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Breakthroughs in understanding addiction and close relationships
Available online at www.sciencedirect.com
ScienceDirect Breakthroughs in understanding addiction and close relationships Lindsey M Rodriguez1 and Jaye Derrick2 Substance use is one aspect of life that can serve to bring couples together or tear them apart. Evidence has accumulated for both substance use affecting relationship distress (e.g., partners of substance users report poorer individual and relational outcomes) as well as relationship conflict affecting subsequent substance use (e.g., individuals use substances as a way to cope with interpersonal conflict and distress). We discuss several determinants of each association, including individual difference and relationshipspecific constructs. We conclude by considering how conceptualizing addiction as an interdependent — rather than independent — process is critical for future theory refinement and intervention development. Addresses 1 University of New Hampshire, USA 2 University of Houston, USA Corresponding author: Rodriguez, Lindsey M ([email protected])
Current Opinion in Psychology 2017, 13:115–119 This review comes from a themed issue on Relationships and stress Edited by Gery C Karantzas, Marita P McCabe and Jeffry A Simpson
http://dx.doi.org/10.1016/j.copsyc.2016.05.011 2352-250X/# 2017 Elsevier Ltd. All rights reserved.
Romantic partnerships are among the greatest potential source of both joy and grief. Close relationships are vitally tied to physical and psychological well-being due to the interdependence that they embody. Close others are support systems when stressors arise, and regulation systems when unhealthy behaviors emerge. Substance use is one aspect of life that can serve beneficial or deleterious purposes for those in relationships. When perceived as normative or relationship-enhancing, substance use can be a source of bonding and shared experiences. However, when perceived as excessive, substance use becomes a central source of stress, conflict, and tension. Figure 1 presents a guiding conceptual model describing how substance use affects relationship outcomes and vice versa. Below, we detail recent support for each path as well www.sciencedirect.com
as determinants affecting each path. Some factors (e.g. attachment insecurity) are vulnerabilities arising from a specific partner, whereas other factors (e.g. concordance) are factors related to the specific couple.
Support for Path A (substance use ! relationship quality) Couples in which one partner drinks heavily or uses other substances show lower levels of satisfaction [1,2] and substance use is among the most common reasons given for divorce [3]. Moreover, heavy drinking has been identified as a key factor in intimate partner violence (IPV) perpetration and victimization among couples [4–6]. Addressing the criticism of uncertainty around alcohol as a proximal predictor of IPV, results from a recent study [7] suggested that IPV was significantly more likely to occur when alcohol had been consumed in the previous 4 hours, consistent with the pharmacological properties of alcohol. Recent evidence linking marijuana and partner aggression is mixed, and we believe this may be partly due to differences in types of partner aggression, sample gender, and type of relationship. Examining psychological aggression, one study using only college women demonstrated an association between marijuana use and psychological aggression perpetration [8], but another study using only college men did not [6]. On the other hand, multiple studies have failed to find an association between marijuana use and physical aggression perpetration [6,8,9]. Only one longitudinal study found a negative association between marijuana use and physical aggression perpetration [10]. This was the only study to use a sample of married couples from the community and to control for demographic characteristics; the other studies used individuals (mostly college students) in dating relationships. Therefore, although evidence for psychological aggression is mixed, the recent literature suggests that marijuana is unrelated to or potentially an inhibitor of physical aggression.
Determinants for Path A (substance use ! relationship functioning) Concordance
Research largely supports the notion that couples with discrepant substance use patterns fare more poorly than those with non-discrepant use [11–13], with more consistent results using alcohol use as compared with marijuana or illicit substances. Discrepant heavy drinking newlywed couples (particularly those with a heavier drinking wife) are more likely to divorce in the first nine years of marriage than concordant non-heavy drinkers, controlling Current Opinion in Psychology 2017, 13:115–119
116 Relationships and stress
Figure 1
Concordance Regulation
Perception Jealousy
Impulse control/anger
A
Relationship Quality/ Intimate Partner Violence (IPV)
Substance Use
B
Perceived partner responsiveness Attachment anxiety
Relationship-contingent self-esteem Jealousy
Relationship-specific alcohol expectancies Partner-focused desire to quit Current Opinion in Psychology
Conceptual model supporting determinants of the reciprocal relationship between substance use and relationship quality/IPV.
for other substance use, personality variables, and sociodemographic factors [14]. Similar results for discrepancy on relationship dissatisfaction have also been recently replicated in same-sex relationships [15].
marijuana are at greater risk for IPV [20]. Although concordant use may be less risky than discrepant use for relationship distress and divorce, concordant use seems to elevate risk for IPV.
Recently, research has focused more on the risk carried by concordant heavy-drinking couples. One study followed young adult partnerships for six years and found that concordant heavy drinking couples at baseline were the most likely to have experienced separation and divorce six years later [16]. Similarly, among older couples, the divorce risk of concordant heavy drinkers is higher than that of concordant light drinkers. The highest risk occurs, however, when only the wife is a heavy drinker [17,18], consistent with other work [14]. Thus, both discrepant and concordant heavy drinking couples experience greater relationship risk than concordant light drinking couples. Furthermore, most studies show that discrepant couples (particularly those with a heavy drinking wife) experience greater relationship risk than concordant heavy drinkers.
Interpersonal perception and regulation strategies
Research linking concordant substance use and IPV is mixed. One study has shown that concordant marijuana users are the least likely to experience IPV longitudinally [10]. On the other hand, other studies show that concordant marijuana users are at greater risk for IPV [19], and that couples in which the husband uses illicit drugs (with or without co-morbid marijuana use) and the wife uses Current Opinion in Psychology 2017, 13:115–119
Perceptions about a partner’s behavior often have more powerful effects on outcomes than the partner’s actual self-reported behavior. Perceiving that the partner’s drinking is a strain on the relationship is a stronger predictor of relationship outcomes than is the partner’s actual drinking [21]. This perception is less detrimental, however, if individuals perceive that they themselves have a problem with drinking [22]. Moreover, romantic partners are among the first to attempt to change what is perceived to be unhealthy behavior. Research on social control has distinguished attempts along a positive/negative reinforcement dimensionality, with positively reinforcing regulation behaviors evincing positive outcomes and punishing behaviors evincing largely negative outcomes. In the substance use domain, partner regulation attempts follow a similar distinction, with the association between partner drinking (perceived and actual) and poorer relationship functioning mediated by punishing, but not rewarding, strategies [22,23]. Importantly, punishing strategies are ineffective: they are associated with increased partner alcohol-related consequences, whereas rewarding strategies are associated with decreased partner drinking (LM Rodriguez, under revision). www.sciencedirect.com
Breakthroughs in addiction and close relationships Rodriguez and Derrick 117
Jealousy
Recent research has illustrated that some of the variance in the strength of the alcohol-IPV association can be accounted for by individual difference and couple variables. Among these moderators is romantic jealousy, which can be distinguished along positive (i.e. desire for monogamy) and negative (i.e. suspicion that a partner is cheating) dimensions. These dimensions moderate the drinking problems-IPV link in opposite directions: Drinking problems are associated with increased IPV perpetration among individuals higher in negative and lower in positive jealousy [24].
Impulse control and anger
Recent work has shown that hazardous drinking was more strongly associated with IPV when actors reported greater difficulties in impulse control [25]. Another study identified angry affect as a moderator of the effects of alcohol and marijuana use on aggression: Alcohol is positively associated with psychological and physical aggression when angry affect is high, but unrelated when angry affect is low. Marijuana use is also associated with psychological aggression when angry affect is high [8]. Further, trait anger and childhood physical abuse become stronger predictors of IPV as alcohol use increases [26].
Support for Path B (relationship functioning ! substance use) Recent studies have replicated and extended previous findings showing that relationship distress can lead to alcohol and substance use. For example, partner conflict in young adults is longitudinally associated with increased likelihood of experiencing comorbid alcohol-use and tobacco-use disorders, rather than a single substance use disorder [27]. Another study identified coping-depression motives as a mediator of the link between relationship conflict and alcohol-related problems for women [28]. Similarly, conflict detracts from both personal and relational well-being in a diary study of moderately drinking couples: Victims and perpetrators both experience poorer mood and relationship functioning after they report verbal aggression, but their mood and relationship functioning are not influenced by their partner’s report of verbal aggression. In other words, it is the perception of the event, and not necessarily the event itself, that diminishes well-being [29]. Subsequent analyses examining alcohol use as an outcome have revealed similar results.
Determinants for Path B (relationship functioning ! substance use) Perceived partner responsiveness
Among newlywed couples in which one or both partners smoke, those who perceive high partner responsiveness at the time of marriage show decreases in cigarette quantity and the likelihood of being a smoker over the following nine years. These decreases are not observed among www.sciencedirect.com
those who perceive relatively low partner responsiveness at marriage [30]. Attachment anxiety, relationship-contingent self-esteem (RCSE), and jealousy
Recent research has begun to place more emphasis on targeting individual vulnerabilities that exacerbate the links between relationship conflict and substance use. One recent paper examined the role of anxious attachment in individuals’ use of alcohol to cope specifically with relationship problems. Relationship-specific coping motives mediated both the effect of anxious attachment on the frequency of drinking apart (i.e. separately) from one’s partner and the effect of anxious attachment on marital alcohol problems [31]. Other research has identified relationship-contingent self-esteem (RCSE) as a vulnerability factor in explaining drinking to cope and related consequences when relationship turbulence arises. When relatively unsatisfied, men high in RCSE are more likely to drink to cope, and in turn, experience greater alcohol-related consequences [32]. These processes were later shown to be mediated by cognitive jealousy, or the suspicion that the partner is not being faithful [33]. Other recent research has identified the negative aspects of jealousy as a precursor to drinking to cope, and in turn, alcohol-related problems [34]. Relationship-specific alcohol expectancies (RSAE)
People’s beliefs about the effects alcohol will have on their relationship influence how drinking with and without the partner affect relationship outcomes. In a longitudinal analyses of newlyweds, RSAE were shown to influence and be influenced by relationship-drinking contexts. Results provided support for both adaptive and maladaptive drinking processes: intimacy and social expectancies show a reciprocal relationship with drinking-with-partner, and power expectancies show a reciprocal relationship with drinking-apart-from-partner [35]. Additionally, RSAE moderate associations between relationship-drinking contexts and next-day relationship functioning. After drinking with their partner, men high in social RSAE and women high in intimacy RSAE report better relationship functioning. However, the day after drinking apart from their partner, both men and women high in intimacy expectancies report greater negative relationship functioning [36]. Partner-focused desire to quit
Although much research focuses on individuals’ concern for their own health when quitting smoking, many people are motivated by a desire to prevent harm to their partner as well. Smokers in dual-smoker couples are more interested in quitting smoking if they are worried about their partner’s health, perceive the partner to be at-risk, and believe that their smoking has already caused their partner harm [37]. Furthermore, interventions for smoking cessation in dual-smoker couples that are framed in terms Current Opinion in Psychology 2017, 13:115–119
118 Relationships and stress
of couple-based outcomes are more successful than those framed in individual-based outcomes [38]. People are also more willing to provide support for smoking cessation when they are concerned about their partner’s health [39].
Conclusion Regardless of whether substances are used as a way to cope with stressors that arise from inside or outside the relationship, relationship partners play a critical role in the development, maintenance, and potential reduction of or abstention from substance use. The variables discussed here underscore the importance of future research and intervention development focusing on the emergent dynamic from two interdependent individuals. A focus on harnessing the positive influence that close others can have via support provision and perceived partner responsiveness is key to future efforts to reduce and prevent substance abuse.
Conflict of interest statement Nothing declared.
Acknowledgments All persons who have made substantial contributions to the work reported in the manuscript (e.g. technical help, writing and editing assistance, general support), but who do not meet the criteria for authorship, are named in the Acknowledgments and have given us their written permission to be named. If we have not included an Acknowledgements in our manuscript, then that indicates that we have not received substantial contributions from nonauthors.
References and recommended reading Papers of particular interest, published within the period of review, have been highlighted as: of special interest of outstanding interest
dating violence perpetration: a daily diary study with female college students. Psychol Addict Behav 2014, 28:516-523. 9.
Temple JR, Shorey RC, Fite P, Stuart GL, Le VD: Substance use as a longitudinal predictor of the perpetration of teen dating violence. J Youth Adolesc 2013, 42:596-606.
10. Smith PH, Homish GG, Collins RL, Giovino GA, White HR, Leonard KE: Couples’ marijuana use is inversely related to their intimate partner violence over the first nine years of marriage. Psychol Addict Behav 2014, 28:734-742. Newlywed couples were followed over the first nine years of marriage. Time-lagged multivariate generalized multilevel models were utilized to show that more frequent marijuana use by both spouses predicted less frequent IPV perpetration by husbands and husband marijuana use predicted less frequent IPV perpetration by wives. Couples wherein both partners frequently used marijuana reported the least IPV perpetration. 11. Homish GG, Leonard KE: The drinking partnership and marital satisfaction: the longitudinal influence of discrepant drinking. J Consult Clin Psychol 2007, 75:43-51. 12. Homish GG, Leonard KE, Kozlowski LT, Cornelius JR: The longitudinal association between multiple substance use discrepancies and marital satisfaction. Addict 2009, 104:12011209. 13. Ostermann J, Sloan FA, Taylor DH: Heavy alcohol use and marital dissolution in the USA. Soc Sci Med 2005, 61:2304-2316. 14. Leonard KE, Smith PH, Homish GG: Concordant and discordant alcohol, tobacco, and marijuana use as predictors of marital dissolution. Psychol Addict Behav 2014, 28:780-789. 15. Kelley ML, Lewis RJ, Mason TB: Discrepant alcohol use, intimate partner violence, and relationship adjustment among lesbian women and their same-sex intimate partners. J Fam Violence 2015, 30:977-986. 16. Wiersma JD, Fischer JL: Young adult drinking partnerships: alcohol-related consequences and relationship problems six years later. J Stud Alcohol Drugs 2014, 75:704-712. Examination of the drinking partnership among young adults showed four clusters of couples based on drinking within the couples and that discrepant partnerships when young predict more alcohol-related problems six years later. Young adults in congruent heavy drinking partnerships reported higher rates of separation, divorce, and alcohol use as adults. The negative effects of congruent heavy drinking were shown primarily for women.
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Dawson DA, Grant BF, Chou SP, Stinson FS: The impact of partner alcohol problems on women’s physical and mental health. J Stud Alcohol Drugs 2007, 68:66-75.
17. Torvik FA, Røysamb E, Gustavson K, Idstad M, Tambs K: Discordant and concordant alcohol use in spouses as predictors of marital dissolution in the general population: results from the HUNT study. Alcohol Clin Exp Res 2013, 37:877884.
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Homish GG, Leonard KE, Kearns-Bodkin JN: Alcohol use, alcohol problems, and depressive symptomatology among newly married couples. Drug Alcohol Depend 2006, 83:185-192.
18. Torvik FA, Gustavson K, Røysamb E, Tambs K: Health, health behaviors, and health dissimilarities predict divorce: results from the HUNT study. BMC Psychol 2015, 3:1-9.
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Amato PR, Previti D: People’s reasons for divorcing gender, social class, the life course, and adjustment. J Fam Issues 2003, 24:602-626.
19. Cunradi CB, Todd M, Mair C: Discrepant patterns of heavy drinking, marijuana use, and smoking and intimate partner violence: results from the California community health study of couples. J Drug Educ 2015, 45:73-95.
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King DM, Hatcher SS, Bride B: An exploration of risk factors associated with dating violence: examining the predictability of adolescent female dating violence perpetration. J Hum Behav Soc Environ 2015, 25:907-922.
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Shorey RC, Brasfield H, Zapor H, Febres J, Stuart GL: The relation between alcohol use and psychological, physical, and sexual dating violence perpetration among male college students. Violence Against Women 2015, 21:151-164.
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Shorey RC, Stuart GL, McNulty JK, Moore TM: Acute alcohol use temporally increases the odds of male perpetrated dating violence: a 90-day diary analysis. Addict Behav 2014, 39:365368.
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Testa M, Derrick JL: A daily process examination of the temporal association between alcohol use and verbal and physical aggression in community couples. Psychol Addict Behav 2014, 28:127-138.
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Current Opinion in Psychology 2017, 13:115–119
20. Smith PH, Homish GG, Leonard KE, Collins RL, Giovino GA, White HR: The interaction between spouses’ drug use in the prediction of intimate partner violence. Drug Alcohol Depend 2014, 140:e212-e213. 21. Rodriguez LM, Neighbors C: An interdependent look at perceptions of spousal drinking problems and marital outcomes. Alcohol 2015, 49:597-605. 22. Rodriguez LM, DiBello AM, Neighbors C: Perceptions of partner drinking problems, regulation strategies and relationship outcomes. Addict Behav 2013, 38:2949-2957. 23. Rodriguez LM, DiBello AM, Wickham R: Regulation strategies mediate associations between heavy drinking and relationship outcomes in married couples. Addict Behav 2016, 54:64-69. Married couples were followed over six months to examine the role of partner punishment and reward in the link between drinking and partner relationship outcomes. Significant indirect effects for punishment revealed that part of the reason partner drinking is deleterious for relationship www.sciencedirect.com
Breakthroughs in addiction and close relationships Rodriguez and Derrick 119
functioning is because individuals are using punishing strategies to try to change their partner’s drinking. 24. Rodriguez LM, DiBello AM, Neighbors C: Positive and negative jealousy in the association between problem drinking and IPV perpetration. J Fam Violence 2015, 30:987-997. 25. Watkins LE, Maldonado RC, DiLillo D: Hazardous alcohol use and intimate partner aggression among dating couples: the role of impulse control difficulties. Aggress Behav 2014, 40:369-381. 26. Maldonado RC, Watkins LE, DiLillo D: The interplay of trait anger, childhood physical abuse, and alcohol consumption in predicting intimate partner aggression. J Interpers Violence 2015, 30:1112-1127. 27. Meacham MC, Bailey JA, Hill KG, Epstein M, Hawkins JD: Alcohol and tobacco use disorder comorbidity in young adults and the influence of romantic partner environments. Drug Alcohol Depend 2013, 132:149-157. 28. Lambe L, Mackinnon SP, Stewart SH: Dyadic conflict, drinking to cope, and alcohol-related problems: a psychometric study and longitudinal actor–partner interdependence model. J Fam Psychol 2015, 29:697-707. 29. Derrick JL, Testa M, Leonard KE: Daily reports of intimate partner verbal aggression by self and partner: short-term consequences and implications for measurement. Psychol Violence 2014, 4:416-431. 30. Derrick JL, Leonard KE, Homish GG: Perceived partner responsiveness predicts decreases in smoking during the first nine years of marriage. Nicotine Tob Res 2013, 15:1528-1536. General social support plays a role in smokers’ trajectories, such that spouses who reported greater partner responsiveness showed a decrease over the following nine years in the likelihood of being a smoker and in cigarette quantity.
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31. Levitt A, Leonard KE: Insecure attachment styles, relationshipdrinking contexts, and marital alcohol problems: testing the mediating role of relationship-specific drinking-to-cope motives. Psychol Addict Behav 2015, 29:696-705. 32. Rodriguez LM, Knee CR, Neighbors C: Relationships can drive some to drink: relationship-contingent self-esteem and drinking problems. J Soc Pers Relat 2014, 31:270-290. 33. DiBello AM, Rodriguez LM, Hadden BW, Neighbors C: The greeneyed monster in the bottle: relationship contingent selfesteem, romantic jealousy, and alcohol-related problems. Addict Behav 2015, 49:52-58. 34. DiBello AM, Neighbors C, Rodriguez LM, Lindgren K: Coping with jealousy: the association between maladaptive aspects of jealousy and drinking problems is mediated by drinking to cope. Addict Behav 2014, 39:94-100. 35. Levitt A, Leonard KE: Relationship-specific alcohol expectancies and relationship-drinking contexts: reciprocal influence and gender-specific effects over the first nine years of marriage. Psychol Addict Behav 2013, 27:986-996. 36. Levitt A, Derrick JL, Testa M: Relationship-specific alcohol expectancies and gender moderate the effects of relationship drinking contexts on daily relationship functioning. J Stud Alcohol Drugs 2014, 75:269-278. 37. Ranby KW, Lewis MA, Toll BA, Rohrbaugh MJ, Lipkus IM: Perceptions of smoking related risk and worry among dualsmoker couples. Nicotine Tob Res 2013, 15:734-738. 38. Lipkus IM, Ranby KW, Lewis MA, Toll B: Reactions to framing of cessation messages: insights from dual-smoker couples. Nicotine Tob Res 2013, 15:2022-2028. 39. vanDellen MR, Boyd SM, Ranby KW, MacKillop J, Lipkus IM: Willingness to provide support for a quit attempt: a study of partners of smokers. J Health Psychol 2015, 1:1-10.
Current Opinion in Psychology 2017, 13:115–119
ScienceDirect Breakthroughs in understanding addiction and close relationships Lindsey M Rodriguez1 and Jaye Derrick2 Substance use is one aspect of life that can serve to bring couples together or tear them apart. Evidence has accumulated for both substance use affecting relationship distress (e.g., partners of substance users report poorer individual and relational outcomes) as well as relationship conflict affecting subsequent substance use (e.g., individuals use substances as a way to cope with interpersonal conflict and distress). We discuss several determinants of each association, including individual difference and relationshipspecific constructs. We conclude by considering how conceptualizing addiction as an interdependent — rather than independent — process is critical for future theory refinement and intervention development. Addresses 1 University of New Hampshire, USA 2 University of Houston, USA Corresponding author: Rodriguez, Lindsey M ([email protected])
Current Opinion in Psychology 2017, 13:115–119 This review comes from a themed issue on Relationships and stress Edited by Gery C Karantzas, Marita P McCabe and Jeffry A Simpson
http://dx.doi.org/10.1016/j.copsyc.2016.05.011 2352-250X/# 2017 Elsevier Ltd. All rights reserved.
Romantic partnerships are among the greatest potential source of both joy and grief. Close relationships are vitally tied to physical and psychological well-being due to the interdependence that they embody. Close others are support systems when stressors arise, and regulation systems when unhealthy behaviors emerge. Substance use is one aspect of life that can serve beneficial or deleterious purposes for those in relationships. When perceived as normative or relationship-enhancing, substance use can be a source of bonding and shared experiences. However, when perceived as excessive, substance use becomes a central source of stress, conflict, and tension. Figure 1 presents a guiding conceptual model describing how substance use affects relationship outcomes and vice versa. Below, we detail recent support for each path as well www.sciencedirect.com
as determinants affecting each path. Some factors (e.g. attachment insecurity) are vulnerabilities arising from a specific partner, whereas other factors (e.g. concordance) are factors related to the specific couple.
Support for Path A (substance use ! relationship quality) Couples in which one partner drinks heavily or uses other substances show lower levels of satisfaction [1,2] and substance use is among the most common reasons given for divorce [3]. Moreover, heavy drinking has been identified as a key factor in intimate partner violence (IPV) perpetration and victimization among couples [4–6]. Addressing the criticism of uncertainty around alcohol as a proximal predictor of IPV, results from a recent study [7] suggested that IPV was significantly more likely to occur when alcohol had been consumed in the previous 4 hours, consistent with the pharmacological properties of alcohol. Recent evidence linking marijuana and partner aggression is mixed, and we believe this may be partly due to differences in types of partner aggression, sample gender, and type of relationship. Examining psychological aggression, one study using only college women demonstrated an association between marijuana use and psychological aggression perpetration [8], but another study using only college men did not [6]. On the other hand, multiple studies have failed to find an association between marijuana use and physical aggression perpetration [6,8,9]. Only one longitudinal study found a negative association between marijuana use and physical aggression perpetration [10]. This was the only study to use a sample of married couples from the community and to control for demographic characteristics; the other studies used individuals (mostly college students) in dating relationships. Therefore, although evidence for psychological aggression is mixed, the recent literature suggests that marijuana is unrelated to or potentially an inhibitor of physical aggression.
Determinants for Path A (substance use ! relationship functioning) Concordance
Research largely supports the notion that couples with discrepant substance use patterns fare more poorly than those with non-discrepant use [11–13], with more consistent results using alcohol use as compared with marijuana or illicit substances. Discrepant heavy drinking newlywed couples (particularly those with a heavier drinking wife) are more likely to divorce in the first nine years of marriage than concordant non-heavy drinkers, controlling Current Opinion in Psychology 2017, 13:115–119
116 Relationships and stress
Figure 1
Concordance Regulation
Perception Jealousy
Impulse control/anger
A
Relationship Quality/ Intimate Partner Violence (IPV)
Substance Use
B
Perceived partner responsiveness Attachment anxiety
Relationship-contingent self-esteem Jealousy
Relationship-specific alcohol expectancies Partner-focused desire to quit Current Opinion in Psychology
Conceptual model supporting determinants of the reciprocal relationship between substance use and relationship quality/IPV.
for other substance use, personality variables, and sociodemographic factors [14]. Similar results for discrepancy on relationship dissatisfaction have also been recently replicated in same-sex relationships [15].
marijuana are at greater risk for IPV [20]. Although concordant use may be less risky than discrepant use for relationship distress and divorce, concordant use seems to elevate risk for IPV.
Recently, research has focused more on the risk carried by concordant heavy-drinking couples. One study followed young adult partnerships for six years and found that concordant heavy drinking couples at baseline were the most likely to have experienced separation and divorce six years later [16]. Similarly, among older couples, the divorce risk of concordant heavy drinkers is higher than that of concordant light drinkers. The highest risk occurs, however, when only the wife is a heavy drinker [17,18], consistent with other work [14]. Thus, both discrepant and concordant heavy drinking couples experience greater relationship risk than concordant light drinking couples. Furthermore, most studies show that discrepant couples (particularly those with a heavy drinking wife) experience greater relationship risk than concordant heavy drinkers.
Interpersonal perception and regulation strategies
Research linking concordant substance use and IPV is mixed. One study has shown that concordant marijuana users are the least likely to experience IPV longitudinally [10]. On the other hand, other studies show that concordant marijuana users are at greater risk for IPV [19], and that couples in which the husband uses illicit drugs (with or without co-morbid marijuana use) and the wife uses Current Opinion in Psychology 2017, 13:115–119
Perceptions about a partner’s behavior often have more powerful effects on outcomes than the partner’s actual self-reported behavior. Perceiving that the partner’s drinking is a strain on the relationship is a stronger predictor of relationship outcomes than is the partner’s actual drinking [21]. This perception is less detrimental, however, if individuals perceive that they themselves have a problem with drinking [22]. Moreover, romantic partners are among the first to attempt to change what is perceived to be unhealthy behavior. Research on social control has distinguished attempts along a positive/negative reinforcement dimensionality, with positively reinforcing regulation behaviors evincing positive outcomes and punishing behaviors evincing largely negative outcomes. In the substance use domain, partner regulation attempts follow a similar distinction, with the association between partner drinking (perceived and actual) and poorer relationship functioning mediated by punishing, but not rewarding, strategies [22,23]. Importantly, punishing strategies are ineffective: they are associated with increased partner alcohol-related consequences, whereas rewarding strategies are associated with decreased partner drinking (LM Rodriguez, under revision). www.sciencedirect.com
Breakthroughs in addiction and close relationships Rodriguez and Derrick 117
Jealousy
Recent research has illustrated that some of the variance in the strength of the alcohol-IPV association can be accounted for by individual difference and couple variables. Among these moderators is romantic jealousy, which can be distinguished along positive (i.e. desire for monogamy) and negative (i.e. suspicion that a partner is cheating) dimensions. These dimensions moderate the drinking problems-IPV link in opposite directions: Drinking problems are associated with increased IPV perpetration among individuals higher in negative and lower in positive jealousy [24].
Impulse control and anger
Recent work has shown that hazardous drinking was more strongly associated with IPV when actors reported greater difficulties in impulse control [25]. Another study identified angry affect as a moderator of the effects of alcohol and marijuana use on aggression: Alcohol is positively associated with psychological and physical aggression when angry affect is high, but unrelated when angry affect is low. Marijuana use is also associated with psychological aggression when angry affect is high [8]. Further, trait anger and childhood physical abuse become stronger predictors of IPV as alcohol use increases [26].
Support for Path B (relationship functioning ! substance use) Recent studies have replicated and extended previous findings showing that relationship distress can lead to alcohol and substance use. For example, partner conflict in young adults is longitudinally associated with increased likelihood of experiencing comorbid alcohol-use and tobacco-use disorders, rather than a single substance use disorder [27]. Another study identified coping-depression motives as a mediator of the link between relationship conflict and alcohol-related problems for women [28]. Similarly, conflict detracts from both personal and relational well-being in a diary study of moderately drinking couples: Victims and perpetrators both experience poorer mood and relationship functioning after they report verbal aggression, but their mood and relationship functioning are not influenced by their partner’s report of verbal aggression. In other words, it is the perception of the event, and not necessarily the event itself, that diminishes well-being [29]. Subsequent analyses examining alcohol use as an outcome have revealed similar results.
Determinants for Path B (relationship functioning ! substance use) Perceived partner responsiveness
Among newlywed couples in which one or both partners smoke, those who perceive high partner responsiveness at the time of marriage show decreases in cigarette quantity and the likelihood of being a smoker over the following nine years. These decreases are not observed among www.sciencedirect.com
those who perceive relatively low partner responsiveness at marriage [30]. Attachment anxiety, relationship-contingent self-esteem (RCSE), and jealousy
Recent research has begun to place more emphasis on targeting individual vulnerabilities that exacerbate the links between relationship conflict and substance use. One recent paper examined the role of anxious attachment in individuals’ use of alcohol to cope specifically with relationship problems. Relationship-specific coping motives mediated both the effect of anxious attachment on the frequency of drinking apart (i.e. separately) from one’s partner and the effect of anxious attachment on marital alcohol problems [31]. Other research has identified relationship-contingent self-esteem (RCSE) as a vulnerability factor in explaining drinking to cope and related consequences when relationship turbulence arises. When relatively unsatisfied, men high in RCSE are more likely to drink to cope, and in turn, experience greater alcohol-related consequences [32]. These processes were later shown to be mediated by cognitive jealousy, or the suspicion that the partner is not being faithful [33]. Other recent research has identified the negative aspects of jealousy as a precursor to drinking to cope, and in turn, alcohol-related problems [34]. Relationship-specific alcohol expectancies (RSAE)
People’s beliefs about the effects alcohol will have on their relationship influence how drinking with and without the partner affect relationship outcomes. In a longitudinal analyses of newlyweds, RSAE were shown to influence and be influenced by relationship-drinking contexts. Results provided support for both adaptive and maladaptive drinking processes: intimacy and social expectancies show a reciprocal relationship with drinking-with-partner, and power expectancies show a reciprocal relationship with drinking-apart-from-partner [35]. Additionally, RSAE moderate associations between relationship-drinking contexts and next-day relationship functioning. After drinking with their partner, men high in social RSAE and women high in intimacy RSAE report better relationship functioning. However, the day after drinking apart from their partner, both men and women high in intimacy expectancies report greater negative relationship functioning [36]. Partner-focused desire to quit
Although much research focuses on individuals’ concern for their own health when quitting smoking, many people are motivated by a desire to prevent harm to their partner as well. Smokers in dual-smoker couples are more interested in quitting smoking if they are worried about their partner’s health, perceive the partner to be at-risk, and believe that their smoking has already caused their partner harm [37]. Furthermore, interventions for smoking cessation in dual-smoker couples that are framed in terms Current Opinion in Psychology 2017, 13:115–119
118 Relationships and stress
of couple-based outcomes are more successful than those framed in individual-based outcomes [38]. People are also more willing to provide support for smoking cessation when they are concerned about their partner’s health [39].
Conclusion Regardless of whether substances are used as a way to cope with stressors that arise from inside or outside the relationship, relationship partners play a critical role in the development, maintenance, and potential reduction of or abstention from substance use. The variables discussed here underscore the importance of future research and intervention development focusing on the emergent dynamic from two interdependent individuals. A focus on harnessing the positive influence that close others can have via support provision and perceived partner responsiveness is key to future efforts to reduce and prevent substance abuse.
Conflict of interest statement Nothing declared.
Acknowledgments All persons who have made substantial contributions to the work reported in the manuscript (e.g. technical help, writing and editing assistance, general support), but who do not meet the criteria for authorship, are named in the Acknowledgments and have given us their written permission to be named. If we have not included an Acknowledgements in our manuscript, then that indicates that we have not received substantial contributions from nonauthors.
References and recommended reading Papers of particular interest, published within the period of review, have been highlighted as: of special interest of outstanding interest
dating violence perpetration: a daily diary study with female college students. Psychol Addict Behav 2014, 28:516-523. 9.
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10. Smith PH, Homish GG, Collins RL, Giovino GA, White HR, Leonard KE: Couples’ marijuana use is inversely related to their intimate partner violence over the first nine years of marriage. Psychol Addict Behav 2014, 28:734-742. Newlywed couples were followed over the first nine years of marriage. Time-lagged multivariate generalized multilevel models were utilized to show that more frequent marijuana use by both spouses predicted less frequent IPV perpetration by husbands and husband marijuana use predicted less frequent IPV perpetration by wives. Couples wherein both partners frequently used marijuana reported the least IPV perpetration. 11. Homish GG, Leonard KE: The drinking partnership and marital satisfaction: the longitudinal influence of discrepant drinking. J Consult Clin Psychol 2007, 75:43-51. 12. Homish GG, Leonard KE, Kozlowski LT, Cornelius JR: The longitudinal association between multiple substance use discrepancies and marital satisfaction. Addict 2009, 104:12011209. 13. Ostermann J, Sloan FA, Taylor DH: Heavy alcohol use and marital dissolution in the USA. Soc Sci Med 2005, 61:2304-2316. 14. Leonard KE, Smith PH, Homish GG: Concordant and discordant alcohol, tobacco, and marijuana use as predictors of marital dissolution. Psychol Addict Behav 2014, 28:780-789. 15. Kelley ML, Lewis RJ, Mason TB: Discrepant alcohol use, intimate partner violence, and relationship adjustment among lesbian women and their same-sex intimate partners. J Fam Violence 2015, 30:977-986. 16. Wiersma JD, Fischer JL: Young adult drinking partnerships: alcohol-related consequences and relationship problems six years later. J Stud Alcohol Drugs 2014, 75:704-712. Examination of the drinking partnership among young adults showed four clusters of couples based on drinking within the couples and that discrepant partnerships when young predict more alcohol-related problems six years later. Young adults in congruent heavy drinking partnerships reported higher rates of separation, divorce, and alcohol use as adults. The negative effects of congruent heavy drinking were shown primarily for women.
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Shorey RC, Stuart GL, McNulty JK, Moore TM: Acute alcohol use temporally increases the odds of male perpetrated dating violence: a 90-day diary analysis. Addict Behav 2014, 39:365368.
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20. Smith PH, Homish GG, Leonard KE, Collins RL, Giovino GA, White HR: The interaction between spouses’ drug use in the prediction of intimate partner violence. Drug Alcohol Depend 2014, 140:e212-e213. 21. Rodriguez LM, Neighbors C: An interdependent look at perceptions of spousal drinking problems and marital outcomes. Alcohol 2015, 49:597-605. 22. Rodriguez LM, DiBello AM, Neighbors C: Perceptions of partner drinking problems, regulation strategies and relationship outcomes. Addict Behav 2013, 38:2949-2957. 23. Rodriguez LM, DiBello AM, Wickham R: Regulation strategies mediate associations between heavy drinking and relationship outcomes in married couples. Addict Behav 2016, 54:64-69. Married couples were followed over six months to examine the role of partner punishment and reward in the link between drinking and partner relationship outcomes. Significant indirect effects for punishment revealed that part of the reason partner drinking is deleterious for relationship www.sciencedirect.com
Breakthroughs in addiction and close relationships Rodriguez and Derrick 119
functioning is because individuals are using punishing strategies to try to change their partner’s drinking. 24. Rodriguez LM, DiBello AM, Neighbors C: Positive and negative jealousy in the association between problem drinking and IPV perpetration. J Fam Violence 2015, 30:987-997. 25. Watkins LE, Maldonado RC, DiLillo D: Hazardous alcohol use and intimate partner aggression among dating couples: the role of impulse control difficulties. Aggress Behav 2014, 40:369-381. 26. Maldonado RC, Watkins LE, DiLillo D: The interplay of trait anger, childhood physical abuse, and alcohol consumption in predicting intimate partner aggression. J Interpers Violence 2015, 30:1112-1127. 27. Meacham MC, Bailey JA, Hill KG, Epstein M, Hawkins JD: Alcohol and tobacco use disorder comorbidity in young adults and the influence of romantic partner environments. Drug Alcohol Depend 2013, 132:149-157. 28. Lambe L, Mackinnon SP, Stewart SH: Dyadic conflict, drinking to cope, and alcohol-related problems: a psychometric study and longitudinal actor–partner interdependence model. J Fam Psychol 2015, 29:697-707. 29. Derrick JL, Testa M, Leonard KE: Daily reports of intimate partner verbal aggression by self and partner: short-term consequences and implications for measurement. Psychol Violence 2014, 4:416-431. 30. Derrick JL, Leonard KE, Homish GG: Perceived partner responsiveness predicts decreases in smoking during the first nine years of marriage. Nicotine Tob Res 2013, 15:1528-1536. General social support plays a role in smokers’ trajectories, such that spouses who reported greater partner responsiveness showed a decrease over the following nine years in the likelihood of being a smoker and in cigarette quantity.
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31. Levitt A, Leonard KE: Insecure attachment styles, relationshipdrinking contexts, and marital alcohol problems: testing the mediating role of relationship-specific drinking-to-cope motives. Psychol Addict Behav 2015, 29:696-705. 32. Rodriguez LM, Knee CR, Neighbors C: Relationships can drive some to drink: relationship-contingent self-esteem and drinking problems. J Soc Pers Relat 2014, 31:270-290. 33. DiBello AM, Rodriguez LM, Hadden BW, Neighbors C: The greeneyed monster in the bottle: relationship contingent selfesteem, romantic jealousy, and alcohol-related problems. Addict Behav 2015, 49:52-58. 34. DiBello AM, Neighbors C, Rodriguez LM, Lindgren K: Coping with jealousy: the association between maladaptive aspects of jealousy and drinking problems is mediated by drinking to cope. Addict Behav 2014, 39:94-100. 35. Levitt A, Leonard KE: Relationship-specific alcohol expectancies and relationship-drinking contexts: reciprocal influence and gender-specific effects over the first nine years of marriage. Psychol Addict Behav 2013, 27:986-996. 36. Levitt A, Derrick JL, Testa M: Relationship-specific alcohol expectancies and gender moderate the effects of relationship drinking contexts on daily relationship functioning. J Stud Alcohol Drugs 2014, 75:269-278. 37. Ranby KW, Lewis MA, Toll BA, Rohrbaugh MJ, Lipkus IM: Perceptions of smoking related risk and worry among dualsmoker couples. Nicotine Tob Res 2013, 15:734-738. 38. Lipkus IM, Ranby KW, Lewis MA, Toll B: Reactions to framing of cessation messages: insights from dual-smoker couples. Nicotine Tob Res 2013, 15:2022-2028. 39. vanDellen MR, Boyd SM, Ranby KW, MacKillop J, Lipkus IM: Willingness to provide support for a quit attempt: a study of partners of smokers. J Health Psychol 2015, 1:1-10.
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