Chermack Stephen T, Blow Frederic C
John D. Dingell VA Medical Center, 4646 John R. Street, Detroit, MI 48201, USA.
Drug Alcohol Depend. 2002 Mar 1;66(1):29-37. doi: 10.1016/s0376-8716(01)00180-6.
This study examined factors associated with expressed violence in the 90 days prior to substance abuse (SA) treatment among 125 men and 125 women recently enrolled in treatment. Approximately 85% of the sample reported a significant conflict situation, and over 32% reported an incident of physical violence. Both general alcohol and cocaine use patterns (on days not involving significant interpersonal conflict), as well as alcohol and cocaine use on the day of the violent incident, were associated with violence severity. Regression analyses revealed that race, education, age, and both general drinking and cocaine use patterns were associated with violence severity for the most severe violent incident reported. Similarly, regression analyses focusing on alcohol and cocaine use on the day of the most severe incident revealed that higher drinking levels, younger age, minority status, and the interaction of alcohol and cocaine use were associated with violence severity. The results provide important information regarding factors associated with expression of violence among men and women in SA treatment, and have implications regarding the assessment of violence risk factors. Further, the findings suggest that screening and intervention approaches for violence-related problems should be routine in SA treatment, and appear to be especially indicated for patients reporting alcohol consumption, and co-occurring alcohol and cocaine consumption.
本研究调查了近期接受药物滥用（SA）治疗的125名男性和125名女性在药物滥用治疗前90天内与显性暴力相关的因素。大约85%的样本报告了重大冲突情况，超过32%的样本报告了身体暴力事件。一般酒精和可卡因使用模式（在不涉及重大人际冲突的日子里）以及暴力事件当天的酒精和可卡因使用情况，均与暴力严重程度相关。回归分析显示，种族、教育程度、年龄以及一般饮酒和可卡因使用模式，都与所报告的最严重暴力事件的暴力严重程度相关。同样，针对最严重事件当天的酒精和可卡因使用情况进行的回归分析表明，饮酒量较高、年龄较小、少数族裔身份以及酒精和可卡因使用的相互作用，都与暴力严重程度相关。研究结果提供了有关SA治疗中男性和女性暴力表达相关因素的重要信息，并对暴力风险因素的评估具有启示意义。此外，研究结果表明，针对暴力相关问题的筛查和干预方法在SA治疗中应成为常规操作，而且对于报告饮酒以及同时存在酒精和可卡因消费情况的患者似乎尤为适用。
