Drug Abuse and Partner Violence among Women in Methadone Treatment

This study aims to (1) describe rates of lifetime and current partner abuse among women on methadone; (2) examine the relationship between partner violence and demographics, substance abuse, and drug risk behaviors; and (3) explore the association between a victim's current use of crack/cocaine, heroin, marijuana, and drug risk behavior after controlling for demographics, household composition, history of victimization and sex trading. Approximately three-fourths of the women ever experienced physical, sexual, or life-threatening abuse and slightly less than one-third experienced at least one type of abuse during the previous year. A history of childhood victimization was reported by more than half of the women and one-third witnessed her mother being abused. Risk of partner violence was associated with victim's current drug and alcohol use, visiting shooting galleries, and living with someone with drug or alcohol problems. The study discusses the implications of the findings for research and intervention.     

History of Traumatic Abuse and HIV Risk Behaviorsin Severely Mentally Ill Substance Abusing Adults

Epidemiological studies in the United States estimate HIV seroprevalence rates ranging between 4% and 23% for serious mentally ill adults (SMIA; i.e., schizophrenia, bipolar disorder, and other chronic disorders with psychotic features), with substantially greater estimates for risky sexual behaviors. Among the most consistent factors linked to HIV risk in non-SMIA populations is a history of emotional, physical, or sexual abuse. The current study examined the intersection of abuse history and HIV sexual risk behavior in SMIAs with a group of men (n = 64) and women (n = 115) recruited from eight geographically diverse and representative clinical sites around Florida. A cross-sectional interview revealed a high prevalence of alcohol and other drugs problems, as well as a history of emotional, physical, or sexual abuse in 75% of the participants, with 68% of these reporting multiple types of abuse. Compared to nonabused counterparts, those with a history of abuse reported significantly greater: (a) lifetime and current psychiatric symptoms, (b) recent unprotected sexual intercourse, and (c) crack cocaine, heroin, and marijuana use. No gender differences were detected in the associations of abuse history and sexual risk behaviors. These results underscore the need for HIV prevention efforts targeted to SMIAs and the critical importance of addressing abuse history in interventions with this underserved population.     

Childhood Sexual Abuse and Intimate Partner Violence among Women in Methadone Treatment: A Direct or Mediated Relationship?

Women in substance use treatment report rates of childhood sexual abuse and intimate partner violence that far exceed those reported by women in the general population. Previous research with nonrandom samples of women in substance use treatment suggests that there is a statistically significant relationship between childhood sexual abuse and intimate partner violence; however, little is known about the mechanisms of risk between these two public health concerns among this population of women. To address this gap in knowledge and to inform intervention strategies, this study examined direct and mediated relationships between childhood sexual abuse and intimate partner violence risk among a random sample of 416 women in methadone treatment. In addition to high rates of childhood sexual abuse (57.9%), intimate partner violence (lifetime prevalence, 89.7%; 6-month prevalence, 78.4%), posttraumatic stress disorder (PTSD, 28.6%), and global psychological distress (19.5%), findings suggest that the relationship between childhood sexual abuse and intimate partner violence is mediated by mental health problems and that women experiencing PTSD or global psychological distress are 2.7 and 2.4 times more likely to experience intimate partner violence than women without such experiences, respectively. Although not a mediator in this relationship, financial independence reduced women's risk of partner violence by two-thirds. The paper includes discussion of social learning and stress and coping theories to explicate the findings and to inform intervention strategies. This study is based, in part, on the first author's dissertation. A previous version of this paper was presented at the Society for Social Work and Research Annual Conference held in January 2005 in New Orleans, Louisiana. The following grants provided funding for this study: R01DA11027 and 3T32MH014623-22S1.     

Predictors of sexually coercive behavior in a nationally representative sample of adolescent males

Data from male participants in the National Longitudinal Study of Adolescent Health are used to examine childhood predictors of late adolescent and early adulthood sexually coercive behavior and adolescent mediators of these relationships. A path analysis shows that experiencing sexual abuse as a child has a direct effect on perpetrating subsequent coercion that is partially mediated by early sexual initiation. Involvement in delinquent activities in adolescence was the only additional significant predictor of sexually coercive behavior and completely mediated the relationship between physical abuse in childhood and later sexual coercion. Of note, more than half of men reporting sexually aggressive acts had no history of childhood victimization, so pathways to sexually coercive behavior for this group remain unidentified. In addition to the universal prevention approaches currently in use in the field, these findings suggest that targeted prevention programs need to be formulated for youth with histories of childhood sexual or physical abuse.     

Substance use and PTSD symptoms impact the likelihood of rape and revictimization in college women

The present study utilized a mixed retrospective and prospective design with an 8-month follow-up period to test a model of revictimization that included multiple childhood (i.e., child sexual, physical, and emotional abuse) and situational variables (i.e., substance use, sexual behavior) for predicting rape among 276 college women. It was of particular interest to determine whether traumatic responses (e.g., posttraumatic symptomatology or risky behavior) increased vulnerability for revictimization. During the 8-month follow-up period, 9% of participants were raped; 88% of assaults involved substance use by the victim. Posttraumatic stress disorder (PTSD) symptomatology predicted rape, substance use, and sexual behavior. Substance use, but not sexual behavior, mediated the relation between PTSD symptomatology and rape during the follow-up period. Sexual behavior indirectly impacted risk for rape via substance use. Results suggest that college women with PTSD symptomatology may be at greater risk for rape if they use substances to reduce distress.     

Patterns of Crime and Substance Abuse among Israeli Ex-Addict Female Inmates

The current study examined the relationship between drug addiction and crime involvement among Israeli female prisoners, and further examined the differential contribution of early onset of drug, sexual abuse and poly drug use, to predict involvement in offenses against person. Fifty-four ex-addict female inmates participated in this study. Research findings indicated that a majority began using drugs prior to their involvement in crime and most were convicted of drug-related crimes. In addition, almost half had a history of sexual abuse. Female inmates who were sexually abused were characterized by an early onset of drug and poly drug use. A relationship was observed between poly drug use and offenses against person. Also, the duration of drug abstinence corresponded to a lower sense of coherence and higher level of trait anxiety among female inmates. The implications of these findings for substance abuse treatment are discussed. Gila Chen, PhD, is a lecturer in the Criminology Department at Ashkelon Academic College and Bar-Ilan University. Her academic interests include youth at risk, female offenders, self-help groups, and drug addiction.     

Parental Sociopathy as a Predictor of Childhood Sexual Abuse

Research on childhood sexual abuse has often examined, in isolation of one another, such highly correlated risk factors as parental substance abuse, domestic violence, and pathological family functioning. Investigating comorbid antecedents separately does not allow accurate specification of the predictors of abuse. Moreover, sexual trauma research has tended to neglect parental sociopathy as a risk factor. Given the limitations of past research, the present study examined the relationships among parental sociopathy, parental substance use, marital violence, poor family functioning, and childhood sexual abuse. We administered a battery of questionnaires to a nonclinical sample of 130 college women and replicated previous findings by showing that parental substance use predicted sexual abuse when examined in isolation. However, when parental sociopathy and the other risk factors were included in a regression model, parental sociopathy was the only significant predictor. Mother's and father's sociopathy predicted sexual abuse independently and when combined.     

Characteristics of victims of sexual abuse by gender and race in a community corrections population

The purpose of this study was to examine how victims of sexual abuse in a community corrections population differ as a result of their sex and race. Of the 19,422 participants, a total of 1,298 (6.7%) reported a history of sexual abuse and were compared with nonabused participants. The sample was analyzed by race-gender groups (White men, White women, African American men, and African American women) using univariate and logistic regression analyses, which were conducted separately for each group. White women were the most likely to report a history of sexual abuse (26.5%), followed by African American women (16.0%), White men (4.0%), and African American men (1.1%). For all groups, histories of suicidal ideation and suicide attempts were associated with a history of sexual abuse. Sexual abuse was associated with substance abuse problems for women but not the men. Cannabis dependence was associated with sexual abuse for the White women while cocaine dependence was associated with sexual abuse for the African American women. Several other variables were associated with sexual abuse for women but not men, including lower education (White women only), a history of violent offenses (White women only), and living in a shelter (African American women only). African American men tended to have higher levels of education; this was the only variable uniquely associated with either male group. Receiving psychiatric medications was associated with sexual abuse for all groups except African American men and a history of sex for drugs was associated with sexual abuse for all groups except White men. Consistent with national sample, women, particularly White women, were more likely to be victims of sexual abuse. The gender-race differences for the sociodemographic factors associated with sexual abuse, particularly the risk of substance abuse for women, suggest the need for tailored interventions for sexual abuse prevention and treatment.     

Pathways to adult sexual revictimization: direct and indirect behavioral risk factors across the lifespan

The purpose of this study is to investigate direct and indirect social and behavioral risk factors for adult sexual revictimization. Participants include 147 adult, predominantly African American (88%) women, 59% of whom had a documented history of child sexual abuse. Participants are interviewed in adulthood about adolescent and adult sexual victimization as well as other background and lifestyle characteristics. Structural equation modeling indicates that the relationship between child and adolescent sexual victimization is indirect, mediated by adolescent risk-taking behavior. The relationship between adolescent and adult sexual victimization is also indirect, mediated by risky sexual behavior. The residual effects of early childhood family environment and childhood physical abuse also indirectly predict sexual revictimization. Results provide empirical support for the general supposition that the relationship between child and adult sexual victimization is complex and that many intermediary factors differentially affect risk for a heightened vulnerability to sexual revictimization.     

A prospective analysis of the relationship between childhood sexual victimization and perpetration of dating violence and sexual assault in adulthood

The majority of studies evaluating the relationship between childhood sexual assault and subsequent sexual assault perpetration by men have been conducted retrospectively and with incarcerated populations. The present study seeks to improve on previous research by prospectively investigating the relationship between childhood sexual assault and subsequent perpetration of dating violence in adulthood in men. Although there is a significant relationship between childhood sexual abuse and history of sexual assault perpetration at baseline, prospective analyses indicate that childhood sexual assault is not predictive of perpetration during the follow-up period. The role of family factors, including parental conflict resolution, is implicated in subsequent sexual aggression. These results are supportive of the idea that the effects of childhood sexual abuse may be mediated by a variety of factors.     

Victimization and perpetration among perinatal substance abusers

This study examined associations between demographic, psychiatric, substance abuse, and childhood abuse variables and past 30-day victimization and perpetration among 77 perinatal substance abusers. Victimization rates were 70% emotional, 34% physical, 29% sexual, and 42% personal freedom violations. For perpetration, incidence was 71% emotional, 25% physical, 5% sexual, and 9% personal freedom violations. Through univariate regression, Addiction Severity Index (ASI) psychiatric and drug composite scores, childhood physical abuse, borderline personality disorder (BPD) and post-traumatic stress disorder (PTSD) were found to significantly predict victimization. In contrast, ASI psychiatric and drug composite scores, BPD, PTSD, and aggressive-sadistic and antisocial personality disorders were found to significantly predict perpetration. In multiple regression models, ASI drug and psychiatric composite scores accounted for the majority of the variance for both victimization and perpetration, suggesting that women with high ASI scores should be queried about their involvement in abusive acts at time of admission to drug treatment.     

The links between religiosity, childhood sexual abuse, and subsequent marijuana use: an empirical inquiry of a sample of female college students

A number of studies indicate that childhood sexual abuse (CSA) has a negative impact on later psychological well-being. It is well documented that experiences of CSA are associated with depression, self-destructiveness, and subsequent substance abuse or alcohol consumption. Compared with women who experienced no such sexual abuse in childhood, women who were victims of sexual abuse in childhood were more likely to be depressed and use drugs or consume alcohol in later life. Analyzing data of 1,569 females derived from the "Longitudinal Study of Violence Against Women," this study examines whether the strain caused by sexual victimization leads to a higher level of subsequent marijuana use and whether religiosity moderates the negative effects of CSA. It was found that CSA was associated with an increased level of marijuana use in high school. However, more proximate sexual victimization (victimization in college) seemed to override the impact of CSA on subsequent marijuana use. Religiosity was found to moderate the effect of CSA on marijuana use in high school. Religiosity was negatively associated with marijuana use in high school as well as the second and fourth collegiate years. Policy implications and promising directions for future research are discussed.     

Parental Effects on the Exchange of Sex for Drugs or Money in Adolescents

Research has examined risk factors related to involvement in prostitution and sex trafficking using samples of adult prostitutes, runaway and homeless youth, and youth involved in the juvenile system. There is scant research that includes adolescents who cannot be categorized into these groups. Additionally, research is limited related to how parents affect the decision for adolescents to engage in sex for drugs or money. We examine risk factors concerning the exchange of sex for drugs or money from a nationally representative sample of adolescents. The data are structured where responses can be compared to a group of adolescents who indicated never exchanging sex for drugs or money. We used a negative binomial regression analysis to examine how the effects of parental and individual factors influence the exchange of sex for drugs or money among adolescents. Analyses revealed that individual factors were significant while parental factors were not significant; however, parental effects were significant when dimensions of parental involvement were examined.     

Psychiatric and Forensic Differences Between Men Charged with Sex Offences and Men Charged with Other Offences

Studies on differences between individuals convicted of sexual offences and nonsexual offences are sparse and there is an on-going debate as to whether sexual offenders differ from other offenders. The primary aim of this study was to determine demographic characteristics, prevalence of mental disorders, alcohol and drug use at the time of the crime and the criminal responsibility of individuals charged with sexual offences, compared to nonsexual crimes, with the aim of bringing awareness to the similarities and differences between men charged with sex offences and those charged with other crimes. This is a single-institution retrospective study of subjects charged with sexual offences and sent for institutional psychiatric evaluation to a Forensic Psychiatric Centre in an urban, academic, tertiary-care center. The control group consisted of individuals charged with nonsexual offences referred to the same center. Results showed significant differences between individuals charged with sexual offences and nonsexual offences. Men charged with sex offences more frequently committed their crimes alone and victimized children equally as often as adults. They also less frequently pleaded guilty in court. They were more likely to be abused in childhood and more often had antisocial personality disorder and paraphilias and less often substance-related disorders. The majority were considered criminally responsible. Our results show that sex offenders are different from nonsex offenders in many characteristics of their personal history, offence characteristics and forensic evaluations and these particular differences warrant different approaches to the prevention of future re-offending, compared to nonsex offenders.     

Child abuse and chronic pain in a community survey of women

This study examined the relationship between a self-reported history of child physical and sexual abuse and chronic pain among women (N = 3,381) in a provincewide community sample. Chronic pain was significantly associated with physical abuse, education, and age of the respondents and was unrelated to child sexual abuse alone or in combination with physical abuse, mental disorder (anxiety, depression, or substance abuse), or low income. Number of health problems and mental health disorders did not mediate the relationship between physical abuse and chronic pain. Despite considerable evidence from the clinical literature linking exposure to child maltreatment and chronic pain in adulthood, this may well be the first population-based study to investigate this relationship for child physical and sexual abuse independently. The significant association between childhood history of physical abuse and pain in adulthood calls for a greater awareness of the potential for chronic pain problems associated with this type of maltreatment. Further research is needed to understand the mechanism for this complex relationship.     

Sexual relationship power, intimate partner violence, and condom use among minority urban girls

This study examined the association between sexual relationship power, intimate partner violence, and condom use among African American and Hispanic urban girls. In this sample of 56 sexually active girls, 50% did not use condoms consistently and therefore were at higher risk for acquiring HIV or sexually transmitted diseases (STDs). Teens who experienced more intimate partner violence had a significantly higher likelihood of inconsistent condom use and therefore a greater risk for HIV/STDs. Girls' sense of sexual control in their relationships was not directly associated with inconsistent condom use but was inversely related to verbal and emotional abuse. Interventions aimed at reducing HIV/STD risk for adolescent girls need to address patterns of dominance and control in adolescent relationships as well as multiple forms of partner violence. This suggests the need for multilevel intervention approaches that promote girls' agency and multiple ways to keep girls safe from perpetrators of partner abuse.     

Risk Factors for Male Sexual Aggression on College Campuses

Risk factors for college male sexual aggression that were both theoretically and empirically based were tested using multivariate regression analyses. These included substance abuse patterns, pornography consumption, negative gender-based attitudes, and child sexual abuse experiences. Regression analyses indicated that some gender attitudes, pornography use, and alcohol abuse were significant predictors of perpetration of sexual violence. Although a number of men were sexually abused as children, this risk factor did not predict sexual aggression as an adult. Many men reported alcohol-related sexual coercion and held many rape-supportive attitudes and beliefs. These practices by college men contribute to the prorape cultures found on many campuses. Strategies are needed to identify and intervene with high-risk men to prevent sexual victimization of women in college.     

Adolescent sexual risk and multiple contexts: interpersonal violence, parenting, and poverty

In this study we estimated the combined effects of violence experiences, parenting processes, and community poverty on sexual onset, alcohol or other drug (AOD) use at last sex, multiple sex partners, and prior pregnancy in a sample of 7th-, 9th-, and 11th-grade adolescents (n = 7,891), and the subsample of sexually experienced adolescents (n = 2,108). Multilevel multivariate logistic regression analyses revealed that having experienced any interpersonal violence, and low levels of perceived parental warmth and parental knowledge predicted sexual onset. Adult sexual abuse or peer sexual coercion increased the odds for AOD use at last sex and having multiple sexual partners. When demographic, violence experiences and parenting behaviors were accounted for, poverty was not associated with sexual onset, AOD use at last sex, or multiple sex partners. Results suggest prevention efforts to reduce teen dating violence may be especially important to diminish sexually risky behaviors among adolescents.     

Men and intimate partner rape: characteristics of men who sexually abuse their partner

This article explores men's use of sexual violence against their intimate partner. Although there is a growing body of information about men's use of physical violence, there is less data about men's sexual violence in intimate partnerships. Data were collected from 229 men who were enrolled in an intervention program for men who abuse. Of men in this study, 53% had sexually assaulted their partner at least one time. This article will address the ways in which this sample of men sexually abused their partner and the connection between physical and sexual abuse within their relationships.