Fleur L. Kraanen

Prediction of intimate partner violence by type of substance use disorder

The present study investigated whether (combinations of) specific substance use disorders predicted any and severe perpetration and victimization in males and females entering substance abuse treatment. All patients (N = 1799) were screened for IPV perpetration and victimization; almost one third of the sample committed or experienced any IPV in the past year. For males, an alcohol use disorder in combination with a cannabis and/or cocaine use disorder significantly predicted any IPV (perpetration and/or victimization) as well as severe IPV perpetration. For females, alcohol and cocaine abuse/dependence predicted both any IPV (perpetration and/or victimization) and severe IPV perpetration. Results from the present study emphasize the importance of routinely assessing IPV in patients in substance abuse treatment and demonstrate that clinicians should be particularly alert for IPV in patients with specific substance use disorder combinations.

Substance Use Disorders in Forensic Psychiatry: Differences Among Different Types of Offenders

This is the first study that compared different types of offenders in forensic outpatient treatment (i.e., offenders of general violence [GV], intimate partner violence [IPV], sex crimes, and “other offenses” such as drug smuggling and property crimes) regarding the prevalence of substance use disorders at the time of the offense. In total, 35.8% of participants (n = 187) were diagnosed with any substance use disorder. Specifically, 61.5% of GV perpetrators, 30.9% of IPV perpetrators, 9.1% of sex offenders, and 26.7% of “other offenders” were diagnosed with substance abuse or dependence. More GV offenders and less sex offenders fulfilled diagnostic criteria for a substance use disorder. Furthermore, 29.9% of the offenders were intoxicated by substances at the moment they committed the offense (48.5% of GV perpetrators, 25.0% of IPV perpetrators, 17.4% of sex offenders, and 21.0% of other offenders). More GV perpetrators were intoxicated during the offense. As there is a clear association between substance abuse and criminal behavior, substance abuse in offenders should be assessed and, if present, be treated.

Substance Use Disorders in Perpetrators of Intimate Partner Violence in a Forensic Setting

This study investigates the point prevalence of substance use disorders in 150 perpetrators of intimate partner violence (IPV) in a forensic setting and compares participants with and without substance use disorders on demographic and offence-related variables. Furthermore, it investigates the frequency of IPV perpetrated under the influence of substances. Half the sample (50.0%) meets diagnostic criteria for at least one substance-related diagnosis. Significantly more IPV perpetrators without substance use disorders compared with IPV perpetrators with substance use disorders have children living at home and have abused their children. Relative to IPV perpetrators without substance use disorders, significantly more IPV perpetrators with substance-related disorders are found to be under the influence of substances at the time of the offence. Results highlight the importance of understanding the prevalence of substance use disorders in IPV perpetrators in forensic settings.

Screening on Perpetration and Victimization of Intimate Partner Violence (IPV): Two Studies on the Validity of an IPV Screening Instrument in Patients in Substance Abuse Treatment

Background About 50% of patients in substance abuse treatment with a partner perpetrated and/or experienced intimate partner violence in the past year. To date, there are no screeners to identify both perpetrators and victims of partner intimate violence in a substance abusing population. We developed a 4 item screening instrument for this purpose, the Jellinek Inventory for assessing Partner Violence (J-IPV). Important strengths of the J-IPV are that it takes only 2 minutes to administer and is easy to use and to score. Methods To investigate the validity of the J-IPV, two independent studies were conducted including 98 and 99 participants, respectively. Aim of the second study was to cross-validate findings from the first study. Psychometric properties of the J-IPV were determined by calculating sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratio’s by comparing J-IPV outcomes to outcomes on the Revised Conflict Tactics Scales (‘gold standard’). Also, receiver operator characteristics (ROC)-curves were determined to weight sensitivity and specificity as a result of different J-IPV cutoffs, and the area under the curve (AUC) was calculated. Results Results of the first study demonstrated that the J-IPV possesses good psychometric properties to detect perpetrators and victims of any as well as severe intimate partner violence. Results from the second study replicated findings from the first study. Conclusions We recommend administering the J-IPV to patients entering substance abuse treatment. If perpetrators and victims of partner violence are identified, action can be taken to stop IPV perpetration and arrange help for victims, for example by offering perpetrators treatment or by providing safety planning or advocacy interventions to victims.

Psychopathologie bij behandelde verslaafden: Een onderzoek naar comorbiditeit

In de klinische praktijk blijkt dat verslaving vaak voorkomt in combinatie met andere stoornissen. Dit is het eerste onderzoek in Nederland dat kijkt naar de prevalentie van comorbide stoornissen in een verslaafde populatie. Als de resultaten van deze studie vergeleken worden met de resultaten van een Nederlands bevolkingsonderzoek, blijkt de prevalentie van as-I-stoornissen in deze populatie hoger dan in de normale populatie. Dit onderzoek bevestigt dat er veel psychopathologie voorkomt bij verslaafden. Het is raadzaam patiënten hierop te onderzoeken, zodat ook eventueel aanwezige comorbide stoornissen behandeld kunnen worden.

Integrated treatment for substance abuse and partner violence (I-StoP): a case study

Substance use disorders and intimate partner violence (IPV) perpetration frequently co-occur, and it has been hypothesized that alcohol use and IPV perpetration are causally related. This led to the development of an Integrated treatment for Substance abuse and Partner violence (I-StoP). This case study describes the treatment of Henry, who repeatedly abused his partner and was diagnosed with alcohol and cannabis dependence. Treatment with I-StoP was highly successful with respect to IPV: At posttreatment and 6 months follow-up, no IPV had taken place. However, Henry had not changed substance use. This can be explained by the spurious model that states that a third variable, such as inadequate problem-solving skills (which was addressed in I-StoP), may be responsible for both IPV and substance abuse. In addition, Henry’s partner was involved in treatment and became more assertive and, in contrast, he did change substance use. This case study illustrates that IPV is a very complex problem and that it is important to involve the partner.