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Rojczyk P, Heller C, Seitz-Holland J, Kaufmann E, Sydnor VJ, Berger L, Pankatz L, Rathi Y, Bouix S, Pasternak O, Salat D, Hinds SR, Esopenko C, Fortier CB, Milberg WP, Shenton ME, Koerte IK. Intimate partner violence perpetration among veterans: associations with neuropsychiatric symptoms and limbic microstructure. Front Neurol 2024; 15:1360424. [PMID: 38882690 PMCID: PMC11178105 DOI: 10.3389/fneur.2024.1360424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 05/03/2024] [Indexed: 06/18/2024] Open
Abstract
Background Intimate partner violence (IPV) perpetration is highly prevalent among veterans. Suggested risk factors of IPV perpetration include combat exposure, post-traumatic stress disorder (PTSD), depression, alcohol use, and mild traumatic brain injury (mTBI). While the underlying brain pathophysiological characteristics associated with IPV perpetration remain largely unknown, previous studies have linked aggression and violence to alterations of the limbic system. Here, we investigate whether IPV perpetration is associated with limbic microstructural abnormalities in military veterans. Further, we test the effect of potential risk factors (i.e., PTSD, depression, substance use disorder, mTBI, and war zone-related stress) on the prevalence of IPV perpetration. Methods Structural and diffusion-weighted magnetic resonance imaging (dMRI) data were acquired from 49 male veterans of the Iraq and Afghanistan wars (Operation Enduring Freedom/Operation Iraqi Freedom; OEF/OIF) of the Translational Research Center for TBI and Stress Disorders (TRACTS) study. IPV perpetration was assessed using the psychological aggression and physical assault sub-scales of the Revised Conflict Tactics Scales (CTS2). Odds ratios were calculated to assess the likelihood of IPV perpetration in veterans with either of the following diagnoses: PTSD, depression, substance use disorder, or mTBI. Fractional anisotropy tissue (FA) measures were calculated for limbic gray matter structures (amygdala-hippocampus complex, cingulate, parahippocampal gyrus, entorhinal cortex). Partial correlations were calculated between IPV perpetration, neuropsychiatric symptoms, and FA. Results Veterans with a diagnosis of PTSD, depression, substance use disorder, or mTBI had higher odds of perpetrating IPV. Greater war zone-related stress, and symptom severity of PTSD, depression, and mTBI were significantly associated with IPV perpetration. CTS2 (psychological aggression), a measure of IPV perpetration, was associated with higher FA in the right amygdala-hippocampus complex (r = 0.400, p = 0.005). Conclusion Veterans with psychiatric disorders and/or mTBI exhibit higher odds of engaging in IPV perpetration. Further, the more severe the symptoms of PTSD, depression, or TBI, and the greater the war zone-related stress, the greater the frequency of IPV perpetration. Moreover, we report a significant association between psychological aggression against an intimate partner and microstructural alterations in the right amygdala-hippocampus complex. These findings suggest the possibility of a structural brain correlate underlying IPV perpetration that requires further research.
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Affiliation(s)
- Philine Rojczyk
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Carina Heller
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- Department of Clinical Psychology, Friedrich Schiller University Jena, Jena, Germany
- German Center for Mental Health (DZPG), Halle-Jena-Magdeburg, Germany
- Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits underlying Mental Health (C-I-R-C), Halle-Jena-Magdeburg, Germany
| | - Johanna Seitz-Holland
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Elisabeth Kaufmann
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
| | - Valerie J Sydnor
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
| | - Luisa Berger
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Lara Pankatz
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Software Engineering and IT, École de technologie supérieure, Montreal, QC, Canada
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - David Salat
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, United States
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, United States
- Massachusetts General Hospital Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, United States
| | - Sidney R Hinds
- Department of Radiology and Neurology, Uniformed Services University, Bethesda, MD, United States
| | - Carrie Esopenko
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Catherine B Fortier
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - William P Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, United States
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Inga K Koerte
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, United States
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Graduate School of Systemic Neuroscience, Ludwig-Maximilians-University, Munich, Germany
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2
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Lai K, Jameson JT, Russell DW. Prevalence and correlates of destructive behaviors in the US Naval Surface Forces from 2010-2020. BMC Psychol 2023; 11:103. [PMID: 37029407 PMCID: PMC10080869 DOI: 10.1186/s40359-023-01134-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 03/21/2023] [Indexed: 04/09/2023] Open
Abstract
PURPOSE To estimate the prevalence of domestic violence, sexual assault, and suicide for United States Navy (USN) personnel between 2010 and 2020 and identify potential associated factors. METHODS Official report data were used to calculate prevalence rates and odds ratios, accounting for sample and general USN population demographic data to assess differences in over- or underrepresentation of destructive behaviors. RESULTS Domestic violence and sexual assault offenders tended to be younger lower-ranked males. For sexual assaults, offenders were three times more likely to be senior to the victim, which was not the case for domestic violence. Females were overrepresented in terms of suicidal ideation and attempts relative to the USN population, while males accounted for more actual suicides. The relative rates of suicidal ideation and attempts for females exceeded those for males (i.e., comparing the sample rate against the USN male and female populations), but the sample proportion for completed suicides (compared to the USN population) were greater for males than for females. Those in the junior enlisted (E1-E3) paygrades exhibited greater odds of suicide attempts versus suicidal ideations relative to those in the Petty Officers (E4-E6) paygrades, although E4-E6s completed more suicides. CONCLUSION The descriptive profile of destructive behaviors in a representative sample of USN personnel provides an overview of the possible factors associated with destructive behaviors and includes an exploration of the relational dynamics and nature of the incidents. The results suggest that sexual assault and domestic violence are characterized by unique relational dynamics and that these destructive behaviors should not necessarily be classified together as male-oriented aggressions (i.e., mainly perpetrated by males against female victims). Those in the E1-E3 and E4-E6 paygrades displayed different patterns in suicidal ideation, attempts, and actual suicides. The results highlight individual characteristics to help inform the development of targeted policies, practices, and interventions for military and other hierarchical organizations (e.g., police).
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Affiliation(s)
- Kevin Lai
- Leidos, Naval Health Research Center, 329 Ryne Road, San Diego, CA 92152 USA
| | - Jason T. Jameson
- Leidos, Naval Health Research Center, 329 Ryne Road, San Diego, CA 92152 USA
| | - Dale W. Russell
- Commander, Naval Surface Force, U.S. Pacific Fleet, Coronado, CA USA
- Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814 USA
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Slep AMS, Heyman RE, Lorber MF, Baucom KJW, Linkh DJ. Evaluating the Effectiveness of NORTH STAR: a Community-Based Framework to Reduce Adult Substance Misuse, Intimate Partner Violence, Child Abuse, Suicidality, and Cumulative Risk. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 21:949-959. [PMID: 32827290 DOI: 10.1007/s11121-020-01156-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
We evaluated the effectiveness of NORTH STAR, a community assessment, planning, and action framework to reduce the prevalence of several secretive adult problems (hazardous drinking, controlled prescription drug misuse, suicidality, and clinically significant intimate partner violence and child abuse [both emotional and physical]) as well as cumulative risk. One-third of US Air Force (AF) bases worldwide were randomly assigned to NORTH STAR (n = 12) or an assessment-and-feedback-only condition (n = 12). Two AF-wide, cross-sectional, anonymous, web-based surveys were conducted of randomly selected samples assessing risk/protective factors and outcomes. Process data regarding attitudes, context, and implementation factors were also collected from Community Action Team members. Analyzed at the level of individuals, NORTH STAR significantly reduced intimate partner emotional abuse, child physical abuse, and suicidality, at sites with supportive conditions for community prevention (i.e., moderation effects). Given its relatively low cost, use of empirically supported light-touch interventions, and emphasis on sustainability with existing resources, NORTH STAR may be a useful framework for the prevention of a range of adult behavioral health problems that are difficult to impact.
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Affiliation(s)
| | | | | | | | - David J Linkh
- Ellsworth Air Force Base, AFB, SD, Ellsworth, IO, USA
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4
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Slep AMS, Heyman RE, Lorber MF, Linkh DJ. The Impact of NORTH STAR on Suicidality, Substance Problems, Intimate Partner Violence, and Child Abuse. Mil Med 2021; 186:e351-e358. [PMID: 33169138 DOI: 10.1093/milmed/usaa380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/01/2020] [Accepted: 09/17/2020] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION We evaluated the effectiveness of New Orientation for Reducing Threats to Health from Secretive-problems That Affect Readiness (NORTH STAR), a community assessment, planning, and action framework to reduce the prevalence of suicidality, substance problems, intimate partner violence, and child abuse. MATERIALS AND METHODS One-third of U.S. Air Force bases worldwide were randomly assigned to NORTH STAR (n = 12) or an assessment-and-feedback-only condition (n = 12). Two Air Force-wide, cross-sectional, anonymous, web-based surveys were conducted of randomly selected samples assessing risk/protective factors and outcomes. This study was reviewed and approved by the institutional review board at the investigators' university and by the institutional review board at Fort Detrick. RESULTS NORTH STAR, relative to control, bases experienced a 33% absolute risk reduction in hazardous drinking rates and cumulative risk, although, given the small number of bases, these effects were not statistically significant. CONCLUSIONS Given its relatively low cost, use of empirically supported light-touch interventions, and emphasis on sustainability with existing resources, NORTH STAR may be a useful system for prevention of a range of adult behavioral health problems that are difficult to impact.
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Affiliation(s)
- Amy M Smith Slep
- Family Translational Research Group, New York University, New York, NY 10010, US
| | - Richard E Heyman
- Family Translational Research Group, New York University, New York, NY 10010, US
| | - Michael F Lorber
- Family Translational Research Group, New York University, New York, NY 10010, US
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López-Castro T, Smith KZ, Nicholson RA, Armas A, Hien DA. Does a history of violent offending impact treatment response for comorbid PTSD and substance use disorders? A secondary analysis of a randomized controlled trial. J Subst Abuse Treat 2018; 97:47-58. [PMID: 30577899 DOI: 10.1016/j.jsat.2018.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Teresa López-Castro
- The City College of New York, The City University of New York, 160 Convent Avenue, NAC Building 7/120, New York, NY 10031, USA.
| | - Kathryn Z Smith
- New York State Psychiatric Institute, Division on Substance Use Disorders, 1051 Riverside Drive, New York, NY 10032, USA
| | - Ronald A Nicholson
- The City College of New York, The City University of New York, 160 Convent Avenue, NAC Building 7/120, New York, NY 10031, USA
| | - Aeriell Armas
- The City College of New York, The City University of New York, 160 Convent Avenue, NAC Building 7/120, New York, NY 10031, USA
| | - Denise A Hien
- Center of Alcohol Studies, Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey, Smithers Hall, 607 Allison Road, Piscataway, NJ 08854, USA.
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6
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Kwan J, Jones M, Somaini G, Hull L, Wessely S, Fear NT, MacManus D. Post-deployment family violence among UK military personnel. Psychol Med 2018; 48:2202-2212. [PMID: 29254510 DOI: 10.1017/s0033291717003695] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Research into violence among military personnel has not differentiated between stranger- and family-directed violence. While military factors (combat exposure and post-deployment mental health problems) are risk factors for general violence, there has been limited research on their impact on violence within the family environment. This study aims to compare the prevalence of family-directed and stranger-directed violence among a deployed sample of UK military personnel and to explore risk factors associated with both family- and stranger-directed violence. METHOD This study utilised data from a large cohort study which collected information by questionnaire from a representative sample of randomly selected deployed UK military personnel (n = 6711). RESULTS The prevalence of family violence immediately following return from deployment was 3.6% and 7.8% for stranger violence. Family violence was significantly associated with having left service, while stranger violence was associated with younger age, male gender, being single, having a history of antisocial behaviour as well as having left service. Deployment in a combat role was significantly associated with both family and stranger violence after adjustment for confounders [adjusted odds ratio (aOR) = 1.92 (1.25-2.94), p = 0.003 and aOR = 1.77 (1.31-2.40), p < 0.001, respectively], as was the presence of symptoms of post-traumatic stress disorder, common mental disorders and aggression. CONCLUSIONS Exposure to combat and post-deployment mental health problems are risk factors for violence both inside and outside the family environment and should be considered in violence reduction programmes for military personnel. Further research using a validated measurement tool for family violence would improve comparability with other research.
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Affiliation(s)
- Jamie Kwan
- Department of Psychological Medicine,Weston Education Centre,10 Cutcombe Road,Denmark Hill,London,SE5 9RJ,UK
| | - Margaret Jones
- King's Centre for Military Health Research,King's College London,London,UK
| | - Greta Somaini
- Department of Forensic and Neurodevelopmental Sciences,Institute of Psychiatry,Psychology and Neuroscience,King's College London,London,UK
| | - Lisa Hull
- King's Centre for Military Health Research,King's College London,London,UK
| | - Simon Wessely
- King's Centre for Military Health Research,King's College London,London,UK
| | - Nicola T Fear
- King's Centre for Military Health Research,King's College London,London,UK
| | - Deirdre MacManus
- King's Centre for Military Health Research,King's College London,London,UK
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Woodruff SI, Hurtado SL, Simon-Arndt CM, Lawrenz J. An exploratory case study of environmental factors related to military alcohol misuse. BMC Public Health 2018; 18:902. [PMID: 30029602 PMCID: PMC6053706 DOI: 10.1186/s12889-018-5843-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/12/2018] [Indexed: 12/29/2022] Open
Abstract
Background Alcohol misuse has been an ongoing issue for the US Armed Services, with the Marine Corps maintaining the highest levels of problematic drinking. Broad environmental, social, and policy factors play an important role in alcohol misuse but are rarely studied as objective measures. Methods This case study used a pattern-matching approach to examine the associations between objective on- and off-base community environmental risk and protective factors and 4 objective alcohol-related outcomes at 3 large Marine Corps installations. The study utilized existing aggregated data from Marine Corps electronic data sources and information from internet searches of installation and community services and characteristics. Installation-level alcohol misuse outcomes included the rates of personnel receiving non-medical alcohol services, combined inpatient and outpatient alcohol-related primary diagnoses, alcohol-related domestic violence, and driving under the influence arrests. Installation-level environmental correlates included dollars spent on alcohol sales, density of alcohol outlets, extent of alternative activities, and installation and off-base sociodemographic factors. Results In general, younger age, enlisted pay grade, and being stationed overseas were related with higher rates of alcohol-related problems among Marines. Greater on-base alcohol sales (both in bars and stores), as well as a greater density of restaurants and bars that serve alcohol, were associated with alcohol misuse outcomes. Several community factors were also associated with alcohol misuse. The hypothesized protective effects of alternative activities were inconsistent. Conclusions Findings suggest that environmentally-oriented strategies, particularly restricting on-base sales of alcohol, may help to reduce alcohol-related harm in the Marine Corps.
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Affiliation(s)
- Susan I Woodruff
- School of Social Work, Center for Alcohol and Drug Studies and Services, San Diego State University, 5500 Campanile Drive, HH 203, San Diego, CA, 92182, USA.
| | | | | | - Jessica Lawrenz
- San Diego State University Research Foundation, San Diego, CA, USA
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Wagman JA, Donta B, Ritter J, Naik DD, Nair S, Saggurti N, Raj A, Silverman JG. Husband's Alcohol Use, Intimate Partner Violence, and Family Maltreatment of Low-Income Postpartum Women in Mumbai, India. JOURNAL OF INTERPERSONAL VIOLENCE 2018; 33:2241-2267. [PMID: 26802047 PMCID: PMC6886467 DOI: 10.1177/0886260515624235] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Husbands' alcohol use has been associated with family-level stress and intimate partner violence (IPV) against women in India. Joint family systems are common in India and IPV often co-occurs with non-violent family maltreatment of wives (e.g., nutritional deprivation, deprivation of sleep, blocking access to health care). Alcohol use increases for some parents following the birth of a child. This study examined 1,038 postpartum women's reports of their husbands' alcohol use and their own experiences of IPV (by husband) and non-violent maltreatment from husbands and/or in-laws. We analyzed cross-sectional, quantitative data collected in 2008, from women (ages 15-35) seeking immunizations for their infants <6 months at three large urban health centers in Mumbai, India. Crude and adjusted logistic regression models estimated associations between the independent variable (husbands' past month use of alcohol) and two dependent variables (postpartum IPV and maltreatment). Overall, 15% of husbands used alcohol, ranging from daily drinkers (10%) to those who drank one to two times per week (54%). Prevalence of postpartum IPV and family maltreatment was 18% and 42%, respectively. Prevalence of IPV among women married to alcohol users was 27%. Most abused women's husbands always (27%) or sometimes (37%) drank during violent episodes. Risk for IPV increased with a man's increasing frequency of consumption. Women who lived with a husband who drank alcohol, relative to non-drinkers, were more likely to report postpartum IPV, aOR = 2.0, 95% confidence interval (CI) = [1.3, 3.1]. Husbands' drinking was marginally associated with increased risk for family maltreatment, aOR = 1.4, 95% CI = [1.0, 2.1]. Our findings suggest that men's alcohol use is an important risk factor for postpartum IPV and maltreatment. Targeted services for Indian women contending with these issues are implicated. Postpartum care offers an ideal opportunity to screen for IPV, household maltreatment, and other health risks, such as husband's use of alcohol. There is need to scale up proven successful interventions for reducing men's alcohol use and design strategies that provide at-risk women protection from alcohol-related IPV.
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Affiliation(s)
| | - Balaiah Donta
- National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, India
| | | | - D. D. Naik
- National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, India
| | - Saritha Nair
- National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | | | - Anita Raj
- University of California, San Diego, CA, USA
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9
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Rodriguez LM, Osilla KC, Trail T, Gore K, Pedersen E. Alcohol Use Among Concerned Partners of Heavy Drinking Service Members and Veterans. JOURNAL OF MARITAL AND FAMILY THERAPY 2018; 44:277-291. [PMID: 28782116 PMCID: PMC5803486 DOI: 10.1111/jmft.12261] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Heavy drinking in relationships is complex and we focus on an understudied sample of concerned partners (CPs) worried about their U.S. service member/veteran partner's drinking. We evaluated the link between CP drinking and their own mental health, and how CP drinking moderated the efficacy of a web-based intervention designed to address CPs' mental health and communication. CPs (N = 234) were randomly assigned to intervention or control and completed assessments at baseline and 5 months later. CP drinking was associated with greater CP depression, anxiety, and anger independent of partner drinking. Moreover, the intervention was more efficacious in reducing depression for heavy drinking CPs. CPs are often an overlooked population and resources to help support them are needed.
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Kelley ML, Bravo AJ, Hollis BF. Work Stressors, Depressive Symptoms, and Hazardous Drinking Among Navy Members Across Deployment. MILITARY PSYCHOLOGY 2017. [DOI: 10.1037/mil0000177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Adrian J. Bravo
- Center on Alcoholism, Substance Abuse, & Addictions, University of New Mexico
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11
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Fink DS, Keyes KM, Calabrese JR, Liberzon I, Tamburrino MB, Cohen GH, Sampson L, Galea S. Deployment and Alcohol Use in a Military Cohort: Use of Combined Methods to Account for Exposure-Related Covariates and Heterogeneous Response to Exposure. Am J Epidemiol 2017; 186:411-419. [PMID: 28482012 DOI: 10.1093/aje/kww230] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 09/20/2016] [Indexed: 01/08/2023] Open
Abstract
Studies have shown that combat-area deployment is associated with increases in alcohol use; however, studying the influence of deployment on alcohol use faces 2 complications. First, the military considers a confluence of factors before determining whether to deploy a service member, creating a nonignorable exposure and unbalanced comparison groups that inevitably complicate inference about the role of deployment itself. Second, regression analysis assumes that a single effect estimate can approximate the population's change in postdeployment alcohol use, which ignores previous studies that have documented that respondents tend to exhibit heterogeneous postdeployment drinking behaviors. Therefore, we used propensity score matching to balance baseline covariates for the 2 comparison groups (deployed and nondeployed), followed by a variable-oriented difference-in-differences approach to account for the confounding and a person-oriented approach using a latent growth mixture model to account for the heterogeneous response to deployment in this prospective cohort study of the US Army National Guard (2009-2014). We observed a nonsignificant increase in estimated monthly drinks in the first year after deployment that regressed to predeployment drinking levels 2 years after deployment. We found a 4-class model that fit these data best, suggesting that common regression analyses likely conceal substantial interindividual heterogeneity in postdeployment alcohol-use behaviors.
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12
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Treatment of Intimate Partner Violence Perpetration Among Male Veterans: An Example of a Comprehensive Approach. CONTEMPORARY FAMILY THERAPY 2015. [DOI: 10.1007/s10591-015-9353-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Watkins LE, Maldonado RC, DiLillo D. Hazardous alcohol use and intimate partner aggression among dating couples: the role of impulse control difficulties. Aggress Behav 2014; 40:369-81. [PMID: 24464403 DOI: 10.1002/ab.21528] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 12/20/2013] [Indexed: 11/07/2022]
Abstract
To date, research identifying moderators of the alcohol-intimate partner aggression (IPA) relationship has focused almost exclusively on male-perpetrated aggression, without accounting for the dyadic processes of IPA. The current study examined hazardous alcohol use and impulse control difficulties as predictors of IPA among a sample of 73 heterosexual dating couples. Both actor and partner effects of these risk factors on physical and psychological aggression were examined. Results indicated that impulse control difficulties were an important actor and partner predictor of both physical and psychological aggression. Findings supported the multiple threshold model such that the interaction between impulse control difficulties and hazardous alcohol use significantly predicted physical aggression severity. These results suggest the importance of targeting impulse control difficulties and hazardous alcohol use in IPA treatment, as well as the advantages of examining risk factors of IPA within a dyadic rather than individual framework.
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Affiliation(s)
- Laura E Watkins
- Department of Psychology, University of Nebraska, Lincoln, Nebraska
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Kelley ML, Runnals J, Pearson MR, Miller M, Fairbank JA, Brancu M, Brancu M. Alcohol use and trauma exposure among male and female veterans before, during, and after military service. Drug Alcohol Depend 2013; 133:615-24. [PMID: 24054989 PMCID: PMC5287364 DOI: 10.1016/j.drugalcdep.2013.08.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Revised: 07/30/2013] [Accepted: 08/02/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND The present study examined lifespan and combat-related trauma exposure as predictors of alcohol use among male and female veterans. Posttraumatic stress and depressive symptoms were examined as mediators of the effects of trauma exposure on alcohol use. METHODS Data were examined from 1825 (1450 male, 375 female) veterans and active duty service members who took part in a multi-site research study conducted through the Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC). RESULTS For both men and women, depressive symptoms significantly mediated the effects of non-combat trauma exposure experienced before, during and after the military, as well as combat-exposure, on alcohol use. With posttraumatic stress symptoms, the models for men and women differed. For men, the effects of non-combat trauma exposure during and after military service, and combat exposure, on alcohol use were mediated by PTSD symptoms; however, for women, PTSD symptoms did not mediate these relationships. CONCLUSION Findings are discussed in the context of potential gender differences in response to trauma such as use of alcohol to cope with traumatic events.
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Affiliation(s)
- Michelle L. Kelley
- Department of Psychology, Old Dominion University, Norfolk, VA 23529, USA
| | - Jennifer Runnals
- Mid-Atlantic Region VA Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC), Durham, NC 27705, USA,Durham VA Medical Center, Durham, NC 27705, USA,Duke University Medical Center, Durham, NC 27705, USA
| | - Matthew R. Pearson
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, NM, 87106, USA
| | - Marinell Miller
- Mid-Atlantic Region VA Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC), Durham, NC 27705, USA,Hampton VA Medical Center, Hampton, VA 23667, USA
| | - John A. Fairbank
- Mid-Atlantic Region VA Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC), Durham, NC 27705, USA,Durham VA Medical Center, Durham, NC 27705, USA,Duke University Medical Center, Durham, NC 27705, USA
| | | | - Mira Brancu
- Mid-Atlantic Region VA Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC), Durham, NC 27705, USA,Durham VA Medical Center, Durham, NC 27705, USA,Duke University Medical Center, Durham, NC 27705, USA
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Kim HK, Tiberio SS, Pears KC, Capaldi DM, Washburn IJ. Growth of men's alcohol use in early adulthood: intimate partners' influence. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2013; 27:1167-74. [PMID: 23915372 DOI: 10.1037/a0033502] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The present study examined the effects of intimate partners' alcohol use on the developmental trajectories of men's alcohol use across their early to late 20s. Longitudinal data from a community sample of 110 at-risk young men and their intimate partners were analyzed using latent growth modeling. Results indicated that, in general, men showed a significant linear decrease in alcohol use across their 20s, as expected. However, partners' alcohol use had significant and positive effects on men's concurrent alcohol use across their 20s, regardless of relationship status, even after taking into account autoregressive effects of men's own alcohol use and their antisocial behavior. Furthermore, a new partner's alcohol use had a significantly greater influence on the man's alcohol use in his late 20s compared to a partner's alcohol use from intact relationships. Findings from the present study highlight the importance of considering intimate partners' alcohol use as part of the proximal psychosocial environment influencing men's alcohol use during early adulthood. Implications for prevention and intervention efforts are discussed.
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Walton TO, Walker DD, Kaysen DL, Roffman RA, Mbilinyi L, Neighbors C. Reaching soldiers with untreated substance use disorder: lessons learned in the development of a marketing campaign for the Warrior Check-Up study. Subst Use Misuse 2013; 48:908-21. [PMID: 23869462 PMCID: PMC4942844 DOI: 10.3109/10826084.2013.797996] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The Warrior Check-Up, a confidential telephone-delivered intervention, is designed to reach active-duty soldiers with untreated substance-use disorder at a large U.S. military base. This paper describes the development and successful implementation of the study's marketing strategies at the recruitment period's midpoint (2010-2012). Qualitative analyses of focus groups (n = 26) and survey responses (n = 278) describe the process of campaign design. Measures of demographics, media exposure, post-traumatic stress, anxiety and depression gathered from callers (n = 172) are used in quantitative analysis assessing the campaign's success in reaching this population. Implications, limitations, and suggestions for future research are discussed. Department of Defense provided study funding.
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Affiliation(s)
- Thomas O Walton
- University of Washington, School of Social Work, 909 NE 43rd St., Suite 304, Seattle, WA 98105, USA.
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