Todd M. Moore

Reasons for Intimate Partner Violence Perpetration Among Arrested Women

There are limited empirical data regarding the reasons or motives for the perpetration of intimate partner violence among women arrested for domestic violence and court referred to violence intervention programs. The present study examined arrested women’s self-report reasons for partner violence perpetration and investigated whether women who were victims of severe intimate partner violence were more likely than were women who were victims of minor partner violence to report self-defense as a reason for their behavior. In all, 87 women in violence intervention programs completed a measure of violence perpetration and victimization and a questionnaire assessing 29 reasons for violence perpetration. Self-defense, poor emotion regulation, provocation by the partner, and retaliation for past abuse were the most common reasons for violence perpetration. Victims of severe partner violence were significantly more likely than were victims of minor partner violence to report self-defense as a reason for their violence perpetration. The clinical implications of these findings are discussed.

Psychopathology in Women Arrested for Domestic Violence

This study examined the prevalence of psychopathology among women arrested for violence and whether the experience of intimate partner violence (IPV) was associated with Axis I psychopathology. Women who were arrested for domestic violence perpetration and court referred to violence intervention programs (N= 103) completed measures of IPV victimization, perpetration, and psychopathology. Results revealed high rates of posttraumatic stress disorder (PTSD), depression, generalized anxiety disorder (GAD), panic disorder, substance use disorders, borderline personality disorder, and antisocial personality disorder. Violence victimization was significantly associated with symptoms of psychopathology. Logistic regression analyses showed that sexual and psychological abuse by partners were associated with the presence of PTSD, depression, and GADdiagnoses. Results highlight the potential importance of the role of violence victimization in psychopathology. Results suggest that Axis I and Axis II psychopathology should routinely be assessed as part of violence intervention programs for women and that intervention programs could be improved by offering adjunct or integrated mental health treatment.

A review of the literature on masculinity and partner violence

There has been increasing interest in examining aspects of masculinity as potential predictors of partner violence. This review critically examined the literature on the relationship between masculinity and partner violence. Four distinct approaches to operationalizing masculinity were identified: trait approach, normative approach, gender role conflict approach, and indirect approach. Results generally supported a relationship between each domain of masculinity and partner violence, with the exception of the trait approach. Implications for future research include the importance of examining socialization processes in the development of masculinity and partner violence, being sensitive to methods for operationalizing masculinity, using a greater proportion of clinical samples of violent men, and testing masculine-related components of interventions to reduce partner violence. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

A Comparison of Common Screening Methods for Predicting Aberrant Drug‐Related Behavior among Patients Receiving Opioids for Chronic Pain Management

OBJECTIVE The ability to predict risk for violating opioid medication policies, known as aberrant drug-related behavior, is critical for providing optimal treatment. Many pain management centers measure risk using one of several partially validated measures: the Screener and Opioid Assessment for Patients with Pain (SOAPP), the Diagnosis, Intractability, Risk, and Efficacy inventory (DIRE), and/or the Opioid Risk Tool (ORT). However, little is known about how these measures compare with each other in predicting aberrant drug-related behavior and discontinuance of opioid pain medications. The current study aimed to address this research question. PATIENTS Participants were 48 patients who attended a pain management center in Tennessee but were later discontinued from opioids for aberrant drug-related behavior. Patients referred for opioid medication for pain management participated in a semi-structured clinical interview with the staff psychologist and completed the aforementioned measures. Patients generally returned to the pain clinic on a monthly basis for medication management. Results. Analyses compared the sensitivity of each self-report measure and the clinical interview in predicting discontinuance for aberrant drug-related behavior. RESULTS showed the highest sensitivity for the clinical interview (0.77) and the SOAPP (0.72), followed by the ORT (0.45) and the DIRE (0.17). Combining the clinical interview with the SOAPP increased sensitivity to 0.90. CONCLUSIONS Among patients who were discontinued from opioids for aberrant drug-related behaviors, the clinical interview and the SOAPP were most effective at predicting risk at baseline. Implications for future research and clinical practice are discussed.

Paclitaxel and concurrent radiation for locally advanced pancreatic cancer

PURPOSE To determine the activity and toxicity of paclitaxel and concurrent radiation for pancreatic cancer. METHODS AND MATERIALS Forty-four patients with locally unresectable pancreatic cancer were studied. Patients received paclitaxel, 50 mg/m(2) by 3 h i.v. (IV) infusion, weekly, on Days 1, 8, 15, 22 and 29. Radiation was administered concurrently to a total dose of 50.4 Gy, in 1.80 Gy fractions, for 28 treatments. RESULTS Nausea and vomiting were the most common toxicities, Grade 3 in five patients (12%). Two patients (5%) had Grade 4 hypersensitivity reactions to their first dose of paclitaxel. Of 42 evaluable patients, the overall response rate was 26%. The median survival was 8 months, and the 1-year survival was 30%. CONCLUSION Concurrent paclitaxel and radiation demonstrate local-regional activity in pancreatic cancer. Future investigations combining paclitaxel with other local-regional and systemic treatments are warranted.

Paclitaxel, Cisplatin, and Concurrent Radiation for Esophageal Cancer

Paclitaxel is an active agent for adenocarcinomas and squamous cell carcinomas of the esophagus and is a radiation sensitizer. We sought to investigate the toxicity and complete response rate of paclitaxel, cisplatin, and concurrent radiation for esophageal cancer. Forty-one patients with esophageal cancer were studied, 29 with adenocarcinomas and 12 with squamous cell cancers. Twelve patients had tumor extension into the proximal stomach and/or abdominal adenopathy. Patients received paclitaxel 60 mg/m2 by 3-hour intravenous (IV) infusion, and cisplatin 25 mg/m2 weekly on days 1, 8, 15, and 22. Radiation was administered concurrently to a total dose of 39.60 Gy, in 1.80 Gy fractions, for 22 treatments. Patients with medical or surgical contraindications to esophagectomy received 2 additional weeks of paclitaxel with a radiation boost to 50.4 Gy. Neutropenia was the most common grade 3/4 toxicity occurring in 10 patients (24%). Only 2 patients (5%) had grade 4 esophagitis requiring parenteral nutrition. Twelve patients (29%) obtained a complete response. The 2-year progression-free and overall survival rates were 40% and 42%, respectively. Esophagitis was less severe than expected and prophylactic enteral feeding tubes were not necessary. Additional effective systemic treatments are needed to reduce the development of distant metastases.

Masculine gender role stress and intimate abuse: Effects of gender relevance of conflict situations on men's attributions and affective responses.

This article proposes an approach to understanding mens abuse of their intimate partners. The authors suggest that the concept of masculine gender role stress (MGRS) might be useful in identifying men who are predisposed to become abusive with their intimate partners. College men who scored either high or low on an MGRS scale were assessed, and their attributions, affect, and conflict resolution behavior toward their intimate female partners were examined. Participants were presented with masculine-gender-relevant and masculine-gender-irrelevant vignettes involving disputes with their intimate female partners. Results indicated that men high in MGRS attributed greater negative intent; expressed more irritation, anger, and jealousy; and endorsed aggressive responding more often than did men low in MGRS. Implications of MGRS and masculine relevance of conflicts for understanding male abusive behavior are discussed.

A comparison of various risk screening methods in predicting discharge from opioid treatment.

ObjectivesRisk assessment and stratification has become an important aspect of the prescribing of opioids to patients with chronic pain. There is little empirical data available on the sensitivity and specificity of commonly used risk assessment tools. This paper describes 2 studies that compare the prediction capabilities of various risk assessment tools. MethodsThe first study presents data on patients at a pain practice whose treatment with opioids was stopped due to their engaging in aberrant drug-related behavior. Patients were assessed with the Screener and Opioid Assessment for Patients with Pain–Revised (SOAPP-R), the Pain Medication Questionnaire, the Opioid Risk Tool, and a clinical interview. A second study compared the risk assessment measures, SOAPP-R, Pain Medication Questionnaire, Opioid Risk Tool, and a clinical interview. Data were gathered on whether patients had engaged in aberrant drug-related behavior at 6-month follow-up. ResultsSignificant differences in the measures were found. Accuracy did not appear to be a function of the type of aberrant drug-related behavior that the patient engaged in for any of the measures. The clinical interview showed the best sensitivity of the 4 risk measures in predicting risk. The SOAPP-R showed the best sensitivity of the self-report measures. However, the SOAPP-R appears to overrate risk. DiscussionOverall, these studies indicate that not all risk assessment tools are equal in their ability to accurately predict future aberrant drug-related behavior. It may be that written risk assessment tools that use more subtle items are better suited to certain patient populations.

The temporal association between substance use and intimate partner violence among women arrested for domestic violence.

OBJECTIVE There is a paucity of research on the temporal association between substance use and intimate partner violence (IPV) perpetration and victimization, especially among women arrested for domestic violence. The current study examined whether the probability of IPV perpetration and victimization increases following alcohol or drug use relative to days of no use among women arrested for domestic violence. METHOD Women arrested for domestic violence and court referred to batterer intervention programs who met criteria for hazardous drinking participated in the current study (N = 105). Women who reported drinking 4 or more drinks on 1 occasion at least once per month for the past 6 months were considered hazardous drinkers. Violence and substance use were assessed with the Timeline Followback Interviews for substance use and IPV. RESULTS Women were more likely to perpetrate physical violence on a drinking day (OR = 10.58; 95% CI [5.38, 20.79]) and on a heavy drinking day (OR = 12.81; 95% CI [8.10, 33.57]), relative to a nondrinking day. Women were more likely to be victimized by physical violence on a drinking day (OR = 5.22; 95% CI [2.79, 9.77]) and on a heavy drinking day (OR = 6.16; 95% CI [3.25, 11.68]), relative to a nondrinking day. They were more likely to be victims of sexual coercion (OR = 6.06; 95% CI [1.19, 30.80]) on a cocaine use day relative to a nonuse day. CONCLUSIONS Alcohol use was temporally associated with physical violence perpetration and victimization, and cocaine use was temporally associated with sexual coercion victimization, suggesting that substance use should be targeted in batterer intervention programs for women.

Domains of Masculine Gender Role Stress and Intimate Partner Violence in a Clinical Sample of Violent Men

This study investigated the relationship between the specific factors of the Masculine Gender Role Stress (MGRS) scale and intimate partner violence among a clinical sample of violent men. Participants were 339 men court-mandated to attend violence intervention programs. After demonstrating that the 5-factor MGRS model evidenced strong fit in this sample, analyses revealed that MGRS total scores were associated with each form of intimate partner violence perpetration. However, subsequent analyses that regressed each form of aggression onto all 5 MGRS factors simultaneously revealed that different factors were responsible for each association. Specifically, gender role stress regarding failure to perform in work and sexual domains was the only factor associated with psychological aggression, gender role stress regarding appearing physically fit and not appearing feminine was the only factor associated with sexual coercion, and gender role stress regarding intellectual inferiority was the only factor associated with injury to partners. No single MGRS factor was uniquely associated with physical aggression. Implications are discussed in terms of the importance of examining specific domains of gender role stress when studying and treating partner violence.