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. Author manuscript; available in PMC: 2012 Nov 1.
Published in final edited form as: Aggress Violent Behav. 2011 Nov-Dec;16(6):541–550. doi: 10.1016/j.avb.2011.08.003

Dating Violence and Substance Use in College Students: A Review of the Literature

Ryan C Shorey 1, Gregory L Stuart 1, Tara L Cornelius 2
PMCID: PMC3224085  NIHMSID: NIHMS322192  PMID: 22125415

Abstract

Dating violence is a serious and prevalent problem among college-aged dating couples. Although substance use has been shown to be associated with dating violence among college students in empirical studies, the use of substances as they relate to dating violence has yet to be systematically reviewed. The purpose of the present manuscript is to review research on dating violence (perpetration and victimization) and substance use (alcohol and drugs). First, theoretical explanations for the association between substances and dating violence are presented. Second, the literature on substance use and dating violence is reviewed. The literature suggests a consistent association between alcohol and dating violence perpetration and victimization, although the association between drug use and dating violence is less clear. Implications of this review for dating violence prevention programming and future research are discussed.

Keywords: Dating violence; aggression; substance use; alcohol, drugs; college students

The association between substance use and intimate partner violence (IPV) has been the focus of increased empirical attention in recent years (Klosterman & Fals-Stewart, 2006). The majority of research focus has been conducted on substance use and IPV among community and treatment samples of adults (e.g., Cunradi, Caetano, Clark, & Schafer, 1999; Foran & O’Leary, 2008; Leonard & Quigley, 1999; Stuart et al., 2006, 2008). Yet, violence between college-aged dating partners is a serious problem and has been shown to be associated with substance use (Hines & Straus, 2007). The purpose of the current manuscript is to review the literature on substance use (i.e., alcohol and drugs) and dating violence perpetration and victimization among college students. First, we present a brief summary of the prevalence and negative consequences of dating violence. Second, we present theoretical explanations for the association between substance use and IPV. Third, we present research on the association between dating violence perpetration/victimization and substance use. Finally, we discuss implications for prevention programming and we provide recommendations for future research.

Dating Violence

Dating violence can be conceptualized as the occurrence of physical, psychological, or sexual aggression between dating partners (see review by Shorey, Cornelius, & Bell, 2008a). For the current review, we will focus on dating violence that occurs between college-aged couples. Although the definition and prevalence rates of dating violence have been discussed elsewhere (e.g., Cornelius, Shorey, & Kunde, 2009; Lewis & Fremouw, 2001; Shorey et al., 2008a), research consistently demonstrates that approximately 20–30% of dating couples experience at least one act of physical aggression, 70–90% experience psychological aggression, and 3–20% experience sexual aggression each year (Shorey et al., 2008a). The modal forms of aggression experienced by college students is often classified as “minor” in severity (Straus, Hamby, Boney-McCoy, & Sugarman, 1996), which include insulting, yelling, swearing, or doing something to spite one’s partner (psychological aggression), pushing, grabbing, or slapping one’s partner (physical aggression), and insisting on sex with a partner when he/she does not want to (sexual aggression).

Rates of severe aggression are less commonly reported in the literature, but it is estimated that approximately 8–16% of individuals in college dating relationships experience at least one act of severe physical aggression (e.g., punch, choke, kick partner), 12–30% experience severe psychological aggression (e.g., threaten to hit partner, destroy personal belonging of partner), and 3–9% experience severe sexual aggression (e.g., use force/threats to have sex with partner) each year (Bell & Naugle, 2007; Hines & Saudino, 2003). Regardless of the severity of the aggression, prevalence rates for dating couples are similar across gender, with males and females perpetrating and being victimized by comparable levels of aggression (Prospero, 2007; Shorey et al., 2008a; Straus, 2008).

Furthermore, dating violence is associated with a number of health problems. For instance, both minor and severe forms of dating violence victimization are associated with increased depressive and anxious symptomatology (Harned, 2001), somatic complaints (Kaura & Lohman, 2007), and physical injuries (Amar & Gennaro, 2005). Although female victims are more likely than male victims to sustain physical injuries as a result of abuse (Archer, 2000), research increasingly indicates that male victims of dating violence often experience a similar number of mental health problems as their female counterparts (Prospero, 2007). In all, the mental and physical health toll associated with dating violence victimization is devastating.

Although the rates and negative consequences of dating violence are similar to that found in community samples of adults, there are a number of unique aspects of dating violence that differentiate it from IPV that occurs in marital/older adult relationships. For instance, dating violence is often less severe in nature than aggression that occurs between intimate partners in marital or cohabitating relationships, particularly with regard to physical aggression (Shorey et al., 2008a). This may be due to college students often having multiple dating relationships of short duration (Cooper, 2002), and IPV generally increases in frequency and intensity when relationship length increases (Marcus & Swett, 2002), making it more likely that marital relationships would experience more severe aggression. Further, dating partners rarely cohabitate, and IPV is more frequent and severe in cohabitating relationships (Stets, 1991). In addition, psychological aggression that occurs between dating partners rarely includes behaviors that are intended to restrict or control the financial behaviors of one’s partner (Murphy & Hoover, 1999), which is a common definitional component of psychological aggression and a type of behavior that often occurs in marital, cohabitating relationships. Thus, dating violence represents a form of IPV that is unique in many aspects from IPV that occurs in marital/cohabitating relationships.

Substance Use and Violence

It is generally well established that substance use is associated with an increased risk for IPV among community and treatment samples of adult intimate partners (see reviews by Foran & O’Leary, 2008; Moore et al., 2008, Stuart, O’Farrell, & Temple, 2009; Temple, Stuart, & O’Farrell, 2009). For instance, Foran and O’Leary (2008) found a small to moderate effect size for the association between alcohol use and male-to-female and female-to-male IPV perpetration. Similarly, Moore et al. (2008) found small to moderate effect sizes for the association between cocaine use and marijuana use and the perpetration of physical, psychological, and sexual IPV against an intimate partner. Additionally, research with adult substance use treatment samples show that reductions in substance use is associated with reductions in IPV perpetration (e.g., O’Farrell, Fals-Stewart, Murphy, & Murphy, 2003; O’Farrell, Murphy, Stephan, Fals-Stewart, & Murphy, 2004; Stuart et al., 2009; Stuart et al., 2003; Stuart et al., 2002). Therefore, the link between substance use and IPV among community and treatment samples of adults has been extensively explored with consistent associations found between substance use and IPV.

Unfortunately, the link between substance use and dating violence among college students has yet to be systematically reviewed, hindering our understanding of whether substance use may be as robust a correlate of aggression for these young couples as it is for community and treatment samples of adults. Knowing this information is important because it may help guide more effective interventions for dating violence, as the current literature suggests that dating violence prevention programs have only had minimal success at reducing aggression (see Cornelius & Resseguie, 2007, and Whitaker et al., 2006, for reviews). In fact, dating violence prevention programs have often neglected the potential influence of alcohol and drug use in their programs (Roudsari, Leahy, & Walters, 2009; Shorey, Rhatigan, Fite, & Stuart, 2011). Thus, systematically reviewing the literature on the association between substance use and dating violence will help researchers and clinicians clarify whether adding substance use components to existing and newly developed prevention programs may enhance their effectiveness.

Theoretical Considerations

Before reviewing the literature on substance use and dating violence, it is important to consider relevant theoretical frameworks for this association. Although there are a number of theoretical frameworks that have been used to explain the link between substance use and aggression (see review by Giancola, 2002), we will focus only on the theoretical models that have either been directly tested with IPV or were developed specifically for explaining the link between substance use and IPV.

First, the indirect effects model posits that substance use has detrimental and corrosive effects on relationship quality, with long-term substance use setting the stage for conflict between partners and, ultimately, aggression (Klosterman & Fals-Stewart, 2006). For instance, substance use by one or both partners may increase the chances of arguments between partners, leading to reduced relationship quality and, in turn, aggression. However, as reviewed by Klosterman and Fals-Stewart (2006), even after controlling for relationship discord and other negative relationship variables, substance use is still directly associated with IPV perpetration. This suggests that substance use most likely has a different path to IPV that is not solely mediated through decreased relationship quality. Therefore, the explanatory power of the indirect effects model may not be sufficient.

The spurious effects model posits that the relationship between substance use and IPV is due to other, third variables that are associated with both substance use and aggression (Klosterman & Fals-Stewart, 2006). For example, personality dispositions to become angry or hostile, beliefs about IPV, socioeconomic status, and race have all been shown to be related to IPV and substance use, and it is possible that these variables are responsible for the association between substance use and IPV. However, the overwhelming majority of research shows that substance use is associated with IPV even after controlling for variables known to be related to both substance use and IPV (Klosterman & Fals-Stewart, 2006), suggesting that substance use has an independent effect on IPV. Therefore, like the indirect effects model, the spurious effects model does not appear to be the soundest theoretical framework for explaining the relationship between substance use and domestic violence.

The proximal effects model posits that substance use is a causal agent in the association between use and aggression, with the pharmacological effects of substances (e.g., reduced cognitive processing, increased impulsivity) mediating the relationship between use and aggression (e.g., Chermack & Taylor, 1995). For instance, acute alcohol use may make negative situational factors (e.g., negative affect) more salient due to decreased information processing capabilities, causing an individual to focus their attention on the negative aspects of a situation, thus increasing one’s risk for aggression. Research examining the temporal association between substance use and IPV perpetration has shown that substance use often occurs prior to, and temporally close in time to, aggression (e.g., Fals-Stewart, 2003; Parks, Hsieh, Bradizza, & Romosz, 2008). Overall, the proximal effects model has received the greatest empirical support for explaining the association between substance use and aggression (Klosterman & Fals-Stewart, 2006; Leonard & Quigley, 1999). However, the majority of research on this theory has been conducted with non-college student samples, limiting the generalizability of findings to college students.

Similar to the proximal effects model, Leonard (1993) developed a conceptual framework that proposes that acute alcohol use impacts specific episodes of aggression, but that it is only under conditions of negative interactions among partners that alcohol use will likely lead to aggression. Furthermore, distal factors, such as personality traits and relationship discord, interact with acute alcohol use to increase one’s risk for aggression. Finally, alcohol use by both partners is hypothesized to play an important role in risk for aggression, not just alcohol use by the perpetrator. Although developed specifically to explain the effects of alcohol on IPV, this framework has also been extended to include the acute effects of drugs on one’s risk for IPV (Moore & Stuart, 2005; Stuart et al., 2008). Although research with men and women arrested for IPV has demonstrated support for this framework (Stuart et al., 2006, 2008), it is difficult to generalize these findings to college-aged dating couples due to the likely difference in aggression severity among these distinct samples. Thus, the utility of Leonard’s model in explaining dating violence is in need of investigation in college samples.

The above theoretical frameworks for the association between substance use and IPV have received the most empirical attention from researchers. However, an additional theoretical explanation for the association between substance use and IPV has recently been developed. Bell and Naugle (2008) proposed a theory of IPV which combined existing research with basic behavioral theory principles in an attempt to provide a parsimonious framework to explain the perpetration of IPV. In their theoretical framework, substance use is viewed as an antecedent condition to aggression, specifically a motivating factor. A motivating factor is an antecedent condition that temporarily alters the potency of a particular consequence (e.g., a reinforce or punisher), thus temporarily altering the chances that a specific target behavior (i.e., aggression) will occur (Bell & Naugle, 2008). As articulated by Bell and Naugle (2008), “it is possible that substance use (or the state of being under the influence of drugs or alcohol) may temporarily alter the potency of reinforcers or punishers associated with IPV perpetration and may momentarily increase the likelihood that physical aggression will occur” (p. 1103). Research is needed to determine whether there is empirical support for their conceptualization of how substance use is associated with IPV.

One limitation to the existing theoretical frameworks on the association between substance use and IPV is their focus on the perpetration of aggression. That is, there is a lack of theoretical explanations for the association between substance use and IPV victimization. Research shows that victims of IPV evidence increased substance use (e.g., Howard & Wang, 2003; Parks et al., 2008; Silverman, Raj, Mucci, & Hathaway, 2001), and theoretical explanations for this association is needed. It is likely that theoretical development in this area has been limited due to concerns of blaming victims for their own victimization. However, a few researchers have attempted to integrate victimization into their theoretical frameworks in order to provide a fuller picture of the relationship between substance use and interpersonal aggression.

Leonard’s (1993, 2001) framework proposes that substance use by both partners in a relationship can influence episodes of aggression, suggesting that substance use places individuals at risk for victimization. Indeed, research indicates that substance use is temporally related to victimization experiences (e.g., Parks & Fals-Stewart; 2004), which is consistent with Leonard’s theory and the proximal effects model. One potential explanation for this link is that the effects of substances may undermine individuals’ risk perception (Cattaneo, Bell, Goodman, & Dutton, 2007), placing them at risk for victimization. It is also possible that victims and perpetrators consume substances together, creating a context which is conducive to aggression, although research is needed that examines this possibility.

An additional explanation regarding why substance use is associated with victimization experiences is that victims may use substances to cope with the aftermath of aggression (Anderson, 2002; Kaysen et al., 2007). Indeed, research shows that victims often consume substances immediately following episodes of aggression (Parks et al., 2008) and that victimization experiences predict the onset of substance use (Salomon, Bussuk, & Huntington, 2002). It is also possible that substance use and victimization are associated because individuals under the effects of substances perpetrate aggression first, with victimization occurring secondary to perpetration (Testa, Livingston, & Leonard, 2003). Continued empirical research is needed to help clarify the mechanisms responsible for the association between substance use and IPV victimization.

Dating Violence and Substance Use

The following review on the association between dating violence and substance use is restricted to college student studies only, as there are a large number of investigations that have examined the association between substance use and dating violence in this population. Research that has examined substance use and substance-related problems as related to dating violence are reviewed. In addition, only studies that have separated perpetration and victimization, and alcohol and drug use into separate variables are reviewed. This was done because it is difficult to draw conclusions from studies that have combined these distinct topographies of aggression and distinct types of substances. First, the association between dating violence perpetration and substance use is reviewed, with separate sections for studies that examined males, females, and both genders combined. Second, the above is repeated for the association between dating violence victimization and substance use.

Alcohol and Male Perpetration

As displayed in Table 1, numerous studies have examined the association between dating violence perpetration and alcohol in college student males. A number of cross-sectional studies have shown that alcohol problems are related to perpetration (Baker & Stith, 2008; Fossos, Neighbors, Kaysen, & Hove, 2007; Hove, Parkhill, Neighbors, McConchie, & Fossos, 2010), and perpetrators have more alcohol problems than non-perpetrators (Cogan & Ballinger, 2006; Lundeberg, Stith, Penn, & Ward, 2004). Alcohol problems refer to problems that occur as a result of alcohol use, such as drinking and driving, arguments, etc. (White & Labouvie, 1989).

Table 1.

Studies on Substance Use and Dating Violence Perpetration among College Students

Study Sample
Size		 Substance Indicator/Aggression Type Findings
    Males     Alcohol
Baker & Stith (2008) 132 Problems (RAPI)/Physical (CTS2) Problems related to more perpetration
Barnes, Greenwood, & Sommer (1991) 202 Frequency past month (2 questions created for study)/Physical (CTS) Increased frequency associated with more perpetration
Cogan & Ballinger (2006) 482 Problems (SMAST)/Psychological & Physical (CTS) Perpetrators had more problems than non-perpetrators
Foo & Margolin (1995) 111 Frequency past month (3 questions designed for study)/Physical (CTS) Increased frequency associated with more perpetration
Fossos, Neighbors, Kaysen, & Hove (2007) 333 Problems & frequency per week (RAPI/DDQ)/Psychological, physical, and sexual combined (CTS2) Problems related to more perpetration; No association found for frequency
Gidycz, Warkentin, & Orchowski (2007) 425 Problem & average daily (DDHQ)/Psychological, physical, and sexual (CTS2/SES) No association found
Hove, Parkhill, Neighbors, McConchie, & Fossos, (2010) 313 Problems & frequency per week (RAPI/DDQ)/Psychological, physical, and sexual combined (CTS2) Problems related to more perpetration; Increased frequency associated with more perpetration
Lundeberg, Stith, Penn, & Ward (2004) 115 Problems (RAPI)/Psychological & Physical (CTS2) Perpetrators had more problems than non-perpetrators
Luthra & Gidycz (2006) 200 Frequency past month (1 question designed for study)/Physical (CTS) Increased frequency associated with more perpetration
Rapoza & Baker (2008) 171 Frequency (AUDIT-C)/Physical (CTS2) Increased frequency associated with more perpetration
Rapoza & Drake (2009) 164 Binge (AUDIT-C)/Sexual (CTS2) Binge drinkers perpetrated more aggression than non-drinkers
Roudsari, Leahy, & Walters (2009) 97 Drinking at time of aggression (1 question designed for study)/Psychological & physical (CADRI) Under the influence of alcohol for 100% of physical and 58% of psychological perpetration
Shook, Gerrity, Jurich, & Segrist (2000) 177 General drinking & drinking at time of aggression (2 questions adapted for study)/Psychological & physical (CTS) Drinking 3 hours before/after argument related to perpetration; General drinking related to less perpetration
Stets & Henderson (1991) 148 Frequency past year (2 questions adapted for study)/Physical (CTS) No association found
Tontodonato & Crew (1992) 347 Frequency past year (1 question created for study)/Physical (Modified CTS) No association found
Williams & Smith (1994) 117 Frequency (DPQ)/Physical (CTS) Frequency related to less perpetration
    Females     Alcohol
Baker & Stith (2008) 342 Problems (RAPI)/Physical (CTS2) Problems related to more perpetration
Cogan & Ballinger (2006) 997 Problems (SMAST)/Physical (CTS)
Durant et al. (2007) 2,453 Past 30 days (1 question designed for study)/Physical (1 question designed for study) Associated with more perpetration
Foo & Margolin (1995) 179 Frequency past month (3 items designed for study)/Physical (CTS) No association found
Fossos et al. (2007) 447 Problems & frequency per week (RAPI/DDQ)/Psychological, physical, and sexual combined (CTS2) Problems related to more perpetration;
Lewis, Travea, & Fremouw (2002) 300 General drinking (KAT)/Physical (CTS) Perpetrators did not consume more alcohol than non-perpetrators
Luthra & Gidycz (2006) 100 Frequency past month (1 question)/Physical (CTS) Perpetrators consumed more alcohol than non-perpetrators
Rapoza & Baker (2008) 171 Frequency (AUDIT-C)/Physical (CTS2) Perpetrators consumed more alcohol than non-perpetrators
Roudsari et al. (2009) 183 Drinking at time of aggression (1 question designed for study)/Psychological & physical (CADRI) Under the influence of alcohol for 18% of physical and 75% of psychological
Shook et al. (2000) 295 General drinking & drinking at time of aggression (2 questions adapted for study)/Psychological & physical (CTS) Drinking 3 hours before/after argument was associated with increased risk for perpetration
Tontodonato & Crew (1992) 500 Frequency past year (1 question designed for study)/Physical (CTS) No association found
    Males and Females Combined     Alcohol
Follingstad, Bradley, Laughlin, & Burke (1999) 617 Problems & consumption (10 items created for study)/Physical (CTS) Problems associated with more perpetration with effect stronger for males
Hammock & O’Hearn (2002) 387 Weekly consumption (2 question created for study)/Psychological (O’Hearn & Davis, 1997, measure) Associated with more perpetration for males only
Hines & Straus (2007) 7,291 Binge (PRP)/Physical (CTS2) Associated with more perpetration; no gender differences
Makepeace (1981) 202 Drinking at time of aggression 1 question designed for study)/Physical (8 questions designed for study) 31.6%–50% under influence of alcohol at time of aggression
Roudsari et al. (2009) 280 BAC/Psychological (CADRI) Higher BAC associated with increased perpetration
Stets & Henderson (1991) 272 Frequency past year & drinking at time of aggression (2 questions designed for study)/Physical (CTS) Drinking 3 hours before incident increased risk for perpetrating
Taft et al. (2010) 199 Problems MAST)/Psychological & physical (CTS2) Problems was related to more psychological and physical perpetration
Williams & Smith (1994) 221 Drinking at time of aggression (1 question designed for study)/Physical (CTS) 40% under the influence of alcohol at time of aggression
    Males     Drugs
Nabors (2010) 638 Used specific type in past year (1 question for each drug designed for study)/Physical (CTS2) Steroid users less likely to perpetration
Tontodonato & Crew (1992) 347 Frequency past year (1 question designed for study)/Physical (Modified CTS) Associated with more perpetration
    Females     Drugs
Durant et al. (2007) 2,453 Marijuana past 30 days (1 question designed for study)/Physical (1 question designed for study) Associated with more perpetration
Nabors (2010) 997 Used specific type in past year (1 question for each drug designed for study)/Physical (CTS2) Depressant users more likely to perpetrate; opiate users less likely to perpetrate
Tontodonato & Crew (1992) 500 Frequency past year (1 question designed for study)/Physical (Modified CTS) Associated with more perpetration
    Males and Females Combined     Drugs
Nabors (2010) 1,635 Used specific type in past year (1 question for each drug designed for study)/Physical (CTS2) Marijuana and depressant users more likely to perpetrate
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Note: CTS2 = Revised Conflict Tactics Scales; CTS = Conflict Tactics Scales; PMWI = Psychological Maltreatment of Women Inventory; SES = Sexual Experiences Survey; CADRI = Conflict in Adolescent Dating Relationships Inventory; DDQ = Daily Drinking Questionnaire; DDHQ =Drinking and Drug Habits Questionnaire; AUDIT-C = Alcohol Use Disorders Identification Test - Core; RAPI = Rutgers Alcohol Problem Inventory; SMAST = Short Michigan Alcohol Screening Test; MAST = Michigan Alcohol Screening Test; DPQ = Drinking Practices Questionnaire; KAT = Khavari Alcohol Test; PRP = Personal and Relationship Profile.

Research also shows that binge drinkers, defined as the consumption of 5 or more standard drinks (e.g., 12 ounce beer) for men and 4 or more standard drinks for women on one occasion (Wechsler, Lee, Kuo, & Lee, 2000), perpetrate more sexual aggression than non-perpetrators (Rapoza & Drake, 2009). Additional research shows that aggression occurs when males consume alcohol proximally close in time to aggression perpetration (Shook, Gerrity, Jurich, & Segristm, 2000), and are often under the influence of alcohol at the time of aggression (Roudsari, Leahy, & Walters, 2009). These studies are important because they speak to the potential proximal influence of alcohol use on aggression, indicating that acute alcohol use may increase one’s risk for perpetrating dating violence. However, these studies did not assess the amount of alcohol consumed prior to aggression or whether the risk of aggression was greater under states of acute alcohol intoxication versus states of sobriety. The cross-sectional nature of these studies also precludes the determination of the temporal relations among alcohol and aggression perpetration.

Additional cross-sectional studies have shown that the frequency with which males consume alcohol is associated with dating violence perpetration (Barnes, Greenwood, & Sommer, 1991; Foo & Margolin, 1995; Hove et al., 2010; Luthra & Gidycz, 2006; Rapoza & Baker, 2008), specifically physical aggression. Although the vast majority of research has shown an association between drinking frequency and dating violence perpetration for men, a few cross-sectional studies have failed to find such an association (Fossos et al., 2007; Gidycz, Warkentin, & Orchowski, 2007; Tontodonato & Crew, 1992; Stets & Henderson, 1991; Williams & Smith, 1991). However, these null results may be attributable to the different measures and indicators of aggression and alcohol use across these studies. For example, Fossos et al. (2007) combined physical, psychological, and sexual aggression into one overall violence variable and Gidycz and colleagues (2007) used a measure of alcohol that has not been used by other researchers in the current review.

Alcohol and Female Perpetration

As with their male counterparts, researchers have investigated the relationship between alcohol and dating violence perpetration among women (Table 1). Studies have shown that alcohol problems (as defined above) are positively associated with aggression perpetration (Baker & Stith, 2008; Fossos et al., 2007). Research also shows that as the frequency of alcohol consumption increases physical aggression also increases (Durant et al., 2007) and perpetrators of physical aggression consume alcohol more frequently than non-perpetrators (Luthra & Gidycz, 2006; Rapoza & Baker, 2008). In addition, alcohol is often consumed close in time to physical and psychological aggression (Shook et al., 2000) and perpetrators of these forms of aggression are often under the influence of alcohol at the time of perpetration (Roudsari et al., 2009). It should be noted that all of these studies were cross-sectional.

Although most studies show an association between alcohol and dating violence for women, a few cross-sectional studies have failed to find support for a relationship between frequency of alcohol use and aggression perpetration among women (Foo & Margolin, 1995; Tontodonato & Crew, 1992). In addition, studies have failed to show that physically aggressive women consume more alcohol (Lewis, Travea, & Fremouw, 2002) or have more alcohol problems (Cogan & Ballinger, 2006) than their non-aggressive peers. It is plausible that these null findings are due to the various indicators of alcohol and aggression utilized in these studies, consistent with research on male perpetrated aggression. However, it is also possible that alcohol use is not as robust a correlate for female perpetrated aggression as it is for men, which may be due to females generally consuming less alcohol than males (Chen, Dufour, & Yi, 2004).

Alcohol and Combined Male and Female Perpetration

A number of cross-sectional studies have combined males and females into an overall sample when examining the association between alcohol use and dating violence perpetration or have examined differences in the alcohol use-perpetration relationship among males and females (Table 1). Follingstad, Bradley, Laughlin, and Burke (1999) found that alcohol problems predicted perpetration of physical aggression, and this effect was stronger for males than females. Hammock and O’Hearn (2002) showed that average weekly alcohol consumption was associated with psychological aggression for males but not females. However, Hines and Straus (2007) found no gender difference in the association between binge drinking and physical aggression perpetration. Thus, further research is needed that examines whether the association between alcohol and perpetration varies depending on the gender of the perpetrator.

Additional cross-sectional research that has examined males and females as a combined sample has shown that between 31.6% and 50% of physically aggressive perpetrators were under the influence of alcohol at the time of aggression (Makepeace, 1981; Williams & Smith, 1994) and that drinking three hours before an incident of physical aggression increased one’s risk for perpetrating aggression (Stets & Henderson, 1991). Also, estimated peak blood alcohol concentration (BAC) during the past month was associated with increased psychological aggression perpetration (Roudsari et al., 2009). Further, alcohol problems were associated with increased physical and psychological aggression perpetration (Taft, Schumm, Orazem, Meis, & Pinto, 2010). These studies provide further evidence for an association between alcohol and dating violence perpetration.

Drug use and Dating Violence Perpetration

Drugs and Male Perpetration

There is a paucity of research examining drug use as it relates to dating violence perpetration among college students (Table 1). Tontodonato and Crew (1992) found that drug use was associated with physical aggression perpetration, but did not separate specific types of drugs due to low response rates for drug use. Nabors (2010) cross-sectionally examined the associations between cannabis, depressants, hallucinogens, stimulants, narcotics, inhalants, and anabolic steroids with physical aggression perpetration. Findings showed that male users of anabolic steroids were 65% less likely to perpetrate physical aggression than non-users. No other drugs emerged as significant predictors for men specifically. These findings suggest that drug use may indeed be a correlate of perpetrating dating violence for men, and some drugs may even be protective for perpetrating aggression, although much more research is needed in this area to fully understand what specific drug types are related to dating violence. Clearly, research on the association between drug use and violence perpetration among college student males is in its infancy.

Drugs and Female Perpetration

As with their male counterparts, we are aware of only a few studies that have examined the association between drug use and dating violence perpetration among women (Table 1). Studies have shown that drug use is associated with increased risk of perpetrating physical aggression (Durant et al., 2007; Tontodonato & Crew, 1992), including marijuana (Durant et al., 2007). However, it has been suggested that marijuana use itself may not cause aggression but, rather, it may be marijuana withdrawal that is related to IPV (Moore et al., 2008). Longitudinal research is needed to determine the mechanism(s) through which marijuana may impact female’s risk for perpetrating dating violence.

Finally, Nabors (2010) found that depressant users were twice as likely as non-users to perpetrate physical aggression. However, the number of women who actually used depressants was quite small, suggesting that this drug class is likely present in only a small percentage of dating violence episodes. On the other hand, users of narcotics (i.e., opiates) were 65% less likely to perpetrate physical aggression than non-users, which may be due to the calming effects of narcotics. These findings speak to the importance of recognizing that not all drug use will lead to an increased risk for aggression perpetration despite the negative consequences often associated with using mind altering substances. In addition, the findings by Nabors (2010) suggests that drug use is not a robust correlate of perpetrating dating violence, and that drug use may only impact risk for aggression in a small number of college students.

Drugs and Combined Male and Female Perpetration

In addition to examining males and females separately, Nabors (2010) also examined males and females jointly to determine the association between drug use and physical aggression across gender. Findings shows that marijuana users were 35% more likely to use physical aggression than non-users, and users of depressants were 57% more likely to use physical aggression than non-users (Table 1). As mentioned previously, research is needed to determine whether the acute effects of marijuana increases one’s risk for aggression or whether marijuana withdrawal or some third variable is associated with dating violence perpetration. In addition, because marijuana and depressants were not related to male perpetration when males were examined separately, it is possible that these significant findings were driven by the association between marijuana and depressants for females. Thus, additional research is needed to replicate and extend these findings.

Alcohol use and Dating Violence Victimization

Before reviewing the literature on dating violence victimization and substance use, it is important to emphasize that that the association between victimization and substance use does not imply that victims are at fault for their victimization. There are numerous potential explanations for why victimization may be associated with substance use (discussed previously), and victims’ substance use should never be used to blame them for their victimization.

Alcohol and Male Victimization

Although there is considerably less research on the association between alcohol use and dating violence victimization for men as compared to research on perpetration, a few studies have examined this association using cross-sectional designs (Table 2). Two studies have shown that alcohol problems are positively related to victimization (Baker & Stith, 2008; Shorey et al., 2011). However, these studies were not consistent on which type of victimization was associated with alcohol problems, which may be due to these studies employing different measures of alcohol problems (as displayed in Table 2). In addition, research shows that male victims are under the influence of alcohol for a large percentage of the times they are victimized by psychological and physical aggression (Roudsari et al., 2009). However, it is possible that males perpetrated aggression first and were then victimized, which could be one explanation for these findings. Thus, research is needed to determine whether alcohol use increases the risk for victimization or if it is just a product of the often bi-directional nature of dating violence (Cornelius, Shorey, & Beebe, 2010).

Table 2.

Studies on Substance Use and Dating Violence Victimization among College Students

Study Sample
Size		 Substance Indicator/Aggression Type Findings
    Males     Alcohol
Baker & Stith (2008) 132 Problems (RAPI)/Physical & Psychological CTS2) Victimization related to more problems
Roudsari, Leahy, & Walters (2009) 97 Drinking at time of aggression (1 question designed for study)/Psychological & physical (CADRI) Under the influence of alcohol for 61% of physical and 33% of psychological perpetration
Shorey, Rhatigan, Fite, & Stuart, 2011 187 Problems (AUDIT)/Physical, psychological, & sexual (CTS2) Psychological victimization associated with more problems
    Females     Alcohol
Baker & Stith (2008) 342 Problems (RAPI)/Physical & psychological (CTS2) Victimization related to more problems
Lewis, Travea, & Fremouw (2002) 300 General drinking (KAT)/Physical (CTS) Victims did not consume more alcohol than non-victims
Roudsari et al. (2009) 183 Drinking at time of aggression (1 question designed for study)/Psychological & physical (CADRI) Under the influence of alcohol for 75% of physical and 72% of psychological
Shorey et al., 2011 253 Problems (AUDIT)/Physical, psychological, and sexual (CTS2) Psychological and sexual victimization related to more problems
Straight, Harper, & Arias, 2003 151 Problems (4 questions designed for study)/Psychological (PMWI) No association
    Males and Females Combined     Alcohol
Roudsari et al. (2009) 280 BAC/Psychological (CADRI) Victimization associated with increased BAC
Stets & Henderson (1991) 272 General drinking & drinking at time of aggression (2 questions designed for study)/Physical (CTS) Drinking 3 hours before incident increased risk for victimization; no association for general drinking
    Males     Drugs
Durant et al. (2007) 1,434 Drug types past 30 days (1 question designed for study)/Physical (1 question designed for study) Victimization associated with more tobacco and amphetamine use
    Females     Drugs
Durant et al. (2007) 2,453 Drug types past 30 days (1 question designed for study)/Physical (1 study designed for study) Victimization associated with more drug use (no specific type defined)
Straight et al. (2003) 151 Drug use (6 items designed for study)/Psychological (PMWI) Victimization associated with more drug use (no specific type defined)
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Note: CTS2 = Revised Conflict Tactics Scales; CTS = Conflict Tactics Scales; PMWI = Psychological Maltreatment of Women Inventory; CADRI = Conflict in Adolescent Dating Relationships Inventory; AUDIT = Alcohol Use Disorders Identification Test; RAPI = Rutgers Alcohol Problem Inventory.

Alcohol and Female Victimization

Like their male counterparts, two studies have shown victimization to be associated with alcohol problems for females (Baker & Stith, 2008; Shorey et al., 2011), although these studies varied on which types of victimization were positively associated with alcohol problems. As mentioned earlier, these discrepant findings could be due to these studies using two different measures of alcohol-related problems. Also consistent with their male counterparts, females report being under the influence of alcohol for a large percentage of their psychological and physical victimization experiences (Roudsari et al., 2009). This suggests that alcohol use may increase one’s risk for victimization, although longitudinal research that more thoroughly examines the temporal precedence of alcohol on victimization is needed.

A few studies, however, have failed to find an association between alcohol use and dating violence victimization among women (Lewis et al., 2002; Straight et al., 2003). Lewis et al. (2002) found no difference between victims and non-victims on usual drinking patterns and most alcohol consumed in one specified time period in their cross-sectional study. Thus, it may be that victims do not consume more alcohol than non-victims but that the acute effects of alcohol increase risk for victimization. In addition, Straight et al.’s (2003) measure of alcohol problems only contained four questions, and this may not have captured the possible range of alcohol problems experienced by victims.

Alcohol and Combined Male and Female Victimization

Roudsari et al. (2009) found that estimated peak BAC during the past month was associated with increased psychological aggression victimization. However, because this study was cross-sectional, longitudinal research is needed to determine the causal direction of this relationship since research and theory suggests that alcohol use may lead to victimization and/or victimization may lead to alcohol use. Stets and Henderson (1991) cross-sectionally showed that general drinking patterns was not associated with physical aggression victimization, but drinking three hours before an incident increased one’s risk for being victimized by physical aggression, which would be consistent with theory on the relationship between alcohol use and victimization (e.g., Leonard, 1993). Still, it is possible that the victimization occurred secondary to perpetration, and research is needed to determine the precise temporal sequence of events leading to victimization.

Drug use and Dating Violence Victimization

Drugs and Male Victimization

Unfortunately, we are only aware of one study that has examined the association between dating violence victimization and drug use among male victims. Durant et al. (2007) found that physical victimization was cross-sectionally associated with smoking tobacco and amphetamine use. Due to the health hazards of smoking tobacco, this finding deserves replication to determine whether victimization experiences increase men’s risk for smoking. Given the limited research conducted on male victimization and drug use, caution should be taken when making interpretations and generalizations of this study.

Drugs and Female Victimization

We are aware of only two studies that have examined the association between dating violence victimization and drug use. Durant et al. (2007) found that physical victimization was associated with illegal drug use and Straight et al. (2003) found that psychological victimization was positively associated with illegal drug use. However, both of these studies did not indicate the types of drugs used by victims, limiting our understanding of the specific substances related to female victimization experiences.

Summary

The current paper sought to review the association between substance use and dating violence among college students in an attempt to determine whether substance use is as robust a correlate of aggression as it is for community samples of adults. With few exceptions, the current review indicates that alcohol is consistently related to dating violence perpetration for college-aged men and women. For example, from this review, it is clear that males who evidence alcohol problems and binge drinking are more likely to perpetrate physical and sexual aggression than men without such problems. In addition, increased frequency of alcohol consumption is related to more psychological and physical aggression perpetration. These same findings hold true for females, with females who evidence alcohol problems, binge drinking, and increased frequency of drinking being more likely to perpetrate physical aggression. The literature reviewed is also largely consistent with the proximal effects model of substance use and aggression, as research has shown that aggression is more likely to occur when one is under the influence of alcohol (e.g., Roudsari et al., 2009; Shook et al., 2000; Williams & Smith, 1994). It should be noted that all of the studies reviewed were cross-sectional, and longitudinal research will allow researchers to more accurately determine the theoretical model(s) that best account for the relations among alcohol and dating violence. Further, it should be noted that a few studies failed to find significant relations among alcohol and dating violence.

As for drug use and dating violence perpetration, there are too few studies in the literature to make strong conclusions regarding the link between drug use and perpetration. However, it appears that certain substances are associated with an increased likelihood of perpetrating physical aggression for both males and females. Marijuana is one drug that has shown to be associated with perpetrating physical aggression, and research is needed to determine whether acute marijuana use is associated with perpetration or whether it is marijuana withdrawal symptoms or third variables that are associated with perpetration.

The extant literature on alcohol and dating violence victimization suggests that victims of all three forms of victimization are at increased risk for alcohol problems and increased frequency of alcohol use. In addition, research suggests that male victims of physical aggression may be more likely to smoke cigarettes, whereas female victims may be more likely to use illegal substances. As with the research on drug use and perpetration, there is a need for continued research on the association between drug use and victimization, as it is difficult to make broad interpretations on the basis of only a few studies. Continued research in this area will also help to elucidate the theoretical framework(s) that best account for the association between substance use and victimization (e.g., the proximal effects model; indirect effects model).

Prevention Implications

Overall, this review has potential implications for dating violence prevention programming. To date, dating violence prevention programs have largely ignored the effects of substance use on aggressive behavior (Roudsari et al., 2009; Shorey et al., 2011). However, this review suggests that there is a consistent link between alcohol and dating violence perpetration and victimization, and that dating violence prevention programs may benefit from targeting alcohol use. First, it may be helpful to educate participants in prevention programs on the effects of alcohol on aggressive behavior and that alcohol use does not excuse one’s aggressive behavior. For instance, participants could be provided with an explanation of the proximal effects model of substance use and aggression and that one’s risk for aggression is increased when under the influence of substances, particularly alcohol. Participants could also be informed that there are factors that likely interact with alcohol to increase one’s risk for aggression (e.g., childhood abuse history, trait anger, hostility), and participants could be informed of the dangers of consuming alcohol when one may have predispositions to behave aggressively. Furthermore, information on the effects of alcohol on reduced risk perception, which may increase one’s risk for victimization, could also be provided.

Prevention programs may also benefit from screening participants on their alcohol use and their motivation to change their drinking habits. Participants with heavy drinking backgrounds and/or low motivation to change their drinking habits may benefit from motivational interventions designed to raise one’s awareness to the harmful effects of drinking and how drinking can lead to aggression, while also increasing their motivation to change their drinking and aggressive behavior. For instance, Woodin and O’Leary (2010) developed a brief motivational intervention to target physical aggression in dating couples. This program assessed participant’s alcohol use and implemented individualized feedback sessions with each participant that discussed their alcohol use and aggressive behavior. Results showed positive benefits of receiving the intervention, which included reduced alcohol use and physical aggression. Thus, although time consuming to provide each participant with individualized feedback, focusing efforts on individuals with heavy drinking backgrounds may be one way to capture individuals at greatest risk for aggression. Indeed, researchers have called for prevention programming to focus their efforts on individuals at heightened risk for aggressive behavior (Cornelius & Resseguie, 2007; Shorey, Cornelius, & Bell, 2008b; Whitaker et al., 2006).

It should also be noted that a strict reliance on targeting alcohol use in prevention programming will probably be ineffective for many participants, as it is likely that a number of factors are contributing to aggressive behavior in addition to alcohol. Thus, prevention programs will need to focus efforts on targeting multiple risk factors for aggression, such as anger and emotional dysregulation, beliefs about aggressive behavior, communication skills, and alcohol use, to name a few. Screening participants on individual risk factors for aggression will aid prevention programs in providing the most effective educational and skill-building material to participants (Shorey et al., 2008b). In addition, because it appears that drug use may play a role in dating violence for a small number of individuals, screening participants on their drug use and then providing individualized feedback for individuals who consume drugs may be beneficial.

Directions for future research

Although there is a limited amount of research that has examined gender differences in the association between substance use and dating violence perpetration and victimization, the existing research does suggest that differences exist (e.g., Hammock & O’Hearn, 2002; Nabors, 2010). Therefore, future research should examine males and females separately when investigating substance use and dating violence. In addition, researchers should separate all three forms of dating violence into distinct variables. Knowing how substance use is associated with different topographies of dating violence may help prevention and intervention programs use the most effective treatment strategies for specific forms of aggression. Toward this end, examining perpetration and victimization separately will be important for future research, as some researchers have combined these behaviors (e.g., Parks et al., 2008; Stappenbeck & Fromme, 2010) despite potential differences in their associations with substance use. Furthermore, the continued use of psychometrically sounds measures of dating violence, such as those used in the current review (e.g., CTS, CTS2, PMWI, CADRI), will be important for future research.

Similarly, examining alcohol and drug use separately will be important for future research, as a number of studies have combined these distinct substances into a single variable despite research showing different relations to aggression depending on the substance being examined. Researchers should also examine different aspects of substance use as they relate to dating violence. For instance, research shows that weekly alcohol use (e.g., Hammock & O’Hearn, 2002), alcohol problems (e.g., Baker & Stith, 2008), and peak BAC levels (e.g., Roudsari et al., 2009), are all related to dating violence. However, a number of studies have failed to disentangle these various aspects of alcohol use, making it difficult to interpret findings. In addition, no known study has examined aspects of drug use other than actual consumption of drugs, such as drug problems. This type of research could provide researchers and clinicians with a better understanding of the role drug use plays in dating violence.

The examination of factors that moderate and/or mediate the relationship between substance use and dating violence should also be investigated. It is generally accepted that substance use alone is not a sufficient explanation for aggression for all individuals (Parrott & Giancola, 2007), and that moderating/mediating factors may be present and increase one’s risk for aggression. For instance, Hines and Straus (2007) found that antisocial personality disorder traits fully mediated the relationship between binge drinking and the perpetration of physical aggression in college students. Shorey et al. (2011) found that perceived social support interacted with victimization to predict reduced alcohol problems. Continued investigation of moderating/mediating factors that increase or decrease the association between aggression and substance use is needed, such as childhood abuse, emotion regulation, dating violence attitudes, and personal characteristics (e.g., depression, anxiety), to name a few.

Finally, longitudinal research is needed that examines the association between substance use and dating violence. For instance, daily diary methods will help researchers understand the temporal association between substance use and dating violence while also reducing problems of retrospective reporting. In addition, researchers should attempt to examine specific theoretical models of the association between substance use and dating violence, as the majority of research on this topic to date has been atheoretical. Examining theoretical models will help researchers interpret findings, guide additional research, and inform prevention and intervention programs.

Summary

In summary, the current review suggests that, among college students, alcohol use and dating violence victimization and perpetration are associated, consistent with research on community and treatment samples of adults. The association between drug use and dating violence is less clear, as there are only a small number of studies that have examined this topic. This review suggests that dating violence prevention programming might benefit from targeting alcohol use specifically in their programs, something that has not been a focal point of most prevention efforts, suggesting that a more active focus on substance use may be warranted. In addition, continued research on the association between substance use and dating violence is needed, particularly research that employs longitudinal designs and is guided by theoretical models.

Highlights.

  • Alcohol use and problems are consistently related to dating violence perpetration and victimization

  • Additional research is needed to determine the role of drug use on dating violence victimization and perpetration

  • Future research should examine theoretical models of substance use and dating violence

Footnotes

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