Problem Drinking and Marijuana Use as Risks for Unidirectional and Bidirectional Partner Violence

Abstract

Despite evidence that most who perpetrate intimate partner violence (IPV) also report victimization, little is known about bidirectional IPV among Emergency Department patients and its association with problem drinking and marijuana use. We conducted an observational, cross-sectional survey among low- and moderate-acuity patients at a Northern California safety-net ED. Physical IPV was measured with the Revised Conflict Tactics Scale (CTS2). We recorded patient's frequency of intoxication and marijuana use. Spouse/partner's problem drinking and marijuana use were measured dichotomously. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multinomial logistic regression models of unidirectional and bidirectional IPV. Among 1,037 patients (53% female), perpetration only, victimization only, and bidirectional IPV were reported by 3.8%, 6.2%, and 13.3% of the sample, respectively. Frequency of intoxication was associated with perpetration (OR = 1.50; 95% CI 1.18–1.92) and bidirectional IPV (OR = 1.34; 95% CI 1.13–1.58). Days of marijuana use were associated with bidirectional IPV (OR = 1.15; 95% CI 1.03–1.28). Patients whose partners were problem drinkers were at risk for victimization (OR = 2.56; 95% CI = 1.38, 4.76) and bidirectional IPV (OR = 1.97; 95% CI 1.18, 3.27). Among patients who reported any past-year IPV, most experienced bidirectional aggression. ED staff should consider asking patients who are married, cohabiting, or in a dating relationship about their experience with past-year IPV and inquire about their substance use patterns and those of their romantic partner, to share information about potential linkages. Medical and recreational marijuana legalization trends underscore the importance of further research on IPV and marijuana.

Frequency of Intimate Partner Violence among an Urban Emergency Department Sample: A Multilevel Analysis

“…Gender-specific models were estimated for frequency of any IPV, and for frequency of any severe IPV. The models include sociodemographic, psychosocial, substance use, and household factors previously shown to be associated with IPV [ 6 , 7 , 28 ]. Among the 1037 survey participants, cases in which the participant described themselves as transgender ( n = 3) were dropped from the analysis due to small numbers.…”

“…The observed higher prevalence of IPV among patients who seek medical care at urban safety-net EDs can be partially explained by their social disadvantage and other characteristics that are associated with greater likelihood of IPV [ 6 , 7 ]. For example, compared to the general population, urban ED patients have elevated rates of substance use, mental health problems, and unemployment [ 8 , 9 , 10 ] and are more often exposed to aspects of the social environment that are linked with increased likelihood of IPV, such as neighborhood poverty [ 11 ].…”

“…Given the dearth of ED-based studies that have examined how neighborhood social disadvantage may be linked to IPV, the aim of this study is to analyze the extent that individual, household, and neighborhood-related factors are associated with frequency of IPV and severe IPV among a sample of married/partnered male and female urban ED patients. Previous analyses of the data found that 23% of study participants reported past-year physical IPV; among those reporting any IPV, most (57.3%) reported both victimization and perpetration [ 7 ]. In addition, among those who reported any IPV, approximately half reported severe IPV [ 6 ].…”

Interrelationships of Economic Stressors, Mental Health Problems, Substance Use, and Intimate Partner Violence among Hispanic Emergency Department Patients: The Role of Language-Based Acculturation

“…This allowed for a gender-stratified analysis, to compare the prevalence and correlates of the study outcomes. Since IPV is most often bidirectional (i.e., men and women report both perpetration and victimization) [27,28,[53][54][55], it is important to measure both behaviors independently. By measuring IPV perpetration and victimization among all study participants, this study helps to overcome a limitation of some previous IPV research among Hispanics, in which factors related to IPV perpetration were confined to male study participants [26,56,57], and factors related to IPV victimization were confined to female study participants [58][59][60][61].…”

Adverse childhood experiences are associated with at-risk drinking, cannabis and illicit drug use in females but not males: an Emergency Department study

“…Nearly one-third had not completed high school; less than 10% had graduated from college. Almost half reported that they sometimes or often ran out of food during the past 12 months and did not have enough money to get more (32). The hospital where the study was conducted is part of a county-wide integrated public health-care system.…”