Substance Use and Intimate Partner Abuse (IPA): A Descriptive Model of the Pathways Between Substance Use and IPA Perpetration for Men

Abstract

Intimate partner abuse (IPA) is a pervasive public health and human rights issue disproportionately affecting women. There is a complex link between IPA and substance use; substance use can increase both the frequency and severity of IPA. Pathway models have been applied to explore heterogeneous trajectories into other behaviours and to identify areas for intervention. This approach has not previously been applied in the area of substance use and IPA. Inductive thematic analysis of 37 interviews with heterosexual men aged 28–52 who had reported previous IPA perpetration was conducted. Men were recruited from alcohol and drug services across two areas of England. Three groupings of pathways into substance use-related IPA were generated: 1) Rule Breaking Pathway (n = 11); 2) Entrenched Substance Use Pathway (n = 13); and 3) Relationship Insecurity Pathway (n = 13). Across the three groupings of pathways, the men’s childhood and early experiences led to different journeys into SU-related IPA (abuse that was associated with intoxication, withdrawal, acquisition and substance use lifestyle). Each pathway presented differently with varying core features, for example core features of generalised violence, mental health or jealousy, and different predisposing background factors, including types and timing of childhood abuse and trauma. Adopting a pathways approach drawing on principles of equifinality and multifinality can improve understanding of heterogeneity in men who perpetrate IPA and use substances and propose treatment/intervention targets.

Participants in Court-mandated Intervention Programs for Intimate Partner Violence Perpetrators with Substance Use Problems: A Systematic Review of Specific Risk Factors

“…Other salient, identified risk factors in IPV perpetrators with ADUPs were, in terms of personality disorders, a trend towards higher scores on antisocial and borderline personality disorders, in terms of clinical symptomatology, higher clinical symptomatology, depression, and trauma symptomatology and, in terms of executive functions, higher mental rigidity. According to Gilchrist et al (2022) , one of the pathways into substance use-related IPV revealed that perpetrators reported using substances as a coping mechanism to help them deal with their emotional pain and mental health issues caused by unresolved previous trauma. Similarly, the self-medication hypothesis states that individuals with PTSD are more likely to develop ADUPs in light of a tendency to drink or use drugs to alleviate PTSD symptoms and cope with difficult internal experiences ( Hawn et al, 2020 ; Khantzian, 1997 ; Lawrence et al, 2023 ).…”

“…These findings underscore the need to address the function of substance use in intervention programs for IPV perpetrators with ADUPs. Effective interventions with this high-risk group of perpetrators should focus on re-scripting childhood experiences, reframing unhelpful schemas, and expressing emotional needs to enhance self-regulation and trauma healing ( Gilchrist et al, 2022 ). However, as IPV perpetrators with ADUPs present high dropout and recidivism rates, retention strategies are also needed to help them complete the intervention and improve their outcomes ( Lila et al, 2020 ; Olver et al, 2011 ).…”

“…Previous research suggests that unresolved trauma in IPV perpetrators could have an impact on ADUPs (e.g., substance use can be used as a way of coping with stress and trauma) and on intimate relationships by intensifying IPV perpetration ( Gilchrist et al, 2019 ; Mathews et al, 2015 ). Specifically, IPV perpetrators who disclosed childhood trauma experiences could be perpetrating IPV and using drugs as a defence to regain control and power over their lives ( Gilchrist et al, 2022 ; Øverup et al, 2015 ). These findings evidence the fact that exploring the history of trauma of IPV perpetrators with ADUPs and their narratives could inform interventions and improve outcomes.…”

“…In this line, a meta-analysis and systematic review by Karakurt et al (2019) showed that including trauma-based or substance-use treatment components yielded better outcomes than interventions without this component, as they reported more effective results in decreasing male IPV perpetration. Interventions targeting anti-social cognitions and schemas that sustain their use of violence while promoting intimate and network support could also be helpful ( Gilchrist et al, 2022 ).…”

Adapting the ADVANCE group program for digitally-supported delivery to reduce intimate partner violence by men in substance use treatment: a feasibility study

“…We developed the ADVANCE perpetrator group program (25)(26)(27) to address the complex interplay between substance use and IPV perpetration in the context of intoxication, withdrawal, craving and acquiring substances (28)(29)(30), neglected in other programs. Our research highlighted the importance of addressing sexual jealousy and entitlement, the wider dynamics of power and control, and psychological vulnerabilities (29)(30)(31).…”