This bibliography is compiled for use by the Illinois Domestic Violence / Substance Abuse Multidisciplinary Task Force.  Comments and additions should be sent to Larry Bennett
 

• General / Overview
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O'Farrell, Timothy J; Murphy, Christopher M. (2002). Behavioral couples therapy for alcoholism and drug abuse: Encountering the problem of domestic violence. Wekerle, Christine (Ed); Wall, Anne-Marie (Ed). The violence and addiction equation: Theoretical and clinical issues in substance abuse and relationship violence. (pp. 293-303). New York, NY, US: Brunner-Routledge. xii, 376pp.
Describes and clarifies the role of behavioral couples therapy (BCT) in treating partner violence among men seeking treatment for alcoholism and drug abuse, as well as discusses general clinical issues in intervention for intimate violence and addiction problems. Treatment methods and results from outcome studies of BCT are discussed. The chapter also discusses BCT and partner violence, how partner violence is handled in BCT with alcoholic and drug-abusing patients, and gives cautions and clarifications about BCT and partner violence in the treatment of substance-abusing patients. The chapter concludes with a plea for reliance on evidence rather than ideology to guide interventions for the combined problems of intimate violence and addiction so that best practices may be consonant with evidence-based therapy.
 

Leonard, Kenneth E. (2002). Alcohol and substance abuse in marital violence and child maltreatment. Wekerle, Christine (Ed); Wall, Anne-Marie (Ed). (2002). The violence and addiction equation: Theoretical and clinical issues in substance abuse and relationship violence. (pp. 194-219). New York, NY, US: Brunner-Routledge.
Discusses the following topics(1) developmental issues in alcohol use across the early adult years, (2) developmental issues in marital and parental violence, (3) developmental challenges and the alcohol-family violence relationship, (4) the alcohol-marital violence relationship (including its moderators and acute alcohol effects), and (5) the alcohol-child abuse and child neglect relationship (including its moderators and acute alcohol effects). A review of the research literature emphasizes that acute and chronic alcohol use play important roles in violence for certain people under certain circumstances. The author suggests that while the research has tended to neglect developmental aspects, the relationship between alcohol and family violence may differ importantly across developmental epochs. The author emphasizes that while violent behavior clearly has roots in childhood, the developmental transitions to adolescence, early adulthood, and parenthood provide contextual shifts in which this behavior may be altered.
 

Crittenden, Patricia McKinsey; Claussen, Angelika Hartl. (2002). Developmental psychopathology perspectives on substance abuse and relationship violence. Wekerle, Christine (Ed); Wall, Anne-Marie (Ed). (2002). The violence and addiction equation: Theoretical and clinical issues in substance abuse and relationship violence. (pp. 44-63). New York, NY, US: Brunner-Routledge.
This chapter is concerned with the developmental pathways that increase the probability of drug use, relationship violence, and the co-occurence of these conditions. Two central ideas form the underlying structure of this chapter. The first is the assumption that, in most cases, risk for maladaptation and maladaptation itself are not random events, but rather follow a series of developmental experiences that increase the probability of specific risk outcomes. The second is that both substance abuse and relationship violence can be considered strategies for resolving problems. The question becomes why some individuals select these strategies, while others do not. The chapter begins with a review of research on the antecedents and correlates of (1) substance abuse and (2) interpersonal violence, and their effects on development. Both discussions include a brief overview of theories regarding each. Then, a theoretical model for describing context-adapted coping strategies, together with predisposing developmental conditions, is presented. The authors conclude by linking the empirical evidence to these strategies to suggest several developmental pathways that carry risk for substance abuse and interpersonal violence.

Wekerle, Christine; Wall, Anne-Marie. (2002). Introduction: The overlap between relationship violence and substance abuse. Wekerle, Christine (Ed); Wall, Anne-Marie (Ed). The violence and addiction equation: Theoretical and clinical issues in substance abuse and relationship violence. (pp. 1-21). New York, NY, US: Brunner-Routledge. xii, 376pp.
Examines the extent to which alcohol and drug use, abuse, and dependence coexist with violence among intimates. First, the overlap between child abuse and parental substance use and abuse is presented, followed by a discussion of the contribution of child abuse to adult addiction. Next, the role of alcohol and drugs in domestic violence is examined. It is concluded that the prevalence of the overlap between substance abuse and relationship violence is generally high, and that this is most evident in high-risk samples (i.e., those that are positive on either relationship violence or substance abuse). The authors note that the specific estimate of the prevalence of this overlap depends on many factors, including definitional criteria (i.e., diagnostic, legal), sampling procedures (i.e., self-referred, court-ordered), data-gathering method (i.e., interview, questionnaire), and information source (i.e., parent, partner, child, professional). Other conclusions and directions for future work are considered.
 

Wekerle, Christine & Wall, Anne-Marie (2002). The violence and addiction equation: Theoretical and clinical issues in substance abuse and relationship violence. New York, NY, US: Brunner-Routledge.
Attempts to document the dual problem of relationship violence and addictions, as well as examine estimates of their overlap across the lifespan and subpopulations. The editors note that in varying degrees, the weight of the data point to the overlap among child maltreatment, partner violence, alcohol abuse, illicit drug abuse, and polysubstance abuse. A main goal for this volume is to direct scholarly attention to theoretical frameworks that could guide understanding and inform the development of dual-focused prevention and treatment programs. A second goal is to address these overlapping problems at different stages across the lifespan, from adolescence to older adulthood. Finally, attention to the clinical reality for the dual problem of relationship violence and addition leads to an examination of prevention and treatment efforts. In addition to discussing important issues for intervention, this volume seeks to profile novel and promising prevention and treatment approaches, and to present more established, empirically validated interventions. Contextual questions such as cultural differences and access to treatment are addressed, and conceptual models informing intervention are presented.

I. Theoretical frameworks

Biological bases of addiction and aggression in close relationships (Robert O. Pihl and Peter N. S. Hoaken)Developmental psychopathology perspectives on substance abuse and relationship violence (Patricia McKinsey Crittenden and Angelika Hartl Claussen)

Personality factors and substance abuse in relationship violence and child abuse: A review and theoretical analysis (Gordon L. Flett and Paul L. Hewitt)Substance abuse and co-occurring psychiatric disorders in victims of intimate violence (Sherry H. Stewart and Anne L. Israeli)Cognitive social learning models of substance use and intimate violence (Anne-Marie Wall and Sherry McKee)

II. Relationship violence and addiction across the lifespan

Bullying, sexual harassment, dating violence, and substance use among adolescents (Debra J. Pepler, Wendy M. Craig, Jennifer Connolly, and Kathryn Henderson) Sexual assault and relationship violence among college students: Examining the role of alcohol and other drugs (Mark D. Wood and Kenneth J. Sher) Alcohol and substance abuse in marital violence and child maltreatment (Kenneth E. Leonard) Substance abuse and interpersonal violence in older adults (Mandra L. Rasmussen Hall and Victoria M. Follette)

III. Clinical issues in intervention for intimate violence and addiction problems

Violence and alcohol: Cultural issues and barriers to treatment (John Schafer and Raul Caetano) Treating dual problems of partner violence and substance abuse (William R. Downs and Brenda A. Miller) Treating the addicted male batterer: Promising directions for dual-focused programming (Caroline Easton and Rajita Sinha) Behavioral couples therapy for alcoholism and drug abuse: Encountering the problem of domestic violence (Timothy J. O'Farrell and Christopher M. Murphy) Bridging the gap: Prevention of adolescent risk behaviors and development of healthy nonviolent dating relationships (Anna-Lee Pittman and David A. Wolfe)

Conclusion: Clinical and research issues in relationship violence and substance abuse (Christine Wekerle and Anne-Marie Wall)
 

De Bellis, Michael D. (2002). Developmental traumatology: A contributory mechanism for alcohol and substance use disorders. Psychoneuroendocrinology. 27(1-2), 155-170.
Early childhood traumatic experiences, such as childhood maltreatment, are associated with an enhanced risk of adolescent and adult alcohol and substance use disorders (defined as Mental Disorders-IV (DSM-IV) alcohol or substance abuse or dependence). Maltreated children and adolescents manifest dysregulation of major biological stress response systems including adverse influences on brain development. Dysregulation of biological stress response systems may lead to an enhanced vulnerability for psychopathology, particularly posttraumatic stress disorder (PTSD) and depression. These negative affect disorders may put a child at increased risk for adolescent or young adult onset alcohol or substance use disorders. Thus, studies in developmental traumatology may prove to be critical in the effort to attempt to link the neurobiology of maltreatment-related PTSD with the neurobiology of alcohol and substance use disorders and in developing early strategies for the prevention of adolescent and adult alcohol and substance use disorders.
 

Testa, Maria; Leonard, Kenneth E. (2001). The impact of husband physical aggression and alcohol use on marital functioning: Does alcohol "excuse" the violence? Violence & Victims, 16(5), 507-516.
Replicated and extended a study which suggested that wives hold husbands less responsible for their aggressive behavior when husbands are problem drinkers (J. Katz et al, 1995). The independent and interactive effects of husband physical aggression and husband alcohol use on wives' marital satisfaction and thoughts of divorce were examined among newlywed couples. Data were collected on husband alcohol use over the past year, wives' marital adjustment, husbands' marital aggression, and wives' thoughts of divorce. There were a total of 387 participants. Husband physical aggression had a significant negative effect on marital satisfaction and a significant positive effect on divorce ideation regardless of the measure of husband alcohol use employed. Alcohol dependence had a negative effect on satisfaction; however, in no case was there an interaction between alcohol and aggression. Results fail to replicate an earlier study supporting an excuse function of alcohol and suggest that alcohol does not mitigate the negative effects of domestic violence on marital functioning.
 

Chartas, Nicole D; Culbreth, John R. (2001). Counselor treatment of coexisting domestic violence and substance abuse: A qualitative study. Journal of Addictions & Offender Counseling. Vol 22(1), 2-11.
This study explored the philosophical issues hindering the linkage of substance abuse and domestic violence treatment. Results suggest that counselors tend to use treatment models that could not concurrently assign responsibility and address either present or past victimization.
 

Coker, Ann L; Smith, Paige Hall; McKeown, Robert E; King, Melissa J. (2000). Frequency and correlates of intimate partner violence by type: Physical, sexual, and psychological battering. American Journal of Public Health. Vol 90(4), 553-559.
Examined frequency and correlates of intimate partner violence, including physical and sexual abuse, battering, and perceived emotional abuse, among females seeking primary health care. 1,401 females (aged 18-65 yrs) attending family practice clinics completed an in-clinic survey assessing intimate partner violence. Results show that 55.1% of Ss had experienced some type of intimate partner violence in a current, most recent, or past intimate relationship with a male partner. 20.2% were currently experiencing intimate partner violence. Among those who had experienced partner violence in any relationship, 77.3% experienced physical or sexual violence, and 22.7% experienced nonphysical abuse. Alcohol or drug abuse by the male partner was the strongest correlate of violence. It is concluded that partner substance abuse and intimate partner violence in the family of origin were strong risk factors for experiencing violence.
 

Schafer, John; Caetano, Raul. (2002). Violence and alcohol: Cultural issues and barriers to treatment. Wekerle, Christine (Ed); Wall, Anne-Marie (Ed). (2002). The violence and addiction equation: Theoretical and clinical issues in substance abuse and relationship violence. (pp. 239-253). New York, NY, US: Brunner-Routledge.
Notes that access to health care in the US is a function of many variables, including income, education, health insurance coverage (HIC), and ethnicity. This chapter briefly discusses the barriers associated with access to HIC and how this gateway to health care is associated with alcohol consumption and intimate partner violence (IPV). Specifically, the chapter examines the empirical data on HIC for treatment for IPV and alcoholism among ethnic Americans. An analysis of the 1995 Couples Study, comprising a total of 1,599 Black, Hispanic, White, and mixed ethnicity (in which the ethnicities of the partners did not match) heterosexual couples, is presented. Ss were interviewed about their demographic characteristics, alcohol consumption patterns, HIC, and the occurrence of 11 IPV behaviors. Results suggest that barriers to minority health care exist and are particularly prevalent among US Hispanics. Income was the most important factor in determining HIC status. Results suggest that minority couples who are affected by alcohol problems, including alcohol-related IPV, will be less likely to find the appropriate care to solve their problems. It is suggested that the inequality in access to care is likely to further contribute to the disparity in IPV across ethnic groups.
 

Caetano, Raul; Nelson, Scott; Cunradi, C. (2001). Intimate partner violence, dependence symptoms and social consequences from drinking among White, Black and Hispanic couples in the United States. American Journal on Addictions. Vol 10(Suppl) 2001, 60-69.
Examined the relationship between intimate partner violence (IPV), alcohol dependence symptoms, and drinking-drug use social consequences among White, Black, and Hispanic couples. 1,440 couples (aged 18+ yrs) completed interviews concerning sociodemographic characteristics, psychological-psychosocial aggression attitudes, IPV, alcohol consumption, alcohol problems, and drug use. Results show that Ss who reported alcohol dependence symptoms or social consequences from drinking were more likely to inflict IPV. IPV rates were affected by social consequences from drinking for Whites and Blacks, and were associated more with problems of male Ss than female Ss. Alcohol dependence among Blacks was strongly associated with IPV, and Blacks were more associated with IPV independent of problem type. Findings suggest that involvement in a violent relationship is part of a problem behavior syndrome among Blacks more than any other ethnic group. It is concluded that predictors of IPV vary by ethnicity.
 

Chermack, Stephen T; Fuller, Bret E; Blow, Frederic C. (2000). Predictors of expressed partner and non-partner violence among patients in substance abuse treatment. Drug & Alcohol Dependence. Vol 58(1-2) Feb 2000, 43-54.
Explored the extent and nature of expressed violence in both partner and non-partner relationships, presents descriptive information regarding factors associated with violence severity, and examined with Structural Equation Modeling (SEM) the interrelationships among potential predictor variables (age, gender, minority status, SES and alcohol and drug problem severity) in relation to partner and non-partner violence. This study examined reports of expressed partner and non-partner violence among 126 men and 126 women (aged 18-73 yrs) in the 12 mo prior to substance abuse treatment. Rates of violence were 57% for partner, 53% for non-partner, and 75% collapsing across partner and non-partner relationships. Partner violence was predicted by age, marital status, and drug problem severity. Non-partner violence was predicted by gender, income, alcohol and drug problem severity. It is concluded that results highlight that individuals in substance abuse treatment are at high risk for violence, and targeted screening and intervention approaches should be routine in addictions treatment.
 

Suman, L.. N; Nagalakshmi, S. V. (1996). Family dysfunction in alcoholic families. Indian Journal of Clinical Psychology. Vol 23(2) Sep 1996, 117-121.
Examined the variables that influence the degree of family dysfunction in alcoholic families. 40 alochol dependent men (mean age 39.40 yrs) and their spouses (mean age 32.55 yrs) were administered a semi structured interview schedule, the Interpersonal Checklist, the Eysenck Personality Questionnaire and Family Interaction Scales. Data were analyzed using stepwise multiple regression analysis. Results indicate that 8 variables significantly influenced family functioning: emotional problems in the children, discrepancy between spouse's perception of the alcoholic and spouse's perception of ideal spouse on the Dominance dimension, role functioning of the alocholic, Psychoticism scores of the alcoholic, discrepancy between alcoholic's perception of self and spouse's perception of the alcoholic on the Love dimension, Neuroticism scores of the spouses, discrepancy between alcoholic's perception of self and spouse's perception of ideal spouse on the Dominance dimension, and spouse abuse by the alcoholic.
 

Smith, James W. (2000). Addiction medicine and domestic violence. Journal of Substance Abuse Treatment. Vol 19(4), 329-338.
Discusses characteristics of a domestic violence relationship and appropriate action by addiction medicine practitioners. Typical strategies that allow the abuser to establish power and control over his partner include isolating the victim, physical and psychological battering, and sexual abuse. These strategies are not used continuously. Instead, violent behavior generally follows a cyclic pattern consisting of the 3 phases of the explosive phase, the honeymoon phase, and the tension-building phase. Because alcohol and other drug dependencies are frequently found in both the perpetrators and victims of violence, addiction medicine practitioners have a unique opportunity to intervene in these life-threatening disorders. Guidelines for dealing with the victims of domestic violence in the addiction medicine patient population include asking victims direct questions about battering in a private interview, assessing safety by listening to patients' stories, providing referrals or information about resources, arranging follow-up visits, and documenting information in patients' charts. The appropriate timing of intervention can facilitate treatment for addiction and domestic violence.
 

Hirschel, David; Hutchison, Ira W. (2001). The relative effects of offense, offender and victim variables on the decision to prosecute domestic violence cases. Violence Against Women. Vol 7(1), 46-59.
Traditionally, even when the police have arrested suspected spouse abusers, prosecutors have been reluctant to follow through with prosecution. Using a sample of 424 cases in which abusers were either arrested on the scene or issued citations for court appearance, this research study investigates whether characteristics surrounding the offense (such as cause of the argument and victim injury), offender characteristics (such as prior record and substance abuse), or victim characteristics (such as relationship with the offender and substance abuse) most impact the prosecution's decision to prosecute. The policy implications of the findings also are discussed.
 

Markward, Martha; Dozier, Cheryl; Hooks, Kirk; Markward, Nathan. (2000). Culture and the intergenerational transmission of substance abuse, women abuse, and child abuse: A diathesis-stress perspective. Children & Youth Services Review. Vol 22(3-4), 237-250.
This manuscript focuses on culture as moderating the transmission of substance abuse and spouse abuse to impact child well-being in families across generations. Within the context of a diathesis-stress model, the authors propose that it is the interaction between particular internal factors, such as biochemical, genetic, and/or psychosocial factors, and external factors that is critical in understanding intergenerational transmission. Based on a review of related literature, the authors suggest a nonlinear dynamic perspective on intergenerational transmission that maintains a presumption of cultural and ethnic "environment" distinctly interacting with genetics and physiology to produce self-reinforcing behaviors that may be passed from one generation to another.

Easton, Caroline J; Swan, Suzanne; Sinha, Rajita. (2000). Prevalence of family violence in clients entering substance abuse treatment. Journal of Substance Abuse Treatment. Vol 18(1), 23-28.
Evaluated 105 clients who were assessed for substance-related problems and a history of domestic violence. A brief survey on family violence examined whether clients were adult victims, childhood victims, and/or perpetrators of physical violence. Results indicated that 37% of the sample reported that they experienced a family history of physical violence. A total of 22% reported being an adult victim of physical violence, 14% reported being a victim of childhood abuse, and 18% reported being a perpetrator of physical violence. Results showed that substance-using clients with a history of family violence (SAFV+) tended to have more individual therapy sessions attended than substance-using clients without a history of family violence (SAFV-). The SAFV+ group was different from the SAFV- group in that they had significantly higher scores on the Michigan Alcoholism Screening Test and the Beck Depression Inventory. The SAFV+ group also had more positive urine screens for cocaine use within the 2-mo monitoring period. Findings indicate the importance of assessing family history of violence in substance abusers entering treatment, as this may have significant implications for treatment outcome.
 

Leonard, Kenneth E. (1999). Alcohol use and husband marital aggression among newlywed couples. In Arriaga, Ximena B. (Ed); Oskamp, Stuart (Ed). Violence in intimate relationships. (pp. 113-135). Thousand Oaks, CA: Sage.
This chapter addresses the role of alcoholism among domestically violent men. The authors initiated the Buffalo Newlywed Study (BNS) to determine the extent that both alcohol consumption (frequency of intoxication, average daily alcohol consumption) and alcohol abuse (excessive consumption and the occurrence of problems associated with consumption) are significantly related to marital aggression. The BNS is a three-wave longitudinal study of 647 newly married couples (aged 18-29) conducted over the first three years of marriage. The core questionnaires focused on four general domains: Alcohol consumption patterns, alcohol expectancies, personality factors, and relationship functioning factors. The results of this research are consistent with the hypothesis that alcohol has a role in the occurrence of domestic violence among newly married couples. In addition, the presence of alcohol, particularly among husbands, is associated with the occurrence of physical rather than verbal aggression. While alcohol plays a role in marital aggression, this role should not be overstated. Alcohol is neither a necessary nor a sufficient cause of marital aggression.
 

Gehrenbeck-Shim, Anne R. (1998). The effects of physical and sexual abuse on treatment outcome among substance abusers. Dissertation Abstracts International: Section B: the Sciences & Engineering. Vol 59(3-B), 1366, US: Univ. Microfilms International.
Previous literature has shown links between abuse experiences and substance use problems. Substance abuse is theorized as a form of self-medication for painful affects following traumatic abuse experiences. The paucity of prospective studies addressing treatment course for substance abusers who have abuse histories has necessitated research in this area. The purpose of this study was to explore whether substance abusers who report histories of physical and/or sexual abuse have more severe psychopathology and poorer treatment outcomes. The design consisted of interviews and questionnaires administered to male and female patients entering substance abuse treatment at Roger Williams Hospital. Follow-up interviews and questionnaires were administered at one-, two- and three-month intervals. The interview instrument assessed levels of substance use and treatment utilization. Questionnaires assessed the presence of a reported physical and/or sexual abuse history and levels of psychiatric symptomatology. The results replicate other studies which have shown that, among a substance abuse population, there is a high prevalence of patients reporting abuse histories. Statistical analyses revealed significant relationships between reported abuse histories during childhood and greater initial levels of psychopathology. Childhood physical abuse resulted in the greatest degree of elevated psychiatric symptomatology (depression, anxiety, PTSD symptoms, dissociation, and general psychiatric distress). Childhood sexual abuse also resulted in elevated levels of trauma symptomatology, dissociation, and psychiatric distress. Tests of the relationship between the outcome variables (substance relapse and treatment utilization) and abuse history were not significant. No relationship was shown between the presence of an abuse history and greater likelihood of substance relapse within the first three months of treatment or lesser likelihood to engage in recommended treatment activities. Additional analyses were conducted to ascertain whether patients who discontinued participation in the study differed significantly from those who continued. Dropout/follow-up was not related to demographics or abuse history. Whereas there were highly significant relationships between childhood abuse and almost every measure of psychopathology, there were no significant relationships found between childhood abuse and the two outcome measures. These findings and recent studies suggest the need for future research incorporating the independent variables of abuse history, psychopathology, and specific drug of choice in the prediction of treatment outcome.
 

Waldorf, Virginia Ann. (1998). The relationship between neuropsychological deficits and spouse abuse: An examination of both abuser and victim. Dissertation Abstracts International: Section B: the Sciences & Engineering. Vol 58(10-B), 5660.
Attempts to characterize the men and women involved in domestically violent relationships have yielded mixed results across a wide range of variables. These have included personality styles, violence in the family of origin, and a history of substance abuse. What has been lacking in the research to date is a thorough exploration of the neuropsychological characteristics of these individuals. The present study was designed to test certain neurocognitive functions using neuropsychological assessment in both the males and females currently involved in a violent relationship. In Phase I of the study, 163 individuals from domestically violent couples, 83 women and 80 men, were assessed on certain neuropsychological variables. These included measures of cognitive flexibility, verbal proficiency, empathic capacity, effective planning, and impulse control. A multivariate analysis of variance (MANOVA) was used to determine how these variables correlated with other variables considered to be common in this population. Phase II of the research explored how effective the use of these neurocognitive variables would be in differentiating between two matched groups of maritally discordant men and women. Twenty-one individuals from violent relationships were matched on the variables of age, education, ethnicity, and marital status with 21 individuals from maritally discordant, but nonviolent relationships. A MANOVA was used first to determine whether these two groups could be discriminated using the predictor variables found discriminative in earlier work, and secondly, to determine if these groups could be discriminated on the basis of the neurocognitive variables. Results from Phase I indicated that only the verbal proficiency variable was significantly correlated with certain personality styles. Additionally, and as predicted, no significant gender difference was found on the neurocognitive variables within the domestically violent group. On all neuropsychological variables the men and women performed comparably. Results from Phase II indicated that these same tests of verbal proficiency were significantly discriminative between the violent and nonviolent groups (F (1,39) = 5.25, p<.01). There also was a significant group difference on one measure of impulse control (F (1,39) = 6.53, p<.05). Significance of findings, limitations of research, and treatment implications were discussed.
 

Kunitz, Stephen J; Levy, Jerrold E; McCloskey, Joanne; Gabriel, K. Ruben. (1998). Alcohol dependence and domestic violence as sequelae of abuse and conduct disorder in childhood. Child Abuse & Neglect. Vol 22(11), 1079-1091.
Examined (1) the importance of childhood abuse as a risk factor for conduct disorder; (2) the importance of each form of abuse and conduct disorder as risk factors for alcohol dependence; and (3) the relative importance of each form of abuse, conduct disorder, and alcohol dependence as risk factors for being a perpetrator and/or victim of domestic violence in the Navajo population. Cases between the ages of 21 and 65 were interviewed in alcohol treatment program and matched to community controls (alcohol dependent and nonalcohol dependent). When adjusted for stratification by age, community of residence, and sex, the combined control groups comprise a representative sample of the Navajo male and female population 21-65 yrs of age. The prevalence of physical and sexual abuse before age 15 is within limits observed in other populations. Each form of abuse is a risk factor for conduct disorder. Along with conduct disorder, physical abuse is a risk factor for alcohol dependence. Physical abuse and alcohol dependence are independent risk factors for being involved in domestic violence as both perpetrator and victim. There is suggestive evidence that domestic violence has become more common.
 

Weiss, Michael J. Salomon; Wagner, Sheldon H. (1998). What explains the negative consequences of adverse childhood experiences on adult health? Insights from cognitive and neuroscience research. American Journal of Preventive Medicine. Vol 14(4), 356-360.
Expands on the article by V. J. Felitti et al (see record 1998-04002-001) on the effects of adverse childhood experiences on adult risk behavior, health status, and disease by discussing results from cognitive and neuroscience research. Felitti's results would be of little surprise to cognitive and neuroscience researchers in that they are consistent with a vast confluence of data from studies of CNS plasticity (the study of CNS organization as a function of experience). Weiss and Wagner describe the neuron as a self-organizing system, plasticity and CNS organization, the endurance of brain plasticity through adulthood, and behavioral correlates to CNS plasticity, including infant auditory perception, the effects of early intervention on intellectual and academic achievement, and language acquisition.
 

Collins, James J; Kroutil, Larry A; Roland, E. Joyce; Moore-Gurrera, Marlee. (1997). Issues in the linkages of alcohol and domestic violence services. Galanter, Marc (Ed). Recent developments in alcoholism, Vol. 13: Alcohol and violence: Epidemiology, neurobiology, psychology, family issues. Recent developments in alcoholism, Vol. 13. (pp. 387-405). New York, NY, US: Plenum Press.
Discuss the role of substance abuse in domestic violence and the implications that the association between substance abuse and domestic violence have for programs that deal with these problems / there are good reasons to think that a substance abuse-domestic violence program service linkage would be beneficial to clients / such linkage is infrequent, however, and there are significant impediments to linkage / addresses these issues based on a review of the literature in the substance abuse and domestic violence fields and on interviews conducted with service providers in these fields models for service linkage.
 

Galanter, Marc (Ed). (1997). Recent developments in alcoholism, Vol. 13: Alcohol and violence: Epidemiology, neurobiology, psychology, family issues. [Book Series Title: Recent developments in alcoholism], Vol. 13. New York, NY, US: Plenum Press.
It is both appropriate and timely that this volume of "Recent Developments in Alcoholism" is devoted to alcohol and violence, since violence is regarded by many as the most important problem facing our society today. At this point in time, it appears that alcohol is one of several factors leading to violence. The other types of factors contributing to aggression appear to be biochemical, genetic, psychological, and environmental in nature. Other sections of this volume discuss these factors. Another key question is how does the mix of all these factors increase aggression in some individuals but not in others? The public health model may be useful in answering this question. The premise of the public health model is that alcohol-related problems arise from an interaction of individual (host) variables, alcohol (agent), and environmental factors.
 

Dunnegan, Shelly Wolf. (1997). Violence, trauma and substance abuse. Journal of Psychoactive Drugs. Vol 29(4), 345-351.
A review of the relevant literature concerning posttraumatic stress disorder (PTSD), violence, and domestic violence suggests that violent behavior, trauma, and substance abuse have a substantial connection; it also suggests that shame is a powerful agent for rage. Shame permeates many levels of society: the individual, the family, institutions and the community. The policies of the criminal justice system are directed toward promoting more shame in a population that has been saturated with shame in the many levels of the culture. Attention is focused on the role of alcohol and other drug use in the cycle of violence. Violent behavior, violent individuals, and victims of violence are deeply affected emotionally, physically, politically, and spiritually by drug use. This suggests that any program designed to promote healing violent behavior, for victims and/or perpetrators, should include attention to each of these spheres. The author describes a program developed in the San Francisco City and County Jails that includes a stress reduction group, a personal writing group, a partner abuse group, and an anger and conflict management Group. The milieu is described, as well as the components, methods and rationale for each group.

Irons, Richard; Schneider, Jennifer P. (1997). When is domestic violence a hidden face of addiction? Journal of Psychoactive Drugs. Vol 29(4) Oct-Dec 1997, 337-344.
This article reviews studies that address the comorbidity of domestic violence, addictive disorders, and sexual abuse, and presents a model in which domestic violence parallels the chief features of chemical dependency. Domestic violence and addictive disorders share a number of behavioral features, including loss of control, continuation of behavior despite adverse consequences, preoccupation or obsession, development of tolerance, and family involvement. Domestic violence predisposes the next generation to both domestic violence and addictive disorders Sexual abuse within the family of origin and/or the couple relationship is a common feature of both domestic violence and substance addiction, and predisposes to both disorders in the next generation. Clinicians encountering patients who are perpetrators or victims of domestic violence or sexual trauma, or have addictive disorders, must assess for the presence of comorbid problems.
 

Fischbach, Ruth L; Herbert, Barbara. (1997). Domestic violence and mental health: Correlates and conundrums within and across cultures. Social Science & Medicine. Vol 45(8) 1161-1176.
Discusses domestic violence in developing countries and examines the impact on the mental health of victims. Accruing data reveal strengthening associations between spouse abuse and depression, stress-related syndromes, chemical dependency and substance abuse, and suicide. Documentation reveals domestic violence to be endemic and to represent a significant cause of physical morbidity and mortality to women in virtually every culture. Historically, the human rights community has failed to recognize these violations against women's rights. Brief narratives illustrate 3 common forms of violence: marital rape, dowry-related deaths, and disproportionate exposure to HIV/AIDS. Emerging social, legal, medical, and educational strategies, often culture specific, offer novel local models to promote social change, beginning with raising the status of women.
 

Brookoff, Daniel; O'Brien, Kimberly; Cook, Charles S; Thompson, Terry D; Williams, Charles. (1997). Characteristics of participants in domestic violence. Journal of the American Medical Association. Vol 277(17), 1369-1373.
Surveyed 64 assailants and 72 victims at the scenes of domestic violence as to circumstances of the assault, history of domestic violence, previous arrests, use of antipsychotic medications, and previous use of health care facilities and shelters as a result of domestic violence. Assessing families in their homes allowed the identification of the involvement of children, either as witnesses (85% of the cases) or as victims (15%), and the identification of barriers to seeking help (e.g., fear of exacerbating the violence, strong emotional and economic bonds with the perpetrator). Many of the perpetrators were habitual substance abusers, and two thirds of the perpetrators had used the combination of cocaine and ethanol on the day of the assault.
 

Lindquist, Carol U; Sass, Lillian E; Bottomley, Denise; Katin, Suzanne M; et al. (1997). Should abused women's reports of partner substance abuse be accepted as valid? Journal of Family Violence. Vol 12(1) Mar 1997, 75-83.
Current research suggests that a husband's substance abuse is correlated with severity of physical abuse and the woman's decision to leave a violent situation. Often, only the battered woman's report of abuse is available. This study compares women's reports of their partners' substance use/abuse with their partners' report using a brief measure of polydrug and alcohol abuse, the Substance Abuse Subtle Screening Inventory (SASSI) and the Conflict Tactics Scale (CTS). Data were analyzed for 25 recovery couples and 25 nonrecovery couples. The correlations for all 50 couples between the male's reported use and the female's report of her partner's use on the SASSI and the CTS were significant on all but one of the CTS scales (physical violence). This suggests that the SASSI and possibly the CTS could be used as valuable tools for assessing women's reports of their partner's substance use/abuse.
 

Irons, Richard R. (1996). Comorbidity between violence and addictive disease. Sexual Addiction & Compulsivity. Vol 3(2), 85-96.
The single most significant cause of injury to women in the United States is battery by someone with whom they have had an intimate relationship. In many cases, substance-related disorders are at play. But the relationship of substance abuse and violent behavior is not simply one of cause and effect. Addictive sexual disorders are also associated with domestic violence, which may start as pressure to submit to unwanted sexual play. Sex may deteriorate into hostile or repressive activity, with abused partners participating to avoid physical violence. A common barrier to treatment of sexual addiction is the perpetrator's fear of exposure. Another complicating factor is the clinician's countertransference. Helping professionals would do well to develop clinical plans for approaching both victims and perpetrators. This should include taking a thorough history, having literature on hand about available resources, obtaining informed consent, documenting the trauma, and considering the consequences of whatever actions are taken.
 

Windle, Michael; Windle, Rebecca C; Scheidt, Douglas M; Miller, Gregory B. (1995). Physical and sexual abuse and associated mental disorders among alcoholic inpatients. American Journal of Psychiatry. Vol 152(9), 1322-1328.
Investigated the adult psychiatric correlates of childhood abuse among 481 male and 321 female alcoholic inpatients (aged 19-57 yrs). Prevalence of reported childhood abuse was 59% for women and 30% for men. Family history of alcoholism was associated with higher levels of physical and sexual abuse. 49% of women and 12% of men reported sexual abuse (with or without physical abuse); 33% of women and 24% of men reported physical abuse (with or without sexual abuse); and 23% of women and 5% of men reported dual abuse. Abuse status, and especially dual abuse, was associated with higher rates of antisocial personality disorder and suicide attempts among women and men, with generalized anxiety disorder among women, and with major depression among men.
 

Robins, Lee N. (1995). The epidemiology of aggression. Hollander, Eric (Ed); Stein, Dan J. (Ed). Impulsivity and aggression. (pp. 43-55). New York, NY: John Wiley & Sons
[discuss] aggression [and] note that violence is closely related to conduct disorder, antisocial personality, and substance abuse / attempt to estimate how large the problem of violence is, how substantial the evidence is that it is increasing, in what parts of the population it appears most frequently, and what its correlates are, in the hope that they may shed light on the causes of its increase information from police and hospitals and social agencies [assault, child abuse] / survey data in general populations [victims, domestic violence, fighting]

O'Farrell, Timothy; Murphy, Christopher M. (1995). Marital violence before and after alcoholism treatment. Journal of Consulting & Clinical Psychology. Vol 63(2), 256-262.
The prevalence and frequency of marital violence were assessed for 88 male alcoholics and their wives at entry to and 1 year after completing a behavioral marital therapy (BMT) program. In the year before BMT, both the alcoholics and their wives had a significantly and substantially higher prevalence and frequency of marital violence than reported by a demographically matched, nonalcoholic comparison sample. Although violence decreased significantly in prevalence and frequency in the year after BMT it remained significantly elevated relative to the matched controls when the entire sample of alcoholics was considered. However, extent of violence after BMT was significantly associated with the alcoholics' drinking outcome status: After treatment, remitted alcoholics no longer had elevated marital violence levels whereas relapsed alcoholics did. Implications for understanding the marital violence and alcoholism connection and cautions that should be exercised in interpreting the results are discussed.

Conner, Kenneth R; Ackerly, Gary D. (1994). Alcohol-related battering: Developing treatment strategies. Journal of Family Violence. Vol 9(2), 143-155.
Explored the relationship between alcohol and battering to develop appropriate intervention strategies. Studies demonstrating a correlation between alcohol and battering are reviewed, and the intoxicated aggression literature is summarized using K. Graham's (see record 1981-23587-001) conceptual system. It is tentatively concluded that the role of physiological and cognitive changes brought on by alcohol, the interaction of alcohol and frustration in producing aggression, and needs for personal power in men who drink and then aggress are all promising explanations for the alcohol-battering link. The applicability of disease model-based treatment for alcoholism, cognitive-behavioral-based treatment for alcoholism and battering, and feminist-based treatment for battering are each considered. A model for incorporating an alcohol component to a batterer treatment program is introduced.
 

Bennett, Larry; Lawson, Marie. (1994). Barriers to cooperation between domestic-violence and substance-abuse programs. Families in Society. Vol 75(5), 277-286.
388 staff and administrators drawn from a statewide sample of 74 substance abuse and domestic violence programs completed a questionnaire on linkage, referral, impairments to interagency cooperation, and beliefs about cross-problem incidence. Ss estimated that 46% of the male substance abusers currently in their care were batterers, 60% of the female substance abusers were victims, and 42% of the women currently in domestic violence programs were substance abusers. 80% of Ss indicated that these clients would benefit from increased cooperation between substance abuse and domestic violence programs.
 

Cooley, Cynthia S; Severson, Kathleen. (1993). Establishing feminist systemic criteria for viewing violence and alcoholism. Hansen, Marsali (Ed); Harway, Michele (Ed). Battering and family therapy: A feminist perspective. (pp. 217-226). Thousand Oaks, CA, US; Thousand Oaks, CA, US: Sage
(from the book) alcohol abuse and family violence have been linked by many researchers / addresses the specific concerns of therapists who may need to treat both problems simultaneously / discusses the difficulties inherent in current theoretical formulations employed by popular approaches to the treatment of drug and alcohol abuse and presents more useful conceptualizations, including recommendations for treatment (from the chapter) present feminist systemic criteria for viewing violence and alcoholism by exploring the techniques of clearly naming violence, highlighting linguistic dilemmas facing the alcoholism field, and challenging clients to leave the source of violence

Kurtz, David S. (1993). Alcohol abuse as a predictor and correlate of domestic violence. Dissertation Abstracts International. Vol 53(7-B), Jan 1993, 3779.

Collins, James J; Messerschmidt, Pamela M. (1993). Epidemiology of alcohol-related violence. Alcohol Health & Research World. Vol 17(2), 93-100.
Reviews research on alcohol consumption as a contributor to interpersonal criminal violence. Studies of the relationship between drinking and homicide/nonsexual assault, sexual assault, domestic violence, and robbery are detailed. These types of violence often involve drinking by the offender, the victim, or both. It is suggested, however, that the relationship between alcohol use and such behavior is complex, involving individual, situational, and sociocultural influences.

O'Farrell, Timothy J; Choquette, Keith. (1991). Marital violence in the year before and after spouse-involved alcoholism treatment. Family Dynamics of Addiction Quarterly. Vol 1(1), 32-40.
Administered the Conflict Tactics Scales questionnaire on marital violence to 29 alcoholics (aged 28-56 yrs) and their wives (aged 28-63 yrs) at entry into and 1 yr after completing a behavioral marital therapy (BMT) treatment program. In the year before BMT, both Ss and their wives had a significantly higher and 5-6 times greater prevalence of any violent act, of minor to moderate violent acts, and of severe violent acts than that reported by a 1985 US national sample. In the year after BMT, husband-to-wife overall, moderate, and severe violence decreased significantly in prevalence or frequency. The prevalence of overall violence by Ss remained significantly elevated relative to national norms, being still more than twice as prevalent among Ss. Wife-to-husband violence after BMT was significantly decreased in prevalence or frequency and no longer significantly elevated relative to national norms for overall, moderate, and severe violence.

Miller, Brenda A. (1990). The interrelationships between alcohol and drugs and family violence.
National Institute on Drug Abuse: Research Monograph Series. Research Mono 103, 177-207.
Presents research findings from studies that explored the multidimensional relationships between family violence and alcohol or drug problems. Three forms of family violence were considered: child abuse, childhood sexual abuse, and spousal violence. Studies were conducted using (1) 45 alcoholic women in treatment and 40 women in the general population, and (2) 82 male parolees and their spouses. Among the findings: (1) women alcoholics were more likely than general population women to experience spousal violence; (2) alcohol problems in women contributed to the level of spousal violence women experienced; (3) experiences of child abuse were related to the development of alcohol problems; and (4) childhood sexual abuse was related to the development of alcohol problems in women.

Lowrance, N. Ann. (1990). Domestic violence. Engs, Ruth C. (Ed). Alcohol & Drug Problems n. (1990). Women: Alcohol and other drugs. (pp. 165-173). Dubuque, IA, US: Kendall/Hunt Publishing Company. xiv, 173pp.
(from the chapter) historically, family violence and chemical dependency have been linked / while commonalities exist, available data does not support the contention that substance abuse causes men or women to batter or that family violence causes substance abuse / when substance use disorders and domestic violence co-exist in the same family unit, both issues must be addressed battered woman syndrome [stereotype images of family and male-female relations, traumatic bonding, learned helplessness, fear, physical safety, economic hardships, lack of support] / alcohol, drugs and spousal violence
 

Slater, Nancy A. (1990). Connections: An integrative literature analysis of publications examining the relationships among substance abuse, eating disorders, sexual abuse and physical abuse. Dissertation Abstracts International. Vol 50(8-B), Feb 1990, 3679

Stewart, Sherry H; Israeli, Anne L. (2002). Substance abuse and co-occurring psychiatric disorders in victims of intimate violence. Wekerle, Christine (Ed); Wall, Anne-Marie (Ed). The violence and addiction equation: Theoretical and clinical issues in substance abuse and relationship violence. (pp. 98-122). New York, NY, US: Brunner-Routledge.
Explores the possible roles that a variety of psychological disorders might play in the well-documented relation between violence exposure and substance disorders in victims of familial violence. Three specific disorders are focused upon: depression, posttraumatic stress disorder, and sexual dysfunction. The authors first examine the mental health correlates of exposure to familial childhood physical and sexual abuse, including both psychiatric disorders and substance-related disorders. Included are studies with adults using long-term retrospective methodologies, studies with adolescents conducted closer in time to the childhood violence exposure, and a few prospective, longitudinal studies. Studies concerning the mental health correlates of partner-to-partner violence ("spousal battery"), including both psychiatric and chemical use disorders, are reviewed next. The authors explore specific mechanisms that may explain the higher rates of both certain psychiatric disorders and of substance-related disorders among victims of domestic violence, and review evidence regarding comorbidity and potential function relations. Finally, a methodological critique of studies is provided and suggestions are proposed for future research.
 

Flett, Gordon L; Hewitt, Paul L. (2002). Personality factors and substance abuse in relationship violence and child abuse: A review and theoretical analysis. Wekerle, Christine (Ed); Wall, Anne-Marie (Ed). The violence and addiction equation: Theoretical and clinical issues in substance abuse and relationship violence. (pp. 64-97). New York, NY, US: Brunner-Routledge.
Selectively reviews existing reserach and theory on the role of personality factors in domestic violence and child abuse, with a particular focus on the associations among personality, substance abuse, and mistreatment of significant others. The chapter begins with an overview of various models and conceptualizations that focus on the role of personality factors in relationship violence. Next, research on the role of personality factors in relationship violence is reviewed, with the caveat that most of the research has focused on domestic violence and relatively few of the reviewed investigations examined the role of personality factors and substance abuse in child maltreatment. The review concludes with an integrative model that seeks to apply a diathesis-stress and coping approach to domestic violence and child maltreatment.
 

Bergman, Bo; Brismar, Bo. (1993). Assailants and victims: A comparative study of male wife-beaters and battered males. Journal of Addictive Diseases. Vol 12(4) 1993, 1-10.
18 male wife-beaters were compared with 19 battered males concerning their background, history of addiction, and present social situation, as well as present violence. The 2 groups of males had a very similar background, including violence in their parental home. Alcohol and drug problems were common, the males generally belonged to the lower social classes, and the number of divorcees was large. Many of the battered males had abused someone and the male batterers had been victimized themselves. Results indicate that the same background and precipitating factors will predestine the male to be a batterer or to be battered, but most probably both.
 

Easton, Caroline; Sinha, Rajita. (2002). Treating the addicted male batterer: Promising directions for dual-focused programming. Wekerle, Christine (Ed); Wall, Anne-Marie (Ed). The violence and addiction equation: Theoretical and clinical issues in substance abuse and relationship violence. (pp. 275-292). New York, NY, US: Brunner-Routledge.
Discusses several issues in the treatment of co-occuring substance abuse and family violence problems. The authors note that despite the overlap between substance abuse and domestic violence, integrated treatment services for both violence problems and substance abuse in batterers are rare. It is also noted that court-mandated batterers account for the majority of clients attending battering programs, and that this fact raises issues as to the batter's level of motivation to change his behaviors with respect to internal vs external motivators. The authors argue that it is necessary to understand who male batterers are in terms of not only their violence and legal histories, but also with regard to their psychiatric status, including substance abuse and dependence, within the context of what brings the batterer to treatment. Specific topics discussed include criminal justice issues affecting batterer interventions, domestic violence legislation, diversion programs and conditions of probation, treatment compliance and treatment outcomes, policies regarding substance use at the time of an alleged offense, and treatment models for male batterers.
 

Umhau, John C; George, David T; Reedd, Shawn; Petrulis, Sarah G; Rawlings, Robert; Porges, Stephen W. (2002). Atypical autonomic regulation in perpetrators of violent domestic abuse. Psychophysiology. Vol 39(2) Mar 2002, 117-123. 
Perpetrators of domestic violence describe symptoms that are compatible with exaggerated autonomic arousal at the domestic violence. This inappropriate arousal may be reflected in altered heart rate regulation. If heart rate is systematically regulated by vagal mechanisms, then increases in heart rate should correlate with decreases in cardiac as indexed by respiratory sinus arrhythmia (RSA). We hypothesized that perpetrators of domestic violence have an alteration in heart rate regulation. To test this hypothesis we compared the results of a postural shift on perpetrators, healthy volunteers, and nonviolent alcoholics. Results showed there were no significant differences in heart rate, RSA, or catecholamines. However, the significant inverse relationship between posture-elicited changes in RSA and heart rate present in the healthy volunteers was not found in perpetrators. These differences in the covariation between heart rate and RSA may represent differences in the neural regulation of heart rate and may be to difficulties in controlling autonomic state.

Johnson, Richard R. (2001). Intensive probation for domestic violence offenders. Federal Probation. 65(3), 36-39. 
Discusses an intensive probation program to supervise the rising number of the most serious domestic violence offenders in Kane County, Illinois. Challenges discussed that led to development of the Domestic Violence Officer probation program include motivating the offender to change behavior not seen as wrong, return of the victim to the offender in spousal abuse cases, substance abuse, and long patterns of abuse by offenders. The program selects higher-risk domestic violence offenders for specialized stricter supervision. The program involves a requirement that all offenders complete a 26-wk domestic violence counseling program, and if substance abuse is involved, special counseling can be ordered. Early analysis of the program suggests that the program appears successful at preserving community safety, holding offenders accountable, and improving the non-violent coping skills of the offenders
 

Dalton, Bruce. (2001). Batterer characteristics and treatment completion. Journal of Interpersonal Violence, 16(12), 1223-1238. 
Investigated the relationship between completion of domestic violence treatment and the level of threat or consequence perceived by a batterer from the referral source. 79 male and 6 female batterers (aged 18-63 yrs) completed interviews concerning substance abuse, arrest history, violence history, and perception of coercion that Ss felt from the referral source. Results show that 20 Ss were unemployed or employed part-time. Half the Ss had some indication of alcohol or drug abuse symptoms. Most had a prior arrest record, and 22 had a prior arrest for domestic violence. 87% reported partner violence within the past yr. 66% of Ss reported perceiving a high level of external coercion, and 18% perceived a medium level of coercion. 71% of Ss completed treatment, but the degree of threat from the referral source did not predict treatment completion. Significant predictors of treatment completion were reported symptoms of drug abuse and unemployment. 
 

George, David T; Umhau, John C; Phillips, Monte J; Emmela, Devadatham; Ragan, Paul W; Shoaf, Susan E; Rawlings, Robert R. (2001). Serotonin, testosterone and alcohol in the etiology of domestic violence.Psychiatry Research. 104(1), 27-37. 
Compared the cerebral spinal fluid (CSF) concentrations of 5-hydroxyindoleacetic acid (5-HIAA) and testosterone obtained from perpetrators of domestic violence and a group of healthy comparison Ss. Perpetrators with alcohol dependence (DV-ALC; n=13), perpetrators without alcohol dependence (DV-NALC; n=10) and healthy comparison Ss (HCS; n=20) were clinically assessed using the Spielberger Trait Anxiety, Brown-Goodwin Aggression Scale, Buss Durkee Hostility Inventory and Straus Conflict Tactics. Following an overnight fast and bed rest, Ss received a lumbar puncture to obtain CSF concentrations of 5-HIAA and testosterone. Perpetrators scored significantly higher on measures of aggression than HCS. DV-NALC had significantly lower concentrations of CSF 5-HIAA and higher Straus Conflict Tactics (CT) physical violence scores than DV-ALC and HCS. DV-ALC had significantly higher concentrations of CSF testosterone than DV-NALC. DV-ALC also had significantly higher Straus CT physical violence scores than HCS. DV-NALC and DV-ALC differed on 5-HIAA concentrations, testosterone concentrations, Straus CT physical violence scores and alcohol dependence. These results suggest that DV-NALC and DV-ALC groups could have different biological mechanisms mediating domestic violence.
 

Smith, Carol Lynn. (2001). A potentially useful screening tool for domestic violence offenders derived from the Substance Abuse Subtle Screening Inventory-3 (SASSI-3). Dissertation Abstracts International: Section B: the Sciences & Engineering. Vol 62(2-B), 1137.
Domestic violence exacts a tremendous cost on individuals, families, and society. Victims pay in many ways from the injuries suffered from physical violence to the trauma of emotional and psychological abuse. The cost to society has been estimated at $3 to $5 billion annually. Domestic violence offenders are not easily identified by distinguishing characteristics. Often intervention for domestic violence only occurs following an arrest and judicial directives to the offender to undergo treatment for domestic violence, Since there are on average nine violent incidents before a victim will call for police assistance, the family will have already endured extensive negative effects. There has been no screening tool for domestic violence offenders available for treatment providers. The Substance Abuse Subtle Screening Inventory-3 (SASSI-3) is a widely used screening instrument for substance abuse. The SAS SI-3 was investigated to determine if it could also be used as a screening tool for domestic violence offenders. This study compared 150 violent male offenders to a self identified nonviolent control group of 75 men on the subtle items of the SASSI-3 to determine if there would be significant differences between the groups. The offender group scored higher on four sub-scales of the SASSI-3 than the control group. One scale alone, the FAM scale was significantly different between groups. Combined with the OAT, SAT, and SAM sub-scales, the FAM scale was able to predict group membership with 78.7 percent accuracy. Clinical implications and suggestion for future research are presented.
 

McBurnett, Keith; Kerckhoff, Carl; Capasso, Lisa; Pfiffner, Linda J; Rathouz, Paul J; McCord, Mike; Harris, Steven M. (2001). Antisocial personality, substance abuse, and exposure to parental violence in males referred for domestic violence. Violence & Victims. Vol 16(5), 491-506. 
Investigated whether childhood disruptive behavior (hyperactivity, oppositional-defiance, conduct problems) plus adult psychopathic adjustment are associated with domestic violence. Ss were 66 adult males in diversion programs. Ss completed the Wender Utah Rating Scale (WURS), MMPI Psychopathic Deviate scale (PD), Conflict Tactics Scales representing themselves and their parents, and substance use measures. Substance use and lifespan antisocial personality (measured by high WURS and PD scores) were robust predictors of verbal and moderate physical domestic abuse. Violence in the family of origin was associated with abuse when tested alone, but failed to exhibit unique association with abuse when other predictors were taken into account. The possibility that antisocial batterers respond to contingencies by moderating physical harm, while persisting at psychological harm, is discussed. 
 

Olson, David E; Stalans, Loretta J. (2001). Violent offenders on probation: Profile, sentence, and outcome differences among domestic violence and other violent probationers. Violence Against Women. 7(10) Oct 2001, 1164-1185. 
Compared personal characteristics, sentencing conditions, and recidivism rates of probationary domestic violence offenders with those of probationers convicted of other violent offenses. Probation officers completed data forms for 124 probationers (aged <21-41+ yrs) convicted specifically of domestic violence and 287 probationers convicted of other violent offenses. Collected data included age, race, gender, education, prior adult convictions, substance abuse, length of sentence, conditions of probation, revocation of probation, and technical violations while on parole. Results show that Ss convicted of domestic violence were more likely to have a substance abuse history, to be older, White males, to have completed high school, and to have a prior adult conviction. Sentences for domestic violence Ss were shorter; however, there were more conditions placed on the probation period. Recidivism rates for domestic violence Ss were similar to those convicted of other violent offenses.
 

Hudak, Koreen Victoria Bailey. (2001). An investigation of variables related to attrition of Hispanic men from a domestic violence treatment program. Dissertation Abstracts International: Section B: the Sciences & Engineering. Vol 61(11-B), 6137.
This study examines personality, demographic, and psychosocial variables of Hispanic batterers involved in a court-mandated domestic violence treatment program. The objective of the study was to explore selected MMPI-2 scale differences between batterers who completed and those who dropped out of treatment. Data were analyzed on a total of 91 subjects, all of whom were Hispanic males. Variables were examined to determine if there were identifiable differences between English-speaking completers (n = 31) and dropouts (n = 21) and Spanish-speaking completers (n = 25) and dropouts (n = 14). English-speaking dropouts scored significantly higher on MMPI-2 Scale 4 than did the English-speaking completers. The MMPI-2 data suggested that the English-speaking dropouts were more immature, angry, rebellious, impulsive, and at risk for substance abuse than the English-speaking completers. English-speaking dropouts were also more likely to be unemployed, to earn less than $12,000 per year, and were slightly more likely to be single than the English-speaking completers. No significant differences were found to differentiate the Spanish-speaking dropouts from completers across personality or demographic variables. However, a trend was noted that Spanish-speaking dropouts were slightly more likely to have experienced physical abuse as a child than completers. Recommendations for future research are presented and implications for program policy are discussed.
 

Holtzworth-Munroe, Amy; Meehan, Jeffrey C; Herron, Katherine; Rehman, Uzma; Stuart, Gregory L. (2000). Testing the Holtzworth-Munroe and Stuart (1994) batterer typology. Journal of Consulting & Clinical Psychology. Vol 68(6), 1000-1019. 
A. Holtzworth-Munroe and G. L. Stuart (1994) proposed that 3 subtypes (family only [FO], borderline-dysphoric [BD], and generally violent-antisocial [GVAI) would be identified using 3 descriptive dimensions (i.e., severity of marital violence, generality of violence, psychopathology) and would differ on distal and proximal correlates of violence. Maritally violent men (n = 102) and their wives were recruited from the community, as were 2 comparison groups of nonviolent couples (i.e., maritally distressed and nondistressed). Four clusters of violent men were identified. Three resembled the predicted subtypes and generally differed in the manner predicted (e.g., FO men resembled nonviolent groups; BD men scored highest on measures of dependency and jealousy; GVA men had the most involvement with delinquent peers, substance abuse, and criminal behavior; and both BID and GVA men were impulsive, accepted violence, were hostile toward women, and lacked social skills). The 4th cluster (i.e., low-level antisocial) fell between the FO and GVA clusters on many measures.
 

Baugh, Stacey-Ann Robotham. (2001). An examination of the relationship between male-to-female physical aggression and psychoactive substance use severity in men entering treatment for domestic violence. Dissertation Abstracts International: Section B: the Sciences & Engineering. Vol 61(9-B), 4971.
Domestic violence is a significant problem in the United States. One out of every six U.S. couples experiences an incident involving a physical assault each year. Excessive alcohol use is associated with greater risk for domestic violence. There also appears to be an increased risk for domestic violence associated with drug use. Despite the evidence linking substance abuse problems with domestic violence, surprisingly little research has been conducted examining the relationship between addiction severity and spousal violence frequency among individuals entering treatment for domestic violence. The current study examined a sample of cohabiting couples in which the male partner was entering treatment for domestic violence. Data was collected one time from both partners within the couple. Results of the study indicate that greater drug and alcohol use is significantly related to higher frequency of domestic violence. However, the interaction of drug and alcohol use did not significantly predict the frequency of domestic violence. Results of the study also indicated that perpetrators who met diagnostic criteria for substance abuse diagnoses had higher frequency of domestic violence incidents than perpetrators who did not meet these criteria.
 

Meehan, Jeffrey C; Holtzworth-Munroe, Amy; Herron, Katherine. (2001). Maritally violent men's heart rate reactivity to marital interactions: A failure to replicate the Gottman et al. (1995) typology. Journal of Family Psychology. Vol 15(3), 394-408. 
In an attempt to replicate the J. A Gottman et al. (1995) batterer typology, 58 men who had engaged in moderate-to-severe marital violence in the past year were studied. The sample was split into Gottman et al.'s Type 1 men (i.e., whose heart rates decreased, from baseline, during a marital conflict task) and Type 2 men (i.e., whose heart rates increased). The groups did not differ in the manner predicted on measures of marital violence, antisocial or aggressive-sadistic personality, drug dependence, criminality, general violence, childhood exposure to interparental violence, behavior during marital interactions, or relationship stability. Contrary to expectations, wives of Type 1 men rated their husband as more jealous and angry and reported more marital distress. In the only finding consistent with Gottman et al., Type 2 men scored higher on a measure of dependent personality. Implications for future research are discussed. 
 

Murphy, Christopher M; O'Farrell, Timothy J; Fals-Stewart, William; Feehan, Michael. (2001). Correlates of intimate partner violence among male alcoholic patients. Journal of Consulting & Clinical Psychology. Vol 69(3) Jun 2001, 528-540. 
Male-to-female partner violence was investigated in heterosexual couples with an alcoholic male partner. Partner violent (PV) alcoholic patients (n = 183), when compared with nonviolent (NV) alcoholic patients (n = 120), had more antisocial personality characteristics, greater alcohol problem severity, greater use of other drugs, higher relationship distress, and stronger beliefs in the link between alcohol consumption and relationship problems. Demographic factors did not account for these PV-NV differences. Relationship distress and alcohol problem severity had independent associations with partner violence. Relationship adjustment and drug use remained significantly associated with partner violence, whereas alcohol problem severity did not, after controlling for patient antisocial traits. Beliefs in the link between drinking and relationship problems were associated with partner violence independent of other clinical factors. 
 

Daly, Jennifer Ella. (1998). Predicting compliance among men who batter: The contribution of demographics, violence-related factors and psychopathology. Dissertation Abstracts International: Section B: the Sciences & Engineering. Vol 59(5-B), Nov 1998, 2414
This research examined the predictors of program attendance and participation among men referred for batterers' intervention services. Two hundred and twenty men seeking services at PIVOT of Aid to Victims of Domestic Violence (AVDA), a community-based batterers' program, completed measures of past battering (Conflict Tactics Scale, CTS, Straus, 1979), antisocial behavior, and current psychological functioning (Michigan Alcoholism Screening Test; MAST, Selzer, 1971; Millon Clinical Multiaxial Inventory, MCMI-III; Millon, 1993). One hundred and fifty-three women also completed telephone interviews regarding their partners' past violence and their beliefs about men's compliance. It was predicted that variables from demographic, violence-related (i.e., battering and criminal history) and interpersonal (i.e., psychopathology) domains would predict the number of sessions attended and staff ratings of group participation. Results indicate that attendance was higher for men who were court-ordered to attend, men in white collar occupations, men who were employed at intake and those who scored low on the MAST. Multiple regressions revealed that only referral source (i.e., court vs. noncourt-ordered), employment status and presence of alcohol-related problems predicted sessions after equating men on the other correlates. Staff ratings were higher for men with higher education and those who reported witnessing battering as children, and lower for Latino men and men who were unemployed at intake. Only race (i.e., Latino) significantly predicted staff ratings of group participation after controlling for the other variables. Few significant differences were found in the predictors of attendance or participation for court and noncourt-ordered men. Exploration of women's predictions of attendance revealed that 96% (n = 101) believed that their partners' would complete the program. Results provide valuable information about batterers' attendance and group participation that can aid victims' decision making and batterer program implementation. 
 

Bennett, Larry W; Tolman, Richard M; Rogalski, Carol J; Srinivasaraghavan, Jagannathan.
(1994). Domestic abuse by male alcohol and drug addicts. Violence & Victims. Vol 9(4) Win 1994, 59-368. Investigated domestic abuse by male alcoholics and drug addicts. 63 male inpatient alcohol and drug addicts were interviewed, followed by an interview of 34 of their female partners to assess the reliability of the men's reports of domestic abuse. The frequency of both physical and nonphysical abuse were measured. Results indicate that neither quantity nor frequency of alcohol use nor the severity of alcohol dependence was associated with an increase in abuse. Further, domestic abuse by male addicts was not directly related to experience of violence or addiction in the family of origin, external locus of control or severity of alcohol abuse. Correlates of domestic abuse were: early onset of drug/alcohol-related problems; low income; a history of nonalcohol drug use, particularly cocaine; and a history of arrest and outpatient counseling. 
 

Murphy, Christopher M; O'Farrell, Timothy J. (1994). Factors associated with marital aggression in male alcoholics. Journal of Family Psychology. Vol 8(3) Sep 1994, 321-335. 
Male alcoholics who were physically aggressive toward their wives in the year before alcoholism treatment (n = 71) were compared with nonaggressive counterparts (n = 36). Two key patterns were associated with marital aggression: (a) binge drinking linked with coercive marital conflicts and (b) markers of a severe early onset alcoholism syndrome. Maritally aggressive men were younger and exhibited more binge drinking, higher prevalence of arrest, more verbal aggression, greater alcohol problem severity, earlier alcohol problem onset, more alcoholism among male biological relatives, less maternal alcohol use, less confidence in their ability to manage interpersonal conflict without drinking, and stronger beliefs that alcohol causes marital problems. Marital adjustment levels were not associated with marital aggression, and very few differences were found between moderate and severe violence groups. 
 

Downs, William R; Miller, Brenda A; Panek, Denise D. (1993). Differential patterns of partner-to-woman violence: A comparison of samples of community, alcohol-abusing, and battered women. Journal of Family Violence. Vol 8(2) Jun 1993, 113-135. 
Compared patterns of partner-to-woman verbal abuse and physical violence among 45 alcoholic women, 38 battered women, and 40 women randomly selected from the community. Range of violence and high vs low frequency of violence were measured by Conflict Tactics Scales (CTS). Results show that at the highest frequency of violence, battered women reported the highest scores on each CTS subscale. CTS scores of alcoholic women were higher than those of community women. Membership in the alcoholic sample significantly predicted a high frequency of negative verbal interaction and moderate violence, controlling for presence of a partner with alcohol-related problems and demographic differences among the samples. 
 

Stith, Sandra M; Farley, Sarah C. A predictive model of male spousal violence. Journal of Family Violence. Vol 8(2) Jun 1993, 183-201. 
Developed and tested a multivariate causal model of predictors of marital violence (MV) by men. Variables examined were observation of MV during childhood, marital stress, attitude toward acceptability of MV, sex-role egalitarianism, alcoholism, and self-esteem. Hypotheses regarding relationships among variables were based on social learning theory. Path analysis regression was computed based on questionnaire responses of 91 men in violence or alcoholism treatment programs. Results suggest that sex-role egalitarianism and approval of MV both have direct effects on the use of severe MV. Observation of MV had a negative effect on self-esteem, which influenced marital stress and level of alcoholism and subsequently influenced approval of MV. Observation of MV as a child also had a direct effect on approval of MV and a negative effect on sex-role egalitarianism. 
 

Julian, Teresa W; McKenry, Patrick C. (1993). Mediators of male violence toward female intimates. Journal of Family Violence. Vol 8(1) Mar 1993, 39-56. 
Compared perceived life stressors, alcohol usage, and perceived quality of the intimate relationship among 42 men who had abused their female intimate with 50 men with no history of partner abuse. Ss completed various demographic and health questions as well as the Michigan Alcoholism Screen Test, E. S. Schaefer and M. Edgerton's (1982) Autonomy/Relatedness Scale, the Life Experiences Survey, and the Conflict-Tactics Scale. Stepwise logistic regression indicated that higher perceived quality of the intimate relationship, race, and greater depression were significant predictors of male violence toward female intimates. (PsycINFO Database Record (c) 2000 APA, all rights reserved) (unassigned)
 

Dinwiddie, Stephen H. (1992). Psychiatric disorders among wife batterers. Comprehensive Psychiatry. Vol 33(6) Nov-Dec 1992, 411-416. 
61 male spouse batterers were identified from a population of relatives of treated alcoholics and compared with 319 married or formerly married men without a reported history of battering on lifetime psychiatric diagnoses and antecedent behaviors. Batterers had higher lifetime rates of alcoholism, antisocial personality disorder, and depression than nonbatterers, but not other psychiatric disorders. While batterers and nonbatterers could not be differentiated based on violent behaviors occurring before the age of 15 yrs, 95% of batterers reported other fighting as an adult. Batterers were more likely to have been divorced 2 or more times and to report repeated infidelity. 
 

Stith, Sandra M; Crossman, Rita K; Bischof, Gary P. (1991). Alcoholism and marital violence: A comparative study of men in alcohol treatment programs and batterer treatment programs. Alcoholism Treatment Quarterly. Vol 8(2) 1991, 3-20. 
Compared 39 men enrolled in batterer programs and 52 men enrolled in alcohol treatment programs on factors related to marital violence. All Ss were currently in a relationship. Factors that were compared included age, education, income, race, marital status, current level of marital stress, level of self-esteem, socially desirable response bias, attitude toward marital violence, level of sex-role egalitarianism, history of childhood violence, level of violence in current relationship, and level of alcohol abuse. Very few differences between the men were found on any of the variables. The majority of men in both groups were alcoholics (64% of the men in the batterer programs and 96% of the men in alcohol programs) and used violent conflict tactics in their relationships (82% of the men in batterer programs and 59% of those in alcohol programs). Implications for treatment of dually affected men are presented. 
 

Gondolf, Edward W; Foster, Robert A. (1991). Wife assault among VA alcohol rehabilitation patients. Hospital & Community Psychiatry. Vol 42(1) Jan 1991, 74-79. 
Administered the short Michigan Alcoholism Screening Test and the Conflict Tactics Scales to 218 patients in a Veterans Affairs (VA) alcohol rehabilitation program for military veterans. More than 33% of the Ss reported assaulting their wives or partners at least once in the previous year, and 20% reported committing severe assaults. A subsample of 33 wives or partners of the Ss reported higher rates of assault than did their male partners. An examination of clinical records of 25 Ss indicated that clinicians had identified some sort of "domestic violence" for only 20% of this subsample. A dysfunctional family of origin and previous arrest were associated with higher rates of wife assault. 
 

Rooney, Jennifer; Hanson, R. Karl. (2001). Predicting attrition from treatment programs for abusive men. Journal of Family Violence. Vol 16(2), 131-149. 
Attrition in male battering treatment programs is a serious problem. To keep clients in treatment, it is crucial to understand why they drop out. The current study examined the contribution of both client and program characteristics in predicting dropout from treatment programs for abusive men. Data were collected at intake from 306 abusive men (mean age 35.5 yrs) who sought treatment at 4 different sites. The rate of preprogram attrition (from intake to the first treatment session) was higher in the program that had a lengthy waiting list than in the other programs. In-program attrition was more highly related to client characteristics than program characteristics. Those men who dropped out after starting treatment tended to have unstable lifestyles (e.g., substance abuse problems, criminal history, unemployment) and to have inflicted more severe abuse than those who completed treatment. Results also supported a significant interaction between verbal aptitude and structure of program; men with low verbal aptitude were the most likely to drop out of an unstructured program. Possible strategies for preventing attrition are discussed.
 

White, Robert Jeffrey. (2000). Self-reported woman battering, personality characteristics and substance abuse of low security federal prison inmates. Dissertation Abstracts International: Section B: the Sciences & Engineering. Vol 61(4-B), 2230.
This study describes woman battering, personality characteristics and substance abuse reported by 115 inmates entering a low security federal prison. The objective is to describe the extent and characteristics of woman batterers in a large, understudied male population. The research questions are; (1) To what extent do inmates acknowledge battering and present characteristics associated with battering? (2) How can self-identified inmate batterers be characterized in terms of personality functioning and substance abuse? and (3) How do these characteristics inform batterers interventions in low security federal prisons? Archival data from Psychology Services files was examined for 115 inmates who completed consecutive, mandatory intake assessments between February and July 1998. Assessments occurred within 30 days of inmates' arrival to the prison and consisted of the Conflict Tactics Scale, Michigan Alcohol Screening Test, Millon Clinical Multiaxial Inventory, Version Three, and the standard Psychology Services intake questionnaire. Characteristics of the full inmate sample and the subsarnple of inmates who admitted battering on the Conflict Tactics Scale are described and treatment implications are discussed. The full sample approximates the composition of the prison and of low security Federal prisons. The inmates report high levels of identified risk factors for woman battering, in particular substance abuse, and 1 in 3 acknowledge recent physical violence against women partners. The 38 self-identified batterers exhibit high rates of antisocial personality tendencies and substance use problems. Systematic groupings of their personality profiles suggest, nonetheless, that the prevailing trimodal batterer typology is represented. The findings suggest that screening for domestic violence may be needed in low security federal prisons for a large, rapidly growing male population that ultimately returns to society and that the established, gender-based, cognitive-behavioral batterers intervention model may be appropriate with important modifications. Batterers programs in these facilities may need to accommodate borderline/dysphoric and psychopathic tendencies that characterize inmate batterers, address substance abuse problems, and adopt programs to institutional realities. The findings and implications are considered tentative and suggest future research directions.
 

Conner, Kenneth R; Duberstein, Paul R; Conwell, Yeates. (2000). Domestic violence, separation and suicide in young men with early onset alcoholism: Reanalyses of Murphy's data. . Suicide & Life-Threatening Behavior. Vol 30(4) Win 2000, 354-359. 
Investigated partner violence and partner separation at the time of completed suicide in 42 male alcoholics originally described by G. E. Murphy (1992). Data was based on psychological autopsies. Results show that half of the men had domestic violence histories. Partner-violent men were younger, had an earlier age of onset of alcoholism, and were more likely to be separated from their partner at the time of death than partner-nonviolent men. Loss of a close personal relationship, often a domestic partner, was common during the last year of life among alcoholic men completing suicide. Domestic violence appears to typify many of their domestic relationships, particularly among younger men and men with early onset alcoholism.
 

Soler, Hosanna; Vinayak, Preeti; Quadagno, David. (2000). Biosocial aspects of domestic violence. Psychoneuroendocrinology. Vol 25(7), 721-739. 
Examined the relationships between a biological variable (testosterone level), social variables (demographics, social integration), and behavior (substance use) and self-reported domestic violence. The sample consisted of 54 men (aged 18-45 yrs) who had a main sexual partner and who identified themselves as Black, White, or Hispanic. The men were recruited from various social-service agency sites in the area of Miami, Florida, on the basis of their risk factors for HIV/AIDS. Ss completed the Conflict Tactics Scale. A high percentage of Ss reported some level of both verbal and physical aggression towards their partners. Testosterone levels were significantly associated with levels of both verbal aggression and physical violence self-reported by the men. Testosterone level, demographic characteristics, and alcohol consumption contributed to explaining the variance in self-reported verbal and physical abuse.
 

Easton, Caroline; Swan, Suzanne; Sinha, Rajita. (2000). Motivation to change substance use among offenders of domestic violence. Journal of Substance Abuse Treatment. Vol 19(1), 1-5. 
Given the high rates of co-occurring substance use (SU) and family violence-related problems, SU was assessed in 41 male offenders of domestic violence (aged 18-64 yrs) who were mandated by court to attend anger management classes. Rates of substance dependence diagnoses ranged from 33% to 50%, while rates of substance abuse diagnoses ranged from 60% to 75%. This study evaluated the effectiveness of a motivational enhancement intervention on readiness to change SU in these 41 Ss. Two anger management groups were targeted to assess SU, violence, and motivation to change SU behaviors. One group was randomly chosen to partake in a motivational enhancement intervention session. The comparison group was offered standard anger management classes. A brief motivation to change survey, adapted from the Readiness to Change subscale of the Stages of Change Readiness and Treatment Eagerness Scale, was administered pre- and postsession. Results indicate that a motivational enhancement intervention is feasible and effective in increasing readiness to change SU among domestic violence offenders. The results illustrate the importance of assessing and treating substance use among offenders of domestic violence as this may be an important indicator for higher dropout rates and reoffending.
 

Bresnahan, Sean Patrick. (1999). Men who are violent against their partners: A study evaluating the effectiveness of a domestic violence treatment program in a correctional setting. Dissertation Abstracts International: Section B: the Sciences & Engineering. Vol 60(3-B), 1289
Over the past 15 years, much research has been conducted regarding the effectiveness of programs developed to treat men specifically for abusing their partners. The research tends to show mixed results (Eckhardt, Barbour, & Stuart, 1997; Barbour, Eckhardt, Davison, & Kassinove, 1998) for two reasons. The first is methodological research designs which are faulty due to such problem as lack of control groups and high drop-out rates. The second reason is treatment programs have primarily focused on nonpersonality factors such as substance abuse and the stress of daily living. The purpose of this present study was to evaluate the efficacy of a violence-reduction program on behavior and psychological characteristics of intimate abusers, while making an effort to avoid the methodological flaws related to recent studies. This was done by comparing a group of intimately abusive offenders (N = 12) who completed an eight week, cognitive-behavioral treatment program with a group of offenders (N =1 2) who were comparable to the treated offenders but were not yet in treatment for administrative reasons. The entire sample was administered a battery of measures prior to the treatment program in order to identify core psychological variables. They were then measured at the conclusion of the treatment program on those same variables. The results were then compared to the pretest measures' and to the separate samples. In this study, the results indicated that there were few significant changes between pre-treatment and post-treatment measures for the treatment group, as compared to the control group. It was found that the treatment program may have significantly reduced total hostility as measured by the Buss-Durkee Hostility Inventory (Buss, & Durkee, 1957). This suggests that these men who participated in the treatment program significantly reduced their levels of verbal hostility, indirect hostility, suspicion, negativism, irritability, resentment, and assault, as compared to the control group. Additionally, the subscale verbal hostility on the Buss-Durkee Hostility Inventory (Buss et al., 1957) was significantly reduced while the subscale attitude toward the law, as measured by the Criminal Sentiment Scale (Gendreau, Grant, Leipciger, & Collins, 1979, Andrews, & Wormith, 1984; Sheilds, & Simourd, 1991) significantly increased. However, the remaining results indicated that the treatment program did not have an affect on criminal sentiment, or locus of control. On the other hand, as was expected, most of the identified psychological characteristics fell within the normative ranges found from previous research, which supports the prevalence of these features in intimate abusers. Even though the results were not able to significantly predict placement in the treatment group as opposed to the control group on any of the factors measured, the best predictor turned out to be total hostility on the Buss-Durkee measure (Buss et al., 1957). In the future, longitudinal studies should be conducted in order to evaluate the stability of changes achieved by the Domestic Violence Reduction Group or the relationship between the changes that were experienced and subsequent behavior within their relationships and the community longitudinally. In addition, the research should focus on recidivism rates and offense.
 

Francis, Elie; Hughes, Patrick; Schinka, John. (1999). Improving cost-effectiveness in a substance abuse treatment program. Psychiatric Services. Vol 50(5) May 1999, 633-635. 
Describes the reorganization process of a Veterans Affairs substance abuse program in response to needs for more cost-efficiency. The challenge was to transform the inpatient-focused program into a comprehensive ambulatory care service for patients who are largely homeless and unemployed and who have very limited family support or transportation capabilities. Needs of patients and referring services were assessed through the use of task forces, and decisions were made on which services would be most effective and would best meet the needs of clients. Program building blocks included the elimination of consultation waiting lists and the addition of an intensive outpatient day program, an intensive evening rehabilitation program, a relapse prevention program, an outpatient detoxification clinic, and a domestic violence intervention program. This substance abuse program was successfully restructured in a way that encourages cost-effectiveness while maintaining accountability and quality of care.
 

O'Farrell, Timothy J; Van Hutton, Valerie; Murphy, Christopher M. (1999). Domestic violence before and after alcoholism treatment: A two-year longitudinal study. Journal of Studies on Alcohol. Vol 60(3), 317-321. 
An initial study of 88 male alcoholics and their wives had shown that domestic violence decreased significantly in the year following a behavioral marital therapy (BMT) alcoholism treatment program (see record 1995-25613-001). To determine if violence reductions were stable, the present study examined the prevalence and frequency of domestic violence during the 2nd year following BMT for the 75 of the original couples (mean age 45 yrs) who provided 2-yr follow-up data on violence. Comparison rates of domestic violence were derived from a nationally representative survey of violence in American families. For both the 1st and 2nd year after BMT, violence was significantly reduced and the extent of violence was associated with the extent of the alcoholics' drinking. Frequency of posttreatment drinking was positively correlated with violence, and remitted alcoholics no longer had elevated domestic violence levels when compared with controls whereas relapsed alcoholics did. Results indicate that domestic violence decreased after BMT alcoholism treatment. Further, among remitted alcoholics, violence returned to the level experienced by other families, in the same way that other aspects of marital, family and psychosocial functioning improve after successful treatment of alcoholism. 
 

Brown, Thomas G; Werk, Annette; Caplan, Tom; Seraganian, Peter. (1999). Violent substance abusers in domestic violence treatment. Violence & Victims. Vol 14(2), 179-190. 
This study had 2 main objectives: (1) the characterization of psychoactive substance abuse disorders; and (2) clarification of the role of substance abuse on the sociodemographic, personality, psychosocial, and abuse characteristics of dual-problem men. 53 adult men who were attending domestic violence treatment were recruited. They were administered the Addiction Severity Index, the Conflicts Tactics Scale, Structured Clinical Diagnostic, the Sixteen Personality Factor Questionnaire, and the Symptoms Checklist-90. 63% of the men had a current diagnosis of psychoactive substance abuse or dependence, while 92% had a lifetime diagnosis. Of the former, the majority was diagnosed as multiply dependent on alcohol and other drugs. Dual-problem men reported more hostility, apprehension, frustration and suspiciousness and past arrests than did their violence-only cohorts as well as a history of multiple (unsuccessful) treatment for substance abuse. These findings suggest that the trend toward multiple drug complaints seen in other clinical milieus is also being confronted in conjugal violence settings. 
 

Gondolf, Edward W. (1999). Characteristics of court-mandated batterers in four cities: Diversity and dichotomies. Violence Against Women. Vol 5(11), 1277-1293. 
Background and test data, including information from the Michigan Alcoholism Screening Test and the Millon Clinical Multiaxial Inventory-III, were systematically collected from 840 Ss (aged 18-65 yrs) from 4 geographically distributed batterer programs. Results show that the Ss appeared similar demographically to those in previous portrayals of court-mandated batterers, except that this sample had a greater portion of African American and Latino Ss. Several dichotomies appeared among the Ss that might influence intervention, such as differences in living arrangements, education, employment, and drinking. Over half of the Ss had been arrested for offenses other than domestic violence. Over half of the Ss had alcoholic tendencies, and over one quarter showed evidence of several mental disorders. The 4 programs reflected regional differences in demographics but had relatively similar portions of Ss with previous arrests, mental problems, and alcoholic tendencies. 
 

Koch, Gregory Lee. (1998). Previous arrests, alcoholism, psychopathology, and performance in court-mandated treatment for domestic violence. Dissertation Abstracts International: Section B: the Sciences & Engineering. Vol 59(2-B), 0875
Problem. The purpose of this study was to investigate the relationship between previous arrests, alcoholism, psychopathology and treatment attendance for domestic violence offenders enrolled in court-mandated psychoeducational treatment. The study also examined the relationship between previous arrests, alcoholism, psychopathology, and participation in treatment. Method. 62 male Subjects enrolled in a court-mandated domestic violence psychoeducational treatment program were administered the Michigan Alcohol Screening Test (MAST) and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Subjects were also interviewed regarding previous arrests and contacts with the police. Treatment attendance records were compiled and subjects' participation in treatment was analyzed. The resulting data were analyzed using correlation techniques and multiple regression tests in order to explain the relationship between the variables. Results. The study revealed that domestic violence offenders receiving court-mandated treatment typically had been arrested or had had contact with the police before the arrest for which they were being treated. The mean MAST indicated that the typical subject had a rather severe alcohol problem. MMPI-2 mean scores indicated that the average subject scored in the normal range on the F Scale and in the high normal range of the Psychopathic Deviate Scale. In examining the relationship between the variables, previous arrests were significantly negatively correlated with both number of treatment sessions attended and the quality and level of participation in treatment. The MMPI-2 F Scale was not significantly correlated with number of treatment sessions attended or with the quality and level of participation in treatment, although the relationship between the F Scale and the number of treatment sessions attended approached statistical significant. The relationships between MAST scores and both number of treatment sessions attended and the quality and level of participation in treatment were not significant. When previous arrests, MAST score, F Scale score, and Psychopathic Deviate Scale score were included in various combinations to analyze their relationship with number of treatment sessions attended and with quality and level of participation in treatment, only the combination of previous arrests and the MMPI-2 F Scale score was significantly correlated with number of treatment sessions attended. None of the independent variable combinations was significantly related to quality and level of participation in treatment.
 

Teoh-Goh, Daphne Phaik-Kin. (1997). The phenomenon of wife beating among males in treatment for alcoholism and domestic violence. Dissertation Abstracts International: Section B: the Sciences & Engineering. Vol 57(10-B), 6597 
This study investigated variables hypothesized to be correlated with wife beating among males in treatment for alcoholism and domestic violence. Specifically, it was hypothesized that there would significant positive correlations between stress, alcoholism, attitude toward women, attitude toward violence against women, being severely punished as a child and observation of parental spousal violence in the family of origin, and violent behaviour toward an intimate partner. The sample consisted of 70 males, recruited from county-approved treatment programs for alcoholism and domestic violence. Respondents completed a survey instrument containing a demographic questionnaire, two inventories specially designed for this study to measure the degree of physical violence experienced (PE) as a child and degree of violence observed between parents (VO), and four published instruments to measure stress (Life Experiences Survey), severity of alcoholism (Short Michigan Alcoholism Screening Test), attitude toward women (Attitude Toward Women Scale), and beliefs about wife beating (Inventory of Beliefs about Wife-Beating). The dependent variable was measured with two instruments: the Conflict Tactics Scale, which measured violent and nonviolent means of conflict resolutions, and the Abusive Behavior Inventory, an inventory of physically and psychologically abusive behaviours. Correlational analyses found significant support for the hypothesized relationship between observation of violence between parents and respondents' own violent behaviour and psychological abuse perpetrated against their intimate partners. Additionally, respondents who believe that wife-beating is justified, and that wives gain from being physically abused, are also more likely to have engaged physical violence and psychological abuse against their intimate partners. Among this sample, stress and alcohol abuse were not found to be related to wife beating. Stepwise multiple regression analyses found further support for the results of the correlational analyses. That is, violence observed between parents accounted for 15% of the variance in wife beating. Believing that wife-beating is justified accounted for an additional 5% of the variance. Results of this study were discussed in relation to findings of previous studies. Clinical implications of the results were explored. Assumptions and limitations of this study were discussed, followed by recommendations for future research. 
 

Lee, W. Vernon; Gottheil, Edward; Sterling, Robert C; Weinstein, Stephen P; Serota, Ronald D. (1997). Characteristics of cocaine-addicted individuals who abuse their partners. Journal of Substance Abuse Treatment. Vol 14(4), 367-371. 
Attempted to determine what proportion of individuals entering treatment for cocaine dependence admitted to battering an intimate partner and compared the characteristics of those who were not identified as batterers. Of the 77 men in the sample, 29 (38%) were characterized as cocaine-dependent batterers. The batterers and nonbatterers were found to differ on a variety of background and assessment variables. Cocaine-dependent batterers more often reported a history of serious conflict with their sexual partner, trouble controlling violent behavior, greater psychiatric disturbance, difficulty relaxing, and being easily annoyed. 
 

Murphy, Christopher M; O'Farrell, Timothy J. (1997). Couple communication patterns of maritally aggressive and nonaggressive male alcoholics. Journal of Studies on Alcohol. Vol 58(1), 83-90. 
Studied the links between communication problems and marital violence in couples with a male alcoholic, and compared them with those of nonalcoholic community samples. 90 newly-abstinent male alcoholics and their wives completed a 10-min problem discussion while both partners were sober. Their communication behaviors were also recorded and coded. The couples were grouped either into nonaggressive husbands and their wives (mean ages 48.1 and 45.6 yrs), or physically aggressive husbands and their wives (mean ages 40.7 and 38.0 yrs). Results showed that: (1) there were more aversive-defensive communication for couples with a physically aggressive husband; (2) there were similar levels of facilitative-enhancing communication in both groups, but generally displayed less by alcoholic husbands than their wives; (3) the physically aggressive husbands, but not their wives, showed more negative reciprocity than the nonaggressive husbands. 
 

Schafer, John; Fals-Stewart, William. (1997). Spousal violence and cognitive functioning among men recovering from multiple substance abuse. Addictive Behaviors. Vol 22(1), 127-130. 
Experimental research suggests that substance use is associated with increased aggression, and other research suggests that substance use is also a risk factor in spousal violence. In addition, neuropsychological status is associated with both spousal violence and substance abuse. This study builds on previous work demonstrating an association between lower levels of performance on a brief neuropsychological test battery and higher levels of total couple, husband-to-wife, and severe husband-to-wife violence for 31 married men recovering from multiple substance abuse. 
 

Downs, William R; Smyth, Nancy J; Miller, Brenda A. (1996). The relationship between childhood violence and alcohol problems among men who batter: An empirical review and synthesis. Aggression & Violent Behavior. Vol 1(4), 327-344. 
The available literature indicates that: (a) experiences of childhood violence are associated with mediator variables, including antisocial behaviors and depressive symptomatology; (b) experiences of childhood violence and observation of interpersonal violence during childhood predict perpetration of partner violence in adulthood for men; (c) presence of partner violence is associated with certain types of alcohol problems for men; (d) both partner violence and alcohol problems are associated with marital conflict. Based on available research, two indirect pathways between childhood violence and adulthood problems are proposed as guides for future research in the areas of family violence and alcohol problems for men. Bidirectional associations between alcohol problems and partner violence are proposed. Finally, inclusion of important moderator and mediator variables in multivariate research designs is suggested. 
 

Murphy, Christopher M; O'Farrell, Timothy J. (1996). Marital violence among alcoholics.Current Directions in Psychological Science. Vol 5(6), 183-186. 
Discusses initial studies that have shown that a high proportion of male alcoholics seeking treatment have been violent toward their wives, and that have identified factors that may help to explain this association. The authors argue that male alcoholics who physically abuse their partners differ in important ways from alcoholics who do not, displaying a cluster of signs associated with a severe, early onset form of alcoholism, including an inheritance pattern largely limited to male relatives and previous arrests. The maritally violent alcoholics are also more likely to binge drink, have more negative styles of communicating with their spouses, and maintain strong beliefs about the negative influences of alcohol on marriage. Initial evidence suggests that cessation of problem drinking after alcoholism treatment involving the spouse is associated with significant and substantial reductions in marital violence, whereas relapse to drinking after such treatment is associated with continued marital violence. 
 

Maiden, R. Paul. (1996). The incidence of domestic violence among alcoholic EAP clients before and after treatment. Employee Assistance Quarterly. Vol 11(3), 21-46. 
Examined the effect of an employee assistance program (EAP) on domestic violence with 80 clients referred for alcoholism treatment. Ss completed the Conflict Tactics Scale. 94% of Ss had engaged in behavior ranging from verbal intimidation to severe physical aggression prior to intervention. Moderate physical aggression and verbal intimidation continued to be reported after intervention. Regular attendance at AA and frequent sponsor contact were significant in reducing domestic violence. Post-intervention domestic violence suggests a continued pattern of violence but with less frequency and severity. Implications for EAP practitioners are considered. 
 

Jarman, Randall W. (1991). An investigation of alcohol, personality and violence variables in predicting treatment attendance for wife battering men. Dissertation Abstracts International. Vol 52(3-B), 1767
 

Hamberger, L. Kevin; Hastings, James E. (1991). Personality correlates of men who batter and nonviolent men: Some continuities and discontinuities. Journal of Family Violence. Vol 6(2) 131-147. 
Investigated personality and family-of-origin differences among 38 male batterers referred for treatment who were alcoholic, 61 who were nonalcoholic, 28 community-identified maritally violent males, and 64 male nonviolent controls. Multivariate analyses of variance (MANOVAs) of the Millon Clinical Multiaxial Inventory (MCMI) showed that alcoholic and nonalcoholic batterers showed higher levels of borderline characteristics. Alcoholic batterers showed the highest MCMI elevations, followed by nonalcoholic batterers. Community-identified batterers showed no predicted significant differences from the nonviolent controls. On measures of family-of-origin pathology and disruption, only alcoholic batterers differed significantly from nonbatterers on both experienced and witnessed abuse victimization. 

Zweig, Janine M; Schlichter, Kathryn A; Burt, Martha R. (2002). Assisting women victims of violence who experience multiple barriers to services. Violence Against Women. Vol 8,162-180. 
Examined the extent to which programs for domestic violence and sexual assault gear services toward women facing multiple barriers (i.e., substance abuse disorders, mental health problems or learning disabilities, incarceration, and prostitution) and the unique problems such women encounter when accessing services. As part of a national evaluation, the authors interviewed staff from 20 programs focusing their service efforts on multibarriered women. Results show that problems encountered by such women include lack of services dealing with multiple barriers, uneducated service providers, and batterers using women's barriers to further control or victimize them. The strategies programs use to meet these women's distinct needs are described.
 

Testa, Maria; Leonard, Kenneth E. (2001). The impact of marital aggression on women's psychological and marital functioning in a newlywed sample. Journal of Family Violence. Vol 16(2), 115-130. 
The impact of husband-to-wife physical aggression on changes in wives' personal and marital well-being was examined in a representative sample of newlywed couples. The sample consisted of 543 couples who completed baseline and first anniversary assessments. After controlling for sociodemographic variables, initial relationship satisfaction, and verbal aggression, wives who experienced physical aggression from their husbands during the first year of marriage reported increased stress and lower marital satisfaction at the first anniversary. Further, they were more likely to report separation from husbands due to marital problems during the first year of marriage. Experiences of partner physical aggression during the premarital period were associated with greater frequency of heavy drinking episodes among wives, although they were not associated with changes in average daily volume of ethanol consumed. Results suggest that among a community sample, experiences of husband-to-wif e physical aggression have negative consequences for both women's psychological well-being and marital functioning. 
 

Kelly, Patricia J; Blacksin, Beth; Mason, Ellen. (2001). Factors affecting substance abuse treatment completion for women. Issues in Mental Health Nursing. Vol 22(3),287-304. 
Substance abuse by women is considered an individual pathology, and the larger social processes of recovery are seldom explored. This research study examined social factors that influenced completion of an outpatient women-centered substance abuse treatment program. The treatment records of a group of 15 pregnant women who completed the program were compared with a group who did not complete the program. More completers had previous life successes in the areas of education, job skills, and employment history. Completers also had fewer children, less involvement with child protective services, and lower levels of chaos, a construct that included the presence of two of any of the following in women's lives: child protective services, homelessness, psychiatric diagnosis, or domestic violence. Completion of substance abuse treatment seems more likely for women with personal and social resources. If programs are to be successful, adequate funding must be provided for both assessment and support of the social problems encountered by the most vulnerable women.
 

Hirsch, Amy E. (2001). "The world was never a safe place for them": Abuse, welfare reform and women with drug convictions. Violence Against Women. Vol 7(2), 159-175. 

Tolman, Richard M; Rosen, Daniel. (2001). Domestic violence in the lives of women receiving welfare. Violence Against Women. Vol 7(2), 141-158. 
Using data from 753 women (aged 18-54 yrs) from the welfare caseload in an urban Michigan county, the authors investigate the prevalence of domestic violence and its association with mental health, health, and economic well-being. Data was collected in the areas of domestic violence, health, mental health, maternal deprivation, and employment and welfare status. Nearly a quarter of the women experienced physical partner violence in the past 12 mo, and almost two thirds in their lifetimes. Recent victims had significantly higher rates of 5 psychiatric disorders (depression, generalized anxiety disorder, post-traumatic stress disorder, drug dependence, and alcohol dependence) and health problems than women who never experienced domestic violence. Recent partner violence was also associated with greater material hardship. 
 

Freeman Gustafson, Carl Scott. (2001). Re-viewing treatment for female addicted victims of domestic violence. Dissertation Abstracts International: Section B: the Sciences & Engineering. Vol 60(12-B), 2000, 6361.
This study explores the intervention strategies used by providers while working with women who are addicted victims of domestic violence ('AVDV'). The central hypothesis of this study is that the current treatment system traditionally views substance abuse and domestic violence as two distinct problems with two separate sets of interventions being provided by separate service providers. The intent is to facilitate a discussion that may lead to a re-viewing of intervention strategies, with the hypothesis that more integrated treatment or increased cooperation between providers will lead to reduced recidivism, decreases in the gaps in service delivery and may save women's lives. The object of this inquiry is to obtain data from service providers in three states: Alabama, California and Massachusetts. The goal is to asses what services are offered, how the services are being provided, and the extent and nature of any cooperative treatment with other providers. Descriptive analysis of programmatic practices, client and provider demographic features is utilized to assess and characterize the data.
 

Steele, Caryl Trotter. (2000). Providing clinical treatment to substance abusing trauma survivors. Alcoholism Treatment Quarterly. Vol 18(3), 71-81. 
Research and clinical observation have shown that women seeking substance abuse treatment are more likely to he victims of interpersonal violence than those in the general population. Such research clearly marks a close association between early interpersonal violence and subsequent development of substance abuse and dependency. Survivors of violence are likely to become dependent upon chemicals as a way to reduce tension rather than learn other ways of managing stress. To produce successful treatment outcomes, both disorders must be treated together. Some of the theoretical models that help to explain the causes, consequences, and clinical implications of interpersonal abuse are described. A classification system is described to understand the timing issues involved for treatment planning. Descriptions of a developmental model of treatment for unresolved posttraumatic stress disorder and addictions is offered. Concluding remarks include notations from the author's experience in working with this dual model and diagnosis.
 

Kimerling, Rachel; Goldsmith, Rachel. (2000). Links between exposure to violence and HIV-infection: Implications for substance abuse treatment with women. Alcoholism Treatment Quarterly. Vol 18(3), 61-69. Among women, a history of exposure to violence is associated with both an increased likelihood of substance use and an increased risk of HIV-infection. Thus substance use and other behaviors which can affect the risk of HIV exposure are often influenced by the psychosocial sequelae of violent victimization. Because these issues are interrelated, mental health interventions focused on any one of these issues in isolation may be less effective than in integrated approach. The current paper reviews the extant literature on these topics and proposes that treatment of women substance users must address the relationships between psychological trauma and increased HIV-risk behaviors and that attention to substance abuse and psychological trauma are necessary foci of services to HIV-infected women. 

Miller, Brenda A; Wilsnack, Sharon C; Cunradi, Carol B. (2000). Family violence and victimization: Treatment issues for women with alcohol problems. Alcoholism: Clinical & Experimental Research. Vol 24(8), 1287-1297. 
Presents a brief overview of the prevalence of violence in women's lives and psychological and physical consequences of these experiences, with special attention to populations of women with alcohol and other drug problems. The authors discuss barriers to identification of violent victimization within health care settings and identify potential areas for future consideration regarding policy, practice, and research. Also, the authors document the relationships between women's experiences of violent victimization and their use of alcohol and drugs, although prior research has not fully explained or explored the etiological nature of these relationships. Of additional importance is the recognition that various forms of violence occur throughout a single life span. Women's histories of violent victimization negatively affect their children, and thus, intergenerational issues are of concern. The authors believe that understanding how the combined problems of alcohol and drugs interconnect with violence is relevant to the delivery of health services for women.
 

Brown, Vivian B; Melchior, Lisa A; Panter, A. T; Slaughter, Ruth; Huba, G. J. (2000). Women's steps of change and entry into drug abuse treatment: A multidimensional stages of change model. Journal of Substance Abuse Treatment. Vol 18(3), 231-240. 
The Transtheoretical, or Stages of Change Model, has been applied to the investigation of help-seeking related to a number of addictive behaviors. Overall, the model has shown to be very important in understanding the process of help-seeking. However, substance abuse rarely exists in isolation from other health, mental health, and social problems. The present work extends the original Stages of Change Model by proposing "Steps of Change" as they relate to entry into substance abuse treatment programs for women. The Steps of Change Model hypothesizes that help-seeking behavior of substance-abusing women may reflect a hierarchy of readiness based on the immediacy, or time urgency, of their treatment issues. Readiness to make life changes in 4 domains--domestic violence, HIV sexual risk behavior, substance abuse, and mental health--was examined among 451 women (aged 15-69 yrs) in relation to entry into 4 substance abuse treatment modalities (12-step, detoxification, outpatient, and residential). A series of logistic regression analyses predicted entry into 4 separate treatment modalities. In general, Ss in the preparation and action stages were more likely to enter drug treatment, whereas clients in the precontemplation and contemplation stages were less likely to enter treatment. Results suggest a multidimensional Stages of Change Model that may extend to other populations and to other types of help-seeking behaviors.
 

El-Bassel, Nabila; Gilbert, Louisa; Schilling, Robert; Wada, Takeshi. (2000). Drug abuse and partner violence among women in methadone treatment. Journal of Family Violence. Vol 15(3), 209-228. 
Aimed to (1) describe rates of lifetime and current partner abuse among women on methadone; (2) examine the relationship between partner violence and demographics, substance abuse, and drug risk behaviors; and (3) explore the association between a victim's current use of crack/cocaine, heroin, marijuana, and drug risk behavior after controlling for demographics, household composition, history of victimization and sex trading. 145 women participated in this study (mean age 38.5 yrs). Approximately three-fourths of the women ever experienced physical, sexual, or life-threatening abuse and slightly less than one-third experienced at least one type of abuse during the previous year. A history of childhood victimization was reported by more than half of the women and one-third witnessed her mother being abused. Risk of partner violence was associated with victim's current drug and alcohol use, visiting shooting galleries, and living with someone with drug or alcohol problems. The study discusses the implications of the findings for research and intervention. 
 

Simpson, Tracy Lynn. (1999). An exploration of the functional roles of alcohol use among women drinkers. (childhood sexual abuse, sexual abuse). Dissertation Abstracts International: Section B: the Sciences & Engineering. Vol 60(4-B), 1873
Substantial evidence indicates that women with substance abuse problems report markedly higher rates of childhood sexual abuse (CSA) than do women in the general population. It has been frequently postulated that a history of CSA is a critical mediator of both the development of substance abuse, and of relapse among many women with alcohol and drug problems. Four groups of women (N = 141) were assessed regarding the functional roles of their alcohol consumption and their treatment histories: women with and without histories of CSA seeking treatment for alcohol-related problems and non-problem drinking women with and without histories of CSA. Three aspects of the functional role of alcohol were assessed: alcohol expectancies, reasons for drinking, and the reported actual effects obtained from drinking. The results indicate that a history of CSA is associated with increased risk of meeting diagnostic criteria for posttraumatic stress disorder (PTSD) among both problem and non-problem drinking women, and that CSA status is not a marker of other current distress. The anticipated differences in functions of drinking across CSA groups were not found. Analyses involving the women in treatment found that current PTSD status was associated with drinking to facilitate social interactions, positive experiences, and verbal expression of feelings, and to punish oneself. They also reported more often obtaining the following effects from drinking: increased feelings of power, enhanced social interactions and positive experiences, and reduced problems with negative affect and PTSD-like symptoms. These results indicate that PTSD status is more clearly associated with drinking to cope than is CSA status. Other results from the present study revealed that women in treatment with CSA histories have received slightly less treatment for substance abuse problems and slightly more psychological services than did their nonabused peers. However, women with lifetime histories of PTSD, whether they were also sexually abused as children, report more overall treatment than did those without PTSD. The specific patterns of treatment utilization (substance abuse treatment versus psychological treatment) were found to vary as a function of both PTSD status and CSA status. The theoretical and clinical implications of these findings are discussed.
 

Melchior, Lisa A; Huba, G. J; Brown, Vivian B; Slaughter, Ruth. (1999). Evaluation of the effects of outreach to women with multiple vulnerabilities on entry into substance abuse treatment. Evaluation & Program Planning. Vol 22(3), 269-277. 
Investigated whether the number of outreach contacts to substance abusing women predicts the likelihood of their entry into drug abuse treatment and examined the relationships among readiness to seek assistance, the women's level of involvement with the outreach project, and admission to treatment. 665 women (aged 16-74 yrs) who participated in an enhanced outreach and treatment readiness preparation program were tracked to examine patterns of referral and entry into substance abuse treatment. The number of outreach contacts was inversely related to receiving referrals to substance abuse treatment, as well as to the completion of those referrals (for a subsample of 551 women who had received referrals). Victims of domestic violence were 50% more likely to receive a referral to drug abuse treatment, but of the women who received such a referral, the lack of involvement in a violent relationship predicted entry into treatment. Findings are discussed in terms of their implications for designing and implementing outreach and treatment programs for women with multiple therapeutic issues, particularly substance abuse and domestic violence. 
 

Amaro, Hortensia; Nieves, Rita; Johannes, Sergut Wolde; Cabeza, Nirzka M. Labault. (1999). Substance abuse treatment: Critical issues and challenges in the treatment of Latina women.Hispanic Journal of Behavioral Sciences. Vol 21(3), 266-282. 
Described the history of childhood abuse (emotional, physical, and sexual), mental health problems, and medical problems of 66 Latinas 18-35+ yr old, enrolled in a residential substance abuse treatment program. Data were gathered through interviews conducted at program entry. A significant majority reported a childhood history of abuse (80%) and past year diagnosis of mental health problems (76%) and health (68%) problems. Compared to those with no reported history of childhood abuse, women with a history of abuse were more likely to be predominantly Spanish speakers, report significantly higher levels of health problems, have had children removed from their custody, and drop out in the early stages of treatment. These findings have important implications for the course of treatment, how history of abuse is handled in residential treatment, and support services needed by clients. 
 

Palacios, Wilson R; Urmann, Catherine F; Newel, Richard; Hamilton, Nancy. (1999). Developing a sociological framework for dually diagnosed women. Journal of Substance Abuse Treatment. Vol 17(1-2), 91-102. 
Studied social stressors and the incidence of a comorbid diagnosis among women in a residential therapeutic community for substance abuse treatment. Women were assessed at the beginning of treatment and 6 mo after leaving the program. Baseline assessments were completed for 143 18-37 yr old women. Clinically significant scores on measures of antisocial and borderline personality were noted for 116 women, 68 of whom completed 6-mo posttreatment assessments. Assessments noted history of abuse, delinquent or criminal behavior, arrests, and number of drugs used. Outcome variables were whether patients were arrest-free, drug-free, and reunited with children. Women with histories of delinquent and/or criminal behavior were more likely to have used more types of drugs and multiple drugs. These women also tended to have a history of being abused emotionally (57.1%), physically (48.9%), or sexually (39.7%). This group was also less successful on all outcome measures at the 6-mo follow-up. These results are consistent with research that indicates abuse plays a central role in the development and chronic effect of personality disorders and, in particular, posttraumatic stress disorder. 
 

Harm, Nancy J; Thompson, Patricia J; Chambers, Helen. (1998). The effectiveness of parent education for substance abusing women offenders. Alcoholism Treatment Quarterly. Vol 16(3), 63-77. 
Evaluated a 15-wk parent education program in a state prison for 104 women in which 63% of the participants reported high use of drugs and/or alcohol. The Hudson's Index of Self-Esteem (W. W. Hudson, 1982) and Bavolek's Adult-Adolescent Parenting Inventory (S. J. Bavolek, 1984) were completed by the Ss before and after the program. Data was also collected on families of origin, childhood abuse, domestic violence, drug and alcohol use, mental and physical health histories, employment, information about children, and parenting history. At the end of the program, Ss were interviewed about their perceptions of the efficacy of the program, the teaching methods employed, the skills of the teachers, and the value of the classes to them personally. The authors found no difference in the measures used between alcohol and drug-abusing women and the other participants. However, the presence of a history of personal victimization, reported by a high percentage of substance abusers, did influence scores. 
 

Hien, Denise; Hien, Nina M. (1998). Women, violence with intimates and substance abuse: Relevant theory, empirical findings, and recommendations for future research. American Journal of Drug & Alcohol Abuse. Vol 24(3), 419-438. 
Evidence from the domains of anthropology, criminology, psychology, and sociology indicates that women are involved in many of the same acts of aggression and violence as men, and that substance use may play an important role in these acts. However, little is known of the pathways between violence and drug for women. The authors review and integrate existing literature addressing female violence and substance abuse, presenting available epidemiology, theories, and research applicable to the study of this problem. They also examine the political and methodological obstacles to conducting systematic research on female aggressiveness and offer recommendations for future epidemiological, preventive, and therapeutic research efforts in area. 
 

Brewer, Devon D; Fleming, Charles B; Haggerty, Kevin P; Catalano, Richard F. (1998). Drug use predictors of partner violence in opiate dependent women. Violence & Victims. Vol 13(2), 107-115. 
Examined the use of specific drugs as longitudinal predictors of violence between domestic partners in a sample of 82 women in methadone treatment for opiate addiction. Crack cocaine use, use of other forms of cocaine, and tranquilizer use were each modestly to moderately positively associated with partner violence victimization. Women who were heavy users of these drugs were more likely to be hit, slapped, or shoved by their partners than light users or nonusers of these drugs. In addition, women who had been using opiates for a shorter time and were older when they began using were more likely to be victimized than those who had been using them a longer time and were younger when they began using, respectively. A similar pattern of relationships held for predictors of partner violence perpetration, but the associations were smaller than those for victimizations. Three possible expla- nations of these associations are considered. 
 

Murphy, Bridget S; Stevens, Sally J; McGrath, Robin A; Wexler, Harry K; Reardon, Deborah. (1998). Women and violence: A different look. Drugs & Society. Vol 13(1-2), 131-144. 
Examines the role (i.e., perpetrator vs. victim) that drug using women assume in different episodes and/or settings of violence, and with whom these violent encounters occur. It is hypothesized that women would be the perpetrator of violence against sibling(s), sex partner(s), and their children (i.e., in a "home setting" in which they might feel more power and/or control). Moreover, it is thought that while women would frequently report being a victim of violence from family member(s), many women would also report being the victim of violence from a stranger. The self reported life experience of violent encounters of 98 women (mean age 30.7 yrs) enrolled in a residential drug treatment center in Tucson, Arizona is described. Results of the study indicate that many of the women were both the perpetrators and victims of violence. Additionally, the results indicate that aggressive acts from or against others may, in part, be related to the amount of power or control that women had in the relationship as well as the setting in which the violence occurred. 
 

Clark, Alicia Hilton.Testing a self-medication hypothesis in battered women. Dissertation Abstracts International: Section B: the Sciences & Engineering. Vol 57(10-B), 6562, US: Univ. Microfilms International.Self-medication provides a compelling explanation of motive for a woman to overuse and become dependent on alcohol and drugs, especially given intense stress symptoms that are characteristically manifested in response to chronic and traumatic victimization, such as childhood abuse and/or spousal battering. This study sampled 78 battered women, using validated pen and paper instruments to measure the variables of substance abuse, severity of battering, childhood physical and sexual abuse, and Posttraumatic Stress Disorder (PTSD). Significant correlations were found between severity of battering and victim alcohol abuse and between childhood sexual abuse and victim alcohol abuse, supporting a self-medication model. Multiple regressions yielded childhood sexual abuse as the strongest predictor of victim alcohol abuse, when parental substance abuse was statistically controlled. 
 

Lisek, Victor Joseph. (1996). Family of origin characteristics and personality disorders/tendencies of type 1 male, type 2 male and female alcoholics. Dissertation Abstracts International, A (Humanities and Social Sciences). Vol 56(8-A), 3004.
The study investigates the relationship of family of origin characteristics and personality disorders on three subgroups of alcoholics: type 1 male, type 2 male and female. Data were retrieved from medical charts of 204 patients (51 females, 99 type 1 males and 54 type 2 males) who were diagnosed alcoholic and admitted to an inpatient treatment program. Nineteen family of origin characteristics were extracted from each patient's social and family history. Mean scores of thirteen DSM-II-R personality disorders from the Millon Clinical Multiaxial Inventory were used. Analysis of the data gave a descriptive statistic profile of each subgroup. Family of origin characteristics of each subgroup were analyzed using chi-square. T-test analyses were used to compare male and female subgroups and type 1 male and type 2 male alcoholics. Parental and familial alcoholism and childhood abuse were common patterns in all of the subgroups. Findings also indicated high antisocial, aggressive and narcissistic personality scores for males and high dependent, self-defeating and borderline personality scores for females. Type 1 males had high compulsive personality disorder scores and type 2 males had high histrionic scores. Seven of nineteen family of origin characteristics and seven of thirteen personality disorders showed a significant relationship with alcoholics. Differences were higher between men and women than between type 1 and type 2 male alcoholics. 
 

Miller, Brenda A; Downs, William R. (1995). Violent victimization among women with alcohol problems. Galanter, Marc (Ed). Recent developments in alcoholism, Vol. 12: Alcoholism and women. (pp. 81-101). New York, NY, US: Plenum Press. 
(from the chapter) review existing studies that suggest a significant and important link between childhood victimization [particularly childhood sexual abuse] and the later development of women's alcohol problems / a brief review of methodological issues is provided for assessing the empirical evidence to date / explanations for how and why these events are linked provide a framework for understanding how intervention and prevention programs might benefit from this knowledge / the importance of this work for policy, planning, delivery of treatment, prevention, and future research is discussed 
 

Miller, Brenda A; Downs, William R. (1993). The impact of family violence on the use of alcohol by women. Alcohol Health & Research World. Vol 17(2), 137-143. 
Examined the relationship between violence and alcohol problems in women. Interviews were conducted with 472 women (aged 18-45 yrs) from 5 sources: outpatient alcoholism treatment programs (OATPs), drinking and driving classes (DDCs), shelters and support groups for women who have experienced partner violence, outpatient mental health centers, and randomly selected households. OATP Ss experienced higher rates of childhood victimization, significantly more severe violence by fathers, and more childhood sexual abuse than did DDC Ss and women in households. OATP Ss also experienced significantly more childhood sexual abuse than did Ss without alcohol problems in other treatment settings and significantly higher levels of violence by partners than Ss in the household sample. 
 

Miller, Brenda A; Downs, William R; Testa, Maria. (1993). Interrelationships between victimization experiences and women's alcohol use. Journal of Studies on Alcohol. Suppl 11, 109-117. 
Explored the interrelationships between experiences of childhood victimization and the development of women's alcohol-related problems for 472 women (aged 18-45 yrs). Two different forms of childhood victimization were examined: parent-to-child violence and childhood sexual abuse (familial and nonfamilial). High rates of childhood victimization for women with alcohol problems suggest that there is a link between victimization and the development, specifically, of women's alcohol problems. The rates of childhood victimization were significantly greater for Ss with alcohol problems in treatment as compared to Ss without alcohol problems in treatment. Even when holding the treatment condition and family background variables constant, childhood victimization had a specific connection to the development of women's alcohol problems. 
 

Parisi-Dunne, Darlene. (1992). Chemically dependent battered women: Some women's reality. 
Dissertation Abstracts International. Vol 52(10-A), 3726
 

Bayatpour, Mahin; Wells, Robert D; Holford, Susan. (). Physical and sexual abuse as predictors of substance use and suicide among pregnant teenagers. Journal of Adolescent Health. Vol 13(2), 128-132. 
In order to better define risk factors for perinatal substance abuse, data from 352 pregnant adolescents (aged 12-19 yrs) enrolled in a comprehensive prenatal clinic were analyzed. Following an interview, all Ss were given a complete prenatal examination, including drug toxicology screening. Self-reported rates of substance use before awareness of conception varied from 23% for tobacco to 17% for alcohol and marijuana; 7% of the Ss reported use of illicit substances (e.g., cocaine) after conception was confirmed. 80 Ss acknowledged having been physically or sexually abused, and 40 admitted to having suicidal ideation or actions. A comparison of those Ss who had been physically or sexually abused with the remaining cohort revealed significant differences on marijuana and cocaine use prior to awareness of conception and on prior suicidality. 
 

Ladwig, Gail B; Andersen, Marcia D. (). Substance abuse in women: Relationship between chemical dependency of women and past reports of physical and/or sexual abuse. 
 

Sampselle, Carolyn M. (Ed). (1992). Violence against women: Nursing research, education, and practice issues. Series in health care for women. (pp. 167-180). Washington, DC, US: Hemisphere Publishing Corp.
(from the chapter) look at the histories of female incarcerated felons who are chemically dependent or who are chemically dependent prior to their conviction / in reviewing the histories, we looked for self-reporting of past family violence and/or sexual abuse / we are not suggesting cause and effect but are reporting on a possible association literature review [incest, sexual and family violence; boundary inadequacy; specific concerns of women; assessment needs] / conceptual framework / intervention model / research design and methodology 
 

Swett, Chester; Cohen, Caryn; Surrey, Janet; Compaine, Andrew; et al. (1991). High rates of alcohol use and history of physical and sexual abuse among women outpatients. AmericanJournal of Drug & Alcohol Abuse. Vol 17(1), 49-60. 
Surveyed 189 new female patients at an adult psychiatric outpatient clinic that did not have a specific alcoholic treatment program. 27 Ss reported a history of heavy alcohol consumption measured by scores of 10 or more on the Michigan Alcoholism Screening Test (MAST), but only 16 had a diagnosis of alcohol abuse or alcohol dependence made by a clinician. Ss with a self-reported history of physical and/or sexual abuse had significantly higher MAST scores than Ss with no such history. When the 1st abuse occurred before age 18 yrs and there was no recent reported abuse, the association of abuse and high MAST scores persisted. This suggests that early physical or sexual abuse may be associated with current levels of alcohol use. 
 

Woodhouse, Lynn D. (1990). An exploratory study of the use of life history methods to determine treatment needs for female substance abusers. Response to the Victimization of Women & Children. Vol 13(3), 12-15. Studied 25 women (aged 18-32 yrs) in a substance abuse treatment program, using life history methods. Most Ss had experienced psychic pain for many years from bottled-up fear and anger, self-hate, and neglect. The most prominent theme was that of violence and abuse. More than half the Ss reported that they had been raped or had been the victim of incest, child abuse, or domestic violence. Other themes included male dominance; heavy dependence on men for money, drugs, and sex; motherhood and parenting; neglect; depression; guilt; sexuality and the possibility of having acquired immune deficiency syndrome (AIDS); and use of material possessions to define worth. It is suggested that treatment for female substance abusers should draw on a full range of community agencies. A gender-specific treatment program is outlined. 
 

Beeman, Sandra K; Hagemeister, Annelies K; Edleson, Jeffrey L. (2001). Case assessment and service receipt in families experiencing both child maltreatment and woman battering.Journal of Interpersonal Violence. Vol 16(5) May 2001, 437-458. 
Notes that professional attention to families experiencing both child maltreatment and woman battering has increased in recent years. This study examined data for 172 families--95 families for which police had filed child abuse incident reports and adult domestic assault incident reports, and 77 other families for which police had filed child maltreatment reports but had no documentation of domestic assaults. Exploring differences between the 2 groups of families, the authors found that dual-violence families were more likely to include an unrelated male in the household, to involve a neglect allegation, and to include perpetrator substance abuse. Child protection workers assessed dual-violence families to be at higher risk and were more likely to open the case for child protection services. Among open cases, however, dual-violence families received fewer services but were more likely to be referred to the county attorney. These findings and their implications for policy, practice, and research are discussed.
 

McCloskey, Laura Ann. (2001). The "Medea complex" among men: The instrumental abuse of children to injure wives. Violence & Victims. Vol 16(1), 19-37. 
It has been previously documented that wife and child abuse often co-occur. The present study tested competing hypotheses about the reasons for this co-occurrence, specifically trait versus instrumental theories of aggression within families. Three commonly cited catalysts (unemployment, drinking, and life stress events) for men's abuse of family members were analyzed to determine whether they equally predict partner or child abuse. Interviews were conducted with 363 women and children about spousal and paternal abuse, and women were interviewed about sociodemographcis and the stressors described above. Families were oversampled for the presence of spousal violence. Logistic regressions revealed that heavy drinking and life stress events predicted men's abuse of their partners. These risk factors were unrelated to child abuse. Wife battering, however, placed children at heightened risk. Children of battered women stood a 42% chance of receiving escalated abuse from their fathers. It is proposed that men's abuse of children is in many instances instrumental in order to coerce or retaliate against women, echoing the Greek myth of Medea who killed her own children to spite their father.
 

Malpique, Celeste; Barrias, Paula; Morais, Luisa; Salgado, Monica; Pinta da Costa, Isabel; Rodriques, Marta. (1998). Violence and alcoholism in the family: How are the children affected? Alcohol & Alcoholism. Vol 33(1), 42-46. 
Evaluated the effects of an alcohol-associated violent family environment on children and adolescents in such a family. Specifically, this study examined the offspring's mental representation of their father, the effects of the model of the marital relationship that was presented to them, and their psychological well-being, including feelings of insecurity, dependence and depression. Interviews were conducted with the members of 20 families with known violence associated with alcohol problems and the children and adolescents completed psychological tests, including the Corman Family Drawing test and the Patte Noire test. Results show the existence of psychopathological disturbances in these children, whose immaturity and insecurity were expressed by aggressive behavior or by depressive manifestations. Also found was a transgenerational alcoholism-violence frequency. 
 

Cruz, J. Michael; Peralta, Robert L. (2001). Family violence and substance use: The perceived effects of substance use within gay male relationships. Violence & Victims. Vol 16(2), 161-172. 
Examined the life situations of gay men where domestic violence was present. This article expands on previously published works by examining respondents' perceptions of what role alcohol and other drug use plays in causing substance use-related domestic violence. In-depth interviews were conducted with 25 gay males (aged 23-43 yrs). Three different perceptions emerged from the data and are presented here. First, drugs and alcohol use were perceived to be causally related to the domestic violence the respondents endured. Second, respondents believed substance abuse resulted from the violence--it was used as a coping mechanism. Finally, many respondents did not believe there was any association between substance abuse and violence. The need for further in-depth data related to the relationship between drugs, alcohol, and domestic violence is noted.
 

Neisen, Joseph H; Sandall, Hilary. (1990). Alcohol and other drug abuse in a gay/lesbian population: Related to victimization? Journal of Psychology & Human Sexuality. Vol 3(1), 151-168. 
Studied the prevalence of sexual abuse in recovering chemically dependent lesbians and gay men. A retrospective chart review of 201 inpatients (aged 20-39 yrs) showed that nearly 50% reported being sexually abused in childhood. These data are placed in the context of long-term effects of childhood sexual abuse. Chemical dependency treatment programs must recognize and support their clients' need to address sexual abuse to prevent relapse and to improve general emotional well-being. However, most treatment centers are reluctant to address sexuality and related problems. 
 

Schilit, Rebecca; Lie, Gwat-yong; Montagne, Marilyn. (1990). Substance use as a correlate of violence in intimate lesbian relationships. Journal of Homosexuality. Vol 19(3), 51-65. 
Examined the problem of domestic violence as related to substance abuse in lesbian relationships by surveying 104 self-identified lesbians (aged 22-52 yrs). Of the 39 Ss who reported a past or present abusive relationship, 64% reported alcohol or drugs were involved before or during incidents of battering. Ss' frequency of drinking significantly correlated with committing abusive acts as well as with being the victim of abusive acts.