Yael Chatav Schonbrun

Subtypes of partner violence perpetrators among male and female psychiatric patients.

The goal of this naturalistic study was to examine heterogeneity among female and male civil psychiatric patients with a history of intimate partner violence (IPV) perpetration. Participants were 567 patients drawn from the MacArthur Violence Risk Assessment Study (J. Monahan et al., 2001). The authors examined subtype composition among 138 women and 93 men with positive histories of IPV and compared these groups with 111 women and 225 men with no histories of IPV. Findings for men and women were consistent with reports from studies of male perpetrators in forensic and community settings in that generally violent/antisocial, borderline/dysphoric, and family only/low-psychopathology subtypes of perpetrators were identified in both men and women. This study provides preliminary evidence for the generalizability of typologies derived from nonpsychiatric partner violence perpetrators to psychiatric populations and suggests that typologies derived from studies of male IPV perpetrators may provide useful guidance for the investigation of female IPV perpetration.

SOCIAL CONSEQUENCES OF BORDERLINE PERSONALITY DISORDER SYMPTOMS IN A POPULATION-BASED SURVEY: MARITAL DISTRESS, MARITAL VIOLENCE, AND MARITAL DISRUPTION

Associations between borderline personality disorder (BPD) symptoms and marital distress, perpetration of marital violence, and marital dissolution were evaluated in a population-based sample of married adults. The incremental association between BPD symptom severity and marital outcomes was also examined, controlling for the presence of Axis I disorders. Respondents from the National Comorbidity Survey Replication (NCS-R) who had been married at least once completed measures of BPD symptoms and provided information about their marital histories; a subset of participants completed measures of marital distress and marital violence. BPD symptom severity was positively associated with marital distress, perpetration of minor and severe marital violence, and marital disruption. Associations remained significant when controlling for presence of 12-month Axis I disorders. These findings underscore the importance of examining adverse social consequences of BPD.

Adulthood Animal Abuse Among Men Arrested for Domestic Violence

Learning more about intimate partner violence (IPV), perpetrators could aid the development of more effective treatments. The prevalence of adulthood animal abuse (AAA) perpetration and its association with IPV perpetration, antisociality, and alcohol use in 307 men arrested for domestic violence were examined. Forty-one percent (n = 125) of the men committed at least one act of animal abuse since the age of 18, in contrast to the 1.5% prevalence rate reported by men in the general population. Controlling for antisociality and alcohol use, AAA showed a trend toward a significant association with physical and severe psychological IPV perpetration.

Male Batterers’ Alcohol Use and Gambling Behavior

Little work has examined the interrelations among intimate partner violence (IPV), alcohol use, and gambling behavior, and no studies have examined these relationships among males court-ordered to batterer intervention programs (BIPs). The aim of the current investigation was to explore the associations between IPV, alcohol use, and gambling behavior among 341 males court-mandated to attend BIPs utilizing self-report measures. Voluntary, anonymous questionnaires were administered and completed during regularly scheduled BIP sessions. Compared to the general population, a higher percentage of the sample met criteria for pathological gambling (9%), and problem gambling (17%). Further, males exhibiting pathological gambling were more likely to be hazardous drinkers, and hazardous drinkers were more likely to exhibit pathological gambling. Additionally, pathological gamblers were at an increased risk for the perpetration of both physical and sexual aggression. Finally, gambling behavior uniquely predicted the perpetration of sexual aggression above and beyond alcohol use, impulsivity, and relationship satisfaction. The implications of these results for future research and intervention are discussed.

Marital distress and mental health care service utilization.

OBJECTIVE This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). METHOD The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for specific sectors of treatment providers, including psychiatrist, other mental health provider, other medical provider, and religious services provider. Interviews were used to assess past-year service utilization and presence of anxiety, mood, and substance use disorders. RESULTS Approximately 12% of married individuals sought help for problems with their emotions, nerves, or substance use during the 12 months preceding the interview. Marital distress was significantly associated with (a) overall mental health service utilization and service utilization provided by each of the sectors of providers when controlling for demographic variables and (b) overall mental health service utilization and receiving treatment from a psychiatrist when additionally controlling for past-year anxiety, mood, or substance use disorders. There was little evidence that the associations between marital distress and service utilization were moderated by gender or presence of psychiatric disorders. CONCLUSION The finding that marital distress is associated with greater mental health care service utilization suggests that clinicians should assess both individual and relationship factors among individuals presenting for treatment.

Examining the interface between substance misuse and intimate partner violence.

There is considerable theoretical and empirical support for a link between substance misuse and perpetration and victimization of intimate partner violence. This review briefly summarizes this literature and highlights current research that addresses the interface between treatment for substance abuse and intimate partner violence. Suggestions for future research and clinical implications are provided.

A qualitative study of treatment needs among pregnant and postpartum women with substance use and depression.

Little is known about treatment for pregnant and postpartum women with cooccurring substance use and depression. Funded by the National Institute of Drug Abuse, we conducted three focus groups with 18 pregnant and postpartum women in 2011 at an urban substance use treatment clinic. A semi-structured discussion guide probed for factors impacting treatment outcomes and needs. Data were analyzed using grounded theory. Women identified motivational, family, friend, romantic, and agency characteristics as facilitative or challenging to their recoveries, and desired structure (group treatment, a safe environment, and transportation) and content (attention to mental health, family, and gender-specific issues) of treatment.

The Association between Intimate Partner Violence Perpetration, Victimization, and Mental Health among Women Arrested for Domestic Violence

Intimate partner violence (IPV) is a major problem. Unfortunately, there is a dearth of research on the associations between IPV perpetration, victimization, and mental health among women. This study examined these associations among a sample of women arrested for domestic violence and court-referred to batterer intervention programs (BIPs; N = 88). Using self-report screening instruments for Axis I and Axis II mental health problems, results showed very high rates of mental health problems among women. In addition, both IPV perpetration and victimization were associated with increased mental health symptoms. Women who met diagnostic cutoff scores reported greater IPV perpetration/victimization than women who did not meet those cutoff scores. Implications of these findings for future research and IPV interventions are discussed.

“I know if I drink I won’t feel anything”: substance use relapse among depressed women leaving prison

PURPOSE The purpose of this paper is to explore treatment needs and factors contributing to engagement in substance use and sobriety among women with co-occurring substance use and major depressive disorders (MDDs) as they return to the community from prison. DESIGN/METHODOLOGY/APPROACH The paper used qualitative methods to evaluate the perspectives of 15 women with co-occurring substance use and MDDs on the circumstances surrounding their relapse and recovery episodes following release from a US prison. Women were recruited in prison; qualitative data were collected using semi-structured interviews conducted after prison release and were analyzed using grounded theory analysis. Survey data from 39 participants supplemented qualitative findings. FINDINGS Results indicated that relationship, emotion, and mental health factors influenced womens first post-prison substance use. Women attributed episodes of recovery to sober and social support, treatment, and building on recovery work done in prison. However, they described a need for comprehensive pre-release planning and post-release treatment that would address mental health, family, and housing/employment and more actively assist them in overcoming barriers to care. PRACTICAL IMPLICATIONS In-prison and aftercare treatment should help depressed, substance using women prisoners reduce or manage negative affect, improve relationships, and obtain active and comprehensive transitional support. ORIGINALITY/VALUE Women with co-occurring mental health and substance use disorders are a high-risk population for negative post-release outcomes, but limited information exists regarding the processes by which they relapse or retain recovery after release from prison. Findings inform treatment and aftercare development efforts.

Linking measures of adult nicotine dependence to a common latent continuum and a comparison with adolescent patterns.

BACKGROUND An ongoing debate regarding the nature of nicotine dependence (ND) is whether the same instrument can be applied to measure ND among adults and adolescents. Using a hierarchical item response model (IRM), we examined evidence for a common continuum underlying ND symptoms among adults and adolescents. METHOD The analyses are based on two waves of interviews with subsamples of parents and adolescents from a multi-ethnic longitudinal cohort of one thousand and thirty-nine 6-10th graders from the Chicago Public Schools (CPS). Adults and adolescents who reported smoking cigarettes the last 30 days prior to waves 3 and 5 completed three common instruments measuring ND symptoms and one item measuring loss of autonomy. RESULTS A stable continuum of ND, first identified among adolescents, was replicated among adults. However, some symptoms, such as tolerance and withdrawal, differed markedly across adults and adolescents. The majority of mFTQ items were observed within the highest levels of ND, the NDSS items within the lowest levels, and the DSM-IV items were arrayed in the middle and upper third of the continuum of dependence severity. Loss of autonomy was positioned at the lower end of the continuum. We propose a ten-symptom measure of ND for adolescents and adults. CONCLUSIONS Despite marked differences in the relative severity of specific ND symptoms in each group, common instrumentation of ND can apply to adults and adolescents. The results increase confidence in the ability to describe phenotypic heterogeneity in ND across important developmental periods.