Breakthroughs in understanding addiction and close relationships

Do Substances Used in Adolescence Predict the Persistence of Substance Use Disorders in Adulthood? A 15-Year Study of Youth After Detention

PURPOSE

Investigate if the type of substance use disorder (SUD) in adolescence predicts SUDs in adulthood and examine sex and racial/ethnic differences in the persistence of SUDs.

METHODS

Data are from the Northwestern Juvenile Project, a 15-year longitudinal study of 1829 youth randomly sampled from detention in Chicago, IL (1995-1998). Interviewers assessed SUDs using structured diagnostic interviews.

RESULTS

Compared with females without an SUD at detention, females with cannabis alone, comorbid alcohol and cannabis, or SUDs other than alcohol and cannabis at detention had higher odds of having an SUD 5 years later (25%, 32%, and 36% vs. 15%, adjusted odds ratio [AOR] = 1.94, 95% confidence interval [CI] 1.11-3.40; AOR = 2.76, 95% CI 1.58-4.83; AOR = 3.46, 95% CI 1.56-7.66, respectively). Males and females with SUDs other than alcohol and cannabis at detention had greater odds of having an SUD 15 years later, compared with those without an SUD at detention (males: 36% vs. 14%, AOR = 2.98, 95% CI 1.14-7.83; females: 29% vs. 8%, AOR = 4.77, 95% CI 1.85-12.30). Among youth with an SUD at detention, males were more likely than females to have an SUD 15 years later (AOR = 1.84, 95% CI 1.03-3.29); non-Hispanic White and Hispanic males were more likely to persist than Black males (AOR = 3.32, 95% CI 1.50-7.35; AOR = 2.32, 95% CI 1.04-5.18, respectively).

DISCUSSION

The type of SUD during adolescence matters. Youth with SUDs such as cocaine and opioids fared the worst. Healthcare providers must collaborate with correctional officials to increase service provision.

Elixir of love or venom of violence: When does a drinking event result in couple intimacy or couple conflict?

The short-term consequences of drinking events may be positive or negative. Most studies have considered only one outcome, but people may experience different alcohol outcomes on different occasions, depending on the circumstances. The present study sought to identify predictors of drinking events that resulted in couple intimacy, conflict, or neither outcome using existing data from a 30-day ecological momentary assessment (EMA) study. Participants were a community sample of partnered, moderately drinking adults with a recent history of verbal or physical partner aggression (N = 249 couples). They provided reports of drinking events, intimacy and conflict events, and ratings of relationship harmony and discord in three randomly signaled reports each day. Mixed-effects multinomial analyses were used to compare predictors of drinking events that, within three hours, resulted in intimacy, conflict, or neither outcome. Consistent with previous research, characteristics of the drinker (individual tendencies to experience intimacy or conflict) and characteristics of the drinking event (alcohol quantity, drinking companions) both predicted drinking outcomes. Moreover, the pre-drinking relationship context predicted post-drinking relationship outcomes, consistent with the idea that alcohol focuses attention on salient contextual cues. Specifically, greater pre-drinking relationship harmony predicted greater likelihood of experiencing intimacy after drinking, whereas greater pre-drinking relationship discord predicted greater likelihood of experiencing conflict after drinking. In summary, characteristics of the drinker, the drinking event, and the pre-drinking relationship context contribute to the likelihood that a given drinking event will have short-term positive or negative relationship outcomes.

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.

Relationship perceptions and conflict behavior among cannabis users

BACKGROUND

Cannabis use is increasingly common, yet few studies have examined its associations with couple functioning. To address this gap, we used actor-partner interdependence modeling to examine the associations between cannabis use, relationship perceptions, and observed conflict behavior in a community-based sample of cannabis users and their partners.

METHODS

Cannabis users (N = 232; 96 males; 122 females; 14 undisclosed biological sex) and their partners completed self-reports of cannabis frequency and global relationship satisfaction and commitment. At a laboratory visit, couples engaged in a 10 min conflict discussion and a 5 min discussion of areas of agreement, and reported on their post-conflict perceptions. Each partner's parasympathetic activity was assessed during the conflict task, and trained raters coded conflict and recovery behavior RESULTS: More frequent actor cannabis use was associated with more negative engagement and avoidance behavior during conflict, less parasympathetic withdrawal during conflict, and less effective behavioral recovery immediately after conflict. More frequent cannabis use was also associated with greater satisfaction with conflict resolution following the conflict discussion, but was not associated with perceived overall relationship satisfaction or commitment. Cannabis effects were independent of alcohol use CONCLUSIONS: Among cannabis users, there are discrepancies between perceived and objective measures of relationship functioning, such that cannabis users viewed their relationships as better functioning compared to independent raters' reports. These findings highlight the need for a nuanced understanding of the associations between cannabis and relationship functioning, which appear to be distinct from alcohol, as well as an organizing theoretical framework to stimulate future research.

Effects of couple drinking events on short-term relationship harmony and discord: An ecological momentary assessment study

OBJECTIVE

Couples with concordant drinking patterns have higher relationship satisfaction and greater relationship stability over time. Emerging evidence suggests that episodes of drinking with one's intimate partner can have positive immediate consequences for relationship functioning, whereas drinking episodes without partner do not. The present ecological momentary assessment (EMA) study examined the impact of drinking with partner (DWP) and drinking without partner (DWOP) events on immediate and next-day self-reported relationship harmony and discord.

METHOD

Heterosexual, cohabiting community couples with congruent drinking patterns, ages 21-35 (N = 191), made three random reports each day for 30 days. Multilevel modeling was used to examine the impact of DWP and DWOP events on momentary relationship functioning, controlling for quantity of alcohol consumed and for functioning at the previous report.

RESULTS

As hypothesized, harmony increased immediately after DWP (but not after DWOP) compared with no drinking for men and women. There were no immediate effects of drinking on discord. There were also positive effects of DWP on next morning harmony, but these were specific to women's drinking reports. Women's DWP and DWOP predicted reduced next morning discord for men; however, men's and women's discord increased as women consumed more drinks the previous evening.

CONCLUSIONS

Findings suggest that concordant drinking couples may achieve immediate benefits for couple harmony from drinking together. Women's drinking seems to be more impactful than men's on next-day harmony and discord, with greater harmony following women's evening DWP but increased discord associated with heavier evening drinking by women. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Do relationships provide the same levels of protection against heavy drinking for lesbian and bisexual women? An intersectional approach

PURPOSE

Sexual minority women (SMW; e.g., lesbian, bisexual) are more likely than heterosexual women to be heavy drinkers, with bisexual women showing the highest risk. There is ample literature demonstrating that intimate relationships protect against stress-related health risk behaviors in the general population. However, very little research has focused on SMW's relationships and far less is known about the relationships of SMW of color. Using intersectionality theory as our framework, we tested two competing models to determine whether the effects of minority sexual identity (lesbian, bisexual) and race/ethnicity (African American, Latinx, White) are: 1) additive, or 2) multiplicative in the associations between relationship status and heavy drinking.

METHODS

Data are from a diverse sample of cisgender sexual minority women (N = 641) interviewed in Wave 3 of the CHLEW study, a 20-year longitudinal study of SMW's health.

RESULTS

Findings from two- and three-way interactions provide mixed evidence for both the additive and multiplicative hypotheses; support for each varied by sexual identity and race/ethnicity. Overall, we found that Latinx SMW, particularly single and bisexual Latinx SMW report the highest rates of heavy drinking compared to their cohabiting and lesbian counterparts, respectively. African American single SMW reported significantly higher rates of heavy drinking compared to their cohabiting counterparts.

CONCLUSION

Our findings suggest that the protective qualities of SMW's intimate relationships vary based on sexual identity and race/ethnicity-and the intersections between them. These results highlight that research among SMW that does not take into account multiple marginalized identities may obscure differences.

PUBLIC SIGNIFICANCE

Little research has focused on health within sexual minority women's relationships, particularly among sexual minority women of color. Given the potential additive or multiplicative effects of multiple sources of oppression such as heterosexism, racism, and sexism, understanding the potential protective effects of relationships is important. Our findings demonstrate that the protective qualities of intimate relationships among SMW vary based on sexual identity and race/ethnicity - and the intersections between them.

An instrument for assessing progress in substance use disorder treatment: a pilot study of initial reliability and factor structure of the Treatment Progress Assessment-8

New instruments are needed to assist substance use disorder (SUD) clinics in monitoring client treatment progress. This paper describes the development of an 8-item monitoring tool and results from a pilot to understand the tool's structure and reliability. 393 clients completed the tool upon treatment entry. A factor analysis resulted in a 2-factor solution: SUD symptoms and treatment progress. Multiple regression analyses showed that clients in inpatient detoxification had lower scores than those in less intensive levels of care. Acceptable internal consistency reliability was found. This study shows promise for the tool and sets the stage for future validation work.

Alcohol, conflict, and aggression in intimate relationships: A dyadic approach

Intimate partner aggression (IPA) is a critical public health problem that requires clear and testable etiological models that may translate into effective interventions. While alcohol intoxication and a pattern of heavy alcohol consumption are robust correlates of IPA perpetration, there has been limited research that examines this association from a dyadic perspective. In the present review, we discuss compelling reasons for understanding dyadic factors that assist our understanding of alcohol-facilitated IPA, review the relatively small number of studies that have investigated such factors, and provide a theoretical and methodological framework for researchers to conceptualize how to model alcohol-facilitated IPA from a dyadic framework.

Marijuana Use Episodes and Partner Intimacy Experiences: A Daily Report Study

Although marijuana use has been linked to negative consequences for intimate relationships, an emerging literature suggests that under some circumstances it may have positive consequences. Couples who use substances together report better relationship functioning over time and may experience positive short-term outcomes. Using a sample of 183 heterosexual, frequent marijuana-using couples from the community, reporting over 30 consecutive days, we examined whether marijuana use episodes were associated temporally with reports of couple intimacy experiences within the next two hours. We used multilevel modeling, within an Actor Partner Interdependence Model (APIM) framework, modeling male and female outcomes simultaneously. Consistent with hypotheses, simultaneous marijuana use (male and female partners reported use at the same hour) increased the likelihood of an intimate experience for both men and women. However, we also found positive effects for Actor and Partner solo marijuana use on male and female reports of intimacy events. When analyses were limited to marijuana use episodes in which the respondent reported on presence of partner, we found that positive effects on intimate experiences were limited to marijuana use episodes in which partner was present; use without partner did not influence likelihood of intimacy. The robust positive effects of using marijuana with one's partner on intimacy events may serve to reinforce continued couple use and explain the positive effects of concordant substance use on relationship functioning over time.

Marijuana use by intimate partners: Does discrepant use impair relationship functioning?

Intimate couples with discrepant use of alcohol and other drugs experience poorer relationship functioning relative to couples with concordant use or nonuse. Within a sample of marijuana-using couples, we hypothesized that greater discrepancy in marijuana use frequency between partners would be associated with lower relationship satisfaction and perceived partner responsiveness and with greater conflict, negative interpersonal exchange, and psychological and physical aggression. The Actor Partner Interdependence Model (APIM) allowed us to account for the effects of each partner's marijuana use, as well as the discrepancy between partners' use, on his or her own perceptions of relationship functioning. Using multivariate, two-level models, we considered both between-couple and within-couple effects of partner marijuana discrepancy using 4 waves of data collected over 10 months. The sample consisted of heterosexual community couples (ages 18-30) in which at least one partner reported using marijuana two or more times per week. For several outcome measures, we observed negative within-couple discrepancy effects on reports of relationship functioning: at time points when absolute discrepancy in marijuana use was greater than typical for the couple, relationship functioning was poorer. The pattern was the same regardless of whether it was the male or female partner who used more frequently. There were also some negative between-couple effects associated with more frequent female use. Findings replicate and extend prior research on partner discrepancy by demonstrating the dynamic nature of these effects over time. (PsycINFO Database Record

Temporal Effects of Perpetrating or Receiving Intimate Partner Aggression on Alcohol Consumption: A Daily Diary Study of Community Couples

OBJECTIVE

Survey studies provide evidence that experiencing intimate partner aggression (IPA) contributes to subsequent alcohol use. However, it is unknown whether the increase in alcohol use over time reflects a temporal effect of IPA. We examined verbal and physical IPA as predictors of alcohol use and heavy drinking within the next few hours. We also investigated whether both victims and perpetrators drank following IPA, and if it mattered which partner reported the aggression.

METHOD

The data reported here were derived from a 56-day diary study examining the association between alcohol use and partner aggression in 118 heterosexual couples. We examined whether alcohol use in a given hour could be predicted by IPA in the previous 3 hours, taking into account victim/perpetrator status, source of the report (self, other), and gender.

RESULTS

Victims were twice as likely to use alcohol in a given hour when they reported having received verbal IPA in the previous 3 hours, independent of the perpetrator's report. Similarly, perpetrators were more than twice as likely to use alcohol in a given hour when they reported having perpetrated verbal IPA in the previous 3 hours, independent of the victim's report. Results were similar when reports of mutual IPA were considered. Verbal IPA increased the likelihood of drinking but not the likelihood of heavy drinking. Results for physical IPA were not significant.

CONCLUSIONS

Verbal IPA is a proximal predictor of alcohol use for both victims and perpetrators. However, effects emerge only when individuals report aggression, and not when their partner provides the sole report, emphasizing the importance of the individual's perception of IPA.