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Abstract
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Histories of violence were assessed in 275 consecutive male primary alcoholics who were interviewed and followed up 1 year later. After excluding individuals with primary antisocial personalities or primary drug abuse, 80 of these men were found to have histories of violence. Compared to the remaining subjects, this group was significantly younger and demonstrated significantly more social problems with school, home, and police both as adolescents and adults; these subjects were significantly more likely to have used drugs other than alcohol. The 12-month follow-up revealed a continued higher percentage of drinking among those with histories of violence as well as a greater risk for alcohol-related problems and some patterns of drug misuse. A history of prior violence may be a factor of prognostic importance in the treatment of primary alcoholism.
VioLit summary:
OBJECTIVE:
The aim of this paper by Schuckit and Russell was to describe the clinical differences between male alcoholics who are violent and those who are not who were in treatment at the San Diego Veterans Administration Medical Center.
METHODOLOGY:
This study used a non-experimental, exploratory methodology to study 275 male primary alcoholics who were receiving treatment at the Medical Center. Alcoholics who displayed primary antisocial personalities were excluded from the study. Face-to-face interviewing was used to obtain the data. Interviewing took place at two points in time--at the beginning of the study and 12 months later. Only 1% refused to participate. The intake interview lasted 40 minutes and obtained information on demography, early antisocial problems, and alcohol and drug use histories as well as associated problems, psychiatric histories, and psychiatric disorders in all first degree-relatives. The criteria for alcoholism were based on DSM-III guidelines with an emphasis on alcohol abuse causing marital separation or divorce, job loss or layoff, two or more alcohol-related arrests, or has harmed health. Drug abuse was defined in the same terms with the above problems associated with drug use or a history of intravenous drug use. Antisocial personality was defined with evidence of antisocial problems for family, school, peers, and police beginning before age 16 and before onset of substance abuse. All other criteria were based on DSM-III. Primary diagnoses were established by the history of the age at which the individual first met the criteria for a given diagnosis--the primary diagnosis being the first. 414 males entered the program during the study period; 323 fulfilled the criteria for primary alcoholism. 275 of the 323 (85%) either completed the follow-up interview or were determined to have died (2.5%). Primary alcoholics were divided into two mutually exclusive groups based on their history of violence. Violence was defined as either having harmed someone to the point of needing medical attention or having used a weapon. 80 (29%) qualified as violent; the other 195 were used as controls. Chi-square and t-tests were used to analyze the data.
FINDINGS/DISCUSSION:
The average patient was in his mid 40's, Caucasian, blue-collar, separated or divorced, with an eleventh grade education. 60% had completed high school. The men with histories of violence were significantly younger (p=<.01) and more likely to be black. Primary alcoholics with histories of violence demonstrated significantly more anti-social behavior as children and adults than did the non-violent group (p=<.01; significant items were police or arrest record since age 16, commission of a felony, inflicted injury requiring medical attention, ever used a weapon, been expelled or suspended from school; p=<.05 for considered incorrigible by parents). In terms of alcohol and drug history, the violent group significantly exceeded the nonviolent group in drinks per day, most drinks/day (p=<.01), alcohol involved in job firings, public intoxication arrest (p=<.01), and alcohol being involved in jail incarceration (p=<.01). Age at onset of alcoholism was significantly lower for the violent group. Additionally, the violent group was significantly more likely to use other drugs--amphetamines, cocaine (p=<.01), marijuana (p=<.01), hallucinogens (p=<.01), barbiturates (p=<.01). Men in the violent group were significantly more likely to have developed a health problem or spent a night in jail due to alcohol. The nonviolent group was significantly more likely to have abstained all 12 months and had significantly less most drinks per drinking day than the violent group. The overall alcohol problem score incorporating life problems due to alcohol was significantly higher for the violent group (p=<.01).
AUTHORS' RECOMMENDATIONS:
The authors argued that antisocial and violent behavior was most often seen before the incidence of alcoholism. Even among primary alcoholics, the history of violence with associated life problems was thought to have prognostic significance.
EVALUATION:
This study presents some important findings. The assumption has been that alcoholism leads to violence, and control of the alcoholism is what is required to control the violence. These authors have demonstrated that anti-social behavior and violence often precedes alcoholism--evidence that counters the common beliefs. However, one is left to ask what does precede alcoholism and antisocialism? There must be a hidden factor which contributes to both problems and which definitely impacts anti-social behavior. In this regard, this study does little to enlighten our knowledge of the important antecedents of problem behavior. This study's contribution was, through reasonably thorough methods, providing more research questions into this alcohol-violence relationship. It will be long-term longitudinal data with a sample representative of the general population that some clarity may be found. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)
KW - California
KW - Male Offender
KW - Male Violence
KW - Male Substance Use
KW - Alcohol Use Effects
KW - Adult Male
KW - Adult Offender
KW - Adult Violence
KW - Adult Substance Use
KW - Alcohol Related Violence
KW - Alcohol Use Effects
KW - Substance Use-Violence Co-Occurence
KW - Violent-Nonviolent Comparison
KW - Violence Causes
KW - Offender Characteristics
Language: en |