Attitudes towards the use of violence and partner directed aggression

The present prospective study examined implicit and explicit attitudes toward the use of violence and their capacity to predict past and future partner-directed aggression in a nonclinical sample. Implicit violence attitudes were measured using a modified version of the Implicit Association Test. A battery of commonly-utilized explicit self-report measures indexed explicit attitudes toward intimate partner violence (IPV). Measurement of violence attitudes occurred prior to engaging in the Articulated Thoughts in Simulated Situations behavioral aggression paradigm. Participants (N = 81) were randomly assigned to conditions of imagined provocative (n = 48) or non-provocative (n = 33) relationship scenarios and given the option to stick pins in dolls representing characters depicted in the scenarios. Simultaneously, participants thought out loud into a microphone about their thoughts. After the scenario, participants were provided with a list of physically and verbally aggressive behaviors and asked to indicate, if given the opportunity, their desire to have engaged in each behavior while they listened to the scenario. The results indicated that individuals with a history of recent psychological IPV perpetration showed more positive implicit attitudes toward violence relative to participants without a psychological IPV history. Implicit violence attitudes were unrelated to participant history of physical IPV perpetration. Explicit, but not implicit attitudes moderated the relationship between relationship provocation and the desire to engage in physically violent behavior. Implicit measures of violence attitudes did not show an incremental contribution toward the prediction of behavioral aggression on the present measures over and above explicit self-report measures of the construct

Randomized Controlled Trial of an Attention-based Intervention for Alcohol-facilitated Intimate Partner Aggression

This research examined a theoretically-based attention bias modification (ABMT) intervention for reducing alcohol-facilitated intimate partner aggression (IPA). As the task trains attention away from aggressive cues, I expected that alcohol’s myopic enhancement of salient non-aggressive information would reduce aggression-related biases and IPA. A community sample (87.4% European American) of heterosexual couples (N = 28) was recruited in which at least one member of each couple endorsed past-year minor physical IPA perpetration and heavy drinking. Couples completed questionnaires that assessed typical and problematic alcohol use, anger problems, and perpetration of intimate partner aggression. One heavy-drinking and partner-violent member of each couple continued in the study to engage in alcoholic beverage administration, assessment of visual aggression cue biases, and a competitive aggression paradigm ostensibly with their partner. The other member of the couple was dismissed. Physical and verbal IPA perpetration were measured using a white noise blast-based aggression task simulating interaction with their intimate partner. The ABMT, relative to the control, buffered against negative affect and reduced biased attention toward aggressive cues as indicated by a) a facilitated response time when a neutral target was surrounded by aggressive distractors and b) elimination of the anger-driven dwell time on aggressive cues. Intervention condition, IPA risk factors, and aggression attention biases were unrelated to laboratory IPA perpetration. The findings suggest that an ABMT designed to train attention away from aggression-related information may be a highly-portable intervention for disrupting aggressogenic cognitive patterns in the context of alcohol intoxication, even though this may not confer a reduction in aggressive behavior

The significant others’ responses to trauma scale (SORTS): applying factor analysis and item response theory to a measure of PTSD symptom accommodation

Background: Symptom accommodation by family members (FMs) of individuals with posttraumatic stress disorder (PTSD) includes FMs’ participation in patients’ avoidance/safety behaviours and constraining self-expression to minimise conflict, potentially maintaining patients’ symptoms. The Significant Others’ Responses to Trauma Scale (SORTS) is the only existing measure of accommodation in PTSD but has not been rigorously psychometrically tested.Objective: We aimed to conduct further psychometric analyses to determine the factor structure and overall performance of the SORTS. Method: We conducted exploratory and confirmatory factor analyses using a sample of N = 715 FMs (85.7% female, 62.1% White, 86.7% romantic partners of individuals with elevated PTSD symptoms).Results: After dropping cross-loading items, results indicated good fit for a higher-order model of accommodation with two factors: an anger-related accommodation factor encompassed items related largely to minimising conflict, and an anxiety-related accommodation factor encompassed items related primarily to changes to the FM’s activities. Accommodation was positively related to PTSD severity and negatively related to relationship satisfaction, although the factors showed somewhat distinct associations. Item Response Theory analyses indicated that the scale provided good information and robust coverage of different accommodation levels.Conclusions: SORTS data should be analysed as both a single score as well as two factors to explore the factors’ potential differential performance across treatment and relationship outcomes

Community-Based Cluster-Randomized Trial to Reduce Opioid Overdose Deaths

BACKGROUNDEvidence-based practices for reducing opioid-related overdose deaths include overdose education and naloxone distribution, the use of medications for the treatment of opioid use disorder, and prescription opioid safety. Data are needed on the effectiveness of a community-engaged intervention to reduce opioid-related overdose deaths through enhanced uptake of these practices.METHODSIn this community-level, cluster-randomized trial, we randomly assigned 67 communities in Kentucky, Massachusetts, New York, and Ohio to receive the intervention (34 communities) or a wait-list control (33 communities), stratified according to state. The trial was conducted within the context of both the coronavirus disease 2019 (Covid-19) pandemic and a national surge in the number of fentanyl-related overdose deaths. The trial groups were balanced within states according to urban or rural classification, previous overdose rate, and community population. The primary outcome was the number of opioid-related overdose deaths among community adults.RESULTSDuring the comparison period from July 2021 through June 2022, the population-averaged rates of opioid-related overdose deaths were similar in the intervention group and the control group (47.2 deaths per 100,000 population vs. 51.7 per 100,000 population), for an adjusted rate ratio of 0.91 (95% confidence interval, 0.76 to 1.09; P = 0.30). The effect of the intervention on the rate of opioid-related overdose deaths did not differ appreciably according to state, urban or rural category, age, sex, or race or ethnic group. Intervention communities implemented 615 evidence-based practice strategies from the 806 strategies selected by communities (254 involving overdose education and naloxone distribution, 256 involving the use of medications for opioid use disorder, and 105 involving prescription opioid safety). Of these evidence-based practice strategies, only 235 (38%) had been initiated by the start of the comparison year.CONCLUSIONSIn this 12-month multimodal intervention trial involving community coalitions in the deployment of evidence-based practices to reduce opioid overdose deaths, death rates were similar in the intervention group and the control group in the context of the Covid-19 pandemic and the fentanyl-related overdose epidemic. (Funded by the National Institutes of Health; HCS ClinicalTrials.gov number, NCT04111939.)