Women's substance use and experiences of intimate partner violence: A longitudinal investigation among a community sample

Abstract

Although cross-sectional studies reveal an association between women's substance use and experiencing physical violence from one's intimate partner, the temporal ordering of these variables is not clearly established. The current study involved longitudinal examination of the association of women's substance use with subsequent experiences of intimate partner violence as well as the association between women's experiences of intimate partner violence and their subsequent substance use. Women ages 18–30 who were in heterosexual relationships (n=724) were recruited through random digit dialing in the Buffalo, NY, area. Within ongoing relationships, women's use of hard drugs was associated with increased odds of experiencing intimate partner violence over the next 12 months. Both marijuana and hard drug use were associated with increased likelihood of experiencing violence in new relationships. Women's heavy episodic drinking did not predict subsequent experiences of partner violence in ongoing or new relationships. Experiences of intimate partner violence had a significant effect on subsequent relationship satisfaction, which was modestly associated with subsequent heavy episodic drinking but not with subsequent drug use.

Introduction

The association between substance use and intimate partner violence (IPV) has long been recognized. The bulk of literature addressing this association has focused on the link between substance use and perpetration of partner violence, primarily by men toward their female partners (for reviews, see Lipsey et al., 1997, Schumacher et al., 2001). However, there is also some evidence that women who report higher levels of substance use or abuse are more likely to report experiencing IPV. For example, among adolescent girls, substance use is associated with experiencing dating violence Malik et al., 1997, Silverman et al., 2001. Studies of married and cohabitating couples reveal similar findings. Using data from the 1985 National Family Violence Survey, Kantor and Straus (1989) found that wives who reported minor physical violence from a spouse in the past year were three times more likely to have been high on drugs and twice as likely to have been drunk in the past year compared to women not reporting violence. Neither women's drinking nor drug use was related to experiences of severe assault, a finding the authors attribute to the low baserate of severe violence. Kantor and Jasinski (1995) found similar results using 1990 National Family Violence Survey data, which included more sophisticated measures of alcohol and drug use. Using data from a multiwave telephone survey of adolescents and young adults in New Jersey, White and Chen (2002) also found evidence for an association between problem drinking and experiencing IPV among young married or cohabitating women. This relationship was obtained after controlling for several risk factors, including experiencing violence as a child and negative affect, which were assessed in earlier waves of the survey. However, because partner violence and problem drinking were assessed at the same data collection point, the temporal ordering of these variables cannot be determined. Using data from the National Survey of Families and Households, a large national telephone survey, Anderson (2002) also found an association between reporting an alcohol or drug problem and experiencing IPV but not between substance abuse and perpetration of partner violence. The association between violence victimization and substance abuse was stronger for women than for men.

Although the association between women's substance use or abuse and intimate partner victimization appears relatively robust, interpretation of this finding is more complicated. In their review of the literature regarding the association between women's substance use and their experiences of IPV, Kantor and Asdigian (1997) discuss several mechanisms by which a woman's intoxication or problem drinking may contribute to increased likelihood of her experiencing violence from her male partner. For example, an intoxicated or alcoholic woman may be victimized because of negative views of substance abusing women. Evidence for this mechanism is generally absent, however. Kantor and Asdigian conclude that the relationship between women's substance use and victimization is likely to be spurious, reflecting the association of women's substance use with her partner's substance use or the association of both substance use and partner violence with common third variables such as violence in the family of origin.

Understanding the temporal or causal ordering of women's substance use and their experiences of intimate partner victimization is greatly aided by prospective studies; however, few such studies have been conducted. Quigley and Leonard (2000) found no evidence for a main effect of women's drinking on subsequent male-to-female violence in a longitudinal study of newlywed couples. Rather, violence was elevated in couples in which husbands were heavy drinkers but wives were light drinkers or abstainers. Use of substances other than alcohol was not considered. Using data from the Dunedin birth cohort, Magdol, Moffitt, Caspi, and Silva, (1998a) found that problem behaviors at age 15, including substance abuse, were predictive of female reports of partner violence perpetration and victimization at age 21 in multivariate analyses. Given the long time lag between measurement of substance use and measurement of partner violence, the finding is probably best interpreted as reflecting the role of social deviance on later violence, rather than indicating the substance use within relationships exacerbates conflict and contributes to violence.

It is also possible that the observed association between women's experiences of partner violence and substance use reflects the use of substances as a means of self-medication following victimization. Such an association is consistent with studies showing increased substance abuse following trauma such as physical or sexual assault (e.g., Kilpatrick, Acierno, Resnick, Saunders, & Best, 1997) and with studies showing increased depression and decreased marital satisfaction resulting from IPV (e.g., Heyman et al., 1995, Stets & Straus, 1990). A recent study by Anderson (2002) revealed associations between one's own alcohol problems and both IPV victimization and mutual IPV but no association between alcohol problems and IPV perpetration, a pattern that was stronger for women than for men. The author interpreted these cross-sectional findings as evidence that IPV contributes to problem drinking rather than the reverse; however, it is also possible that the findings reflect a contribution of victim problem drinking to subsequent victimization. Stronger evidence that experiencing IPV influences subsequent alcohol use is provided by a longitudinal study by Testa and Leonard (2001) showing that women's experiences of IPV in the first year of marriage were positively associated with greater stress, lower marital satisfaction, and increased occasions of heavy episodic drinking at the first wedding anniversary. Although effects of IPV on subsequent drinking were modest, the study provides some support for the notion that the association between women's alcohol problems and victimization found in cross-sectional studies may reflect the use of alcohol as a reaction to victimization. In another longitudinal study, Salomon, Bassuk, and Huntington (2002) found that experiences of partner violence predicted subsequent onset of drug use among a sample of low-income mothers, although violence was not associated with subsequent problem alcohol use.

The goal of the current study was to examine evidence for effects of women's substance use on their subsequent experiences of IPV as well as for effects of IPV on women's subsequent substance use. Evidence for these bidirectional effects was examined in a longitudinal study involving a community sample of young women. We considered women's illicit drug use as well as alcohol use. It is possible that because of its illicit nature and association with deviance and criminal activity, women's drug use is more strongly associated with violent victimization than is alcohol use (Kilpatrick et al., 1997). The sample was diverse in terms of women's relationship status and included single, cohabitating, and married women. While many intimate relationships were maintained over the course of the study, a significant number ended, allowing us to examine the role of women's substance use on subsequent partner violence both within enduring relationships as well as across relationships.