Timothy J. O'Farrell

Partner violence before and after couples-based alcoholism treatment for male alcoholic patients: the role of treatment involvement and abstinence

This study examined partner violence before and after behavioral couples therapy (BCT) for 303 married or cohabiting male alcoholic patients and used a demographically matched nonalcoholic comparison sample. In the year before BCT, 60% of alcoholic patients had been violent toward their female partner, 5 times the comparison sample rate of 12%. In the 1st and 2nd year after BCT, violence decreased significantly from the year before BCT, and clinically significant violence reductions occurred for patients whose alcoholism was remitted after BCT. Structural equation modeling indicated that greater treatment involvement (attending BCT sessions and using BCT-targeted behaviors) was related to lower violence after BCT and that this association was mediated by reduced problem drinking and enhanced relationship functioning.

Evaluating behavioral marital therapy for male alcoholics: Effects on marital adjustment and communication from before to after treatment

Married couples, in which the husband had recently begun individual outpatient alcoholism counseling, were randomly assigned to a no-marital-treatment control group or to 10 weekly sessions of either a behavioral or an interactional couples therapy group. Couples who received the behavioral marital therapy (BMT) improved significantly from before to after treatment on overall marital adjustment, extent of desired relationship change, marital stability, and positiveness of communication when discussing a current marital problem. Interactionally treated couples improved on extent of desired relationship change and positive communication while discussing vignettes from the Inventory of Marital Conflicts. The control couples did not improve on any of the marital relationship variables. BMT produced better results than no marital therapy on marital adjustment and

Correlates of intimate partner violence among male alcoholic patients.

Male-to-female partner violence was investigated in heterosexual couples with an alcoholic male partner. Partner violent (PV) alcoholic patients (n = 183), when compared with nonviolent (NV) alcoholic patients (n = 120), had more antisocial personality characteristics, greater alcohol problem severity, greater use of other drugs, higher relationship distress, and stronger beliefs in the link between alcohol consumption and relationship problems. Demographic factors did not account for these PV-NV differences. Relationship distress and alcohol problem severity had independent associations with partner violence. Relationship adjustment and drug use remained significantly associated with partner violence, whereas alcohol problem severity did not, after controlling for patient antisocial traits. Beliefs in the link between drinking and relationship problems were associated with partner violence independent of other clinical factors.

Alcohol consumption and intimate partner violence by alcoholic men: comparing violent and nonviolent conflicts.

Alcoholic men and their relationship partners were interviewed about a conflict in which physical assault occurred and 1 in which psychological aggression occurred without physical assault. The interview assessed the quantity of alcohol consumed prior to each conflict, other drug use, and the topics, location, timing, duration, and speed of escalation for each conflict. The number of standard drinks consumed by the husband in the previous 12 hr was significantly higher prior to violent versus nonviolent conflicts for both self- and collateral reports, as was blood alcohol concentration estimated from self-report. Other drug use was not significantly different. Greater drinking by wives prior to violent conflicts was found in some analyses. These within-subject comparisons help to rule out individual difference explanations for the alcohol-violence association and indicate that alcohol consumption is a proximal risk factor for partner violence in alcoholic men.

Examining the Correlates of Psychological Aggression Among a Community Sample of Couples

In this study, the authors examined the correlates of psychological aggression victimization and perpetration among a community sample of 145 heterosexual couples. For both women and men, psychological aggression victimization was associated with greater psychological distress, anxiety, and physical health symptoms beyond the effects of physical aggression. Psychological aggression victimization was also uniquely associated with higher levels of depression for women. Trait anger and poor relationship adjustment were the strongest correlates of psychological aggression perpetration across genders. Childhood father-to-child and father-to-mother aggressions were associated with psychological aggression perpetration for men only, suggesting possible distinct etiologies across genders. These data highlight the importance of the further development of models for psychological aggression in both women and men.

Behavioral couples therapy for drug-abusing patients: effects on partner violence

Using data from a previous investigation, the purpose of the present study was to examine the effect of Behavioral Couples Therapy (BCT) on the prevalence of partner violence among married or cohabiting substance-abusing men (N = 80). Participants were randomly assigned to receive either BCT or individual-based treatment (IBT). The proportion of couples who engaged in male-to-female physical aggression was not different during the year before treatment for dyads in BCT (n = 17, 43%) and IBT (n = 19, 48%). However, a smaller proportion of couples in the BCT condition reported male-to-female physical aggression during the year after treatment (n = 7, 18%) than those in the IBT condition (n = 17, 43%). Dyadic adjustment, frequency of heavy drinking, and frequency of drug use during the year after treatment mediated the relationship between type of treatment and the prevalence of male-to-female physical aggression.

Addictive behaviors among hospitalized psychiatric patients

A survey was conducted to assess the extent of alcohol abuse, drug abuse, obesity, and smoking among patients hospitalized on other than substance abuse treatment wards of a large psychiatric hospital. The results revealed extensive addictive behavior problems in the sample with nearly 90% of the patients having at least one of the problems. Prevalence rates for smoking and alcohol abuse substantially exceeded, and for obesity was equivalent to, the prevalence of these behaviors in the general population. Drug abuse was the least frequent problem and comparisons to the general population could not be made. Another major finding was that a relatively small proportion of patients was receiving any treatment for their addictive problems that was likely to be effective. For the most part, it seemed that patients receiving treatment were cases in which the addictive problem caused a serious immediate danger to the patient or others on the ward or seriously disrupted the ward routine.

Drug-abusing patients and their intimate partners: dyadic adjustment, relationship stability, and substance use.

The dyadic adjustment and substance use of couples with a drug-abusing husband (n = 94), couples with a drug-abusing wife (n = 36), couples in which both partners abused drugs (n = 87), and non-substance-abusing conflicted couples (n = 70) were examined. For couples with 1 drug-abusing partner, a higher percentage of days abstinent during the year before treatment for drug abuse was associated with a higher level of relationship satisfaction. When both partners abused drugs, the relationship between percentage of days abstinent and relationship satisfaction became stronger and more negative as the time partners spent together using drugs increased. A higher percentage of days abstinent was associated with relationship stability for couples with 1 drug-abusing partner during and 1 year after treatment; for couples in which both partners abused drugs, a higher percentage of days abstinent was associated with relationship instability.

Behavioral couples therapy for female substance-abusing patients: Effects on substance use and relationship adjustment.

Married or cohabiting female drug-abusing patients (N = 75) were randomly assigned to either a behavioral couples therapy condition (BCT; n = 37), which consisted of group, individual, and behavioral couples therapy sessions, or to an equally intensive individual-based treatment condition (IBT; n = 38), which consisted of group and individual counseling. During most of the 1-year follow-up, compared with participants who received IBT, those who received BCT reported (a) fewer days of substance use, (b) longer periods of continuous abstinence, (c) lower levels of alcohol, drug, and family problems, and (d) higher relationship satisfaction. However, differences in relationship satisfaction and number of days of substance use dissipated over the course of the posttreatment follow-up period and were not significantly different by the end of 1 year.

Review of the Association Between Treatment for Substance Misuse and Reductions in Intimate Partner Violence

A substantial body of research supports a strong cross-sectional and longitudinal association between substance misuse and perpetration of intimate partner violence (IPV). This article briefly addresses the theoretical connection between substance use and intimate partner violence and research on the association between substance misuse and IPV. Studies examining the effect of individual and couples-based addiction treatments on IPV are reviewed. The implications of this work and future directions for research are discussed.