Samantha Wells

Demographic and substance use factors related to violent and accidental injuries : results from an emergency room study

OBJECTIVE The primary goal of this study was to identify demographic and substance use factors associated with violent injuries, accidental injuries, and medical conditions or illnesses (non-injured). METHOD Data were examined from a sample of 1701 admissions to emergency rooms at two Canadian hospitals. These patients were interviewed and provided urine samples to detect the presence of drug metabolites for alcohol, THC, benzodiazepines, barbiturates, morphine, and codeine. RESULTS Those with violent injuries were significantly (P<0.0001) more likely to be male and have lower incomes compared with both the accidental injury and non-injury groups. About 37% of violent injuries occurred at a bar or restaurant, which was significantly more than 3% for accidental injuries and 2% for non-injuries (P<0.00001). The violent injury group was significantly more likely than the other two groups to report feeling the effects of alcohol at the time of the injury and to report negative consequences of alcohol use (P<0.00001). Furthermore, about 42% of those with violent injuries had a blood alcohol level (BAL) over 80 mg% compared to only 4% with accidental injuries (P<0.00001) and 2% of non-injuries (P<0.00001). In terms of drug tests for other substances, the violent injury group was significantly more likely to test positive for benzodiazepines than the accidental injury group (P<0.01) while all between group comparisons for other drugs were not significant.

A Framework for Applying Explanations of Alcohol-Related Aggression to Naturally Occurring Aggressive Behavior

This paper provides a framework in which theories/explanations of alcohol-related aggression are identified and operationalized in such a way that they can be applied systematically to naturally occurring aggressive behavior associated with alcohol use. Summaries of explanations are provided along with a brief discussion of how these explanations might be assessed using real-world data. Explanations are grouped by whether they are based on: (a) the effects of alcohol; (b) the drinking set or setting; or (c) expectations and other characteristics of individual drinkers. These explanations are then assessed in terms of relevance and applicability to two examples of naturally occurring incidents of aggression, one based on unobtrusive observation, the second elicited as part of a telephone interview study.

The Social Context of Physical Aggression Among Adults

Adult respondents to a telephone survey who had been involved in an incident of physical aggression in the past 12 months were asked open- and closed-ended questions regarding the social context of the most recent incident. Incidents that occurred in bars were more likely to involve male participants, drinking by the respondent and opponent, more than two participants, and low emotional impact. Incidents in public places also tended to involve males and drinking by the opponent. Aggression in social gatherings occurred primarily among friends or acquaintances and was reported equally often by males and females with most incidents involving both genders or males only. Incidents in the home were more likely to be reported by females than males and tended to occur between intimate couples, involve only two participants, and have high emotional impact. The usefulness of a contextual approach for developing a better under-standing of naturally-occurring aggression is discussed.

When Do First-Year College Students Drink Most During the Academic Year? An Internet-Based Study of Daily and Weekly Drinking

Abstract Objective: The authors investigated the alcohol consumption trajectories among first-year university students. Participants: A sample of 415 students attending a large university in Southwestern Ontario, Canada, was recruited. Methods: Students completed a baseline questionnaire and 26 weekly brief Internet surveys assessing alcohol consumption from September 2006 to April 2007. Results: Findings indicated that alcohol consumption varies considerably as a function of time of the academic year. Overall trends indicate that students drink more heavily at the beginning of each semester and less during exam periods. Daily patterns indicate that most drinking occurs on weekends. The highest drinking days in the first academic year included Halloween, New Years Eve, and St. Patricks Day. Conclusions: The present study provides evidence that periods of high and low alcohol consumption are contingent upon specific events and the time of the year.

“The Good, the Bad, and the Ugly”: Responses by Security Staff to Aggressive Incidents in Public Drinking Settings

Naturally-occurring incidents of aggression among young people in public drinking establishments (from observations and interviews) were analyzed in order to better understand how security staff respond to barroom aggression. Behavior of security staff fell broadly into four main categories: “good,” “neutral,” “bad,” and “ugly.” “Good” security staff responses involved the prevention of aggression through identifying problem situations and reducing provocative behavior. “Neutral” responses were adequate to address immediate aggressive behavior but involved less preventative responses, such as allowing incidents to escalate before intervening and failing to prevent future incidents by permitting aggressive patrons to remain in the bar. “Bad” responses involved inconsistent or unfair behavior as well as using poor judgement when resolving disputes. “Ugly” responses included bullying or harassing patrons, provoking aggression, or being physically aggressive. Implications in terms of training and licensing are discussed.

The Two Worlds of Aggression for Men and Women

The purpose of this research was to assess differences in the nature of physical aggression experienced by men and women. Random digit dialing with Computer Assisted Telephone Interviewing was used to obtain a sample of 1,753 Ontario adults aged 18–60 (response rate of 67%). This method of sampling obtains respondents who reflect the ethnic and social diversity of Ontario. Respondents were asked to describe the most recent incident of physical aggression in which they had been personally involved during the past year. Most incidents reported by females were with a male opponent, usually a spouse, partner, or friend, did not involve alcohol consumption, resulted in high negative emotional impact, and pertained to jealousy. Incidents reported by males tended to be with other males, friends or strangers, in bars or public places, and involved four or more participants who had been drinking. Incidents involving only men had lower emotional impact on respondents and included more punching, threatening, and insulting behavior compared to incidents involving other gender combinations. These results are discussed in terms of the implications for violence generally and the importance of addressing male-to-male aggression and factors that foster this form of aggression.

Harm, Intent, and the Nature of Aggressive Behavior Measuring Naturally Occurring Aggression in Barroom Settings

The research goals were to use the constructs of harm and intent to quantify the severity of aggression in the real-world setting of the bar/club, to describe the range of aggressive behaviors and their relationship to harm and intent, and to examine gender differences in the form and severity of aggression. Systematic observations were conducted by trained observers on 1,334 nights in 118 bars/clubs. Observers documented a range of aggressive acts by 1,754 patrons in 1,052 incidents, with many forms of aggression occurring at more than one harm and intent level. Women used different forms of aggression, inflicted less harm, and were more likely to have defensive intent compared with men. Implications of the findings for research and measurement of aggression and applications to preventing aggression and violence are discussed.

The relationship between alcohol consumption patterns and car, work, sports and home accidents for different age groups.

The purpose of this study was to examine the relationship between alcohol consumption patterns and car, work, sports and home accidents for different age groups. A secondary analysis of data from a randomized household survey of 10385 Canadians was conducted. Overall, alcohol consumption patterns were significantly associated with car collisions, work and sports accidents for younger age groups (i.e. 15-24 and 25-34), but this relationship was not significant for the older age groups.

Does the relationship between depression and intimate partner aggression vary by gender, victim-perpetrator role, and aggression severity?

Research has shown a consistent link between intimate partner violence (IPV) and depression, although this association may vary by gender, role in IPV (victim, perpetrator, or bidirectional), and aggression severity. We evaluated these factors in a telephone survey of 14,063 Canadians. All three factors were found to affect the association of depression with IPV. Specifically, depression was more strongly associated with IPV by a partner (i.e., victimization) for women but with aggression toward a partner (i.e., perpetration) for men. Severity of aggression was associated with increased risk of depression for both one-sided and bidirectional aggression by a partner but more strongly for one-sided aggression toward a partner. These findings suggest that research, prevention, and treatment should focus on all roles in IPV, not just male-to-female aggression.

Where, With Whom, and How Much Alcohol Is Consumed on Drinking Events Involving Aggression? Event-Level Associations in a Canadian National Survey of University Students

BACKGROUND Epidemiological research using event-level data can provide a better understanding of the association between alcohol consumption, characteristics of drinking contexts, and the likelihood of aggressive behavior. The present research assessed whether alcohol intake and characteristics of the drinking context were associated with the likelihood of aggression within individuals across 3 drinking events based on a national sample of university students, taking into account individual characteristics and university level variables. Additionally, we determined whether individual characteristics, particularly drinking pattern, were associated with alcohol-related aggression controlling for drinking event characteristics, and whether relations of aggression to alcohol and drinking contexts differed by gender. METHODS Secondary analyses of the 2004 Canadian Campus Survey (CCS), a national survey of 6,282 university students (41% response rate) at 40 Canadian universities, were conducted. Respondents were asked about their three most recent drinking events, including whether they were in an argument or fight with someone, number of drinks consumed, and characteristics of the drinking context as well as their usual drinking frequency and heavy episodic drinking. We used multi-level analyses to account for the nested structure of the data (i.e., drinking events nested within individuals who were nested within universities). RESULTS The number of drinks consumed was positively associated with aggression. Drinking contexts found to be positively associated with aggression included being at a party, at a fraternity/sorority and/or residence, at three or more drinking places (versus 1 or 2), and having a partner present whereas having a meal reduced the likelihood of aggression. A significant interaction was found between gender and being at a party, with a significant effect found for women but not for men. CONCLUSIONS These results support experimental evidence indicating a direct role of alcohol in aggression and point to characteristics of the drinking context that might be targeted in future prevention initiatives.