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Chermack ST, Bonar EE, Goldstick JE, Winters J, Blow FC, Friday S, Ilgen MA, Rauch SA, Perron BE, Ngo QM, Walton MA. A randomized controlled trial for aggression and substance use involvement among Veterans: Impact of combining Motivational Interviewing, Cognitive Behavioral Treatment and telephone-based Continuing Care. J Subst Abuse Treat 2019; 98:78-88. [DOI: 10.1016/j.jsat.2019.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 12/24/2018] [Accepted: 01/02/2019] [Indexed: 11/30/2022]
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2
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Alcohol Drinking by Husbands/Partners is Associated with Higher Intimate Partner Violence against Women in Angola. SAFETY 2019. [DOI: 10.3390/safety5010005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Intimate partner violence (IPV), as the most prevalent form of violence against women, is a commonly encountered phenomenon across sub-Saharan African countries, including Angola. As a fast-growing economy, Angola is experiencing a booming alcohol industry and persistent IPV and women’s rights issues, along with weak prohibition and enforcement against this practice. However, so far, there is no systematic research investigating the predictors of IPV in Angola and whether spousal alcohol drinking has any relationship with women’s experience of IPV. Therefore, in this study, we aimed to assess the predictors of IPV (defined as physical, emotional, and sexual violence) among Angolan women with a special focus on their partners’ alcohol drinking habit. Cross-sectional data on 7669 women aged 15–49 years from the Angola Demographic and Health Survey were used for this study. Data were analyzed using descriptive and logistic regression methods. Results indicated that physical IPV (32.3%, 95% Confidence Interval = 30.3 to 34.5) was most prevalent, followed by emotional (27.3%, 95% CI = 25.3 to 29.4) and sexual IPV (7.4%, 95% CI = 6.6 to 8.4). In the multivariate analysis, higher education and household wealth status showed protective effects against certain forms of IPV. Alcohol drinking by husbands/partners was associated with significantly higher odds of experiencing physical [OR = 2.950; 95% CI = 2.632, 3.306], emotional [OR = 2.470; 95% CI = 2.187,2.789], and sexual IPV [OR = 2.729; 95% CI = 2.220, 3.354] among women. Women who reported experiencing physical IPV had increased odds of drinking alcohol [OR = 1.474; 95% CI = 1.290, 1.684] compared with those who did not. These findings reflect the widespread prevalence of IPV in sub-Saharan African countries. Special focus should be given to married men with alcohol drinking habits to reduce women’s vulnerability to IPV and dependence on alcohol use.
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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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Bonar EE, Matusiewicz AK, Bohnert ASB, Ilgen MA, Sanborn ML, Chermack ST. Coping and violence perpetration in a residential substance use disorder treatment sample. J Addict Dis 2018; 37:23-33. [PMID: 29856278 DOI: 10.1080/10550887.2018.1479611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
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.
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Affiliation(s)
- Erin E Bonar
- a Addiction Center, Department of Psychiatry , University of Michigan , Ann Arbor , MI , USA
| | - Alexis K Matusiewicz
- a Addiction Center, Department of Psychiatry , University of Michigan , Ann Arbor , MI , USA.,b VA Ann Arbor , Center for Clinical Management Research and VA Health Services Research & Development , Ann Arbor , MI , USA
| | - Amy S B Bohnert
- a Addiction Center, Department of Psychiatry , University of Michigan , Ann Arbor , MI , USA.,b VA Ann Arbor , Center for Clinical Management Research and VA Health Services Research & Development , Ann Arbor , MI , USA
| | - Mark A Ilgen
- a Addiction Center, Department of Psychiatry , University of Michigan , Ann Arbor , MI , USA.,b VA Ann Arbor , Center for Clinical Management Research and VA Health Services Research & Development , Ann Arbor , MI , USA
| | - Michelle L Sanborn
- a Addiction Center, Department of Psychiatry , University of Michigan , Ann Arbor , MI , USA
| | - Stephen T Chermack
- a Addiction Center, Department of Psychiatry , University of Michigan , Ann Arbor , MI , USA.,b VA Ann Arbor , Center for Clinical Management Research and VA Health Services Research & Development , Ann Arbor , MI , USA
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Stover CS, Carlson M, Patel S. Integrating intimate partner violence and parenting intervention into residential substance use disorder treatment for fathers. J Subst Abuse Treat 2017; 81:35-43. [PMID: 28847453 DOI: 10.1016/j.jsat.2017.07.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 07/25/2017] [Accepted: 07/27/2017] [Indexed: 10/19/2022]
Abstract
Despite positive outcomes for the incorporation of gender- and motherhood-focused programing within substance use disorder treatment programs for women, a focus on gender and fatherhood has not been the focus of intervention or evaluation research for men in substance use disorder treatment. This was a mixed method study to examine the initial feasibility of incorporating a fatherhood-focused intervention within a substance use disorder treatment program for men. Forty-four fathers enrolled in a coordinated intervention for intimate partner violence and parenting. Interviews were conducted at baseline and follow-up to assess the impact of the intervention on anger, hostile thinking and emotion regulation problems. Focus groups were also conducted with the participants to gain further insight into their needs as fathers and their recommendations for interventions that they would find helpful. Results indicated a high prevalence of anger related thoughts at baseline that significantly decreased at follow up; there were also significant reductions in affect regulation problems. Importantly, 84.1% of participants completed the program in its entirety and were highly satisfied with the content. These findings suggest that Fathers for Change can be implemented, successfully, in a men's residential treatment program.
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Flanagan JC, Fischer MS, Badour CL, Ornan G, Killeen TK, Back SE. The Role of Relationship Adjustment in an Integrated Individual Treatment for PTSD and Substance Use Disorders Among Veterans: An Exploratory Study. J Dual Diagn 2017; 13:213-218. [PMID: 28541802 PMCID: PMC5544565 DOI: 10.1080/15504263.2017.1312039] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Identifying factors that influence treatment outcomes of emerging integrated interventions for co-occurring posttraumatic stress disorder (PTSD) and substance use disorder is crucial to maximize veterans' health. Dyadic adjustment suffers among individuals with PTSD and substance use disorder and may be an important mechanism of change in treatment. This exploratory study examined the association between dyadic adjustment and treatment outcomes in individual integrated treatment for co-occurring PTSD and substance use disorder. METHODS Participants were treatment-seeking veterans (N = 15) participating in a larger randomized controlled trial examining the efficacy of a novel integrated treatment for co-occurring PTSD and substance use disorder. Multiple regression analyses controlling for baseline symptom severity and independent sample t-tests were used to examine the relation between dyadic adjustment and treatment outcome variables including PTSD, substance use disorder, and depression symptom severity. RESULTS Baseline dyadic adjustment was associated with session 12 PTSD symptom severity as measured by both the Clinician-Administered PTSD Scale (CAPS) and PTSD Checklist (PCL), such that participants with high dyadic adjustment had significantly lower session 12 CAPS and PCL scores compared to participants with low dyadic adjustment. Baseline dyadic adjustment was not associated with session 12 depression symptoms or frequency of substance use. CONCLUSIONS These findings suggest that while the primary determinant of treatment outcome in this sample is the application of an evidence-based intervention, dyadic adjustment may play a role in individual treatment outcome for some treatment-seeking veterans. Data from this study were derived from clinical trial NCT01365247.
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Affiliation(s)
- Julianne C. Flanagan
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Melanie S. Fischer
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
| | | | - Gili Ornan
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
| | - Therese K. Killeen
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Sudie E. Back
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
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Anderson RE, Bonar EE, Walton MA, Goldstick JE, Rauch SAM, Epstein-Ngo QM, Chermack ST. A Latent Profile Analysis of Aggression and Victimization Across Relationship Types Among Veterans Who Use Substances. J Stud Alcohol Drugs 2017; 78:597-607. [PMID: 28728642 PMCID: PMC5551664 DOI: 10.15288/jsad.2017.78.597] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 01/11/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study examined patterns of violence victimization and aggression in both intimate partner and nonpartner relationships among U.S. military veterans using latent profile analysis to identify subtypes of violence involvement. METHOD Participants were 839 substance use treatment-seeking veterans (93% male) from a large Veterans Affairs Medical Center who completed screening measures for a randomized controlled trial. RESULTS Past-year violence involvement, including both intimate partner violence (IPV) and nonpartner violence (NPV), was common in the sample, although NPV occurred at somewhat higher rates. When we included either IPV or NPV aggression or victimization, more than 40% reported involvement with physical violence, 30% with violence involving injury, and 86% with psychological aggression. Latent profile analysis including both aggression and victimization in partner and nonpartner relationships indicated a four-profile solution: no/low violence (NLV; n = 377), predominantly IPV (n = 219), predominantly NPV (n = 134), and high general violence (HGV; n = 109). Multinomial logistic regression analyses revealed that, compared with the NLV group, the remaining three groups differed in age, cocaine use, posttraumatic stress disorder (PTSD) symptoms, and legal involvement. Legal issues appeared to differentiate the profiles most, with the predominantly NPV and HGV profiles reporting more instances of driving under the influence and the HGV profile reporting legal problems related to aggression. CONCLUSIONS IPV and NPV are fairly common among veterans seeking substance use treatment. The clinical characteristics of violence profiles indicate that cocaine use, PTSD symptoms, and legal involvement are treatment needs that vary with violence profile and may be useful for clinical decision making.
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Affiliation(s)
- RaeAnn E. Anderson
- Department of Psychological Sciences, Kent State University, Kent, Ohio
- Mental Health Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Erin E. Bonar
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Maureen A. Walton
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
- Injury Center, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan
| | - Jason E. Goldstick
- Injury Center, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan
| | - Sheila A. M. Rauch
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
- Mental Health Service Line, Atlanta Veterans Affairs Medical Center, Decatur, Georgia
| | - Quyen M. Epstein-Ngo
- Injury Center, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan
- Institute for Research on Women & Gender, University of Michigan, Ann Arbor, Michigan
| | - Stephen T. Chermack
- Mental Health Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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8
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Crane CA, Schlauch RC, Devine S, Easton CJ. Comorbid substance use diagnoses and partner violence among offenders receiving pharmacotherapy for opioid dependence. J Addict Dis 2016; 35:205-11. [PMID: 26901289 DOI: 10.1080/10550887.2016.1154400] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
While previous studies find mixed evidence of an association between opioid use and intimate partner violence perpetration among community samples, initial evidence has detected increased rates of partner violence among individuals receiving pharmacological intervention for opioid dependence. The current study evaluated the role of current comorbid substance use diagnoses, a robust risk factor for violent behavior, on the likelihood of perpetrating partner violence among a high risk sample of offenders receiving pharmacological intervention for opioid dependence. The authors analyzed self-report data provided by 81 (55 male) opioid dependent offenders during a court-ordered substance use interview. Approximately one-third of the sample evidenced the recent use of intimate partner violence. Findings indicated that cocaine and benzodiazepine use were independently associated with an increased likelihood of reporting physical partner violence. Alcohol and cannabis use were not associated with partner violence. The current results offer further support for the ongoing need to conduct routine partner violence screenings among substance involved offenders and highlight the importance of developing individualized treatment plans that address comorbid substance use and partner-violent behaviors among individuals in treatment for opioid dependence.
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Affiliation(s)
- Cory A Crane
- a Biomedical Sciences Department , Rochester Institute of Technology , Rochester , New York , USA.,b Behavioral Health, Department of Veterans Affairs Medical Center , Canandaigua , New York , USA
| | - Robert C Schlauch
- c Department of Psychology , University of South Florida , Tampa , Florida , USA
| | - Susan Devine
- d School of Nursing, Yale University School of Medicine , New Haven , Connecticut , USA
| | - Caroline J Easton
- a Biomedical Sciences Department , Rochester Institute of Technology , Rochester , New York , USA
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Heinz AJ, Makin-Byrd K, Blonigen DM, Reilly P, Timko C. Aggressive behavior among military veterans in substance use disorder treatment: the roles of posttraumatic stress and impulsivity. J Subst Abuse Treat 2015; 50:59-66. [PMID: 25468005 PMCID: PMC4623561 DOI: 10.1016/j.jsat.2014.10.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 10/16/2014] [Accepted: 10/27/2014] [Indexed: 01/25/2023]
Abstract
This study examined posttraumatic stress disorder (PTSD) symptom severity and impulsivity as predictors of aggressive behavior among 133 male military veterans entering substance abuse treatment who endorsed difficulty controlling anger in the past year. At treatment intake, participants completed measures assessing PTSD symptom severity, impulsivity and aggressive behavior. Perpetration of aggressive behavior was reassessed 4 months later. Results from multivariate models indicated that PTSD symptom severity and impulsivity explained unique variance in aggressive behavior at intake but not follow-up. Mediation models indicated that the association between PTSD symptom severity and aggressive behavior was accounted for by impulsivity. The identification of impulsivity as a key mediator between trauma symptoms and aggressive behavior has significant clinical and research implications. Based on these findings, clinicians are encouraged to consider a standard assessment of impulsivity and the selection of interventions that target impulsivity as a trans-diagnostic process among at-risk client populations.
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Affiliation(s)
- Adrienne J Heinz
- Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA; National Center for PTSD, Dissemination and Training Division, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA.
| | - Kerry Makin-Byrd
- National Center for PTSD, Dissemination and Training Division, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA
| | - Daniel M Blonigen
- Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA
| | - Patrick Reilly
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Christine Timko
- Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
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Choo EK, Benz M, Rybarczyk M, Broderick K, Linden J, Boudreaux ED, Ranney ML. The intersecting roles of violence, gender, and substance use in the emergency department: a research agenda. Acad Emerg Med 2014; 21:1447-52. [PMID: 25421993 PMCID: PMC4393747 DOI: 10.1111/acem.12525] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 09/10/2014] [Accepted: 09/10/2014] [Indexed: 12/29/2022]
Abstract
The relationship between gender, violence, and substance use in the emergency department (ED) is complex. This article examines the role of gender in the intersection of substance use and three types of violence: peer violence, intimate partner violence, and firearm violence. Current approaches to treatment of substance abuse and violence are similar across both genders; however, as patterns of violence and substance abuse differ by gender, interventions may be more effective if they are designed with a specific gender focus.
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Affiliation(s)
- Esther K Choo
- Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI
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Epstein-Ngo QM, Walton MA, Sanborn M, Kraus S, Blow F, Cunningham R, Chermack ST. Distal and proximal factors associated with aggression towards partners and non-partners among patients in substance abuse treatment. J Subst Abuse Treat 2014; 47:282-92. [PMID: 25012548 PMCID: PMC4292794 DOI: 10.1016/j.jsat.2014.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Revised: 05/14/2014] [Accepted: 05/26/2014] [Indexed: 10/25/2022]
Abstract
Studies of violence in substance use disorder (SUD) treatment settings typically focus on partner aggression (PA) although non-partner aggression (NPA) is also a common problem. This study examines potentially distinct paths of distal and proximal risk factors related to aggression towards non-partners (NPA) and partners (PA) among a SUD treatment sample. The sample included 176 adults reporting past-year violence. Bivariate analyses indicated several distal and proximal factors were associated with NPA and PA. According to multivariate, multiple mediation analyses youth aggression history was a factor for both NPA and PA. Alcohol and cocaine use and psychological distress were associated with NPA; marijuana use was associated with PA. There also was evidence of indirect effects of distal factors on NPA and PA. The results suggest that there may be substantially different dynamics associated with NPA and PA, and have implications for developing screening, assessment and treatment protocols targeting violence among individuals in SUD treatment.
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Affiliation(s)
- Quyen M Epstein-Ngo
- University of Michigan Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI 48109, USA; University of Michigan Injury Center, University of Michigan, Ann Arbor, MI 48105, USA.
| | - Maureen A Walton
- University of Michigan Injury Center, University of Michigan, Ann Arbor, MI 48105, USA; University of Michigan Addiction Research Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI 48105, USA
| | - Michelle Sanborn
- University of Michigan Addiction Research Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI 48105, USA
| | - Shane Kraus
- Mental Illness Research, Education & Clinical Center, VA Connecticut Healthcare System, West Haven, CT 06515, USA
| | - Fred Blow
- University of Michigan Addiction Research Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI 48105, USA; Department of Veterans Affairs, Health Services Research and Development, Ann Arbor, MI 48109, USA
| | - Rebecca Cunningham
- University of Michigan Injury Center, University of Michigan, Ann Arbor, MI 48105, USA; Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; Department of Emergency Medicine, University of Michigan, Ann Arbor, MI 48105, USA
| | - Stephen T Chermack
- University of Michigan Addiction Research Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI 48105, USA; Department of Veterans Affairs, Health Services Research and Development, Ann Arbor, MI 48109, USA
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Kim DJ, Choo EK, Ranney ML. Impact of gender on patient preferences for technology-based behavioral interventions. West J Emerg Med 2014; 15:593-9. [PMID: 25157307 PMCID: PMC4140202 DOI: 10.5811/westjem.2014.4.21448] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 03/26/2014] [Accepted: 04/14/2014] [Indexed: 11/16/2022] Open
Abstract
Introduction: Technology-based interventions offer an opportunity to address high-risk behaviors in the emergency department (ED). Prior studies suggest behavioral health strategies are more effective when gender differences are considered. However, the role of gender in ED patient preferences for technology-based interventions has not been examined. The objective was to assess whether patient preferences for technology-based interventions varies by gender. Methods: This was a secondary analysis of data from a systematic survey of adult (≥18 years of age), English-speaking patients in a large urban academic ED. Subjects were randomly selected during a purposive sample of shifts. The iPad survey included questions on access to technology, preferences for receiving health information, and demographics. We defined “technology-based” as web, text message, e-mail, social networking, or DVD; “non-technology-based” was defined as in-person, written materials, or landline. We calculated descriptive statistics and used univariate tests to compare men and women. Gender-stratified multivariable logistic regression models were used to examine associations between other demographic factors (age, race, ethnicity, income) and technology-based preferences for information on specific risky behaviors. Results: Of 417 participants, 45.1% were male. There were no significant demographic differences between men and women. Women were more likely to use computers (90.8% versus 81.9%; p=0.03), Internet (66.8% versus 59.0%; p=0.03), and social networks (53.3% versus 42.6%; p=0.01). 89% of men and 90% of women preferred technology-based formats for at least type of health information; interest in technology-based for individual health topics did not vary by gender. Concern about confidentiality was the most common barrier to technology-based use for both genders. Multivariate analysis showed that for smoking, depression, drug/alcohol use, and injury prevention, gender modified the relationship between other demographic factors and preference for technology-based health information; e.g., older age decreases interest in technology-based information for smoking cessation in women but not in men (aOR 0.96, 95% CI 0.93-0.99 versus aOR 1.00, 95% CI 0.97-1.03). Conclusion: Our findings suggest ED patients' gender may affect technology preferences. Receptivity to technology-based interventions may be a complex interaction between gender and other demographic factors. Considering gender may help target ED patient populations most likely to be receptive to technology-based interventions.
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Affiliation(s)
- David J Kim
- The Warren Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode Island
| | - Esther K Choo
- The Warren Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode Island
| | - Megan L Ranney
- The Warren Alpert Medical School of Brown University, Department of Emergency Medicine, Providence, Rhode Island
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Characteristics and treatment interests among individuals with substance use disorders and a history of past six-month violence: findings from an emergency department study. Addict Behav 2014; 39:265-72. [PMID: 24148140 DOI: 10.1016/j.addbeh.2013.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 09/08/2013] [Accepted: 10/01/2013] [Indexed: 11/22/2022]
Abstract
The study examined clinical characteristics and treatment interests of individuals identified to have substance use disorders (SUDs) in an urban emergency department (ED) who reported past six-month history of violence or victimization. Specifically, participants were 1441 ED patients enrolled in a randomized controlled trial of interventions designed to link those with SUDs to treatment. To examine factors related to violence type, four groups based on participants' reports of violence toward others were created: no violence (46.8%), partner violence only (17.3%), non-partner violence only (20.2%), and both partner and non-partner violence (15.7%). Four groups based on participants' reports of victimization were also created: no violence (42.1%), victimization from partner only (18.7%), victimization from non-partner only (20.2%), and both partner and non-partner victimization (17.7%). Separate multinomial logistic regression analyses were conducted to examine which variables distinguished the violence and victimization groups from those reporting no violence or victimization. For violence toward others, demographic variables, alcohol and cocaine disorders, and rating treatment for psychological problems were higher for violence groups, with some differences depending on the type of violence. For victimization, demographic variables, having an alcohol disorder, and rating treatment for family/social problems were higher for violence groups, also with some differences depending on the type of violence. Findings from the present study could be useful for designing effective brief interventions and services for ED settings.
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Kubiak SP, Kim WJ, Fedock G, Bybee D. Differences among incarcerated women with assaultive offenses: isolated versus patterned use of violence. JOURNAL OF INTERPERSONAL VIOLENCE 2013; 28:2462-2490. [PMID: 23508089 DOI: 10.1177/0886260513479034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A majority of the existing research on women's use of violence focuses on intimate partner violence, often excluding other types of violence for which women may be incarcerated. The current study expands this area of research by assessing between and within-group differences among a randomly selected group of incarcerated women (n = 543). Comparisons between violent and nonviolent offense types among women found few differences, but significant differences among women with an assaultive offense, based on the presence or absence of a self-reported uncaught violence, were found. Differences in women with isolated (i.e., single incident of violence perpetration through a review of formal and self-report data) and patterned uses of violence were present in relation to issues of mental health, substance abuse, criminogenic risk, and expressions of anger and personality factors. These findings have important implications for intervention as well as future research.
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Bonar EE, Bohnert ASB, Ilgen MA, Sanborn ML, Chermack ST. Physical assault victimization and coping among adults in residential substance use disorder treatment. VIOLENCE AND VICTIMS 2013; 28:849-64. [PMID: 24364127 PMCID: PMC4048994 DOI: 10.1891/0886-6708.vv-d-12-00052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Many individuals with substance use disorders (SUDs) have been victims of violence and individuals with SUDs often exhibit coping skills deficits. The extent to which coping skills relate to victimization is unknown. This study evaluated the relationships between physical assault victimization types (i.e., only partner victimization, only nonpartner victimization, or both partner and nonpartner victimization) and emotion-focused, problem-focused, and avoidant coping among individuals in residential SUD treatment. More frequent use of problem-focused coping was associated with reduced odds of being victimized by partners and nonpartners and more frequent use of avoidant coping was associated with increased odds of victimization across both partners and nonpartners. These results highlight the potential value of assessing violence across relationship types and bolstering adaptive coping among individuals with SUDs.
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Affiliation(s)
- Erin E Bonar
- Department of Psychiatry, Addiction Research Center, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Amy S B Bohnert
- Department of Psychiatry, Addiction Research Center, University of Michigan, Ann Arbor, MI 48109, USA
| | - Mark A Ilgen
- Department of Psychiatry, Addiction Research Center, University of Michigan, Ann Arbor, MI 48109, USA
| | - Michelle L Sanborn
- Department of Psychiatry, Addiction Research Center, University of Michigan, Ann Arbor, MI 48109, USA
| | - Stephen T Chermack
- Department of Psychiatry, Addiction Research Center, University of Michigan, Ann Arbor, MI 48109, USA
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Gender, violence and brief interventions for alcohol in the emergency department. Drug Alcohol Depend 2013; 127:115-21. [PMID: 22818512 PMCID: PMC4325369 DOI: 10.1016/j.drugalcdep.2012.06.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 06/08/2012] [Accepted: 06/20/2012] [Indexed: 02/02/2023]
Abstract
BACKGROUND The impact of gender and violence on brief interventions (BIs) for alcohol use in the emergency department (ED) has not been studied. Our objective was to examine the effectiveness of alcohol BIs in an ED population stratified by gender and violence. METHODS This was a secondary analysis of datasets pooled from three ED-based randomized controlled studies of alcohol BIs. AUDIT-C was the primary outcome measure; secondary outcomes were binge drinking and achievement of NIAAA safe drinking levels. We conducted univariate comparisons and developed generalized linear models (GLM) for the primary outcome and generalized estimating equation (GEE) models for secondary outcomes to examine the intervention effect on the whole study group, gender-stratified subgroups, and gender- and violence-stratified subgroups. RESULTS Of 1219 participants enrolled, 30% were female; 31% of women and 42% of men reported violence involvement at baseline. In univariate analysis, no differences in outcomes were found between intervention and control groups for any subgroup. However, in multivariable models, men demonstrated an intervention effect for likelihood of safe drinking limits. Stratifying further by violence, only men without violence involvement demonstrated a positive intervention effect for safe drinking limits. There was no evidence of an intervention effect on women. CONCLUSIONS Analyzing the overall effect of ED-based BI may mask its ability to improve alcohol-related outcomes in a subset of the population. Alternatively, interventions may need to be significantly improved in subsets of the ED population, e.g., in women and in men with involvement in violence.
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Alexandercikova Z, Walton MA, Chermack ST, Cunningham RM, Barry KL, Blow FC. Correlates of partner and non-partner aggression among patients with substance use disorders in an urban ED. JOURNAL OF SUBSTANCE USE 2012. [DOI: 10.3109/14659891.2012.668260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Wood SR. Co-occurring Psychiatric and Substance Dependence Disorders as Predictors of Parolee Time to Rearrest. JOURNAL OF OFFENDER REHABILITATION 2011; 50:175-190. [PMID: 22582021 PMCID: PMC3349337 DOI: 10.1080/10509674.2011.571076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
An estimated 500,000-plus people are on parole each year, many with serious co-occurring psychiatric and substance use disorders. Using cross sectional, self-report data this study examined the relationships between parolee time to rearrest, serious mental illnesses, and substance dependency (n = 1,121). Regression analyses indicated that after controlling for demographic and criminal justice variables, parolees with serious psychiatric and substance dependence disorders were rearrested faster than non-dually diagnosed parolees (p < .05). An explanation is that compared with parolees without dual diagnoses, parole violations by dually diagnosed parolees are detected and punished more quickly because of closer parole supervision.
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Affiliation(s)
- Steven R Wood
- National Development and Research Institutes, Public Health Solutions, New York, New York, USA and Department of Sociology, John Jay College of Criminal Justice, City University of New York, New York, New York, USA
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Chermack ST, Grogan-Kaylor A, Perron BE, Murray RL, De Chavez P, Walton MA. Violence among men and women in substance use disorder treatment: a multi-level event-based analysis. Drug Alcohol Depend 2010; 112:194-200. [PMID: 20667666 PMCID: PMC3641785 DOI: 10.1016/j.drugalcdep.2010.06.005] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Revised: 06/04/2010] [Accepted: 06/06/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study examined associations between acute alcohol and drug use and violence towards others in conflict incidents (overall, partner, and non-partner conflict incidents) by men and women recruited from substance use disorder (SUD) treatment. METHODS Semi-structured interviews were used to obtain details about interpersonal conflict incidents (substance use, whether specific conflicts were with intimate partners or non-partners) in the 180 days pre-treatment. Participants for this study were selected for screening positive for past-year violence (N=160; 77% men, 23% women). RESULTS Multi-level multinomial regression models showed that after adjusting for clustering within individual participants, the most consistent predictors of violence across models were acute cocaine use (significant for overall, intimate partner and non-partner models), acute heavy alcohol use (significant for overall and non-partner models), and male gender (significant in all models). CONCLUSIONS This study was the first to explicitly examine the role of acute alcohol and drug use across overall, partner and non-partner conflict incidents. Consistent with prior studies using a variety of methodologies, alcohol, cocaine use and male gender was most consistently and positively related to violence severity (e.g., resulting in injury). The results provide important and novel event-level information regarding the relationship between acute alcohol and specific drug use and the severity of violence in interpersonal conflict incidents.
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Affiliation(s)
- Stephen T Chermack
- University of Michigan Addiction Research Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI 48105, USA.
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Cunningham RM, Murray R, Walton MA, Chermack ST, Wojnar M, Wozniak P, Booth BM, Blow FC. Prevalence of past year assault among inner-city emergency department patients. Ann Emerg Med 2009; 53:814-23.e15. [PMID: 19282061 DOI: 10.1016/j.annemergmed.2009.01.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2008] [Revised: 12/17/2008] [Accepted: 01/06/2009] [Indexed: 11/17/2022]
Abstract
STUDY OBJECTIVE We determine the rates of past year nonpartner violent assault, both victimization and aggression, and assess variables associated with nonpartner violent assault, particularly with regard to substance use. METHODS A cross-sectional computerized standardized survey study was conducted to assess nonpartner violent assault, physical and mental health, and substance use among patients presenting to an inner-city ED during 2 years. Patients (aged 19 to 60 years) with normal vital signs in an urban emergency department (ED) from 9 am to 11 pm were eligible; pregnant patients and those with a chief complaint of psychiatric evaluation were excluded. Logistic regression analyses were conducted to predict any nonpartner violent assault. RESULTS Ten thousand seven hundred forty-four patients were enrolled (80% response rate); 14% of the sample reported any past year nonpartner violent assault (9% perpetration; 11% victimization). Findings from regression analyses found that participants with any past year nonpartner violent assault (victimization or aggression) were more likely than their counterparts to be men (2.2), to be single (1.5), to be unemployed (1.1), to present to the ED for injury (1.9), and to report poor physical health (1.3) or poor mental health (1.9). They were less likely to be black (0.8), or older (0.95). Alcohol use (1.7), marijuana use (2.4), cocaine use (3.1), prescription drug use (1.4), and past treatment (1.7) were associated with experiencing past year nonpartner violent assault. CONCLUSION Fourteen percent of patients seeking care in this inner-city ED experience violence with a nonpartner. Substance use-specifically cocaine-was the strongest predictor of any nonpartner violent assault.
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Affiliation(s)
- Rebecca M Cunningham
- Department of Emergency Medicine Injury Research Center, University of Michigan, Ann Arbor, USA.
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