Drinking and spousal abuse by male US Army soldiers

December 14, 2004

Domestic violence is a significant and preventable cause of injury to women. The majority of cases involve violence perpetrated by a male partner, and heavy drinking has also been implicated as a risk factor. A study in the December issue of Alcoholism: Clinical & Experimental Research looks at alcohol consumption and perpetration of spousal abuse by male U.S. Army soldiers. Findings indicate that soldiers who drink heavily are more likely to abuse their spouses both when they are and when they are not drinking alcohol; heavy drinking is also associated with subsequent episodes of spouse abuse even when drinking habits are measured years prior to the event.

"Women are not only more likely than men to be victims of abuse at some point in their lifetime, but women are also more likely to sustain serious injury than are male victims of abuse," said Nicole S. Bell, first author of the study and a vice-president at Social Sectors Development Strategies, Incorporated. "However, it is important to note that married men and women are about equally likely to initiate physical abuse against each other. In fact, male victims of abuse may find it more difficult than female victims to come forward to report their experience due to social stigmatization or shame."

Bell added that heavy drinking is clearly a risk factor for intimate partner violence (IPV). "Men who drink heavily are more likely to abuse their partners both when they are drinking and when they are not drinking than men who are light drinkers. Put another way, women who live with heavy drinkers are more likely to be victims of IPV. Furthermore, women who are themselves heavy drinkers are also more likely to be victims of IPV, though it is not always clear whether their heavy drinking preceded the abuse event or is adopted as a way to cope with an unpleasant home life."

"One of the unique things about this study is that it's able to link data from difference sources," added Gordon Smith, an associate public health professor at Johns Hopkins Bloomberg School of Public Health. "This study was able to measure baseline alcohol consumption of a group of soldiers, and then follow them over time to see if there's an increased risk of them being a perpetrator of spousal abuse. Most studies take more of a cross sectional approach, interviewing people who have already been accused of spousal abuse, and then looking at their drinking. Self reports of alcohol consumption at the time of the abuse event are likely unreliable; it's an emotional time, and some people may over or under report their alcohol consumption ... we really don't know."

For this study, participants comprised all active-duty, male, enlisted Army spousal abusers identified in the Army's Central Registry (ACR) who had also completed an Army Health Risk Appraisal Survey (HRA) between the years of 1991 and 1998 (n=9,534). Their data were compared with that of 21,786 "controls" who were matched on gender, rank, marital status and had also completed an HRA.

"We chose to focus on Army soldiers primarily because we have extensive data available to study them both before and after the abuse event," said Bell. "We were able to examine the stability of the relationship between drinking and perpetration of spousal abuse over a relatively long follow-up time. Furthermore, unlike some other studies of perpetrators that have examined populations with criminal backgrounds or those in treatment programs, this study population is relatively high functioning in that they're fully employed, have full access to healthcare, and hold a wide range of different occupations within the Army such as truck drivers, cooks, infantry soldiers, flight crew, and mechanics. Finally, the sheer size of this study population allowed us to explore variations in risk for abuse in different race and age subgroups."

The results showed that those classified as the heaviest drinkers (22 or more drinks per week) were 66 percent more likely to abuse their spouses than those classified as abstainers. In addition, self-reported moderate (8 to 14 drinks per week) and heavy drinkers (15 to 21 drinks per week) were three times as likely, and light drinkers (1 to 7 drinks per week) were twice as likely, as soldiers who report they typically consume less than one drink per week, to be drinking during the time of the abuse event.

"In short, we found that the enlisted, married, male Army soldiers who drink heavily are more likely to abuse their spouses both when they are and when they are not drinking alcohol," said Bell.

Researchers also found that heavy drinking is associated with subsequent episodes of spousal abuse even when drinking habits are measured years prior to the event. "The link between self-reported typical drinking habits and increased risk for spousal abuse appears to be stable even over long periods of time," said Bell. "That is, soldiers who report drinking heavily who are then followed for several years are still, years later, at greater risk for spousal-abuse events, particularly those involving alcohol during the event, but also those not involving alcohol."

Bell added that the study's findings have several implications. "First, it might be wise to evaluate soldiers identified as heavy drinkers during routine health screening tests for interpersonal violence," she said. "Likewise, soldiers identified as spouse-abuse perpetrators or victims should be carefully screened for alcohol abuse. Second, alcohol use is related to increased risk for spousal abuse when neither the perpetrator nor the victim has been drinking, and this is true even when alcohol-use habits are measured years before the event. Thus, there may be some behavioral or social factors that are associated with both drinking and the propensity to abuse a spouse - such as impulsivity or aggression - and these factors may not dissipate over time. Young men who are heavy drinkers may 'age out' of these drinking behaviors or at least moderate their drinking as they get older, but it is not clear if they will also 'age out' of other factors that may go along with heavy drinking behaviors, such as impulsivity or aggression."

"Many people assume you can't do anything about heavy drinking, but there are clearly studies that show if you can screen and identify people with problem drinking and get them into early treatment then you can significantly reduce the consequences of the drinking, including spousal abuse," added Smith. "Treatment for alcoholism or problem drinking has similar effectiveness to that for other chronic diseases like asthma and diabetes. If people have asthma, they will keep having recurring attacks of asthma no matter how good the treatment is, but treatment reduces the frequency and severity of the attacks. It's the same with people who have diabetes. Treatment for alcoholism does work, and can prevent or reduce the frequency of relapses in many people. However, like most chronic-disease therapies, treatment does not always work 100 percent of the time."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Drinking and spouse abuse among U.S. Army soldiers," were Thomas C. Harford of the Boston University School of Public Health; James E. McCarroll of the Department of Psychiatry at Uniformed Services University of the Health Sciences; and Laura Senier of Social Sectors Development Strategies, Inc. The study was funded by the National Institute on Alcohol Abuse and Alcoholism.

Alcoholism: Clinical & Experimental Research

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