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心伤害。虽然伴侣间的暴力行为大多是相互的，但妇女因受害而受到的伤害远远大于男子。酒精与暴力关系有关，既是暴力事件的长期风险因素，也是暴力事件的直接威胁。人们对伴侣之间的日常冲突过程、饮酒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。我们的研究计划使用非线性动力学分析，以“看看里面的黑箱”的夫妇之间的暴力交流。 在一个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，并要求他们回答60天的每日电话调查。参与者还将完成基线和研究结束调查，以解决受害和酗酒的风险因素和结果。每天，他们都会报告伴侣暴力、酗酒、争吵、争吵、压力和婚姻亲密度。非线性系统分析将确定暴力和酗酒的模式以及其他日常因素的影响。将采取若干措施促进安全。 本探索性研究的具体目的是：1。探讨对日常亲密伴侣暴力和酒精使用及其预测因素进行大规模纵向研究的伦理可行性。我们将：估计招募率、保留率和缺失数据率;估计效应量以帮助确定样本量;评价研究参与对受试者的影响，包括安全性。 2.进行初步测试 20对有暴力关系的夫妇，为了：A。评估合作伙伴报告的一致性 暴力行为; B.估计60天内每日暴力事件和酒精摄入的线性/非线性; C.理解男性和女性伴侣之间以及暴力和酒精摄入之间暴力事件的协变性和稳定性;以及D.通过识别反馈机制，为系统动力学建模模拟做好准备，这些机制可以解释丈夫实施暴力、寻求治疗和婚姻分居的动态模式。 这一系列的调查旨在解开复杂的相互影响的丈夫-妻子酒精使用协变性，暴力协变性，和近端的酒精使用暴力的关系。最终，这些发现可能具有重要的临床应用，建议基于夫妇动态或潜在变化的杠杆点进行干预。查明暴力事件的具体模式，可以使处于危险中的妇女自我监测预警信号，保健专业人员进行风险筛查和简要干预，和/或受害者维权者确认干预的最佳时机。

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.