Dynamics of Violence and Alcohol Use in Couples

描述(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。尽管伴侣间的暴力行为很大程度上是对等的，但女性遭受的伤害要比男性大得多。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互动过程、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。我们的研究项目使用非线性动力学分析来“观察”夫妻之间剧烈交换的“黑匣子”。在初级保健诊所的病人等待时间内，我们建议招募20对最近有亲密伴侣暴力史的夫妇，并要求他们回答为期60天的每日电话调查。参与者还将完成关于受害和酗酒的风险因素和结果的基线和研究结束调查。每天，他们将报告伴侣的暴力、饮酒、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饮酒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.探索对日常恐吓伴侣暴力和饮酒行为及其预测因素进行大规模纵向研究的伦理学可行性。我们将：估计招募、保留和遗漏数据率；估计效应大小，以帮助确定样本量；以及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 对20对处于暴力关系中的夫妇进行评估，以便：A.评估伴侣报告的一致性 这些研究包括：B.估计日常暴力事件和饮酒超过60天的线性/非线性；C.了解男性和女性伴侣之间以及暴力和饮酒之间暴力事件的协变性和稳定性；D.通过识别反馈机制，为系统动力学建模模拟做准备，该反馈机制可以解释丈夫犯下的暴力、寻求治疗和婚姻分离的动态模式。这条调查路线试图解开丈夫和妻子酒精使用的协变性、暴力的协变性和最近的酒精使用-暴力关系的复杂的互惠影响。最终，这些发现可能会有重要的临床应用，建议基于夫妇动态或杠杆点的干预措施，以实现潜在的变化。确定暴力事件的具体模式可使高危妇女自我监测警示信号，保健专业人员进行风险筛查和简短干预，和/或受害者权益倡导者认识到干预的最佳时机。

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.