Reducing Violence Against Women with Alcoholic Partners

描述（由申请人提供）：本申请建立在研究人员先前的工作基础上，评估和培训没有接受治疗的酗酒伴侣的女性更有效的应对技能。迄今为止，这项工作主要集中在应对技能培训（CST）和替代的12步促进（TSF）治疗对妇女自身功能的影响，其次是对伴侣饮酒的影响。然而，探索性分析表明，CST可能是特别有效的（相对于TSF），在减少伴侣对妇女的身体暴力，减少暴力伴侣饮酒随着时间的推移，并消除在后续合作伙伴饮酒和暴力之间的积极关系。在这个应用中，我们使用改进的关系暴力方法来（a）测试 这些发现的可复制性，（B）评估治疗对妇女自身对伴侣的暴力行为的影响--迄今为止尚未评估，以及（c）探索酒精伴侣和配偶负面影响、伴侣酒精参与、厌恶性婚姻行为和配偶自我控制（应对）技能的启发式模型中的结构和推定因果途径。对于后者，我们将探讨是否增加妇女的应对技能，在CST，相对于TSF，将缓和（缓冲）的影响，合作伙伴酒精的参与和合作伙伴暴力对她自己的负面影响。技能水平也被认为进一步缓和了妇女对其自身暴力关系行为的负面影响。据推测，减少妇女自身的暴力行为是为了减少伴侣的暴力行为和伴侣自身的负面影响。后者的减少被认为是他饮酒减少和对妇女暴力行为进一步减少的原因。将在2组CST与TSF纵向设计中评价上述先验和探索性目标。150名女性与身体暴力酗酒的合作伙伴目前没有在治疗中将随机分配到治疗组中的CST或TSF。所有参与者将在治疗后的12个月内每隔90天进行随访，在此期间评估女性和伴侣的负面影响和厌恶的婚姻行为，测量伴侣饮酒情况，并评估女性的应对技能获得。据估计，有酗酒伴侣的所有妇女中有近一半经历过伴侣的身体暴力。尽管这些女性通常被家人、朋友和其他人建议离开这段关系，但许多人仍然留下来。帮助这些人改善自己的功能，减少他们所经历的暴力，可能比简单地建议他们离开伴侣或将他们介绍给12步小组更有益于公共卫生。

DESCRIPTION (provided by applicant): This application builds on the investigators' prior work assessing and training more effective coping skills in women with an alcoholic partner who is not in treatment. To date, that work has focused largely on the effects of Coping Skills Training (CST) and an alternate, 12-step Facilitation (TSF) treatment on the woman's own functioning and, secondarily, on the partner's drinking. However, exploratory analyses suggest that CST may be particularly effective (relative to TSF) in reducing partner physical violence against the woman, reducing violent-partner drinking over time, and eliminating the positive relationship between partner drinking and violence during follow-up. In this application, we use improved relationship-violence methodology to (a) test the replicability of these findings, (b) evaluate the effects of the treatments on the woman's own violence toward her partner-heretofore not assessed, and (c) explore the constructs and putative causal pathways operating in a heuristic model of alcoholic partner and spouse negative affect, partner alcohol involvement, aversive marital behaviors, and spouse self-control (coping) skills. With respect to the latter, we will explore whether an increase in the woman's coping skill in CST, relative to TSF, will moderate (buffer) the effects of partner alcohol involvement and partner violence on her own negative affect. Skill level also is thought to further moderate the effect of the woman's negative affect on her own violent relationship behaviors. A reduction in the woman's own violence is hypothesized to reduce partner violence and the partner's own negative affect. A reduction in the latter then is thought to account for a reduction in his drinking and a further reduction in his violence against the woman. The above a priori and exploratory aims will be evaluated in a 2- group CST vs. TSF longitudinal design. One hundred and fifty women with a physically-violent alcoholic partner not currently in treatment will be randomly assigned within therapy groups to either CST or TSF. All participants will be followed at 90-day intervals for a period of 12 months posttreatment during which both the woman's and partner's negative affect and aversive marital behaviors are assessed, partner drinking measured, and the woman's coping skill acquisition evaluated. Estimates suggest that nearly half of all women with alcoholic partners experience some partner physical violence. Although these women typically have been advised by family, friends, and others to leave the relationship, many remain. Helping these individuals improve their own functioning and reduce the violence they experience may have a greater public health benefit than simply advising them to leave the partner or referring them to 12-step groups.