Effects of couple conflict on alcohol craving: Does intimate partner violence play a role?

Dual-substance use disorder couples: An integrative review and proposed theoretical model

Committed romantic relationships between two individuals with Substance Use Disorder (or dual-SUD couples) are prevalent. Dual-SUD couples have poor treatment engagement and outcomes. Research has established a reciprocal link between relationship dynamics (e.g., conflict, intimacy) and substance use. Thus, the couple's relationship presents a distinct social context for both partner's substance use. Dual-SUD couples face unique challenges due to substance use being a shared behavior that may serve as a rewarding source of compatibility, closeness, and short-term relationship satisfaction despite it being at the cost of other alternative sources of substance-free reinforcement. Yet, treatment options for these couples are scarce. Dual-maladaptive health behaviors (e.g., dual-substance use) are challenging to treat; however, theory and preliminary research suggests that transformation of couple's joint motivation toward adaptive health behavior change may result in a more satisfying relationship and improved treatment outcomes for both individuals. The current paper reviews the extant literature on dual-SUD couples from theoretical, empirical, and treatment research and proposes an expanded paradigm regarding how we understand dual-SUD couples with the aim of informing basic research and treatment development.

Histories of violence among clients seeking substance use disorder treatment: a systematic mapping review

Introduction

There is a limited literature base regarding the intersection of drug and alcohol treatment, violence, and trauma. While research substantiates that exposure to violence and trauma impacts the propensity to misuse substances, the conceptualization in clinical trials and practice has largely been narrow and gendered, referring only to intimate partner or domestic violence. Our systematic mapping review explored a more inclusive and expansive review of survivors of and perpetrators of violence and trauma (e.g., intimate partner violence, sexual assault, stalking, child abuse, political and community violence, criminal violence, micro violence, structural violence, and oppression) to establish: 1) the types of treatment settings included in intervention studies, 2) the common indicators of success or common outcomes recorded, and 3) understanding who is seeking treatment for drug and alcohol use with histories of violence.

Methods

A systematic mapping review was conducted to identify any peer-reviewed articles published from 2011 to 2022. The Web of Science database was searched using a broad set of Boolean search terms related to violence, substance use disorders, and treatment. Over 8,800 records were identified from the systematic review with a total of 48 articles meeting inclusion criteria.

Results

Most studies in this review included populations reporting perpetration of violence (n=23, 48%) versus participants reporting survival of trauma/violence (n=17, 35%). Results also indicated female identifying populations (n=19; 40%) were predominantly served, were treated in the US (n=33; 69%) and seen in an outpatient setting (n=24; 50%). Authors also were attentive to studies that included sexual and gender minorities and discovered only three studies (6%) explicitly acknowledging inclusion of transgender participants or participants in relationship with partners of the same sex; three more studies (6%) were focused on participants with histories of or engaging in sex work.

Discussion

This review outlines treatment and research implications directly situated in the gap of service delivery found in this review. Specifically, the results elucidate the impact on minoritized and excluded identities based on gender, sexual preference, criminal legal status and directions for research and treatment to increase inclusion, representation, and equity across research and treatment settings.

Suicide from intimate partner and other relationship conflicts: demographic and clinical correlates'

BACKGROUND

A significant portion of suicides are precipitated by interpersonal relationship problems.

AIMS

To examine demographic and clinical correlates of any intimate partner conflicts (IPC) and other interpersonal conflicts (OPC) as suicide precipitants.

METHODS

We analyzed data on 92,805 (72,628 male; 20,177 female) adult suicide decedents from the 2017 to 2019 U.S. National Violent Death Reporting System, using multinomial and binary logistic regression models. We included case examples from coroners/medical examiner (CME) and law enforcement (LE) agency reports.

RESULTS

Of all decedents, 23.6% had IPC and 8.0% had OPC as a suicide precipitant. Compared to those without any relationship conflict, those who had IPC or OPC were younger and more likely to have had previous suicide attempt(s), alcohol/other substance use problems, and job/finance/housing and legal problems. Compared to those with OPC, those with IPC were more likely to be male and Hispanic and had higher odds of previous suicide attempt, depression diagnosis, alcohol problems, and more acute crises. CME/LE reports showed distress of divorce/break-up, other life stressors, prior suicide attempt(s), alcohol/other substance involvement, and/or loss of family support.

CONCLUSIONS

Access to behavioral health treatment for those at risk of suicide in the face of IPC or OPC is essential for suicide prevention.

Gender Directionality of Intimate Partner Violence and Relationship Quality Among Chinese Couples

Gender symmetry is a long-standing controversy in intimate partner violence (IPV) research. This study explored the gender directionality of IPV and differences in the quality of relationships between different dyadic patterns. IPV experiences and relationship quality of 371 heterosexual couples were examined. Results indicate that females reported more IPV perpetration than males. Generally, the male-only IPV and bidirectional IPV couples showed lower levels of relationship quality compared with female-only IPV and no-IPV couples. Future studies should realize that different dyadic types of IPV may have different mechanisms and consequences, and more attention should be paid to gender directionality.

The Proximal Effect of Alcohol on Intimate Partner Violence: Comparing the Antecedents of Intoxicated and Sober Men's Violent Acts

Alcohol use is known to correlate with intimate partner violence (IPV) perpetration, yet little research examines how alcohol influences how the violence unfolds. The current study used sequential analysis to examine descriptions of past violent incidents and explore the behaviors that preceded men's perpetration of IPV. In accordance with the alcohol myopia model of alcohol use, it was hypothesized that intoxicated men would respond violently to a wide range of partner cues, whereas men who were sober would only react violently in response to the most threatening partner cues. Moreover, intoxicated men were expected to demonstrate less inhibition of violence to suppressor cues of the partners' distress as compared to sober men. Participants were 80 couples reporting male-to-female IPV within the past year. Female partners' descriptions of two past violent events were coded and entered into sequential analysis. Antecedents to the men's first violent action were examined. While sober men were likely to react violently to their partner's physical threat and perceived threat, intoxicate men did not. Sober men were less likely to become violent after their partners displayed distress cues, whereas there was no suppressor effect of women's distress for intoxicated men. The precursors of the violence of intoxicated men appears to be indiscriminate and unpredictable. Clinical interventions that rely on behavioral strategies or communication skills training are unlikely to be effective for those who have an unmanaged alcohol use disorder.

Examining the role of social support in treatment for co-occurring substance use disorder and posttraumatic stress disorder

Objective

Social support may be a critical mechanism in the treatment of co-occurring substance use disorder (SUD) and posttraumatic stress disorder (PTSD). However, no studies have examined how social support changes as a function of treatment or predicts treatment outcome in a Veteran population with co-occurring SUD and PTSD.

Method

The current study is a secondary analysis that examined social support over the course of treatment for co-occurring SUD and PTSD (N = 81). Analyses were conducted to examine if a) social support predicts change in substance use and PTSD symptoms, respectively, over the course of treatment and during follow-up, and b) substance use and PTSD symptoms, respectively, predicts change in social support over treatment and during follow-up.

Results

The findings revealed that between-person social support moderated decreases in substance use (B = -0.17, SE = 0.07, p = 0.017) and PTSD symptom severity (B = -0.12, SE = 0.05, p = 0.009) during treatment but not during follow-up. Within-person substance use and PTSD symptom severity predicted social support but substance use and PTSD symptoms did not moderate changes in social support during treatment or follow-up.

Conclusions

The findings highlight the critical role of social support during treatment in enhancing outcomes for individuals with co-occurring SUD and PTSD.