Tami P. Sullivan

A Review of Research on Women's Use of Violence With Male Intimate Partners

This article provides a review of research literature on women who use violence with intimate partners. The central purpose is to inform service providers in the military and civilian communities who work with domestically violent women. The major points of this review are as follows: (a) women’s violence usually occurs in the context of violence against them by their male partners; (b) in general, women and men perpetrate equivalent levels of physical and psychological aggression, but evidence suggests that men perpetrate sexual abuse, coercive control, and stalking more frequently than women and that women also are much more frequently injured during domestic violence incidents; (c) women and men are equally likely to initiate physical violence in relationships involving less serious “situational couple violence,” and in relationships in which serious and very violent “intimate terrorism” occurs, men are much more likely to be perpetrators and women victims; (d) women’s physical violence is more likely than men’s violence to be motivated by self-defense and fear, whereas men’s physical violence is more likely than women’s to be driven by control motives; (e) studies of couples in mutually violent relationships find more negative effects for women than for men; and (f) because of the many differences in behaviors and motivations between women’s and men’s violence, interventions based on male models of partner violence are likely not effective for many women.

PTSD Symptom Clusters Are Differentially Related to Substance Use Among Community Women Exposed to Intimate Partner Violence

Women who experience intimate partner violence (IPV) have higher rates of posttraumatic stress disorder (PTSD) and substance abuse compared to women who do not experience IPV. However, the extent to which IPV-related PTSD symptoms are related to womens substance use involvement largely has been unexplored. The current study investigated PTSD symptomatology and substance use in a community sample of 212 IPV-exposed women. Drug-using women reported higher PTSD severity scores compared to women who reported no substance use or alcohol use only. Moreover, the reexperiencing, avoidance and numbing, and arousal clusters demonstrated unique associations with substance use involvement. Findings not only elucidate the associations among IPV-related PTSD symptoms and substance use, but they also can inform community-based preventive interventions.

PRECURSORS AND CORRELATES OF WOMEN'S VIOLENCE: CHILD ABUSE TRAUMATIZATION, VICTIMIZATION OF WOMEN, AVOIDANCE COPING, AND PSYCHOLOGICAL SYMPTOMS

Path modeling assessed (a) the influence of child abuse traumatization on womens use of violence and their experiences of being victimized, (b) the association of these three variables to depressive and posttraumatic stress symptoms, and (c) the indirect pathways from women using violence and their being victimized to psychological symptoms through avoidance coping. Among 108 primarily African American women recruited from the community who used violence with a male partner, womens use of violence, but not their experiences of being victimized, was predicted by child abuse traumatization. Womens use of violence did not directly or indirectly predict symptomatology. In contrast, child abuse traumatization and womens experiences of being victimized were predictive of both depressive and posttraumatic stress symptoms, and being victimized also was related indirectly to depressive symptoms through avoidance coping.

Testing Posttraumatic Stress as a Mediator of Physical, Sexual, and Psychological Intimate Partner Violence and Substance Problems Among Women

This study examined whether posttraumatic stress specifically resulting from intimate partner violence (IPV-related posttraumatic stress) mediated relationships between types of IPV and drug and alcohol problems among 212 women currently experiencing IPV. Six-month prevalence was high for drug use (48%) and alcohol use (59%). Structural equation modeling revealed that the frequency of physical, sexual, and psychological IPV were significantly and positively related to greater IPV-related posttraumatic stress, and IPV-related posttraumatic stress was significantly and positively related to drug problems. Further, IPV-related posttraumatic stress mediated the relationships between physical IPV and drug problems and psychological IPV and drug problems. Findings suggest that prevention and intervention efforts targeting posttraumatic stress among IPV-exposed women may reduce drug problems in this population.

Do Differing Types of Victimization and Coping Strategies Influence the Type of Social Reactions Experienced by Current Victims of Intimate Partner Violence

This study examines whether differing types of victimization and coping strategies influence the type of social reactions experienced by 173 current victims of intimate partner violence (IPV). Results of path analyses showed that psychological and sexual IPV victimization were related to positive social reactions, whereas physical, psychological, and sexual IPV victimization were related to negative social reactions. Indirect relationships between victimization and social reactions differed by types of coping strategies (social support, problem solving, and avoidance) examined. Implications are discussed regarding the development of interventions with women’s support networks and the augmentation of services to help victims modify their coping strategies.

Is it the exception or the rule? Daily co-occurrence of physical, sexual, and psychological partner violence in a 90-day study of substance-using, community women

OBJECTIVE This study aims to describe the daily co-occurrence of physical, sexual, and psychological intimate partner violence (IPV) among substance-using, community-based women currently experiencing IPV. METHODS A micro-longitudinal study design was used to collect data daily from 49 women for 90 days. RESULTS On the majority of days (62%), no IPV occurred; 27% of days were characterized by psychological IPV alone, followed by the co-occurrence of psychological and physical IPV (6% of IPV days). Results of person-level analyses showed comparable sized correlations between the proportion of days with physical and sexual IPV and the proportion of days with physical and psychological IPV. However, results of day-level analyses revealed that the association between physical and psychological IPV was much stronger than the association between physical and sexual IPV; Physical IPV was 64 times more likely to occur on days when psychological IPV occurred. CONCLUSIONS Results revealed new information about physical, sexual, and psychological IPV experiences and demonstrate the utility of a micro-longitudinal design among this high risk population. Implications for practice, future research, and the development of preventive interventions are noted, underscoring the importance of psychological IPV and the range of IPV experiences among women.

Associations Between Expectancies of Alcohol and Drug Use, Severity of Partner Violence, and Posttraumatic Stress Among Women

Women who experience recurrent intimate partner violence (IPV) may use alcohol or drugs because they expect that these substances will help them cope with the negative physical and psychological sequelae of IPV. However, expectancies for alcohol and drug use have not been explored among this population of women. We used the Relaxation and Tension-Reduction Scale, Arousal and Aggression Scale, and Social Assertion Scale of the Alcohol Expectancy Questionnaire and modified its items to assess both alcohol and drug expectancies of 212 community-based, IPV-exposed women. Results of bivariate correlations showed that greater alcohol and drug expectancies were significantly correlated with greater alcohol problems and greater posttraumatic stress total and symptom severity scores. Results of a multivariate regression model showed that after controlling for demographic characteristics and history of childhood trauma, Relaxation and Tension- Reduction expectancies were associated with number of days of alcohol use, alcohol problems, physical and sexual IPV severity scores, and posttraumatic stress total and reexperiencing symptom severity scores. Expectancies do not significantly moderate the relationships between IPV, posttraumatic stress, and problematic alcohol and drug use. Given the strong relationships of expectancies with IPV severity, posttraumatic stress, and alcohol problems, expectancies may serve as targets for interventions to reduce alcohol use and problems and improve health-related outcomes in IPV-exposed women.

The Role of Coping and Problem Drinking in Men's Abuse of Female Partners: Test of a Path Model

This article examines the relationship of coping and problem drinking to men’s abusive behavior towards female partners. While previous research has demonstrated a consistent association between problem drinking and male abuse of intimate partners, virtually no studies have assessed the role of coping in relation to men’s violence. Furthermore, multivariate studies have not examined how these factors operate together to increase risk for abusive behavior. An ethnically diverse sample of 147 men in a court-mandated program for domestic violence offenders completed questionnaires at the first session. Path modeling was conducted to test the extent to which coping and problem drinking predicted both physical and psychological abuse. In addition, the relationships of problem drinking and physical abuse to injury of the men’s female partners were examined. Results indicated that both the use of avoidance and problem-solving coping to deal with relationship problems were related indirectly to abusive behavior through problem drinking. Greater use of avoidance coping strategies was more likely among problem drinkers. By contrast, men who used higher levels of problem-solving coping were less likely to be problem drinkers. Avoidance, but not problem-solving coping also was directly and positively related to physical and psychological abuse. Men identified as problem drinkers were more likely to use both physical and psychological abuse. Finally, greater use of physical violence was strongly related to higher levels of injury among female partners, and served to mediate the relationship between problem drinking and injury. Results are discussed in terms of their contribution to the identification of risk and protective factors for men’s violent behavior toward intimate female partners and implications for developing intervention strategies.

Posttraumatic stress disorder symptoms and risky behaviors among trauma-exposed inpatients with substance dependence: The influence of negative and positive urgency

BACKGROUND Posttraumatic stress disorder (PTSD) among inpatients with substance use disorders (SUDs) is associated with heightened engagement in a variety of risky, self-destructive, and health-compromising behaviors (e.g., risky sexual behavior, aggression). Extant research provides support for the role of emotion dysregulation in the PTSD-risky behavior relation among inpatients with SUD; however, this research has been limited by a focus on emotion dysregulation involving negative (versus positive) emotions. The goal of the current study was to extend past research on the PTSD-risky behavior relation by examining the potential mediating roles of negative and positive urgency (two domains of emotion dysregulation defined by the tendency to engage in risky behavior in the context of negative and positive emotions, respectively). METHODS Participants were 158 trauma-exposed inpatients with (n=91) and without (n=67) lifetime PTSD consecutively admitted to a residential SUD treatment facility (M age=34.34; 59.5% White, 50.6% female). Patients were administered diagnostic interviews and completed self-report questionnaires. RESULTS Significant positive associations were found among lifetime PTSD symptoms, negative and positive urgency, and risky behaviors. Moreover, findings revealed significant indirect effects of lifetime PTSD symptoms on risky behaviors through the pathways of both negative and positive urgency. CONCLUSIONS Results provide initial support for the mediating roles of both negative and positive urgency in the PTSD-risky behavior relation, highlighting the potential utility of teaching trauma-exposed inpatients with PTSD-SUD skills for tolerating negative and positive emotional states without engaging in maladaptive behaviors.

Risk Factors for Alcohol-Related Problems Among Victims of Partner Violence

Despite the high prevalence of alcohol-related problems and disorders among women who experience intimate partner violence (IPV), factors related to current alcohol use are understudied. We examined current risk factors for alcohol-related problems among 143 substance-using, IPV-exposed women recruited from an urban community from 2007 to 2010. Posttraumatic stress disorder (PTSD) symptom severity was associated with alcohol-related problems and a positive alcohol screen; physical IPV severity was related to alcohol dependence. Post hoc analyses revealed that PTSD symptom severity mediated relationships between physical IPV severity and hazardous, harmful, and dependent drinking. Focusing on managing PTSD symptoms and physical IPV in community-based interventions may halt the progression from alcohol use to dependence.