Abstract
This study examined whether female-to-male (FTM) psychological aggression predicted men’s relapse of substance use disorder (SUD) 6 months following substance use treatment. Men diagnosed with either a substance abuse or dependence disorder who had recently begun an SUD treatment program participated in the study with their female relationship partners (N = 173). Logistic regression was used to examine the relationship between baseline FTM psychological aggression and SUD relapse when controlling for baseline demographic, dyadic, substance abuse- and treatment-related variables, as well as frequencies of other male- and female-perpetrated aggressive dyadic behaviors. Higher frequencies of severe, but not minor, forms of FTM psychological aggression uniquely predicted an increased risk of relapse at 6 months follow-up. These data add to the developing research program highlighting the negative sequelae of female-perpetrated psychological aggression and also provide an empirical basis for targeting specific dyadic behaviors in the context of SUD treatment and relapse prevention.
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Notes
A “day” of treatment for outpatient and day treatment settings was defined as at least 2 h of treatment per day.
We used the substance abuse section and the psychotic screen of the SCID, respectively, with the alcoholic patient to establish current substance use disorder diagnoses and to rule out current comorbid psychotic disorders. We did not administer other sections of the SCID. The SCID sections were conducted by one of four trained research assistants with Bachelors or Masters degrees. A doctoral level psychologist with extensive experience administering and scoring the SCID trained the interviewers. SCID interviewer training consisted of (a) reading and reviewing guidelines for conducting SCID interviews; (b) reviewing sample cases to learn how to code responses to SCID questions; (c) practicing reading SCID interview questions aloud; (d) conducting simulated SCID interviews with colleagues; and (e) reviewing audio recordings of SCID interview responses from patients and discussing ratings and diagnoses. Data on inter-rater agreement were not available for the SCID diagnostic interviews in the current study.
Setting “heavy,” and not any, alcohol use as an operational criteria allows for a more conservative differentiation between participants who relapse, per se, as opposed to those who experience a “lapse,” indicating an episode of relatively minor use. However, as it is likely that the severity and clinical significance of use frequency varies across substance type, any instance of illicit substances was used as an operational criterion because it potentially indicates a greater deviation from sobriety than an instance of light alcohol consumption (McKay et al. 2006). The negative consequences associated with use were excluded because the consequences stemming from substance use behaviors likely represent a construct separate from, albeit related to, relapse, and separating substance use from its negative consequences allowed for the latter to be used as a baseline control variable in the foregoing analyses.
Although relationships in which a causal direction is posited are often assessed using regression weights and not the Pearson r correlation coefficient, using the latter is justifiable in cases where predictor variables have equal variances (Kenny et al. 2006).
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Acknowledgements
This research was supported by grants to Timothy O’Farrell from the National Institute on Alcohol Abuse and Alcoholism (R01AA10796 and K02AA00234) and by the Department of Veterans Affairs. We extend our gratitude to Marie Murphy for her assistance with preparation of data. We would also like to thank Bryan Edwards and James MacKillop for their consultation regarding aspects of the statistical analyses. Portions of this article were presented at the Annual Meeting of the Association for Advancement of Cognitive and Behavior Therapies, Chicago, November, 2006.
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Mattson, R.E., O’Farrell, T.J., Monson, C.M. et al. Female Perpetrated Dyadic Psychological Aggression Predicts Relapse in a Treatment Sample of Men with Substance Use Disorders. J Fam Viol 25, 33–42 (2010). https://doi.org/10.1007/s10896-009-9267-y
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DOI: https://doi.org/10.1007/s10896-009-9267-y