When is domestic violence a hidden face of addiction?

The Prevalence of Domestic Violence in the Lives of Female Heterosexual Partners of Sex Addicts

This study provides evidence that rates of domestic violence (DV) run considerably higher in the lives of heterosexual women who identify as partners of sex addicts (PSAs) than in the general population. Data collected from 558 survey participants, from a variety of high-income nations, revealed that 92.1% had ever experienced any form of DV perpetrated by their partner and 57.7% had experienced physical and/or sexual intimate partner violence with their partner. The study also tests several hypotheses about sex addiction behaviors and PSA intimate partner violence (IPV), to help those working with these populations understand what factors may be contributing to, or mitigating, these women's experiences of violence.

Mental Pain and Suicidal Tendencies in Sexual and Physical Abuse Victims

We examine differential effects of mental pain and suicidal tendencies in female victims who have been sexually and physically abused, hypothesizing that sexual abuse victims report more mental pain and suicidal tendencies than physical abuse victims. A group of 98 women completed questionnaires that measured mental pain, suicidal tendencies and thoughts, and demographic details. Sexual abuse victims suffered more mental pain than physical abuse victims while the physical abuse victims demonstrated more repulsion by life than sexual abuse victims. Only sexual abuse victims demonstrated less attraction to life and only physical abuse victims showed more attraction to death.

Factors associated with severity of intimate partner abuse in Mexico: results of the first National Survey of Violence Against Women

OBJECTIVE

To identify factors associated with the severity of intimate partner abuse (IPA) in Mexico.

METHODS

Data were gathered from the National Survey of Violence Against Women (November 2002-November 2003), a nationwide study in which 18,902 women over the age of 14 participated. Subjects were recipients of national public health care services. The severity of IPA was measured using a 27-item scale. Multinomial logistic regression analyses were performed to explore significant factors associated with partner violence.

RESULTS

One in four participants reported experiencing IPA. This model showed that younger and less educated women had a higher risk of IPA. Working out of the home (OR [odds ratio] 1.3, 95% confidence interval [CI] 0.99-1.72), two or more children in the household (OR 1.44, CI 1.18-1.77), alcohol consumption (OR 2.51, CI 1.63-3.90) and history of childhood abuse (OR 3.7, CI 3.03-4.52) increased the possibility of severe violence. The most important predictor of severe IPA was the partner's alcohol consumption (daily or almost daily, OR 14.7, 95% CI 13.25-16.46).

CONCLUSIONS

Awareness about the risk factors associated with IPA will help identify populations at greater risk of severe injury and could orient the health sector to direct actions toward this vulnerable population.

Padrões de violência domiciliar associada ao uso de álcool no Brasil

OBJETIVO: Analisar as situações de violência domiciliar ocorridas com o agressor sob efeito do álcool. MÉTODOS: Foi realizado um levantamento domiciliar que incluiu as 108 cidades brasileiras com mais de 200 mil habitantes em 2005. A amostragem foi por conglomerados, estratificada, probabilística e autoponderada, obtida em três estágios de seleção: setores censitários, domicílios e respondentes (população entre 12-65 anos de idade). O instrumento utilizado para obtenção dos dados foi o Substance Abuse and Mental Health Services Administration, com perguntas sobre dados sociodemográficos e uso de drogas psicotrópicas. RESULTADOS: Foram pesquisados 7.939 domicílios. Em 33,5% foi relatado histórico de violência domiciliar, sendo 17,1% com agressores alcoolizados. Os tipos de violência em associação com uso de álcool mais freqüentes foram: discussões direcionadas a pessoas do domicílio (81,8%), escândalos não direcionados a alguém específico (70,9%), ameaça de agressão física (39,5%) e de quebra de objetos (38,7%), agressões físicas (27,8%), com armas (5,5%) e abuso sexual (3,2%). Mais da metade dos agressores era morador do domicílio, 88,8% deles do sexo masculino. A maioria das vítimas era do sexo feminino (63,9%); 33,9% eram esposas e 18,2% filhos. Quanto às reincidências, 14,1% dos casos perduraram por período entre um a cinco anos e em 14,3% ultrapassaram uma década. A maior parte das vítimas (86%) e dos agressores (77,9%) não procurou por ajuda em serviço de saúde e/ou delegacia. CONCLUSÕES: Além da alta proporção de domicílios brasileiros com histórico de violência com agressores alcoolizados, as agressões apresentaram várias especificidades. A baixa procura por ajuda em serviços de saúde/segurança indica a importância da detecção ativa de casos de violência domiciliar.

[Domestic violence, alcohol and substance abuse]

Domestic violence and substance abuse are common in primary care patients. Although these problems are associated with severe physical and psychological sequelae, they are often undiagnosed. This article provides an overview of the prevalence of these problems, the health-related consequences for adults, children and elderly, as well as the challenges for clinicians in screening, assessment and referral.

Problem gambling in the partner of the emergency department patient as a risk factor for intimate partner violence

It has been suggested that the increase in gambling activity nationally has resulted in an increase in intimate partner violence (IPV). There are apparently no studies that have assessed problem gambling as a risk factor for IPV. To determine if problem gambling in the partner is a risk factor for IPV, a cross-sectional study was conducted at a university-based Emergency Department (ED). All women aged 19 to 65 years who presented to the ED for treatment and were not decisionally incapacitated or acutely ill were eligible. Data were collected by a research assistant during 4 or 8-h blocks covering each day of the week over a 10-week period during the months of June through August 1999. There were 300 consecutive women approached, and 286 (95%) agreed to participate. Of the women who agreed to participate, 237 (83%) reported having an intimate partner in the last year, and 61 (25.7%) of these women were categorized as experiencing IPV. The odds ratio (OR) of experiencing IPV was the main outcome measure, estimated using standard logistic regression, given the presence of various personal and partner characteristics, including problem gambling in the partner. The results revealed that the relative odds were elevated for women whose partners were problem gamblers (adjusted OR: 10.5; 95% CI: 1.3-82) or problem drinkers (adjusted OR: 6.1; 95% CI: 2.5-14). The presence of both problem gambling and problem drinking in the partner was associated with an even higher OR (adjusted OR: 50; 95% CI: 9-280). Our study shows that problem gambling in the partner is associated with IPV. The causes of IPV are not fully known, but the association of problem gambling in the partner with IPV could lead to new intervention strategies and Emergency Medicine research in the future.

Assessment and treatment of addictive sexual disorders: relevance for chemical dependency relapse

Despite some skepticism about the existence of sexual addiction, the addiction model has proven very useful for treating compulsive sexual behaviors. Addictive sexual disorders often coexist with chemical dependency and are a frequently unrecognized cause of chemical dependency relapse. Sex addiction also contributes significantly to the spread of HIV disease. This paper reviews the differential diagnosis of addictive sexual disorders, their assessment. their treatment, and their interaction with chemical dependency, and provides information about 12-step (mutual-help) resources.

Exploring the self-reported sexual problems and concerns of drug-dependent males and females in modified, therapeutic community treatment

The importance of sexual trauma and sexual problems in the treatment of chemically dependent persons has long been recognized by clinicians working with this population. This study was undertaken to describe the degree of self-reported sexual problems and concerns for 163 males admitted into a Philadelphia- or New York City-based modified therapeutic community (TC) program and 100 females admitted to the same New York City program. Results indicated that the majority of men and women identified some sexual problems and concerns shortly after being admitted, with females in the New York City sample endorsing sexual problems more often than males in the Philadelphia or New York City samples. These findings are considered in view of the fact that these clients' sexual problems were usually not addressed on their Master Treatment Plans. The implications of addressing or not addressing these sexual problems are considered.

The substance user at risk of harm to self or others: assessment and treatment issues

This article is divided into two main sections, one discussing suicide and substance use, and the other describing substance use and various forms of violent behavior toward others, including sexual assault and domestic violence. In each section, issues regarding prevalence of harm to self and others in substance users, clinical assessment and treatment, etiologic factors, definitional problems, and research needs are discussed. Substance use appears to be associated strongly with both violence toward self and violence toward others, but the exact nature of these relationships is somewhat unclear.