Womens Substance Use and Intimate Partner Violence

描述（由申请人提供）：本提案属于挑战主题“发起创新干预措施以防止家庭暴力：09- da -103.09”下的广泛挑战领域“09：健康差距”。在这一主题领域的描述中，要求提出“探索家庭暴力与药物滥用之间关系的本质”的建议。本提案正是针对挑战主题的目标而提出的。家庭暴力是15-44岁妇女受伤的主要原因，解决对妇女的暴力问题已成为国家优先事项（拜登，1993年）。强制治疗亲密伴侣暴力（IPV）或施暴者治疗(a)非常昂贵，(b)通常侧重于男性，(c)相对无效（Babcock et al., 2004）。此外，男性也是IPV的受害者（Archer, 2000），而女性的IPV很少被提及。针对这一社会问题的许多政府资金都被浪费了，因为缺乏基于对女性和男性在实施IPV中的代理作用的研究的循证治疗方案。此外，有证据表明，他们对伴侣的身体攻击使他们更有可能在报复中遭受伤害（Whitaker etal ., 2007）。影响妇女IPV的环境因素尚未得到很好的理解，进一步的研究将为预防和治疗方案提供信息和加强。药物使用与IPV有关，经常被认为是男性IPV的一个促成因素，但在女性中很少研究这个问题。最近的研究表明(a)女性和男性对伴侣进行某种程度的身体攻击的比率相对相等，而且夫妻关系中的许多身体攻击是相互的；(b)男性和女性参与IPV的发展历史表明，在青春期发展的反社会行为预示着后来对浪漫伴侣的攻击行为，这一点很相似，不仅对年轻男性如此，对年轻女性也是如此。这些发现表明个体精神病理作为女性攻击性预测指标的重要性。我们将IPV视为一种二元行为，并采用动态发展系统的方法来研究男性和女性的特征、当前情境、与伴侣互动时的行为以及随时间的变化之间的相互作用，所有这些都会影响他们未来的互动，女性的反社会行为和抑郁症状与她们参与IPV有关，也与物质使用有关（Glantz & Leshner, 2000）。因此，了解药物使用与妇女IPV行为之间的关系至关重要。这项拟议研究的主要目的是研究物质使用的关系，包括尼古丁、酒精、大麻和其他非法药物，以及对160名社会经济地位一般较低的女性和俄勒冈州青年研究夫妇样本中的同一男性伴侣进行多次研究。现有的数据集包括对女性及其男性伴侣的物质使用、反社会行为、精神病理和IPV的测量。我们还建议收集新的数据，以提供关于妇女及其伴侣目前和终生药物使用的额外诊断信息，这将添加到正在进行的关于夫妇压力、健康和IPV的研究中（Grant HD46364； Deborah Capaldi博士，PI）。我们还将检验不同模型的有效性，这些模型可能解释观察到的物质使用与IPV之间的关联。模型验证结果对于药物滥用预防和治疗方案作为间接预防和治疗妇女IPV的有效性具有重要意义。拟议的研究将提高我们对以下方面的理解：(a)物质使用和依赖对20多岁妇女开始发生亲密伴侣暴力的贡献，(b)妇女的物质使用问题与其男性伴侣对妇女的伤害之间的联系，以及(c)妇女在生活中戒除物质时是否比使用物质时较少实施亲密伴侣暴力。这对药物使用治疗作为减少亲密伴侣暴力干预的有效性具有重要意义。

DESCRIPTION (provided by applicant): This proposal is subsumed under Challenge Topic Initiating Innovative Interventions to Prevent Family Violence: 09-DA-103.09 in the broad challenge area of 09: Health Disparities. Within the description of this topic area is a request for proposals that "Explore the nature of the relationship between family violence and substance abuse." This proposal is in response to that goal of the challenge topic. Domestic violence is the leading cause of injuries to women aged 15-44 years, and addressing the issue of violence against women has become a national priority (Biden, 1993). Mandated treatment of intimate partner violence (IPV), or batterer treatment, is (a) very costly, (b) generally focused on men, and (c) relatively ineffective (Babcock et al., 2004). Furthermore, men also are victims of IPV (Archer, 2000), and women's IPV is little addressed. Much governmental funding targeting this social problem has been wasted because of the lack of evidence-based treatment programs grounded in research on the agentic role of women as well as men in perpetrating IPV. Moreover, there is evidence that their physical aggression toward a partner makes them more likely to sustain an injury in retaliation (Whitaker et al., 2007). Contextual factors influencing women's IPV are not well understood, and further research would inform and strengthen prevention and treatment programs. Substance use is associated with IPV and frequently has been considered a contributing factor to IPV for men, but this issue has been little examined in women. Recent studies show that (a) women and men have engaged in some level of physical aggression toward a partner at relatively equal rates and that much physical aggression in couples' relationships is mutual and (b) developmental histories of men and women engaging in IPV show similarity in that antisocial behavior that develops by adolescence predicts later aggressive behavior toward a romantic partner, not only for young men but also for young women. These findings suggest the importance of individual psychopathology as a predictor of aggression for women. We view IPV as a dyadic behavior and take a dynamic developmental systems approach to examining the interaction of the men's and women's characteristics, current context, behavior during interaction with their partner, and changes over time, all of which affect their future interactions Antisocial behavior and depressive symptoms in women are associated with their engagement in IPV and are also associated with substance use (Glantz & Leshner, 2000). Thus, it is of critical importance to understand the association of substance use and perpetration of IPV by women. The primary purpose of the proposed study will be to examine the association of substance use, including nicotine, alcohol, marijuana, and other illicit drugs, and IPV for a sample of 160 generally lower socioeconomic women studied over multiple times with the same male partner in the Oregon Youth Study Couples sample. The extant data set includes measurement of substance use, antisocial behavior, psychopathology, and IPV for both the women and their male partners. We are also proposing to collect new data to provide additional diagnostic information on both the women and their partners' current and lifetime substance use, which will be added to an ongoing study of the couples' stress, health, and IPV (Grant HD46364; Dr. Deborah Capaldi, PI). We will also examine the validity of different models that might explain the observed associations between substance use and IPV. Model validation findings would have important implications regarding the efficacy of substance abuse prevention and treatment programs as indirect prevention and treatment for women's IPV. The proposed research will improve our understanding of (a) the contribution of substance use and dependence to the initiation of intimate partner violence for women in their twenties, (b) the association between women's substance use problems and their male partners' victimization of the women, and (c) whether women commit less intimate partner violence during times in their lives when they are abstinent from substances than when they are using, which has important implications for the effectiveness of substance use treatment as an intimate partner violence reduction intervention.