This study examined intimate partner aggression in a sample of 489 participants enrolled in substance use disorder treatment, and expands on prior research by including measures of various forms of aggression, a mixed gender sample (76% men, 24% women), and measurement of several potential risk domains. Aggression measures included both participant-to-partner and partner-to-participant psychological aggression, physical aggression and injury. Analyses focused on the role of distal and proximal risk factors, including demographics, history of childhood physical and sexual abuse, and family history of problems with alcohol, drugs and depression, as well as recent substance use and symptoms of depression. Overall rates of participant-to-partner psychological aggression (77%), physical aggression (54%) and injuring partners (33%) were high, as were rates of partner-to-participant psychological aggression (73%), physical aggression (51%), and injury (33%). Several distal (family history variables, physical abuse) and proximal factors (binge drinking, several different drugs, depressive symptoms) were bivariately related to most of the aggression measures. However, according to multivariate analyses predicting aggression and injury measures, binge drinking and cocaine use were the drugs significantly associated with most measures, depression symptoms also were related to most aggression and injury measures, and a history of reported childhood physical abuse was related to all frequency of aggression and injury measures among those reporting such behaviors. Overall, the high rates of aggression among both men and women observed in this study further illustrate the need for interventions targeting substance use and aggression, and for further research regarding the interrelationships among substance, aggression and depressive symptoms.

Background This study examined associations between acute alcohol and drug use and violence towards others in conflict incidents (overall, partner, and non-partner conflict incidents) by men and women recruited from substance use disorder (SUD) treatment. Methods Semi-structured interviews were used to obtain details about interpersonal conflict incidents (substance use, whether specific conflicts were with intimate partners or non-partners) in the 180 days pre-treatment. Participants for this study were selected for screening positive for past-year violence (N = 160; 77% men, 23% women). Results Multilevel multinomial regression models showed that after adjusting for clustering within individual participants, the most consistent predictors of violence across models were acute cocaine use (significant for overall, intimate partner and non-partner models), acute heavy alcohol use (significant for overall and non-partner models), and male gender (significant in all models). Conclusions This study was the first to explicitly examine the role of acute alcohol and drug use across overall, partner and non-partner conflict incidents. Consistent with prior studies using a variety of methodologies, alcohol, cocaine use and male gender were most consistently and positively related to violence severity (e.g., resulting in injury). The results provide important and novel event-level information regarding the relationship between acute alcohol and specific drug use and the severity of violence in interpersonal conflict incidents.

Emergency Medical Service (EMS) responders deliver patient care in high-risk, high-stress, and highly variable scenarios. This unpredictable work environment exposes EMS responders to many risks, one of which is violence. The primary goals of this systematic literature review were to (1) define the issue of violence experienced by EMS responders and (2) identify the risk factors of violence associated with the EMS profession. An innovative inclusion of industrial literature with traditional peer-reviewed literature was performed. Of 387 articles retrieved, 104 articles were assessed and reviewed. Career exposure for EMS responders to at least one instance of verbal and/or physical violence was between 57 and 93 percent. There is a great need for rigorously designed, nationally representative examinations of occupational exposures in order to better understand the temporal associations of violence, cumulative occupational stressors, and the outcomes of physical and psychosocial injuries that are occurring as a result of exposures to violence.

The present study surveyed medical and/or injured patients (men and women) in an inner city ED to examine the rates and correlates of IPV, including substance use patterns. Over a two-year period, participants (n=10,744) self-administered a computerized health survey during their ED visit that included screening items regarding past year history of IPV (including victimization and aggression). Overall, rates of any involvement in past year IPV were 8.7% (7.3% victimization and 4.4% aggression); however, women were more likely than men to report IPV. When examining participants' substance use patterns, participants who reported using both alcohol and cocaine were most likely to report IPV. Predictors of partner aggression and victimization were remarkably similar. This paper provides unique data regarding correlates of past year IPV history among a comprehensive sample of male and female ED patients presenting for medical complaints and/or injury.