Violent substance abusers in domestic violence treatment.

Although substance abuse is frequently encountered in men receiving services in violence treatment settings, systematic study of these 'dual-problem' men has lagged. This study had two main objectives: (1) the characterization of psychoactive substance abuse disorders in a naturalistic sample of men in domestic violence treatment; and (2) clarification of the role of substance abuse on the sociodemographic, personality, psychosocial, and abuse characteristics of dual-problem men. Fifty-three adult men who were attending domestic violence treatment were recruited. They were administered the Addiction Severity Index, the Conflicts Tactics Scale, Structured Clinical Diagnostic Interview, the 16PF and the Symptoms Checklist-90. Partners, when available, were asked to provide corroboration. Sixty-three percent of the men had a current diagnosis of psychoactive substance abuse or dependence, while 92.5% had a lifetime diagnosis. Of the former, the majority was diagnosed as multiply dependent on alcohol and other drugs. As the severity of the substance abuse increased, so too did the dangerousness and frequency of abusive behaviors. Moreover, dual-problem men reported more hostility, apprehension, frustration and suspiciousness and past arrests than did their violence-only cohorts as well as a history of multiple (unsuccessful) treatments for substance abuse. These findings suggest that the trend toward multiple drug complaints seen in other clinical milieus is also being confronted in conjugal violence settings. In addition to the greater therapeutic challenge such dual-problem men present, these findings speak to the need to investigate integrated treatment approaches to improve the outlook of men grappling with both conjugal violence and multiple substance abuse problems.