Intimate partner violence and drinking patterns among white, black, and Hispanic couples in the U.S

Social ecological predictors and correlates of Latinos' IPV behaviors: A systematic review and critique of the research literature

The current paper utilizes an ecological level of analysis framework to review and critique the literature surrounding predictors, correlates, and antecedents of Latinos' intimate partner violence (IPV) behaviors. More specifically, the ecological levels of analysis framework was employed to demonstrate how Latino males' IPV perpetration is being understood and studied. A total of n = 34 peer-reviewed articles were reviewed and critiqued. Findings indicated that most IPV research is being conducted at and comprehended from the individual (n = 33; 97%) and microsystem/small group (n = 24; 71%) levels of analysis, while linkages to organizational, locality, and institutional levels of analysis are largely neglected. Researchers and interventionists appear to view Latinos' IPV behaviors through deficit models, employ decontextualized and homogenized representations of the population, and neglect higher ecological levels of analysis. These three shortcomings in IPV research as it pertains to Latino populations must be addressed in future research studies if investigators desire to end the stigmatization and demonization of Latinos as a cultural and people group, and to maximize battering intervention effectiveness and efficiency for men of Latino origin.

Racial Microaggressions Mediate the Association Between Posttraumatic Stress and Alcohol Use Among Women of Color Experiencing Intimate Partner Violence

Objective: Women of Color (WoC) experiencing intimate partner violence (IPV) have elevated rates of posttraumatic stress disorder (PTSD) and alcohol use and related harm (e.g., increased alcohol use and negative consequences). This secondary data analysis assessed the role of racial microaggressions in the association between PTSD and alcohol use and related harm among WoC experiencing IPV. Methods: Participants were 103 WoC currently experiencing IPV and using substances (Mage=40.39, 51.5% Black) who were recruited from the community and completed assessments of PTSD, racial microaggressions, and alcohol use and related harm. Results: Assumptions of Inferiority (e.g., intelligence; B = 1.44, SE = 0.90, 95% CI [0.10, 3.54]) and Environmental Microaggressions (e.g., portrayal in media; B = 1.88, SE = 1.03, 95% CI [0.28, 4.30]) explained the association between PTSD and alcohol use and related harm. Conclusions: Findings underscore the influence of specific microaggressions in the relation between PTSD and alcohol use and related harm among WoC experiencing IPV.

Alcohol use disorder among Whites and Hispanics on and off the U.S./Mexico border in California

This paper examines whether U.S./Mexico border residence in California is related to the prevalence of DSM-5 alcohol use disorder (AUD) among Whites and Hispanics. Household survey data were obtained from 1,209 adults (59.7% female) 18 to 39 years of age resident in four counties in California: Imperial on the U.S./Mexico border; and Kern, Tulare, and Madera in California's Central Valley. Households were selected using a list assisted sample, with data collected on the phone or online. Results show that AUD rates were not different between border and non-border location and between Whites and Hispanics. AUD was negatively associated with higher income ($20,000 to $60,000: AOR=.38; 95%CI=.17-.86; p<.01-more than $60,000: AOR=.27; 95%CI: .09-.81; p<.01) and poor risk perception (AOR=.86; 95%CI=.78-.94; p<.01). AUD was positively associated with continued volume of drinking (AOR = 1.05; 95%CI = 1.01-1.09; p<.01), drinking in Mexico (AOR = 4.28; 95%CI = 1.61-11.36; p<.01), marijuana use (AOR = 4.11; 95%CI = 1.73-9.77; p<.01), and impulsivity (AOR = 1.55; 95%CI = 1.23-1.94). Efforts to prevent AUD in the population in California, and especially among those who live close to the border with Mexico, should take into consideration factors such as impulsivity, marijuana use, border crossing to drink in Mexico, all of which increased risk of AUD.

Adverse childhood experiences and intimate partner violence: A meta-analysis

Intimate partner violence (IPV) represents a significant public health concern. Adverse childhood experiences (ACEs) represent one risk factor for IPV, however, the results of existing research on the association between ACEs and IPV demonstrate mixed findings. The present research sought to meta-analytically examine the association between ACEs and (a) IPV perpetration and (b) IPV victimization. Moderator analyses were conducted to determine factors that may impact the association between ACEs and IPV involvement. Electronic searches were conducted in MEDLINE, Embase, and PsycINFO in August of 2021. One-hundred and twenty-three records were screened for inclusion. All studies included a measure of ACEs and IPV victimization or perpetration. Among the 27 studies and 41 samples included in the meta-analysis, 65,330 participants were included. The results of the meta-analyses demonstrated that ACEs were positively associated with IPV perpetration and victimization. Significant methodological and measurement moderators further inform our understanding of ACEs and IPV involvement. The present meta-analyses demonstrates that trauma-informed approaches to IPV screening, prevention, and intervention may be useful, given that individuals who are involved with IPV may be more likely to possess a history of ACEs exposure.

Contexts of Drinking- and Alcohol-Related Problems Among Whites and Hispanics on and off the US/Mexico border in California

BACKGROUND

This paper examines the association between drinking context use by Whites and Hispanics on and off the US/Mexico border and alcohol problems.

METHODS

Data come from a household sample of 1209 adults 18 to 39 years of age resident in Imperial County on the California/Mexico border; and Kern, Tulare, and Madera in California's Central Valley. Data were collected on the phone or online and analyzed with an ordinal generalized linear model.

RESULTS

The pattern of statistically significant associations between the frequency and the volume of drinking in different contexts varies across problem types. Furthermore, some contexts of drinking are associated with problems in more than one area. For instance, frequency of drinking at bars/pubs is associated with social problems, risky sex, and fights, but not with injuries. Injuries are associated with the frequency of drinking at home alone or with family and at restaurants. Volume of drinking at bars/pubs is also significantly associated with three different contexts: social problems, injury, and fights. But the volume of drinking at the home of friends or relatives is associated with fights only. Border location is an effect modifier, changing the effect of frequency of drinking at bars and pubs from protective to a factor of risk for social problems and fights.

CONCLUSION

These results provide support for the social ecology of drinking and micro environmental factors or risk. The effect of border location on frequency of drinking in bars/pubs underlines the importance of the macro environment in problem generation.

Afrocentric Cultural Norms, Mental Health Functioning, and the Perception of Intimate Partner Violence Among Young Black Men

Intimate partner violence (IPV) is a serious public health concern that profoundly impacts the lives of women globally. While IPV cuts across race, socioeconomic status, age groups, and geography, Black women are disproportionately affected. Prior studies report that Black women predominantly couple with Black men and thus, understanding factors associated with IPV perpetration among Black men is essential. Subsequently, the present study explored an important gap in the literature, exploring how collectivism, a core belief ascribed to Afrocentric cultural norms, and factors associated with mental health functioning in emerging adult Black men in the USA is associated with their views of IPV. Data for the study was drawn from a sample of self-identifying Black American males between the ages of 18 and 25 (n=300). Regression analysis demonstrated no significant relationship between age, household income, and education level among participants. Anxiety had a significant relationship with intimate partner beliefs with participants with increased anxiety having more problematic intimate partner beliefs. A model including anxiety, collectivism, and aggressiveness was a significant predictor of problematic intimate partner beliefs. In the final model, collectivism and aggressiveness were statistically significant predictors of perceptions endorsing IPV. Participants who reported higher levels of global aggressive confrontation with others were more likely to endorse IPV. Overall, participants with a sense of value for collectivism over individualism were least likely to endorse IPV. This study provides evidence that cultural norms potentially have a role in Black men's beliefs about IPV. Implications for future research are provided.

Gender moderates the association between posttraumatic stress disorder and mutual intimate partner violence in an emergency department sample

INTRODUCTION

Patients in emergency departments (EDs) constitute a diverse population with multiple health-related risk factors, many of which are associated with intimate partner violence (IPV). This paper examines the interaction effect of depression, posttraumatic stress disorder (PTSD), impulsivity, drug use, adverse childhood experiences (ACEs), at-risk drinking, and having a hazardous drinker partner with gender on mutual physical IPV in an urban ED sample.

METHODS

Research assistants surveyed 1037 married, cohabiting, or partnered patients in face-to-face interviews (87% response rate) regarding IPV exposure, alcohol and drug use, psychological distress, ACEs, and other sociodemographic features. IPV was measured with the Revised Conflict Tactics Scale. Interaction effects were examined in multinomial and logistic models.

RESULTS

Results showed a significant interaction of gender and PTSD (odds ratio [OR] 3.06, 95% CI 1.21-7.23, p < 0.05) for mutual IPV. Regarding main effects, there were also statistically significant positive associations between mutual physical IPV and at-risk drinking (OR 1.73, 95% CI 1.07-2.77, p < 0.05), having a hazardous drinker partner (OR 2.19, 95% CI 1.35-3.55, p < 0.01), illicit drug use (OR 2.09, 95% CI 1.18-3.71, p < 0.01), ACEs (OR 1.23, 95% CI 1.06-1.42, p < 0.01), days of cannabis use past in the 12 months (OR 1.003, 95% CI 1.002-1.005, p < 0.001), and impulsivity (OR 2.04, 95% CI 1.29-3.22, p < 0.01).

CONCLUSIONS

IPV risk assessment in EDs will be more effective if implemented with attention to patients' gender and the presence of various and diverse other risk factors, especially PTSD.

Intimate Partner Violence Among Hispanic/Latinx and White College Students

Hispanic/Latinx individuals disproportionately experience intimate partner violence (IPV) compared to their non-Hispanic/Latinx counterparts, and little is known about IPV among college-aged Hispanic/Latinx students. This study examines the rates of IPV victimization and perpetration and their correlates among Hispanic/Latinx and non-Hispanic White college students by analyzing cross-sectional survey data of 3,397 Hispanic/Latinx and White college students enrolled in seven universities. Compared to their White counterparts, Hispanic/Latinx students reported higher rates of IPV victimization and perpetration. Age, gender, drug use, and adverse childhood experience were associated with both IPV victimization and perpetration, while ethnicity was only associated with IPV perpetration. This study's findings highlight the urgent need for more culturally sensitive IPV prevention services and responses to support Hispanic/Latinx college students.

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.

Risk Factors of Female-Perpetrated Intimate Partner Violence among Hispanic Young Adults: Attachment Style, Emotional Dysregulation, and Negative Childhood Experiences

This paper examined whether risk factors commonly associated with intimate partner violence (IPV) are associated with female-perpetrated physical IPV and female physical IPV victimization among young Hispanic women. It also examined how emotion dysregulation, impulsivity, and attachment style exacerbated these relationships. Furthermore, it investigates how these associations differ by the type of self-reported physical violence against their romantic partner. Based on the participants' self-reported physical violence, they were classified into one of four groups: nonviolent, victim-only, perpetrator-only, and bidirectionally violent. Bidirectional violence was by far the most common form of violence reported. Utilizing self-report data from 360 young Hispanic women, we used binary logistic regression to examine potential predictors of physical IPV perpetration and victimization for each group. Results demonstrated that women in the bidirectionally violent group reported the highest levels of perpetration and victimization. Parental violence victimization, witnessing interparental violence, insecure attachment styles, and emotional dysregulation predicted physical IPV perpetration and victimization. These findings emphasize the need for effective interventions that include both members of the dyad and acknowledge the impact of women's attachment style, emotion dysregulation, and adverse childhood experiences on female-perpetrated IPV and female IPV victimization.

Association of Cannabis Use and At-Risk Alcohol Use With Intimate Partner Violence in an Urban ED Sample

INTRODUCTION

Urban ED patients have elevated rates of substance use and intimate partner violence. The purpose of this study is to describe the risk profiles for intimate partner violence among urban ED patients who report at-risk alcohol use only, cannabis use only, or both types of substance use.

METHODS

Cross-sectional survey data were collected from study participants (N = 1037; 53% female; ages 18-50) following informed consent. We measured participants' past-year at-risk drinking (women/men who had 4+/5+ drinks in a day), cannabis use, psychosocial and demographic characteristics, and past-year physical intimate partner violence (assessed with the Revised Conflict Tactics Scale). We used bivariate analysis to assess whether rates of intimate partner violence perpetration and victimization differed by type of substance use behavior. Multivariate logistic regression models were estimated for each intimate partner violence outcome. All analyses were stratified by gender.

RESULTS

Rates of intimate partner violence differed significantly by type of substance use behavior and were highest among those who reported both at-risk drinking and cannabis use. Multivariate analysis showed that women who reported at-risk drinking only, cannabis use only, or both types of substance use had increased odds for intimate partner violence perpetration and victimization compared with women who reported neither type of substance use. Men's at-risk drinking and cannabis use were not associated with elevated odds of intimate partner violence perpetration or victimization.

DISCUSSION

Brief screening of patients' at-risk drinking and cannabis use behaviors may help identify those at greater risk for intimate partner violence and those in need of referral to treatment.

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.

Racial/Ethnic Differences in Alcohol and Drug Misuse Among IPV-Victimized Women: Exploring the Role of Difficulties Regulating Positive Emotions

Alcohol and drug misuse is prevalent and problematic among women who experience intimate partner violence (IPV). Emotional dysfunction has been identified as a key mechanism in the etiology, maintenance, and treatment of alcohol and drug misuse. However, existing research has not considered the role of race/ethnicity in the relations between emotional dysfunction and alcohol and drug misuse. Furthermore, past research in this area has focused almost exclusively on emotional dysfunction stemming from negative (vs. positive) emotions. The goals of the current study were as follows: (a) to explore whether levels of difficulties regulating positive emotions differ among Latina, African American, and White IPV-victimized women, and (b) to examine the moderating role of race/ethnicity in the relations between difficulties regulating positive emotions and alcohol and drug misuse. Participants were 197 IPV-victimized women recruited through the criminal justice system (Mage = 36.14; 51.8% African American, 31.5% White, and 16.8% Latina). Difficulties regulating positive emotions did not differ as a function of race/ethnicity. However, relations among difficulties regulating positive emotions and alcohol and drug misuse were significant for Latina and White but not African American IPV-victimized women. Moreover, race/ethnicity moderated an association between difficulties regulating positive emotions and drug misuse; this relation was significant and positive for White (compared with African American) IPV-victimized women. While preliminary, these results may inform culturally sensitive interventions for alcohol and drug misuse that are tailored to the unique needs of Latina, African American, and White IPV-victimized women.

Drinking in Mexico by Whites and Hispanics on and off the US/Mexico border in California

This paper compares drinking patterns of Whites and Hispanics who after crossing the U.S./Mexico border drink and do not drink in Mexico. Data came from a household survey of 1,209 adults 18 to 39 years of age in California. Residence near the US/Mexico border increases the likelihood of drinking in Mexico (AOR = 4.57; 95%CI = 2.45-8.52; p < .001). Hispanics (AOR = 1.91; 95%CI = 1.26-2.90; p < .01), those who drink more frequently (AOR = 1.05; 95%CI = 1.02-1.09; p < .01) and those who drink six or more drinks in day (AOR = 1.91; 95%CI = 1.26-2.29; p < .01) are more likely than Whites and lighter drinkers to report this behavior. Crossing the U.S./Mexico border to drink is influenced by living close to the border, Hispanic ethnicity, and drinking many drinks in a day.

Pathways to Seeking Help From a Partner Abuse Intervention Program: A Qualitative Study of Voluntary and Non-Court-Mandated Latino Men's Experiences

Involvement in treatment for intimate partner violence and abuse (IPV/A) perpetration is often limited to those who are arrested and convicted of domestic violence offenses. Consequently, the majority of research into partner abuse intervention programs (PAIPs; also known as batterer intervention programs [BIPs]) has utilized data from court-mandated participants despite the existence of voluntary programs. Therefore, little is known about the experiences of voluntary and non-court-mandated BIP/PAIP participants. Using an interpretive phenomenological analysis, this study sought to understand how participants perceived their lived experience in seeking help from a voluntary BIP/PAIP serving Latino men. Men volunteering for this study participated in semi-structured in-depth interviews (N = 16). The findings reveal that the decision to engage in a BIP/PAIP voluntarily is process laden. Participants described the process as involving a breakdown in the health of their intimate relationship, reaching tipping points at which avoiding help was no longer an option, and locating specific information on where to seek treatment. The findings also reveal that once involved, most participants anticipated and desired to engage in the program long term. This study illuminates the many factors that may contribute to decision-making when men who have acted abusively seek help. Strategies for increasing voluntary BIP/PAIP participation may involve enhancing marketing of services or information for accessing services, and personal relationship building between facilitators and potential participants.

Frequency of Intimate Partner Violence among an Urban Emergency Department Sample: A Multilevel Analysis

Intimate partner violence (IPV) is a pervasive public health problem. Within the U.S., urban emergency department (ED) patients have elevated prevalence of IPV, substance use, and other social problems compared to those in the general household population. Using a social-ecological framework, this cross-sectional study analyzes the extent to which individual, household, and neighborhood factors are associated with the frequency of IPV among a socially disadvantaged sample of urban ED patients. Confidential survey interviews were conducted with 1037 married/partnered study participants (46% male; 50% Hispanic; 29% African American) at a public safety-net hospital. Gender-stratified multilevel Tobit regression models were estimated for frequency of past-year physical IPV (perpetration and victimization) and frequency of severe IPV. Approximately 23% of participants reported IPV. Among men and women, impulsivity, adverse childhood experiences, substance use, and their spouse/partner's hazardous drinking were associated with IPV frequency. Additionally, household food insufficiency, being fired or laid off from their job, perceived neighborhood disorder, and neighborhood demographic characteristics were associated with IPV frequency among women. Similar patterns were observed in models of severe IPV frequency. IPV prevention strategies implemented in urban ED settings should address the individual, household, and neighborhood risk factors that are linked with partner aggression among socially disadvantaged couples.

Racial/Ethnic Discrimination and Intimate Partner Violence Perpetration in Latino Men: The Mediating Effects of Mental Health

PURPOSE

Intimate partner violence (IPV) is a serious public health problem that disproportionately affects racial/ethnic minorities in the U.S. This study examines risk factors for IPV perpetration that are salient for racial/ethnic minorities; specifically, we test if racial/ethnic discrimination among Latino men is associated with IPV perpetration, if poor mental health (MH) mediates this link, and whether relationships differ by immigrant status.

METHODS

Using National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-II) Wave 2 (2004-2005) data, multigroup structural equation modeling compared immigrant (N = 1187) and U.S.-born (N = 1077) Latinos on a mediation model whereby discrimination increases IPV risk via poor MH (anxiety, depression, post-traumatic stress (PTSS); alcohol dependence (AD) and drug dependence (DD)).

RESULTS

For U.S.-born Latinos, discrimination increased anxiety (β = 0.24, p < 0.001), depression (β = 0.16, p < 0.001), PTSS (β = 0.09, p < 0.001), AD (β = 0.11, p < 0.001) and DD (β = 0.16, p < 0.001); anxiety (β = 0.16, p < 0.001), AD (β = 0.19, p < 0.001) and DD (β = 0.09, p < 0.01) increased IPV risk. Among Latino immigrants, discrimination increased anxiety (β = 0.07, p < 0.001), depression (β = 0.16, p < 0.001), PTSS (β = 0.08, p < 0.001) and DD (β = 0.03, p < 0.001); PTSS (β = 0.16, p < 0.001), AD (β = 0.21, p < 0.001) and DD (β = 0.05, p < 0.01) increased IPV risk.

CONCLUSIONS

Among Latino men, discrimination is associated with poorer MH and contributes to IPV perpetration; MH risk factors vary by immigrant status.

Adverse childhood experiences are associated with at-risk drinking, cannabis and illicit drug use in females but not males: an Emergency Department study

BACKGROUND

Adverse childhood experiences (ACEs) are associated with adult substance use in the general population. Given pervasive health disparities among underserved populations, understanding how ACEs are associated with substance use among urban Emergency Department (ED) patients could help inform design of effective screening, brief interventions, and referral to treatment.

OBJECTIVES

To estimate gender differences in prevalence of separate and cumulative ACEs among a sample of urban ED patients, and assess its association with at-risk drinking (4+/5+ drinks for females/males), cannabis, and illicit drug use. We hypothesized that the association between ACEs and each outcome would be stronger among females than males.

METHODS

Cross-sectional survey data were obtained from 1,037 married/partnered ED patients (53% female) at a public safety-net hospital. Gender-stratified logistic regression models were estimated for each substance use outcome.

RESULTS

One+ ACEs were reported by 53% of males and 60% of females. Females whose mother was a victim of domestic violence had greater odds of at-risk drinking compared to females who did not report this ACE (AOR = 1.72; 95% CI 1.03, 2.88). Females' cumulative ACEs were associated with cannabis use (OR = 2.26, 95% CI 1.06, 4.83) and illicit drug use (OR = 3.35; 95% CI 1.21, 9.30). Males' separate and cumulative ACEs were not associated with increased likelihood for any of the outcomes.

CONCLUSION

ACEs are associated with greater odds of substance use among female than male ED patients. The prevalence of ACE exposure in this urban ED sample underscores the importance of ED staff providing trauma-informed care.

Longitudinal Trajectory of Exposure to Psychological Interpersonal Violence

Psychological intimate partner violence (P-IPV) refers to verbal abuse from one partner to another and abuse of power or control from one partner to another. To date, no studies have examined the longitudinal course of P-IPV exposure among mothers or the effect that witnessing P-IPV can have on their children. Using latent class growth analysis, the current study identified five trajectory groups with the following intercept and growth characteristics: low stable, low-increasing, moderate-decreasing, high-decreasing, and consistently elevated. Membership in the four groups characterized by higher P-IPV exposure was predicted by maternal race and exposure to physical abuse. The children of mothers in the low-increasing and consistently elevated groups had elevated scores on the Internalizing and Externalizing scales of the Childhood Behavior Checklist. These findings remained after controlling for child sex, race, cumulative trauma exposure, and maternal depression.

Alcohol Use and Harm to Children by Parents and Other Adults

This study used mixed methods to examine parent-reported harm to children (lack of supervision or physical harm) due to alcohol use by themselves or someone else as well as parent beliefs about alcohol, parenting, and harms to children. We conducted a cross-sectional general population survey of 1,599 parents who were primary caregivers to a child aged 10 or younger and follow-up interviews with 23 parents who responded "yes" to one of the questions about alcohol use causing harm their child. Survey data were analyzed using multilevel logistic models. Compared to abstainers, parents who drank at least once a year were less likely to report that someone else's drinking caused a lack of supervision or physical harm to their child. Higher continued volumes of drinking were related to fewer reports of not watching a child closely enough. Social companionship support (having people to go out with) was related to greater odds that a parent's drinking would cause physical harm to his or her child(ren). In the qualitative analysis, four relevant themes emerged: perceived effects of alcohol use, tangible support and child supervision, immediate and distal harm, and turning points in drinking behaviors.

Intimate Partner Violence Against Women Among North Korean Refugees: A Comparison With South Koreans

North Korean refugees in South Korea have been reported as at higher risk of intimate partner violence (IPV). However, few studies have examined risk factors of IPV among North Korean refugees. This study aimed to report the prevalence of IPV against women among North Korean refugees, and compared the risk factors of IPV against women between South Koreans and North Korean refugees in South Korea. Data from a nationwide survey about domestic violence in South Korea were used. The rate of IPV against women by North Korean refugees was 57.1%, which is considerably higher than that of South Koreans (9.9%). The regression analysis indicated that North Korean refugees perpetrated partner violence against women more frequently than South Koreans, even after controlling for socioeconomic factors. Child abuse victimization and witnessing IPV between parents were the main factors of IPV against women among South Koreans. On the other hand, stress and a tolerant attitude toward using violence were significantly associated with IPV against women among North Korean refugees. The findings suggested that stress management and education on reducing tolerance to violence should be provided to prevent IPV against women among North Korean refugees.

Co-Occurrence of Multiple Risk Factors and Intimate Partner Violence in an Urban Emergency Department

INTRODUCTION

Urban emergency departments (ED) provide care to populations with multiple health-related and overlapping risk factors, many of which are associated with intimate partner violence (IPV). We examine the 12-month rate of physical IPV and its association with multiple joint risk factors in an urban ED.

METHODS

Research assistants surveyed patients regarding IPV exposure, associated risk factors, and other sociodemographic features. The joint occurrence of seven risk factors was measured by a variable scored 0-7 with the following risk factors: depression; adverse childhood experiences; drug use; impulsivity; post-traumatic stress disorder; at-risk drinking; and partner's score on the Alcohol Use Disorders Identification Test. The survey (N = 1037) achieved an 87.5% participation rate.

RESULTS

About 23% of the sample reported an IPV event in the prior 12 months. Logistic regression showed that IPV risk increased in a stepwise fashion with the number of present risk factors, as follows: one risk factor (adjusted odds ratio [AOR] [3.09]; 95% confidence interval [CI], 1.47-6.50; p<.01); two risk factors (AOR [6.26]; 95% CI, 3.04-12.87; p<.01); three risk factors (AOR = 9.44; 95% CI, 4.44-20.08; p<.001); four to seven risk factors (AOR [18.62]; 95% CI, 9.00-38.52; p<001). Ordered logistic regression showed that IPV severity increased in a similar way, as follows: one risk factor (AOR [3.17]; 95% CI, 1.39-7.20; p<.01); two risk factors (AOR [6.73]; 95% CI, 3.04-14.90; p<.001); three risk factors (AOR [10.36]; 95%CI, 4.52-23.76; p<.001); four to seven risk factors (AOR [20.61]; 95% CI, 9.11-46.64; p<001).

CONCLUSION

Among patients in an urban ED, IPV likelihood and IPV severity increase with the number of reported risk factors. The best approach to identify IPV and avoid false negatives is, therefore, multi-risk assessment.

The Men's Group at St. Pius V: A Case Study of a Parish-Based Voluntary Partner Abuse Intervention Program

Literature on Latino men and intervention for intimate partner violence/abuse (IPV/A) is slim. Over 100 men have voluntarily sought help for IPV/A perpetration from “The Men’s Group” (TMG) at St. Pius V parish in Chicago, IL (US) and remained engaged for extended periods. Given the rarity of prolonged non-court mandated engagement in batterer intervention programs (BIPs), a case study was conducted to explore how TMG functions. Drawing on multiple data sources, this study examined development and implementation of TMG, while also investigating contextual factors, motivators and facilitators of participants’ involvement. Data revealed that TMG functions within a supportive community context by using a mixture of traditional techniques and innovative practices, creating a unique treatment modality. The program was found to be culturally-sensitive and spirituality-based. Reasons for initial attendance varied but included: (1) fear of losing or actual loss of their partner/family; (2) acknowledging a problem and desiring to change for self or others; and (3) a desire to reach inner peace. Three themes shed light on why men remain engaged in TMG, including: (1) being met with respect by facilitators; (2) experiencing TMG as “family”; and (3) gaining benefits. Reliance upon the criminal justice system is not enough to address IPV/A perpetration. This program shows promise as an alternative or supplement to traditional BIPs, which typically rely on clients being court-mandated to attend treatment. Given the widespread nature of IPV/A, understanding the operation of potential community-based alternatives or supplements to BIPs is critical in widening access to treatment.

Problem Drinking and Marijuana Use as Risks for Unidirectional and Bidirectional Partner Violence

Despite evidence that most who perpetrate intimate partner violence (IPV) also report victimization, little is known about bidirectional IPV among Emergency Department (ED) patients and its association with problem drinking and marijuana use. We conducted an observational, cross-sectional survey among low- and moderate-acuity patients at a Northern California safety-net ED. Physical IPV was measured with the Revised Conflict Tactics Scale (CTS2). We recorded patient's frequency of intoxication and marijuana use. Spouse/partner's problem drinking and marijuana use were measured dichotomously. Odds Ratios [ORs] and 95% confidence intervals [CIs] were estimated using multinomial logistic regression models of unidirectional and bidirectional IPV. Among 1,037 patients (53% female), perpetration only, victimization only, and bidirectional IPV were reported by 3.8%, 6.2%, and 13.3% of the sample, respectively. Frequency of intoxication was associated with perpetration (OR 1.50; 95% CI 1.18 to 1.92) and bidirectional IPV (OR=1.34; 95% CI 1.13 to 1.58). Days of marijuana use were associated with bidirectional IPV (OR=1.15; 95% CI 1.03 to 1.28). Patients whose partners were problem drinkers were at risk for victimization (OR=2.56; 95% CI=1.38, 4.76) and bidirectional IPV (OR=1.97; 95% CI 1.18, 3.27). Among patients who reported any past-year IPV, most experienced bidirectional aggression. ED staff should consider asking patients who are married, cohabiting, or in a dating relationship about their experience with past-year IPV and inquire about their substance use patterns and those of their romantic partner, to share information about potential linkages. Medical and recreational marijuana legalization trends underscore the importance of further research on IPV and marijuana.

Fluctuations in daily PTSD symptoms are related to proximal alcohol use: a micro-longitudinal study of women victims of intimate partner violence

Background: One-third of women who experience intimate partner violence (IPV) are identified as having alcohol use problems. Yet, little research has examined factors that may increase the risk of alcohol use among this high-risk population. Objectives: This study overcomes limitations of previous research by using micro-longitudinal methods to examine how fluctuations in PTSD symptoms throughout the day are associated with proximal drinking behavior and whether these associations are related to individuals' overall PTSD severity and race/ethnicity. Methods: Using phone-based interactive voice response, 244 female victims of current IPV reported their PTSD symptoms and drinking four times daily for 14 days. Results: Results indicated positive associations between PTSD symptom cluster severity and drinking level at the person, daily and within-day levels. The effects of within-person fluctuations in daily levels of PTSD severity on levels of drinking were stronger for individuals with lower PTSD severity. No evidence was found for within-person differences on time-lagged effects of PTSD on drinking or by racial/ethnic group. Further, in time-lagged models no evidence was found for reverse causation whereby alcohol use predicts increased PTSD symptom severity. Conclusions: Findings suggest that IPV-exposed women use alcohol to alleviate their PTSD symptoms at the micro-process level and that prevention and treatment efforts targeting PTSD symptoms may be useful in reducing alcohol use in this population. Further, these efforts should consider the overall severity of PTSD symptoms experienced given the differential findings among women with higher vs. lower PTSD symptom severity.

Economics of Child Protection: Maltreatment, Foster Care, and Intimate Partner Violence

Violence within families and child neglect are strikingly common: 700,000 children are found to be victims of abuse or neglect in the United States each year; over the course of childhood, 6% of children are placed in foster care, and 18% witness intimate partner violence. These children are at much higher risks of homelessness, criminal justice involvement, unemployment, and chronic health conditions compared to their neighbors. This article reviews the state of the economics literature on the causes and consequences of child maltreatment and intimate partner violence and calls for greater research into interventions aimed at improving child well-being.

Childhood interpersonal violence and adult alcohol, cannabis, and tobacco use disorders: variation by race/ethnicity?

BACKGROUND

Exposure to child maltreatment has been shown to increase lifetime risk for substance use disorders (SUD). However, this has not been systematically examined among race/ethnic groups, for whom rates of exposure to assaultive violence and SUD differ. This study examined variation by race/ethnicity and gender in associations of alcohol (AUD), cannabis (CUD), and tobacco (TUD) use disorders with three types of childhood interpersonal violence (cIPV): physical abuse, sexual abuse, and witnessing parental violence.

METHOD

Data from the National Epidemiologic Survey of Alcohol-Related Conditions-III (N: 36 309), a US nationally representative sample, was utilized to examine associations of DSM-5 AUD, CUD and TUD with cIPV among men and women of five racial/ethnic groups. Models were adjusted for additional risk factors (e.g. parental substance use problems, participant's co-occurring SUD).

RESULTS

Independent contributions of childhood physical and sexual abuse to AUD, CUD, and TUD, and of witnessing parental violence to AUD and TUD were observed. Associations of cIPV and SUD were relatively similar across race/ethnicity and gender [Odds Ratios (ORs) ranged from 1.1 to 1.9], although associations of physical abuse with AUD and TUD were greater among males, associations of parental violence and AUD were greater among females, and associations of parental violence with AUD were greater among Hispanic women and American Indian men.

CONCLUSIONS

Given the paucity of research in this area, and the potential identification of modifiable risk factors to reduce the impact of childhood interpersonal violence on SUDs, further research and consideration of tailoring prevention and intervention efforts to different populations are warranted.

Intimate Partner Violence Against Women in Northwestern Botswana: The Maun Women’s Study

Factors characterizing intimate partner violence (IPV) against women vary according to setting and must be understood in localized environments if effective interventions are to be identified. This 2009-2010 exploratory study in Maun, Botswana, used semistructured interviews to elicit information from 469 women about their experiences with IPV. Characteristics found to be important included suicide attempts, childhood exposure to familial violence, access to and control over certain tangible assets, number of children, household location and monthly income, controlling behavior by a partner, and alcohol consumption. Controlling behavior by a partner was the single greatest predictor of physical or psychological IPV.

Comparison of Characteristics of Female Drivers with Single and Multiple DUI Convictions

BACKGROUND

Women are increasingly involved in drunk driving and fatal crashes, yet except for the screening performed in criminal justice settings, little is known about their life context, psychiatric histories, and family backgrounds. This study describes a sample of women with histories of arrest for driving under the influence of alcohol (DUI) who were interviewed outside a criminal justice setting and contrasts women with single versus multiple DUI convictions.

METHODS

Women with recent documented histories of DUI participated in a study of women's health behaviors. Thirty-six women with 1 DUI and 62 with 2 or more DUIs participated in a diagnostic telephone interview which assessed demographics, alcohol use and problems, psychiatric problems, treatment, and partner violence.

RESULTS

The sample overall had high rates of co-occurring psychiatric problems, parental alcohol problems, early sexual and physical abuse, and head injuries. Alcohol use severity and the prevalence of head injuries and partner alcohol problems were significantly higher among women with multiple DUIs than women with a single DUI. Measures reflecting life context, such as marital status, number of children, and childhood trauma, were not associated with number of DUIs.

CONCLUSIONS

Findings suggest that DUI recidivism in women is accounted for primarily by AUD severity and is not influenced by previous life events such as partner violence, psychiatric problems, and family context such as divorce/separation or number of children. Multiple DUIs in women may mark an alcohol severity threshold beyond which few factors account for additional risk.

Intimate Partner Violence May Be One Mechanism by Which Male Partner Socioeconomic Status and Substance Use Affect Female Partner Health

Background: Although male partners' socioeconomic status (SES) and substance use is associated with worse health of female partners, the mechanism behind this link is still unknown. Objectives: To investigate whether intimate partner violence (IPV) is a mechanism by which male partners' SES and substance use influence female partners' self-rated health (SRH) as victims and survivors of IPV. Materials and Methods: Fragile Families and Child Wellbeing Study (FFCWS) is an ongoing population-based cohort. Male and female partners' SES, anxiety, depression, and substance use, and their relationship status were measured at baseline. IPV victimization was also asked among female partners' at baseline. Female partners' subjective health was measured 3 times (baseline-1998, 3 years later-2001, and 5 years later-2003). Using AMOS, we fitted two structural equation models (SEM) for data analysis. In Model 1 we tested direct paths from male partners' SES and mental health to female partners' SRH, in the absence of IPV. In the Model 2 we conceptualized female partners' IPV victimization between male partners' SES and mental health and female partners' SRH. In both models we controlled for the effect of female partners' SES and mental health. Results: In Model 1, male partners' poor SES and substance use were associated with worse trajectory of SRH of female partner. In Model 2, male to female IPV was the mechanism by which male partners' SES and substance use were associated with female partners' SRH. Conclusions: IPV is one of the mechanisms by which male partners' SES and substance use can influence female partners' health. That is, IPV may operate as a vehicle by which male partners' social and psychological risk factors impact female partners' health. Thus, this study demonstrates how male partners' socio-ecological risk factors such as low SES and substance use impact female partners' health. Therefore, there is a need for broader socio-ecological approach to IPV prevention and intervention that recognizes the relationship between male partners' risk factors and their female partners' health outcomes. Such approach can inform prevention and treatment of IPV and enhance partner wellbeing.

Disorganization Theory, Neighborhood Social Capital, and Ethnic Inequalities in Intimate Partner Violence between Arab and Jewish Women Citizens of Israel

We draw on social disorganization (SD) theory and social capital to examine the impact of neighborhood environment on the ethnic gap in intimate partner violence (IPV) between Arab and Jewish women in Israel. We linked census data on neighborhood socioeconomic status (SES) to national data we gathered in 2014-2015 on 1401 women (436 Arab, 965 Jewish) age 16-48. Women were interviewed while visiting 65 maternal and child health clinics throughout Israel. We used General Estimated Equation (GEE) multivariate logistic regression models to adjust for clinic cluster effects and estimated the contribution of neighborhood collective efficacy, problems, relative socioeconomic status (SES), bridging and linking social capital, and social support to explaining ethnic inequalities in IPV, while adjusting for women's socioeconomic and socio-demographic characteristics. We found that any IPV is higher among Arab compared to Jewish women (odds ratio (OR) and 95% confidence intervals (CI) = 4.19 (2.72,6.42)). Collective efficacy and social group membership (bridging social capital) had no effect on the ethnic inequality in any IPV and types of IPV. Women's active participation in social groups (linking social capital), higher social support, and living in neighborhoods with relative SES similar to the ethnic group average) had a protective effect from any IPV and physical IPV. Neighborhood problems were associated with increased any IPV and physical IPV. In the final model, the ethnic gap in IPV was reduced but not eliminated (OR (95%CI) = 3.28 (2.01, 5.35). Collective efficacy did not explain the ethnic gap in IPV, while women's active participation (linking social capital) had a protective effect from IPV. Given the protective nature of women's activism in this population, future research should investigate how this might be incorporated into solutions to IPV. In addition, reducing neighborhood problems, improving neighborhood SES, and increasing social support might help reduce IPV among Arab women, thus decreasing the ethnic gap in IPV.

Clarifying the Association Between Mother-Father Relationship Aggression and Parenting

Although much research examines the association between fathers' relationship aggression and mothers' parenting, little attention is given to mothers' aggression, mutual aggression, or fathers' parenting. Using a sample of coresiding couples from the Fragile Families and Child Wellbeing Study (N = 973), the authors examine the association between mothers' and fathers' relationship aggression, measured as frequency and perpetration-victimization types (mutual, mother-only, father-only), and mothers' and fathers' parenting. Fixed effects regression models show that fathers' aggression-father-only or mutual-is positively related to mothers' parenting stress, whereas father-only or mother-only aggression is related to fathers' stress. For both parents, aggression perpetration is negatively related to their own engagement with children. Mother-only aggression is negatively related to mothers' spanking and positively related to fathers' spanking. These findings suggest the importance of examining both parents' aggression and perpetrators' as well as victims' parenting to better understand the link between relationship aggression and parenting.

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.

Racial/ethnic differences moderate associations of coping strategies and posttraumatic stress disorder symptom clusters among women experiencing partner violence: a multigroup path analysis

BACKGROUND

Past research underscores the key role of coping strategies in the development, maintenance, and exacerbation of posttraumatic stress disorder (PTSD) symptoms. The goal of the current study was to extend existing literature by examining whether race/ethnicity moderates the relations among coping strategies (social support, problem-solving, avoidance) and PTSD symptom clusters (intrusion, avoidance, numbing, arousal).

METHODS

Participants were 369 community women (134 African Americans, 131 Latinas, 104 Whites) who reported bidirectional aggression with a current male partner. Multigroup path analysis was utilized to test the moderating role of race/ethnicity in a model linking coping strategies to PTSD symptom clusters.

RESULTS

The strength and direction of relations among coping strategies and PTSD symptom clusters varied as a function of race/ethnicity. Greater social support coping was related to more arousal symptoms for Latinas and Whites. Greater problem-solving coping was related to fewer arousal symptoms for Latinas. Greater avoidance coping was related to more symptoms across many of the PTSD clusters for African Americans, Latinas, and Whites, however, these relations were strongest for African Americans.

CONCLUSION

Results provide support for the moderating role of race/ethnicity in the relations among coping strategies and PTSD symptom clusters, and highlight potential targets for culturally informed PTSD treatments.

Mothers' Reentry into Family Life Following Incarceration

The experiences of a group of mothers reentering the community after a period of incarceration are explored. The authors are particularly interested in how incarceration and subsequent reentry influence mothers' family relationships and primary risk and protective factors. Eighty-min interviews are conducted with 28 women probationers who had at least one minor child and had undergone incarceration at least 2 months prior to release. Descriptive analyses reveal that mental health risks characterize many mothers in this study, resource adequacy and parenting stress are significantly related, and family support is an important factor in successful reentry. It also appears that incarceration, even for short periods, is associated with shifts in family configuration on mothers' release by increasing the likelihood of divorce and decreasing the likelihood that mothers will reside with the father of at least one of their biological children. Implications for intervention and directions for future research are discussed.

Acculturation, Drinking, and Intimate Partner Violence among Hispanic Couples in the United States: A Longitudinal Study

This article examines the 5-year association between acculturation, drinking, and maleto-female partner violence and female-to-male partner violence among Hispanic couples in the United States. A national representative sample of Hispanic couples 18 years of age or older was interviewed in 1995 and 2000. Both members of the couple were independently interviewed. Differences in prevalence rates of male-to-female partner violence and female-to-male partner violence, incidence, and recurrence across acculturation groups are not significant. Drinking is associated with acculturation among women. Couples with mixed acculturation level (high-medium) are less at risk for maleto-female partner violence. An increase of five standard drinks per week in men’s drinking decreases the risk of female-to-male partner violence by 10%. Acculturation level at Time 1 is not associated with male-to-female partner violence and female-to-male partner violence status 5 years later.

Knowledge and Attitudes About Intimate Partner Violence Among Immigrant Latinos in Rural North Carolina

To create appropriate intimate partner violence (IPV) services for Latino immigrants, practitioners must be aware of their needs. We conducted interviews with 100 recent Latino immigrants in a rural North Carolina county. Overall, IPV was not perceived to be a problem; however, men and women differed in their perceptions. Men were more likely to agree with IPV myths, and both men and women felt that IPV had a detrimental impact on children. Many did not know about the local domestic violence agency, and knowledge about protective orders was limited. Outreach should emphasize the seriousness of IPV, adapt content for gender-specific audiences, and increase awareness about local resources.

Experiences With Intimate Partner Violence Among Latina Women

This study examined experiences with intimate partner violence in 292 Latina women classified as U.S. born, immigrant, or migrant-seasonal workers. High lifetime rates of violence were found, with 33.9% reporting physical violence, 20.9% reporting sexual coercion, and 82.5% reporting psychological aggression. Rates of violence in the preceding year were also high, with 18.5% experiencing physical violence, 14.4% experiencing sexual coercion, and 72.6% experiencing psychological aggression. Participants' marital status and partners' substance use were associated with victimization. The present findings suggest the need for screening for intimate partner violence and associated risk factors in settings that serve Latina women.

Alcohol Consumption at Any Level Increases Risk of Injury Caused by Others: Data from the Study on Global AGEing and Adult Health

BACKGROUND

Alcohol use is a well-known risk factor for injury. However, information is needed about alcohol drinking patterns and the risk of injury among older adults in low- and middle-income countries as this population grows. We aimed to examine the influence of drinking patterns on the burden of injury and investigate factors associated with different types of injury in older populations in six emerging economies.

METHODS

Data from more than 37,000 adults aged 50 years and older were included from the Study on Global AGEing and Adult Health (SAGE) Wave 1 conducted in six emerging economies, namely, China, Ghana, India, Mexico, Russia, and South Africa. We investigated past-year reported injuries from falls, traffic accidents, and being hit or stabbed. Alcohol drinking patterns were measured as lifetime abstinence, ever but not past- week use, and gender-specific past-week low-risk and high-risk use. We stratified by gender and used logistic regression models to observe the association between alcohol drinking pattern and risk of injury by controlling for other factors.

RESULTS

During the year prior to interview, 627 (2.2%) subjects reported bodily injury resulting from a car accident, 1,156 (4.2%) from a fall, and 339 (0.9%) from being hit or stabbed during the past year. For women, only being a high-risk drinker increased the risk of being hit or stabbed, whereas for men, all levels of drinking were associated with an increased risk of being hit or stabbed. We observed a higher risk of being hit or stabbed from past-week high-risk drinking among women (odds ratio [OR] = 6.09, P < 0.01) than among men (OR = 3.57, P < 0.01). We observed no association between alcohol drinking pattern and injury due to car accidents for either women or men.

CONCLUSIONS

The risk of experiencing injury due to violence increased with level of alcohol exposure of the victim. The increase in alcohol use in emerging economies calls for further study into the consequences of alcohol use and for public health initiatives to reduce the risk of violence in older adult populations, with special attention to the experience of older adult women.

Applying Ecological Positive Youth Development Theory to Address Co-Occurring Health Disparities Among Immigrant Latino Youth

This article outlines the theory and resulting approach employed in a multilevel, integrated, collaborative community intervention called Adelante, implemented by a university-community partnership in a Latino immigrant community to address co-occurring health disparities of substance abuse, sex risk, and interpersonal violence among youth. The basis for the intervention is a social-ecological interpretation of positive youth development theory, which focuses on changes in the person environment context and community assets as a preventive mechanism. This approach is viewed as appropriate for a community facing multiple barriers to health equity. The article describes the translation of this positive youth development model to practice, including the design of the intervention, intervention components, and the protocol for evaluation. The Adelante intervention is intended to reduce health disparities and, in addition, to add a broader community model to the evidence base.

How Well Do Survey Studies Capture Alcohol's Harm to Others?

Empirical studies assessing alcohol’s harm to others very often rely on population survey data. This study addresses some of the problems and challenges in using survey data for this purpose. Such problems include the limited capacity of population surveys in identifying infrequent harm and long-term consequences of drinking. Moreover, the drinker may report the alcohol-related harm or the person being harmed may report the damage. However, irrespective of who reports the harm, causal attribution to drinking is problematic. Challenges for future population surveys to address alcohol’s harm to others include the need for improved models and understanding of complex mechanisms to guide empirical studies within the broad range of harm. Study designs other than cross-sectional surveys, such as longitudinal study designs and combinations of population surveys and other data sources, are likely to overcome some of the identified problems in current population surveys of alcohol’s harm to others.

Determinants of Intimate Partner Violence in Sub-Saharan Africa: A Review of Prevention and Intervention Programs

Intimate partner violence (IPV) in sub-Saharan Africa affects 36% of the population. Several African countries rank among the highest globally. In this article, we present evidence on the prevalence, determinants, and impact of IPV across several sub-Saharan African countries interpreted against the backdrop of social ecological theory. We also describe prevention or intervention programs tested in different regions of Africa, selecting only those programs which were published in a journal outlet and which met a high criteria of implementation and methodology (n = 7). Based on our review of the empirical literature, some risk factors for violence documented in Western societies are the same in Africa, including poverty, drinking, a past history of child abuse or posttraumatic stress disorder, and highly traditional gender role beliefs. Low education is also associated with IPV for both women and men. In Africa, partner abuse intersects with the HIV pandemic, making violence prevention especially urgent. African programs to prevent IPV are often incorporated with HIV prevention; community building and community engagement are emphasized more in Africa than in North America or Europe, which invoke more individually focused approaches. Some programs we review lowered HIV exposure in women; others contributed to reduced violence perpetration among men. The programs show sufficient promise to recommend replication and dissemination in sub-Saharan Africa.

Domestic Violence Perpetrator Programs: A Proposal for Evidence-Based Standards in the United States

In the United States, the judicial system response to violence between intimate partners, or intimate partner violence (IPV), typically mandates that adjudicated perpetrators complete a batterer intervention program (BIP). The social science data has found that these programs, on the whole, are only minimally effective in reducing rates of IPV. The authors examined the social science literature on the characteristics and efficacy of BIPs. More than 400 studies were considered, including a sweeping, recently conducted survey of BIP directors across the United States and Canada. Results of this review indicate that the limitations of BIPs are due, in large part, to the limitations of current state standards regulating these programs and, furthermore, that these standards are not grounded in the body of empirical research evidence or best practices. The authors, all of whom have considerable expertise in the area of domestic violence perpetrator treatment, conducted an exhaustive investigation of the following key intervention areas: overall effectiveness of BIPs; length of treatment/length of group sessions; number of group participants and number of facilitators; group format and curriculum; assessment protocol and instruments; victim contact; modality of treatment; differential treatment; working with female perpetrators; working with perpetrators in racial and ethnic minority groups; working with lesbian, gay, bisexual, and transgender (LGBT) perpetrators; perpetrator treatment and practitioner–client relationships; and required practitioner education and training. Recommendations for evidence-based national BIP standards were made based on findings from this review.

Posttraumatic stress disorder symptoms and risky behaviors among trauma-exposed inpatients with substance dependence: The influence of negative and positive urgency

BACKGROUND

Posttraumatic stress disorder (PTSD) among inpatients with substance use disorders (SUDs) is associated with heightened engagement in a variety of risky, self-destructive, and health-compromising behaviors (e.g., risky sexual behavior, aggression). Extant research provides support for the role of emotion dysregulation in the PTSD-risky behavior relation among inpatients with SUD; however, this research has been limited by a focus on emotion dysregulation involving negative (versus positive) emotions. The goal of the current study was to extend past research on the PTSD-risky behavior relation by examining the potential mediating roles of negative and positive urgency (two domains of emotion dysregulation defined by the tendency to engage in risky behavior in the context of negative and positive emotions, respectively).

METHODS

Participants were 158 trauma-exposed inpatients with (n=91) and without (n=67) lifetime PTSD consecutively admitted to a residential SUD treatment facility (M age=34.34; 59.5% White, 50.6% female). Patients were administered diagnostic interviews and completed self-report questionnaires.

RESULTS

Significant positive associations were found among lifetime PTSD symptoms, negative and positive urgency, and risky behaviors. Moreover, findings revealed significant indirect effects of lifetime PTSD symptoms on risky behaviors through the pathways of both negative and positive urgency.

CONCLUSIONS

Results provide initial support for the mediating roles of both negative and positive urgency in the PTSD-risky behavior relation, highlighting the potential utility of teaching trauma-exposed inpatients with PTSD-SUD skills for tolerating negative and positive emotional states without engaging in maladaptive behaviors.

Spousal Violence in 5 Transitional Countries: A Population-Based Multilevel Analysis of Individual and Contextual Factors

OBJECTIVES

I examined the individual- and community-level factors associated with spousal violence in post-Soviet countries.

METHODS

I used population-based data from the Demographic and Health Survey conducted between 2005 and 2012. My sample included currently married women of reproductive age (n = 3932 in Azerbaijan, n = 4053 in Moldova, n = 1932 in Ukraine, n = 4361 in Kyrgyzstan, and n = 4093 in Tajikistan). I selected respondents using stratified multistage cluster sampling. Because of the nested structure of the data, multilevel logistic regressions for survey data were fitted to examine factors associated with spousal violence in the last 12 months.

RESULTS

Partner's problem drinking was the strongest risk factor associated with spousal violence in all 5 countries. In Moldova, Ukraine, and Kyrgyzstan, women with greater financial power than their spouses were more likely to experience violence. Effects of community economic deprivation and of empowerment status of women in the community on spousal violence differed across countries. Women living in communities with a high tolerance of violence faced a higher risk of spousal violence in Moldova and Ukraine. In more traditional countries (Azerbaijan, Kyrgyzstan, and Tajikistan), spousal violence was lower in conservative communities with patriarchal gender beliefs or higher financial dependency on husbands.

CONCLUSIONS

My findings underscore the importance of examining individual risk factors in the context of community-level factors and developing individual- and community-level interventions.

[Temporal analysis of mortality due to intimate partner violence in Spain]

OBJECTIVES

To analyze the temporal distribution of mortality due to violence by intimate partners (VIP) and to identify possible temporal clusters in women deaths by VIP in Spain.

METHODS

We performed a descriptive epidemiological study based on the VIP deaths included in the database of the Federation of Divorced and Separated Women (1998-2003). The epidemic index (EI) was calculated as the ratio between the actual number of VIP deaths in a given month from January to July 2003 and the median number in the same month in the five preceding years. A Poisson model was used to analyze the distribution by years (1998-2002), seasons, months, and days. Simple regression analysis was performed with three-monthly means. A temporal cluster analysis was also carried out.

RESULTS

In 2003, the EI of VIP mortality was high in January (EI = 1.6), March (EI = 1.2), May (EI = 1.5), June (EI = 2), and July (EI = 2.5). Compared with 1998 and Sundays, respectively, mortality due to VIP was significantly increased in 2001 (relative risk, RR = 1.52; 95% confidence interval [CI], 1.05-2.20) and on Mondays (RR = 1.77; 95%CI, 1.13-2.76). The regression analyses confirmed an increase between the first three-month period of 1998 and the last three-month period of 2001. There were no differences between seasons and months. No temporal clusters of deaths were detected.

CONCLUSIONS

VIP is currently an increasing epidemic in Spain with no clear temporal pattern. Political and legal efforts to reduce this problem do not seem to be successful.

Prevalência de violência física por parceiro íntimo em homens e mulheres de Florianópolis, Santa Catarina, Brasil: estudo de base populacional

Investigou-se a associação entre sexo e violência física entre parceiros íntimos. Encontrou-se prevalência de sofrer qualquer violência física (17%), violência física moderada (16,6%) e violência física grave (7,3%). Não houve diferença significativa para violência física moderada em homens e mulheres, porém, quanto mais grave o ato maior a ocorrência deste nas mulheres. Por meio de regressão logística testou-se a associação da violência com o sexo, ajustando-se às variáveis exploratórias. Mulheres de maior idade, viúvas/separadas, pobres, menos escolarizadas e pretas registram maior probabilidade de sofrer violência. Nos homens, a prevalência de violência física grave apresentou alteração significativa apenas para estado civil. Uso abusivo de álcool por mulheres representou maior chance de sofrer violência física.

Sexual Violence Victimization and Associations with Health in a Community Sample of Hispanic Women

This study sought to add to the limited information currently available on circumstances of sexual violence victimization and associated negative health experiences among Hispanic women. Data come from a community sample of mostly Mexican women in an urban southwestern city. Household interviews were completed with a sample of 142 women during 3 months in 2010. Findings indicate that 31.2% of women reported rape victimization and 22.7% reported being sexually coerced in their lifetime. Victims of rape and/or sexual coercion were significantly more likely to report symptoms of depression and post-traumatic stress disorder (PTSD) during their lifetime. Among victims whose first unwanted sexual experience resulted in rape and/or sexual coercion, perpetrators were almost always someone known to the victims, and were mostly family members or intimate partners, depending on the victim's age. About one-fifth of victims were injured and 17.1% needed medical services. These findings suggest the need for more attention to the physical and mental health needs of sexually victimized Hispanic women.

Individual and interpersonal risk factors for physical intimate partner violence perpetration by biological sex and ethnicity

Intimate partner violence (IPV) is a public health problem that reaches across age, sex, and ethnicity. In this study, we examined risk factors for physical IPV perpetration among young adult males and females from four ethnic groups. Data were taken from Waves 1-3 of the National Longitudinal Study of Adolescent Health (Add Health). The sample included 10,141 Wave 3 respondents (ages ranged from 18-27 years old) who reported being in a current romantic relationship. Physical IPV perpetration was reported by 14.10% of White, 23.28% of Black, 18.82% of Latino, and 18.02% of Asian males. Physical IPV perpetration was reported by 19.01% of White, 24.80% of Black, 25.97% of Latina, and 19.21% of Asian females. Following an ecological framework, proximal risk factors at intrapersonal and interpersonal levels were included in the analyses. Despite finding fairly consistent percentage of physical IPV perpetration across sample groups, the risk factors for physical IPV perpetration were rather uncommon across sex and ethnicity. Only 1 factor--psychological IPV perpetration toward a romantic partner--was consistently associated with physical IPV perpetration across all groups. Our findings have implications for tailoring prevention and intervention efforts toward risk factors of physical IPV perpetration that are uniquely associated with biological sex and ethnicity.

Discrepant Patterns of Heavy Drinking, Marijuana Use, and Smoking and Intimate Partner Violence: Results From the California Community Health Study of Couples

This study analyzed whether discrepant (husband or wife use only) or concordant (both partners use) patterns of heavy drinking, marijuana use, and smoking are associated with increased risk for male-to-female partner violence and female-to-male partner violence among adult couples. Based on a geographic sample of married or cohabiting couples residing in 50 California cities, logistic regression analyses were conducted using dyadic data on past-year partner violence, binge drinking and frequency of intoxication, marijuana use, and smoking. When all substance use patterns were included simultaneously, wife-only heavy drinking couples were at elevated risk for male-to-female partner violence, as were concordant marijuana-using couples. Husband-only marijuana discrepant couples were at increased risk for female-to-male partner violence. Further research is needed to explore the processes by which discrepant and concordant substance use patterns may contribute to partner aggression.