Violent victimization among women with alcohol problems

Sexual assault history and its association with the use of drinking protective behavioral strategies among college women

OBJECTIVE

The current study examined the relationship between sexual assault history and drinking protective behavioral strategies (PBS). Given the relationship between sexual assault history and alcohol use, we hypothesized that after we controlled for drinking behavior, women with a childhood sexual abuse (CSA) history would use fewer drinking PBS than those without a CSA history. We also hypothesized that a history of adolescent/adult sexual assault (ASA) involving incapacitation and force would be associated with lower use of drinking PBS after controlling for CSA history and drinking behavior.

METHOD

A total of 800 undergraduate college women completed a survey online.

RESULTS

Regression analyses indicated that the only sexual assault history type that was consistently related to all three types of drinking PBS was ASA involving incapacitation. Women with a history of incapacitated ASA were less likely to use any type of drinking PBS than women without such history. A history of other types of sexual assault (CSA, physically forced ASA, and verbally coerced ASA) was associated only with lower use of serious harm-reduction drinking PBS, such as going home with a friend or knowing the location of your drink.

CONCLUSIONS

This was the first study to examine the relationship between different sexual assault histories and drinking PBS, and it furthers our understanding of the relationship between alcohol and sexual assault. Possible reasons for this relationship between ASA and PBS use are discussed.

Sexual assault, drinking norms, and drinking behavior among a national sample of lesbian and bisexual women

Childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) are strongly associated with women's alcohol use and the rates of both alcohol use and sexual assault history are higher among lesbian and bisexual women than heterosexual women. Although descriptive drinking norms are one of the highest predictors of alcohol use in emerging adults, this is the first study to examine the relationship between sexual assault history, drinking norms, and alcohol use in lesbian and bisexual women. We found that CSA severity was associated with a higher likelihood of experiencing more severe alcohol-involved ASA, more severe physically forced ASA, and was indirectly associated with more drinking behavior and higher drinking norms. Additionally, more severe alcohol-involved ASA was associated with higher drinking norms and more drinking behavior, but physically forced ASA was not. These findings help explain previous contradictory findings and provide information for interventions.

Childhood sexual abuse characteristics, intimate partner violence exposure, and psychological distress among women in methadone treatment

Traumatic experiences and their biopsychosocial sequelae present complex challenges in substance use treatment. For women with substance use problems, childhood sexual abuse (CSA), intimate partner violence exposure (IPV), posttraumatic stress disorder (PTSD), and overall psychological distress are often co-occurring concerns. To address gaps in knowledge and to strengthen practice regarding these critical issues in substance use treatment, we drew upon cross-sectional and longitudinal data from baseline and 12-month interviews with a random sample of 416 women in methadone treatment to examine relationships between CSA characteristics, particularly the presence of force and involvement of family, IPV, and mental health concerns. Although CSA involving force and family was not associated with IPV as hypothesized, it was associated with increased risk of PTSD and overall psychological distress. The multivariate findings underscore the psychological vulnerabilities associated with CSA involving force and family and suggest that drug use and financial circumstances may be important targets to reduce IPV risk.

A comparative study examining associations between women's drug-related lifestyle factors and victimization within the family

This study explores and compares the interrelationships between lifespan childhood and adult partner victimization and the drug lifestyles for 609 women, aged 18-65, from a drug-treatment sample, a women's domestic violence shelter sample, and community samples matched with the drug-treatment and shelter samples. Significant findings indicate that lifespan childhood and adult partner victimization were the strongest predictors of women's drug-related lifestyle activities. Three proposed hypotheses were supported to suggest that an association exists between the respondents' lifespan childhood and partner victimization scores and drug-related lifestyle activities scores, with these relationships modified by intervening variables, such as age, marital status, partner substance use, and parental substance use. Findings also indicate significant differences among the four sample groups in terms of victimization and drug-related lifestyle factors. Implications, limitations, and areas for future research are discussed.

Women, Co-occurring Disorders, and Violence Study: Evaluation design and study population

The Women, Co-occurring Disorders, and Violence Study (WCDVS) was a multi-site cooperative study to evaluate new service models for women with co-occurring mental health and substance use disorders and a history of physical and/or sexual abuse. Despite common features in the service interventions and evaluation procedures, diversity across the nine sites plus differences introduced by non-random assignment led to numerous methodological challenges. This article describes the design, measurement, and analysis decisions behind the WCDVS and lays the foundation for understanding participant-level outcomes and service costs. This article also describes the study population, as recruited and following attrition at the 6-month follow-up, in order to address the threat of selection bias to inferences drawn from this multi-site study.

Women's treatment utilization and its relationship to childhood sexual abuse history and lifetime PTSD

A central issue in the substance abuse literature is whether a history of childhood sexual abuse (CSA) is a risk factor for poorer treatment outcomes. Although there is a strong belief that CSA is associated with increased substance abuse treatment utilization and relapse among women clients, most empirical evidence does not support this position. This study addresses this conundrum by exploring several possible explanations among a sample of women in substance abuse treatment. Unexpectedly, the results indicate that women with more severe histories of CSA were likely to have received less lifetime substance abuse treatment, although they were likely to have received more mental health treatment. In addition, the expected interaction between posttraumatic stress disorder (PTSD) status and CSA status and increased rates of both types of treatment was not found. However, participants with both PTSD and CSA concentrated on mental health treatment while those with only PTSD focused on substance abuse treatment.

Drug treatment outcomes: investigating the long-term effects of sexual and physical abuse histories

Individuals in drug treatment, particularly women, generally report high levels of past sexual and physical abuse. Although histories of sexual and physical abuse are associated with greater prevalence and severity of depression, anxiety, phobias, and interpersonal difficulties for individuals seeking substance-related treatment, several recent studies failed to show that prior sexual or physical abuse compromised short-term drug treatment outcomes. This study examined the possible effects of sexual and physical abuse on a wide array of behavioral domains over a two-year posttreatment period. The findings indicate few differences between those with and without past histories of such abuse in terms of drug use, drug treatment and 12-Step program participation, criminality, income sources, intimate relationships, family functioning, and psychiatric symptoms. There are specific exceptions, but they apply only to men. Overall, the findings indicate that the impact of sexual and physical abuse histories on relatively long-term treatment outcomes is minimal. Addressing the sexual and physical abuse histories of those seeking treatment for drug abuse may be justified on humanistic grounds, but it will not significantly improve the long-term effectiveness of drug treatment, nor will it substantially enhance the lives of those with histories of abuse.