Cognitive and Affective Mediators of Alcohol-Facilitated Intimate Partner Aggression

Preliminary Efficacy of Positive Change(+Change): A Pilot Randomized Controlled Trial of an Integrated Alcohol and Sexual Assault Prevention Program Tailored by Gender and Sexual Orientation

The current study presents preliminary efficacy findings of a pilot randomized controlled trial of Positive Change© (+Change© ). +Change© utilizes personalized normative feedback to target alcohol use, sexual assault (SA) victimization, SA perpetration, and bystander intervention tailored for heterosexual cisgender men, heterosexual cisgender women, and sexual and gender-minoritized (SGM) groups. Participants included 165 undergraduate students aged 18 to 25 years old from a large public university in the Southwestern U.S. who engaged in past month heavy episodic drinking. Participants (57 cisgender heterosexual men; 54 cisgender heterosexual women; and 54 SGM) were randomized to +Change© (n = 83) or an assessment-only control (n = 82) and completed surveys online at baseline and 3-month follow-up in a parallel design with a 1:1 ratio (NCT04089137). The current study presents the secondary outcomes of the pilot randomized controlled trial which include alcohol use, SA victimization, SA perpetration, and bystander intervention behavior. +Change© was associated with significantly less severe SA victimization and more bystander intervention behavior at 3-month follow-up relative to the control. There were no significant differences between conditions in alcohol use at 3-month follow-up, however, the magnitude of decreases in drinking in the +Change© condition in this pilot study were consistent with other personalized normative feedback interventions. The present study was unable to assess differences in SA perpetration due to low base rates. No adverse effects among those receiving the intervention were observed. Findings suggested that +Change© may be a feasible strategy to prevent SA, by reducing student SA victimization and increasing bystander intervention. A fully powered randomized clinical trial is needed to examine the effects of +Change©.

Both partners' negative emotion drives aggression during couples' conflict

Researchers examining conflict between intimate partners believe that the experience and expression of emotion drives aggressive behaviour. Intra-personally, increases in negative affect make aggression more likely. Inter-personally, theoretical models suggest that each individuals' perception of their partners' emotion also influences aggression, potentially creating a Violence Escalation Cycle. Here, using a lab-based aggression task across a primary study (n = 104, number of trials = 3095) and a replication (n = 58, number of trials = 3167), we show that both intra- and inter-personal experiences of negative emotion predict reactive aggression within couples, revealing retaliation but not escalation. Critically, analyses of facial affect reveal that prototypic displays of negative emotions have a compounding effect, leading to dramatic changes in aggression depending on whether one, both, or neither partner expressed negative emotion. We propose a mechanism by which temporal delays (i.e., experimentally imposed forced breaks) reduce aggression by decreasing negative emotional arousal and limiting impulsive action. Our results show that both forced breaks and elective breaks (i.e., extra participant-initiated extensions of the forced break time) reduce aggression, providing exciting evidence that interventions focused on preventing impulsive action when people are in a provoked state can reduce aggression within couples.

Emotion differentiation and intimate partner violence: Effects of provocation and alcohol intoxication

OBJECTIVE

This study investigated the impact of relational provocation on intimate partner violence (IPV) perpetration as a function of alcohol intoxication and individuals' emotion differentiation (ED; i.e., the ability to differentiate between positive and negative emotions). We hypothesized that provocation and acute intoxication would be associated with lower ED, such that individuals would demonstrate lower ED following provocation and while intoxicated. We also hypothesized an intoxication-by-ED interaction, such that only individuals who were intoxicated and undifferentiated would perpetrate IPV.

METHOD

Two hundred fifty community-based adults completed an aggression paradigm ostensibly with their romantic partners where they were randomly assigned to an alcohol or no-alcohol condition. Participants' ED across positive and negative subscales was calculated at baseline (Time 1), postprovocation and intoxication (Time 2), and postbehavioral aggression (Time 3). IPV was operationalized as the strength and duration of shocks issued to their partner during the aggression paradigm.

RESULTS

Both sober and intoxicated participants experienced lower ED following provocation, suggesting a main effect of provocation but no main effect of intoxication. There was a significant alcohol-by-ED interaction in the predicted direction. For intoxicated participants, low ED was associated with greater IPV perpetration. For sober participants, low ED was associated with less IPV perpetration.

CONCLUSIONS

Consistent with hypotheses, low ED is associated with greater IPV perpetration among intoxicated individuals. In contrast to prior research, low ED was associated with less IPV perpetration among sober individuals. Alcohol-related cognitive impairments may increase the likelihood of IPV perpetration by disrupting the ED process that may otherwise inhibit impulsive aggression. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Alcohol Use, Discrimination, and Psychological Partner Abuse Among LGBQ+ College Students: Results From a Daily Diary Study

Alcohol use correlates with psychological partner abuse (PA) perpetration among lesbian, gay, bisexual, queer, and other nonheterosexual (LGBQ+) young adults. However, less is known about the proximal association between alcohol use and psychological PA within this population, which would provide valuable information for intervention development. Informed by minority stress and alcohol-related PA theories, we evaluated whether (a) psychological PA perpetration odds increased as the number of drinks consumed prior to psychological PA on a given day increased, (b) psychological PA perpetration odds were greater following heavy episodic drinking (HED) relative to non-HED, and (c) experiencing LGBQ+-specific discrimination (i.e., heterosexist harassment, incivility, and hostility) strengthened the association between daily alcohol use (number of drinks, HED) and subsequent psychological PA perpetration. LGBQ+ college students (N = 41; 75.6% women, 22.0% men, and 2.4% transgender/non-binary) completed a baseline survey of past-year discrimination before completing daily reports of their alcohol use and psychological PA for 60 consecutive days. Multilevel modeling revealed that drinking more than one usually does on a given day is positively associated with subsequent psychological PA odds (OR = 1.31, p < .001). Psychological PA was more likely following HED relative to non-HED (OR = 3.23, p < .001). Unexpectedly, experiencing discrimination was negatively associated with psychological PA odds across models (OR = .26 p = .01). No alcohol × discrimination interactions emerged. Results support alcohol use as a proximal risk factor for psychological PA among LGBQ+ college students and underscore the need for more nuanced examination of discrimination and other contextual variables in alcohol-related PA.

Impulsivity and Reactive-Proactive Aggression as Mechanisms of Alcohol-Related Sexual Intimate Partner Violence Perpetration among Romantic Partners

Background: Sexual intimate partner violence (S-IPV) commonly occurs within the contexts of committed romantic relationshops. Prior research has demonstrated the existence of a robust link between alcohol use and S-IPV. Despite this, few research studies have explored the etiological underpinnings of alcohol-related S-IPV perpetration, specifically. The present study examines the role of several key factors (i.e., problematic drinking, negative and positive urgency, proactive and reactive aggression) on S-IPV perpetration. Methods: Participants were 337 heavy drinking men and women in intimate relatinships who reported perpetrating some form of IPV toward their current partner within the past-year. A moderated-mediation model was used to determine how the key study variables interacted to predict S-IPV perpetration. Results: Results indicated that problematic drinking was positively correlated with both negative urgency and positive uregency. Findings also revealed that negative urgency, positive urgency, proactive aggression, and reactive aggression were all positively related to S-IPV perpetration. The indirect relationship between problematic drinking and S-IPV perpetration was mediated by positive urgency. Additionally, a significant main effect of proactive aggression on S-IPV perpetration was also detected. Conclusions: These findings suggest that impulsivity, specifically positive urgency, and proactive aggression may be under-appreciated constructs within the existing sexual aggression literature, and future research examining these variables as mechanisms explaining the association between the alcohol and S-IPV is warranted.

Preliminary Efficacy of a Web-Based Alcohol and Emotion Regulation Intervention on Intimate Partner Aggression Among College Women

Objective

Intimate partner aggression (IPA), encompassing psychological and physical aggression, is a public health concern due to its high rates among young adults. Research and theory connect heavy drinking and emotion regulation (ER) difficulties to IPA and highlight their potential role in reducing IPA. A web-based intervention combining alcohol reduction strategies with ER skills demonstrated initial efficacy at reducing heavy drinking and improving ER abilities among college women with sexual assault victimization histories.

Method

The present study represents a secondary analysis of this brief web-based intervention to evaluate its preliminary efficacy on IPA. The sample comprised 200 heavy drinking college women with histories of sexual assault victimization randomized to an assessment only control or the intervention consisting of 14 brief online alcohol reduction and ER skill building modules administered daily over a two-week period. The analytic sample included 103 women who reported their psychological and physical IPA at both the 1- and 6-month follow-up surveys.

Results

After controlling for alcohol use, repeated measures mixed models examining changes from baseline to 6-month follow-up by condition revealed a significant time-by-intervention interaction effect on psychological IPA. Women who received the intervention had a significant decrease in psychological IPA from baseline to 6-month follow-up; there was no change in psychological IPA among women in the control condition. There was no significant effect of the intervention on physical IPA.

Conclusion

Reducing alcohol use and improving ER skills may be beneficial in helping women cope with relational conflict, thereby decreasing their use of psychological IPA.

Emotion regulation and intimate partner violence perpetration: A meta-analysis

Intimate partner violence (IPV) is a significant public health concern that affects millions of individuals each year. As such, research informing its prediction and prevention is paramount. Etiological models of IPV perpetration and empirical findings suggest that emotion regulation (ER) is associated with IPV perpetration. Further, research has suggested that depending on ER conceptualization, ER may predict either increased (e.g., risk factor) or decreased IPV perpetration (e.g., protective factor). Despite its documented association with IPV perpetration, and amenability to intervention, ER's aggregate association with IPV perpetration has not been evaluated. The present systematic review and meta-analysis analyzes ER's association with IPV perpetration. Two hundred and sixty-five effect sizes from 62 unique samples were included for analysis. Results suggested a small to moderate association between ER and IPV perpetration, the magnitude of which varied by ER construct, whether ER predicted increased or decreased IPV perpetration, and the type of IPV perpetration measured. The magnitude of association between ER and IPV perpetration did not vary by sample type or gender. Implications of these findings were reviewed in the context of meta-theoretical and clinically-focused models of IPV perpetration and suggestions for future research were explored.

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.

Childhood Maltreatment and Use of Aggression among Veterans with Co-occurring PTSD and Alcohol Use Disorder: The Mediating Role of Hostile Cognitions

History of childhood maltreatment is common among military veterans, particularly those with posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Childhood maltreatment is associated with negative psychosocial outcomes, including use of aggression during adulthood. Prior research has identified maladaptive cognitions as a key mediating variable in the association between early life trauma and aggression. Given the high rates of comorbid PTSD and AUD among veterans and the increased risk of aggression when these conditions co-occur, it is critical to examine malleable intervention targets, such as maladaptive cognitions, for this population. The current secondary analyses examined the mediating role of hostile cognitions on the associations between childhood maltreatment and adulthood aggression in a sample of dually diagnosed veterans. Participants were veterans with co-occurring PTSD and AUD (N = 73) who were enrolled in a larger randomized controlled laboratory trial. Participants completed self-report measures of childhood maltreatment, hostile cognitions, and aggressive behavior. Three models were tested to examine the mediating effect of hostility on the associations between childhood maltreatment, abuse, and neglect on aggression. Results indicated that hostility fully mediated the effect of maltreatment on aggression and partially mediated the effect of childhood abuse on aggression. The effect of childhood neglect on aggression was nonsignificant. Hostile cognitions may be a critical intervention target for veterans with co-occurring PTSD and AUD and history of childhood maltreatment, particularly for those who have experienced higher levels of childhood abuse.

A randomized controlled trial examining the effects of intranasal oxytocin on alcohol craving and intimate partner aggression among couples

BACKGROUND

While alcohol use disorder (AUD) is a well-established risk factor for intimate partner aggression (IPA), effective treatments for co-occurring AUD and IPA (AUD/IPA) are lacking. Oxytocin is one promising pharmacological candidate for AUD/IPA given its potential to modulate social behavior and attenuate alcohol use. However, emerging data suggests that oxytocin's prosocial effects are inconsistent, and a small number of studies have also found that oxytocin might have the potential to be aggressogenic. No studies have directly examined the impact of oxytocin on alcohol- or IPA-related outcomes in a dyadic context.

METHODS

The goal of this double-blind, randomized, and placebo-controlled trial was to examine the effects of a single dose of intranasal oxytocin (40 international units) on cue-induced alcohol craving, subjective aggression, laboratory task-based IPA, and cortisol reactivity in a sample of 100 couples (N = 200 individuals) with AUD and physical IPA in their current relationship.

RESULTS

There were no statistically significant differences between the oxytocin and placebo conditions for any of the primary outcomes.

CONCLUSIONS

Findings suggest that a single dose of intranasal oxytocin was not efficacious in mitigating alcohol craving or aggression in this sample. Although hypotheses were not supported, the findings provide important evidence that oxytocin was not aggressogenic in this high-risk sample. Future research investigating dispositional and contextual moderators of oxytocin response in addition to the therapeutic effects of more intensive oxytocin dosing or administration strategies on alcohol craving and aggression is warranted.

Impulsivity and Perpetration of Intimate Partner Aggression: The Moderating Effects of Negative Affective State and Alcohol

Background: The goal of this study was to test the interactive effects of negative urgency, state negative affect, and alcohol intoxication on intimate partner aggression (IPA) perpetration. Methods: Heavy drinkers who recently perpetrated IPA completed self-report measures of impulsivity, were administered an alcohol or control beverage, and completed a laboratory aggression task. State negative affect was assessed unobtrusively via the Facial Action Coding System. Results: Consistent with our prediction, negative urgency was significantly and positively related to IPA when state negative affect was also high, but this relation was not significant when state negative affect was low. Conclusions: These results have implications for understanding the role of negative affect and impulsivity in IPA perpetration and for understanding trait models of impulsivity in general.

The instigating effects of isolation on substance-related intimate partner violence: A review

In this article, we examine the empirical and theoretical support for the idea that experiences of isolation can intensify substance use, even among those in committed close relationships, and can increase the likelihood of negative conflict behaviors, including intimate partner violence (IPV). Cross-sectional, longitudinal, and laboratory-based research suggest that individuals and couples who report experiences of social exclusion and have fewer social supports experience more mental health problems, more negative emotional experiences, and higher levels of stress. These negative outcomes spur coping efforts to reduce these distressing states, which often involve pain-relieving substances such as alcohol. We describe how dynamic models of relationship conflict and IPV can integrate alcohol and substance use patterns among both individuals and couples to understand and predict contexts leading to conflict escalation and IPV perpetration.