimate partner violence. And these charities have different priorities, um, not necessarily a focus on doing research. M and so any participation in research needs to be very carefully designed and needs to be timed appropriately. Um, because people who um, are um, so that the service users will have um, very often very chaotic lives or will be facing uh, ongoing challenges and potentially ongoing trauma. Um, you can't ask someone to take part in research and to be a core researcher, at any time. Uh, so this needs to be uh, sort of carefully designed so the solution we've found with the charities is to uh, involve um, young people who have um, been sort of with the charity for a long time, um, and who might be able to contribute some thoughts also from having received interventions and might be in a place where they can sort of use their experience to contribute to the research meaningfully.
Professor Rochelle Burgess: And I think what's really nice about your example there, Patrizia is actually gives another example of what co production looks like in practise, which is actually a willingness among a research team to completely shift strategy or completely change timelines or adjust these things like a necessity for real flexibility around these things because participation and involvement needs to be enabled and supported and sort of structured. Um, and that cannot work on sort of like how we sometimes imagine our traditional research timelines. Like the real world doesn't operate in the way that we sometimes want it to. Um, and so what having a co production lens allows you to do is sort of actually makes it okay for you to have that flexibility and sort of find ways to sort of push back on maybe a classical approach to how you sort of might time things. And I guess what's nice about this particular project is you've got these multiple streams so there are some things that just always keep going in the back. You know, there's secondary analyses are going and ticking over and producing really great stuff, um, which gives us space and confidence to say actually no, we can do that thing slower, we can make space to do it right. And so bringing co production into projects or methodologies where you might not necessarily think that they always align with I feels particularly powerful here for sort of that willingness to how we I guess make space and you know, enable and support participation, uh, meaningful participation,
Siobhan Morris: really interesting, and sustained participation as well. I guess. So it's not a one off. We've co designed the research question with participants but then we haven't engaged them for the next six months. You know how you keep that sustained uh, over time approach. Really interesting. Thank you both. So you touched on working with partners and working across different sectors and the benefits to doing that. Um, I wanted to ask about working across different disciplines within research as well and what are some of the challenges but also the benefits of taking that approach for this specific project?
Professor Rochelle Burgess: I think Patrizia should answer that because she's had to carry my non-quant brain for a little while now. And so it would be really interesting to hear what that feels like in this particular type of collaboration. I think you've explained it to me before in a really nice way that's made me feel good about myself. So I'm very happy to hear it again.
Dr Patrizia Pezzoli: So to me it's been incredibly stimulating to work across disciplines and to collaborate with Rochelle in particular. Um, so when you work on a cross disciplinary project you might need to expect that it's not going to be as smooth a ride as if you were working with someone who speaks the same language, uses the same tools, thinks in the same way. Inevitably, if it's a good project, you're going to be challenged. Um, so I've been challenged when designing the methods that we use. For example in the school based study. Uh, I've been challenged um, in our approach to co production and to recruiting for example participants to co productions. I've been challenged a lot in thinking about the language that we use and how someone is not embedded within the same research, might perceive or interpret um, the terminology that we use. Um, and this has actually only made the project better and if anything it's made me better as a researcher, uh, because it's forced me to think about how again people who are not um, within my field will understand the work I do.
So that has hopefully made me a better communicator, uh, has hopefully allowed me to engage with different stakeholders, with different partners and different people, uh, better and invol them in the research, uh, and allow them to sort of understand what it is that we do and why and address some of the misconceptions that come with doing this kind of research. Because let's not forget, if you're studying individual factors, individual level characteristics that are associated with the risk of experiencing something like intimate partner violence, there's a huge risk that the findings and the research more broadly will be misinterpreted as being stigmatising or being sort of victim profiling or perpetrator profiling, which is absolutely not what we're trying to do. Um, what we're trying to do is to keep into account the fact that there are these individual differences and if we ignore them we might actually risk leaving um, the most vulnerable unsupported. So we need to understand these individual differences and we need to think about how we do prevention in a way that accounts for them. Um, and as I said, this means tailoring or targeting interventions, making interventions more targeted to support everyone, particularly those who are most vulnerable.
Professor Rochelle Burgess: I think you did that really well.
Siobhan Morris: I see what you mean. Rochelle, she's got a great answer to that one.
Professor Rochelle Burgess: I mean in another life, which feels like another life, I Sort of studied classic psychology. So I was, you know, that's what was my undergrad, um, my first degree in developmental psychology and all. So I spent a lot of time thinking about things like personality and motivation and emotion and these different types of things. And then as I moved into a space with psychology that became, I guess, more socio-political, more qualitative instead of quantitative, I kind of had left those bits behind, the individual behind rather than. And taking it and to look at the individual in context. And what for me has been really nice about this project is to come back again to where I started and really think about, well, actually, what have I learned about putting the individual in society that then can be used into how we think about supporting individuals? And it really is this idea about getting deep understandings about how risk manifests in lots of different ways, sort of, you know, collective and social risk factors, things that are happening at sort of like big levels, but bringing it back down to the individuals that are navigating the world in a certain way with or without resources.
And so actually talking with Patrizia has made me think, oh, actually, yes, personality types are actually these ways of going through the world. Like they're the types of resource, uh, a type of resource that people have, you know, in their arsenal. And sometimes that resource is not well suited to parts of the context that you find yourself in, or sometimes that resource is a risky resource and you need other things to counteract that. And, and I think that that is a really important thing to hold onto when we try to action the learnings about sort of collective and societal and political risk in individual lives. And so it's more about how these things can come and sit together and work together, and how do they sort of like collectively advance us in certain different directions. So I, you know, this stuff is really exciting to me and very nice to sort of have a coming home to some of that classic psychology stuff. So for me, that's been the extra nice thing on top of, you know, a wonderful new set of colleagues in the division of psychology. So it's been great.
Siobhan Morris: Thank you Rochelle, is going to ask why your kind of personal interest in this topic you spoke about there, the kind of research methods, um, is it a topic that you think in terms of personality types and the effects? Is it misunderstood? It's not spoken about very often in society at large, as you just mentioned. Why might that be? You know, what is a kind of driving factor for you to get involved in this particular topic?
Professor Rochelle Burgess: I think there's a couple things for me I am um, uh, really interested in, I suppose, how labels can sometimes be used in sort of ways that narrow our visions of people. And so I think for me I'd always imagined that personality categories felt like that in sort of some of the work that I had studied a very long time ago. But I think actually in talking with Patrizia it sort of connects to sort of this previous question about why cross disciplinary work is so good. It sort of really just expand. It just sort of blew my assumptions about things out of the water. So for me I'm sort of, I'm always interested in risk, how risk manifests in people's lives to have negative impacts on their mental health and well being.
I have done work in the space of intimate partner violence in, and violence against women in low-resource settings globally in the past. So I've been involved with uh, projects looking at risk like that, um, in South Africa, um, led by one of my amazing colleagues at the Institute for Global Health, Genvive Manel, who's sort of a, a global expert on intimate partner violence in sort of high prevalence settings uh, in the global majority world. And so you know, uh, that's sort of an intersection and a crossing back into sort of different phases and spaces of my life and also really a chance to sort of unpack some of the taken-for-grantedness of some of these sort of big concepts that sort of actually float, float around in psychology but aren't used in this. I wasn't encountering them in the other space where I was doing work on intimate partner violence. And you know that it wasn't really conversations about personality type or anything like that. And then actually you sort of hear it and you pause and you think I want to understand that a bit more. It can't be just what it looks like on um, on the tin. And I think that's actually what the, where the most fruitful science comes from in a grand sense of things, that there's this idea or this concept that is taken for granted and someone pauses and says actually there's a lot more going on here than we think there is and can we start to unpack and pull that apart? And that's, you know, Patrizia is doing that with some crazy maths and stuff that I'll never understand but like I understand the outputs of it and they tell a really interesting and powerful storey that can shape the way that we support people.
Siobhan Morris: Thank you. Patrizia. Finally, how can students, practitioners or other researchers find out more about the project or get involved in the next stages in your future work.
Dr Patrizia Pezzoli: Yes. So anyone who's interested can find out more on the website saferelationshipsproject.co.uk and they're also very welcome to just get in touch with uh, me directly. Um, so the whole ethos of the project, as Rochelle has beautifully explained, is that good research on adolescent relationships has um, to involve the people who are closest to those relationships. Um, so the more voices we can bring in, the better. Yeah. So if you're a researcher interested in collaboration, a practitioner working with young people or someone with lived experience would like to know more about the project or our approach to co production, uh, would generally love to hear from you.
Siobhan Morris: Thank you both. I just wanted to check if there was anything in particular you wanted to add.
Professor Rochelle Burgess: Um, how has the school's been going? Do you think that the. And now I'm slipping into host mode. I don't know how to turn that off. But like, um, do you know, I feel like it would be maybe nice to reflect on how if you feel the co production has shaped your experience in schools in a positive way. Because we did all that stuff with the schools and now you're in the schools and so what has that looked like in, in the real world?
Dr Patrizia Pezzoli: Co production has really, really helped us think about how we do things and uh, particularly how um, we approach the school-based data collection. So we have received input, really helpful input from teachers at participating schools about how to present the research to young people to try and ensure that there is interest that they understand why we're doing this research, what will be asked of them, um, how we're going to be using their data, the information that they share with us, um, and what, what they would get in return. Um, so we hope we've done a good job in sort of explaining to young people that this is really going to help us um, understand their strengths and vulnerabilities and the challenges that they might have to navigate, uh, when sort of developing their first romantic relationships. Um, and a few examples of how this has impacted the way we do things. Um, so first of all we had um, um, so we're using, for example, let's take, let's start with the questionnaires. We um, have to use questionnaires that have been validated, that have been used in previous research. But teachers have really helped us understand how the instructions for uh, completing those questionnaires could be delivered in a way that would make them more accessible. Um, there were also many uh, terms that, that students age 14 to 15 would not necessarily be familiar with. So we've included some definitions, um, that would allow them to better understand the questions that they're being asked.
Um, we've discussed uh, the order of questions, um, in a way that would sort of allow students to sort of start with maybe questions that don't feel as personal, that are more about their opinions, and then follow on with questions that are more about their, for example, their personalities and sort of describing themselves and uh, the discussions with teachers have also helped us understand how to actually administer those questionnaires in school. So, uh, we were just in schools recently and uh, it was really important for us to be able to sort of be there and provide that sort of one on one support if a student was struggling to understand some of the questions or uh, they had questions about sort of what things meant or how the uh, information that they were providing was going to be used. So it was really important for us to sort of plan for us to have sufficient sort of researchers, uh, on site, uh, sufficient people to be, you know, able to explain what we were doing and to support students as they were doing the questionnaires. Um, and I think this has probably helped getting better quality data, if you will. So hopefully better, more valid responses from the young people.
Siobhan Morris: Thank you. And I guess really important just to show that you can have these conversations in schools amongst students as well, that this can be a topic that is discussed.
Dr Patrizia Pezzoli: 100%. I do think some of them have. Some of the students didn't know that we would be doing research on these things necessarily. They weren't familiar with the fact that there would be research, um, on these things. And of course young people differ greatly in their backgrounds and in their understanding of what academic research might be like. So I think for some of them to understand that it's actually something they can get involved in that is very close to their lives and actually that might shape, might shape their lives and might shape their relationship. Education that they receive, for example, was really new and I think, um, I really value that. I really value the opportunity to make research and academic research a bit more accessible and bit more closer to the young people.
Professor Rochelle Burgess: I think that will be so important in so many ways for them. Um, I feel like you might in 10, 15 years time when you're full. Prof. You might sort of see some of these students coming through to study with you because you've just sort of created this different way of seeing the world, of viewing the world, of seeing yourself in the world. And I think that that is another powerful piece of co production that we often, you know, forget that it actually can have individual impacts on, on how people relate to the world. And there's all kinds of theory about critical education that I won't go into here, but that's essentially sort of give people an opportunity to see themselves and their relationship to the world differently. And things in support environments can totally change. So look out for your future PhD students. And they'll say, oh, Prof. I was in that study you did a billion years ago. And the whole thing comes full circle and you get weepy and it's very nice.
Dr Patrizia Pezzoli: I very much look forward to that. So, yeah, so part of the things we're doing in schools is also, uh, we're offering them sort of we can go into the school and do presentations on the research that we do on what it means to do research and why we're doing research, um, uh, involving young people, um, and we're hoping that that will um, again make some of them curious about this world. We're also hosting, uh, students from schools who can come and sort of visit UCL to understand what the life of a researcher looks like. And for these initiatives, we're particularly target those who might not be exposed to this, you know, to academic environments, um, otherwise. So we're really hoping that we'll be giving something back to schools for the time, uh, that they're investing to take part in the research.
Siobhan Morris: And Rochelle, the point you made around focusing on the individual brought to mind, uh, the comment earlier. Excellent point you were making earlier, around time and slowing down. And do you think there's a tendency to focus on interventions that work for the largest proportion of a community rather than necessarily thinking about interventions on an individual level?
Professor Rochelle Burgess: Yeah, and that's like a global thing. Everybody wants to like the silver bullet that will help as many people as possible. And then you sort of like in the production of those types of interventions which historically very rarely work, um, you sort of leave out so much of the context or the individual factors that really shape what an intervention might mean to people. And so I think now in biological sciences, you're getting an alternative narrative around precision medicine that I think will actually help the way we do prevention and promotion to be more meaningfully targeted around different thinking around context, you know, context and individual context and relational context and social context that are really targeted to the actual experience that people are having. And I think the best way that you get interventions like that actually is through bringing people who the interventions are for along in that journey with you. Like you can't make an intervention for people without them. That's always been the strangest thing to me my whole career, just really, I couldn't understand why this wasn't happening. And it's been really nice to see this shift towards the fact that actually things that are for people should include the people, therefore, and hopefully that stays our practice. Now for the long term
Siobhan Morris: Mental Health Awareness Week this year is Action. You know, this project just, you know, it doesn't have to be action in terms of what we might think of as a traditional intervention. And I think we had a really nice conversation around that as well.
Dr Patrizia Pezzoli: And I think impact as well, because there's a lot of conversation in, you know, for us academics, there's a lot of pressure to have impact. And what it actually means is sometimes, you know, citations on your manuscripts, which is great. But actually doing co production with Rochelle has really taught me about many other ways in which it can have an impact. Your research can have an impact. They're so valuable and so tangible and so real. Um, so that's really been amazing. So to be able to, as I was mentioning, see the curiosity in a young person has never heard about research, particularly on sensitive topics like this, um, or sort of how, ah, willing both schools and charities, uh, that support young people can be to get involved in research and to try and sort of shape how we do research and how we communicate. The research, uh, has been really inspiring and has been to me a great example of impact, um, because we're involving the public in making research as well as in communicating research that, uh, gave me goosebumps.
Professor Rochelle Burgess: that, uh, gave me goosebumps. I think that's lovely. That's so nice.
Siobhan Morris: What a great conversation. Thank you both.
Dr Patrizia Pezzoli: Thank you so much, Siobhan and everyone.
Professor Rochelle Burgess: It was lovely.
Siobhan Morris: Patrizia, Rochelle, thank you both very much for joining us today. You've been listening to Disruptive Voices. This episode was presented by me, Siobhan Morris, produced by Decibelle Creative and edited by Annabelle Buckland at Decibelle Creative. If you'd like to hear more of these fascinating discussions from Disruptive Voices, make sure you're subscribed to this podcast so you don't miss future episodes. And, come and discover more online and keep up with the latest grand challenges, news, events and research. Just Google UCL grand challenges. Thank you both once again.