Reducing Violence Against Women with Alcoholic Partners

描述(由申请人提供)：这项申请建立在调查人员先前的工作基础上，评估和培训有未接受治疗的酗酒伴侣的妇女的更有效的应对技能。到目前为止，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)治疗对女性自身功能的影响，其次是对伴侣饮酒的影响。然而，探索性分析表明，与TSF相比，CST可能在减少伴侣对女性的身体暴力方面特别有效，随着时间的推移减少伴侣之间的暴力饮酒，并在后续行动中消除伴侣饮酒和暴力之间的积极关系。在此应用程序中，我们使用改进的关系暴力方法来(A)测试 这些研究结果的可重复性：(B)评估治疗对女性自身对其伴侣的暴力的影响--到目前为止还没有评估过；和(C)探索酒精伴侣和配偶负面情绪、伴侣酒精介入、厌恶的婚姻行为和配偶自我控制(应对)技能的启发式模型中运行的结构和假定的因果路径。对于后者，我们将探索女性在CST中相对于TSF的应对技能的提高是否会缓和(缓冲)伴侣酒精介入和伴侣暴力对其自身负面影响的影响。技能水平也被认为可以进一步缓和女性负面情绪对自己暴力关系行为的影响。假设减少女性自己的暴力行为是为了减少伴侣的暴力行为和伴侣自己的负面影响。因此，后者的减少被认为是他减少饮酒和进一步减少对妇女的暴力的原因。上述先验和探索性目标将在两组CST和TSF纵向设计中进行评估。150名有身体暴力酗酒伴侣的女性目前没有接受治疗，她们将被随机分配到治疗组中，接受CST或TSF治疗。所有参与者将在治疗后的12个月内每隔90天接受一次跟踪，在此期间，评估女性和伴侣的负面情绪和厌恶的婚姻行为，测量伴侣饮酒，并评估女性的应对技能获得。据估计，在所有有酗酒伴侣的女性中，有近一半的人经历过伴侣的身体暴力。尽管这些女性通常会被家人、朋友和其他人建议离开这段关系，但仍有许多人留了下来。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让他们参加12步小组更能带来公共健康方面的好处。

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.