Brenda A. Miller

The role of childhood sexual abuse in the development of alcoholism in women

The effects of childhood sexual abuse on the development of alcoholism in women were examined by comparing a sample of 45 alcoholic women selected from local treatment agencies and Alcoholics Anonymous groups with a group of 40 nonalcoholic women selected randomly from a household population. Face-to-face interview schedules were administered to both samples. Sexual abuse was defined as any unwanted sexual contact with a person at least five years older than the respondent, or with any family relative, regardless of age difference. Types of sexual contact included both nonphysical contact (e.g., invitations, exposure) and physical contact (e.g., fondling, intercourse). Results showed that alcoholic women were more likely to have experienced sexual abuse, had a greater number of different types of sexual abuse experiences, and endured sexual abuse over a longer period than the comparison group. The presence of any childhood sexual abuse experience was sufficient to discriminate between the alcoholic women and the comparison group, even controlling for demographic variables and the presence of a parent with alcohol-related problems. Although alcoholic women were more likely to report that a parent had alcohol-related problems, relatively few of the sexual abuse incidents were perpetrated by a parent. The data suggest that vulnerabilities to sexual abuse were attributable to environmental or psychological factors in homes in which a parent was reported as having alcohol-related problems.

The moderating impact of social support following childhood sexual abuse

The role of social support in moderating the impact of childhood sexual abuse on adult psychological adjustment was examined. Subjects included 475 women, age 18-45, some of whom were currently receiving treatment, others who were not. Women in the treatment group were receiving therapy for either alcoholism, for being battered, or for mental health problems. The comparison group was drawn from two sources: a random household sample and a sample of women attending drinking driver classes. Among both groups, women who had been sexually abused exhibited more psychological symptoms and lower self-esteem compared to those who were not abused. Latency of disclosure of childhood sexual abuse had no impact on long-term consequences of the abuse for either the treatment or the comparison group. However, among women in the comparison group, those who experienced supportive reactions following disclosure of sexual abuse had fewer psychological symptoms and somewhat higher self-esteem relative to those who did not receive support. Social support had no apparent effect on the long-term adjustment of women in the treatment group. Possible explanations for this pattern and directions for future research are discussed.

Bar Victimization of Women

Little is known about the types and specific circumstances that surround the victimization of women who drink in the public context of bars. This study provides a preliminary description of the types of violence experienced by women bar drinkers and the roles of exposure and impairment as risk factors for encountering bar-related aggression. Both quantitative and qualitative data were collected from 52 women bar drinkers through self-administered questionnaires and focus-group discussions about their lifestyles, alcohol and drug use, and patterns of bar drinking. Nearly half of the women (48.1%) had experienced physical violence (e.g., assault) and one third (32.6%) had experienced either attempted or completed rape associated with drinking in a bar. Our findings indicate that women who regularly drink in bars experience a substantial amount of physical and sexual aggression associated with these settings.

Women's descriptions of drinking in bars : Reasons and risks

Fifty-two women bar drinkers participated infocus group discussions about womens reasons fordrinking, victimization experiences, and behaviors thatinfluence risk for victimization, in bars. The majority of the participants were White (67.3%),one-third were Black (30.8%), and one was NativeAmerican. Qualitative data analytic techniques were usedto assess the content of these discussions. Womendescribed distinct reasons for going to bars and providednumerous accounts of aggression they had witnessed orexperienced associated with this setting. Depictions ofphysical violence ranged from having an object thrown at them or being pushed, to accounts ofrape and attempted murder. These women also describedobservable changes in other womens behavior followingalcohol consumption, and how these behaviors increase risk for victimization in bars. The qualitativefindings are discussed in terms of what they tell usabout women bar drinkers and the insight theyprovide fordesigning future studies and interventions that focus on education and prevention.

Long-Term Effects of Parent-to-Child Violence for Women

The relationships between experiences of parental violence during childhood and the development of victimization by severe violence from partner or alcohol-related problems in adulthood were examined by comparing women with partner victimization only ( N = 69), alcohol-related problems only ( N = 59), both partner victimization and alcohol-related problems ( N = 83), and neither problem ( N = 80). Face-to-face interviews were administered to all respondents. The Conflict Tactics Scale was used to assess father-to-daughter, mother-to-daughter, and partner-to-woman relationships. Associations between parental violence and adulthood problems were examined in a multivariate model. Control variables included childhood socioeconomic status, presence of a parent with alcohol-related problems, number of changes in childhood family structure, race of respondent, and the Global Severity Index. The mother-to-daughter relationship appeared a moderately better predictor of partner violence than the father-to-daughter relationship. Conversely, the father-to-daughter relationship was a better predictor of alcohol problems than the mother-to-daughter relationship. Father-to-daughter verbal aggression was found an especially important predictor of alcohol problems for women.

Violent victimization among women with alcohol problems.

Empirical evidence regarding the role of childhood victimization in the development of womens alcohol problems is examined in this chapter. In particular, childhood sexual abuse and father-to-daughter violence are found to predict later alcohol problems. Key variables that link experiences of childhood victimization and the development of adult alcohol problems are identified. Strengths and weaknesses of the research provide a better assessment of our confidence in the empirical evidence to date. Possible explanations for how and why the experiences of violent victimization may lead to womens alcohol problems are presented. Finally, important directions for policymakers, clinicians, and researchers are discussed.

Alcohol, Drugs, and Violence in Children’s Lives

This chapter reviews the current state of knowledge concerning the interrelationship between the cycle of alcohol and other drugs (AOD) use and the cycle of violence. This issue is framed in terms of two questions. The first is the extent to which AOD use by the perpetrator is related to the perpetration of violence toward children, defined here as including both physical and sexual abuse. The second question is whether the experience of abuse during childhood is related to the subsequent development of the abuse of alcohol and other drugs. The review indicates that parental AOD abuse is related to physical and sexual abuse. However, because most perpetrators are not parents, the relationship is not yet clear. The data do support the link between experiencing childhood violence and the development of later AOD abuse. Theoretical explanations for each link are reviewed and mediating variables are identified. The review concludes with a presentation of methodological issues and the directions for future research.

Differential patterns of partner-to-woman violence: a comparison of samples of community, alcohol-abusing, and battered women

This paper compared a sample of women in treatment for alcoholism (N = 45) with a randomly selected sample of women from the local community (N = 40), and a sample of women receiving services for victimization by severe partner violence (N = 38). Conflict Tactics Scale (CTS) items were dichotomized into low frequency of partner violence (twice per year or less) and high frequency of violence (once per month or more), and then summed to yield separate low frequency and high frequency scores for each CTS subscale. Results showed that at the high frequency level, battered women reported the highest scores on each subscale, alcoholic women the second highest, and the community sample of women reported the lowest level of violence. A multiple regression analysis revealed that being in the alcoholic sample significantly predicted high frequency negative verbal interaction and moderate violence, controlling for presence of a partner with alcohol-related problems and demographic differences among the samples.

Childhood experiences of parental physical violence for alcoholic women as compared with a randomly selected household sample of women

The effects of childhood experiences of parental violence on the development of alcoholism in women were examined by comparing a sample of 45 alcoholic women selected from local treatment agencies and Alcoholics Anonymous groups with 40 nonalcoholic women selected randomly from the population. Two-hour person-to-person interview schedules were administered to both samples. The Conflict Tactics Scale (CTS) assessed both father-to-daughter and mother-to-daughter relationships. Type of sample was regressed on each CTS subscale, controlling for presence of parental alcoholism, number of childhood changes in family structure, present age of respondent, and present income source. Alcoholic women were found to have higher father-to-daughter negative verbal interaction, moderate violence, and serious violence than household women. Father-to-daughter positive verbal interaction was found unrelated to membership in the alcoholism sample. None of the mother-to-daughter subscales were found to predict membership in the alcoholism sample.

THE EFFECTS OF A DRINKER-DRIVER TREATMENT PROGRAM. DOES CRIMINAL HISTORY MAKE A DIFFERENCE?

The impact of a 12-week group therapy treatment program for driving-while-intoxicated (DWI) offenders on DWI rearrest rates, self-reported drinking, and self-reported drinking and driving was appraised. Individuals with a criminal history, excluding DWI arrests, were more than twice as likely as those with no criminal history to be rearrested for a DWI within a 24-month period. The higher DWI recidivism rate for individuals with a prior criminal record was consistent across the dropout and treatment-completed subgroups. However, for individuals with no criminal history, the treatment-completed subgroup showed a significantly lower rate of recidivism than the dropouts. Follow-up self-report measures of frequency of drinking behavior showed similar differences with respect to criminal history. The results suggest that consideration of DWI subgroups, specifically criminal history, may be important when assessing the impact of intervention and treatment strategies.