Guest Editor’s Introduction

IPV

While the specific behaviors that comprise IPV can vary from study to study, the U.S. Centers for Disease Control and Prevention (CDC) views IPV as physical, sexual, or psychological harm by a current or former partner or spouse (CDC, 2017a). A recent World Health Organization (2013) report found that 30% of women worldwide who had ever been in a relationship had experienced physical and/or sexual violence by an intimate partner. In findings from CDC’s National Intimate Partner and Sexual Violence Survey (NISVS), one in four U.S. women and one in seven men have been a victim of severe physical violence by an intimate partner (Black et al., 2011). Nearly 24% of 18- to 28-year-old young adults report past-year IPV (Whitaker, Haileyesus, Swahn, & Saltzman, 2007). Approximately half of IPV episodes are reciprocally violent (Caetano, Ramisetty-Mikler, & Field, 2005; Whitaker et al., 2007), although women are more likely than men to sustain injuries as a result of the violence (Coker et al., 2002; Tjaden & Thoennes, 2000).

The use of alcohol is a robust predictor of IPV (Devries et al., 2014). Measures of heavy drinking consistently have been linked with increased IPV risk (Schafer, Caetano, & Cunradi, 2004; Testa et al., 2012), and cross-sectional research has found that alcoholic males report higher rates of IPV than do nonalcoholic males (Chermack, Fuller, & Blow, 2000), while longitudinal studies often have found that husbands’ alcohol use predicts marital aggression (Leonard & Senchak, 1996; Quigley & Leonard, 2000) and daily diary studies suggest that alcohol consumption increases the likelihood of same-day partner aggression (Shorey, Stuart, McNulty, & Moore, 2014; Stuart et al., 2013; Testa & Derrick, 2014). In addition, experimental studies have demonstrated that alcohol intoxication increases males’ aggressive behaviors toward females (Crane, Godleski, Przybyla, Schlauch, & Testa, 2016) as well as aggressive verbalizations during simulated relationship conflicts, especially among violent men who are prone to anger (Eckhardt, 2007). While this convergence of findings has led some to conclude that alcohol use is a “contributing cause” of IPV (Leonard, 2005), it should be emphasized that alcohol consumption is neither necessary nor sufficient for IPV to occur, as the effect size of alcohol on aggression is moderate (e.g., Ito, Miller, & Pollock, 1996) and a number of moderating factors in the relationship, including executive functioning deficits (Parrott, Swartout, Eckhardt, & Subramani, 2017), have been noted (see, e.g., Birkley & Eckhardt, 2015; Parrott & Giancola, 2004).

Alcohol’s effects on IPV are thought to reflect impairment of cognitive control and response inhibition (Curtin & Fairchild, 2003; Fillmore, Ostling, Martin, & Kelly, 2009; Giancola, Josephs, Parrott, & Duke, 2010). The alcohol–aggression relationship most often has been understood in terms of alcohol myopia theory (AMT; Steele & Josephs, 1990), which suggests that alcohol consumption results in a narrowed attentional focus that restricts the drinker’s ability in processing instigatory and inhibitory cues so that intoxicated individuals tend to focus on only the most salient—and often instigatory—cues in a particular situation, rather than on more distal cues that may be inhibitory.

Interventions for IPV have demonstrated only minimal effectiveness (Babcock, Green, & Robie, 2004; Murphy & Ting, 2010). While several studies have shown that treatment for alcohol use disorders (AUDs; i.e., alcohol abuse or alcohol dependence) can reduce partner aggression (O’Farrell, Fals-Stewart, Murphy, & Murphy, 2003; O’Farrell, Van Hutton, & Murphy, 1999), follow-up of the couples in these studies tends to be of relatively short duration, while it is often unclear if improvement in abusive behavior is primarily attributable to reductions in drinking or to some more general improvement in relationship functioning (Murphy & Ting, 2010). Moreover, not all alcohol-involved aggression is perpetrated by people with AUDs. For instance, Testa and Derrick (2014) found a robust effect of acute alcohol use episodes on the odds of subsequent partner aggression in a sample of moderate drinking community couples in which those with alcohol problems had been excluded. Furthermore, even if AUD treatment is pursued as an intervention for IPV, many patients do not achieve sustained abstinence from problem drinking. Therefore, it is of critical important that a variety of intervention approaches be assessed for effectiveness in reducing IPV among violent alcohol-using couples.

The first article in this issue, by Brem and colleagues, represents the kind of sound etiological research important for the development of effective interventions for IPV. The authors investigate one of the identified moderators of the alcohol–IPV relationship—trait jealousy—in a sample of 74 men who had been arrested for domestic violence and court-ordered to batterer intervention programs (BIPs). They find that alcohol problems are positively related to physical and sexual IPV among men in this sample reporting high—but not low—trait jealousy, suggesting that effective BIPs will need to target both jealousy-related cognitions and alcohol problems.

The next article in this issue, by Lewis and associates, investigates IPV among sexual minority women couples. Some evidence suggests that this group is at elevated risk for IPV. The NISVS found, for instance, that 44% of U.S. lesbian women and 61% of bisexual women—compared with 35% of heterosexual women—reported lifetime experience of rape, physical violence, and/or stalking by an intimate partner, while 26% of gay and 37% of bisexual men, compared with 29% of heterosexual men, reported such lifetime victimization by an intimate partner (Walters, Chen, & Breiding, 2013). Lewis and colleagues report data from a sample of self-identified lesbian participants who report on their own and their partner’s alcohol use and perpetration of psychological aggression and physical violence at three timepoints. Their analyses reveal that discrepancies in the partners’ drinking (i.e., differences in their alcohol usage) predicted participants’ subsequent perpetration of psychological aggression, but not physical violence, while both psychological aggression and physical aggression predicted subsequent discrepant drinking. Thus, as has been found among heterosexual couples (see, e.g., Homish & Leonard, 2005; Mudar, Leonard, & Soltysinski, 2001), discrepancies in lesbian couples’ alcohol use appear to be a risk factor for disharmony and aggression in the relationship.

DV

DV usually refers to a form of IPV occurring among adolescents and extending to physical, psychological, or sexual abuse; harassment; or stalking of any person ages 12-18 years in the context of a past or present romantic or consensual relationship (U.S. Department of Justice, Office of Justice Programs, National Institute of Justice, 2017). Involvement in DV has been associated with a range of psychiatric disorders (McCauley, Breslau, Saito, & Miller, 2015), with physical DV associated with high trait anger and anger management deficits (Shorey, McNulty, Moore, & Stuart, 2017; Reyes et al., 2015), gender role attitudes (Reyes, Foshee, Niolon, Reidy, & Hall, 2016) and gender role stress (Reidy, Smith-Darden, Cortina, Kernsmith, & Kernsmith, 2015), and DV victimization associated with a variety of factors including history of pornography viewing (Rothman & Adhia, 2015) and witnessing interparental violence (Coker et al., 2014; Karlsson, Temple, Weston, & Le, 2016). Among U.S. high school students involved in relationships, one third report DV victimization by a partner and 20% report perpetrating DV in the previous 12 months, with rates of victimization and perpetration generally higher among females and those not exclusively attracted to the opposite sex (Coker et al., 2014). Although some research indicates that DV rates among U.S. high school students have not changed substantially in a decade or more (Rothman & Xuan, 2014), DV has in recent years received growing attention as a problem among youth (see, e.g., CDC, 2017b) as victims of DV often report subsequent increases in health symptoms such as depression, anxiety, drug use, and suicidal ideation (Chermack & Giancola, 1997; Chermack et al., 2010; Epstein-Ngo et al., 2013).

Moreover, as is the case with IPV, alcohol use consistently has been linked with dating aggression in psychosocial research as well as in laboratory studies (Coker et al., 2014; Rothman, McNaughton Reyes, Johnson, & LaValley, 2012; Whiteside et al., 2013), and daily diary studies have shown that alcohol use increases the odds of DV among college students (Shorey et al., 2014; Shorey, Stuart, Moore, & McNulty, 2014). While much of the research on alcohol use as it relates to DV has focused on middle school– and high school–aged adolescents and young college students, less attention has been paid to DV among emerging adults (e.g., 18-25 years) who are not attending college (Bingham, Shope, & Tang, 2005; Dawson, Grant, Stinson, & Chou, 2005; Herrera, Wiersma, & Cleveland, 2008). Nevertheless, rates of alcohol misuse peak during this period (Jackson, Sher, & Schulenberg, 2008; White, Jackson, & Loeber, 2009), and the fact that high-risk emerging adults often are unaffiliated with an educational institution and frequently lack a source of primary medical care (see, e.g., Arnett, 2000; Marshall, 2011; McCormick, Kass, Elixhauser, Thompson, & Simpson, 2000; Orthner & Randolph, 1999) highlights the importance of understanding the factors involved in DV in this population.

The article presented in this issue by Ngo and colleagues is based on data from 735 emerging adults who were queried in an urban emergency department (ED) in the Midwest. Over 27% of the sample had perpetrated physical dating violence (PDV) and 16.5% had perpetrated sexual dating violence (SDV), with alcohol consumption positively associated with both forms of DV. Anxiety was positively associated with PDV. Interestingly, trait mindfulness, an emotion regulation (ER) skill that promotes nonjudgmental acceptance and tolerance of upsetting emotions, was found to be negatively associated with both PDV and SDV, suggesting that mindfulness—which has been effective in brief interventions in reducing substance use (Bowen & Marlatt, 2009; Stappenbeck et al., 2015)—might offer a promising path forward in reducing interpersonal violence. However, research to determine whether ER interventions can be applied in reducing men’s intoxicated aggression is at an early stage.

The next article in this issue, by Rothman and colleagues, presents data from a prospective cohort study involving 60 non–college attending young adults who were queried over the course of 3 months. The authors find that DV perpetration was substantially higher on days when participants reported using alcohol, although analyses of the temporal order did not find that alcohol was a proximal predictor of DV. Same-day marijuana use was not associated with elevated risk of DV perpetration, a conclusion that runs counter to some other published DV research (see, e.g., McNaughton Reyes, Foshee, Bauer, & Ennett, 2014). Study findings suggest the need for further investigation of the relationship of both alcohol and marijuana use to DV (see, e.g., Parker, Debnam, Pas, & Bradshaw, 2015; Shorey, Haynes, Strauss, Temple, & Stuart, 2017).

The two studies of DV presented here contribute to the body of research on factors impacting the association between alcohol use and DV among non–college high-risk emerging adults. While understanding such factors has important implications for the development of interventions aimed at reducing these harmful behaviors, intervention development aimed at this population will need to consider that such individuals may be particularly likely to use EDs for their health care. The ED is one of a limited number of entry points for the initiation of substance use and mental health services (Bernstein & D’Onofrio, 2009; McCormick et al., 2000), but limited on-site substance use staff and time constraints during ED visits are likely to impede treatment for alcohol use and DV.

Bystander Prevention Approaches for SA

SA encompasses any type of forced or coerced sexual contact or behavior that happens without consent, and includes rape and attempted rape, child molestation, and sexual harassment or threats (Office on Women’s Health, U.S. Department of Health Human Services, 2017). According to the NISVS, 1.3 million U.S. women were raped (defined here as any completed or attempted unwanted vaginal, oral, or anal penetration through the use of physical force or threats to physically harm, and includes times when the victim was drunk, high, drugged, or passed out and unable to consent) during the year preceding the NISVS survey and 18% reported lifetime rape victimization (Black et al., 2011). The SA problem is especially acute on college campuses, as yearly incidence of SA is higher among college women than women of a comparable age in the general population (Fisher, Cullen, & Turner, 2000; Testa & Livingston, 2009). In a national survey of college women (Koss, Gidycz, & Wisniewski, 1987), 54% reported having experienced some form of sexual aggression since age 14 years, and 27.5% of these cases met the Federal Bureau of Investigation (FBI) definition of rape. As many as one in four undergraduate women in the United States experience some form of sexual victimization during their time in college (Fisher et al., 2000). The recent Campus Climate Survey of nine universities (Krebs et al., 2016) found that between 4 and 20% of college women reported SA in the past year and 12-38% since entering college.

Consistent with the pattern for IPV and DV described earlier, it is generally believed that at least 50%—and possibly as many as three-quarters (Abbey, 2002; Testa & Livingston, 1999)—of SAs among college students involve alcohol use. Campus sexual violence often occurs at—or after attending—bars or parties where attendees are likely to be drinking alcohol (Armstrong, Hamilton, & Sweeney, 2006; Flack et al., 2007; Planty, 2002). In such drinking contexts, a third party (or “bystander,” i.e., someone other than the potential victim and perpetrator) is often present. For such reasons, a recent White House Task Force that focused on the reduction of campus SA (White House Task Force to Protect Students from Sexual Assault, 2014) identified bystander interventions as key elements of an overall strategy and public service campaign to reduce campus SA (DeGue et al., 2014). Such programs typically are grounded in the well-established bystander decision-making model of Latane and Darley (1970), which suggests that successful bystander intervention involves completion of five steps, including (a) noticing the event, (b) interpreting it as an emergency, (c) developing a feeling of personal obligation to act, (d) deciding how to help, and (e) choosing to act (and being able to do so). Indeed, bystander programs have shown some evidence of efficacy, as those who participate in bystander training reportedly are more likely to reduce their acceptance of DV (e.g., Ahrens, Rich, & Ullman, 2011; Amar, Sutherland, & Kesler, 2012; Coker et al., 2011) and to report increased intentions to, and confidence in, intervening in potentially risky situations (e.g., Gidycz, Orchowski, & Berkowitz, 2011; Kleinsasser, Jouriles, McDonald, & Rosenfield, 2015; Palm Reed, Hines, Armstrong, & Cameron, 2015). Until recently, it appeared that bystander programs had had somewhat stronger impacts on attitudes and behavioral intentions than on actual bystander behavior (Katz & Moore, 2013), but several such programs recently have reported increases in bystander behaviors (Moynihan et al., 2015; Salazar, Vivolo-Kantor, Hardin, & Berkowitz, 2014; Sargent, Jouriles, Rosenfield, & McDonald, 2017).

Nevertheless, situational barriers at any of the five steps in the Latané and Darley model may impede the occurrence of successful bystander intervention. For instance, the presence of other bystanders in the setting is a robust situational cue that may inhibit one from taking action in an emergency situation (see Fischer et al., 2011). As well, college students’ overestimation of the average student’s number of sexual partners, or their assumption that other students are more open to sex in uncommitted relationships than they are (Chia & Lee, 2008), or their fear of negative evaluation from others should they intervene (Burn, 2009; Edwards, Rodenhizer-Stämpfli, & Eckstein, 2015) may hinder the likelihood of intervening. Furthermore, it appears that bystanders are more willing to intervene in those cases where they consider the potential victim to be a member of their own social group, or where they know the victim and/or perpetrator (Bennett, Banyard, & Edwards, 2015; Katz, Pazienza, Olin, & Rich, 2014; Palmer, Nicksa, & McMahon, 2016), while men who do intervene sometimes have been found to encourage the perpetrator of the aggression (Graham et al., 2014). Some other moderators of bystander willingness to intervene include gender (see, e.g., Amar, Sutherland, & Laughon, 2014), victimization/perpetration history and history of misogyny (DeMaria et al., 2018), history of pornography use (Foubert & Bridges, 2017), and victim/perpetrator intoxication, as bystanders who witness conflict between intoxicated individuals are more likely to intervene than are those who witness conflict between sober individuals (Parks, Osgood, Felson, Wells, & Graham, 2013).

An important, though rarely discussed, issue is what happens when the bystander himself/herself has been consuming alcohol. This is hardly a minor matter, as it can be assumed that in drinking contexts most potential bystanders are likely to have been consuming alcohol. To date, only scant research has examined the acute effects of alcohol use on bystander intervention, with one study (Orchowski, Berkowitz, Boggis, & Oesterle, 2015) finding that heavy drinking men are less willing to intervene in a violent event than non–heavy drinking men, and another (Fleming & Wiersma-Mosley, 2015) finding that heavy alcohol use is associated with a lower likelihood of intervening among men, but not among women.

The AMT suggests a number of ways in which alcohol consumption might well hinder effective bystander intervention as portrayed in the Latané and Darley decision-making model. Thus, particularly as the risks in many such potentially violent situations often are not obvious, an intoxicated bystander may be especially slow to recognize that a particular situation suggests an imminent risk for violence (Banyard, Plante, & Moynihan, 2004; Latane & Darley, 1970). While the decision-making model suggests that an effective bystander must assume some responsibility for what may happen in the situation before making the decision to act, alcohol use may narrow the bystander’s attention toward, say, the presence of others in the setting, rather than the potential violence that may occur. Furthermore, intoxication may impair the bystander’s higher-order cognitive functioning, which affects processes such as problem solving, planning, response inhibition, and working memory (Curtin & Fairchild, 2003; Giancola, 2000; Peterson, Rothfleisch, Zelazo, & Pihl, 1990) and, thus, hindering his or her chances of acting effectively in a potential crisis situation. As bystander intoxication increases, he or she may be less likely to fully process information regarding the drinking status of the victim or perpetrator. Thus, even in cases where a heavily drinking bystander may possess the skills and confidence necessary to intervene, the individual may not be able to implement an effective plan of action due to the cognitive impairments induced by alcohol use.

Although responsibility for an episode of sexual violence ultimately must rest with the individual perpetrator, it is clear that an urgent need exists for research that examines bystander behavior in drinking contexts that can inform the development of intervention programming. By understanding how much, and in what ways, alcohol influences the likelihood of bystander intervention, it may be possible to make specific recommendations to inform SA prevention efforts.

The article by Oesterle and colleagues in this issue provides a rich example of the kind of formative research that future bystander intervention work might build upon. Using semistructured individual interviews conducted with college men reporting both past-month heavy drinking and sexual activity within the past 2 months, this study examines how these men recognize and respond to risky sexual situations and explores facilitators of, and barriers to, bystander intervention. Study findings reveal how these constructs vary in the context of alcohol use.

Finally, the article by Haikalis and colleagues, utilizing an incident-specific approach based on reports from 427 female SA victims (ages 18–25), examines situations in which bystanders missed opportunities to prevent an SA. Results indicate that bystanders had an opportunity to intervene before nearly one-quarter (23%) of the assaults. Alcohol use was prevalent in settings where bystanders were present, including use by the bystanders, themselves. Several factors common to situations involving missed intervention opportunity are identified.

Future Directions in Research on Alcohol-Related Partner Violence

While the six articles gathered here clearly suggest the complexity of the alcohol–violence relationship, such basic behavioral research likely will play a vital role in the ongoing search for useful building blocks in the development of effective interventions aimed at preventing and reducing alcohol-involved IPV, DV, and sexual assault. Central to this process will be the guiding frameworks provided by one or more of several emerging models of aggressive behavior. For instance, while the AMT has been influential for almost 3 decades as an explanation for alcohol-related aggression, myopia theory is unclear in explaining why, given an array of potentially instigatory and inhibitory cues in a particular setting, some individuals are more likely to find certain instigatory cues to be salient while others are more likely to find a different set of inhibitory cues to be more salient. The “threshold model” of alcohol-related aggression (Fals-Stewart, Leonard, & Birchler, 2005; Leonard & Quigley, 2017) offers a response to some of these concerns, proposing that the effects of alcohol on aggression in an individual may be linked both to underlying traits and to more momentary states. Thus, this model suggests that individuals low on traits such as trait anger likely will not be aggressive when drinking, while those who rank high on such a trait likely will be aggressive regardless of their level of alcohol consumption. Conversely, those high on inhibitory traits are not likely to be aggressive even when they are using alcohol, while those low on the same trait will be aggressive with or without alcohol use. Importantly, those who score in the midrange on either of these traits may be relatively more susceptible to the aggression-promoting properties of alcohol.

The past few years also have seen the development of the so-called I³ model (Finkel et al., 2012) as well as the resource model of self-control (Muraven & Baumeister, 2000), both of which are likely to play prominent roles in future work on intervention development for partner violence. The I³ model suggests that aggression is a consequence of Instigation (or provocation), Impellance (or dispositional tendency toward aggression), and a lack of Inhibition, or self-control failure. Attempts to integrate I³ Theory and the AMT are underway (see, e.g., Parrott & Eckhardt, 2018), and such an integration may serve as a catalyst for fruitful research that will inform the development of preventive interventions for interpersonal violence. The resource model of self-control holds that self-control can be depleted through use or increased through practice (Muraven & Baumeister, 2000). In this model, self-control is seen as akin to a “muscle” in that, after engaging in an activity requiring self-control, the “muscle” becomes fatigued and completion of subsequent acts requiring self-control becomes more difficult until the resource has had a chance to be replenished (de Ridder, Lensvelt-Mulders, Finkenauer, Stok, & Baumeister, 2012; Hagger, Wood, Stiff, & Chatzisarantis, 2010). Creative extensions of this model for understanding and, perhaps, preventing alcohol-related partner violence might be anticipated in the years ahead.

Future research aimed at understanding and preventing alcohol-related interpersonal violence also might benefit from a widened focus that encompasses some relatively understudied high-risk populations, including members of the military as well as sexual and gender minority groups (as is examined in this issue by Lewis and colleagues). Furthermore, the research field may profitably move “upward” from its current predominant focus on the individual victim or perpetrator. For instance, relatively few studies have sought to determine how an individual’s specific drinking context (i.e., where, how often, and with whom people drink) may be related to subsequent episodes of IPV. Thus, a critical next step is the identification of high-risk drinking contexts for such violence. The recent work of Cunradi and associates (Cunradi, Mair, & Todd, 2014; Cunradi, Mair, Todd, & Remer, 2012; Mair, Cunradi, Gruenewald, Todd, & Remer, 2013) points in this direction and may eventually lead to policy- and bystander-oriented prevention measures. DV research also may advance by moving toward more of a focus on dyadic influences rather than an exclusive focus on the individual (Paradis, Hébert, & Fernet, 2015). Indeed, it has been found that the alcohol use of both partners contributes independently (but not interactively) to the subsequent occurrence of aggression (Testa & Derrick, 2014), yet scant research has examined the synergistic effect of alcohol use by both members of dating dyads on the risk for DV.

Findings from the last two articles in this issue provide useful information that can advance our understanding of how bystanders can prevent sexual assault. Future years are likely to see both the continued development of bystander training as well as new directions in bystander research that likely will focus on how, and in which situations, alcohol intoxication can influence bystander behavior. For instance, it is quite likely that heavier drinkers, owing to their state of elevated disinhibition, may be substantially less fearful about intervening in high-risk situations than are lighter drinkers/abstainers, suggesting that, ultimately, bystander interventions might be tailored to individuals with specific traits or drinking habits. Further investigation of such issues will be critical to progress in the field of bystander prevention for sexual assault.

Nevertheless, it seems clear that the widespread implementation of individual- and/or contextual-level IPV prevention programs is likely to require a substantial outlay of resources (DeGue et al., 2012). Hence, environmental-level (or policy) measures to reduce violence related to alcohol use must be considered in any appraisal of potential directions for prevention work. A substantial body of research suggests that reducing alcohol availability—by, for example, increasing the price of alcoholic beverages, usually achieved through increasing taxes on alcohol—can reduce alcohol consumption (Chaloupka, Grossman, & Saffer, 1998; O’Mara et al., 2009; Skog, 2000; Wagenaar, Salois, & Komro, 2009). Conversely, expanded access to, or availability of, alcohol—in the form of, for example, lower minimum legal purchase age, reduced alcohol prices, drink specials, increased hours and days of sale, or proximity to dense concentration of alcohol outlets—has been associated with higher likelihood of alcohol use and/or alcohol use disorder (Kypri, Bell, Hay, & Baxter, 2008; Popova, Giesbrecht, Bekmuradov, & Patra, 2009), increases in alcohol-related mortality (Stockwell et al., 2011), and acute alcohol intoxication hospitalizations (Bloomfield, Rossow, & Norstrom, 2009). Alcohol control policies that limit the general availability of alcohol, the geospatial concentration of alcohol outlets, and easy access to large quantities of alcohol may offer promise in the effort to reduce levels of interpersonal violence.