Drowning the pain: intimate partner violence and drinking to cope prospectively predict problem drinking

Social and Psychological Mediators of Sexual and Physical Male-Perpetrated Intimate Partner Violence Against Young African American Women: The Role of Alcohol Use and Drinking Context

Problem alcohol use is prevalent among women who experience male-perpetrated intimate partner violence (IPV). However, the pathways by which this occurs remain poorly understood and understudied among African American women. This study sought to examine context-specific social and psychological mediators of this association. Using structural equation modeling (SEM), we tested a conceptual framework predicting problem alcohol use within 3 months of experiencing physical and/or sexual IPV. The sample included 508 young African American women (median age 21, interquartile range 19-22 years). A modified SEM met prespecified global and local fit index criteria. The model identified four indirect paths from IPV to problem alcohol use. Three of the paths were through the endorsement of drinking contexts: negative coping, social drinking, and intimate drinking. Negative coping and social drinking emerged as the most salient pathways (β = .431, 95% CI [0.107, 0.754]; β = .472 [0.103, 0.841], respectively). A fourth path operated via depressive symptomatology and negative coping. The model predictors explained 35% of the variance in problem alcohol use; findings were consistent with full mediation of IPV and problem drinking. These findings increase the understanding of problem alcohol use among African American women who experience IPV and identify modifiable context-specific risk factors for problem alcohol use. Interventions to reduce problem drinking could incorporate trauma-informed counseling, as part of integrated IPV and substance use care, to reduce depressive symptomatology and enhance drinking refusal skills in response to situational drinking.

Does cyber dating abuse victimization predict next-day alcohol and cannabis use among college students?

BACKGROUND AND OBJECTIVES

Cyber dating abuse (CDA) is prevalent on college campuses, with 43% of college students experiencing CDA each year. Yet, the potential impacts of CDA victimization on college students' health outcomes remain poorly understood. Informed by the self-medication hypothesis and longitudinal data linking dating abuse to substance use outcomes, the present study tested the hypothesis that CDA victimization positively associates with college students' next-day alcohol use (number of drinks consumed, odds of any drinking) and odds of cannabis use (yes/no). We also explored whether CDA's association with next-day substance use varied as a function of gender.

METHODS

Daily data on alcohol use, cannabis use, and CDA victimization were collected across 60 consecutive days from 236 undergraduates who were in dating relationships (73.73% cisgender women).

RESULTS

Multilevel modeling revealed gender differences. Among men, CDA victimization predicted next-day cannabis use (aOR = 7.34, p < .001), but negatively related to the number of drinks consumed the following day (B = -2.63, p < .001). Among women, CDA victimization did not relate to next-day cannabis or alcohol use. Regardless of gender, CDA victimization was unrelated to the odds of any drinking.

DISCUSSION AND CONCLUSIONS

College men are more likely to use cannabis the day after experiencing CDA victimization relative to other days. Targeting CDA and related aftermath may benefit college-based substance use intervention.

SCIENTIFIC SIGNIFICANCE

This is the first study to identify that cannabis use occurs subsequent to CDA victimization, which can inform college-based CDA and cannabis use prevention programming.

Intimate Partner Violence Victimization and Drug Use: The Mediating Role of Emotion Regulation Difficulties

Intimate partner violence (IPV) victimization is a risk factor for drug use, which has the potential to negatively impact survivor health and well-being. However, few studies have explored the role of emotion regulation in the association between IPV exposure and drug use. Understanding whether difficulties with emotion regulation mediate the association between IPV victimization and drug use may be important to better understand the mechanisms driving drug use and identify potential intervention targets. Thus, the present study aims to test the role of emotion dysregulation in the link between IPV exposure and drug use among violently injured adults. A total of 367 adults who had experienced a violent injury from any source (Mage = 32.7, 73% male, 80% Black/African-American) from an Urban Level 1 Trauma Center were recruited. Participants completed self-report surveys on their IPV victimization experiences, emotion regulation difficulties, and drug use. Results showed that IPV victimization was associated with greater emotion regulation difficulties and higher levels of drug use. In addition, several domains of emotion regulation difficulties (strategies, non-acceptance, goals, and impulse) were associated with more engagement in drug use, and those domains of emotion regulation difficulties partially mediated the associations between IPV victimization and drug use. These findings highlight the importance of exploring mechanisms of IPV victimization outcomes, such as drug use that can guide education (e.g., stigma prevention), prevention (e.g., early and hospital-based screening), and intervention (e.g., treatments to target emotion regulation) efforts.

The Relationship Between Intimate Partner Violence, Depression, Alcohol Abuse in Black and Hispanic Women

The relationship between intimate partner violence (IPV), depression, and risky alcohol use is complex and multi-dimensional. Depression has been documented as a common consequence of experiencing IPV, where depressed individuals might turn to substances like alcohol as a coping mechanism. Thus, assessing the indirect effect of depression in the relationship between IPV and alcohol abuse in African American and Hispanic women is warranted. Cross-sectional data was collected from 152 African American and Hispanic women living in Miami, Florida. Descriptive statistics, correlation analysis, and Hayes' direct and indirect mediation analyses were conducted. A total of 77% reported IPV. The mean age was 42.84 (SD = 10.69). About 57% of participants identified as African American, and 62% identified as Hispanic/Latino. On average, participant depression scores (8.6, SD = 5.7) showed mild-to-moderate severity, and the average alcohol abuse score was 15.5 (±8.9), suggesting risky alcohol use. IPV was directly associated with alcohol abuse (β = .50, 95% CI [.18, .82]; [R2 = .059, F(1, 150) = 9.37, p < .001), and with depression (β = .48, 95% CI [.27, .69]; [R2 = .119, F(1, 150) = 20.43, p < .001). Depression modified the effect of IPV on alcohol abuse by about 19% (β = .56, 95% CI [.33, .80]; [R2 = .185, F(2, 149) = 16.87, p < .0026). Results of this study suggest that depression is an important component to be considered when addressing alcohol abuse among women with experiences of IPV. This study highlights the importance of assessing women who report IPV for depressive symptoms when treating alcohol use disorders.

The long-term effectiveness of a personality-targeted substance use prevention program on aggression from adolescence to early adulthood

BACKGROUND

Addressing aggressive behavior in adolescence is a key step toward preventing violence and associated social and economic costs in adulthood. This study examined the secondary effects of the personality-targeted substance use preventive program Preventure on aggressive behavior from ages 13 to 20.

METHODS

In total, 339 young people from nine independent schools (M age = 13.03 years, s.d. = 0.47, range = 12-15) who rated highly on one of the four personality traits associated with increased substance use and other emotional/behavioral symptoms (i.e. impulsivity, anxiety sensitivity, sensation seeking, and negative thinking) were included in the analyses (n = 145 in Preventure, n = 194 in control). Self-report assessments were administered at baseline and follow-up (6 months, 1, 2, 3, 5.5, and 7 years). Overall aggression and subtypes of aggressive behaviors (proactive, reactive) were examined using multilevel mixed-effects analysis accounting for school-level clustering.

RESULTS

Across the 7-year follow-up period, the average yearly reduction in the frequency of aggressive behaviors (b = -0.42; 95% confidence interval [CI] -0.64 to -0.20; p < 0.001), reactive aggression (b = -0.22; 95% CI 0.35 to -0.10; p = 0.001), and proactive aggression (b = -0.14; 95% CI -0.23 to -0.05; p = 0.002) was greater for the Preventure group compared to the control group.

CONCLUSIONS

The study suggests a brief personality-targeted intervention may have long-term impacts on aggression among young people; however, this interpretation is limited by imbalance of sex ratios between study groups.

Dual-substance use disorder couples: An integrative review and proposed theoretical model

Committed romantic relationships between two individuals with Substance Use Disorder (or dual-SUD couples) are prevalent. Dual-SUD couples have poor treatment engagement and outcomes. Research has established a reciprocal link between relationship dynamics (e.g., conflict, intimacy) and substance use. Thus, the couple's relationship presents a distinct social context for both partner's substance use. Dual-SUD couples face unique challenges due to substance use being a shared behavior that may serve as a rewarding source of compatibility, closeness, and short-term relationship satisfaction despite it being at the cost of other alternative sources of substance-free reinforcement. Yet, treatment options for these couples are scarce. Dual-maladaptive health behaviors (e.g., dual-substance use) are challenging to treat; however, theory and preliminary research suggests that transformation of couple's joint motivation toward adaptive health behavior change may result in a more satisfying relationship and improved treatment outcomes for both individuals. The current paper reviews the extant literature on dual-SUD couples from theoretical, empirical, and treatment research and proposes an expanded paradigm regarding how we understand dual-SUD couples with the aim of informing basic research and treatment development.

Prevalence, Perpetrators, and Factors Associated With Intimate Partner Violence Among Adolescents Living in Urban Slums of Kampala, Uganda

Intimate partner violence (IPV) poses a public health burden, yet few studies have assessed co-existence of physical, emotional, and sexual IPV among adolescents. We assessed recent IPV victimization and associated factors and described IPV patterns and perpetrators among young people from urban slums in Kampala, Uganda. We conducted a prospective cohort study among 14 to 19-year-old individuals enrolled from March 2019 to March 2020 and followed quarterly for 12 months. We collected data on socio-demographics, sexual behavior, and substance use through interviews. Recent IPV victimization was documented at all visits if a participant reported experiencing physical, emotional, and/or sexual IPV in the past 3 months. Baseline factors associated with recent IPV victimization were determined using multivariable logistic regression. We enrolled 490 adolescents (60.6% female) with median age 18 years (Interquartile range (IQR) 17-18 years), 91.0% had less than secondary level education. Females mainly engaged in sex work (17.5%) and selling fruits/snacks (9.1%) while males commonly earned from sale of metal scrap or plastic waste (28.5%), 41% reported ≥10 life-time sexual partners, 16.1% were high-risk alcohol drinkers and 34.9% used illicit drugs in the past 3 months. Overall, 27.8% reported recent IPV victimization (20.0% females) with emotional IPV being common (17.8%). At baseline, recent IPV victimization was associated with high-risk alcohol consumption (adjusted odds ratio [aOR] 2.57; 95% confidence interval [CI] [1.44, 4.58]), reported paid sex in the past 3 months (aOR 1.82; [1.02, 3.22]) and being separated (aOR 2.47; [1.29, 4.73]). Recent IPV victimization declined from baseline to month 9 and increased at month 12 visits which coincided with the COVID-19 pandemic. IPV victimization is high among young people living in urban slums with emotional IPV being prevalent. IPV interventions are needed and should also address excessive alcohol consumption.

Reproductive Coercion Victimization and Associated Mental Health Outcomes Among Female-Identifying Young Adults

Reproductive coercion is a serious public health problem. Victimization has been associated with poor mental health outcomes, including symptoms of posttraumatic stress disorder (PTSD) and depression in clinical and college samples. We build on these findings by examining the association between reproductive coercion victimization and mental and behavioral health outcomes, including depression, PTSD symptoms, anxiety, and drinking behaviors in a diverse community-derived sample of female-identifying young adults (mean age = 20; SD=.72). Participants (n = 368) were originally recruited as part of a study on dating violence in seven Texas public high schools. Participants completed an online study that included demographic questions and measures that assessed the variables of interest. Results of regression analyses showed that reproductive coercion victimization predicted depression, anxiety, and PTSD symptoms, after controlling for race, sexual orientation, and age. The findings also revealed that victims of reproductive coercion were more likely consume more drinks per drinking occasion compared to their non-victimized counterparts. These results add to the growing literature that experiencing reproductive coercion is a risk marker for poor mental and behavioral health. To develop targeted prevention and intervention programs, future research should examine potential mechanisms underlying this relationship.

Participants in Court-mandated Intervention Programs for Intimate Partner Violence Perpetrators with Substance Use Problems: A Systematic Review of Specific Risk Factors

Men with alcohol and/or other drug use problems (ADUPs) court-mandated to attend intervention programs for intimate partner violence (IPV) perpetrators have been identified as a high-risk, highly resistant group of IPV perpetrators, as they present lower treatment adherence and higher dropout and recidivism rates. Previous research suggests that IPV perpetrators with ADUPs may require tailored interventions to address their specific risk factors. The present systematic review was conducted using PRISMA guidelines to identify the specific risk factors in men with and without ADUPs on entry to court-mandated perpetrator programs. The following databases were searched from inception to November 2021: Web of Science, PsycINFO, and Scopus. There was a screening of 3,995 records, and 29 quantitative studies were included in the review. Risk factors present in males court-mandated to perpetrator programs were grouped into four categories: sociodemographic risk factors, personality disorders and psychological adjustment, social-relational risk factors, and risk factors related to attitudes towards women. Results indicated that the main risk factors in IPV perpetrators with ADUPs, compared to those without, were higher clinical symptomatology (e.g., anger and impulsivity), personality disorders, poorer executive functions, having experienced more stressful life events, higher exposure to childhood trauma, lower intimate social support, and higher responsibility attributed to the offenders' personal context. These results contribute to a deeper understanding of the complex phenomenon of IPV and ADUPs, and could help to inform key targets for perpetrator programs that may improve the well-being of their (ex)partners and increase the effectiveness of intervention programs for IPV perpetrators.

Spatial Analysis of the Alcohol, Intimate Partner Violence, and HIV Syndemic Among Women in South Africa

The co-occurrence of and synergistic interactions between substance abuse, violence, and HIV, known as the "SAVA syndemic," is thought to be a driver of women's elevated risk for HIV in sub-Saharan Africa. This study uses data from the 2016 South African Demographic and Health Survey (DHS) and the 2016 South African Census to examine geospatial associations between alcohol use, intimate partner violence (IPV), unprotected sex, and HIV status among a population-based sample of 8528 South African women (age 15-49). Results support the geographic clustering of alcohol use, unprotected sex, and IPV, but not HIV, and geospatial clustering of HIV alone. This study highlights the need for geographically-tailored interventions to address syndemics through integrated interventions, such as those simultaneously focused on alcohol, IPV, and sexual risk reduction, and points to the need for more targeted research to link these factors to HIV from a place-based risk perspective.

Formative research to develop an app to prevent dating and sexual violence and alcohol use among high school youth

The purpose of this study was to conduct formative research to inform the development of an app, that would simultaneously engage youth and adults, to prevent dating and sexual violence (DSV) and alcohol use (AU). Participants (N = 56) were high school students, parents/guardians, and professionals (e.g., school personnel) from across the United States who participated in online focus groups. Overall, participants had positive perceptions of the utility, helpfulness, and effectiveness of an app to prevent DSV and AU among high school students. Participants provided in depth information about both the content (e.g., local rates of DSV and AU) and features (e.g., skills-based, inclusion of incentives, help button) that the app should include. These preliminary data suggest that future research to develop and pilot an app for both youth and adults to prevent DSV and AU among high school students is warranted.

More GP Consultations by Violence Victims: Results from the Representative German DEGS1 Study

Violence is a growing public health problem influencing physical and mental health. Victims tend to contact medical care in the first place, yet a discrepancy between patients' violence experiences (VE) and general practitioners' (GP) awareness is reported. The number of GP visits by victims is of interest. Using data of the nationally representative German Health Interview and Examination Survey for Adults (DEGS1), associations between the prevalence of ≥1 recent VE (last 12 months) and the number of GP contacts were analyzed with respect to age, gender, socio-economic status, and health conditions. The DEGS1 dataset comprised persons aged 18 to 64 years (n = 5938). The prevalence of a recent VE was 20.7%. Compared to non-victims, VE victims visited their GP significantly more often in the preceding 12 months (3.47 vs. 2.87, p < 0.001), which increased markedly in those who were strongly impaired by a recent physical VE (3.55 GP visits) or psychological VE (4.24). The high frequency of GP contacts in VE victims constitutes opportunities to professionally support this vulnerable patient group and underlines the necessity for GPs to integrate VE as a bio-psycho-social problem in a holistic treatment approach.

Psychological distress, intimate partner violence and substance use in a representative sample from Mexico: A structural equation model

Introduction

Intimate Partner Violence (IPV) is a public health concern associated with multiple adverse health outcomes, including psychological distress (PD).

Objective

To assess the association of IPV and psychological distress, and the mediation of tobacco and alcohol consumption in a national representative sample from Mexico.

Material and methods

Data from the Encuesta Nacional de Consumo de Drogas, Tabaco y Alcohol (ENCODAT) were analyzed. The sample included 34,864 people between the ages of 12 and 65 with a partner. Using Structural Equation Modeling (SEM), the association between IPV, use alcohol, tobacco and psychological distress was measured.

Results

The population was composed of women (51.9%) and men (48.1%); 15.1% (women = 18.2% and men = 11.9%) reported IPV in the last year. The prevalence of psychological distress in the last year was 3.3%, being 3.8% in women, and 2.7% in men. Results from the SEM in women indicated a direct positive effect of the IPV construct on psychological distress (β = 0.298, p < 0.01); these findings confirmed that IPV tended to systematically increase psychological distress. Likewise, the presence of IPV increased the consumption of tobacco (β = 0.077, p < 0.01) and alcohol (β = 0.072, p < 0.01). The SEM results in men showed that alcohol and tobacco consumption tended to increase in the presence of IPV (β = 0.121, p < 0.01, and β = 0.086, p < 0.01, respectively), and in turn, alcohol consumption and tobacco tended to increase psychological distress (β = 0.024, p < 0.01, and β = 0.025, p < 0.01, respectively).

Conclusion

This study indicated that in women, IPV had a direct effect on psychological distress and on alcohol and tobacco consumption. Meanwhile in men, alcohol and tobacco consumption had a mediating effect between IPV and psychological distress. The empirical findings of this study will contribute toward the design of public health policies for the prevention and attention of IPV, alcohol and tobacco consumption, and consequently address the mental health consequences derived from these problems.

Posttraumatic stress as a moderator of the association between HPA-axis functioning and alcohol use disorder among a community sample of women currently experiencing intimate partner violence

Women experiencing intimate partner violence (IPV) experience a heightened prevalence of alcohol use disorder (AUD). Hypothalamic-pituitary-adrenal (HPA)-axis functioning has been associated with increased risk for AUD in other populations, including individuals with posttraumatic stress disorder (PTSD) symptoms. The goal of the present study was to determine whether PTSD symptom severity exacerbates the relationship between HPA-axis functioning and AUD. Participants were 151 community women who had experienced physical or sexual IPV in the past 30 days by their current male partners and used any amount of alcohol or drugs. A two-phase emotion induction protocol was utilized: Neutral mood induction followed by randomly assigned negative, positive, or neutral emotion induction. Saliva cortisol samples were obtained immediately following the neutral mood induction (baseline HPA-axis functioning), 20 min following the individualized emotion induction script (HPA-axis reactivity), and 40 min post the emotionally evocative cue (HPA-axis recovery). Findings revealed that PTSD symptom severity moderated the relations between baseline HPA-axis functioning and HPA-axis recovery and log odds of meeting criteria for AUD. Specifically, baseline HPA-axis functioning was positively associated with log odds of meeting criteria for AUD at high (but not low) PTSD symptom severity, whereas HPA-axis recovery was negatively associated with log odds of meeting criteria for AUD at high (but not low) PTSD symptom severity. Results contribute to our understanding of the biological processes involved in the etiology and maintenance of AUD among women experiencing IPV-specifically the prominent role of PTSD symptom severity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Violence against Women during the COVID-19 Pandemic in Mexico

This study measured the prevalence of cases of domestic violence against women and some associated factors during the COVID-19 pandemic in Mexico. Data were collected through a remote survey during 2020. The sample included 47,819 women aged 15 years and older. Jointpoint regression and logistic regression models were used. The prevalence of violence was 11.5%, which decreased in July and subsequently increased. The associated factors were being unemployed (OR = 2.01; 95%CI 1.89-2.16); being partially and totally quarantined (OR = 1.58; 95%CI 1.43-1.75 and OR = 1.47; 95%CI 1.32-1.63); being a caregiver of children; being a caregiver of elderly and/or suffering from a chronic illness (OR = 1.27; 95%CI 1.19-1.36; OR = 1.42; 95%CI 1.33-1.53; OR = 1.59; 95%CI 1.47-1.73); losing a family member to COVID-19 (OR = 1.26; 95%CI 1.13-1.41); and binge drinking (OR = 1.94; 95%CI 1.78-2.12). The confinement measures increased gender inequalities, economic problems and workload which further evidenced violence against women.

Intimate partner violence, substance use, and health comorbidities among women: A narrative review

Exposure to intimate partner violence (IPV), including physical, sexual, and psychological violence, aggression, and/or stalking, impacts overall health and can have lasting mental and physical health consequences. Substance misuse is common among individuals exposed to IPV, and IPV-exposed women (IPV-EW) are at-risk for transitioning from substance misuse to substance use disorder (SUD) and demonstrate greater SUD symptom severity; this too can have lasting mental and physical health consequences. Moreover, brain injury is highly prevalent in IPV-EW and is also associated with risk of substance misuse and SUD. Substance misuse, mental health diagnoses, and brain injury, which are highly comorbid, can increase risk of revictimization. Determining the interaction between these factors on the health outcomes and quality of life of IPV-EW remains a critical need. This narrative review uses a multidisciplinary perspective to foster further discussion and research in this area by examining how substance use patterns can cloud identification of and treatment for brain injury and IPV. We draw on past research and the knowledge of our multidisciplinary team of researchers to provide recommendations to facilitate access to resources and treatment strategies and highlight intervention strategies capable of addressing the varied and complex needs of IPV-EW.

Is There an Association between Being a Victim of Physical Violence by Intimate Partner and Binge Drinking in Men and Women? Secondary Analysis of a National Study, Peru 2020

The relationship between being a victim of physical violence by an intimate partner and binge drinking (BD) is a poorly explored line of research, especially in men. To determine the association between being a victim of physical violence by an intimate partner and BD in men and women in Peru in 2020, a secondary analytical cross-sectional study was conducted using the Demographic Health Survey. BD was categorized according to the Center of Disease Control definition for men and women, based on the type and amount of alcoholic beverage ingested. Physical violence was based the report of being hit with any part of the body or an object, by their intimate partner. To identify the association, a multivariable general linear model of the family and link log Poisson was used. The results were presented as prevalence ratios (PRs). In the adjusted models stratified by sex, a 90% greater likelihood of BD was found in male victims and an 80% higher probability among female victims (PRa 1.9, 95%CI 1.3;2.7, p < 0.001 vs. PRa 1.8, CI95% 1.1; 2.8, p = 0.013, respectively). An association was found between physical violence by an intimate partner and BD in the Peruvian population older than 15 years, in both men and women.

Gender Moderates Results of a Randomized Clinical Trial for the Khanya Intervention for Substance Use and ART Adherence in HIV Care in South Africa

Little is known about gender effects of alcohol and drug use (AOD) among people living with HIV (PLWH) in resource-limited settings. Using multilevel models, we tested whether gender moderated the effect of Khanya, a cognitive-behavioral therapy-based intervention addressing antiretroviral (ART) adherence and AOD reduction. We enrolled 61 participants from HIV care and examined outcomes at 3- and 6-months compared to enhanced treatment as usual (ETAU). Gender significantly moderated the effect of Khanya on ART adherence (measured using electronically-monitored and biomarker-confirmed adherence), such that women in Khanya had significantly lower ART adherence compared to men in Khanya; no gender differences were found for AOD outcomes. Exploratory trajectory analyses showed men in Khanya and both genders in ETAU had significant reductions in at least one AOD outcome; women in Khanya did not. More research is needed to understand whether a gender lens can support behavioral interventions for PLWH with AOD.Trial registry ClinicalTrials.gov identifier: NCT03529409. Trial registered on May 18, 2018.

An Exploration of Factors that Mediate the Relationship Between Adverse Childhood Experiences and Sexual Assault Victimization Among LGBTQ+ College Students

Despite alarming rates of sexual assault on college campuses, little research has examined risk factors for sexual victimization among LGBTQ+ college students. This exploratory study aims to examine adolescent sexual assault, internalized homonegativity, and problematic alcohol use as mediators linking several types of adverse childhood experiences (ACEs; i.e., childhood sexual abuse, parental abuse, and household disorder) to collegiate sexual assault. Utilizing data from 241 LGBTQ+ college students, path analysis findings demonstrated that these proposed mediators increased risk for sexual assault and that various types of ACEs exerted differential impacts on sexual re-victimization, internalized homonegativity, and problematic alcohol use. Practice-based implications are offered, including the need for affirming programming that includes problem drinking prevention components and considers the role of ACEs and internalized homonegativity in increasing risk for sexual assault during college as well as the need for LGBTQ+ resource centers on campus.

Unpacking Violent Behavior in Young Adulthood: The Relative Importance of Hazardous Alcohol Use

Young adulthood is an important developmental period for investigating the nature of violent behavior. This study examines the unique contribution of alcohol use to violence perpetration among young adults in the Australian community, after accounting for the influence of sociodemographic, early life, trait, and well-being influences. Cross-sectional, self-report data was collected from 507 young adults aged 18-20 years in the Australian general community via an online survey. Sequential logistic regressions examined the relative and independent contribution of adverse childhood experiences (ACEs), impulsivity, psychological distress, and hazardous alcohol use to past-year violent behavior. Results show one in eight young adults aged 18-20 (13%) reported at least one act of violent behavior in the past year, primarily assault perpetrated against another person. Sequential logistic regression identified that after controlling for other risk factors, the number of ACEs reported and hazardous alcohol use were independently and positively associated with increased odds of reporting violent behavior in young adulthood. These findings demonstrate that ACEs and hazardous alcohol use are important, independent correlates of violent behavior in young adults. While preventing early adversity is key for reducing violence in the community, this evidence suggests that it is also important to target proximal causes such as hazardous alcohol use. Increasing early and widespread access to evidence-based, trauma-informed violence-prevention programs targeting risk factors across multiple settings is critical for reducing harm and supporting young people into healthy adulthood.

Modeling reciprocal relations between emotion dysregulation and alcohol use using dynamic structural equation modeling: A micro-longitudinal study

BACKGROUND

Research examining emotion dysregulation and alcohol use has increased exponentially over the past decade. However, these studies have been limited by their use of cross-sectional designs and narrow definitions of emotion dysregulation. To address these significant gaps in the extant literature, this study utilized state-of-the-art methodology (i.e., experience sampling) and statistics (i.e., dynamic structural equation modeling) to examine potential reciprocal associations between negative and positive emotion dysregulation and alcohol use at the momentary level.

METHODS

Participants were 145 community women (mean age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances. Surveys assessing negative and positive emotion dysregulation and alcohol use (i.e., number of standard drinks) were administered three times a day for 30 days using phone-based interactive voice recording.

RESULTS

Significant contemporaneous effects indicated that negative and positive emotion dysregulation both co-occurred with alcohol use. However, levels of negative and positive emotion dysregulation did not predict later alcohol use, nor did alcohol use predict later levels of negative or positive emotion dysregulation. There was significant variability among participants in cross-lagged effects.

CONCLUSIONS

Findings showed that negative and positive emotion dysregulation co-occurred with alcohol use and that there was significant interindividual variability in the cross-lagged associations between negative and positive emotion dysregulation and alcohol use. Research using idiographic approaches may identify women experiencing IPV for whom negative and positive emotion dysregulation drive alcohol use and alcohol use drives negative and positive emotion dysregulation.

Risk Pathways Contributing to the Alcohol Harm Paradox: Socioeconomic Deprivation Confers Susceptibility to Alcohol Dependence via Greater Exposure to Aversive Experience, Internalizing Symptoms and Drinking to Cope

Socioeconomic deprivation is associated with greater alcohol problems despite lower alcohol consumption, but the mechanisms underpinning this alcohol harm paradox remain obscure. Fragmented published evidence collectively supports a multistage causal risk pathway wherein socioeconomic deprivation increases the probability of exposure to aversive experience, which promotes internalizing symptoms (depression and anxiety), which promotes drinking alcohol to cope with negative affect, which in turn accelerates the transition from alcohol use to dependence. To evaluate this proposed risk pathway, 219 hazardous drinkers from an undergraduate population completed questionnaires assessing these constructs in a single, cross sectional, online survey. Partial correlation coefficients revealed that each variable showed the strongest unique association with the next variable in the proposed multistage model, when adjusting for the other variables. Bootstrapped serial mediation analysis revealed that the indirect pathway linking all the variables in the proposed serial order was significant, while all other permutations were non-significant. Network centrality analysis corroborated the serial order of this indirect path. Finally, risk ratios estimated by categorizing the variables suggested that socioeconomic deprivation increased the risk of aversive experience by 32%, which increased the risk of internalizing symptoms by 180%, which increased the risk of drinking to cope by 64%, which increased susceptibility to alcohol dependence by 59%. These preliminary findings need to be corroborated by future research, nevertheless, they call for prevention strategies founded on social justice and the minimization of aversive experience in socially deprived individuals to mitigate mental health problems, maladaptive coping and addiction.

Scope and correlates of high school youths' exposure to dating and sexual violence prevention initiatives

The researchers examined the extent to which high school youth were exposed to dating and sexual violence (DSV) prevention types (e.g., social marketing campaign) across various locations (e.g., in-school) and how exposure to DSV prevention related to perceptions of social norms and collective efficacy. Participants included 877 high school youth who completed in-school surveys across three towns in New England. Most youth (92%) were exposed to DSV prevention. In general, active exposure and active participation, more so than passive exposure, were related to greater perceptions of collective efficacy and perceptions of social norms more intolerant of DSV. Results also suggested that online exposure to DSV prevention was the most consistent correlate of greater perceptions of collective efficacy and perceptions of social norms more intolerant of DSV. These findings provide clues about the types and locations that might be most effective at preventing DSV among youth.

Experiences and Correlates of Violence Among American Indian and Alaska Native Youth: A Brief Report

The purpose of this paper is to document the scope and correlates of past 6-month victimization among American Indian (AI) and Alaska Native (AN) youth. Types of victimization under investigation included sexual assault, dating violence, bullying, sharing of nude photos, sexual harassment, homophobic teasing, and racism. Participants were 400 AI and AN youth in grades 7-10 who completed a survey in school. Results documented concerning rates of all forms of victimization among AI and AN youth during the past 6 months. Although most forms of victimization were related, bullying (at school and electronically), racism, and sexual harassment occurred more often than sexual assault and dating violence. Older youth, girls, and sexual minorities were more likely to report some forms of violence than younger youth, boys, and heterosexual youth respectively. Compared to nonvictims, victim status was consistently related to depressive symptoms, suicidal ideation, and alcohol use and was less consistently correlated with feelings of school mattering. Evidence-based, culturally grounded prevention and response efforts are needed for AI and AN youth, as well as broader initiatives that seek to reduce health disparities among AI and AN youth.

Bidirectional associations between alcohol use and intimate partner violence and sexual assault victimization among college women

Whereas some prior studies have explored whether alcohol increases the risk for victimization and/or whether distress resulting from victimization increases the risk for alcohol use, few studies have simultaneously tested these bidirectional hypotheses among a high-risk sample (i.e., undergraduate women), while including both sexual assault (SA) and intimate partner violence (IPV) victimization, and exploring potential moderating effects of PTSD symptoms on these paths. Among 631 college women, the present study tested these bidirectional associations using cross-lagged panel models across two measurement periods (i.e., Time 1 [T1] and Time 2 [T2], six months later). Results suggested that T1 alcohol use increased risk for T2 SA (but not T2 IPV victimization), and PTSD symptoms moderated this association; at lower levels of PTSD symptoms, there were no significant associations between alcohol use and subsequent SA victimization, whereas at higher levels of PTSD symptoms, alcohol use predicted subsequent SA victimization. By contrast, the opposite directional hypothesis was not supported; neither T1 lifetime SA nor IPV were associated with T2 drinking, regardless of the level of their PTSD symptoms. Prevention and intervention efforts should simultaneously address risk factors for alcohol use and victimization using trauma-informed practices.

Coping With the Experiences of Intimate Partner Violence Among South African Women: Systematic Review and Meta-Synthesis

Background: Intimate partner violence (IPV) continues to be a serious problem worldwide. South Africa has a high prevalence of women experiencing IPV. Although much research reports on the prevalence rates, risk factors, and consequences of IPV, fewer studies report on how women deal with the experiences of IPV. Objective: This systematic review of the empirical literature aimed to identify and synthesize the best available evidence on women's experiences of coping with IPV in South Africa. Methods: A four-level search and retrieval strategy using PRISMA and JBI guidelines was conducted, which included critical appraisal, study selection, data extraction, and data synthesis. Ten studies met the eligibility criteria and were included in the review. They were assessed to meet a set threshold (7/10) based on the JBI Critical Appraisal Checklist for Qualitative Research. All studies were conducted between 2010 and 2020, conducted in South Africa, and used qualitative methodologies to accomplish the overall aim of investigating IPV experiences of women and their responses to it. Results: The total number of women included in the studies was 159. The data extraction yielded 49 findings of which 47 were aggregated into 14 categories and three themes: (1) help- and support-seeking coping, (2) emotional regulation coping, and (3) problem avoidance and distraction coping. Help- and support-seeking coping refers to women's responses when they seek instrumental aid, advice, comfort, and/or understanding from others. Emotional regulation includes responses of women in which their emotions were expressed or regulated. Problem avoidance and distraction coping represent responses of women in which they take efforts to avoid thinking about the problem situation and rather reshift their focus. Conclusion: Overall, this review found that a variety of coping responses are used by South African women experiencing IPV. The findings point to the need for understanding IPV and responses to it within a broader social context rather than just at the personal level. Approaching IPV at many levels may lead to a change in societal norms, better access to and delivery of services to IPV survivors, more functional family affairs, and personal well-being and improved quality of life.

Addiction is driven by excessive goal-directed drug choice under negative affect: translational critique of habit and compulsion theory

Drug addiction may be a goal-directed choice driven by excessive drug value in negative affective states, a habit driven by strong stimulus-response associations, or a compulsion driven by insensitivity to costs imposed on drug seeking. Laboratory animal and human evidence for these three theories is evaluated. Excessive goal theory is supported by dependence severity being associated with greater drug choice/economic demand. Drug choice is demonstrably goal-directed (driven by the expected value of the drug) and can be augmented by stress/negative mood induction and withdrawal-effects amplified in those with psychiatric symptoms and drug use coping motives. Furthermore, psychiatric symptoms confer risk of dependence, and coping motives mediate this risk. Habit theory of addiction has weaker support. Habitual behaviour seen in drug-exposed animals often does not occur in complex decision scenarios, or where responding is rewarded, so habit is unlikely to explain most human addictive behaviour where these conditions apply. Furthermore, most human studies have not found greater propensity to habitual behaviour in drug users or as a function of dependence severity, and the minority that have can be explained by task disengagement producing impaired explicit contingency knowledge. Compulsion theory of addiction also has weak support. The persistence of punished drug seeking in animals is better explained by greater drug value (evinced by the association with economic demand) than by insensitivity to costs. Furthermore, human studies have provided weak evidence that propensity to discount cost imposed on drug seeking is associated with dependence severity. These data suggest that human addiction is primarily driven by excessive goal-directed drug choice under negative affect, and less by habit or compulsion. Addiction is pathological because negative states powerfully increase expected drug value acutely outweighing abstinence goals.

When Partners Turn Violent: Understanding Causality & Signs

Intimate partner violence (IPV) occurs across all cultures, ethnicities, socioeconomic classes, and educational backgrounds. Nurses should be aware of IPV and causative factors that include personal attributes, stressors, and community issues. The Intimate Partner Exposome conceptual model is used to identify exogenous and endogenous IPV risk factors. In addition, distinctive environmental factors can increase risk for IPV. The purpose of this article is to increase recognition of causative factors and presenting signs to enhance the nurse's ability to identify and assist IPV victims.

Understanding School Sabotage Among Survivors of Intimate Partner Violence From Diverse Populations

Higher education is an important pathway to safety for survivors of intimate partner violence (IPV). Recent work documents tactics of school sabotage (behaviors aimed at sabotaging educational efforts) identified by school staff and IPV advocates. However, the perspectives of current students who are IPV survivors are unexplored. As part of a multiphasic study, 20 semi-structured qualitative interviews with community college students who reported current or recent IPV were conducted. Identified tactics included disrupting child care, emotional abuse tied to school, and using manipulation to limit access to campus or resources. Identified impacts include preventing focus, diminished academic achievement, emotional or mental health challenges, and instilling a desire to overcome.

Intimate partner violence in emerging adulthood and subsequent substance use disorders: findings from a longitudinal study

AIMS

To examine the temporal association between the experience of different types of intimate partner violence (IPV) in early adulthood (21 years) and substance use disorders in young adulthood (30 years).

DESIGN

Prospective birth cohort study using data from the Mater-University of Queensland Study of Pregnancy (MUSP).

SETTING

Brisbane, Australia.

PARTICIPANTS

A total of 1353 people (822 females and 531 males).

MEASUREMENTS

IPV was measured using the Composite Abuse Scale (CAS) and alcohol, substance and nicotine use disorders were assessed using the Composite International Diagnostic Interview (CIDI).

FINDINGS

In females, the experience of different forms of IPV at 21 years remained a robust risk factor for subsequent alcohol use disorder [adjusted odds ratios (aORs) ranged from 1.6 to 2.6 (all P < 0.05)], substance use disorder [aORs ranged from 2.1 to 4.0 (all P < 0.001)] and nicotine use disorder [aORs ranged from 2.0 to 2.4 (all P < 0.05)] at 30 years, even after controlling for antecedent substance disorders. However, in males only physical and emotional abuse (but not harassment) were significant in predicting alcohol use disorder [aORs ranged from 1.4 to 1.8 (all P < 0.05)] and drug use disorder [aORs ranged from 1.6 to 2.0 (all P < 0.05)] in the fully adjusted model.

CONCLUSION

Intimate partner violence (IPV) in early adulthood is robustly associated with alcohol, substance and nicotine use disorders in women, whereas in men the association is clear for only some forms of IPV and types of disorder.

Trait Jealousy Moderates the Relationship Between Alcohol Problems and Intimate Partner Violence Among Men in Batterer Intervention Programs

Informed by alcohol myopia theory and Leonard's heuristic model of intimate partner violence (IPV), we hypothesized that alcohol problems would positively relate to IPV among men with high, but not low, trait jealousy. We collected cross-sectional, self-report data from 74 men arrested for domestic violence and court-ordered to batterer intervention programs (BIP). Alcohol problems positively related to physical and sexual IPV among men with high, but not low, trait jealousy. Results provide preliminary support for the need for BIP to target both jealousy-related cognitions and alcohol problems. Future research should investigate jealousy in relation to alcohol-related IPV.

Relationship between childhood abuse and substance misuse problems is mediated by substance use coping motives, in school attending South African adolescents

BACKGROUND

In adults, it has been shown that the relationship between childhood abuse and substance misuse problems is mediated by the belief that substance use helps cope with negative affective states. By contrast, in adolescents, it is unknown whether drug use coping motives play this same mediating role.

METHODS

Secondary analysis of 1149 school attending adolescents in Cape Town, South Africa (average age = 16.24 years, range = 13-23; 60% female). Questionnaire measures obtained during a single test session (among a larger battery) assessed childhood trauma (CTQ), alcohol (AUDIT) and drug problems (DUDIT), and coping orientation (A-COPE) which contained three items assessing drug use to cope with negative affect.

RESULTS

The three types of childhood abuse measured by the CTQ - emotional, physical and sexual - were positively associated with greater alcohol/drug problems, and drug use coping motives. Drug use coping motives mediated the relationships between childhood abuse types and alcohol/drug problems, and these mediational pathways remained significant when gender and other subscales of the A-COPE were included as covariates.

CONCLUSIONS

These data are preliminary insofar as drug use coping motives were assessed with a non-validated subscale of the A-COPE. Nevertheless, drug use to cope with negative affect mediated the relationship between all three types of childhood abuse (emotional, physical, sexual) and alcohol/drug problems in school attending adolescents. The implication is that drug prevention programs for this risk group should seek to mitigate drug use coping motives.

Intimate partner violence, trauma, and mental health need among female community college students

OBJECTIVE

The impact of interpersonal violence on college students has received considerable attention, yet no studies have been conducted among community college students, who comprise 40% of all American college students, and have unique risk factors and needs. Community College students are more likely to be women, people of color, working, parenting, and first generation college students.

PARTICIPANTS

Data were collected from a simple random sample from four community colleges (n=435).

METHODS

A cross-sectional quantitative survey was used to assess the extent of intimate partner violence, trauma exposure, sexual violence, and associated mental health consequences among female students.

RESULTS

Over 27% of participants reported IPV in the past year, while 25% reported sexual assault and 34% reported other uncomfortable sexual experiences in their lifetime. Nearly 20%of participants were currently reporting PTSD symptoms.

CONCLUSIONS

Community Colleges should work with service providers to build their capacity to respond to students' needs.

Depressive statements prime goal-directed alcohol-seeking in individuals who report drinking to cope with negative affect

BACKGROUND

Most variants of negative reinforcement theory predict that acute depressed mood can promote alcohol-seeking behaviour, but the precise mechanisms underpinning this effect remain contested. One possibility is that mood-induced alcohol-seeking is due to the formation of a stimulus-response (S-R) association, enabling depressed mood to elicit alcohol-seeking automatically. A second possibility is that depressed mood undergoes incentive learning, enabling it to enhance the expected value of alcohol and thus promote goal-directed alcohol-seeking.

OBJECTIVES

These two explanations were distinguished using a human outcome-revaluation procedure.

METHODS

One hundred and twenty-eight alcohol drinkers completed questionnaires of alcohol use disorder, drinking to cope with negative affect and depression symptoms. Participants then learned that two responses earned alcohol and food points respectively (baseline) in two alternative forced choice trials. At test, participants rated the valence of randomly sampled negative and positive mood statements and, after each statement, chose between the alcohol- and food-seeking responses in extinction.

RESULTS

The percentage of alcohol- versus food-seeking responses was increased significantly in trials containing negative statements compared to baseline and positive statement trials, in individuals who reported drinking to cope with negative affect (p = .004), but there was no such interaction with indices of alcohol use disorder (p = .87) or depression symptoms (p = .58).

CONCLUSIONS

Individuals who drink to cope with negative affect are more sensitive to the motivational impact of acute depressed mood statements priming goal-directed alcohol-seeking. Negative copers' vulnerability to alcohol dependence may be better explained by excessive affective incentive learning than by S-R habit formation.

Understanding the Context of Romantic Partner Relational Victimization: Links between Relationship Satisfaction, Depressive Symptoms, and Alcohol-Related Problems

OBJECTIVE

The purpose of this study was to examine links across romantic partner relational victimization, depressive symptoms, and drinking problems during young adulthood. We were interested in evaluating depression as a mediator of the association between relational victimization by one's romantic partner, drinking problems, and the conditional indirect effects of relationship satisfaction.

METHOD

269 individuals aged 18 to 26 years (68% female, Mage = 22.78 years, SD = 4.70) participated in the study. They completed self-report measures online.

RESULTS

Mediation results indicated that depression significantly mediated the association between relational victimization and alcohol-related problems. Furthermore, tests of conditional indirect effects suggest that depression mediated the association between romantic partner relational victimization and alcohol-related problems among those who were lower in relationship satisfaction, but not among those who were higher in relationship satisfaction.

CONCLUSIONS

Findings are discussed with attention to the developmental significance of romantic relationships during the transition to young adulthood. Specifically, the current findings add to the existing literature, which has suggested that both relationship aggression and depression are associated with problematic drinking.

Temporal Effects of Perpetrating or Receiving Intimate Partner Aggression on Alcohol Consumption: A Daily Diary Study of Community Couples

OBJECTIVE

Survey studies provide evidence that experiencing intimate partner aggression (IPA) contributes to subsequent alcohol use. However, it is unknown whether the increase in alcohol use over time reflects a temporal effect of IPA. We examined verbal and physical IPA as predictors of alcohol use and heavy drinking within the next few hours. We also investigated whether both victims and perpetrators drank following IPA, and if it mattered which partner reported the aggression.

METHOD

The data reported here were derived from a 56-day diary study examining the association between alcohol use and partner aggression in 118 heterosexual couples. We examined whether alcohol use in a given hour could be predicted by IPA in the previous 3 hours, taking into account victim/perpetrator status, source of the report (self, other), and gender.

RESULTS

Victims were twice as likely to use alcohol in a given hour when they reported having received verbal IPA in the previous 3 hours, independent of the perpetrator's report. Similarly, perpetrators were more than twice as likely to use alcohol in a given hour when they reported having perpetrated verbal IPA in the previous 3 hours, independent of the victim's report. Results were similar when reports of mutual IPA were considered. Verbal IPA increased the likelihood of drinking but not the likelihood of heavy drinking. Results for physical IPA were not significant.

CONCLUSIONS

Verbal IPA is a proximal predictor of alcohol use for both victims and perpetrators. However, effects emerge only when individuals report aggression, and not when their partner provides the sole report, emphasizing the importance of the individual's perception of IPA.

Intimate partner violence trends in Brazil: data from two waves of the Brazilian National Alcohol and Drugs Survey

OBJECTIVE

To compare intimate partner violence (IPV) prevalence rates in 2006 and 2012 in a nationally representative household sample in Brazil. The associations between IPV and substance use were also investigated.

METHODS

IPV was assessed using the Conflict Tactic Scale-R in two waves (2006/2012) of the Brazilian Alcohol and Drugs Survey. Weighted prevalence rates and adjusted logistic regression models were calculated.

RESULTS

Prevalence rates of IPV victimization decreased significantly, especially among women (8.8 to 6.3%). The rates of IPV perpetration also decreased significantly (10.6 to 8.4% for the overall sample and 9.2 to 6.1% in men), as well as the rates of bidirectional violence (by individuals who were simultaneously victims and perpetrators of violence) (3.2 to 2.4% for the overall sample). Alcohol increased the likelihood of being a victim (odds ratio [OR] = 1.6) and perpetrator (OR = 2.4) of IPV. Use of illicit drugs increased up to 4.5 times the likelihood of being a perpetrator.

CONCLUSIONS

In spite of the significant reduction in most types of IPV between 2006 and 2012, violence perpetrated by women was not significantly reduced, and the current national rates are still high. Further, this study suggests that use of alcohol and other psychoactive drugs plays a major role in IPV. Prevention initiatives must take drug misuse into consideration.

Effects of Evaluative Context in Implicit Cognitions Associated with Alcohol and Violent Behaviors

Introduction

A large body of literature has substantiated the relationship between alcohol use and violent behaviors, but little consideration has been given to implicit interactions between the two. This study examines the implicit attitudes associated with alcoholic drinks and violent behaviors, and their relationship to explicit reports of problematic behaviors associated with alcohol use.

Methods

The Go/No-Go Association Task (GNAT; Nosek & Banaji, 2001) was used to test the effect of distracters (noise) on implicit cognitions associated with alcoholic drinks and violent behaviors. Data was collected from 148 students enrolled in a Midwestern university.

Results

Irrespective of contextual distractions, participants consistently exhibited negative implicit cognitions associated with violent behaviors. However, context impacted the valence of cognitions associated with alcoholic beverages. Implicit cognitions associated with alcoholic beverages were negative when nonalcoholic beverages were used as distracters, but were positive when licit and illicit drugs were used as distracters. Implicit cognitions associated with alcoholic drinks were correlated with implicit cognitions associated with violent behaviors and explicit measures of problem drinking, problem drug-related behaviors, and measures of craving, to name a few.

Conclusion

Evaluative context can have an effect on the expressed appraisal of implicit attitudes. Implications, limitations, and future directions for using the GNAT in addictions research are discussed.

•

Implicit cognitions associated with violent behaviors were always negative.

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Implicit cognitions of alcohol were negative when drinks were used as distracters.

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Implicit cognitions of alcohol were positive when drugs were used as distracters.

•

Evaluative context had an effect on the expressed appraisal of implicit attitudes.

Brief Motivational Intervention for Intimate Partner Violence and Heavy Drinking in the Emergency Department: A Randomized Clinical Trial

IMPORTANCE

Intimate partner violence (IPV) and heavy drinking are co-occurring public health problems, but integrated brief interventions for these conditions have not been tested.

OBJECTIVE

To determine whether a brief motivational intervention provided at the time of an emergency department (ED) visit reduces IPV and heavy drinking.

DESIGN, SETTING, AND PARTICIPANTS

A randomized clinical trial conducted at 2 US academic urban EDs between January 2011 and December 2014 to assess the effectiveness of a motivational intervention for IPV-involved female ED patients (ages: 18-64 years; N = 600) who exceeded sex-specific safe drinking limits. All received social service referrals; 2:2:1 to brief intervention (n = 242), assessed control (n = 237), or no-contact control (n = 121).

INTERVENTIONS

A 20- to 30-minute manual-guided motivational intervention (recorded and monitored for fidelity) delivered by master's-level therapists with a follow-up telephone booster. The assessed control group received the same number of assessments as the brief intervention group; the no-contact control group was assessed only once at 3 months.

MAIN OUTCOMES AND MEASURES

Incidents of heavy drinking and experiencing IPV measured over prespecified, 12 weekly assessments using an interactive voice response system.

RESULTS

Of 600 participants, 80% were black women with a mean age of 32 years. Retention was 89% for 2 or more interactive voice response system calls. Seventy-eight percent of women completed the 3-month interview, 79% at 6 months, and 71% at 12 months. During the 12-week period following the brief motivational intervention, there were no significant differences between the intervention group and the assessed control group on weekly assessments for experiencing IPV (odds ratio [OR], 1.02; 95% CI, 0.98-1.06) or heavy drinking (OR, 0.99; 95% CI, 0.96-1.03). From baseline to 12 weeks, the number of women with any IPV in the past week decreased from 57% (134 of 237) in the intervention group to 43% (83 of 194) and from 63% (145 of 231) in the assessed control group to 41% (77 of 187) (absolute difference of 8%). From baseline to 12 weeks, the number of women with past week heavy drinking decreased from 51% (120 of 236) in the intervention group to 43% (83 of 194) and from 46% (107 of 231) in the assessed control group to 41% (77 of 187) (absolute difference of 3%). At 12 months, 43% (71 of 165) of the intervention group and 47% (78 of 165) of the assessed control group reported no IPV during the previous 3 months and 19% (29 of 152) of the intervention group and 24% (37 of 153) of the control group had reduced their alcohol consumption to sex-specific National Institute on Alcohol Abuse and Alcoholism safe drinking levels.

CONCLUSIONS AND RELEVANCE

For women experiencing IPV and heavy drinking, the use of a brief motivational intervention in the ED compared with assessed and no-contact controls did not significantly reduce the days of heavy drinking or incidents of IPV. These findings do not support a brief motivational intervention in this setting.

TRIAL REGISTRATION

clinicaltrials.gov Identifer: NCT01207258.