Bystander Intervention to Prevent Sexual Violence: The Overlooked Role of Bystander Alcohol Intoxication

OBJECTIVES

Bystander training is a promising form of sexual violence (SV) prevention that has proliferated in recent years. Though alcohol commonly accompanies SV, there has been little consideration of the potential impact of bystander alcohol intoxication on SV prevention. The aims of this commentary are to provide an integrative framework for understanding the proximal effect of alcohol on SV intervention, provide recommendations to spark novel research, and guide the application of research to bystander programming efforts.

METHOD

This commentary begins with a review of existing bystander training programs and the need to target alcohol use and misuse in these programming efforts. Next, pertinent alcohol and bystander theories and research are drawn from to develop a framework for the proximal effect of alcohol on SV intervention.

RESULTS

The well-established decision-making model of bystander behavior (Latané & Darley, 1970) and Alcohol Myopia Theory (Josephs & Steele, 1990) are used to identify potential barriers to SV intervention that may be created or exacerbated by alcohol use. Additionally, the ways in which alcohol may facilitate intervention are discussed.

CONCLUSIONS

Specific recommendations are made for elucidating the relationship between alcohol and bystander behavior and testing the impact of alcohol at each level of the presented framework. Methodological and analytic concerns are discussed, including the need for more multi-method studies. Recommendations to guide the application of the present framework to SV prevention programming efforts are provided and consider how the proximal effects of alcohol impact intervention.

Effects of Alcohol and Drinking Experience on Human Physical Aggression

Intoxicated and nonintoxicated male subjects with self-reported low, moderate, and high drinking experience were given the opportunity to administer electrical shocks to an opponent in the context of a competitive reaction time task. Relative to subjects with moderate and high drinking experience, alcohol intoxication enhanced the aggressive behavior of the low-drinking-experience subjects.

The Frequency of Third-Party Involvement in Incidents of Barroom Aggression

This paper examines the frequency and nature of third-party involvement in aggressive incidents occurring in young people's bars and the effects of third parties on incident outcomes. Observational data were collected in 12 bars frequented by young people, and telephone interviews were conducted with 31 young people who responded to advertisements posted at the university campus. In total, 154 incidents of barroom aggression were analyzed. Overall, 49% (76) of incidents included third-party involvement by other patrons. About 40% (n=31) of third-party incidents involved nonaggressive third parties, 22% (n=17) involved aggressive third parties, and 38% (n=29) involved both aggressive and nonaggressive third-party participants. Nonaggressive interventions were more likely to decrease aggression, while aggressive interventions were more likely to increase aggression (χ2=65.5, p<.0001). Females appeared to be somewhat more likely than males to intervene nonaggressively (χ2=11.3, p<.1). The intoxication levels of participants were highest in incidents involving both nonaggressive and aggressive third parties (F-ratio=4.6, p<.01). These findings suggest that third parties play a significant role in the outcome of barroom aggression among young people, and that further research is needed on the role and impact of third parties.

Translational clinical neuroscience perspectives on the cognitive and neurobiological mechanisms underlying alcohol-related aggression

Alcohol-related violence, a longstanding, serious, and pervasive social problem, has provided researchers from diverse disciplines with a model to study individual differences in aggressive and violent behavior. Of course, not all alcohol consumers will become aggressive after drinking and similarly, not all individuals with alcohol use disorders will exhibit such untoward behavior. Rather, the relationship is best conceptualized as complex and indirect and is influenced by a constellation of social, cognitive, and biological factors that differ greatly from one person to the next. Animal experiments and human studies have elucidated how these mechanisms and processes explain (i.e., mediate) the relation between acute and chronic alcohol consumption and aggressive behavior. Further, the rich body of literature on alcohol-related aggression has allowed for identification of several potential high-yield targets for clinical intervention, e.g., cognitive training for executive dysfunction; psychopharmacology targeting affect and threat perception, which may also generalize to other psychiatric conditions characterized by aggressive behavior. Here we aim to integrate pertinent findings, derived from different methodological approaches and theoretical models, which explain heterogeneity in aggressive responses to alcohol. A translational platform is provided, highlighting common factors linking alcohol and aggression that warrant further, interdisciplinary study in order to reduce the devastating social impact of this phenomenon.

Cognitive and neurobiological mechanisms of alcohol-related aggression

Alcohol-related violence is a serious and common social problem. Moreover, violent behaviour is much more common in alcohol-dependent individuals. Animal experiments and human studies have provided insights into the acute effect of alcohol on aggressive behaviour and into common factors underlying acute and chronic alcohol intake and aggression. These studies have shown that environmental factors, such as early-life stress, interact with genetic variations in serotonin-related genes that affect serotonergic and GABAergic neurotransmission. This leads to increased amygdala activity and impaired prefrontal function that, together, predispose to both increased alcohol intake and impulsive aggression. In addition, acute and chronic alcohol intake can further impair executive control and thereby facilitate aggressive behaviour.

Alcohol consumption-related antigay aggression: theoretical considerations for individual- and societal-level interventions

A substantial literature has identified risk factors for intoxicated aggression and the mechanisms by which these effects are exerted. This theoretical and empirical foundation is a valuable resource for the development of treatment inventions. In contrast, a comparable literature is not available to guide development of clinical interventions for intoxicated antigay aggression. To address this gap in the literature, the present article (1) identifies risk factors and mechanisms pertinent to alcohol consumption-related antigay aggression, (2) advances predictions regarding how alcohol will increase antigay aggression, and (3) reviews societal- and individual-level considerations for intervention based upon these hypotheses.

A Further Examination of the Relation Between Trait Anger and Alcohol-Related Aggression: The Role of Anger Control

BACKGROUND

Trait anger has been identified as a risk factor for alcohol-related aggression. However, to develop a more accurate risk profile, it is necessary to examine the interactive relations between trait anger and other key personality variables. The present study examined the influence of anger control on alcohol-related aggression.

METHODS

Participants were 164 social drinking men age 21-35 years old. Trait anger and anger control were assessed with the State-Trait Anger Expression Inventory (Spielberger, 1996). Following consumption of an alcoholic or placebo beverage, participants competed in an aggression paradigm in which electric shocks were received from and administered to a fictitious opponent during a competitive reaction time task. Aggression was operationalized as shock intensities administered to the opponent under conditions of low and high provocation.

RESULTS

Analyses indicated that trait anger significantly predicted aggression, but only among men who were intoxicated and reported low levels of anger control.

CONCLUSIONS

The present findings suggest that anger control may be a crucial risk factor in determining whether one's anger proneness will lead to intoxicated aggression following provocation.

The role of the bar context and social behaviors on women's risk for aggression

The present study is an initial examination of the extent to which the environmental characteristics of bars and social behaviors that women engage in when drinking in this setting are associated with bar-related aggression. As expected, several environmental characteristics (e.g., young patrons, pool playing) and social behaviors (e.g., alcohol consumption, leaving the bar with strangers) were associated with more severe bar-related aggression experienced by women during the past year. These results shed light on the significant problem of bar-related aggression against women and can potentially be used to develop prevention and educational programs.

The relation between alcohol and aggression: an integrated biopsychosocial conceptualization

The relation between acute alcohol consumption and aggressive behavior is a complex phenomenon that has been studied from a variety of different disciplines. This article reviews findings from both survey and experimental research. The influence of both situational and individual difference variables on the alcohol-aggression relation is discussed and the strengths and weaknesses of various methodological approaches are highlighted. Current theoretical perspectives of the alcohol-aggression relation are reviewed. An integrated heuristic framework of the alcohol-aggression relation also is outlined. This conceptualization involves both distal and proximal risk factors for problems with alcohol and violence, which include biological, psychological, interpersonal, and contextual influences. Research and treatment implications of this framework are also discussed. It is recommended that researchers attempt to measure variables from a variety of domains in order to obtain a better understanding of this complex phenomenon. Furthermore, it is emphasized that there is a clear need to further implement and assess primary and secondary prevention efforts and to design integrated and flexible approaches for individuals with alcohol and violence problems.

The relationship of alcohol to injury in assault cases

Little is known about the precise role of alcohol in the escalation of interactions from threats into physical violence or its contribution to the risk of injury. Experimental studies indicate that intoxicated subjects (allegedly) give markedly higher electric shocks than sober subjects and are less sensitive to their cries of pain. However, few studies in a naturalistic setting have examined whether aggressive acts become more serious and result in higher injury rates when the assailants have been drinking than when they are sober. This chapter reviews the two bodies of research on the effects of alcohol on interpersonal aggression and violence; presents new data on the escalation of threatening interactions to assaults and the likelihood of victim injury given an assault, using data from the National Crime Victimization Survey for the years 1992 and 1993; and suggests future directions for research based on our findings that alcohol's impact on both escalation and injury differed according to the victim-assailant relationship.

Effects of response requirement and alcohol on human aggressive responding

Nine men participated in two experiments to determine the effects of increased response requirement and alcohol administration on free-operant aggressive responding. Two response buttons (A and B) were available. Pressing Button A was maintained by a fixed-ratio 100 schedule of point presentation. Subjects were instructed that completion of each fixed-ratio 10 on Button B resulted in the subtraction of a point from a fictitious second subject. Button B presses were defined as aggressive because they ostensibly resulted in the presentation of an aversive stimulus to another person. Aggressive responses were engendered by a random-time schedule of point loss and were maintained by initiation of intervals free of point loss. Instructions attributed these point losses to Button B presses of the fictitious other subject. In Experiment 1, increasing the ratio requirement on Button B decreased the number of ratios completed in 4 of 5 subjects. In Experiment 2, the effects of placebo and three alcohol doses (0.125, 0.25, and 0.375 g/kg) were determined when Button B presses were maintained at ratio values of 20, 40 and 80. Three subjects who reduced aggressive responding with increasing fixed-ratio values reduced aggressive responding further at higher alcohol doses. One subject who did not reduce aggressive responding with increasing fixed-ratio values increased aggressive responding at the highest alcohol dose. The results of this study support suggestions that alcohol alters aggressive behavior by reducing the control of competing contingencies.

Alcohol and social influences: yielding among male social drinkers to social pressure

Thirty men participated as paid volunteers in an experiment exploring whether alcohol intoxication makes a person more or less likely to yield to social pressure. Subjects were randomly assigned to either a Control, a Placebo, or an Alcohol group. The alcohol dose was 0.8 ml of 100% alcohol/kg body weight. Subjects first estimated the length of a line, then received feedback from either a male or a female reference group (social pressure), and finally made a second estimation. This procedure was repeated 30 times. The analysis indicated that the only effect of intoxication was to become more resistant in terms of number of yieldings to social pressure, provided the feedback came from a male reference group. Locus of control in terms of internality significantly predicted number of yieldings for the Alcohol group, although the analysis indicated no significant differences between groups as to mean locus of control scores.

Aggressive and nonaggressive behavior as a function of alcohol intoxication and frustration in women

An experiment tested whether alcohol increases aggression in women in a situation in which both an aggressive and a nonaggressive response alternative of equal instrumentality and of equal variability are available. Subjects were assigned to one of three groups, namely, an alcohol, a placebo, or a control group. The alcohol dose was 1.0 ml of pure alcohol/kg body weight. After drinking their respective drink, subjects were instructed to supervise a bogus partner on a visual scan test over a series of trials. Each time this partner made a mistake, subjects could either give an uncomfortable electric shock (scale 1 to 10) or a comfortable vibration (scale 1 to 10) to the partner. Aggressive and nonaggressive behavior was measured as numbers, intensities, and durations of shocks or vibrations, respectively. Neither alcohol nor frustration differentiated the groups on aggressive or nonaggressive behavior. All groups were significantly more inclined to use the nonaggressive alternative irrespective of alcohol dose and level of frustration. In conclusion it was stated that women do not increase their aggression as a function of alcohol in a situation with more than one response alternative available. The need to incorporate gender differences as to aggressive effects of alcohol was stressed.

Male physical aggression as a function of alcohol intoxication and frustration: experimental results and methodological considerations

Forty-five undergraduate students were assigned to either an Alcohol, a Placebo, or a Control group. The alcohol dose was 0.80 g of 100% alcohol/kg body weight. Subjects were informed that they could win a sum of money depending on the performance of a partner. They then supervised the partner over a series of trials on a visual scan test and could influence the partner by either giving an uncomfortable electric shock (aggressive alternative) or a comfortable vibration (nonaggressive alternative) at each incorrect response from the partner. Both alternatives were said to be equally instrumental in reaching the goal of winning the money and both could be varied in intensity on a 10-point scale and without limits in terms of duration. Aggression was measured as number of aggressive responses chosen, and in terms of intensity and duration. Nonaggression was measured in terms of intensity and duration. Intoxicated subjects did not increase their aggression but all groups chose significantly more nonaggressive responses and did so with higher intensity and duration. Frustration did not significantly affect these types of responding. Results are discussed in terms of methodological considerations and the importance of using realistic experimental paradigms is stressed. Also, theoretical implications are discussed.