Partner violence before and after individually based alcoholism treatment for male alcoholic patients

This study examined partner violence in the year before and the year after individually based, outpatient alcoholism treatment for 301 married or cohabiting male alcoholic patients and used a demographically matched nonalcoholic comparison sample. In the year before treatment, 56% of the alcoholic patients had been violent toward their female partner, 4 times the rate of 14% in the comparison sample. In the year after treatment, violence decreased significantly to 25% of the alcoholic sample but remained higher than in the comparison group. Among remitted alcoholics after treatment, violence prevalence of 15% was nearly identical to the comparison sample and half the rate among relapsed patients (32%). Thus, partner violence decreased after alcoholism treatment, and clinically significant violence reductions occurred for patients whose alcoholism was remitted after treatment.     

Correlates of intimate partner violence among male alcoholic patients

Male-to-female partner violence was investigated in heterosexual couples with an alcoholic male partner. Partner violent (PV) alcoholic patients (n = 183), when compared with nonviolent (NV) alcoholic patients (n = 120), had more antisocial personality characteristics, greater alcohol problem severity, greater use of other drugs, higher relationship distress, and stronger beliefs in the link between alcohol consumption and relationship problems. Demographic factors did not account for these PV-NV differences. Relationship distress and alcohol problem severity had independent associations with partner violence. Relationship adjustment and drug use remained significantly associated with partner violence, whereas alcohol problem severity did not, after controlling for patient antisocial traits. Beliefs in the link between drinking and relationship problems were associated with partner violence independent of other clinical factors.     

Learning sobriety together: A randomized clinical trial examining behavioral couples therapy with alcoholic female patients

Married or cohabiting female alcoholic patients (n = 138) and their non-substance-abusing male partners were randomly assigned to 1 of 3 equally intensive interventions: (a) behavioral couples therapy plus individual-based treatment (BCT; n = 46), (b) individual-based treatment only (IBT; n = 46), or (c) psychoeducational attention control treatment (PACT; n = 46). During treatment, participants in BCT showed significantly greater improvement in dyadic adjustment than those in IBT or PACT; drinking frequency was not significantly different among participants in the different conditions. During the 1-year posttreatment follow-up, compared with participants who received IBT or PACT, participants who received BCT reported (a) fewer days of drinking, (b) fewer drinking-related negative consequences, (c) higher dyadic adjustment, and (d) reduced partner violence.     

Partner violence, partner notification, and women's decisions to have an HIV test

OBJECTIVES: Reports of partner violence against HIV-positive women after they have disclosed their serostatus have led some to reassess partner notification strategies and to speculate that fear of partner violence following partner notification may influence women's HIV testing decisions. We studied whether associations exist between women's declining to have an HIV test and history of partner violence, fear of partner violence, previous experience with partner notification, or beliefs about partner notification. METHODS: In this cross-sectional study, we interviewed women seen at Newark and Miami sexually transmitted disease clinics. The women were at least 18 years old, not known to be HIV positive, not tested for HIV in the previous 3 months, and offered HIV testing during the clinic visit. Women who declined testing were compared with women who accepted. RESULTS: Of 490 participants (89% of eligible women), 16% reported partner violence in the past year, and 28% declined HIV testing. Declining the test was not significantly (p >.05) associated with history or fear of partner violence, previous experience with partner notification, or beliefs about partner notification. When specifically asked, only 2 women responded that their declining the test was related to fear that their partner or partners might harm them if the women tested positive. CONCLUSIONS: Among women seen at these clinics, we did not find evidence that declining the HIV test was strongly influenced by partner violence, previous experience with partner notification, or beliefs about partner notification. However, many women reported partner violence. Therefore, providers should assess the potential for partner violence and be prepared to make appropriate referrals.     

Intimate partner violence and health outcomes in mid-life women: a population-based cohort study

Summary Aim: To investigate the association between experience of intimate partner violence (IPV) and health outcomes measured prospectively. Method: Eleven-year prospective study of a population-based cohort of 438 Australian-born women aged 45–55 years at baseline (in 1991). Annual face-to-face interviews measured health status and quality of life; questionnaires on intimate partner physical, emotional and sexual violence and on experiences of childhood abuse completed in year 6 of follow-up. Results: In year 11 of follow-up 233 women (mean age 59.9 SD 2.5 years) were interviewed of whom 62 (27%) reported experiencing physical and/or emotional and/or sexual IPV prior to the 6^th year of follow-up. In bi-variate analysis a history of IPV was significantly associated with mental and sexual health variables and marital status at baseline and follow-up. Multivariate analysis found that at follow-up after allowing for baseline measures and other co-variates: Frequency of Sexual Activities was lower in women who had experienced IPV (p < 0.05); and negative mood was higher in women with the experience of IPV during the 12 months prior to completing the violence questionnaire (p < 0.05). Conclusion: IPV was a significant contributor to mental and sexual health status measured prospectively in this cohort of mid-aged Australian-born women.     

Intergenerational transmission of partner violence: a 20-year prospective study

An unselected sample of 543 children was followed over 20 years to test the independent effects of parenting, exposure to domestic violence between parents (ETDV), maltreatment, adolescent disruptive behavior disorders, and emerging adult substance abuse disorders (SUDs) on the risk of violence to and from an adult partner. Conduct disorder (CD) was the strongest risk for perpetrating partner violence for both sexes, followed by ETDV, and power assertive punishment. The effect of child abuse was attributable to these 3 risks. ETDV conferred the greatest risk of receiving partner violence; CD increased the odds of receiving partner violence but did not mediate this effect. Child physical abuse and CD in adolescence were strong independent risks for injury to a partner. SUD mediated the effect of adolescent CD on injury to a partner but not on injury by a partner. Prevention implications are highlighted.     

Severe acute alcoholic hepatitis: an audit of medical treatment

Despite advances in treatment, severe alcoholic hepatitis is still associated with a high mortality rate of 30% to 40%. Nutritional support and steroids in selected patients are believed to improve prognosis. In controlled trials steroids have been beneficial in patients with a discriminant function (DF) value >32 or spontaneous hepatic encephalopathy. The aim of this study was to investigate current practice and outcomes in the treatment of acute alcoholic hepatitis. We retrospectively studied patients admitted to our unit with acute alcoholic hepatitis over a 4 year period. Forty-three patients with acute alcoholic hepatitis were admitted between 1994 and 1997. Overall mortality was 26% (11/43). Only 5 patients were treated with steroids of whom 1 died (mortality 20%). Liver biopsy was available in 19/43 of whom 12/19 (63%) had underlying cirrhosis in addition to alcoholic hepatitis. Mortality was higher in patients with a discriminant function of greater than 32 but not significantly so (32%: 8/25 vs 17%: 3/18 p = 0.31). A discriminant function of greater than 32 and contra-indications to steroid use was the best predictor of mortality (60% 6/10 P = 0.0096) compared to patients not fulfilling these criteria In this study overall mortality was comparable with published reports. Of interest was the relatively low liver biopsy rate and the fact that steroids were used in only a minority of eligible patients. We found that mortality was concentrated in a subgroup of patients with a discriminant function value >32 and contra-indications to steroids. These criteria appear to identify a high-risk subgroup of patients. If confirmed, experimental treatments need to be targeted at this group to improve the overall prognosis of acute alcoholic hepatitis.     

Alcohol and intimate partner violence: a meta-analytic review

The link between alcohol use/abuse and partner violence attracted increasing research attention in the past decade. Some studies reported a null or weak association between alcohol use and intimate partner violence, whereas other studies reported a moderate or large association. Using a meta-analytic approach, the link between alcohol use/abuse and male-to-female partner violence as well as female-to-male partner violence was examined herein. The results indicate that there is a small to moderate effect size for the association between alcohol use/abuse and male-to-female partner violence and a small effect size for the association between alcohol use/abuse and female-to-male partner violence. For men only, several moderators were also examined and the magnitude of the effect sizes varied significantly as a function of the type of sample and type of alcohol measure selected. Specifically, there was a larger association of alcohol and aggression in clinical versus non-clinical samples and when measures assessed more severe alcohol problems.     

Brief detection and co-occurrence of violence,depression and alcohol risk in prenatal care settings

Summary The purpose of the study was to examine the rates and inter-relationships among violence receipt, alcohol use problems, and depression in women seeking prenatal care. While waiting for their prenatal care appointment, women (n = 1054) completed measures of past year partner and non-partner violence receipt, alcohol misuse (TWEAK and quantity and frequency of alcohol use in past year), and depression (Center for Epidemiological Studies Depression Scale – CESD and prior history of depression). Over 30% of women reported either violence receipt, alcohol use problems or depression risk. Significant inter-relationships among all measured risk variables were found. Although violence receipt was significantly related to alcohol misuse, cigarette use, less education, and scoring above the cutoff on the CESD (≥ 16) was most strongly associated with violence. Practitioners should be well-equipped to provide assessment, interventions, or referrals as needed to the high numbers of women encountered in prenatal care settings experiencing psychosocial and behavioral problems that may affect their pregnancy.     

Parent and partner violence in families with young children: rates, patterns, and connections

In this study, the authors assessed men's and women's partner and parent physical aggression among 453 representatively sampled families with young children. The prevalences of partner aggression and of severe parent aggression were higher than previously reported. Substantial rates of co-occurrence were found. Risk ratios and regression analyses indicated that connections between (a) husbands' and wives' partner aggression and (b) mothers' and fathers' parent aggression were especially strong. Patterns of co-occurrence pointed to the probable relative importance of family-level, in comparison with individual, predictors of aggression. Patterns of co-occurring violence are described in light of the theoretical literature. Implications for studying family violence in community samples are discussed.     

Community-based intervention for children exposed to intimate partner violence: an efficacy trial

A community-based intervention program was tested with 181 children ages 6-12 and their mothers exposed to intimate partner violence during the past year. A sequential assignment procedure allocated participants to 3 conditions: child-only intervention, child-plus-mother intervention (CM), and a wait-list comparison. A 2-level hierarchical linear model consisting of repeated observations within individuals and individuals assigned to conditions was used to evaluate the effects of time from baseline to postintervention comparing the 3 conditions and from postintervention to 8-month follow-up for both intervention conditions. Outcomes were individual children's externalizing and internalizing behavior problems and attitudes about violence. Of the 3 conditions, CM children showed the greatest improvement over time in externalizing problems and attitudes about violence. There were 79% fewer children with clinical range externalizing scores and 77% fewer children with clinical range internalizing scores from baseline to follow-up for CM children.     

Assessment of subjective sleep disturbance and related factors during female mid-life with the Jenkins Sleep Scale

Objective

To assess sleep disturbance and related factors among mid-aged women.

Methods

This was a cross-sectional study in which 288 women (40–59 years) were requested to complete the Jenkins Sleep Scale (JSS), the 12-item General Health Questionnaire (GHQ-12), the Menopause Rating Scale (MRS) and a general socio-demographic questionnaire containing female and partner data.

Results

Median [interquartile range] age of the whole sample was 47 [8] years. A 62.2% of women were rural residents, 21.2% were postmenopausal, 20.1% were receiving psychotropic drugs, 64.2% had abdominal obesity (waist ≥ 88 cm), and 9.7% reported intimate violence. A 12.8% had an abnormal GHQ-12 score (total score ≥ 3) whereas 14.2% had severe menopause-related symptoms (total MRS score ≥ 17). The prevalence of disturbed sleep (JSS score ≥ 12) was 37.5%. JSS scores displayed significant differences in relation to menopausal status, presence of stress urinary incontinence, use of psychiatric treatment, intimate partner violence, self-perception of healthiness, and partner factors (perception of healthiness, educational level, and regular exercise). Higher JSS scores (disturbed sleep) positively correlated with GHQ-12 and MRS scores, number of co-morbid conditions, body mass index, and female and partner age. Multiple linear regression analysis found that JSS scores correlated positively with somatic MRS scores and with intimate violence, and inversely with partner educational level (r² = 0.375, p < 0.05).

Conclusion

In this mid-aged female sample, disturbed sleep was related to somatic menopause-related symptoms, intimate violence and partner educational level.     

Factors associated with violence against women in a representative sample of the Lebanese population: results of a cross-sectional study

To evaluate the prevalence of violence against women (VAW) and assess factors associated with VAW among a representative sample of the Lebanese population. This cross-sectional study was carried out between September and December 2018. Participants from all Lebanese governorates were enrolled in this study using a proportionate random sample. The percentages of women who were exposed to physical and non-physical abuse were 37.1% and 49.4% respectively. Factors associated with physical abuse were being divorced, having a partner addicted to substances and alcohol, or with a history of threats, violence, assaults, and crimes, higher stressful life experiences, and abuse reported from childhood (physical, sexual, or psychological). Non-physical abuse was associated with abuse reported from childhood (physical, sexual, or psychological), higher stressful life experiences, and the fact that the partner is addicted to substances and alcohol, or has a history of threats. Our results suggest that being divorced, illiterate, and unemployed, having an addicted partner, and having experienced child abuse are all factors that are associated with more violence against women.

     

The informal social control of intimate partner violence against women: Exploring personal attitudes and perceived neighborhood social cohesion

Intimate partner violence against women is a major public health and social problem. However, our understanding of how the geographic community or neighborhood influences its distribution is underdeveloped. In contrast, there is accumulating evidence that neighborhood characteristics, such as social cohesion and related neighborhood factors, are associated with general violence both at the neighborhood and individual levels. Drawing insights from social disorganization, feminist, and bystander intervention research and theory, this cross‐sectional, exploratory study examines influences on the predicted likelihood of intervening in general and intimate partner violence situations, termed enacting informal social control. Specificially, perceptions of neighborhood social cohesion and related neighborhood factors, and personal attitudes toward intimate partner violence are assessed using data from a community sample of 119 New York City residents. Results indicate that perceptions of neighborhood social cohesion were not positively related to predicted likelihood of enacting informal social control of either general violence or intimate partner violence. Personal attitudes towards intimate partner violence were positively associated with predicted informal social control of intimate partner, but not general violence. The need for further research in this area and theoretical and practical implications of the findings for intimate partner violence against women prevention are discussed. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 1001–1018, 2007.     

Intimate partner violence and sexual coercion among pregnant women in India: relationship with depression and post-traumatic stress disorder

BACKGROUND: Intimate partner violence (IPV) is prevalent in most parts of the world. It is also prevalent during pregnancy. METHODS: This study assessed the prevalence of IPV during pregnancy and evaluated its relationship with mental health outcomes, including depression and post-traumatic stress disorder (PTSD). Pregnant women (n=203) attending an antenatal clinic in a public hospital in Bangalore were assessed for presence of IPV as well as depressive, somatic, PTSD symptoms and life satisfaction. RESULTS: Self-reported physical violence in the last year was reported by 14% of women, psychological abuse by 15%, and sexual coercion by 9%. One-half of these women reported ongoing abuse during pregnancy. Depression, somatic, and PTSD symptoms were higher in those with a history of abuse or sexual coercion, and life satisfaction was poorer in those with any form of violence. Among those reporting a history of sexual coercion, severity of violence was related to increased psychiatric morbidity. Alcohol abuse in the spouse was a predictor of the presence and severity of abuse. LIMITATIONS: The study was conducted in a single clinic in southern India which is a large country with very diversified populations. CONCLUSION: The experience of intimate partner violence and its mental health consequences are quite prevalent in India which is a culture where gender disparities are normative and pregnancy is a particularly vulnerable period.     

Acceptability of routine enquiry regarding domestic violence in the antenatal clinic

Domestic Violence poses a significant health risk for the woman and her baby. We wished to determine the acceptability of routine questioning for domestic violence in the maternity hospital setting. A non-anonymised questionnaire was completed by 481 women attending for booking antenatal appointment in a maternity hospital antenatal clinic. The doctor asked four questions regarding experience of partner abuse, The acceptability of these questions was determined. 468 (99%) patients found the questions acceptable and said it would be helpful to ask all patients. Sixty-one (12.9%) women gave a history of at least one form of partner abuse. We concluded that routine enquiry about domestic violence during hospital antenatal visits is acceptable to women and perceived by them to be worthwhile.     

Patterns of partners' abusive behaviors as reported by Latina and non‐Latina survivors

This study builds on the existing knowledge of risk factors for lethal intimate partner violence (IPV) and typologies of IPV abusers by exploring patterns of abusive partners' behaviors among known risk factors for intimate partner femicide (i.e., murder of women) and determines if groups of survivors with similar patterns of abusive behaviors exist. The common patterns are then examined for differences among Latina and non‐Latina survivors. Face‐to‐face interviews were conducted with adult English‐ and Spanish‐speaking survivors of past‐year physical and/or sexual IPV using a validated risk assessment instrument, the Danger Assessment (DA) Questionnaire. Two‐hundred nine IPV survivors participated, 55% Latina. Unique patterns of abusive behaviors perpetrated by an intimate partner or ex‐partner across known risk factors for lethal violence were reported. The patterns clustered into five distinct groups: extreme abuser, physical and sexual violence/controlling abuser, forced sex/controlling abuser, threat/controlling abuser, and low‐level tactics abuser. Latina and non‐Latina survivors reported mean DA scores (13.0 vs. 18.5, respectively) that place them within the “increased danger” and “extreme danger” level, respectively, for lethal violence by an abusive partner. Although both groups were in extreme danger on average, the patterns of abusive behaviors differed. Latina women were more likely to characterize their partner as using forced sex to control the relationship, whereas non‐Latina women were more likely to characterize the use of all types of abusive behaviors (i.e., extreme abuser) or threats to kill them (i.e., threat/controlling abuser) to control the relationship. The findings of this study can be used to develop effective individualized safety plans that include culturally and linguistically competent strategies to reduce violence‐related morbidity and mortality. © 2009 Wiley Periodicals, Inc.     

Sexuality and the commission of physical violence to partners and non-partners by men and women

In 2 studies of physical violence and sexuality among college students, more than 75% of men and more than 60% of women reported committing physical violence in the past year, including more women to partners and more men to non-partners. More than 90% of men who committed violence to partners were also violent to non-partners. In Study 1, among 193 men and 203 women, people who committed violence had higher scores on sexual depression and general depression than did people who were not violent. People violent to non-partners had more sexual preoccupation and more alcohol use problems than did other people. In Study 2, among 160 college men and 138 college women, people in 4 violence groups did not differ in total sexual fantasies or sexual functioning. The findings support the importance of differentiating between violence toward partners and toward non-partners among both men and women and suggest a role of depression in partner violence and antisocial features in violence toward non-partners.     

Behavioral couples therapy (BCT) for alcohol and drug use disorders: a meta-analysis

Narrative reviews conclude that behavioral couples therapy (BCT) produces better outcomes than individual-based treatment for alcoholism and drug abuse problems (e.g., [Epstein, E. E., & McCrady, B. S. (1998). Behavioral couples treatment of alcohol and drug use disorders: Current status and innovations. Clinical Psychology Review, 18(6), 689-711; O'Farrell, T. J., & Fals-Stewart, W. (2003). Alcohol abuse. Journal of Marital and Family Therapy, 29(1), 121-146]). However, the strength and consistency of this effect favoring BCT has not been examined because a meta-analysis of BCT studies has not been reported. This meta-analysis combines multiple well controlled studies to help clarify the overall impact of BCT in the treatment of substance use disorders. A comprehensive literature search produced 12 randomized controlled trials (n=754) that were included in the final analyses. There was a clear overall advantage of including BCT compared to individual-based treatments (Cohen's d=0.54). This was true across outcome domains (frequency of use d=0.36, consequences of use d=0.52, and relationship satisfaction d=0.57). However the pattern of results varied as a function of time. BCT was superior to control conditions only in relationship satisfaction at posttreatment (d=0.64). However, at follow-up BCT was superior on all three outcome domains (frequency of use d=0.45, consequences of use d=0.50, and relationship satisfaction d=0.51). In addition to other control conditions, BCT also outperformed individual cognitive behavioral therapy without couples therapy (d=0.42). Larger sample sizes were associated with higher effect sizes (p=0.02). However, treatment dose and publication year were not related to effect size. Overall, BCT shows better outcomes than more typical individual-based treatment for married or cohabiting individuals who seek help for alcohol dependence or drug dependence problems. The benefit for BCT with low severity problem drinkers has received little attention and one study suggests its efficacy may not extend to this subgroup.