Distal and proximal factors associated with aggression towards partners and non-partners among patients in substance abuse treatment

Abstract

Studies of violence in substance use disorder (SUD) treatment settings typically focus on partner aggression (PA) although non-partner aggression (NPA) is also a common problem. This study examines potentially distinct paths of distal and proximal risk factors related to aggression towards non-partners (NPA) and partners (PA) among a SUD treatment sample. The sample included 176 adults reporting past-year violence. Bivariate analyses indicated several distal and proximal factors were associated with NPA and PA. According to multivariate, multiple mediation analyses youth aggression history was a factor for both NPA and PA. Alcohol and cocaine use and psychological distress were associated with NPA; marijuana use was associated with PA. There also was evidence of indirect effects of distal factors on NPA and PA. The results suggest that there may be substantially different dynamics associated with NPA and PA, and have implications for developing screening, assessment and treatment protocols targeting violence among individuals in SUD treatment.

Associations between PTSD and intimate partner and non-partner aggression among substance using veterans in specialty mental health

“…The CTS2 has good internal consistency and has been well validated (Simpson and Christensen, 2005). Further, the modified version has been shown to have strong internal consistency (alpha > .90) for measuring both partner and non-partner aggression (Epstein-Ngo et al, 2014). The Cronbach’s alphas for each subscale used in the current sample were: partner physical aggression α = .89, non-partner physical aggression α = .90, partner injury aggression α = .71, and non-partner injury aggression α = .84.…”

“…Moreover, past year estimates of violence perpetration in substance use treatment samples are 2–3 times higher than community samples (Chermack et al, 2001). Problematic alcohol and cocaine use have been consistently linked to violence (Chermack et al, 2014; Macdonald et al, 2003), and some research indicates that marijuana use may be more strongly associated with partner violence than non-partner violence (Epstein-Ngo et al, 2014; Moore et al, 2008). Thus, the association between substance use and violence perpetration in veterans is an important area of investigation.…”

“…Studies in non-veteran populations have reported that different factors may be associated with partner violence compared with non-partner violence (Epstein-Ngo et al, 2014). Specifically, Epstein-Ngo and colleagues (2014) found that heavy drinking and cocaine use were associated with non-partner aggression whereas marijuana was associated with partner aggression. Another limitation in prior veteran-focused work is the lack of research on specific substances other than alcohol.…”

“…After adjusting for covariates that have been associated with violence perpetration (Elbogen et al, 2014; Murray et al, 2008; Stappenbeck et al, 2014; Taft et al, 2009a); it was hypothesized that PTSD would be associated with physical violence towards a partner (partner physical aggression), physical violence towards a person other than a partner (non-partner physical aggression), more severe violence resulting in the injury of a partner (partner injury aggression), and violence resulting in the injury of a person other than the perpetrator’s partner (non-partner injury violence). Additionally, based on previous research (Epstein-Ngo et al, 2014), it was hypothesized that past-month heavy alcohol use and cocaine use would be associated with all four types of violence whereas marijuana would only be associated with partner physical and injury aggression.…”

Does marijuana use contribute to intimate partner aggression? A brief review and directions for future research

“…Marijuana use was not associated with IPA among couples in which the man was entering substance abuse treatment [25], but it was in a sample of men and women in substance abuse treatment who had a history of violence [26]. In a sample arrested for partner violence, marijuana use predicted IPA for men but not for women [4].…”