Characteristics of violent bars and bar patrons

OBJECTIVE: The present analysis is an attempt to examine the characteristics of bars in which violence occurs while accounting for the personalities of the clientele that frequent the bar. It is proposed that an explanation of why violence occurs at certain bars requires examining the characteristics of the bars, the personalities of the clientele, and how these two types of variables act together in order to give rise to aggressive behavior. METHOD: We conducted interviews with frequent bar patrons (n = 327), assessing participants on a number of individual differences related to aggression and drinking behavior as well as on characteristics of the usual bar that they attend. Bars were categorized into violent bars (n = 256) or nonviolent bars (n = 71) based on participant responses. RESULTS: Participants' age, alcohol dependence and anger expression differentiated those who frequented violent bars from those who frequented nonviolent bars. The relationship of these individual differences to bar type was mediated by a number of characteristics of the bar itself, including noise, temperature, the presence of bouncers, the gender of the workers, the presence of billiards and illegal activities in the bar. CONCLUSIONS: The results indicate that individuals having certain personality characteristics are attracted to bar environments that promote antinormative behaviors such as violence. However, it seems to be the characteristics of the bars that are the strongest predictors of violence.     

Defending girlfriends, buddies and oneself: injunctive norms and male barroom aggression

Objective

Research has demonstrated that young adults tend to overestimate their peers' approval of risky behaviors (i.e., injunctive norms) and that perceived peer approval is associated with actual behavior; however, no empirical studies have assessed injunctive norms in relation to male barroom aggression. The objectives of the present study were to compare young men's own approval of male barroom aggression with their perceptions of approval by male and female peers and to determine the extent that perceived peer approval of male barroom aggression was associated with self-reported physical aggression at a bar, controlling for own approval and heavy episodic drinking.

Method

525 young adult male university and community college students who reported drinking and going to a bar, club or pub rated their own approval and perceptions of peers' approval of bar aggression on items reflecting four domains of approval: (1) general approval, (2) defend self, (3) defend friend and (4) protect girlfriend.

Results

For all four domains, participants attributed greater approval to male peers than to themselves. Aggression was positively associated with own approval for all domains and with perceived male peer approval for general approval, defend self and defend friend, controlling for heavy episodic drinking and own approval of aggression. Perceived approval by female peers was not associated with increased likelihood of aggression.

Conclusion

The findings suggest that both perceived male peer approval and personal approval are factors associated with male barroom aggression and that addressing approval of barroom aggression is a critical direction for prevention programming.     

Examining a conceptual framework of intimate partner violence in men and women arrested for domestic violence

OBJECTIVE: There is a paucity of research developing and testing conceptual models of intimate partner violence, particularly for female perpetrators of aggression. Several theorists' conceptual frameworks hypothesize that distal factors-such as personality traits, drinking patterns, and marital discord-influence each other and work together to increase the likelihood of physical aggression. The purpose of the present study was to investigate these variables in a relatively large sample of men and women arrested for domestic violence and court-referred to violence intervention programs. METHOD: We recruited 409 participants (272 men and 137 women) who were arrested for domestic violence. We assessed perpetrator alcohol problems, antisociality, trait anger, relationship discord, psychological aggression, and physical abuse. We also assessed the alcohol problems, psychological aggression, and physical abuse of their relationship partners. We used structural equation modeling to examine the interrelationships among these variables in both genders independently. RESULTS: In men and women, alcohol problems in perpetrators and their partners contributed directly to physical abuse and indirectly via psychological aggression, even after perpetrator antisociality, perpetrator trait anger, perpetrator relationship discord, and perpetrator and partner psychological and physical aggression were included in the model. The only significant gender difference found was that, in male perpetrators, trait anger was significantly associated with relationship discord, but this path was not significant for women perpetrators. CONCLUSIONS: The results of the study provide further evidence that alcohol problems in both partners are important in the evolution of psychological aggression and physical violence. There were minimal differences between men and women in the relationships of most distal risk factors with physical aggression, suggesting that the conceptual framework examined may fit equally well regardless of perpetrator gender. This finding suggests that, in arrested men and women, violence intervention programs might have improved outcomes if they offered adjunct or integrated alcohol treatment.     

Correlates of violence history among injured patients in an urban emergency department: gender, substance use, and depression

This study surveyed consecutive injured patients (n = 320) in an urban emergency department (ED) regarding past year violence, substance use, and depression. Victimization and aggression variables (none = N, partner only = P, non-partner only = NP, and generalized/both partner and non-partner = G) were compared on gender, depression, and substance use/consequences. Findings were similar for victimization and aggression variables. Depression was significantly related to violence for women but not for men; women in the P group reported the most depression. Substance variables were significantly related to violence by gender groups. Men in NP and G groups reported the most binge drinking; men in the G group reported the most consequences and drug use. Women in P and G groups reported the most binge drinking and consequences; women in the P group reported the most drug use. Screening urban ED patients for violence is warranted, with interventions addressing both partner and non-partner violence.     

Ethnic Origin,Beverage Preference,and Group Composition in Relation to Alcohol Consumption by Problem Drinkers

New Zealand problem drinkers of European, Maori, and Pacific Island origin did not differ in their mean alcohol consumption during a 2½-h free-drinking period in an experimental bar. Europeans had a smaller beer sip size, ingested more alcohol in the form of spirits, and were more likely to drink both beer and mixed drinks during the session than Polynesians. Dual beverage drinkers consumed more alcohol than did single beverage drinkers. Among drinkers of each ethnic category there was a positive relationship between alcohol consumption and ethnic representation in the drinking group. The results are discussed in the context of earlier baseline studies of drinking by alcoholics and normal drinkers, and observations of different ethnic groups drinking in the natural barroom environment.     

Social approval and facilitation in predicting modeling effects in alcohol consumption

Purpose: An important question for alcohol abuse prevention and treatment is whether individuals with high needs for social approval, or those who drink heavily in social contexts, are particularly vulnerable to modeling effects in alcohol consumption. Methods: Male and female heavy social drinkers (N=202), as distinguished by these cognitive and situational variables, participated in a multisession dyadic modeling effects study along with a same-sex confederate model who exhibited alternating patterns of heavy and light consumption in an experimental barroom. Results: Subjects with high needs for social approval, and those who tend to drink heavily in social contexts, were particularly vulnerable to imitating directional changes in modeled drinking levels across heavy and light consumption experimental sessions. Additionally, modeling effects were revealed, including reductions in drinking levels, regardless of individual characteristics such as demographics or levels of intoxication achieved on “usual drinking occasions.” Implications: Findings suggest that individuals exhibiting high needs for social approval, and those who tend to drink heavily in social contexts, may benefit from (1) befriending lower risk models and (2) prevention and/or intervention efforts to reduce risk for substance use by reducing excessive needs for social approval and/or reducing exposure to social contexts where heavy drinking and related risk behavior is normative.     

Gender,violence and brief interventions for alcohol in the emergency department

BackgroundThe impact of gender and violence on brief interventions (BIs) for alcohol use in the emergency department (ED) has not been studied. Our objective was to examine the effectiveness of alcohol BIs in an ED population stratified by gender and violence.MethodsThis was a secondary analysis of datasets pooled from three ED-based randomized controlled studies of alcohol BIs. AUDIT-C was the primary outcome measure; secondary outcomes were binge drinking and achievement of NIAAA safe drinking levels. We conducted univariate comparisons and developed generalized linear models (GLM) for the primary outcome and generalized estimating equation (GEE) models for secondary outcomes to examine the intervention effect on the whole study group, gender-stratified subgroups, and gender- and violence-stratified subgroups.ResultsOf 1219 participants enrolled, 30% were female; 31% of women and 42% of men reported violence involvement at baseline. In univariate analysis, no differences in outcomes were found between intervention and control groups for any subgroup. However, in multivariable models, men demonstrated an intervention effect for likelihood of safe drinking limits. Stratifying further by violence, only men without violence involvement demonstrated a positive intervention effect for safe drinking limits. There was no evidence of an intervention effect on women.ConclusionsAnalyzing the overall effect of ED-based BI may mask its ability to improve alcohol-related outcomes in a subset of the population. Alternatively, interventions may need to be significantly improved in subsets of the ED population, e.g., in women and in men with involvement in violence.     

Factors associated with partner violence among female alcoholic patients and their male partners

OBJECTIVE: This study described the extent of partner violence victimization and perpetration among married or cohabiting female alcoholic patients and the factors associated with it. METHOD: Male-to-female and female-to-male physical partner violence were examined for 103 female alcoholic patients seeking couples-based outpatient alcoholism treatment. Partner violent (PV) and nonpartner violent (NPV) groups were compared on hypothesized risk factors. RESULTS: In the year before treatment, about two thirds of the women were victimized by their male partners, and a similar proportion engaged in violence toward their male partners. Severe violence also was high, with 22% victimization and 50% perpetration prevalence. Women committed more violent acts overall and were more likely to commit severely violent acts than the men in these couples. Risk factors for PV in both the victimization and perpetration models were as predicted: less education, lower income, greater relationship problems, stronger beliefs in the link between relationship problems and the female patient's drinking, greater cocaine use by the perpetrator of violence and greater emotional distress of the men. Greater alcohol and drug use and more severe alcohol problems also distinguished male perpetrators from their nonviolent counterparts in the female victimization model. Predictions that female patients in the PV group would report greater substance use and problems, childhood violence exposure and emotional distress than their female counterparts in the NPV group were not supported for either victimization or perpetration models. CONCLUSIONS: Partner violence is a serious problem for women in alcoholism treatment. More research is needed to increase understanding of risk factors and explanatory models for such violence.     

Alcohol consumption,setting, gender and activity as predictors of injury: a population-based case-control study

OBJECTIVE: A population-based case-control design was employed to quantify the risk of injury after consumption of alcohol as a function of setting, concurrent activity and usual drinking habits. METHOD: A total of 797 cases (66.6% men) and 797 controls (57.7% women) were interviewed. The response rate was 83% for eligible cases approached for an interview. Cases were injured patients from a hospital emergency department. Community controls used were each paired with a case on suburb of residence, and interviewed regarding their activities in the 6-hour period preceding their paired case's injury. RESULTS: Self-reported alcohol consumption was consistent with both medical records and breath-analyzer tests. Drinking any alcohol and using prescribed medication in the prior 6 hours were both associated with significantly increased risk of injury when controlling for demographic and setting variables. Use of illicit drugs (mainly cannabis) was associated with reduced risk of injury. Setting (e.g., recreational, work) and activity (e.g., sport, travel, work) variables were also independently associated with risk of injury. The risk of injury for women was significantly elevated for any consumption of alcohol; for men it was elevated only when consumption exceeded 90 grams. CONCLUSIONS: These data confirm earlier findings that risk of injury for women for a given level of consumption is greater than for men. They extend earlier findings by identifying significant setting, activity and drug use variables predictive of injury. In addition, when these latter variables are controlled, it is found that for women, but not for men, the risk of injury is significantly elevated even at low levels of alcohol intake.     

“Girls will be served until you have to carry them out”: Gendered serving practices in Oslo

Research on heavy drinking among women implies that this behaviour is deviant and criticised by society, which would suggest that intoxicated women are more likely than men to be denied alcohol at drinking establishments. However, a recent Norwegian study shows that it is more likely for intoxicated women than intoxicated men to be served alcohol. This article explores gender differences and overserving within licensed establishments. The data consist of qualitative interviews with bartenders and pseudo-patrons. The latter were actors who were seemingly intoxicated while attempting to purchase alcohol at drinking establishments. Our analysis suggests that there are three main reasons why alcohol is served to intoxicated women. First, female patrons are profitable for drinking establishments because their presence causes male patrons to remain at the venue and spend more money. Second, female patrons are regarded as being sexually available to other patrons and staff in the barroom, which is a heavily sexually charged scene. Third, female patrons are considered harmless and their presence even dampens male aggression. In contrast to these explanations, there is some concern for the safety of intoxicated women. The night-time economy in Oslo seems to combine a strictly gendered perception of male and female patrons with a new acceptance of female binge drinking. The overserving of female patrons can be regarded as a consequence of the combination of these two seemingly contradictory tendencies.     

Beliefs,attitudes, and male-to-male barroom aggression: Development of a theoretical predictive model

While evidence suggests that male-to-male barroom aggression is linked to attitudes and beliefs, there exists no theoretical model that delineates these relationships. We use theory on attitudes and behavior as well as sociocultural theories of alcohol and aggression to develop a model linking beliefs and attitudes to the likelihood of engaging in male-to-male barroom aggression. The model identifies five dimensions of attitudes and beliefs regarding alcohol-related aggression: (1) expected consequences; (2) perceived normality and acceptability by others; (3) beliefs about drinking and the role of alcohol in aggression; (4) social honor and protection of masculine identity; and (5) personal approval or disapproval of male barroom aggression. Qualitative and ethnographic research on barroom drinking and aggression is used to describe these dimensions and to hypothesize how they might influence the occurrence of male-to-male barroom aggression. This model may be useful for identifying avenues for prevention and for comparing the explanatory role of attitudes and beliefs across cultures.     

Gender differences in the development of substance-related problems: the impact of family history of alcoholism, family history of violence and childhood conduct problems

OBJECTIVE: This study examined gender differences regarding the relative influence of family history of alcoholism (FHA) and family history of violence (FHV) on reported childhood conduct problems (CCP) and adult problems with alcohol, drugs and violence. METHOD: The participants were 110 men and 103 women with alcohol-related problems recruited within 30 days of enrolling in treatment for substance abuse or dependence. Participants completed self-report measures of pretreatment violence, FHV, CCP, substance use and consequences, and demographics; a semi-structured interview was used to assess FHA. RESULTS: Structural equation modeling (SEM) analyses revealed gender differences with regard to the influence of FHA and FHV as important factors in the development of childhood and adult behavioral problems. For women, the influence of FHA on subsequent childhood conduct problems and adult problems with alcohol was accounted for by FHV. For men, FHA was not directly associated with CCP or adult problems with alcohol and violence, but was associated with adult drug problems. For both men and women, FHV was associated with CCP, and CCP were associated with adult problems with drugs and violence. CONCLUSIONS: Overall, the analyses illustrate the relative importance of FHV as a risk factor in the developmental course leading to problems with drugs and violence among individuals with alcohol-related problems enrolled in treatment for substance abuse or dependence. Further, there was evidence that women may be impacted more than men by family background variables (both FHA and FHV) in terms of the development of adult problems with alcohol, drugs and violence.     

The efficacy of compliance therapy in pharmacotherapy for alcohol dependence: a randomized controlled trial

OBJECTIVE: This study sought to evaluate the effectiveness of compliance therapy in increasing adherence to pharmacological treatment for alcohol dependence. METHOD: Forty subjects were randomly allocated to receive usual medical care (n = 20) or usual medical care plus compliance therapy (n = 20). All subjects were prescribed acamprosate (Campral) for 4 months. Subjects were volunteers treated at a hospital-based outpatient drug and alcohol treatment service, and were men and women who were 18-65 years old and with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnosis of alcohol dependence. All subjects received usual medical care consisting of seven medical reviews (duration = 15 minutes) over 4 months. Compliance therapy consisted of four to six individual sessions (duration = 60 minutes) in which beliefs about medication side effects, ambivalence, the benefits of treatment, treatment maintenance and relapse prevention were addressed and explored with motivational interviewing and cognitive behavior therapy techniques. RESULTS: The outcome variables were number of days taking acamprosate, days to first drink, days to first relapse (more than five drinks) and days to first extended relapse (greater than 2 consecutive days of more than five drinks). Intention-to-treat analyses showed little difference between the two groups in the outcome drinking measures. Nevertheless, the per-protocol analyses revealed that participation in three or more sessions of compliance therapy significantly increased adherence to acamprosate and improved overall treatment outcomes. CONCLUSIONS: The present study highlights the need for psychological interventions to improve adherence to pharmacotherapy in the treatment of alcohol dependence and provides initial support for compliance therapy as an effective intervention.     

Difficult temperament, acute alcohol intoxication, and aggressive behavior

The purpose of this study was to investigate the influence of a difficult temperament on alcohol-related aggression in men and women. Subjects were 330 (164 men and 166 women) healthy social drinkers between 21 and 35 years of age. Temperament was measured using the dimensions of temperament survey-revised (DOTS-R). Following the consumption of either an alcohol or a placebo beverage, subjects were tested on a modified version of the Taylor aggression paradigm in which mild electric shocks were received from, and administered to, a fictitious opponent during a competitive task. Aggressive behavior was operationalized as the shock intensities administered to the fictitious opponent under conditions of low and high provocation. Of all the variables, provocation was the strongest elicitor of aggression. Overall, a difficult temperament was positively related to the aggression for all subjects. The finding of greatest importance was that alcohol only increased aggression for men with a difficult temperament. The results highlight the fact that alcohol consumption does not increase aggression in all persons and in all situations. An important goal for future research is to identify which individual difference and which contextual factors are most important in determining who will, and who will not, behave in an aggressive manner when intoxicated.     

Alcohol and drug use among homosexual men and women: epidemiology and population characteristics

Homosexual men and women have been described as at high risk for alcohol and drug abuse, due to psychosocial variables such as stress levels or the cultural importance of bar settings. However, there are few actual data in this regard. This paper presents the findings of a large (n = 3400) survey of a homosexual population regarding population characteristics and patterns of alcohol and drug use. Psychosocial variables that may account for substance use patterns both generally and in this population are discussed in an accompanying paper. Substantially higher proportions of the homosexual sample used alcohol, marijuana, or cocaine than was the case in the general population. Contrary to other reports, this was not accompanied by higher rates of heavy use, although homosexuals did show higher rates of alcohol problems. In the general population women consume less drugs and alcohol than do men, and substance use substantially declines with age. Neither of these patterns were found for the homosexual sample, thus creating overall higher rates of substance abuse. This may reflect differences between homosexuals and the general population in their adherence to sex-role stereotypes and age-related social role changes, as well as culturally specific stressors and vulnerability to substance use.     

Prenatal alcohol use: the role of lifetime problems with alcohol, drugs, depression, and violence.

OBJECTIVE: The purpose of this study was to examine a broader array of lifetime factors that theoretically may be associated with prenatal alcohol use than have previously been studied together, including family history of alcohol-use problems, history of physical or sexual abuse, lifetime major depressive disorder, alcohol-use disorder, illicit-drug-use problems, and partner violence. METHOD: A total of 186 pregnant women, all of whom used alcohol in the year before pregnancy, were initially recruited in prenatal care settings. Women who reported no prenatal alcohol use (n = 96) were compared with women who drank 1-10 standard drinks during pregnancy (n = 75) and with women who drank more than 10 standard drinks during pregnancy (n = 13), considered to be a higher risk group, on the lifetime risk variables. Because of the public health implications, secondary analyses compared women who abstained during pregnancy with those who used any alcohol. RESULTS: Significant intercorrelations were found among most of the lifetime risk factors studied. Multivariate analyses showed that drug-use problems and partner violence were most strongly associated with prenatal alcohol use than any other variable studied. CONCLUSIONS: Consistent with a life span risk framework for alcohol-use problems, results of this study show that childhood abuse, familial alcoholism, lifetime major depressive disorder, and alcohol- and drug-use problems are interrelated. However, when considered together, only lifetime partner violence and drug use are significantly related to various levels of prenatal alcohol use. Identification, assessment, and intervention efforts should integrate these important factors.     

Characteristics and treatment interests among individuals with substance use disorders and a history of past six-month violence: Findings from an emergency department study

The study examined clinical characteristics and treatment interests of individuals identified to have substance use disorders (SUDs) in an urban emergency department (ED) who reported past six-month history of violence or victimization. Specifically, participants were 1441 ED patients enrolled in a randomized controlled trial of interventions designed to link those with SUDs to treatment. To examine factors related to violence type, four groups based on participants' reports of violence toward others were created: no violence (46.8%), partner violence only (17.3%), non-partner violence only (20.2%), and both partner and non-partner violence (15.7%). Four groups based on participants' reports of victimization were also created: no violence (42.1%), victimization from partner only (18.7%), victimization from non-partner only (20.2%), and both partner and non-partner victimization (17.7%). Separate multinomial logistic regression analyses were conducted to examine which variables distinguished the violence and victimization groups from those reporting no violence or victimization. For violence toward others, demographic variables, alcohol and cocaine disorders, and rating treatment for psychological problems were higher for violence groups, with some differences depending on the type of violence. For victimization, demographic variables, having an alcohol disorder, and rating treatment for family/social problems were higher for violence groups, also with some differences depending on the type of violence. Findings from the present study could be useful for designing effective brief interventions and services for ED settings.     

Alcoholic men endorse more DSM-IV withdrawal symptoms than alcoholic women matched in drinking history

OBJECTIVE: Given gender differences in alcohol metabolism, drinking patterns and alcohol-related problems, we asked whether men and women recruited for research protocols from treatment programs would meet different subsets of alcohol dependence or withdrawal criteria or differ in current level of functioning. METHOD: The subjects were 66 men and 62 women meeting DSM-III-R or DSM-IV criteria for alcohol dependence. Gender differences were tested infrequency counts of criteria endorsed and Global Assessment of Functioning (GAF) scores. RESULTS: All seven alcohol dependence criteria were endorsed by 50% of the sample. There were no significant gender differences in frequency of individual criteria endorsed. However, more men than women tended to endorse the withdrawal criterion for alcohol dependence and the tremor criterion for alcohol withdrawal, whereas women had higher GAF scores. When subgroups of men and women were matched on alcohol consumption variables, significantly more men than women endorsed the withdrawal criterion for alcohol dependence and the anxiety criterion for alcohol withdrawal, and women still had significantly higher GAF scores than men. CONCLUSIONS: DSM criteria provide a similar characterization of alcohol dependence in male and female research volunteers. Despite this similarity, the DSM criteria were sensitive to gender differences, which can now be challenged with rigorous testing.     

Who or what do young adults hold responsible for men’s drunken violence?

BackgroundMen are more likely than women to perpetrate serious violence when they have consumed alcohol, but alcohol does not affect all men in the same way. This paper considers young adults’ attribution about agency (the capacity to act) in men’s drunken violence.MethodsInterviews about alcohol use in night-time venues, streets or private parties were conducted with 60 young adults aged 18–24 in Melbourne, Australia, and analysed thematically. Participants included seven men who identified as having initiated violence when drunk.ResultsSome interviewees stated that men chose to be violent, or that men’s violence when they were drunk was purposeful and therefore involved some component of choice. However, much alcohol-related violence enacted by young men was understood (both by men who reported violence and by other young adults) as impelled by forces outside their control. These forces were: diffusely defined effects of drinking alcohol; proclivities of men and masculinity, and the interaction of alcohol and men’s bodies to override capacity for judgement and produce an irresistible urge to fight. The latter was at times explained as caused by the mutually reinforcing actions of alcohol and testosterone, providing a particularly persuasive account of men’s violence as biologically-determined.ConclusionThese categories encapsulate a set of discursive resources that contribute to the rationalisation, naturalisation and production of men’s violence. Participants tended to regard alcohol, masculinities and testosterone as inciting violence predictably and consistently, suggesting that men themselves had relatively little agency over its occurrence. In contrast, research evidence indicates that these actors do not cause violence in any uniform way and that their effects are contingent on changing configurations of factors. Highlighting discrepancies between young adults’ understandings of responsibility for men’s drunken violence, and those expressed in research, presents additional opportunities for intervention.     

Infants of drug addicts: at risk for child abuse, neglect, and placement in foster care

In a methadone maintenance program for pregnant, drug dependent women, an investigation was undertaken (1) to study the occurrence of violence experienced by the women as children and as adults and (2) to lean whether those who report past violence/abuse are more likely to neglect and/or abandon their children to the care of others. Subjects included 178 drug dependent women who completed a Violence Questionnaire and 70 comparable, but drug-free women. Results revealed that a history of violence or abuse is related to drug abuse and also to the placement of one's child(ren) in foster care.