Perpetrators of intimate partner violence use significantly more methamphetamine, cocaine, and alcohol than victims: a report by victims

Acute psychiatric illness and drug addiction during pregnancy and the puerperium

Pregnancy and the puerperium do not protect against acute psychiatric illness. During puerperium, the chance of acute psychiatric illness, such as a psychotic episode or relapse of bipolar disorder, is greatly increased. Suicide is a leading cause of maternal death. Both psychiatric disease and ongoing drug addiction impact not only the pregnant woman's somatic and mental health but also impact short-term and long-term health of the child. Indeed, prompt recognition and expeditious treatment of acute psychiatric illness during pregnancy and the puerperium optimize health outcomes for two patients. Pregnancy and puerperium represent a stage of life of great physiologic adaptations, as well as emotional and social changes. This conjunction of changes in somatic, emotional health and social health may mitigate the occurrence, clinical presentation, and clinical course of acute psychiatric illness and call for a multidisciplinary approach, taking into account both the medical and social domains. This chapter describes acute psychiatric illnesses during pregnancy and the puerperium and illicit substance abuse, from a clinical perspective, while also describing general principles of diagnosis and clinical management during this stage of life, which is an important window of opportunity for both the pregnant woman and the child.

Legal, Social, and Occupational Problems in Persons with Alcohol Use Disorder: An Exploratory Study

BACKGROUND

Very few studies have examined the extent and nature of legal, social, and occupational problems among persons who have SUDs. This study was aimed at studying the prevalence and patterns of the aforementioned problems among individuals with alcohol use disorders (AUDs) and their relationship with the quantity of alcohol consumed and other variables.

METHODS

We conducted a cross-sectional study of adult patients with a diagnosis of AUDs admitted to the deaddiction unit of a tertiary care facility in India, using a semistructured questionnaire prepared for this study.

RESULTS

The mean age (SD) of the 91 subjects (95.6% males) was 40.3 years (8.5). Majority of them (92.3%) had started alcohol consumption before the age of 25 years. Common problems reported were work absenteeism (83.5%), a major altercation with spouse (69.3%), assaulting someone while intoxicated (53.8%), and driving under the influence of alcohol (59.3%). Significant association was found between being unemployed and having a police complaint lodged against them (chi-square = 5.7, P = 0.01). Quantity of alcohol consumed per day was significantly more among those who had a history of work absenteeism (Z = 2.27, P = 0.01), major altercation with spouse (Z = 2.25, P = 0.02) and assaulted someone under intoxication (Z = 2.33, P = 0.02).

CONCLUSION

The quantity of alcohol consumed is significantly more in those who had several legal, social, and occupational problems when compared to those who did not have, highlighting the need for routine assessment of the aforementioned problems among patients of AUDs. Treatment of AUDs should be multidisciplinary, with targeted interventions tailored to the aforementioned problems. Doing so will go a long way in reducing the harm to patients and the community at large.

Psychedelic use and intimate partner violence: The role of emotion regulation

BACKGROUND

Recent evidence suggests that psychedelic use predicts reduced perpetration of intimate partner violence among men involved in the criminal justice system. However, the extent to which this association generalizes to community samples has not been examined, and potential mechanisms underlying this association have not been directly explored.

AIMS

The present study examined the association between lifetime psychedelic use and intimate partner violence among a community sample of men and women. The study also tested the extent to which the associations were mediated by improved emotion regulation.

METHODS

We surveyed 1266 community members aged 16-70 (mean age=22.78, standard deviation =7.71) using an online questionnaire that queried substance use, emotional regulation, and intimate partner violence. Respondents were coded as psychedelic users if they reported one or more instance of using lysergic acid diethylamide and/or psilocybin mushrooms in their lifetime. Results/outcomes: Males reporting any experience using lysergic acid diethylamide and/or psilocybin mushrooms had decreased odds of perpetrating physical violence against their current partner (odds ratio=0.42, p<0.05). Furthermore, our analyses revealed that male psychedelic users reported better emotion regulation when compared to males with no history of psychedelic use. Better emotion regulation mediated the relationship between psychedelic use and lower perpetration of intimate partner violence. This relationship did not extend to females within our sample.

CONCLUSIONS/INTERPRETATION

These findings extend prior research showing a negative relationship between psychedelic use and intimate partner violence, and highlight the potential role of emotion regulation in this association.

Coping and violence perpetration in a residential substance use disorder treatment sample

Background: Individuals in substance use disorder treatment report high rates of violence against partners and non-partners. There is growing interest in integrated coping-oriented treatment approaches for violence and substance use concerns, yet little is known about the relationship between specific coping responses and perpetration of partner and non-partner violence. Objective: This cross-sectional study evaluated relationships between coping responses and partner and non-partner physical assault perpetration in a substance use disorder treatment sample. Methods: Participants included 343 men (76%) and women (24%) who completed self-report survey measures of coping responses, violence perpetration, and substance use as part of screening for a randomized trial. Negative binomial regression was used to examine relationships between coping strategies and partner and non-partner violence perpetration, when accounting for substance use and demographic factors. Results: About one-third of participants reported partner violence perpetration (30%) and non-partner violence perpetration (34%). Frequency of partner violence and non-partner violence were both associated with more use of avoidant and emotion-focused strategies and less use of problem-focused coping in adjusted models. Discussion: Continued research is warranted to determine whether coping-oriented interventions decrease violence among people in substance use disorder treatment.

Simultaneous use of alcohol with methamphetamine but not ecstasy linked with aggression among young adult stimulant users

INTRODUCTION

Illicit stimulants are often combined with alcohol in nightlife entertainment districts, an environment where aggressive behaviour commonly occurs. While alcohol and methamphetamine use are each associated with aggressive behaviour, relatively little is known about the impact of the combined use of alcohol and amphetamine-type stimulants (i.e., ecstasy [MDMA] and methamphetamine) on aggression.

METHOD

Analysis of longitudinal data from a population-based sample of Australian young adult amphetamine-type stimulant users (n=248) to examine: (a) prevalence and timing of simultaneous alcohol and amphetamine-type stimulant use and (b) predictors of ecstasy- and methamphetamine-related aggression and hostility. Prediction models of ecstasy- and methamphetamine-related aggression and hostility were developed using multivariate logistic regression.

RESULTS

Simultaneous alcohol consumption and amphetamine-type stimulant use was prevalent, with drinking generally occurring before consuming amphetamine-type stimulants and while 'high'. Methamphetamine-related aggression and hostility was significantly associated with recurrent risky simultaneous methamphetamine and alcohol use (Adjusted Odds Ratio [AOR] 2.74, 95% CI 1.09-6.89), a high frequency and increasing use methamphetamine trajectory (AOR 7.23, 95% CI 1.27-41.03), and high trait aggression (AOR 5.78, 95% CI 2.53-13.20). In contrast, only trait aggression (moderate: AOR 3.01, 95% CI 1.55-5.84; high: AOR 5.02, 95% CI 2.38-10.61) was associated with ecstasy-related aggression and hostility.

CONCLUSIONS

These findings indicate a link between risky patterns of simultaneous alcohol and methamphetamine use and methamphetamine-related aggression and hostility, independent of separate use of alcohol, methamphetamine and cannabis, trait aggression, psychosis, and gender. The policy challenges of amphetamine-type stimulant and alcohol use require a targeted, multidisciplinary approach.

Association Between Substance Use and the Perpetration of Family Violence in Industrialized Countries: A Systematic Review

This review examines the association between alcohol and illicit drug use and the perpetration of intimate partner violence (IPV) and child maltreatment (CM). In clinical populations, alcohol use is related to IPV, although other variables are also known to influence this relationship. Studies in specialized social/health care and in the community have also demonstrated the association between alcohol use and IPV. Although data on the association between illicit drug use and IPV are less clear, in most studies perpetration seems related to the use of cannabis and cocaine. The occurrence of CM is related to alcohol use in specialized social/health care and community populations but has not been extensively investigated in clinical samples. These findings also apply to studies on the association between illicit drug use and CM. Moreover, many studies on CM fail to distinguish between the effects of alcohol and those of illicit drugs. This review concludes with recommendations for future research about substance use and family violence and discusses implications for prevention and treatment.

Domestic Violence in Methamphetamine Psychotic Users, Psychiatric Inpatients, and Healthy People: A Comparative Study

BACKGROUND

Domestic violence is a serious threat to the physical and mental health of women. The aim of the present study was to find and compare the frequency of domestic violence between methamphetamine users, patients with psychiatric disorders, and healthy people.

METHODS

In this analytical cross-sectional study, methamphetamine users (n=30) and patients with psychiatric disorders (n=30) were women whose husbands were hospitalized during 2014 in Shafa Psychiatric Hospital in Guilan. Diagnosis was done with DSMIV-TR. Healthy people (n=60) were women whose husbands had no primary or drug induced psychiatric disorder or addiction. CTS-2 test was used to evaluate violence.

RESULTS

The frequency of psychological, physical and sexual violence in the groups suffering from psychiatric disease and methamphetamine users was higher than the healthy group (P=0.001). We observed a direct correlation between the mean of psychological and physical violence in the three groups (r=0.9, P=0.001), (r=0.7, P=0.0001) and (r=0.53, P=0.005), respectively. Direct correlation between the psychological and physical violence was only observed in the healthy group (r=0.8, P=0.007).

CONCLUSION

The results showed that methamphetamine users such as psychiatric patients are at increased risk of violence. Domestic violence screening of these patients is necessary. It seems that this substance is a new source of increasing domestic violence with more undesirable outcomes in Iran.

The Connection Between Thwarted Belongingness, Alcohol Consumption, Suicidal, and Homicidal Ideation in a Criminal Justice Sample

BACKGROUND

To determine if thwarted belongingness in combination with frequent alcohol use increased suicidal and homicidal ideation when known predictors were controlled for (eg, depressive disorders, anxiety disorders, drug use, race, sex, age, and employment status).

METHOD

This study utilized an archival database. Participants were 574 individuals at an outpatient substance abuse treatment facility who were under community corrections supervision. The average age was 34.5 (SD = 10.9) years; there were 371 (64.6%) men and 287 (50.0%) Black participants. Data were originally gathered from face-to-face interviews with the participants by their case manager or an intake specialist when they entered treatment. Self-reported suicidal and homicidal ideation was used as a dependent variable in unadjusted and adjusted binary logistic regressions to determine the influence of thwarted belongingness and frequent alcohol use.

RESULTS

Thwarted belongingness alone (ie, without frequent alcohol use) was associated with risk for suicidal ideation, and was approaching significance for homicidal ideation. The combination of thwarted belongingness and frequent alcohol use was associated with the greatest risk for suicidal and homicidal ideation. Cocaine use and employment status were also identified as significant predictors for suicidal and homicidal ideation in the fully adjusted models.

CONCLUSIONS

Thwarted belongingness in combination with frequent alcohol use seems to have a large and meaningful relationship with both suicidal and homicidal ideation. Additional research is needed to better understand the relationship between alcohol, thwarted belongingness, and outcomes such as suicide and homicide.

Hallucinogen use and intimate partner violence: Prospective evidence consistent with protective effects among men with histories of problematic substance use

Evidence suggests that hallucinogens may have therapeutic potential for addressing a variety of problem behaviors related to the externalizing spectrum of psychopathology, such as substance misuse and criminality. Intimate partner violence (IPV) is a prevalent form of criminal violence that is related to externalizing pathology. However, the association between hallucinogen use and IPV has not been comprehensively examined. In this prospective study, we examined the association between IPV and naturalistic hallucinogen use among 302 inmates at a US county jail. Cox regression analyses indicated that hallucinogen use predicted reduced arrest for IPV independently (β=-0.54, SE=0.20, χ(2)=7.19, exp(B)=0.58, p<0.01) and after accounting for covariates (β=-0.48, SE=0.23, χ(2)=4.44, exp(B)=0.62, p<0.05). These results add to a growing literature suggesting distinct therapeutic potential for hallucinogens to assist in the attenuation of problematic behavior.

Clinical features, course and treatment of methamphetamine-induced psychosis in psychiatric inpatients

BACKGROUND

Over the past few years, methamphetamine-induced psychosis (MIP) has increased in Iran, accounting for a significant percentage of psychiatry hospital admissions. The present study was conducted with an aim to investigate clinical symptoms, and course and treatment methods of MIP inpatients in Shafa Psychiatry Hospital in northern Iran.

METHODS

Participants were 152 MIP inpatients. Brief Psychiatric Rating Scale (BPRS) subscales of suspiciousness, unusual thought content; hallucinations and hostility were used to measure psychiatric symptoms. Data regarding suicide and homicide and violence were also obtained through interviews with the inpatients and their family. Based on their lengths of recovery time, the inpatients were categorized into 3 clinical groups. These inpatients received their usual treatments and were monitored for their psychiatric symptoms and clinical course of illness. The data were analyzed by descriptive statistics.

RESULTS

The most frequent psychiatric symptoms were violence (75.6 %), intimate partner violence (61.2 %), delusions of persecution (85.5 %), delusions of reference (38.5 %), delusions of grandiosity (32.9 %), delusions of infidelity (30.2 %), auditory hallucinations (51.3 %), visual hallucinations (18.4 %), suicidal thoughts (14.5 %), homicidal thoughts (3.9 %), suicide attempts (10.5 %) and homicide attempts (0.7 %). Recovery from psychotic symptoms in 31.6 % of the inpatients took more than one month. 46.1% of the inpatients were treated with Risperidone and 37.5 % with Olanzapine. Persecutory delusion and auditory hallucination were the most frequent persistent psychotic symptoms. 20.8 % of the inpatients with duration of psychosis more than one month were treated with electroconvulsive therapy (ECT) along with antipsychotics.

CONCLUSION

All forms of violence are highly frequent in MIP inpatients. Our finding agrees with many other studies suggesting that recovery from MIP can take more than a month. Initial promising findings were found regarding the efficacy of Electroconvulsive therapy in MIP patients.

On the pervasiveness of event-specific alcohol use, general substance use, and mental health problems as risk factors for intimate partner violence

The aim of this study was to evaluate the role of demographic, mental health, and substance use as risk factors for intimate partner violence (IPV). Data were derived from Wave II of the National Epidemiological Survey on Alcohol and Related Conditions (2004-2005). Eligible participants (N = 25,778) reported having an intimate partner 1 year before the survey. Clustered survey multivariate multinomial regression methods were used to assess risk factors for episodes of IPV. IPV victimization, perpetration, and both victims/perpetrators were assessed. Bivariate analyses indicated that African Americans, Hispanics, and women were more likely to be victims, perpetrators, or victim/perpetrators as compared with men and Whites. Multivariate analyses suggested that having a marijuana use disorder was strongly associated with IPV victimization (odds ratio [OR] = 2.61) and victim/perpetration (OR = 2.65). Post-traumatic stress disorder was consistently associated with all IPV typologies. Depression was associated with victimization (OR = 2.00) and IPV victim/perpetration (OR = 1.74). Antisocial Personality Disorder and Mania were both related to IPV perpetration (ORs = 2.53 and 2.32) and victim/perpetration (ORs = 3.15 and 2.31). Results also indicated that alcohol use during episodes of IPV is common (i.e., 35% of those who reported IPV also reported that alcohol was involved). Results indicate several substance- and mental health-related correlates of IPV. In addition, findings indicate that alcohol use by the victim and/or perpetrator is common during IPV events. Policy implications and directions for future research are discussed.

Risk factors associated with different types of intimate partner violence (IPV): an emergency department study

BACKGROUND

Domestic intimate partner violence (IPV) is a serious health care concern, which may be mitigated by early detection, screening, and intervention.

OBJECTIVES

We examine posited predictors in IPV and non-IPV groups, and in four different IPV profiles. Possible factors include 1) alcohol use, 2) drug use, 3) depression, 4) impulsivity, 5) age, and 6) any childhood experience in observing parental violence. We also introduce a new "Five Steps in Screening for IPV" quick reference tool, which may assist emergency physicians in detection and treatment.

METHODS

This was a cross-sectional study using survey data from 412 inner-city emergency department patients. Associations were explored using a chi-squared test of independence, independent-samples t-tests, and a one-way analysis of variance.

RESULTS

Nearly 16% had experienced IPV. As a group, they were younger, and more depressed and impulsive than the non-IPV group. They were more likely to engage in binge drinking, use drugs, and had more childhood exposure to violence. In the IPV group, 31% were perpetrators, 20% victims, and 49% both victims and perpetrators. The latter group was younger, more impulsive and depressed, used drugs, and was more likely to have observed parental violence as a child.

CONCLUSION

Correlates in groups affected by IPV indicate the same general risk factors, which seem to more acutely affect those who are both perpetrators and victims. Alcohol and drug use, depressive symptoms, and childhood exposure to violence may be factors and signs for which emergency physicians should screen in the context of IPV.

Intimate partner violence during pregnancy: victim or perpetrator? Does it make a difference?

OBJECTIVES

To differentiate between forms of intimate partner violence (IPV) (victim only, perpetrator only, or participating in reciprocal violence) and examine risk profiles and pregnancy outcomes.

DESIGN

Prospective.

SETTING

Washington, DC, July 2001 to October 2003.

SAMPLE

A total of 1044 high-risk African-American pregnant women who participated in a randomised controlled trial to address IPV, depression, smoking and environmental tobacco smoke exposure.

METHODS

Multivariable linear and logistic regression.

MAIN OUTCOME MEASURES

Low and very low birthweight, preterm and very preterm birth.

RESULTS

Five percent of women were victims only, 12% were perpetrators only, 27% participated in reciprocal violence and 55% reported no IPV. Women reporting reciprocal violence in the past year were more likely to drink, use illicit drugs and experience environmental tobacco smoke exposure and were less likely to be very happy about their pregnancies. Women reporting any type of IPV were more likely to be depressed than those reporting no IPV. Women experiencing reciprocal violence reported the highest levels of depression. Women who were victims of IPV were more likely to give birth prematurely and deliver low-birthweight and very-low-birthweight infants.

CONCLUSIONS

We conclude that women were at highest risk for pregnancy risk factors when they participated in reciprocal violence and so might be at higher risk for long-term consequences, but women who were victims of IPV were more likely to show proximal negative outcomes like preterm birth and low birthweight infants. Different types of interventions may be needed for these two forms of IPV.

Treatment outcomes for methamphetamine users: California Proposition 36 and comparison clients

Methamphetamine (meth) is a major drug of abuse in California and several other states, particularly among criminal offender populations. Over the past decade, substance abuse treatment systems have had to adapt to and accommodate the increasing needs of meth users and, in California, deal with the impact of Proposition 36, which has resulted in a greater number of criminal offenders entering the treatment system. This study examines selected treatment performance and outcome indicators for California Proposition 36 offenders entering substance abuse treatment for meth use and compares their performance and outcomes to other subgroups of California treatment clients differentiated by whether or not they were admitted to treatment through Proposition 36 and whether or not their primary substance was meth. Significant improvements in all outcome domains were seen across the populations, and treatment performance and outcomes were not substantively inferior for the offender or meth-using groups.

Physical victimization of rural methamphetamine and cocaine users

Substance use and physical violence often coincide, but little has been published on the correlates associated with receipt of partner versus nonpartner physical violence for rural users of methamphetamine and/or cocaine. In this study, participants' substance use, depression and past-year physical victimization were assessed. In separate logistic regression models, received partner violence in females was associated with age; alcohol, cocaine, and methamphetamine abuse/dependence; and number of drugs used in the past 6 months. In males, received nonpartner violence was associated with age, cocaine abuse/dependence, and being Caucasian. Findings suggest a relationship between stimulant use and received violence among rural substance users and a need for victimization screenings in settings where such individuals seek health care.

Mechanisms underlying aggressive and hostile behavior in amphetamine users

PURPOSE OF REVIEW

To review current evidence linking amphetamine use with aggression and to consider possible factors that might underlie this association.

RECENT FINDINGS

Although evidence that amphetamine use is related to increased levels of aggression continues to grow, the underlying processes or mechanisms remain somewhat elusive. In this review, three possible underlying factors are considered. Neurotoxic, pharmacological effects of amphetamine on the dopaminergic and serotonergic systems are related to aggressive, hostile behavior in both animal and human studies. Of particular interest is the converging evidence that amphetamine use is related to impairment in executive functions (including self-control) that are regulated by the prefrontal cortex. Taken together, these findings suggest that amphetamine users may have an impaired capacity to control or inhibit aggressive impulses. Furthermore, high levels of impulsivity related to amphetamine use may also play a role. Finally, amphetamine use is associated with increased positive symptoms of psychosis, particularly paranoia, that contribute to a perception of the environment as a hostile, threatening place.

SUMMARY

Taken separately, each of these factors may lead to an increase in aggression with increased use of amphetamine, but their interactive or synergistic effects may be particularly problematic.