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CORK Bibliography: Domestic Violence

69 citations. January 2007 to present

Prepared: March 2009

Ackerson LK; Kawachi I; Barbeau EM; Subramanian SV. Exposure to domestic violence associated with adult smoking in India: A population based study. Tobacco Control 16(6): 378-383, 2007. (49 refs.)

Objective: To investigate the relation between domestic violence and tobacco use among adults in India. Design: Multilevel cross sectional analyses of a nationally representative population based sample from the 1998-9 Indian national family health survey. Participants: 278,977 individuals aged 15 or older; and 89,092 ever married women aged 15-49. Main outcome: Dichotomous variables for smoking and chewing tobacco. Results: Women who reported being abused more than one year ago and those who reported being abused in the past year were more likely to smoke and chew tobacco than women who have never experienced domestic violence. Compared to individuals who lived in homes where no abuse was reported, those who lived in homes where a woman reported experiencing domestic violence were more likely to smoke and chew tobacco. Conclusion: Domestic violence is associated with higher odds of smoking and chewing tobacco in India. Efforts to control tobacco use need to consider the larger psychosocial circumstances within which individuals who practise such harmful health behaviours reside.

Alvanzo AAH; Svikis DS. History of physical abuse and periconceptional drinking in pregnant women. Substance Use & Misuse 43(8/9): 1098-1109, 2008. (20 refs.)

This study examines the relationship between physical abuse and periconceptional drinking in women presenting to a mid-Atlantic, urban hospital-based OB/GYN clinic serving a largely indigent population between April 2003 and May 2004. During their first prenatal visit, 308 women completed a screening battery that included the Abuse Assessment Screen (AAS) and measures of alcohol use, including the CAGE, T-ACE, TWEAK, and the PRIME-MD Patient Health Questionnaire (PHQ). Bivariate analyses, including odds ratios (ORs) and 95% confidence intervals (CIs), revealed that women with a history of physical abuse were more likely to report drinking alcohol within the 3 months prior to their prenatal care visit and were significantly more likely to meet criteria for risk drinking on multiple measures. A history of physical abuse appears to be associated with higher self-reported rates of periconceptional drinking in pregnant women. Study findings support the need for assessment of abuse history as a potential risk factor for alcohol use in pregnant women.

Angelucci M. Love on the rocks: Domestic violence and alcohol abuse in rural Mexico. B E Journal of Economic Analysis & Policy 8(1): e-article 43, 2008. (43 refs.)

I use experimental data for the evaluation of Oportunidades to study the determinants of domestic violence and alcohol abuse. The program, a combination of cash transfers to women and human capital investments, decreases husbands' alcohol abuse by 15% and changes their aggressive behavior depending on transfer size, husbands' education, and spousal age gap. While small transfers decrease violence by 37% for all households, large transfers increase the aggressive behavior of husbands with traditional views of gender roles, probably because their wife's entitlement to a large transfer threatens their identity. This evidence rejects standard unitary, collective, and bargaining models for this latter group of households. It also shows that, while targeting women as recipients of micro-credit or other welfare programs may have additional beneficial effects by reducing alcoholism and domestic violence in most households, the risk of violence may increase for some.

Armstrong GS; Griffin ML. The effect of local life circumstances on victimization of drug-involved women. Justice Quarterly 24(1): 80-105, 2007. (83 refs.)

While numerous studies have examined female victimization in the general population, fewer studies have focused specifically on high-risk populations such as drug-involved females. Of the existing literature, the Lifestyle Exposure and/or Routine Activities theory is frequently used to examine the antecedent conditions and correlates of female victimization. This study employs a dynamic modeling approach to examine the effect of short-term change (i.e., monthly) in local life circumstances on female victimization within a criminogenic population. Results demonstrated that risk of victimization increased in months a woman was in a relationship, lived with a significant other and/or her children, engaged in criminogenic behavior, or lived in an transitory situation. Contrary to traditional theoretical expectations, conventional employment did not reduce a women's likelihood of victimization.

Bennett L; O'Brien P. Effects of coordinated services for drug-abusing women who are victims of intimate partner violence. Violence Against Women 13(4): 395-411, 2007. (32 refs.)

This article summarizes outcomes from a demonstration project on collaboration between substance abuse and domestic violence agencies. Researchers recruited women seeking services for substance abuse or intimate partner violence at 1 of 6 participating agencies. Admitted women were both victims of domestic violence and abusing alcohol or drugs. Following an initial screening, participants were interviewed at program entry (n = 255) and again 4 to 6 months later (n = 128, 50%). Key outcomes were the number of days substances were used in the past 30 days, women's perceptions of harm from battering, and domestic violence self-efficacy. Results suggest participants used substances less frequently and experienced themselves as more efficacious following services, but they were also more fearful of the consequences of domestic violence. Repeated-measures MANOVA found that Substance abuse days and domestic violence self-efficacy significantly contributed to the multivariate function. Implications for services for women with co-occurring substance abuse and domestic violence victimization are discussed.

Bliss MJ; Ogley-Oliver E; Jackson E; Harp S; Kaslow NJ. African American women's readiness to change abusive relationships. Journal of Family Violence 23(3): 161-171, 2008. (74 refs.)

This study explores 178 low-income, abused African American women's readiness to change abusive relationships and achieve safety. We explore stages of change using Prochaska and DiClemente's transtheoretical model (TM; Precontemplation, Contemplation, Action, Preparation, and Maintenance). Results reveal that: for abused women, the stages fall along a continuum (versus discreet and linear stages); abused women are primarily in the Contemplation stage; and multiple factors (perception of current abuse, number of children in her home, symptoms of general anxiety and posttraumatic stress disorder [PTSD], substance use, spiritual well-being, self-esteem, and social support) affect women's total readiness to change intimate partner violence (IPV). Current IPV, anxiety, PTSD, substance abuse, and spirituality were positively correlated with readiness to change, and children in the home and self-esteem were negatively correlated with readiness to change. Multiple regression analysis revealed that PTSD and spiritual well-being are positive predictors of readiness to change. Findings contribute to the growing body of literature supporting the TM as applied to IPV. Results are discussed in terms of applicability to interventionists, policy makers, and community leaders as they consider the plight of abused women and their efforts towards violence-free relationships.

Branstetter SA; Bower EH; Kamien J; Amass L. A history of sexual, emotional, or physical abuse predicts adjustment during opioid maintenance treatment. Journal of Substance Abuse Treatment 34(2): 208-214, 2008. (37 refs.)

This study examined how having a history of sexual, physical, or emotional abuse is related to overall functioning as assessed by the Addiction Severity Index during short-term opioid maintenance treatment with either buprenorphine/naloxone or methadone. Furthermore, the relation between abuse history and overall functioning by sex was explored. Participants (N = 268) were opioid-dependent adults entering an outpatient randomized clinical trial with buprenorphine/naloxone and methadone. Latent growth modeling indicated that females with an abuse history entered treatment with more problems in the psychiatric and family domains as compared with females without an abuse history. Over the course of treatment, a history of abuse predicted problems in the psychiatric and alcohol domains. Furthermore, a history of abuse predicted slower recovery times and less recovery overall for females in some domains. Males with an abuse history entered treatment with more severe psychiatric and family problems as compared with males with no history of abuse. Victims of abuse may present to substance abuse treatment with weaknesses in the areas of family relations, psychiatric status, and alcohol use. The nature of these problems and their trajectory over time differed by sex.

Brickell K. 'Fire in the house': Gendered experiences of drunkenness and violence in Siem Reap, Cambodia. Geoforum 39(5): 1667-1675, 2008. (94 refs.)

After decades of turmoil and international isolation, Cambodia has embarked on a threefold transition: from armed conflict to peace, from political authoritarianism to liberal democracy, and from a socialist economic system to one based on market-driven capitalist growth. In this context of transition, the paper explores the perceived linkages that exist between drinking, drunkenness and gender-based violence in rural and urban Siem Reap, home to the global tourism site of Angkor. By considering the ways in which men and women relate alcohol use with violence, the paper questions what implications these social constructions have for tackling gender-based violence and concludes that challenging such external explanations for violence is needed in order for gender-based violence to be understood as the struggle for equality in men and women's everyday lives.

Caetano R; Ramisetty-Mikler S; Harris TR. Drinking, alcohol problems and intimate partner violence among white and hispanic couples in the US: Longitudinal associations. Journal of Family Violence 23(1): 37-45, 2008. (47 refs.)

This paper examines longitudinal associations between drinking, alcohol problems and male-to-female (MFPV) and female-to-male partner violence (FMPV) in a national sample of White and Hispanic couples in the United States. The study uses general population household survey longitudinal data collected in 1995 and in 2000. Subjects (18 years or older) constitute a random sample of married and cohabiting couples in the 48 contiguous United States. In 1995, a total of 1,635 couples completed the interview for a response rate of 85%. In 2000, face-to-face interviews were completed with 1,392 couples in their homes. The present analyses include 406 White and 387 Hispanic couples, who remained intact at the follow-up. Alcohol volume, alcohol problems, MFPV and FMPV in 1995 significantly predicted these same behaviors 5 years later. For White couples, female alcohol problems predicted FMPV in 1995. For Hispanics, female alcohol problems predicted FMPV only in 2000. The relationships between the three alcohol variables and MFPV and FMPV are not static, changing across ethnic groups over time. Findings suggest that once a behavior is present, it tends to be a strong predictor of that same behavior in the future.

Charles P; Perreira KM. Intimate partner violence during pregnancy and 1-year post-partum. Journal of Family Violence 22(7): 609-619, 2007. (52 refs.)

Using data on a nationally representative cohort of pregnant women in US cities, this study examines the prevalence and correlates of interpersonal violence (IPV) physical, emotional, and coercion-control-during pregnancy and I year after birth. Overall, 33% of mothers and 40% of fathers experience some form of interpersonal violence during or after pregnancy. Hispanic women and those no longer romantically involved with their children's fathers were most likely to experience interpersonal violence during pregnancy. Less educated women, women who reported that they or their spouses used substances (i.e., alcohol or illicit drugs), and women who reported that their pregnancy was unwanted were at high risk of interpersonal violence both during and after their pregnancy. Violence during pregnancy strongly predicted violence after pregnancy. Recent immigrants were among the least likely to leave a violent relationship 1-year post-partum. US-bom women who were employed during their pregnancy were among the most likely to leave an abusive relationship 1-year post-parturn.

Christian DR; Huber A; Brecht ML; McCann MJ; Marinelli-Casey P; Lord RH; Methamphetamine Treatment Project. Methamphetamine users entering treatment: Characteristics of the Methamphetamine Treatment Project sample. Substance Use & Misuse 42(14): 2207-2222, 2007. (24 refs.)

The Center for Substance Abuse Treatment funded the Metamphetamine Treatment Project to evaluate and compare treatment approaches for methamphetamine users. As part of this study, drug use patterns, history of physical or sexual abuse, history of suicidality, and psychopathology were assessed in 1,016 methamphetamine-dependent outpatients entering treatment between 1999 and 2001 at eight sites across the western United States. The sample was predominately female and racially diverse. The mean age of the participants was 32.8 years. Most were methamphetamine smokers, but there were marked regional variations. Suicidality and physical or sexual abuse were common and measures of current psychopathology were high. These clinical issues were associated with more frequent use of methamphetamine and, more strongly, with concurrent use of other drugs. Therefore, the relationship between polydrug use and psychopathology in methamphetamine users warrants further investigation.

Clark C; Giard J; Fleischer-Bond M; Slavin S; Becker M; Cox A. Creating alcohol and other drug, trauma, and mental health services for women in rural Florida: The Triad Women's Project. Alcoholism Treatment Quarterly 22(3/4): 41-61, 2004

Located in central Florida, the Triad Women's Project is a comprehensive system of care developed to respond to the needs of women and children living in a three-county semi-rural area. The women have histories of abuse or violence, co-occurring alcoholism and other drug (AOD) and mental health disorders, and have been high utililizers of behavioral healthcare services. This paper will describe the efforts of collaborating providers, the women themselves, services researchers, and concerned community members to develop services to assist these women in their AOD recovery, their healing from abuse, and their empowerment in dealing with mental illnesses. Practical information on establishing consensus, dealing with barriers and filling service gaps will be presented.

Cleaver H; Nicholson D; Tarr S; Cleaver D. Child Protection, Domestic Violence and Parental Substance Abuse, Family Experiences and Effective Practice. London: Jessica Kingsley, 2007. (147 refs.)

This book presents findings from a government commissioned study. The group of children and young people studied over a two-year period are those who have lived with domestic violence and/or whose parents/carers have abused substances (alcohol and/or drugs). The goal was to identify how children's social care responds to families where problems require the intervention by both adult and children's services; identify the factors that enable different agencies to work together successfully together at the various stages of assessment, planning and service delivery and review; and finally to examine children and parents' experiences of professional interventions. The book has six chapters (apart from the introduction and conclusions), each of which presents findings from the different data-sets. Overall, findings, whilst not surprising, are very relevant to social work. For example, 50 per cent of parents had �severe difficulty in relation to their parenting capacity� and 81 per cent had �problems in relation to with family history and functioning�. One key finding is the extent of the problems that occurred in inter-agency collaboration with managers reporting confidentiality, a lack of resources, a lack of trust and preconceptions of parents as factors that hindered multi-agency collaboration.

Cunningham R; Walton MA; Tripathi SP; Weber JE; Maio RF; Booth BM. Past-year violence typologies among patients with cocaine-related chest pain. American Journal of Drug and Alcohol Abuse 33(4): 571-582, 2007. (23 refs.)

This study examines a consecutive cohort of patients ( n 219) presenting to an urban Emergency Department (ED) for cocaine- related chest pain ( June 2002 to February 2005). Patients were interviewed regarding violence, substance use, and psychosocial factors. Significant markers of violence were increases in: past- year medical service use, binge drinking, marijuana use, cocaine diagnosis, but not cocaine use days. Rates and correlates of violence differed by relationship type (intimate partner, nonpartner) and role context (victimization, perpetration). Understanding these correlates has public health implications, both for preventing future violence and its associated ED service utilization, and for future interventions in cocaine users presenting to the ED.

Cunradi CB. Drinking level, neighborhood social disorder, and mutual intimate partner violence. Alcoholism: Clinical and Experimental Research 31(6): 1012-1019, 2007. (60 refs.)

Background: Intimate partner violence (IPV) remains a significant public health problem. The purpose of this study is to assess the contribution of drinking patterns to risk for mutual IPV among married/cohabiting adults in the general population, and to determine if the association between drinking level and mutual IPV varies by level of neighborhood social disorder. Methods: The study sample consists of 19,035 non-Hispanic black, Hispanic, and non-Hispanic white married/cohabiting adults who participated in the 2000 National Household Survey on Drug Abuse (NHSDA), and whose responses were available through the NHSDA public use file. Gender-specific multivariate logistic regression models of mutual IPV were developed to assess the association between drinking level and mutual IPV, and to test whether these associations vary by neighborhood social disorder. Results: Compared with men who are abstainers, men who are past-30 day heavy drinkers are at a more than 6-fold increased risk for mutual IPV. Men in less hazardous drinking categories are at a 2- to 3-fold increased risk of mutual IPV. Neighborhood disorder is independently associated with men's risk for mutual IPV (odds ratio=1.61). Except for women in the most hazardous drinking category, neighborhood disorder moderates the association between women's drinking level and risk of mutual IPV such that risk for mutual IPV significantly increases under conditions of high neighborhood disorder, and decreases to insignificant risk under conditions of low neighborhood disorder. Compared with abstainers, women who are past-30 day heavy drinkers are at an approximate 6-fold risk for mutual IPV regardless of level of neighborhood disorder. Conclusions: Drinking level and neighborhood characteristics should be taken into account when assessing risk for mutual IPV among married/cohabiting men and women in the general population. An environmental approach to IPV prevention and intervention which addresses the neighborhood context in which couples reside may be a promising strategy for reducing IPV occurrence.

Cunradi CB; Ames GM; Moore RS. Prevalence and correlates of intimate partner violence among a sample of construction industry workers. Journal of Family Violence 23(2): 101-112, 2008. (51 refs.)

This study assessed the prevalence and correlates of intimate partner violence (IPV) among a sample of unionized construction industry workers, and tested the reliability of new measures of IPV normative beliefs. Study participants (n=100) voluntarily completed confidential and anonymous self-administered questionnaires that measured occupational factors, hazardous drinking, and normative beliefs. Measurement of past-year IPV was based on the Conflict Tactics Scale, Form R. Measures of IPV normative beliefs showed good reliability (Cronbach's alpha 0.94-0.95). Past-year IPV prevalence was 26%. Logistic regression models were developed to assess the contribution of each factor to risk of past-year IPV perpetration. Perceived workplace racial/ethnic discrimination, job strain, interpersonal workplace conflict, normative beliefs, and hazardous drinking were positively associated with elevated IPV risk.Construction industry workers may have higher rates of IPV compared to general population samples that represent various occupations and social classes. Occupational factors appear to be significant correlates of IPV among these workers.

Datner EM; Wiebe DJ; Brensinger CM; Nelson DB. Identifying pregnant women experiencing domestic violence in an urban emergency department. Journal of Interpersonal Violence 22(1): 124-135, 2007. (17 refs.)

The article describes characteristics of pregnant women presenting to the Emergency Department (ED) who are experiencing current violence and presented a screening tool to identify pregnant women experiencing violence. Women completed an in-person interview regarding violence, socio-demographic factors, health status, and drug use. Fifteen percent of women reported at least one episode of violence during the pregnancy. Young age (OR = 3.37, 95% CI: 1.79-6.36), current alcohol use (OR = 1.53, 95% CI: 1.06-2.19), current marijuana use (OR = 1.96, 95% CI: 1.32-2.92), less than a high school education (OR = 1.46, 95% CI: 1.01-2.12), and a prior diagnosis of trichomonas (OR = 1.81, 95% CI: 1.20-2.72) were significantly related to experiencing current violence. Screening patients using these five characteristics identified 8 out of 10 women reporting violence (sensitivity 75.6%). These results identify a set of predictors that may be helpful in identifying pregnant women who are experiencing current domestic violence.

Easton CJ; Lee B; Wupperman P; Zonana H. Substance abuse and domestic violence interventions: The need for theoretical based research. (letter). American Journal on Addictions 17(4): 341-342, 2008. (7 refs.)

Easton CJ; Sacco KA; Neavins TM; Wupperman P; George TP. Neurocognitive performance among alcohol dependent men with and without physical violence toward their partners: A preliminary report. American Journal of Drug and Alcohol Abuse 34(1): 29-37, 2008. (28 refs.)

Ojective: There are high rates of co-occurring alcohol dependence and intimate partner violence (IPV) among men seeking substance abuse treatment. The authors examined neurocognitive performance among treatment-seeking alcohol dependent men with (IPV+) and without reported physical violence (IPV-). Method: Twenty-five subjects participated in this pilot study. All participants underwent a neurocognitive battery including, Continuous Performance Test (CPT), California Verbal Learning Test (CVLT), Digit Span, Iowa Gambling Test (IGT), Wisconsin Card Sort (WCST), Trail Making Test, Parts A B, a visuospatial memory (VSWM) task and the Stroop Color Word Test (SCWT). Result: Alcohol dependent participants with IPV (IPV+; n=9) had more severe deficits in attention, concentration, cognitive flexibility compared to controls (n=7). Both the alcohol dependent (IPV-; n=9) and IPV+groups had significantly more impairments on tasks of impulsivity than the smoking controls. The IPV-group had significantly more impairments on executive functioning compared to smoking controls, but was not significantly different than the IPV+group. Conclusions: Our preliminary results suggests that IPV+males have more severe neuropsychological impairments compared to the smoking control group than did the IPV-group. The implications of these findings are discussed.

Easton CJ; Weinberger AH; McKee SA. Cigarette smoking and intimate partner violence among men referred to substance abuse treatment. American Journal of Drug and Alcohol Abuse 34(1): 39-46, 2008. (14 refs.)

This study examined differences between alcohol-dependent offenders of intimate partner violence (IPV) with and without current daily cigarette smoking. Eighty-five alcohol dependent men arrested for domestic and referred to substance abuse treatment were evaluated. A total of 71% of the participants reported current cigarette smoking. The groups were divided into daily smokers (n=52) vs. non-daily smokers (n=21). Daily smokers had significantly more days of alcohol use in the 28 days prior to starting treatment, significantly more ASI alcohol and legal severity, and significantly more participants with a diagnosis of antisocial personality disorder compared to non-daily smoking alcohol dependent offenders of IPV.

Egan V; Hamilton E. Personality, mating effort and alcohol-related violence expectancies. Addiction Research & Theory 16(4): 369-381, 2008. (56 refs.)

The current study investigated whether scores on the Alcohol Related Aggression Questionnaire (ARAQ) were predictable from the independent influences of personality and intra-sexual competition as measured by the mating effort scale (MES) and whether education had a protective factor in any relationship that arose. Ninety-five participants completed personality, MES and ARAQ scales. Hierachical linear regression independently entering MES followed by agreeableness, conscientiousness, age, education and sex found alcohol-aggression expectancies were predicted by higher MES and younger age; alcohol-related trait aggression was predicted by higher MES, lower agreeableness and younger age; alcohol-related sensitivity to pain and anxiety was related to higher MES and younger age; an expectation of drinking cheap but high potency alcoholic beverages was primarily associated with higher MES alone. These results show that mating effort has a disproportionate influence upon different facets of alcohol-aggression expectancies relative to even established constructs such as personality, and that much of alcohol-related violence in social contexts, may reflect intra-sexual competition and forces within the individual that lead them to discount the future.

Fanslow J; Silva M; Robinson E; Whitehead A. Violence during pregnancy: Associations with pregnancy intendedness, pregnancy-related care, and alcohol and tobacco use among a representative sample of New Zealand women. Australian & New Zealand Journal of Obstetrics & Gynaecology 48(4): 398-404, 2008. (28 refs.)

Aim: To explore the extent of intimate partner violence during pregnancy and its association with pregnancy intendedness and pregnancy-related behaviours among a representative sample of New Zealand women. Methods: Face-to-face interviews were conducted with a representative sample of 2391 women who had ever been pregnant, aged 18-64 years old in two regions (urban and rural) in New Zealand. Results: Six per cent of urban women and 9% of rural women had ever experienced violence during pregnancy): approximately 40% of these had experienced violence in more than one pregnancy. Women who had experienced violence in pregnancy, compared with those who had not, were less likely to report their last pregnancy had been wanted at that time (28% vs 55%), and less likely to report that their partner wanted the pregnancy (40% vs 57%). Antenatal and postnatal care attendance was almost universal during the last pregnancy. Women who had experienced violence during pregnanc,y were more likely to smoke tobacco during pregnancy (67% vs 22%, P < 0.0001), and more commonly, consumed alcohol (31% vs 20%, not significant). For the most recent pregnancy in which women had experienced violence, most was perpetrated by the child's biological father (96%), and most women (74%) reported that the same man had also beaten her before she was pregnant. Conclusions: Violence during pregnancy is a significant problem for New Zealand women, with negative health implications for both women and their children. Active intervention and support is necessary to mitigate potential consequences.

Fawole AO; Hunyinbo KI; Fawole OI. Prevalence of violence against pregnant women in Abeokuta, Nigeria. Australian & New Zealand Journal of Obstetrics & Gynaecology 48(4): 405-414, 2008. (35 refs.)

Aim: To determine the prevalence of violence to pregnant women within 12 months prior to and during the Current pregnancy. Methods: Cross-sectional study of 534 pregnant women attending three secondary and one tertiary health facility in Abeokuta, Nigeria using semistructured interviewer-administered questionnaires. Results: Prevalence of violence within 12 months prior to pregnancy was 14.2%. Polygamous union, low level of education in both woman and partner and consumption of alcohol by partners were significant (P < 0.05) risk factors of violence prior to pregnancy. Verbal abuse was the most common (66.2%) type of abuse. Others included flogging (10.8%), slaps (9.5%), threats of violence (6.8%) and forced sexual intercourse (2.7%). The perpetrators were often husbands (65.8%) and the parents (15.8%). Some 2.3% of pregnant women had experienced violence during current pregnancy. Low level of education was significantly (P < 0.05) associated with experiencing violence during pregnancy. Although almost 25% of the pregnancies were unplanned, this was not significantly associated with experiencing violence (P > 0.05). There were similarities in the perpetrators and forms of violence experienced before and during pregnancy, with partners being the most common perpetrators. Conclusion: Gender-based violence is common in our environment. Health-care providers should routinely screen for gender-based violence during antenatal visits in order to protect the health of both mother and child.

Feingold A; Kerr DCR; Capaldi DM. Associations of substance use problems with intimate partner violence for at-risk men in long-term relationships. Journal of Family Psychology 22(3): 429-438, 2008. (28 refs.)

Associations of substance use problems in men -- defined as a man's meeting at least I criterion of dependence on each of a number of substances by his mid-20s -- with their perpetration of intimate partner violence (IPV) were examined in an at-risk community sample of 150 men in long-term relationships from their late adolescence to their late 20s. Men who had a problem with substances other than sedatives (especially cannabis and hallucinogens) committed more IPV than did men without such problems. Most of the men who had a problem with marijuana also had an alcohol problem, which explains why alcohol was found to have only an indirect association with IPV. The failure of previous alcohol-use studies to control for co-occurrence of alcohol and marijuana problems may explain the discrepancy with conclusions from past research that alcohol problems contribute directly to the perpetration of IPV.

Fingerhood MI. Co-morbid medical disorders. IN: Strain EC; Stitzer ML, eds. The Treatment of Opioid Dependence. Baltimore: Johns Hopkins University Press, 2006. pp. 398-420. (65 refs.)

This chapter focuses on the provision of medical care to individuals receiving opioid agonist medications. It considers the issues related to health maintenance, and the multiple medical complications. Among those with a history of intravenous use, there are special concerns related to the route of administration -- including viruses from needle sharing as well as the soft tissue infections from injecting technique. These problems are not restricted to those involved with opiates, but also common in cocaine users. The chapter begins with an overview of basic primary care, with attention to medical history and physical exam. It then turns of matters related to prescribing, pain management, and drug interactions with methadone, that may have an impact on blood levels or alter methadone's effects. Also specifically addressed are skin and soft tissue infections, HIV/AIDS, sexually transmitted disease, hepatitis, as well as cardiac, pulmonary, renal, neurological, and immunologic complications, and for women concerns related to domestic violence.

Foran HM; O'Leary KD. Problem drinking, jealousy, and anger control: Variables predicting physical aggression against a partner. Journal of Family Violence 23(3): 141-148, 2008. (37 refs.)

Alcohol use and intimate partner violence (IPV) are significantly related, but only a subset of individuals who drink are aggressive and relatively little is known about what moderates this relationship in community samples. Two risk factors, anger control and jealousy, were hypothesized to moderate the relationship between IPV and problem drinking in a sample of 453 community couples. A significant three-way interaction indicated that men with jealousy problems, but not anger control problems, were most likely to show the strongest association between problem drinking and IPV. In accord with the multiple threshold model of IPV, specific combinations of risk factors appeared to represent different thresholds in which problem drinking influenced the likelihood of IPV.

Fowler D. The extent of substance use problems among women partner abuse survivors residing in a domestic violence shelter. Family & Community Health 30(1, Supplement S): s106-s108, 2007. (15 refs.)

The article provides information on the results of research on the extent of substance use problems among women intimate partner (IPA) abuse survivors residing in a domestic violence shelter. It states that approximately 38% to 85% in various samples of women are experiencing coocurrence of IPA and substance abuse which often lead to injury, mental illness and death.

Frye V; Latka MH; Wu YF; Valverde EE; Knowlton AR; Knight KR; INSPIRE Study Team. Intimate partner violence perpetration against main female partners among HIV-positive male injection drug users. Journal of Acquired Immune Deficiency Syndromes 46(Supplement 2): S101-S109, 2007. (68 refs.)

Intimate partner violence (IPV) against women is a serious public health and social problem and is associated with a host of adverse health outcomes and behaviors, HIV risk behaviors included, among women who are victimized. Historically, research has focused on correlates of IPV victimization among women; thus, there is less information on the role of men in perpetrating IPV, particularly among men at risk for transmitting HIV to their female partners. We assessed the self-reported prevalence and correlates of perpetration and threat of perpetration of physical and/or sexual IPV against a main female partner among 317 HIV-positive men who were current injection drug users (IDUs). More than 40% of men reported perpetrating physical (39%) and/or sexual (4%) violence against their main female partners in the past year. Multivariate analyses revealed that low education, homelessness, psychologic distress, and unprotected sex with main and nonmain HIV-negative female partners were positively associated with IPV perpetration against main female partners. These findings reveal that IPV perpetration is prevalent among HIV-positive male IDUs and associated with sexual HIV transmission risk behaviors. IPV assessment and treatment among HIV-positive men in HIV care is recommended as a way to prevent IPV perpetration and victimization and to reduce potential HIV transmission.

Galvani SA. Safety in numbers? Tackling domestic abuse in couples and network therapies. Drug and Alcohol Review 26(2): 175-181, 2007. (53 refs.)

Family, network or couples-based therapies have been helping to support people with substance problems for decades. Their value in supporting a person to change their alcohol or drug use is clear. However, as links between substance use and domestic abuse are increasingly recognised, these approaches need to reflect on the potential safety risks they present to people taking part. The prevalence of domestic abuse among people receiving drug and alcohol services is considerably higher than general population estimates, yet this does not appear to have been adequately addressed in network therapies. This article suggests that this needs to change and that safety of service users needs to be at least as important as the intervention itself. It offers for debate a number of potential safety issues raised by network therapies where there is evidence of domestic abuse; it provides examples of three approaches used to marshal social and network support in substance interventions; and offers a number of suggestions for how network therapies can ensure their use remains safe and supportive where there is domestic abuse.

Galvani SA. Safety in numbers? Tackling domestic abuse in couples and network therapies. Drug and Alcohol Review 26(2): 175-181, 2007. (53 refs.)

Family, network or couples- based therapies have been helping to support people with substance problems for decades. Their value in supporting a person to change their alcohol or drug use is clear. However, as links between substance use and domestic abuse are increasingly recognised, these approaches need to reflect on the potential safety risks they present to people taking part. The prevalence of domestic abuse among people receiving drug and alcohol services is considerably higher than general population estimates, yet this does not appear to have been adequately addressed in network therapies. This article suggests that this needs to change and that safety of service users needs to be at least as important as the intervention itself. It offers for debate a number of potential safety issues raised by network therapies where there is evidence of domestic abuse; it provides examples of three approaches used to marshal social and network support in substance interventions; and offers a number of suggestions for how network therapies can ensure their use remains safe and supportive where there is domestic abuse.

Gielen AC; Ghandour RM; Burke JG; Mahoney P; McDonnell KA; O'Campo P. HIV/AIDS and intimate partner violence: Intersecting women's health issues in the United States. Trauma Violence and Abuse 8(2, Special Issue): 178-198, 2007. (52 refs.)

This article reviews 35 U.S. studies on the intersection of HIV and adult intimate partner violence (IPV). Most studies describe rates of IPV among women at risk or living with HIV/AIDS and identify correlates, using multiple types of convenience samples (e.g., women in methadone treatment, women in shelters or clinics), cross-sectional designs, and self-reported risk behaviors. HIV-positive women appear to experience any IPV at rates comparable to HIV-negative women from the same underlying populations; however, their abuse seems to be more frequent and more severe. The authors found only four relevant interventions and none addressed sexually transmitted HIV and partner violence risk reduction simultaneously. There is a critical need for research on (a) causal pathways and cumulative effects of the syndemic issues of violence, HIV, and substance abuse and (b) interventions that target IPV victims at risk for HIV, as well as HIV-positive women who may be experiencing IPV.

Glass N; Perrin N; Hanson G; Bloom T; Gardner E; Campbell JC. Risk for reassault in abusive female same-sex relationships. American Journal of Public Health 98(6): 1021-1027, 2008. (34 refs.)

Objectives. We revised the Danger Assessment to predict reassault in abusive female same-sex relationships. Methods. We used focus groups and interviews to evaluate the assessment tool and identify new risk factors and telephone interviews at baseline and at 1-month follow-up to evaluate the revised assessment. Results. The new assessment tool comprised 8 original and 10 new items. Predictors included increase in physical violence (relative risk ratio [RRR] = 1.95; 95% confidence interval [CI]=0.84, 4.54), constant jealousy or possessiveness of abuser (RRR = 4.07; 95% CI = 0.61, 27.00), cohabitation (RRR = 1.96; 95% CI = 0.54, 7.12), threats or use of gun by abuser (RRR=1.93; 95% 0=039, 4.75), alcoholism or problem drinking of abuser (RRR = 1.47; 95% CI =0.79, 2.71), illegal drug use or abuse of prescription medications by abuser (RRR = 1.33; 95% CI = 0.72, 2.46), stalking by abuser (RRR = 1.39; 95% CI = 0.70, 2.76), failure of individuals to take victim seriously when she sought help (RRR 1.66; 95% CI 0.90, 3.05), victim's fear of reinforcing negative stereotypes (RRR 1.42; 95% CI 0.73, 2.77), and secrecy of abuse (RRR=1.72; 95% CI=0.74, 3.99). Both unweighted (P <.005) and weighted (P <.004) versions of the revised assessment were significant predictors of reassault. Conclusions. The revised Danger Assessment accurately assesses risk of reassault in abusive female relationships.

Gonzaalez-Guarda RM; Peragallo N; Urrutia MT; Vasquez EP; Mitrani VB. HIV risks, substance abuse, and intimate partner violence among Hispanic women and their intimate partners. JANAC. Journal of the Association of Nurses in AIDS Care 19(4): 252-266, 2008. (49 refs.)

Hispanic women in the United States are disproportionately affected by HIV infection. Substance abuse and intimate partner violence (IPV) are conditions that have been associated with risk for HIV in the general population. However, few studies have explored the intersection of these three conditions within one integrated framework. The purpose of this exploratory study was to describe the relationships between HIV risks, substance abuse, and IPV among Hispanic community-dwelling women. A total of 82 structured interviews were conducted with Hispanic women between the ages of 18 and 60. Data regarding the participant's and her partner's histories of sexually transmitted infections, substance abuse, risky sexual behaviors, and IPV were collected. Relationships between the participant's history of sexually transmitted infections, her partner's substance abuse, risky sexual behaviors, and IPV were explored. Results from this study support the importance of targeting HIV, substance abuse, and IPV prevention among Hispanics within one integrated framework.

Gulati JK. Wife's employment, husbands' alcohol abuse and marital conflict deportment in rural poor families. Man in India 86(3-4): 255-264, 2006. (24 refs.)

The study examined the relationship between wife's employment and marital conflict behavioural patterns in-rural poor households in alliance with husband's alcohol abuse status. Marital conflict behaviour was assessed through three tactic measures i.e. inter-spouse reasoning, verbal aggression and physical violence. The study was based on poverty-stricken rural intact families of Ludhiana district of Punjab. Results revealed that majority of the families displayed high verbal and physical aggression but low reasoning among spouses in poor families. Alcoholism was also seen at an alarming rate in these families. Men were more verbally aggressive and violent as compared to women, whereas wives used more reasoning as a conflict tactic than their husband. Men were more alcoholic if they had working wife, because alcoholism was directly related to wife's employment. Wife's working status was also directly associated with all forms of marital conflict behaviour among the spouses, but significant correlation was observed between her employment and her own use of reasoning as well as verbally aggressive behaviour towards her husband. Correlation analysis for two types of families separately indicated that all forms of marital conflict behaviour were more strongly correlated with husbands' alcohol abuse in working women's families. Women's physical violence as a conflict tactic was significantly associated with husband's alcohol abuse whereas her verbal aggression was not.

Hamburger ME; Leeb RI; Swahn MH. Childhood maltreatment and early alcohol use among high-risk adolescents. Journal of Studies on Alcohol and Drugs 69(2): 291-295, 2008. (28 refs.)

Objective: Child maltreatment (CM) is prevalent among US. youth and has been associated with subsequent maladaptive behaviors, including substance use. The current study examines the associations between early child maltreatment and (1) preteen alcohol-use initiation and (2) heavy episodic drinking among students in a large study of adolescents. Method: The Youth Violence Survey is a cross-sectional survey of public school students enrolled in Grades 7, 9, 11, and 12 in a school district in a high-risk community. The analysis sample was limited to students who provided complete data on all relevant variables (N = 3,559). Fifty-two percent of the analysis sample was female. Early child maltreatment was defined as witnessing domestic violence and experiencing physical and/or sexual abuse before the age of 10 years. Outcome variables include ever drinking alcohol, preteen alcohol-use initiation, and heavy episodic drinking. Results: Witnessing domestic violence, experiencing physical abuse, and experiencing sexual abuse were significantly associated with preteen alcohol-use initiation (adjusted odds ratio [AOR] = 1.55, 95% confidence interval [CI]: 1.26-1.91; AOR = 2.10, 95% CI: 1.69-2.63; AOR = 1.57, 95% CI: 1.16-2.14, respectively). Students who experienced one or more types of maltreatment were 1.5-3 times more likely to report preteen alcohol-use initiation. Heavy episodic drinking was associated only with childhood sexual abuse in boys (AOR = 2.62, 95% CI: 1.52-4.50). Conclusions: Prevention and treatment of the negative impact of early child maltreatment may delay and reduce alcohol use.

Hellmuth JC; Follansbee KW; Moore TM; Stuart GL. Reduction of intimate partner violence in a gay couple following alcohol treatment. Journal of Homosexuality 54(4): 439-448, 2008. (35 refs.)

Although intimate partner violence among heterosexual couples is a growing topic of investigation, there remains a critical deficiency in the amount of research on violence and relationship functioning in gay men. This article presents baseline and follow-up data on a case study examining the effects of partial hospital alcohol treatment on one gay couple. This information may be helpful in understanding the relationship between alcohol use, violence, and relationship functioning in this population. On the basis of past research involving heterosexual couples as participants, we predicted that subsequent to one patient receiving alcohol treatment: 1) alcohol consumption would be reduced; 2) there would be a reduction in the amount of psychological aggression between partners; 3) there would be a reduction in the frequency of physically violent episodes; and 4) an overall improvement in relationship satisfaction would be evident. The couple was followed-up 6 and 12 months following the patient's alcohol treatment. The results indicate a decrease in alcohol use as well as reduced physical and psychological aggression, but no increase in relationship satisfaction. This case illustration may provide insight into the context surrounding intimate partner violence and relationship functioning in gay couples, with implications for further research and treatment.

Hines DA; Brown J; Dunning E. Characteristics of callers to the domestic abuse helpline for men. Journal of Family Violence 22(2): 63-72, 2007. (32 refs.)

Intimate partner violence (IPV) by women against men has been the subject of much debate. Feminists typically argue that IPV is committed only by men against women. Others argue that violence is a human problem and women also commit much IPV. To resolve these debates, IPV has been classified into two categories: common couple violence captured by population-based studies, and patriarchal terrorism, captured by studies of battered women. This typology ignores male victims of extreme IPV. The current study addresses this omission by describing 190 male callers to the Domestic Abuse Helpline for Men. All callers experienced physical abuse from their female partners, and a substantial minority feared their wives' violence and were stalked. Over 90% experienced controlling behaviors, and several men reported frustrating experiences with the domestic violence system. Callers' reports indicated that their female abusers had a history of trauma, alcohol/drug problems, mental illness, and homicidal and suicidal ideations.

Jun HJ; Rich-Edwards JW; Boynton-Jarrett R; Wright RJ. Intimate partner violence and cigarette smoking: Association between smoking risk and psychological abuse with and without co-occurrence of physical and sexual abuse. American Journal of Public Health 983(3): 527-535, 2008. (59 refs.)

Objectives. We examined the association between psychological abuse in a current relationship and current cigarette smoking among women, with and without the co-occurrence of physical or sexual abuse. Methods. Women's experience of psychological abuse, experience of physical or sexual abuse, and smoking status were ascertained through a survey of female nurses. A score of 20 or more on the Women's Experience With Battering scale defined psychological abuse. We used logistic regression to predict current smoking, adjusting for demographic and social covariates. Analyses included women in a current relationship (n = 54 200). Results. Adjusted analyses demonstrated that women experiencing only psychological abuse alone were 33% (95% confidence interval [CI] = 13%, 57%) more likely to smoke than nonabused women. Compared with nonabused women, psychologically abused women's risk of smoking was greater if they reported a single co-occurrence of physical or sexual abuse (odds ratio [OR] = 1.5; 95% CI = 1.3, 1.8) or multiple co-occurrences (OR = 1.9; 95% CI = 1.7, 2.3). Conclusions. Psychological abuse in a current relationship was associated with an increased risk of smoking in this cohort of largely White, well-educated, and employed women. The co-occurrence of physical or sexual abuse enhanced that risk. Further research is needed to see if these associations hold for other groups.

Karamagi CAS; Tumwine JK; Tylleskar T; Heggenhougen K. Intimate partner violence against women in eastern Uganda: implications for HIV prevention. BMC Public Health 6(article 284), 2006. (48 refs.)

Background: We were interested in finding out if the very low antenatal VCT acceptance rate reported in Mbale Hospital was linked to intimate partner violence against women. We therefore set out to i) determine the prevalence of intimate partner violence, ii) identify risk factors for intimate partner violence and iii) look for association between intimate partner violence and HIV prevention particularly in the context of the prevention of mother-to-child transmission of HIV programme (PMTCT). Methods: The study consisted of a household survey of rural and urban women with infants in Mbale district, complemented with focus group discussions with women and men. Women were interviewed on socio-demographic characteristics of the woman and her husband, antenatal and postnatal experience related to the youngest child, antenatal HIV testing, perceptions regarding the marital relationship, and intimate partner violence. We obtained ethical approval from Makerere University and informed consent from all participants in the study. Results: During November and December 2003, we interviewed 457 women in Mbale District. A further 96 women and men participated in the focus group discussions. The prevalence of lifetime intimate partner violence was 54% and physical violence in the past year was 14%. Higher education of women ( OR 0.3, 95% CI 0.1 - 0.7) and marriage satisfaction ( OR 0.3, 95% CI 0.1 - 0.7) were associated with lower risk of intimate partner violence, while rural residence ( OR 4.4, 95% CI 1.2 - 16.2) and the husband having another partner ( OR 2.4, 95% CI 1.02 - 5.7) were associated with higher risk of intimate partner violence. There was a strong association between sexual coercion and lifetime physical violence ( OR 3.8, 95% CI 2.5 - 5.7). Multiple partners and consumption of alcohol were major reasons for intimate partner violence. According to the focus group discussions, women fear to test for HIV, disclose HIV results, and request to use condoms because of fear of intimate partner violence. Conclusion: Intimate partner violence is common in eastern Uganda and is related to gender inequality, multiple partners, alcohol, and poverty. Accordingly, programmes for the prevention of intimate partner violence need to target these underlying factors. The suggested link between intimate partner violence and HIV risky behaviours or prevention strategies calls for further studies to clearly establish this relationship.

Kaysen D; Dillworth TM; Simpson T; Waldrop A; Larimer ME; Resick PA. Domestic violence and alcohol use: Trauma-related symptoms and motives for drinking. Addictive Behaviors 32(6): 1272-1283, 2007. (38 refs.)

Alcohol use is frequently associated with posttraumatic stress disorder (PTSD), especially in the face of chronic traumatic experiences. However, the relationship between alcohol use and symptoms associated with chronic trauma exposure has not been evaluated. This study examined alcohol use in recently battered women (N=369). Differences were found in trauma symptoms between abstainers, moderate drinkers, and heavy drinkers, with heavy drinkers reporting more severe symptoms. Mediational analyses suggest that the relationship between drinking and trauma symptoms is mediated by drinking to cope, which has not been previously demonstrated in a battered population. Results suggest the importance of assessing trauma symptoms and motives for drinking in understanding alcohol use in recent survivors of domestic violence.

Klostermann KC. Substance abuse and intimate partner violence: Treatment considerations. (review). Substance Abuse Treatment, Prevention, and Policy 1: article 24, 2006. (50 refs.)

Given the increased use of marital- and family-based treatments as part of treatment for alcoholism and other drug disorders, providers are increasingly faced with the challenge of addressing intimate partner violence among their patients and their intimate partners. Yet, effective options for clinicians who confront this issue are extremely limited. While the typical response of providers is to refer these cases to some form of batterers' treatment, three fundamental concerns make this strategy problematic: (1) most of the agencies that provide batterers' treatment only accept individuals who are legally mandated to complete their programs; (2) among programs that do accept nonmandated patients, most substance-abusing patients do not accept such referrals or drop out early in the treatment process; and (3) available evidence suggests these programs may not be effective in reducing intimate partner violence. Given these very significant concerns with the current referral approach, coupled with the high incidence of IPV among individuals entering substance abuse treatment, providers need to develop strategies for addressing IPV that can be incorporated and integrated into their base intervention packages.

Kunins H; Gilbert L; Whyte-Etere A; Meissner P; Zachary M. Substance abuse treatment staff perceptions of intimate partner victimization among female clients. Journal of Psychoactive Drugs 39(3): 251-257, 2007. (22 refs.)

Providing intimate partner violence (IPV)-related services to women enrolled in substance abuse treatment programs has the potential to reach a population disproportionately affected by IPV. Integrating basic IPV services into substance abuse treatment, however, poses challenges to organizations and staff. Using focus groups, the authors examined the experiences and attitudes of substance abuse treatment staff towards clients with IPV victimization experiences in order to elucidate factors that might affect the implementation of IPV services within substance abuse treatment. Seven focus groups were conducted with staff members from substance abuse treatment programs in New York City. Although participants believed that IPV is common and negatively affects client recovery, they felt competing time demands, complex confidentiality issues, insufficient training and lack of agency leadership would impede their provision of IPV-services. The study suggests that system-level assessment and change is needed to provide IPV-related services in substance abuse treatment settings.

Landsman MJ; Hartley CC. Attributing responsibility for child maltreatment when domestic violence is present. Child Abuse and Neglect 31(4): 445-461, 2007. (40 refs.)

Objective: The purpose of this study was to examine factors that influence how child welfare workers attribute responsibility for child maltreatment and child safety in cases involving domestic violence. Methods: The study used a factorial survey approach, combining elements of survey research with an experimental design. Case vignettes were constructed by randomly assigning characteristics to vignettes believed to be related to assessments about responsibility for child maltreatment. Public child welfare workers were systematically sampled and asked to rate vignettes on male and female caregivers' responsibility for child maltreatment and concerns for safety. Results: The presence of domestic violence significantly affected workers' assessments of the attribution of responsibility and concern for child safety, more so than variables related to child maltreatment. Responsibility for exposing a child to domestic violence differed for males and females, with more factors explaining female responsibility. Substance use by either caregiver was significant in attributing responsibility for physical harm, not watching the child closely enough, and concern for child safety, but not for exposure to domestic violence. Conclusions: Domestic violence appeared to heighten workers' assessments of responsibility for child maltreatment and concerns about child safety, taking precedence over the characteristics of the child maltreatment itself. Battering tends to work against the domestic violence victim in terms of the attribution of responsibility. A greater number of factors affect female responsibility for exposing a child to domestic violence than male responsibility, even though in every case the male was the designated domestic violence batterer.

Lincoln AK; Liebschutz JM; Chernoff M; Nguyen D; Amaro H. Brief screening for co-occurring disorders among women entering substance abuse treatment. Substance Abuse Treatment, Prevention, and Policy 1: article 26, 2006. (52 refs.)

Background: Despite the importance of identifying co-occurring psychiatric disorders in substance abuse treatment programs, there are few appropriate and validated instruments available to substance abuse treatment staff to conduct brief screen for these conditions. This paper describes the development, implementation and validation of a brief screening instrument for mental health diagnoses and trauma among a diverse sample of Black, Hispanic and White women in substance abuse treatment. With input from clinicians and consumers, we adapted longer existing validated instruments into a 14 question screen covering demographics, mental health symptoms and physical and sexual violence exposure. All women entering treatment (methadone, residential and out-patient) at five treatment sites were screened at intake (N = 374). Results: Eighty nine percent reported a history of interpersonal violence, and 70% reported a history of sexual assault. Eighty-eight percent reported mental health symptoms in the last 30 days. The screening questions administered to 88 female clients were validated against in-depth psychiatric diagnostic assessments by trained mental health clinicians. We estimated measures of predictive validity, including sensitivity, specificity and predictive values positive and negative. Screening items were examined multiple ways to assess utility. The screen is a useful and valid proxy for PTSD but not for other mental illness. Conclusion: Substance abuse treatment programs should incorporate violence exposure questions into clinical use as a matter of policy. More work is needed to develop brief screening tools measures for front-line treatment staff to accurately assess other mental health needs of women entering substance abuse treatment

Lipsky S; Caetano R. Is intimate partner violence associated with the use of alcohol treatment services? Results from the National Survey on Drug Use and Health. Journal of Studies on Alcohol and Drugs 69(1): 30-38, 2008. (76 refs.)

Objective: The purpose of this study was to examine (1) the prevalence of alcohol treatment use by intimate partner violence (IPV) type (any IPV, victimization, and perpetration) among problem drinkers and (2) the relationship between alcohol treatment use and IPV by IPV type, in the general population. Method: The sample was drawn from the 2002 National Survey on Drug Use and Health. Black, Hispanic, and non-Hispanic white cohabiting respondents 18-49 years of age and who reported one or more alcohol problems in the past year are included in the analysis. Logistic regression was used to examine the relationship between alcohol treatment use and IPV Results: The prevalence of alcohol treatment use was significantly greater among individuals exposed to IPV regardless of IPV type (7.4%, 7.8%, and 6.9% among those with any IPV victimization, and perpetration, respectively) compared with those without reported IPV (2.8%, 2.8%, and 3.0%, respectively). Any IPV (adjusted odds ratio [AOR] = 1.97, 95% confidence interval [Cl]: 1.06-3.65) and IPV victimization (AOR = 1.93, Cl: 1.00-3.73), but not perpetration, were associated with alcohol treatment use. Male gender, alcohol abuse/dependence, illicit drug abuse/dependence, and serious mental illness were positively and significantly associated with alcohol treatment in all three models. Conclusions: IPV, especially victimization, may have a substantial impact on alcohol treatment services. Findings highlight the potential to identify IPV in alcohol treatment settings and provide referral and intervention services.

Lysova AV; Hines DA. Binge drinking and violence against intimate partners in Russia. Aggressive Behavior 34(4): 416-427, 2008. (50 refs.)

This study is the first to provide information on the association between intimate partner violence (IPV) and binge drinking among Russian university students. Using data from 500 (58% female) university students from the four Russian sites of the International Dating Violence Study, we found gender differences in rates of IPV perpetration and in the association between binge drinking and IPV. Specifically, more females than males perpetrated IPV, and the associations between binge drinking and IPV were stronger for the female students than for the male students. In addition, antisocial traits and behavior (ATSB) were significantly related to both binge drinking and IPV perpetration for males and females. For males, the relatively weak associations between binge drinking and IPV perpetration disappeared once ASTB was accounted for. For females, the relationship decreased but remained significant when ATSB was statistically controlled. Path analyses confirmed that this pattern of relationships would be consistent with ATSB serving as a partial mediator between binge drinking and IPV perpetration. However, other alternative mediation and moderation models for the relationships between binge drinking, IPV perpetration, and ATSB could not be ruled out with this one-wave correlational study.

Maharajh HD; Ali A. Aggressive sexual behaviour of alcohol-dependent men. Alcoholism Treatment Quarterly 23(4): 101-106, 2005

The purpose of this study is to report the aggressive sexual behaviour of alcohol-dependent men and its implications in clinical practice. A total of thirty women of male alcohol-dependent partners were taken from a psychiatric clinic and matched with a control group of spouses of healthy non-drinking men for the variables of age, gender, ethnicity and social class. These groups were tested for sexually induced marks over a one month period, areas of the body that were marked, duration of body marks and love-making experiences. Our findings indicate that the spouses of alcohol-dependent men are subjected to more aggressive and painful sexual experiences, more body marks in more regions that lasted an average of 7 days and more biting of body surfaces than wives of non-alcohol-dependent men. These behaviours are interpreted as subtle signs of domestic violence which should not be ignored in clinical practice.

McCloskey LA; Williams CM; Lichter E; Gerber M; Ganz ML; Sege R. Abused women disclose partner interference with health care: An unrecognized form of battering. Journal of General Internal Medicine 22(8): 1067-1072, 2007. (22 refs.)

Background: Some providers observe that partners interfere with health care visits or treatment. There are no systematic investigations of the prevalence of or circumstances surrounding partner interference with health care and intimate partner violence (IPV). Objective: To determine whether abused women report partner interference with their health care and to describe the co-occurring risk factors and health impact of such interference. Design: A written survey of women attending health care clinics across 5 different medical departments (e.g., emergency, primary care, obstetrics-gynecology, pediatrics, addiction recovery) housed in 8 hospital and clinic sites in Metropolitan Boston. Participants: Women outpatients (N=2,027) ranging in age, 59% White, 38% married, 22.6% born outside the U.S. Measurement: Questions from the Severity of Violence and Abuse Assessment Scale, the SF-36, and questions about demographics. Results: One in 20 women outpatients (4.6%) reported that their partners prevented them from seeking or interfered with health care. Among women with past-year physical abuse (n=276), 17% reported that a partner interfered with their health care in contrast to 2% of women without abuse (adjusted odds ratios [OR]=7.5). Further adjusted risk markers for partner interference included having less than a high school education (OR=3.2), being born outside the U.S. (OR=2.0), and visiting the clinic with a man attending (OR=1.9). Partner interference raised the odds of women having poor health (OR=1.8). Conclusions: Partner interference with health care is a significant problem for women who are in abusive relationships and poses an obstacle to health care. Health care providers should be alert to signs of patient noncompliance or missed appointments as stemming from abusive partner control tactics.

McHugh MC; Frieze IH. Intimate partner violence: New directions. Annals of the New York Academy of Sciences. Violence and exploitation against women and girls 1087: 121-141, 2006. (124 refs.)

This review examines multiple forms of intimate partner violence, including women's use of violence, and argues for development of more complex conceptualizations of intimate partner violence. As new victims are identified, partner violence has been reconceptualized. Research findings indicate that women are both victims and perpetrators in intimate partner violence, challenging previous conceptualizations and explanations. The authors argue that how researchers conceptualize intimate partner violence influences how they study and measure it. The authors call for researchers to develop more complex constructions of gender, and to distinguish between distinct forms of intimate partner violence.

McPherson MD; Delva J; Cranford JA. A longitudinal investigation of intimate partner violence among mothers with mental illness. Psychiatric Services 58(5): 675-680, 2007. (47 refs.)

Objective: Severe mental illness, substance use, and intimate partner violence have emerged as major intersecting public health problems that adversely and disproportionately impact the lives of women in the United States. This longitudinal study investigated the demographic and clinical correlates of intimate partner violence in a sample of 324 mothers with severe mental illness. Methods: A secondary analysis of longitudinal data was conducted by using multiple logistic regression. Participants were part of a longitudinal, community-based study of mothers with severe mental illness, which was aimed at understanding how these mothers viewed motherhood. The women were interviewed initially at baseline (interviews were conducted between 1995 and 1996) and then about 20 months later at follow-up (interviews were conducted between 1997 and 1998). Results: At follow-up the prevalence rate of intimate partner violence was 19%. Multiple logistic regression analyses showed a significant positive relationship between alcohol and drug misuse at baseline and intimate partner violence at follow-up, indicating that women with a co-occurring diagnosis of a substance use disorder (dual diagnosis) were more likely than women without such a diagnosis to report intimate partner violence. The number of lifetime psychiatric hospitalizations and the number of symptoms related to psychiatric disability exhibited at baseline were positively associated with intimate partner violence at follow-up, and age was inversely associated with intimate partner violence. Conclusions: Mental health professionals serving mothers with mental health problems need to be aware of and prepared to assess the significant correlation between these intersecting public health problems in order to influence successful interventions. Particular attention must be given to the special treatment needs related to dual diagnosis and victimization and the impact of these factors on this vulnerable population.

Nadien MB. Factors that influence abusive interactions between aging women and their caregivers. Annals of the New York Academy of Sciences.Violence and Exploitation against women and girls 1087: 158-169, 2006. (42 refs.)

Research findings suggest that one or more factors-personality and/or drug or financial dependency, cognitive and personality impairments, contextual factors, or severe stress-render elders vulnerable to caregiver maltreatment (i.e., either abuse or neglect), but may also make them more prone to abusing their caregivers. However, it is often the interaction between elders and caregivers that determines whether maltreatment will actually occur. Maltreatment of elders is less likely when caregivers (1) are free of mental impairments and of drug and personality dependency, (2) are trained to cope with the stress of caregiving and of highly provocative and/or abusive elders, (3) and are adequately reimbursed and socially supported.

Nguyen TD; Yoshioka M. Alcoholism level differences between Vietnamese batterers and non-batterers. Journal of Family Violence 21(6): 401-406, 2006. (51 refs.)

Frequency of alcohol consumption and alcoholism levels were compared between Vietnamese batterers and non-batterers. A sample of 200 Vietnamese men was administered a self-reported questionnaire which combined the Conflict Tactics Scale 2 and the Michigan Alcohol Screening Test. Results of the study revealed statistical significant differences between the two groups regarding frequency of alcohol consumption and alcoholism levels. However, through logistic regression analysis, it was found that participants' frequency of alcohol consumption and alcoholism levels were not statistically significant in predicting battering among Vietnamese men.

Olson EC; Kerker BD; McVeigh KH; Stayton C; Van Wye G; Thorpe L. Profiling risk of fear of an intimate partner among men and women. Preventive Medicine 47(5): 559-564, 2008. (45 refs.)

Objective. Fear of a partner, a component of intimate partner violence (IPV), can be used in clinical IPV assessment. This study examines correlates of fear in a population-based, urban sample to inform a gender-specific health care response to IPV. Methods. This study used pooled data on 9687 men and 13,903 women collected in 2002. 2004 and 2005 through three random-digit-dial surveys of New York City adults. Bivariate and multivariable analyses were used to examine associations between fear and sociodemographic and health-related factors. Results. There was no significant difference in age-adjusted prevalence of reported fear of a partner between women (2.7%) and men (2.2%). In multivariable analysis, fear was correlated with being female, younger age, divorced or separated marital status, poor self-reported health status, and multiple sex partners. The most striking gender difference was in the stronger association with multiple sex partners among women (adjusted Odds Ratio [aOR]=6.2: p<0.01). Binge drinking was correlated with fear only among low-income adults (aOR=2.8: p<0.01). Conclusion. IPV is a health concern for both men and women, and a risk profile for fear can guide IPV assessment in health care. Physicians should consider multiple sex partners in women and alcohol misuse in low-income patients as potential markers for IPV.

Paranjape A; Heron S; Thompson M; Bethea K; Wallace T; Kaslow N. Are alcohol problems linked with an increase in depressive symptoms in abused, inner-city African American women? Women's Health Issues 17(1): 37-43, 2007. (50 refs.)

Objective. Little is known regarding the link between intimate partner violence (IPV), alcohol problems (AP), and depression in inner-city African American women. We sought to investigate whether abused inner-city African American women reporting AP endorsed more depressive symptoms compared to women reporting either AP or IPV or reporting neither. Method. Participants for this cross-sectional study were 361 African American women seeking medical care at a large public hospital. Measurements included the Index of Spouse Abuse, Michigan Alcoholism Screening Test, and the Brief Symptom Index-Depression Subscale to assess IPV, AP, and depressive symptoms, respectively. Based on IPV and AP status, participants were assigned to one of four non-hierarchical risk groups: (i) low or no IPV, no AP; (ii) high IPV alone; (iii) AP alone; or (iv) both high IPV and AP. Additive effect of high levels of IPV and AP on outcome were assessed using logistic regression techniques. Results. Thirty percent reported high IPV levels, and 18% had AP. Compared with participants reporting both no AP and low or no IPV, those reporting either high IPV levels or AP reported moderate to severe depressive symptoms 4 times more often (p < .001). Women reporting high IPV and AP endorsed moderate to severe depressive symptoms 8 times more often than women reporting neither (p < .001). Conclusions. Among inner-city, African American women, depressive symptoms are highest among those reporting both high IPV levels and AP. Health care systems serving similar communities should implement a systematic approach to identifying IPV, AP, and depression in patients.

Poole N; Greaves L; Jategaonkar N; Mccullough L; Chabot C. Substance use by women using domestic violence shelters. Substance Use & Misuse 43(8/9): 1129-1150, 2008. (28 refs.)

This study investigated the connections between stressors, substance use, and experience of violence among women (N = 125) who accessed help from domestic violence shelters in British Columbia, Canada between October 2001 and June 2003. Changes in substance use and stressors following a shelter stay were explored, using both qualitative and quantitative methods. Women generally decreased their use of alcohol and stimulants, and this change was found to be integrally connected to social and structural supports made available to them. Future research that augments current stress models of addiction by considering social and structural factors that come into play in women's substance use and domestic violence is suggested. The study's limitations are noted.

Ramisetty-Mikler S; Caetano R; McGrath C. Sexual aggression among White, Black, and Hispanic couples in the US: Alcohol use, physical assault and psychological aggression as its correlates. American Journal of Drug and Alcohol Abuse 33(1): 31-43, 2007. (28 refs.)

This article examines the prevalence of sexual aggression and its association with alcohol and other forms of violence, such as physical abuse and psychological aggression, in a national sample of married and cohabiting couples. These couples were part of a longitudinal study conducted in 1995 and 2000. The analyses include 406 White, 232 Black, and 387 Hispanic couples interviewed in 2000. Male-to-female sexual aggression rates ranged from 11% to 23 % and female-to-male aggression rates ranged from 5.5% to 13.5%. Insisting on having sex without use of physical force and having sex without a condom are the two most frequently reported types of sexual aggression across all ethnic groups. Male and female perpetrated sexual aggression rates among Black couples were over 2 times the rate of White couples. Male perpetrated severe psychological aggression is a significant predictor of male sexual aggression. Female perpetrated severe psychological aggression predicted female sexual aggression. The study findings underscore the importance of addressing alcohol use and the presence of psychological abuse in the light of preventing other forms of violence including sexual aggression among couples.

Rhodes KV; Houry D; Cerulli C; Straus H; Kaslow NJ; McNutt LA. Intimate partner violence and comorbid mental health conditions among urban male patients. Annals of Family Medicine 7(1): 47-55, 2009. (65 refs.)

PURPOSE We wanted to explore the associations between intimate partner violence (IPV) and comorbid health conditions, which have received little attention in male patients. METHODS Using a computer-based self-assessment health questionnaire, we screened sequential emergency department patients who were urban, male, and aged 18 to 55 years. We then examined associations between types of IPV disclosures, co-occurring mental health symptoms, and adverse health behaviors. RESULTS Of 1,669 men seeking nonurgent health care, 1,122 (67.2%) consented to be screened, and 1,026 (91%) completed the screening; 712 (63%) were in a relationship in the past year. Of these men, 261 (37%) disclosed IPV: 20% (n = 144) disclosed victimization only, 6% (n = 40) disclosed perpetration only, and 11% (n = 77) disclosed bidirectional IPV (defined as both victimization and perpetration in their relationships). Men disclosing both victimization and perpetration had the highest frequencies and levels of adverse mental health symptoms. Rates of smoking, alcohol abuse, and drug use were likewise higher in IPV-involved men. CONCLUSIONS A cumulative risk of poor mental health and adverse health behaviors was associated with IPV disclosures. Self-disclosure by men seeking acute health care provides the potential for developing tools to assess level of risk and to guide tailored interventions and referrals based on the sex of the patient.

Schewe P; Riger S; Howard A; Staggs SL; Mason GE. Factors associated with domestic violence and sexual assault victimization. Journal of Family Violence 21(7): 469-475, 2006. (18 refs.)

This study explored factors associated with a lifetime history of domestic violence and sexual assault in a sample of welfare recipients in Illinois. Results indicate that childhood exposure to domestic violence is a risk factor for both sexual assault and domestic violence victimization, but that childhood physical abuse is only a risk factor for domestic violence. Increased education and employment skills and having more children were also risk factors for domestic violence victimization. Domestic violence was significantly associated with depression, while sexual assault was associated with low social support and a greater perceived need for mental health services. Frequent alcohol and drug use were not associated with either type of victimization. Research implications are discussed.

Shannon L; Logan T; Cole J; Walker R. An examination of women's alcohol use and partner victimization experiences among women with protective orders. Substance Use & Misuse 43(8/9): 1110-1128, 2008. (60 refs.)

This study examined associations of women's alcohol use with self-reported experiences of male-perpetrated intimate partner violence among a sample of women with protective orders. Participants were 676 women with a protective order against a male intimate partner from three rural areas and one urban area. Multivariate analyses indicated that women's substance use was associated with psychological abuse tactics and severity of physical and sexual victimization in the last year of the relationship. Women's alcohol use was associated with the severity of physical violence within the last year of the relationship, whereas illegal drug use had associations with the number of verbal abuse, degradation and jealousy/control tactics. There was a significant interaction of women's alcohol and drug use with the severity of sexual assault.

Simons L; Gwin D; Brown M; Gross J. Alcohol and other drug use among college students: Intimate partner violence and health-compromising behaviors. Alcoholism Treatment Quarterly 26(3): 347-364, 2008

A survey was conducted with 400 male and female college students to examine the relationships among intimate partner violence (IPV), alcohol and other drug use, and health-compromising behaviors. The results indicated that IPV was directly related to alcohol use. The results further indicated that alcohol and drug use are directly and IPV is indirectly associated with risky sexual behaviors. Victimized male and female students had higher rates of alcohol and drug use and other health-compromising behaviors compared to nonvictimized male and female students. Implications are suggested for collegiate prevention programs.

Stalans LJ; Ritchie J. Relationship of substance use/abuse with psychological and physical intimate partner violence: Variations across living situations. Journal of Family Violence 23(1): 9-24, 2008. (50 refs.)

This study addresses whether the relationship between illicit drug use/abuse measures and intimate partner violence (IPV) varies across socioeconomic status, racial status, and environmental indictors of a drug supportive culture. Data from 19,131 respondents who were living with intimate partners and had not been treated for a substance abuse problem in the last year and participated in the National Household Survey on Drug Abuse were analyzed. Marijuana use/abuse was a stronger predictor of IPV and psychological abuse for minorities, but was not a significant predictor of Caucasians' IPV. Marijuana use/abuse also was a stronger predictor of IPV for those having a low socioeconomic status, but indicators of a drug supportive culture did not moderate the relationship. Minorities' marijuana use/abuse increased their yelling and insulting behavior toward each other, and this psychological abuse mediated the effect of marijuana use/abuse on IPV. By contrast, stimulant use, sedative use, and alcohol abuse or dependence had independent direct effects on IPV after controlling for psychological abuse. Implications for research and policy are discussed.

Stuart GL; Temple JR; Follansbee KW; Bucossi MA; Hellmuth JC; Moore TM. The role of drug use in a conceptual model of intimate partner violence in men and women arrested for domestic violence. Psychology of Addictive Behaviors 22(1): 12-24, 2008. (62 refs.)

In a previous study, alcohol problems in perpetrators and their partners contributed directly and indirectly to intimate partner violence (IPV), even after including other correlates of violence in the model (G. L. Stuart et al., 2006). The present study extends these findings by examining the role of illicit drug use. We recruited 271 men and 135 women arrested for IPV and used structural equation modeling to examine the data. Results showed that drug use, as reported by the perpetrators, was a stronger predictor of IPV than were alcohol problems in perpetrators and their partners. Arrested males' marijuana use and stimulant use (i.e., cocaine and amphetamines) were associated with perpetration of IPV, and their report of their female partners' stimulant use was associated with her violence perpetration. In arrested women, specific substances used did not predict violence perpetration beyond other model variables; however, female perpetrators' report of male partners' stimulant use predicted male psychological and physical aggression, after controlling for other variables. These results provide further evidence that drug problems by both partners may be important in the evolution of aggression. Implications for batterer intervention programs are discussed.

Temple JR; Weston R; Stuart GL; Marshall LL. The longitudinal association between alcohol use and intimate partner violence among ethnically diverse community women. Addictive Behaviors 33(9): 1244-1248, 2008. (10 refs.)

Research has consistently demonstrated a strong link between substance misuse and the perpetration of intimate partner violence (IPV). However, studies examining whether substance misuse is associated with IPV victimization have been mixed. Using data collected from 835 low-income ethnically diverse community women, this study extends previous research by utilizing a longitudinal design, considering men's and women's alcohol use, and examining multiple forms of abuse. Despite overall decreases in drinking and abuse, the frequency of male partners' drinking continued to be associated with their perpetration of threats, violence, and sexual aggression. Women's alcohol use frequency was associated with sustaining physical violence, but not threats of violence or sexual aggression.

Tollefson DR; Gross ER. Predicting recidivism following participation in a treatment program for batterers. Journal of Social Service Research 32(4): 39-62, 2006. (51 refs.)

This study examined recidivism rates for 197 batterers who participated in a state-sponsored domestic violence treatment program. The primary objective of the study was to identify factors associated with liost-intervention recidivism. Significant factors identified through bivariate analyses were analyzed through logistic regression for the purpose of developing predictive models. Bivariate analyses identified 10 factors associated with post-intervention recidivism. Of these factors, logistic regression identified four factors that were predictive of recidivism. These four factors-psychopathology (personality disorders), psychiatric history, substance abuse, and child abuse in family of origin were able to 'predict 84% of all outcomes and 97% and 28% of abstainers and reoffenders, respectively. The data suggest that batterer characteristics, particularly batterer pathology and substance abuse, are more influential determinants of recidivism than systemic and programmatic factors. These findings are discussed with respect to their implications for policy, practice, and future research.

Trautman DE; McCarthy ML; Miller N; Campbell JC; Kelen GD. Intimate partner violence and emergency department screening: Computerized screening versus usual care. Annals of Emergency Medicine 49(4): 526-534, 2007. (45 refs.)

Study objective: To compare a computer-based method of screening for intimate partner violence (intimate partner violence) with usual care in an emergency department (ED) setting. Methods: During 3 distinct but consecutive 2-week periods, women who presented to the ED were asked to complete a computer-based health survey with or without intimate partner violence screening questions in addition to receiving usual intimate partner violence care (ie, screened voluntarily by ED providers and documented in medical record). The screening, detection, referral and service rates were compared between women who completed the computer-based health survey with the intimate partner violence screening questions to usual care. Results: Of the 411 women who completed the computer-based health survey with the intimate partner violence questions, 99.8% were screened for intimate partner violence compared to 33% of the 594 women who received usual care (67.1% difference; 95% CI 63.3%, 70.9%). The computer-based health survey detected 19% intimate partner violence positive whereas usual care detected 1% (17.8% difference; 95% Cl 13.9%, 21.7%). Referral to social work was higher among those screened by the computer-based health survey (10%) versus usual care (< 1%) (9.7% difference; 95% CI 6.7%, 12.7%). Only 20 subjects received intimate partner violence services, although it was slightly higher among those screened by the computer-based health survey (4%) compared to usual care (1%) (4.0% difference; 95% Cl 2.0%, 6.1%). Conclusion: We found that a computer-based approach led to significantly higher intimate partner violence screening and detection rates compared to usual care. Receipt of intimate partner violence services was also higher than usual care but was not optimal. Computer technology makes routine screening easier and allows us to redirect our energies to addressing patients' intimate partner violence problems.

Tremblay PF; Graham K; Wells S. Severity of physical aggression reported by university students: A test of the interaction between trait aggression and alcohol consumption. Personality and Individual Differences 45(1): 3-9, 2008. (27 refs.)

As part of an online study of aggression, 2647 full-time undergraduate students at six Canadian universities completed the Aggression Questionnaire (Buss & Perry, 1992) and reported on whether they had been involved in incidents of physical aggression in the past 12 months at a (1) bar, nightclub or pub, (2) home or residence, and (3) party or social event. About one in four students reported an incident. Scores on the physical trait aggression scale correlated significantly with severity of aggression in the three locations. Males reported higher severity than did females in the three locations. Alcohol consumption was significantly related to severity at bars and parties but not in the home location. Support was found for an interaction between the physical trait aggression scale and drinking at the time of the incident predicting the severity of aggression for incidents reported in bars.

Veysey BM. Responding to Physical and Sexual Abuse in Women with Alcohol and Other Drug and Mental Disorders: Program Building. Binghamton NY: Haworth Press, 2004. (chapter refs.)

This edited work provides a first-hand account of the process by which community agency programs and service systems were transformed to responde to the needs of women who are endeavoring to deal with a history or trauma and/or sexual abuse along with drug misuse and/or a psychiatric disorder. Each chapter deals with a particular program that has reached out to serve this special populations. Nine different programs are described. As challenges were met and strategy was adapted to �real world� situations, the sites discussed in this text found new and improved methods for helping this unique group of women. The book is directed to professionals in the fields of mental health, substance abuse, and domestic violence. The programs described include rural and urban settings, programs for women and children jointly and serving women only, those serving Latinos and African-Americans. Different authors described how efforts were untaken to integrating services at both the clinical/individual level and at the services or systems leve, and the efforts accross all programs to be gender-specific, sensitive to culturally norms of the communities, respond to parenting skills, and being realistic about socioeconomic difficulties.

Veysey BM; Andersen R; Lewis L; Mueller M; Stenius V. Integration of alcohol and other drug, trauma and mental health services: An experiment in rural services integration in Franklin County, MA. Alcoholism Treatment Quarterly 22(3/4): 19-39, 2004

The Franklin County Women's Research Project is a collaboration among the Western Massachusetts Training Consortium, the Franklin Medical Center, three Women's Resource Centers located across the county, and local consumer/survivor/recovering women (CSRs). This project is unusual in two ways: (1) it is a rural site, and (2) the project was designed, implemented and evaluated by CSRs. The program model integrates services at the person level and at the system level. The Women's Resource Centers are the focal points for the individual level services integration offering women support through their peers, including AA/NA meetings, trauma recovery groups using the Addiction and Trauma Recovery Model (ATRIUM), Peer Resource Advocates, writing, art, and body awareness programs, and a variety of opportunities. The guiding principle is that women heal when they find the resources within themselves to define their lives and engage in activities and work that is meaningful to them. These Centers work in conjunction with the formal treatment systems. Services integration is accomplished through the Services Integration Committee comprised of the mental health, AOD and domestic violence providers, the Community Coordination Council comprised of a wider network of service and support providers, and through the activities of the Trauma Liaison, an employee of Franklin Medical Center who chairs the committees and provides consultation on women with trauma histories.

Veysey BM; Clark C. Introduction. Alcoholism Treatment Quarterly 22(3/4): 1-18, 2004

The Women, Co-occurring Disorders and Violence Study is the first effort to address the significant lack of appropriate services for women with alcohol and other drug and mental health diagnoses who have experienced physical and/or sexual abuse. This program is sponsored by the Substance Abuse and Mental Health Services Administration's three Centers: the Center for Substance Abuse Treatment, the Center for Substance Abuse Prevention and the Center for Mental Health Services. The nine participating sites each developed a services integration intervention addressing the multiple needs of women with co-occurring disorders and histories of violence. As participants in a cross-site initiative, each site created their interventions within the guidelines established by a Federal Steering Committee. Under these guidelines, interventions must be gender-specific, culturally competent, trauma-informed and trauma-specific, comprehensive and integrated, and involve consumers/survivors/recovering persons (CSRs) in substantive and meaningful ways. In this work, each site describes their strategies for developing strategies for integrating services at two levels: at the clinical/individual level and at the services or system level. Within this framework, sites have created programs that are responsive to the strengths and needs of their own communities.