Testing a social-cognitive model of intimate abusiveness among substance-dependent males

Throughout history, the human race has been characterized by the use of physical and emotional aggression by individuals, particularly males, in their intimate relationships. Intimate abusiveness is particularly common among substance-dependent males. As a result of male intimate abusiveness, victims suffer a variety of problems, ranging from emotional trauma to death due to physical injury. Despite increased attention to this problem, our understanding of the process leading to intimate abusiveness is far from comprehensive. The primary purpose of the present study was to expand our understanding of intimate abusiveness through the application of a social-cognitive model of intimate abusiveness among substance-dependent males. Participants were 57 males from an inpatient substance abuse treatment program. Subjects completed questionnaires indicating their level of intimate abusiveness. In addition, they completed partner-related attribution measures, as well as coping response measures indicating how they would interpret and handle five ambiguous vignettes involving their partner. It was hypothesized that violent men would attribute greater negative intent and responsibility to their partner, and that they would choose to handle the ambiguous vignettes in less competent ways compared with nonviolent men. Further, it was predicted that the association between intimate abusiveness and competency of coping responses would be mediated by attributions made about the partner. Results of the study generally supported predictions. The implications of the results are discussed, and suggestions are made for future research.     

Close Relationships and Social Support in Coping with HIV: A Test of Sensitive Interaction Systems Theory

This study tested sensitive interaction systems theory, and examined how persons with HIV seek and receive social support in relationships with peers versus parents and the association between different kinds of support-receiving behaviors and depressive symptoms. The participants were men and women with HIV in southeastern Virginia who completed a self-administered questionnaire about their relations with parents, an intimate partner, and a close friend. Participants reported using more Ask behaviors (a direct form of support seeking) with a friend and an intimate partner than with parents. They also reported receiving more Approach (Solve/Solace) forms of support from a friend and an intimate partner than from parents and less Avoidance (Escape/Dismiss) from a close friend than from parents. As a support-seeking behavior Ask was most likely to be associated with Approach forms of support providing from all types of relationship partners. Avoidance from parents, an intimate partner, or a friend was positively associated with depressive symptoms. Counselors should discuss with clients the social support process and how different forms of support seeking and support providing may be more or less useful in coping with HIV.     

Determinants of HIV Risk Reduction Behaviors Among Female Partners of Men with Hemophilia and HIV Infection

Determinants of safer sexual behaviors (abstinence or consistent condom use) among female partners of HIV-infected adult men with hemophilia were examined. A model was proposed predicting that emotional adjustment, communication skills, self-efficacy, and perceived advantages of condom use would influence the practice of safer sexual behaviors. Confidential surveys were completed by 119 seronegative female partners of men with hemophilia and HIV infection who received care from one of 27 hemophilia treatment centers across the United States. The proposed model was tested using LISREL, and the model explained 40% of the variance in safer sexual behaviors. Emotional adjustment was a significant predictor of both intimate and emotional communication skills. Intimate and emotional communication skills were related to self-efficacy for communicating about safer sex, which in turn influenced both communication about safer sex and perceived advantages of condom use. Communication about safer sex with a partner and perceived advantages of condom use had direct effects on safer sexual behaviors. HIV prevention interventions with women known to have seropositive partners should be multifaceted. Skill-building interventions emphasizing communication skills, increasing self-efficacy for communication about safer sex with a partner, and promoting positive attitudes about safer sex should be considered.     

Theories on coping with loss: the impact of social support and self-esteem on adjustment to emotional and social loneliness following a partner's death in later life

OBJECTIVES: This longitudinal study focused on the role of self-esteem and social support in adjustment to loneliness experienced by bereaved elderly persons. This study also examined the contributions of a general and a specific coping theory toward explaining loneliness. A distinction has been made between emotional loneliness and social loneliness/perceived support. The theory of mental incongruity predicts that the presence of more favorable conditions, such as higher self-esteem or more social support, results in less loneliness (i.e., less incongruity). According to the theory of relational loneliness, the partner's death leads to a loss of identity, thus increasing emotional loneliness, and social support does not mitigate emotional loneliness following a loss. METHODS: In total, 101 participants, aged 55-89 years, were interviewed before and after their partners' deaths. RESULTS: Findings were ambiguous with regard to both theories. As hypothesized, partner loss lowered self-esteem, resulting in higher emotional loneliness and social loneliness, that is, perception of less support. Supportive personal relations reduced emotional loneliness. The presence of close friends, however, seemed to increase emotional and social loneliness (i.e., decrease perceived support) in the long term, particularly among bereaved participants with lower self-esteem. DISCUSSION: The findings highlight the need to integrate theoretical concepts. In explaining adjustment to a partner's death, attention should be paid to underlying mechanisms relevant to the restoration process (e.g., identity change) and the ways in which the adjustment process can be improved (e.g., intimate relationships) or impeded (e.g., dependency-sustaining relationships).     

Intimate Violence and Post-Traumatic Stress Disorder Among Individuals with Cocaine Dependence

Intimate physical assault and post-traumatic stress disorder (PTSD) were assessed in a sample of 91 adults seeking treatment for cocaine dependence. Physical assault included self-report of aggravated assault with a weapon, aggravated assault without a weapon, and simple assault. PTSD was assessed with a structured interview. Overall, 85.7% of the participants reported having been physically assaulted at least once during their lifetime. Slightly less than half of these individuals (46.2%) reported physical assault by an intimate partner. Close to half also met criteria for PTSD at some point in their lives. Women were more likely than men to be physically assaulted by an intimate partner and to report PTSD. Men who experienced physical assault by an intimate were more likely to report PTSD than men assaulted by others. Male victims of intimate violence had higher scores on certain subscales measuring addiction severity than male victims assaulted by others. Findings suggest careful assessment of intimate violence is essential given its high prevalence among cocaine-dependent women and men and its association with PTSD.     

Intimate violence and post-traumatic stress disorder among individuals with cocaine dependence.

Intimate physical assault and post-traumatic stress disorder (PTSD) were assessed in a sample of 91 adults seeking treatment for cocaine dependence. Physical assault included self-report of aggravated assault with a weapon, aggravated assault without a weapon, and simple assault. PTSD was assessed with a structured interview. Overall, 85.7% of the participants reported having been physically assaulted at least once during their lifetime. Slightly less than half of these individuals (46.2%) reported physical assault by an intimate partner. Close to half also met criteria for PTSD at some point in their lives. Women were more likely than men to be physically assaulted by an intimate partner and to report PTSD. Men who experienced physical assault by an intimate were more likely to report PTSD than men assaulted by others. Male victims of intimate violence had higher scores on certain subscales measuring addiction severity than male victims assaulted by others. Findings suggest careful assessment of intimate violence is essential given its high prevalence among cocaine-dependent women and men and its association with PTSD.     

Do responses to an intimate partner violence screen predict scores on a comprehensive measure of intimate partner violence in low-income black women?

STUDY OBJECTIVES: Screening for intimate partner violence has been advocated as an emergency department (ED) procedure. This study aimed to ascertain whether a 5-item intimate partner violence screening questionnaire could be used effectively in the ED with low-income black women to accurately predict partner abuse status. METHODS: Data were collected from 200 black women who answered in the affirmative to at least 1 item on the intimate partner violence screener questionnaire, the Universal Violence Prevention Screening Protocol. The women completed a comprehensive battery of measures, including the Index of Spouse Abuse, a commonly used and psychometrically sound measure of intimate partner violence. RESULTS: Bivariate logistic regression analyses revealed that, compared with women below the physical-intimate partner violence cut point on the Index of Spouse Abuse, women above the cut point on physical-intimate partner violence on the Index of Spouse Abuse were more likely to answer yes to Universal Violence Prevention Screening Protocol screening questions related to physical, sexual, and emotional abuse; threats to be harmed physically; and being afraid. Compared with women below the nonphysical-intimate partner violence cut point on the Index of Spouse Abuse, women above the cut point on nonphysical intimate partner violence on the Index of Spouse Abuse were more likely to answer yes to each screening question on the Universal Violence Prevention Screening Protocol. The 2 Universal Violence Prevention Screening Protocol screening items related to physical abuse best predicted the 2 Index of Spouse Abuse scales. Accurate prediction of physical and nonphysical abuse on the Index of Spouse Abuse required affirmative responses to 4 or more screening questions on the Universal Violence Prevention Screening Protocol. CONCLUSION: A brief intimate partner violence screening device in the emergency care setting can identify abused, low-income, black women. The study is limited by the fact that universal screening was not conducted, the inclusion of only women who acknowledged some form of intimate partner violence, a reliance on retrospective self-reports, and the questionable generalizability of the findings to groups other than low-income black women.     

Client Perspectives on Design and Implementation of a Couples-Based Intervention to Reduce Sexual and Drug Risk Behaviors Among Female Sex Workers and Their Noncommercial Partners in Tijuana and Ciudad Juárez,México

This mixed-methods study examined the acceptability of a hypothetical couples-based HIV prevention program for female sex workers and their intimate (non-commercial) male partners in Mexico. Among 320 participants, 67 % preferred couples-based over individual programs, particularly among men. Reasons cited for preferring couples-based programs included convenience and health benefits for both partners. Participants reported that they would benefit from general health information and services, HIV counseling and testing, job training (particularly for men) and other services. However, qualitative interviews revealed that barriers relating to the environment (i.e., poor access to services), providers (i.e., lack of a therapeutic alliance), and intimate relationships (i.e., mistrust or instability) would need to be addressed before such a program could be successfully implemented. Despite women’s concerns about privacy and men’s preferences for gender-specific services, couples-based HIV prevention programs were largely acceptable to female sex workers and their intimate male partners.     

Spousal Intimate Partner Violence is Associated with HIV and Other STIs Among Married Rwandan Women

HIV is a health problem in Rwanda, where the adult HIV prevalence is 3.1% (WHO 2008 in Online database of HIV/AIDS epidemiological data, found at: ); the majority of those infected are women (UNAIDS 2008 in ). Prior studies indicate that intimate partner violence is frequently associated with increased HIV risk in women, often because men who abuse their wives also exhibit riskier sexual behaviors (Silverman et al. in JAMA 300:703–710 2008. Population—based data from the 2005 Rwanda Demographic and Health Survey indicate that women with few, if any, other sexual risk factors who have experienced sexual, physical, or emotional abuse within their marriages are 1.61–3.46 times as likely to test positive for HIV, and 2.14–4.11 times more likely to report another STI. These findings confirm prior clinical studies that indicate that intimate partner violence is a correlate of HIV/STIs in Rwanda. Further research is needed to determine whether Rwandan men that abuse their wives have higher baseline rates of HIV/STI infection.     

Adult attachment and drinking context as predictors of alcohol problems and relationship satisfaction in college students

Background: Evidence suggests that for young adults, intimate partners influence each other’s drinking patterns. Therefore, exploration of variables related to intimate partner relationships (such as attachment style) could broaden the current understanding of risk factors for alcohol problems in this demographic. Objectives: The current study examined the role of drinking context in the relationships among insecure attachment, alcohol problems, and relationship satisfaction. A path model was hypothesized where the relationship between insecure attachment and alcohol problems would be explained via two distinct drinking contexts (i.e., drinking with one’s partner and drinking away from one’s partner). It was also hypothesized that the relationship between insecure attachment and relationship satisfaction would be explained via these same two drinking contexts. Methods: Participants were 194 undergraduate students ages 18–25 who reported being in a monogamous intimate partner relationship for at least 90 days and had also consumed alcohol in the past 90 days. The sample was comprised of 76% women and 24% men. Results: The hypothesized direct relationship from anxious attachment to alcohol problems was significant; there were also significant direct paths from both anxious and avoidant attachment to relationship satisfaction. The hypotheses regarding indirect relationships were not supported. Conclusion: The results of this study contribute to the existing literature, in that they suggest that drinking in the context of an intimate relationship may not directly affect relationship satisfaction in this population. However, relationship functioning still appears to be an important variable to consider in the prevention and treatment of alcohol-related problems affecting college students.     

Physical activity intervention in older adults: does a participating partner make a difference?

Social integration and social support are expected to facilitate the adoption and maintenance of physical activity. In the context of a physical activity intervention, we distinguished three partner status groups, serving as an indicator of social integration. It was hypothesized that individuals whose partner also participated in the intervention, as opposed to individuals whose partners did not participate, or individuals without an intimate partner, would benefit more in terms of their physical activity. In a second step, a differential prediction pattern of social support on physical activity for each of the three partner status groups was investigated. The study involved 302 men and women (aged 60–95 years) and included two measurement points in time: A baseline assessment with a leaflet intervention to foster physical activity, and a 4-week follow-up assessment. In participants whose partners took part in the intervention, physical activity increased substantially over time, whereas it did not change in those individuals whose partners were not involved in the intervention, and it did not change in singles. Social support was positively related to physical activity when couples participated together in the intervention, but it was negatively related in singles or when partners did not participate. Social support appeared to be beneficial for physical activity in older adults when both partners participate in the intervention, which might reflect joint exercise or reciprocal exercise support. Singles or those with nonparticipating partners are not only less active, they might also be impeded by misguided support that could be perceived as social control.     

Social comparison activity in coping with HIV

Taylor and Lobel's (1989) model of social comparison processes under threat predicts that upward affiliation (a social activity) may be useful to improve the skills and to find inspiration in coping with HIV, whereas downward evaluation (a cognitive activity) may assist someone to feel better by comparing oneself to a less fortunate person. Participants with HIV were randomly assigned, using a 3 x 3 factorial design, to read one of nine vignettes about someone whose HIV medical prognosis and psychological adjustment were described as good, poor or unspecified. Participants desired upward affiliation with a target doing well physically, but they wanted to avoid a target doing poorly psychologically. Participants also evaluated their own physical condition as better than a target coping poorly physically with HIV. The results may be useful in understanding the impact of various role models in coping with HIV.     

The prevalence of partner violence in a group of HIV-infected men

There is a paucity of literature regarding partner violence among males that identifies the sex and relationship of their partner(s). We studied a convenience sample of 54 HIV-infected men, recruited from HIV/AIDS service organizations. Using a standard questionnaire, we collected data on HIV risk behaviours and self-reports of acts of partner violence and forced sex. Physical violence perpetrated by a primary or a casual partner was reported by 39% and 17% of the sample, respectively. Life-time forced sex by a primary or casual partner was reported by 32% and 15% of the sample, respectively. Forced sex was more commonly reported by participants who were non-white and reported a higher number of primary partners in the previous 12 months. We recommend that health care providers be aware of the high rates of intimate partner violence among men infected or at risk of infection with HIV.     

Exploring Coping and Social Support with Gender and Education Among People Living with HIV in China

Social support promotes positive coping strategies among people living with HIV (PLH); however, little is known about the various aspects of social support and their distinct effects on coping. The present study investigates the specific links between coping and perceived social support with respect to gender and education among PLH. A total of 522 PLH in Anhui, China, participated in an assessment that collected data on demographics, perceived tangible and emotional support, and cognitive and behavioral coping. The assessment was conducted using the computer-assisted personal interviewing method. The data were analyzed using linear mixed models. Emotional support was significantly associated with both cognitive and behavioral coping. Tangible support was significantly associated with behavioral coping but not with emotional coping. Women reported significantly lower levels of emotional support, cognitive coping, and behavioral coping than men did. Significant associations between tangible support and coping were found only among illiterate males. Women living with HIV are in greater need of social support and coping strategies. Future interventions should be gender specific, with targeted support for women with lower education levels to enhance their coping strategies.     

Prevalence and Predictors of Uncircumcised,Kenyan Men’s Desire for Circumcision for Their Infant Sons

Men are key decision makers for their son’s circumcision, so understanding their beliefs is important for the uptake of early infant male circumcision in countries in sub-Saharan Africa that have high HIV prevalence. We analyzed men’s preferences for circumcising their sons using data from a population-representative survey of 1501 uncircumcised men aged 25–49 years in western Kenya. Most men (59%) reported they would “definitely” want their son circumcised if a son was born to them within the next year. However, only 25% intended to become circumcised themselves. In multivariable Poisson regression models to estimate prevalence ratios, key predictors of the desire to circumcise their sons included knowledge that circumcision reduces HIV acquisition, having a supportive partner, discussing circumcision with the partner, altruism, and intention to be circumcised himself. Focusing on partner dynamics may have the greatest capacity to increase demand since 55% had not talked to their partner about circumcision.     

Gender differences in intimate partner violence on substance abuse, sexual risks, and depression among a sample of South Africans in Cape Town, South Africa.

Because men account for nearly half of the HIV cases in South Africa, it is critical to understand the contexts in which they live and the behaviors in which they engage. The purpose of this study was to describe and examine gender differences in intimate partner violence on substance abuse, sexual risks, and depression among a sample of South Africans in Cape Town. We found that recent exposure to intimate partner violence among men was associated with all forms of drug use, whereas women who were recently abused were more likely to suffer from depression and problem drinking. We also found high levels of problem drinking among both men (58%) and women (42%). Men were more likely to use drugs. Exposure to community violence increased sexual risk behaviors among men. Overall, these gender differences have important implications for alcohol and drug prevention strategies as they relate to HIV transmission risk.     

Prevalence and correlates of intimate partner physical violence against women in Kofale District, Ethiopia

Using a community-based cross-sectional survey, this study attempted to determine the prevalence and correlates of intimate partner physical violence against women in Kofale District, Ethiopia. The study showed that 52.6% of the respondents had experienced intimate partner physical violence in their lifetime and 30.2% in the 12 months before the survey. Witnessing family violence as a child, education, place of residence, parity, duration of the marriage, a tradition of marriage arrangement and the partners' use of alcohol were associated with intimate partner physical violence.     

Sexual behaviour and condom use among unmarried young men in Cambodia

The objective of this paper is to describe the sexual behaviour of 665 unmarried men aged 15-24, and explore factors associated with condom use at last intercourse. We use data from a cross-sectional survey conducted in economically marginal areas of Phnom Penh and Kratie town, Cambodia. One-third of respondents reported intercourse and half had had sex by the time they were 23. Of these, 39% had given money or gifts in exchange for sex. Transactional sex often occurred in the company of other males, and condom use was higher among those males compared with those who were alone. Of all sexually active respondents, half reported three or more partners, and 71% used a condom at last sex. Regression results showed that condom use varied by type of partner, was less likely among males outside the education system, and higher among those more positive and informed about condoms. Our findings highlight the need for HIV prevention efforts to encourage young men to use condoms with all intimate partners, promote advantages of condoms for both disease and pregnancy prevention, and address the needs of young men no longer in education. Further research, to understand the positive influence that peers have on condom use in certain circumstances, would be useful.     

Close relationships and safer sex among HIV-infected men with haemophilia

The present study sought to inform future behavioural intervention efforts by obtaining information from HIV-positive heterosexual men with haemophilia about their attitudes towards close relationships, attitudes towards risk reduction practices, and actual risk reduction practices. HIVinfected males with haemophilia ( n = 358) responded to a self-administered questionnaire. Men who reported being involved in a close relationship ( n = 237) were compared to men who said that they were not involved at the time of data collection ( n = 121). Involved men were more likely than uninvolved men to agree that close relationships provide benefits such as physical intimacy and communication, and that these benefits are important. Men who were not involved perceived more negative consequences of discussing HIV risk reduction with partners (including partner rejection and negative emotional reactions) than did involved men and were much more concerned about the potential negative consequences of risk reduction discussions. Involvement was associated with having disclosed HIV-seropositivity and having discussed HIV risk reduction. Risk reduction interventions for men with haemophilia who are not involved in close, sexual relationships should address positive and negative attitudes towards close relationships and towards discussing risk reduction. Interventions should emphasize communication skills and rehearsal of serostatus disclosure as well as of risk reduction discussions.     

Crowdsourcing as a method for collecting data pertaining to the effects of alcohol on perceptions of partner aggression

Background: Efforts designed to investigate the effects of recent alcohol use on the perception of intimate partner aggression have been stultified by significant financial and logistical barriers that warrant the development of supplemental research methods that may result in more prolific investigation of the phenomenon. Objectives: The current study explored the viability of using online crowdsourcing to assess the effects of recent alcohol use on the perception of partner aggression. Method: Mechanical Turk was used to recruit a convenience sample of 60 males who were asked to provide information on their own use of partner aggression, their most recent episode of alcohol use, and their perception of the behaviors and characters depicted in a written partner aggression vignette. Data were evaluated using five separate hierarchical multiple regression models predicting participant perception. Results: Analyses revealed that 35% of the sample had used partner aggression in the past year and that 22% of the sample had consumed alcohol in the past day. Nonviolent participants perceived the aggressor and the behavior more negatively than partner violent participants. Some indicators revealed that recent alcohol use was associated with more positive perceptions of partner aggression. Conclusion: Expected associations among prior partner aggression, recent alcohol use, and perception of partner aggression vignettes were observed. Crowdsourcing may represent a source for data evaluating the effects of recent alcohol use on perceptions of aggression. Methodological refinement will benefit research and, ultimately, clinical prevention and intervention.