The Role of Substance Use in Family and Domestic Violence (FDV)

Dr Richelle Mayshak, Dr Ashlee Curtis, Dr David Skvarc, and Travis Harries

Centre for Drug use, Addictive and Anti-social behaviour Research (CEDAAR)

Deakin University, School of Psychology, Faculty of Health

FDV Typologies

• Two major forms of situational FDV:

• Intimate Partner Violence (IPV) which includes intimate partner relationships that are formal and informal, co-habiting and non-cohabiting)

• Family Violence (FV) which includes all other family relationships

• Coercive controlling behaviours

• Non-physical psychological or emotional abusecharacterised by recurrent attempts by one partner to belittle, intimidate, isolate, and otherwise gain control over the other

• Child to parent violence

Illicit Drugs and Police Reported FDV

1. Coomber K, Mayshak R, Liknaitzky P, Curtis A, Walker A, Hyder S, Miller P. The Role of Illicit Drug Use in Family and Domestic Violence in Australia. J Interpers Violence. 2019 Apr 11:886260519843288. doi: 10.1177/0886260519843288. Epub ahead of print. PMID: 30973034.

2. Mayshak, R., Cox, E., Costa, B., Walker, A., Hyder, S., Day, A., ... & Miller, P. Alcohol/Drug-Involved Family Violence in Australia (ADIVA)—Research Bulletin.3. Miller, P., Cox, E., Costa, B., Mayshak, R., Walker, A., Hyder, S., ... & Day, A. (2016). Alcohol/Drug-Involved Family Violence in Australia (ADIVA) Key findings.

ACT NSW SA Tas WA

Year n % n % n % n % n %

2009 4 0.7 263 1.1 - - 123 7.3 226 2.8

2010 8 0.7 227 1.0 58 3.5 247 8.8 245 3.1

2011 6 0.6 226 0.9 66 3.8 229 8.5 233 2.9

2012 17 1.8 333 1.4 104 5.5 203 8.8 295 3.5

2013 14 1.5 416 1.7 108 6.1 235 10.2 306 3.6

2014 3 0.6 - - 181 6.8 90 7.7 395 4.7

Alcohol and Police Reported FDV

ACT: 23.9% NSW: 38.8% NT: 53.6% QLD: 35.4%

SA (victim data only): 54.4%

TAS: 33.5% VIC: 44.2% WA: 39.3%

1. Mayshak R, Curtis A, Coomber K, et al. Alcohol-Involved Family and Domestic Violence Reported to Police in Australia. Journal of Interpersonal Violence. June 2020. doi:10.1177/0886260520928633

2. Miller, P., Cox, E., Costa, B., Mayshak, R., Walker, A., Hyder, S., ... & Day, A. (2016). Alcohol/Drug-Involved Family Violence in Australia (ADIVA) Key findings.

Trends – Alcohol involved FDV incidents, per 10,000 people

Year ACT NSW SA TAS WA NT QLD VIC

2009 14.2 26.0 30.5

2010 5.2 13.3 5.4 18.8 25.0 375.4 33.6 32.3

2011 7.2 12.7 5.5 17.5 25.9 385.3 34.6 36.8

2012 5.3 12.2 5.6 14.7 27.7 353.3 34.9 44.1

2013 6.1 11.7 5.1 14.3 32.9 428.2 36.5 42.0

2014 7.0 27.5 429.8 37.8

2015 35.2

“The tendency is there, but alcohol amplifies it"

Substance use and FDV

• Alcohol use1

• Perpetration of FDV approx. 6.24 times higher when alcohol use is involved

• Males 2.3 times more likely to perpetrate FV when alcohol involved

• Females 2.6 times more likely to perpetrate FV when alcohol involved

• Females 7.4 times more likely to be victim of FV when alcohol use involved

• Bidirectional IPV for males and females 6.9 times more likely when alcohol use is involved

• Substance use problem2

• Males with substance use problem 4.66 times more likely to perpetrate FV than those without substance use problem

• Males and females 3.7 times more likely to be a victim of FV if they have substance use problem, than if no substance use problem

• FV 13.7 times more likely to occur if both partners have a substance use problem.

• Males 3.36 times more likely to experience bidirectional IPV if they use illicit drugs than if they do not

• Females 3.26 times more likely to experience bidirectional IPV if they use sedatives, than if they do not.

1. Ally et al., 2016; Chase, O'Farrell, Murphy, Fals-Stewart, & Murphy, 2003; Coker, Hall Smith, McKeown, & King, 2000; Collibee & Furman, 2018; Crane, Godleski, Przybyla, Schlauch, & Testa, 2016; Crane, Oberleitner, Devine, & Easton, 2014; Fals-Stewart & Clinton-Sherrod, 2009; Gilchrist, Hegarty, Chondros, Herrman, & Gunn, 2010; Gilchrist, Radcliffe, Noto, & D'Oliveira, 2017; Hahn, Aldarondo, Silverman, McCormick, & Koenen, 2015; Izmirli, Sonmez, & Sezik, 2014; Parrott, Swartout, Eckhardt, & Subramani, 2017; Rode & Rode, 2018; Smith Slep, Foran, Heyman, & Snarr, 2015; Snow Jones & Gondolf, 2001; Testa & Derrick, 2014; Vatner & Bjorkly, 2008; Zarza, Ponsoda, & Carrillo, 2009

2. Ally et al., 2016; Coker et al., 2000; Golinelli, Longshore, & Wenzel, 20083. Curtis et al., 2018. Family Violence in the context of Substance use: Stakeholder views and review of guidelines and evidence-base. Unpublished Report.

Odyssey House Victoria & Deakin University, Melbourne, Australia.

Substance use and aggressive behaviours

• Higher order cognition (i.e. decision making, risk evaluation, inhibition, planning etc.) are controlled by the brain's frontal lobes.

• Deficits in functioning in or injuries to the frontal lobes are associated with significant cognitive dysfunction in those higher order functions.

• These injuries can be the result of physical assault, neurodegenerative disease, or substance use.

1. Alvarez, J. A., & Emory, E. (2006). Executive function and the frontal lobes: a meta-analytic review. Neuropsychology review, 16(1), 17-42.2. Cadet, J. L., Bisagno, V., & Milroy, C. M. (2014). Neuropathology of substance use disorders. Acta neuropathologica, 127(1), 91-107.

Substance use and aggressive behaviours cont...

Aggressive behaviour is exacerbated by substance use (acute and chronic).

Aggressive behaviours can be predicted by increased impulsivity and reduced inhibitory control, and substance use reduces inhibitory control.

Cognitive models of aggressive behaviour and substance use suggest a feed-forward mechanism; impulsivity/inhibitory control predict substance use - substance use also predicts impulsivity/inhibitory control. Cognitive deficits beyond inhibitory control also reduce efficacy of remedial/intervention programs

1. Fanning, J. R., Keedy, S., Berman, M. E., Lee, R., & Coccaro, E. F. (2017). Neural correlates of aggressive behavior in real time: a review of fMRI studies of laboratory reactive aggression. Current behavioral neuroscience reports, 4(2), 138-150.2. Lau, M. A., Pihl, R. O., & Peterson, J. B. (1995). Provocation, acute alcohol intoxication, cognitive performance, and aggression. Journal of Abnormal Psychology, 104(1), 150.

I-cubed (I3) model

Instigating factors

Situational factors which ‘afford’ an aggressive response

Inhibiting factors

Personal or situational factors that mitigate the urge to aggress

Impelling factors

Situational or dispositional factors that increase the urge to aggress

(carry out the afforded behaviour)

Example• Aversive and defensive

communication

Example• Experienced child abuse/exposed to

parents IPV• Psychopathology/Anti-social traits• Low relationship satisfaction or

adjustment (consensus and cohesion)

Example• Neurocognitive impairments (reduces

inhibition)• Substance use (reduces inhibition)

1. Murphy, C. M., & O'Farrell, T. J. (1997). Couple communication patterns of maritally aggressive and nonaggressive male alcoholics. Journal of Studies on Alcohol, 58, 83-90. 2. Gilchrist, G., Radcliffe, P., Noto, R., & D'Oliveira, A. (2017). The prevalence and factors associated with ever perpetrating intimate partner violence by men receiving substance use treatment in Brazil and England: A cross-cultural comparison. Drug and Alcohol Review, 36, 34-51.3. Watt, M. H., Guidera, K. E., Hobkirk, A. L., Skinner, D., & Meade, C. S. (2017). Intimate partner violence among men and women who use methamphetamine: A mixed-methods study in South Africa. Drug and Alcohol Review, 36, 97-106.4. Fals-Stewart, W., Leonard, K. E., & Birchler, G. R. (2005). The Occurance of Male-to-Female Intimate Partner Violence on Days of Men's Drinking: The Moderating Effects of Antisocial Personality Disorder. Journal of Consulting and Clinical Psychology, 73(2), 239-248.5. Foran, H. M., Heyman, R. E., Smith Slep, A. M., & Snarr, J. D. (2012). Hazardous Alcohol Use and Intimate Partner Violence in the Military: Understanding Protective Factors. Psychol Addict Behav, 26(3), 471-483.6. Bell, R. K., & Polaschek, D. L. L. (2017). Do high-risk prisoners entering treatment have clinically impaired cognitive impulse control? Psychiatry, Psychology and Law, 24(4), 576–593. https://doi.org/10.1080/13218719.2016.1256016

The ‘perfect storm’

Substance use lowers the threshold for engaging in FDV by acting as a disinhibitor in the context of strong instigation and impellance for violence

1. Finkel, E. J. (2014). The I3 model: Metatheory, theory, and evidence. In Advances in experimental social psychology (Vol. 49, pp. 1-104). Academic Press.

Gendered model

• Substance use exaggerates pre-existing power imbalances in relationships and hostile sexism in males

• More relevant to intimate partner terrorism (IPV w/ coercive control) than situational couple violence

1. Gadd, D., Henderson, J., Radcliffe, P., Stephens-Lewis, D., Johnson, A., & Gilchrist, G. (2019). The dynamics of domestic abuse and drug and alcohol dependency. The British Journal of Criminology, 59(5), 1035–1053. https://doi.org/10.1093/bjc/azz011

2. Sugarman, D. B., & Frankel, S. L. (1996). Patriarchal ideology and wife-assault: A meta-analytic review. Journal of Family Violence, 11 (1), 13–40. https://doi.org/10.1007/BF02333338

3. Radcliffe, P., Gadd, D., Henderson, J., Love, B., Stephens-Lewis, D., Johnson, A., Gilchrist, E., & Gilchrist, G. (2019). What role does substance use play in intimate partner violence? A narrative analysis of in-depth interviews with men in substance use treatment and their current or former female partner. Journal of Interpersonal Violence, 0886260519879259. https://doi.org/10.1177/0886260519879259

4. Gilchrist, G., Dennis, F., Radcliffe, P., Henderson, J., Howard, L. M., & Gadd, D. (2019). The interplay between substance use and intimate partner violence perpetration: A meta-ethnography. International Journal of Drug Policy, 65, 8–23. https://doi.org/10.1016/j.drugpo.2018.12.009

5. Laslett, A. M., Graham, K., Wilson, I. M., Kuntsche, S., Fulu, E., Jewkes, R., & Taft, A. (2021). Does drinking modify the relationship between men's gender‐inequitable attitudes and their perpetration of intimate partner violence? A meta‐analysis of surveys of men from seven countries in the Asia Pacific region. Addiction.

Substance use & adolescent family violence

• Substance use in both the parent and the adolescent increases the likelihood of adolescent family violence

1. Substance use (adolescent) contributes to parent abuse by creating opportunities for confrontation, more so than alcohol myopia

2. Substance use (parent) may increase the likelihood of retaliatory adolescent family violence

1. Levy, L. (1999). Child on parent assault: The impact of parental nurturance and demandingness. University of Miami.2. Pelletier, D., & Coutu, S. (1992). Substance abuse and family violence in adolescents. Canada's Mental Health, 40(2), 6-12.3. Clarke, K., Holt, A., Norris, C., & Nel, P. W. (2017). Adolescent‐to‐parent violence and abuse: Parents' management of tension and ambiguity—an

interpretative phenomenological analysis. Child & Family Social Work, 22(4), 1423-1430.

Other risk factors

INDIVIDUAL

• Lack of self control

• Previous involvement in fights

• Previous arrest

• Anger/hostility

• Perseverance

DEMOGRAPHIC

• Unemployed

• Number of children

• Education

• Family income

RELATIONSHIP

• Beliefs about the

link between alcohol

& relationships

• Financial stress

1. Curtis et al., 2018. Family Violence in the context of Substance use: Stakeholder views and review of guidelines and evidence-base. Unpublished Report. Odyssey House Victoria & Deakin University, Melbourne, Australia.

Intervention Options for Substance Use & FDV

• Duluth/Men's Behaviour Change

• Cognitive Behavioural Therapy (CBT)

• Motivational interviewing (MI)

• Substance Use Interventions

• Relationship Interventions

• Integrated Substance Use and Violence Interventions• Meta-analysis found that integrating substance

use & IPV into one intervention was more effective at reducing violence than addressing IPV alone (Karakurt et al., 2019)

1. Curtis et al., 2018. Family Violence in the context of Substance use: Stakeholder views and review of guidelines and evidence-base. Unpublished Report. Odyssey House Victoria & Deakin University, Melbourne, Australia.

Intervention Effectiveness – Substance use & FDV

Duluth style/Men’s Behaviour Change programs

• No literature for persons who use substances & engage in IPV

Cognitive Behavioural Therapy

• IPV-P treatment: Based on a CBT and MI. Higher success rate at 6 months for those who received treatment (absence of physical, sexual, and/or psychological IPV-P episodes) (Fernandez-Montalvo et al., 2018).

Motivational Interviewing

Small reductions in IPV after intervention, and can reduce substance use (Mbilinyi et al., 2011; Murphy et al., 2018; Rhodes et al., 2015; Schumacher et al., 2011; Stuart et al., 2013)

Substance Use Interventions

• Counselling for alcohol problems: No significant reductions in IPV (Nadkarni, Weobong, et al., 2017; Nadkarni, Weiss, et al., 2017).

• Alcohol monitoring for repeat drink drivers: Significant reductions in domestic violence at the County level (Kilmer et al., 2013).

Relationship Interventions

• Behavioural Couples Therapy: Violence significantly reduces after intervention and also reduces alcohol use (O’Farrell et al., 2004; O’Farrell et al, 1999; O’Farrell et al., 2000; Fals-Stewart & Clinton-Sherrod 2009; Schumm et al., 2014; Schumm et al., 2009; Fals-Stewart et al., 2006; Schumm et al., 2018).

Integrated Substance Use & Violence Interventions

• Integrated Violent Prevention Treatment: Violence significantly decreased, and a significant decline in alcohol use (Chermack et al., 2017).

• Integrated Treatment for Substance Abuse and Partner violence: compared to CBT (substance use + 1 session of partner violence), completers in both conditions significantly improved on both substance use and IPV, and after 8 weeks both groups had almost fully abstained from IPV (Kraanen et al., 2013).

• Chemical dependency treatment + court-mandated domestic violence intervention: Fewer DV re-offences at follow up (Babcock & Steiner, 1999).

1. Curtis et al., 2018. Family Violence in the context of Substance use: Stakeholder views and review of guidelines and evidence-base. Unpublished Report. Odyssey House Victoria & Deakin University, Melbourne, Australia.

Intervention needs -

identified by those who

have engaged in Substance

Use & IPV

• Constructive communication

• Identified as instigator of IPV, and a part of the solution

• Recognition, expression, and regulation of emotions

• Identify & understand emotions

• Effectively express and communicate emotions

• Management of emotions without substances

• Group delivery

• Self-accountability and accountability of peers

• Group dynamic for challenging problematic behaviours

• Learning skills from other group members

• Ongoing programs

• Need for programs that allow people to re-enter at any point

• Consideration of partner involvement

1. Curtis, A., Booth, B., Gruenert, S., Long, C. M., Karantzas, G., Harries, T., Mullins, E., & Miller, P. G. (2021) Identified support needs for intimate partner violence engagement in an alcohol and other drug treatment sample, Journal of Substance Use, DOI: 10.1080/14659891.2020.1867660

Practical Implications

• Situational Violence

• Responsivity• Impact of chronic/heavy substance use on brain• Neurocognitive impairment associated with substance use & aggressive

behaviour/violence (Curtis et al., 2018; Curtis et al., 2021).

• Screening/Risk Assessment

• Intervention options

• Withdrawal/intoxication and implications

1. Curtis, A., Youseff, G., Guadango, B., Manning, V., Enticott, P. G., Lubman, D. I., & Miller, P. M. (2018). Swift, certain, and fair justice: insights from behavioural learning and neurocognitive research. Drug and Alcohol Review, 37, S240-S245.

2. Curtis, A., Gooden, J., Cox, C., Peterson, V., Enticott, P., Sanfilippo, P., Miller, P., Lubman, D, I., Manning, V. (2021). Neurocognitive functioning among people accessing an addiction neuropsychology clinic with and without a history of offending behavior. Psychology, Psychiatry and Law. Online.

3. Enticott, P., Curtis, A., & Ogloff, J. (2020). The neurobiology of aggression and violence, in The Encyclopedia of Child and Adolescent Development.

More information

Centre for Drug use, Addictive and Anti-social behaviour Research (CEDAAR): http://www.deakin.edu.au/cedaar

• Dr Richelle Mayshak: richelle.mayshak@deakin.edu.au

• Dr Ashlee Curtis: ashlee.curtis@deakin.edu.au

• Dr David Skvarc: david.skvarc@deakin.edu.au

• Travis Harries: travis.harries@deakin.edu.au