Dynamics of Violence and Alcohol Use in Couples

描述（由申请人提供）：亲密伴侣暴力在美国很普遍，对受害者造成严重的身体和心理伤害。虽然伴侣暴力在很大程度上是相互的，但妇女受到的伤害比男子大得多。酒精与暴力关系有关，既是暴力发作的长期风险因素，也是暴力发作时的直接威胁。人们对伴侣之间的日常互动过程、酒精使用在这些过程中的直接作用或暴力和饮酒发生的背景知之甚少。我们的研究项目使用非线性动力学分析来“观察”夫妻之间暴力冲突的黑盒子内部。在初级保健诊所的病人等待时间，我们建议招募20对最近有亲密伴侣暴力史的夫妇，并要求他们在60天内每天回答电话调查。参与者还将完成基线和研究结束时的调查，以解决受害和酒精滥用的风险因素和结果。每天，他们都会报告伴侣暴力、酗酒、争吵、争吵、压力和婚姻亲密程度。非线性系统分析将确定暴力和酒精使用的模式以及其他日常因素的影响。几项促进安全的措施将到位。本探索性研究的具体目的是：1。探讨开展日常亲密伴侣暴力和酒精使用的大规模纵向研究及其预测因素的伦理可行性。我们将：估计招聘、保留和丢失数据率；估计效应大小，以帮助确定样本量；并评估研究参与对受试者的影响，包括安全性。2. 进行初步测试

DESCRIPTION (provided by applicant): Intimate partner violence is widespread in the United States and causes serious physical and psychological damage to the victims. Although much of partner violence is reciprocal, women suffer far more damage from victimization than men. Alcohol is implicated in violent relationships, both as a chronic risk factor of and an immediate threat during violent episodes. Little is known about the daily interactional processes between partners, the immediate role of alcohol use in those processes, or the context within which violence and drinking occurs. Our program of study uses nonlinear dynamics analysis to "look inside the black box" of violent interchanges within couples. During patient waiting times in a primary care clinic, we propose to enroll 20 couples with a recent history of intimate partner violence and ask them to respond to a daily telephone survey for 60 days. Participants will also complete baseline and end-of-study surveys addressing risk factors and outcomes of victimization and alcohol abuse. Daily, they will report on partner violence, alcohol use, arguments, hassles, stress, and marital closeness. Nonlinear systems analyses will determine the patterns of violence and alcohol use and the influence of other daily factors. Several measures to promote safety will be in place. The specific aims of this exploratory study are to: 1. To explore the ethical feasibility of conducting a large-scale longitudinal study of daily intimte partner violence and alcohol use, and their predictors. We will: estimate recruitment, retention and missing data rates; estimate effect size to aid in sample size determination; and evaluate the impact of study participation on subjects, including safety. 2. To conduct preliminary testing of 20 couples in violent relationships in order to: A. assess the concordance of partners' reports of violent behaviors; B. estimate linearity/nonlinearity in daily violent events and alcohol intak over 60 days; C. understand the covariability and stability of violent events between male and female partners and between violence and alcohol intake; and D. prepare for system dynamics modeling simulation by identifying feedback mechanisms that could explain the dynamic patterns of husband-perpetrated violence, treatment-seeking, and marital separation. This line of inquiry seeks to unravel the complex reciprocal effects of husband-wife alcohol use covariability, violence covariability, and the proximal alcohol use-violence relationship. Ultimately, these findings could have significant clinical applications, suggesting interventions based on couple dynamics or leverage points for potential change. Identification of specific patterns of violent events may permit self- monitoring for warning signs by at-risk women, risk screening and brief interventions by health care professionals, and/or recognition of optimal times to intervene by victim advocates.