Julie A. Schumacher

Risk factors for male-to-female partner physical abuse

We review the risk and protective factors for male-to-female partner physical abuse and present effect sizes. We distinguish among the various operationalizations of physical aggression (e.g., men in court mandated abuse programs, men identified through a single item on the CTS). Overall, however, several risk factors showed moderate to strong effect sizes. Perpetrator factors include SES, education, history of child sexual victimization, exposure to parental physical and/or verbal aggression, violent adult models in childhood, non-family aggression by parent, elevated levels of state and trait anger and hostility; various personality disorders; various Axis I psychopathology, particularly depression alcohol and drug abuse; deficits in spouse-specific assertiveness; and attitudes that condone abuse. Risk factors for women being victimized included less education, unemployment, and history of child emotional/verbal victimization.

Husbands' and Wives' Marital Adjustment, Verbal Aggression, and Physical Aggression as Longitudinal Predictors of Physical Aggression in Early Marriage.

Marital adjustment, verbal aggression, and physical aggression have long been associated in the marital literature, but the nature of their associations remains unclear. In this study, the authors examined these 3 constructs as risk factors for physical aggression during the first 2 years of marriage in 634 couples recruited as they applied for marriage licenses. Couples completed assessments at the time of marriage and at their 1st and 2nd anniversaries. Results of path analyses suggest that prior verbal aggression and physical aggression by both partners are important longitudinal predictors of physical aggression but do not support the role of marital adjustment as a unique predictor of subsequent physical aggression. Contrary to prior research, results also failed to support physical aggression as a unique predictor of marital adjustment.

Risk factors for child neglect

Child neglect is the most prevalent form of child maltreatment in the US, yet it has received comparatively little research attention. This is no doubt in part due to difficulty defining and operationalizing the construct of neglect. Despite these challenges, a small body of literature investigating risk factors for child neglect has accumulated. This paper reviews this literature, providing effect sizes when possible. Parental demographic, psychological, and behavioral characteristics as well as child, family, and neighborhood factors are reviewed. Although few factors have been examined in more than one study, when taken together, the findings suggest that parental behavioral and psychological characteristics may have the largest relations to neglect, and that limited socioeconomic resources are the most consistently documented risk factor for neglect.

Intimate Partner Aggression Perpetrated and Sustained by Male Afghanistan, Iraq, and Vietnam Veterans With and Without Posttraumatic Stress Disorder

Veterans with posttraumatic stress disorder (PTSD) consistently evidence higher rates of intimate partner aggression perpetration than veterans without PTSD, but most studies have examined rates of aggression among Vietnam veterans several years after their deployment. The primary aim of this study was to examine partner aggression among male Afghanistan or Iraq veterans who served during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) and compare this aggression to that reported by Vietnam veterans with PTSD. Three groups were recruited, OEF/OIF veterans with PTSD (n = 27), OEF/OIF veterans without PTSD (n = 31), and Vietnam veterans with PTSD (n = 28). Though only a few comparisons reached significance, odds ratios suggested that male OEF/OIF veterans with PTSD were approximately 1.9 to 3.1 times more likely to perpetrate aggression toward their female partners and 1.6 to 6 times more likely to report experiencing female perpetrated aggression than the other two groups. Significant correlations among reports of violence perpetrated and sustained suggested many men may have been in mutually violent relationships. Taken together, these results suggest that partner aggression among Iraq and Afghanistan veterans with PTSD may be an important treatment consideration and target for prevention.

Domestic violence treatment referrals for men seeking alcohol treatment

The annual prevalence of intimate partner violence (IPV) in samples of men seeking alcohol treatment has been estimated at 50% or higher. One proposed approach to these co-occurring problems is the provision of IPV screening and treatment referrals within alcohol treatment programs. The current study found that alcohol treatment providers infrequently referred men with a pretreatment year history of IPV to domestic violence treatment programs, and that men receiving such referrals rarely followed the recommendation and sought additional treatment. These findings suggest future research is necessary to identify factors that may act as barriers to IPV assessment or referral in alcohol treatment settings, factors that may limit client follow-through on such referrals, and new strategies for addressing IPV in substance abusing populations.

Risk factors for male-to-female partner psychological abuse

We review the risk and protective factors for male-to-female partner psychological abuse. The conclusions that can be drawn from this review were limited by the small body of research. However, it does appear that partner psychological aggression/abuse may be more difficult to predict than partner physical aggression/abuse. In general, socio-economic status (SES) variables do not appear to significantly increase risk. Certain relationship variables, including communication patterns, marital adjustment, and attachment were significantly associated with psychological aggression, with moderate to strong effect sizes. However, these associations are difficult to interpret, because these relationship variables exhibit a high degree of conceptual and operational overlap with the psychological aggression. Two main directions can be derived from this review. First and foremost, definitional issues must be resolved. Given that partner emotional abuse, unlike physical or sexual abuse, is typically conceptualized as requiring a pervasive pattern rather than a single salient action, reliable and valid assessment is exceedingly challenging. Second, once definitional issues are resolved, etiological and intervention models can be developed and tested. This review indicates that mens personality and couple factors would be the most fruitful areas from which to start.

Exposure Therapy for Substance Abusers with PTSD: Translating Research to Practice.

Epidemiological research indicates that there is substantial comorbidity between posttraumatic stress disorder (PTSD) and substance use disorder (SUD). Moreover, there is growing evidence that having a comorbid PTSD diagnosis is associated with greater substance use problem severity and poorer outcomes from SUD treatment. In an attempt to improve the treatment outcome for individuals with PTSD-SUD, recently developed treatments combine exposure therapy for PTSD with an empirically supported treatment for SUD. This article describes one of the treatments and discusses treatment modifications that have been incorporated when translating this research-based therapy to practice in an inner-city community mental health center.

Serotonin Augmentation Reduces Response to Attack in Aggressive Individuals

We tested the theory that central serotonin (5-hydroxytryptamine, or 5-HT) activity regulates aggression by modulating response to provocation. Eighty men and women (40 with and 40 without a history of aggression) were randomly assigned to receive either 40 mg of paroxetine (to acutely augment serotonergic activity) or a placebo, administered using double-blind procedures. Aggression was assessed during a competitive reaction time game with a fictitious opponent. Shocks were selected by the participant and opponent before each trial, with the loser on each trial receiving the shock set by the other player. Provocation was manipulated by having the opponent select increasingly intense shocks for the participant and eventually an ostensibly severe shock toward the end of the trials. Aggression was measured by the number of severe shocks set by the participant for the opponent. As predicted, aggressive responding after provocation was attenuated by augmentation of serotonin in individuals with a pronounced history of aggression.

Longitudinal Moderators of the Relationship Between Excessive Drinking and Intimate Partner Violence in the Early Years of Marriage

Alcohol problems are one of the most well-established risk factors for physical intimate partner violence. Nonetheless, most individuals who drink heavily do so without ever aggressing against a partner. Laboratory research identifies hostility as an important moderator of the association between alcohol and general aggression, and correlational research suggests that stress and coping may also be important moderators of the alcohol-aggression link. Building on this research, the authors examined hostility, coping, and daily hassles as moderators of the associations between excessive drinking and intimate partner violence across the first 4 years of marriage in a sample of 634 newly married couples. Excessive drinking was a significant cross-sectional correlate, but it did not emerge as a unique longitudinal predictor of intimate partner violence perpetration in this sample. However, alcohol was longitudinally predictive of husband violence among hostile men with high levels of avoidance coping. Findings generally supported the moderation model, particularly for men. These findings implicate hostility, coping, and daily hassles, as well as alcohol, as potentially important targets for partner violence prevention strategies for young married couples.

Impulsivity and risk-taking in borderline personality disorder with and without substance use disorders.

Impulsivity and risk taking propensity were assessed in participants with borderline personality disorder (BPD-only; n = 19), BPD and a current or past substance use disorder (BPD-SUD; n = 32), and a matched comparison group (MC; n = 28). Participants were administered behavioral measures of two facets of the multidimensional construct of impulsivity [GoStop, delay discounting task (DDT)], one measure of risk-taking propensity [Balloon Analog Risk Task (BART)], and two self-report measures of impulsivity (i.e., Barrett Impulsiveness Scale, Eysenck Impulsiveness Scale). The BPD-SUD group, but not the BPD-only group, discounted delayed rewards faster than the MC group on the DDT, suggesting that the BPD-SUD/MC group difference may be because of the SUD rather than BPD. In contrast, both the BPD-SUD and BPD-only groups exhibited poorer behavioral response inhibition compared with the MC group, but the two BPD groups did not differ from one another. This finding suggests that the differences in behavioral response inhibition may be because of BPD rather than SUD and that behavioral response disinhibition may be a core feature of BPD. None of the groups differed on the measure of risk-taking propensity (i.e., BART). On self-report questionnaires, the BPD-SUD group reported more impulsivity than the BPD-only group and both BPD groups reported more impulsivity than the MC group. Data from the DDT and self-report measures provide partial support for the hypothesis that BPD individuals with a SUD are more impulsive than BPD individuals without a SUD on some facets of impulsivity (e.g., desire to obtain a smaller immediate reward rather than wait to obtain a larger reward in the future). Results suggest that behavioral response inhibition may be a novel treatment outcome variable for BPD treatment studies.