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. Author manuscript; available in PMC: 2022 Jan 1.
Published in final edited form as: J Interpers Violence. 2020 May 21;37(1-2):NP1170–NP1196. doi: 10.1177/0886260520922369

Intimate Partner Violence and Couple Conflict Behaviors: The Moderating Effect of Drug Use Problem Severity

Amber M Jarnecke 1, Ruschelle M Leone 2, Charli Kirby 1, Julianne C Flanagan 1,3
PMCID: PMC7679273  NIHMSID: NIHMS1635065  PMID: 32437311

Abstract

Intimate partner violence (IPV) is a maladaptive conflict behavior, and IPV is both a precipitant and consequence of drug use problems among couples. It is unknown how drug use problem severity modulates the association between IPV and observed conflict behaviors. As part of a larger clinical trial, a sample of 30 different-sex substance-misusing couples completed self-report questionnaires and participated in a laboratory conflict resolution task. The current exploratory study tested whether drug use severity moderated the association between IPV perpetration and positive and negative conflict resolution behaviors, respectively, while controlling for IPV victimization. The results suggest that among men, drug use severity moderates the association between psychological IPV perpetration and negative conflict behaviors. Men who report more severe IPV display more negative behaviors when their drug use problems are more severe. Among women, drug use severity moderated the effect between psychological IPV perpetration and negative conflict behaviors among women, such that women with lower drug use problem severity displayed more negative conflict behaviors when psychological IPV perpetration was more versus less severe. Drug use severity also moderated the association between physical IPV perpetration and negative and positive conflict behaviors among women. That is, women who reported more severe physical IPV displayed more negative and fewer positive behaviors when their drug use problems were more severe. Results have preliminary implications for targeting conflict resolution strategies differentially in men and women with drug use and a history of IPV perpetration. Future studies should replicate the current findings in larger, more representative samples, and examine the role specific drugs have on the association between IPV and conflict behaviors.

Keywords: couples, intimate partner violence, conflict, drug use

Although intimate partner violence (IPV) is, in itself, a maladaptive conflict behavior, couples with IPV also demonstrate high levels of general conflict marked by negative interactions (Bonache et al., 2019; Greenfield et al., 1998; Shortt et al., 2010). Although not every episode of conflict among couples with IPV will escalate to psychological or physical violence, certain contextual factors may increase the likelihood that violence will occur. One such factor may be drug use. Drug use disorders are common among individuals who perpetrate IPV and acute drug intoxication may lower one’s inhibitions to express aggression (Cafferky et al., 2018; Crane et al., 2014; Kuypers et al., 2020; Radcliffe et al., 2017). Individuals who experience IPV and use drugs may demonstrate more extreme maladaptive conflict behaviors in day-to-day interactions. Alternatively, individuals may attempt to withdraw from interactions with their partner and engage in fewer conflict behaviors perhaps as a function of poor coping skills or to avoid IPV (Holtzworth-Munroe et al., 1998; Pickover et al., 2017). The current study sought to explore the moderating effect of drug use problem severity on the association between psychological and physical IPV perpetration and positive and negative couple conflict behaviors.

IPV and couple conflict

Not all conflict behaviors are detrimental for a relationship, but sometimes maladaptive conflict can intensify into an episode of IPV (Eisikovits & Buchbinder, 2000; Greenfield et al., 1998; Marshall et al., 2011). Individuals with a history of IPV perpetration tend to employ maladaptive conflict resolution strategies and engage in conflict-laden interactions with their partners. For instance, in a study examining men who perpetrated IPV, a self-reported husband demand-wife withdraw pattern was more prevalent in violent versus nonviolent married different-sex couples (Babcock et al., 1993). Maladaptive communication strategies and even repair attempts, which are generally perceived as adaptive, are notable among violent dating couples (Cornelius et al., 2010). A recent meta-analysis provides additional support that demand-withdraw patterns, poor communication and conflict resolution skills, and controlling behaviors predict IPV perpetration (Love et al., 2018). Other research has shown that violence perpetrated by one partner also influences the other’s communication strategies (Paradis et al., 2017). Furthermore, among different-sex couples, female partner’s self-control is associated with perceptions of male partner’s psychological IPV perpetration (Baker et al., 2018).

Studies that examine observed conflict behaviors in couples with a history of IPV find that IPV is positively associated with expressed negative affect and negatively associated with positive affect (Shortt et al., 2010); however, other research has found differences between characterologically and situationally violent couples, such that characterologically violent couples display less positive and more negative affect than situationally violent couples who are more similar in affective expression to nonviolent couples (Friend et al., 2017).

IPV and Drug Use

Drug use problems and disorders are common among individuals who perpetrate IPV as well as those who experience IPV victimization (Crane et al., 2014; Crane et al., 2016; Sabina et al., 2017; Sullivan et al., 2016; Sullivan & Holt, 2008). Approximately 1%–31% of individuals who perpetrate IPV from community and clinical samples meet criteria for an alcohol or drug use disorder (Afifi et al., 2012; Cunradi et al., 2002; Smith et al., 2012). However, research examining correlates between IPV and specific drugs of abuse is somewhat mixed. Among participants undergoing court-mandated substance use evaluations alcohol and cocaine use disorders were most strongly associated with physical IPV perpetration while opioid and cannabis use disorders were not associated with IPV perpetration (Crane et al., 2014). Data from the National Epidemiologic Survey on Alcohol and Related conditions also supports that alcohol and cocaine use disorders are associated with IPV perpetration (Smith et al., 2012); however, this study also examined IPV victimization and found that cannabis and opioid use disorders were associated with IPV victimization. Data from a large study of college students suggest that cannabis and depressants are associated with increased IPV perpetration as well (Nabors, 2009).

One meta-analysis showed that drug use and related problems are associated with IPV perpetration, and cocaine and cannabis specifically are associated with IPV perpetration (Moore et al., 2008). A more recent meta-analysis revealed that amphetamine, cocaine, and cannabis use, in particular, are each associated with IPV perpetration (Cafferky et al., 2018). The same meta-analysis also found that greater drug-related problem severity was associated with increased risk for IPV perpetration (Cafferky et al., 2018). In fact, among individuals seeking treatment for substance use, those who report IPV display more severe drug use problems (Arteaga et al., 2015; Schumm et al., 2018).

Although most research examining how intoxication impacts IPV has focused on alcohol intoxication, some research supports that intoxication from other substances, particularly stimulants, is associated with increased aggression (Kuypers et al., 2020; Radcliffe et al., 2017). One review examining how substance use predicts same-day IPV found that men and women’s cocaine use increased the likelihood that a woman would experience IPV that day (de Bruijn & de Graaf, 2016). Other research has focused on the role of cannabis use on IPV and found that cannabis use is positively associated with psychological, physical, and sexual IPV perpetration when controlling for alcohol use, alcohol use problems, antisocial personality disorder symptoms, and relationship satisfaction (Shorey et al., 2018). In one of the few studies to examine the associations between drug use and IPV among couples (versus individuals), investigators found that episodes of ones’ own cannabis use (but not their partner’s use of cannabis) increased the occurrence of relationship conflict and verbal aggression but not physical aggression (Testa et al., 2018). No studies to date have examined how drug use problem severity impacts couple conflict behaviors in a controlled laboratory setting.

current Study

Previous research has found clear associations between couple conflict, IPV, and drug use; however, research in this area is limited, as many studies sample from individuals versus couples and/or rely on self-report surveys versus observational coding schemes. Although much of the extant literature has found that drug use disorders and drug intoxication increase the risk of IPV, it is unclear how drug use problem severity may impact the link between IPV history and couple conflict behaviors when individuals are not acutely intoxicated. Individuals with drug use problems tend to employ maladaptive emotion regulation skills (Kober & Bolling, 2014; Wong et al., 2013), particularly during short-term periods of abstinence from their substance of abuse (Fox et al., 2007). Thus, drug-using individuals with a history of IPV may not have the cognitive or emotional resources available to engage in adaptive conflict resolution with a partner even when they are not intoxicated.

The current exploratory study sought to expand on the extant literature by examining the moderating effect of drug use problem severity on the associations between psychological and physical IPV perpetration and negative and positive conflict behaviors, respectively, in a sample of different-sex, substance-misusing couples. It was hypothesized that drug use severity would be associated with greater negative and fewer positive conflict behaviors among men and women who reported more severe levels of psychological and physical IPV perpetration while controlling for alcohol use problem severity and IPV victimization.

Method

Participants

Thirty-three couples (66 total participants) were recruited for a larger randomized controlled trial examining the efficacy of oxytocin versus placebo on couple conflict among substance-misusing couples. For the present investigation, only variables that were collected prior to medication administration were utilized and examined. For the purposes of the larger trial, participants were eligible if they were aged 18–65 years and one or both partners in the couple engaged in hazardous drinking or illicit drug use during the 60 days prior to their laboratory visit. Potential participants were excluded if one or both partners: (a) were pregnant or breastfeeding; (b) had history of or current physical or psychiatric diagnosis known to impact hypothalamic-pituitary-adrenal (HPA) axis function (HPA axis criteria were included as cortisol reactivity was an outcome for the larger trial); (c) had a body mass index (BMI) ≥39; (d) used prescription medications that interfere with HPA axis activity; (e) had active suicidal or homicidal ideation and intent; and (f) reported severe, unilateral IPV in the past year as determined by the Revised Conflict Resolution Tactics Scale (CTS-2; Straus et al., 1996).

The sample included 31 different-sex couples and two same-sex female couples. Given the small number of same-sex couples in the sample, there was not adequate power to examine effects of sex constellations within couples. Thus, the same-sex couples were excluded from the analyses. Another couple was excluded due to questionable reliability of the data. Thus, the sample size for the current study was 30 couples. The Mini-International Neuropsychiatric Interview (MINI; Sheehan et al., 1998) was used to assess for substance use disorder diagnoses and the Timeline Followback (TLFB; Sobell & Sobell, 1992) was used to assess quantity and frequency of substance use over the past 90 days. Twelve participants (six men and six women) met criteria for an alcohol use disorder, five participants (three men and two women) met criteria for a cannabis use disorder, five participants (three men and two women) met criteria for a cocaine use disorder, and one woman met criteria for an opioid use disorder. Participants were an average of 32.1 years old (SD = 9.90) and most identified as African American (n = 53.3%). The majority of couples indicated that they were cohabitating and not married (n = 83.3%).

Measures

IPV.

The CTS-2 (Straus et al., 1996) is the most widely used measured of IPV and was used in the current study to assess psychological and physical IPV victimization and perpetration. This measure has been used with a variety of populations and shows strong psychometric properties (see Straus et al., 1996). The psychological aggression subscale assessed the frequency at which participants perpetrated and experienced aggressive acts, such as insulting or swearing at their partner. The physical assault subscale assessed the frequency at which participants perpetrated and experienced physical acts of violence such as pushing, shoving, kicking, or choking their partner. continuous scores of psychological and physical IPV victimization and perpetration severity, respectively, were calculated by summing the frequency of aggressive acts that had occurred within the last year (α’s ranged from .78 to .86). Higher scores reflect more severe IPV victimization and IPV perpetration, respectively.

Drug use problem severity.

The Drug Abuse Screening Test (DAST-10; Skinner, 1982) consists of 10 items that assess problems related to illicit drug use (e.g., „Have you had ‘blackouts’/‘flashbacks’ as a result of drug use?,“ ``Have you neglected your family because of your use of drugs?“). Items are scored Yes (1)/No (0) and responses to items are summed. Total scores range from 0 to 10. Higher scores reflect greater drug use problem severity (α = .60). The DAST-10 has shown strong reliability and validity in a variety of populations (e.g., psychiatric populations, adults, adolescents) (Giguere & Potvin, 2017; Yudko et al., 2007).

Alcohol use problem severity.

The Alcohol Use Disorders Identification Test (AUDIT; Saunders et al., 1993) was used to assess alcohol use problem severity, which was used as a control variable in analyses. The AUDIT consists of 10 items assessing alcohol intake, dependence, and experiences of harm related to alcohol (α = .88). The AUDIT has been widely used and validated in many samples (e.g., Berner et al., 2007; de Meneses-Gaya et al., 2009).

conflict resolution behaviors.

Couples completed a 10-min video recorded conflict resolution task (see “Procedures” section) and each partner’s behaviors were coded using the Rapid Marital Interaction Coding System (RMICS; Heyman, 2004; Heyman et al., 1995) by trained coders who were blind to treatment condition. Two coders were assigned to each couple. The RMICS requires coders to code all observable actions (i.e., linguistic, affective, motor, and paralinguistic) demonstarted by both partners simultaneously. That is, codes are assigned to each speaker and each listener turn.

Nine types of conflict behaviors (four positive and five negative behaviors) were examined in the current analyses. The frequency at which participants engaged in positive conflict resolution strategies and negative conflict resolution strategies were summed to form composite scores. Thus, higher scores reflect a greater number of positive and negative conflict behaviors, respectively. Positive conflict resolution strategies included acceptance (e.g., active listening to validate or understand partner), relationship-enhancing attributions (e.g., positive attributions), self-disclosure (e.g., statements about one’s emotions, desires, or beliefs), humor (e.g., demonstrations of good humor), constructive problem-solving (e.g., constructive efforts to solve problems). Negative conflict resolution strategies included psychological abuse (e.g., verbal or nonverbal behaviors indicating disgust, contempt, mocking, domineering, or devaluation), distress-maintaining attributions (e.g., statements of blame or denying responsibility), hostility (e.g., negative affect, statements of negative content that do not constitute psychological abuse), dysphoric affect (e.g., sad or depressed emotional state, self-derogatory statements), and withdrawal (e.g., behaviors intended to withdraw from discussion).

Procedures

Study procedures are detailed in full elsewhere (see Flanagan et al., 2018). Of relevance to the current investigation, upon arriving to the laboratory, participants were separated from their partner to read and sign an Institutional Review Board-approved consent form and complete baseline assessment measures. For the purposes of the larger study, women were required to complete a urine pregnancy test and both partners were required to complete breathalyzer and urine drug screen tests. Following the completion of baseline assessments (e.g., measures to assess psychiatric diagnoses, alcohol and drug use problem severity, relationship functioning), participants engaged in a 10-min conflict resolution task. Each partner identified their primary relationship problem. Partners then came together to discuss the topic with one another and were told to work toward the problem’s resolution. In instances where partners’ most important topic was not the same, a coin flip determined which partner’s topic was discussed for the 10-min period. Upon completion of this first conflict resolution task, participants received medication relevant to the larger study’s primary aims and then engaged in a second conflict task. Participants were then debriefed and compensated.

Data Analytic Strategy

Linear mixed models with participant specified at the individual level and couple specified at the dyad level were run in SPSS v. 25 (IBM Corp., 2017). Because our sample consisted of different-sex couples, a two-intercept approach was used with sex as the distinguishing variable (Kenny et al., 2006). This allowed us to test the level of each effect by participant sex. Four independent models tested the moderating effect of drug use problem severity on the associations between psychological and physical IPV perpetration and negative and positive conflict behaviors. Specifically, we examined the effects of IPV perpetration, drug use problem severity, and the interaction of IPV perpetration by drug use problem severity on negative and positive relationship behaviors. To account for the effects of IPV victimization on conflict behaviors, psychological and physical IPV victimization were included as covariates in respective models. Furthermore, because many of the participants in the current study reported alcohol use, alcohol use problem severity was included as a covariate as well. Covariate and predictor variables were centered, maximum likelihood estimation was used, and variances were considered heterogeneous. For all analyses, p values < .05 are considered statistically significant.

Results

Descriptive Statistics and correlations

Substance use characteristics of the sample are presented in Table 1. Men and women in the sample only differed with respect to total days using cannabis (t = 2.11, p = .04). Table 2 shows descriptive statistics and correlations for the variables examined in the current study. Men and women did not significantly differ on any of the variables (ts ranged from −1.05 to 1.35, ps > .05). Men and women’s IPV variables, respectively, were significantly intercorrelated. For men, drug use severity was significantly correlated with psychological IPV victimization and perpetration. No significant correlations emerged among women. The within couple correlations revealed that men and women were significantly correlated on physical IPV perpetration, negative conflict behaviors, and positive conflict behaviors.

Table 1.

Substance Use Characteristics of the Sample.

Men Women
Substance Total Days Used Total Amount Used Total Days Used Total Amount Used
Alcohol 17.17 (18.31) 73.37 (87.89) 18.17 (19.33) 74.23 (105.16)
Stimulants 2.47 (7.71) 106.42 (321.69) 2.57 (7.32) 63.00 (181.99)
Opioids 0.00 (0.00) 0.00 (0.00) 3.00 (16.43) 3.00 (16.43)
Cannabis 28.23 (35.49)a 137.15 (283.76) 12.53 (19.97)a 30.92 (79.90)
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Note. Substance use was assessed over the 90 days prior to laboratory visit. For alcohol, total amount used was assessed with standard drinks. For stimulants, total amount used was assessed with amount of money (i.e., US$) spent. For opioids, total amount used was assessed with number of pills used. For cannabis, total amount used was assessed with joints used.

a

Denotes statistically significant difference between men and women.

Table 2.

Descriptive Statistics and Correlations.

M (SD)
Variable 1 2 3 4 5 6 7 8 Men Women
1. Alcohol use problems .30 −.35 −.28 −.27 −.22 .28 .30 .00 5.80 (5.62) 6.41 (5.79)
2. Psychological IPV victimization −.34 .36 .42* .90* .46* .15 .22 .04 30.03 (26.54) 33.77 (31.01)
3. Physical IPV victimization −.13 .64** .20 .44* .88** −.02 .15 −.12 11.11 (20.96) 7.13 (16.17)
4. Psychological IPV perpetration −.030 .90** .59** .23 .47* .14 .24 .09 28.87 (26.85) 29.57 (29.07)
5. Physical IPV perpetration −..33 .55** .44* .51** .43* −..04 .22 −..07 4.44 (6.14) 6.78 (10.56)
6. Drug use problems .17 .40* .34 .45* .31 −..20 .17 .17 2.13 (1.28) 1.57 (1.91)
7. Negative conflict behaviors −..25 .16 .03 .10 .21 .25 .94** .09 17.55 (26.93) 16.72 (22.04)
8. Positive conflict behaviors .31 −..32 −..20 −..28 −..25 −..18 −..29 .74** 33.28 (14.10) 33.07 (11.10)
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Note. N = 60 (30 couples). For correlations, diagonal (italicized) is the within couples correlation.Women’s correlations are above the diagonal and men’s correlations are below the diagonal. IPV = intimate partner violence.

*

p < .05.

**

p < .01.

Psychological IPV Perpetration on conflict Behaviors

The results from the two-intercept models examining psychological IPV are presented in Table 3. Among men, significant main effects were found for psychological IPV victimization and psychological IPV perpetration on negative and positive conflict behaviors. Specifically, psychological IPV victimization was associated with a display of more negative and fewer positive conflict behaviors. Psychological IPV perpetration showed opposite associations with conflict behaviors and was associated with the display fewer negative and more positive conflict behaviors. Furthermore, alcohol use problem severity was significantly negatively associated with negative conflict behavior and drug use problem severity was significantly negatively associated with positive conflict behaviors. A significant interaction of psychological IPV perpetration by drug use severity on negative conflict behaviors also emerged for men. Upon probing the interaction (see Figure 1A), it was found that men who reported more severe psychological IPV perpetration and more severe drug use problem severity displayed more negative conflict behaviors than men who reported less severe IPV perpetration (t = 5.87, p < .001). Among men who reported less severe drug use problems, there were no differences in negative conflict behaviors between those who reported more or less severe psychological IPV.

Table 3.

Parameter Estimates From the Models Examining Psychological IPV Perpetration.

Negative Conflict Behaviors Positive Conflict Behaviors
Parameter Estimate SE p value Estimate SE p value
Intercept×Male 15.73 4.85 .003 34.31 2.55 .000
Intercept×Female 17.32 3.64 .000 33.49 2.07 .000
Alcohol Use Problems×Male −0.55 0.26 .043 0.41 0.24 .107
Alcohol Use Problems×Female 0.14 0.25 .586 0.14 0.25 .581
Psychological IPV Victimization×Male 0.49 0.13 .001 −0.40 0.12 .002
Psychological IPV Victimization×Female −0.11 0.09 .243 0.05 0.09 .599
Psychological IPV Perpetration×Male −0.55 .15 .001 0.36 0.14 .013
Psychological IPV Perpetration×Female 0.11 0.09 .235 −0.06 0.09 .528
Drug Use Problems×Male 2.08 1.49 .176 −2.84 1.33 .040
Drug Use Problems×Female −0.07 0.64 .917 1.60 0.65 .020
Psychological IPV Perpetration×Drug Use Problems×Male 0.13 0.06 .035 −0.06 0.05 .299
Psychological IPV Perpetration×Drug Use Problems×Female −0.07 0.02 0.005 −0.01 0.02 0.611
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Note. Significant effects (p < .05) are presented in bold. IPV = intimate partner violence.

Figure 1.

Figure 1.

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(A) Men’s negative conflict behaviors by their psychological IPV perpetration and drug use problems and (B) women’s negative conflict behaviors by their psychological IPV perpetration and drug use problems.

Note. IPV = intimate partner violence.

Among women, a main effect of drug use problems on positive conflict behaviors was found, such that women who reported greater drug use problem severity displayed more positive conflict behaviors. In addition, a significant interaction of psychological IPV by drug use severity on negative conflict behaviors emerged for women. A simple slopes analysis revealed that women who reported less drug use problem severity exhibited more negative conflict behaviors if they reported more versus less severe psychological IPV perpetration (t = 2.59, p = .012). Figure 1B depicts this interaction and further illustrates that among women who report less severe levels of psychological IPV perpetration, drug use problem severity does not impact displays of negative conflict behaviors. Among women who report high levels of psychological IPV perpetration, however, those with greater drug use problem severity engage in fewer negative behaviors than women with less severe drug use problems.

Physical IPV Perpetration on conflict Behaviors

Table 4 presents the results from the two-intercept models examining the associations between physical IPV and conflict behaviors. Alcohol use problem severity was negatively associated with negative conflict behaviors and positively associated with positive conflict behaviors among men. There were also main effects of drug use problem severity on negative and positive conflict behaviors among men, such that men who reported more severe drug problems engaged in greater negative and fewer positive conflict behaviors during the conflict resolution task. No other main or interaction effects were found for men.

Table 4.

Parameter Estimates From the Models Examining Physical IPV Perpetration.

Negative Conflict Behaviors Positive Conflict Behaviors
Parameter Estimate SE p value Estimate SE p value
Intercept×Male 16.43 4.66 .001 35.04 2.53 .000
Intercept×Female 17.08 4.10 .000 32.94 1.96 .000
Alcohol Use Problems×Male −1.00 0.26 .001 0.74 0.25 .006
Alcohol Use Problems×Female 0.08 0.23 .733 0.06 0.19 .760
Physical IPV Victimization×Male 0.02 0.07 .799 −0.09 0.07 .204
Physical IPV Victimization×Female 0.14 0.16 .380 −0.13 0.14 .347
Physical IPV Perpetration×Male 0.02 0.30 .935 0.12 0.29 .673
Physical IPV Perpetration×Female 0.09 0.27 .737 −0.06 0.23 .798
Drug Use Problems×Male 3.35 1.17 .008 −3.99 1.14 .001
Drug Use Problems×Female −0.22 0.63 .736 1.11 0.55 .053
Physical IPV Perpetration×Drug Use Problems×Male −0.02 0.15 .887 −0.05 0.15 .737
Physical IPV Perpetration×Drug Use Problems×Female 0.26 0.09 .007 −0.23 0.08 .005
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Note. Significant effects (p < .05) are presented in bold. IPV = intimate partner violence.

Among women, there was a significant interaction of physical IPV perpetration by drug use problem severity on both negative and positive conflict behaviors. With regard to negative conflict behaviors, women who reported more severe drug use problems displayed more negative conflict behaviors when their physical IPV perpetration was more versus less severe (t = 2.41, p = .020). Furthermore, when physical IPV perpetration was more severe, women who reported more severe drug use problems displayed more negative behaviors than women who reported fewer drug use problems. With regard to positive conflict behaviors, a simple slopes analysis suggests that women who reported greater drug use problem severity exhibited fewer positive conflict behaviors when they reported greater versus less psychological IPV perpetration severity (t = −2.43, p = .019). Furthermore, as shown in Figure 2B, no differences in positive conflict behaviors by drug use problems severity were found in women who reported less severe levels of physical IPV perpetration; however, women who reported higher levels of drug use problems engaged in fewer positive conflict behaviors than women who reported less severe levels of drug use problems when physical IPV perpetration was more severe. No other significant effects were found.

Figure 2.

Figure 2.

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(A) Women’s negative conflict behaviors by their physical intimate partner violence (IPV) perpetration and drug use problems and (B) women’s positive conflict behaviors by their physical intimate partner violence (IPV) perpetration and drug use problems.

Note. IPV = intimate partner violence.

Discussion

The current preliminary and exploratory study aimed to examine the impact of drug use problem severity on the association between IPV perpetration and conflict behaviors in a sample of substance-misusing couples. This investigation extended the literature on couple conflict by comparing how substance-misusing couples with varying frequency and severity of IPV in their relationship behave during an observed conflict resolution task. Results suggest that drug use severity moderates the association between psychological IPV perpetration and negative conflict behaviors in both men and women; however, the pattern of this moderation effect differs for men and women. In addition, drug use problem severity moderated the association between physical IPV perpetration and negative and positive conflict behaviors among women but not men.

Findings among men demonstrate that psychological IPV victimization and greater drug use problem severity are generally associated with less adaptive (more negative and fewer positive) conflict behaviors. Furthermore, men who report more severe psychological IPV perpetration demonstrate fewer negative and more positive conflict behaviors overall; however, this effect is moderated by drug use severity. That is, less severe drug use problems may protect against excessive negativity during interactions with a partner when psychological IPV is more severe. It may be that men without significant drug use problems who perpetrate psychological IPV are more easily able to suppress negative conflict strategies when engaging in discussions with their partner to avoid conflict escalation. Future research is needed to examine how conflict discussions might progress to violence among these individuals. It is plausible that men without drug use problems who perpetrate psychological IPV rely more on reacting to their partner’s behavior to select their response. Indeed, male perpetrators of IPV in different-sex relationships frequently cite their partner’s verbal aggression as an antecedent to their own aggression (Eisikovits & Buchbinder, 2000).

Findings among women differed somewhat as compared with the men. Similar to research demonstrating that drug use may have somewhat differential effects on IPV among men versus women (Cafferky et al., 2018), drug misuse may have differing effects on conflict behaviors. Among women, drug use problem severity moderated the impact of both psychological and physical IPV perpetration on negative conflict behaviors; however, this pattern of moderation looked different between the two forms of IPV. Women who reported more severe psychological IPV perpetration displayed fewer negative behaviors when their drug use problems were more versus less severe. In contrast, women who reported more severe physical IPV perpetration displayed more negative behaviors when drug use problems were more versus less severe.

One possible explanation for these findings is that women who perpetrate more severe psychological IPV may be more prone to disengage from conflict discussions, particularly when drug use is more severe (Love et al., 2018; Spencer et al., 2016). Although the present study accounted withdrawal from discussion within the context of overall negative conflict behaviors, it did not employ a specific examination of demand-withdraw patterns of communication in the laboratory. Thus, it is possible that women who perpetrate psychological IPV engaged in fewer conflict behaviors in an attempt to avoid increased emotional arousal on the part of themselves or their partner. Emotional arousal during conflict is associated with poorer couple functioning and satisfaction overall, particularly for women when they attempt to suppress their emotions (Baucom et al., 2011; Dworkin et al., 2019; Tani et al., 2015). These findings are also consistent with a recent study of a large nationally representative sample, which found that perceived relationship instability was associated with less frequent conflict and more withdrawing behaviors among women partners (Johnson et al., 2018). Women who misuse substances and who perpetrate more severe physical IPV may not be attempting to dampen their emotional arousal, however. In fact, this might help to explain how conflict escalates to the perpetration of physical violence among substance misusing women. Additional studies are necessary to examine this question with greater nuance to inform treatment efforts.

Regarding positive conflict behaviors, drug use severity was generally associated with more positive conflict behaviors. However, drug use severity interacted with physical IPV perpetration among women. That is, women who perpetrated more physical IPV displayed fewer positive behaviors when their drug use problems were more severe. Because adaptive couple conflict behaviors are context-dependent and learned behaviors, and laboratory-based communication tasks have been found reliable and valid measure of in vivo behavior (Heyman, 2004; Heyman et al., 1995), it is possible that participants in this sample, who are characterized by their substance misuse, may not have developed strong adaptive emotion regulation or conflict-resolution skills, a known correlate of IPV (Hesser et al., 2017). Couple conflict behaviors outside of the laboratory may have resulted in degenerated adaptive behavior patterns over time.

Considerations and Limitations

Several considerations and limitations warrant discussion. First, the sample was comprised of a majority Black/African American sample and examined couples in different-sex relationships. Thus, results may not generalize to populations of other races and ethnicities or to same-sex couples. Although individuals of every race and ethnicity experience IPV, Black/African American women, in particular, are at increased risk for IPV victimization in the United States (Basile et al., 2019; Black, 2011). Thus, our sample may reflect a population of couples who experience more frequent and severe forms of IPV than individuals from other backgrounds. Furthermore, Black/African American populations may cope with IPV differently—including having greater likelihood to use substances to cope—than individuals with other ethnic identities and this may account for how participants in this study interacted with their partners (Clements et al., 2019; Sullivan et al., 2018).

Due to the relatively small sample size, we were unable to examine partner effects and the dyadic nature of conflict in the present study. Future research should determine how IPV and drug use severity impacts each partner’s behavior during conflict influences the other’s subsequent behavior. Next, the present study did not have adequate power to assess for the differential effects of type of drug on couple behavior. Previous research has identified that different drugs have different pharmacological, affective, and behavioral consequences, including differential effects on aggression and IPV (Cafferky et al., 2018; Kuypers et al., 2020; Moore et al., 2008; Smith et al., 2012; Testa et al., 2018). Future studies should more closely investigate how drug use problems by drug type influences conflict discussions among IPV couples. Furthermore, the study did not account for concordance or discordance of substance use between partners. Recent research has demonstrated that discordance in couples’ drug use is associated with poorer relationship satisfaction (Crane et al., 2016; Cunradi et al., 2015; Low et al., 2017; Testa et al., 2018). Future work should examine these patterns of effects while accounting drug use at the relational level. Our measure of self-reported IPV did not account for whether individuals were using drugs at the time, or if violence was in self-defense or bidirectional. Due to ethical and safety concerns, couples who presented with severe, unilateral IPV were not eligible to participate in this study. Thus, associations between the variables examined here might be different among couples where violence is severe and unilateral, among individuals who have left severely violent relationships, or among individuals who have experienced severe and unilateral IPV in the recent past. Our measure of drug use problem severity had a relatively low internal reliability and thus effects from this investigation may have been attenuated. Finally, to limit the impact of multiple testing, the current study used a composite score on the RMICS and thus it is unknown a specific form of positive (e.g., humor) or negative (e.g., hostility) behavior is driving these effects.

conclusion

This exploratory study found that men who perpetrate psychological IPV and have more serious drug use problems engage in more negative conflict behaviors than men with less serious drug use problems. conversely, women with more serious drug use problems who perpetrate IPV may withdraw from conflict engagement or engage in maladaptive conflict resolution strategies depending on the form of IPV with which they present. Future research in larger samples is needed to replicate findings and learn more about the complex associations between conflict behaviors, IPV, and drug use. The findings from the current study also indicate a need to investigate how specific drugs impact conflict behaviors. Furthermore, future research should target coping skills, specifically those pertaining to withdrawal versus engagement during conflict, in men and women with a history of IPV and drug use to investigate how to best reduce the negative consequences associated with couple conflict.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This manuscript is the result of work supported, in part, by the National Institute on Child Health and Human Development and the Office of Research on Women’s Health (K12HD055885) and the National Institute on Alcohol Abuse and Alcoholism (K23AA023845, K23AA027307, and T32AA007474).

Author Biographies

Amber M. Jarnecke, PhD is a research assistant professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South carolina. Her research focuses on individual and contextual factors that contribute to associations between substance use disorders, trauma, and intimate relationship functioning.

Ruschelle M. Leone, PhD is a postdoctoral fellow in the Mark chaffin center for Healthy Development and the Department of Health Policy and Behavioral Sciences within the School of Public Health at Georgia State University. Her research program examines the intersection of alcohol use and interpersonal violence, with a particular focus on intimate partner and sexual aggression.

Charli Kirby, BA is a program assistant in the department of Psychiatry and Behavioral Sciences at the Medical University of South carolina. She is currently involved in research focused on interpersonal violence and couples-based treatments of alcohol use disorder.

Julianne C. Flanagan, PhD is associate professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South carolina and Staff Psychologist at the Ralph H. Johnson VA Medical center. Her research focuses examining behavioral and neurobiological associations between substance use, posttraumatic stress, and interpersonal violence among individuals and couples, and on developing novel treatments for complex co-occurring conditions.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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