Alcohol use in wife abusers and their spouses

Behaviors, Vol. 10, pp. 127-135, 1985 Printed in the USA. All rights reserved.

Addictive

ALCOHOL

0306-4603185 $3.00 + .OO

Copyright 0 1985 Pergamon Press Ltd

USE IN WIFE ABUSERS

AND

THEIR

SPOUSES

VINCENT B. VAN HASSELT Western Pennsylvania School for Blind Children

RANDALL L. MORRISON Medical College of Pennsylvania

ALAN S. BELLACK Medical College of Pennsylvania Abstract- The present study provided an assessment of alcohol use in couples characterized by wife abuse. The Michigan Alcoholism Screening Test, Quantity-Frequency Index, Impairment Index, and a questionnaire tapping frequency and magnitude of violent episodes were administered to couples who were: (a) physically abusive, (b) maritally discordant but nonviolent, and (c) satisfactorily married. Results indicated significantly higher scores on the Michigan Alcoholism Screening Test in physically abusive males based on their self-reports as well as wives’ reports of husbands’ drinking behavior. No significant differences were found between groups of wives on alcohol measures. In addition, correlational analyses revealed a number of significant relationships between husbands’ self-reported drinking and wives’ responses concerning their spouses’ alcohol use. Findings are discussed in terms of the need for more extensive assessment of physically abusive males, and the utility of examining the interactive influences of alcohol and other factors on marital violence.

Over the past several years, professionals in the fields of psychology, psychiatry, social work, and sociology have directed increased attention to the problem of wife abuse (see Finkelhor, Gelles, Hotaling, & Straus, 1983; Martin, 1978; Roy, 1977; Steinmetz & Straus, 1974). The heightened interest in this area is attributable, in part, to empirically derived estimates suggesting that approximately 30% of married women in the United States are victims of physical abuse by their spouses at some point in their marriage (Straus, 1978). Some investigators contend that the incidence actually may be twice as high (Gelles, 1974; Walker, 1979). Further, many episodes of violence in the home result in serious injury or death. Indeed, Federal Bureau of Investigation statistics show that nearly 13% of homicides in this country are husband-wife killings (Ohrenstein, 1977). Even where less severe forms of violence have occurred, victims often require medical attention and/or hospitalization (Rounsaville & Weissman, 1977). In addition, wife abuse has a devasting psychological impact on victims. For example, there is evidence of depression (Gayford, 1975; Rounsaville, 1978) and suicide attempts (Gayford, 1975) in a number of battered women. Despite the accumulation of data attesting to the magnitude and deleterious effects of wife abuse, only recently have investigations been carried out to study the problem empirically. These initial efforts have identified several factors related to marital violence, including: experiencing child abuse or witnessing interparental violence as a child (Rosenbaum & O’Leary, 1981; Roy, 1977), assertion deficits (Morrison, Van Hasselt,

This study was supported by grant number 1 R03 MH32870-01 from the National Institute of Mental Health. It was carried out while the authors were at the Department of Psychology, University of Pittsburgh. The authors wish to thank Greta Francis for her contribution to the investigation. Requests for reprints should be sent to Vincent B. Van Hasselt, Western Pennsylvania School for Blind Children, 201 N. Bellefield Avenue, Pittsburgh, PA 15213. 127

128

VINCENT B. VAN HASSELT et al.

& Bellack, 1981; Prescott & Letko, 1977; Rosenbaum & O’Leary, 1981), psychiatric disturbance (Faulk, 1974), status inconsistency (Rounsaville, 1978), and idealogical differences (Straus, 1974) between husbands and wives. Another factor that consistently has been implicated in wife abuse is alcohol use by the male (Byles, 1978; Carlson, 1977; Flynn, 1977; Gerson, 1978). Interviews with 101 physically abused women in the NOW Domestic Violence Project (Fojtik, 1977-78) revealed that almost 60% of their husbands abused alcohol. Moreover, wives indicated that two-thirds of assaults were alcohol-related. Similarly, Label1 (1979) found that 72% of 512 physically abused wives reported drinking problems in their husbands. Many of these women also viewed alcohol as the major cause of their spouse’s violent behavior. In contrast, Fojtik (1977-78) and Label1 (1979) both found substantially less drinking (9.7% and 7.8%, respectively) in samples of battered wives. These findings have been corroborated by Star (1978). As part of an assessment of physically abusive couples, Rosenbaum and O’Leary (1981) administered the short form of the Michigan Alcoholism Screening Test (Selzer, Vinokur, & van Rooijen, 1975) to physically abusive couples (in or out of therapy), maritally dysfunctional but nonviolent couples, and satisfactorily married couples. Their results, which were based on wives’ reports of husbands’ drinking, showed that physically abusive males who were not receiving therapy had significantly higher alcoholism scores than the other groups, which did not differ from each other. No differences in wives’ drinking habits were found. While there is a convergence of evidence showing high levels of alcohol use in many physically abusive males, firm conclusions regarding the relationship between drinking and marital violence cannot be drawn at this time for several reasons. First, some contradictory data regarding this association have been presented. Specifically, Bard and Zacker (1974) and Rounsaville (1978) reported relatively infrequent drinking in males during actual episodes of violence. Also, Star (1978) found that a group of nonbattering husbands drank more than battering husbands. Second, with the exception of Rosenbaum and O’Leary (198 l), no systematic assessment of alcohol consumption has been conducted. Generally, descriptions of drinking behavior have been obtained through clinical interviews and/or nonstandardized questionnaires (e.g., Byles, 1978; Flynn, 1977; Gayford, 1975; Snell, Rosenwald, & Robey, 1964). Further, no studies can be found in which data on drinking behavior of physically abusive husbands have been obtained from them directly. Rather, wives’ reports have been the primary source of information concerning their husbands’ alcohol use. In light of the questionable veridicality and accuracy of such reports, any results of these investigations must be interpreted with caution and considered tentative at best. The present study was part of a comprehensive evaluation of alcohol use and psychosocial adjustment in wife abusers and their spouses. In this investigation, standardized measures of alcoholism, and a questionnaire tapping magnitude and frequency of physical abuse were administered to married or cohabiting couples who were: (a) physically abusive, (b) maritally discordant but nonviolent, and (c) satisfactorily married. The second condition was included to control for the potentially confounding effects of marital discord per se. Further, alcohol data were obtained directly from husbands and wives regarding their own drinking habits. In addition, wives provided information about their husbands’ alcohol use. Thus, it was possible to examine the degree of correspondence between husbands’ and wives’ reports. The relationship between alcohol use and frequency of physical abuse also was examined.

Alcohol use in wife abusers

129

METHOD

Subjects Subjects in the present investigation included: (a) 26 couples in which there was evidence from either legal, clinical, or self-report of physical assault against the female by the male (PA), (b) 26 maritally discordant but non-violent couples (MD), and (c) 15 satisfactorily married couples (SC). PA couples were recruited from a number of mental health clinics in the Pittsburgh area, as well as through a special clinical intervention service developed by the Pittsburgh police department to deal with domestic violence. Couples were selected for the PA condition if both members of the dyad admitted to at least one episode of physical abuse of the wife. Assaults ranged from slapping and hitting, to use of objects (e.g., knives, clubs). The severity of assaults ranged from bruises to serious injuries (e.g., lacerations, broken bones) requiring hospitalization. The MD group also was selected from mental health clinics. All referrals from treatment agencies were made within one month of admission to that agency. Couples were selected for the MD condition if both husband and wife denied physical violence and each scored below 90 on the Locke-Wallace Marital Adjustment Scale (Locke & Wallace, 1957). In addition, some PA and MD couples, as well as all SC couples, were recruited through advertisements and public service announcements. Advertisements pertaining to the project indicated that couples would be involved in a study of “marital interaction and marital conflict.” Husbands and wives were carefully screened by telephone to ascertain level of marital adjustment using the Locke-Wallace Scale. Also, the Physical Abuse Questionnaire (PAQ) (Morrison & Van Hasselt, 1980) was administered via telephone to obtain demographic information and data regarding frequency and magnitude of episodes of marital violence. All couples were paid $75.00 for their participation in the study. Of the PA, MD, and SC groups, 87%, 88%, and 100% respectively, were legally married. The remaining couples had a cohabitant relationship for a minimum of 3 years. Characteristics of the sample are presented in Table 1.

Measures As part of an extensive assessment battery, all subjects completed the following measures. Physical Abuse Questionnaire (PAQ). The PAQ is a questionnaire developed specifically for the present project to obtain demographic information, data regarding frequency and magnitude of violent episodes, and the extent of injuries received as a result of physical assault(s) (Morrison & Van Hasselt, 1980.) Michigan Alcoholism Screening Test (MAST). The MAST is a widely-used, 24-item, alcoholism screening device with a weighted scoring system and a score range of O-53 (Selzer, 1971; Selzer et al., 1975). Internal consistency, measured by coefficient alpha, has been reported to range from .79 to .90 (Selzer et al., 1975). Using a cut-off score of 6 or greater as diagnostic of alcoholism, Favazza and Pires (1974) found a 34% rate of false negatives from military alcoholics. Pokorny, Miller, and Kaplan (1972) reported a zero rate in V.A. alcoholics. For a mixed group of alcoholics presumably more representative of the general population of alcoholics than the above sample, Selzer et al. (1975) found 14% false negatives and six percent false positives.

130

VINCENT

Table

1.

B. VAN HASSELT

Characteristics

et al.

of the sample. Group PA

MD

SC

SD

34.2 7.5

35.7 7.6

32.3 5.1

x SD

12.3 2.3

12.7 2.6

12.4 2.1

SD

31.2 7.1

32.7 8.1

30.5 5.1

Education level (in years)

z SD

12.0 2.0

12.2 2.5

12.1 1.7

Years living together

J7 SD

7.7 5.6

8.9 8.3

8.5 4.7

Number

x SD

2.4 1.9

2.1 1.5

1.6 1.6

Husbands Age (in years) Education level in years) Wives Age (in years)

of children

x

x

Note: PA = Physically Abusive couples; SC = Satisfactorily Married couples.

MD = Maritally

Discordant,

Nonviolent

couples;

Quantity-Frequency Index (QFZ). The QFI measures consumption of absolute alcohol in units of average ounces (centiliters) ingested per day over the previous month (Jessor, Graves, Hansen, & Jessor, 1968). This is accomplished by aggregating individual responses to questions about the rate of consumption of beer, wine, and liquor. Jessor et al. (1968) reported a mean QFI of 6.32 oz. for 1340 alcoholics evaluated for alcoholism treatment. Impairment Index (ZZ). The II is a composite of responses to 12 questions designed to measure the extent of behavior problems stemming from the use of alcohol over the past month (Shelton, Hollister, & Gocka, 1969). It has a scoring range of 0 to 33. The mean II score of a sample of alcoholics upon intake was 14.1 (Shelton et al., 1969). In the present study, alcohol use of both husbands and wives was assessed. In addition, information was obtained from wives regarding their husbands’ drinking habits. To accomplish this, wives were administered modified forms of the MAST, QFI, and II in which items were reworded to be relevant to their husbands’ drinking behavior. For example, the MAST question, “Have you lost a job because of drinking” was revised to read, “Has your husband lost a job because of drinking” on the wives’ form concerning husbands’ alcohol use. QFI and II items were similarly adapted. Procedures The procedures reported here were part of a larger project involving the assessment of couples experiencing marital violence. Following referral, a project staff person explained the purpose of the study and procedures to husbands and wives individually by telephone. Interested couples who met criteria for participation were scheduled for an appointment at the Clinical Psychology Center at the University of Pittsburgh. Upon the couple’s arrival for the experimental session, the procedures were again described and an informed consent agreement was signed. Each subject individually completed measures in separate rooms so that no discussion of items or responses was possible. A

131

Alcohol use in wife abusers

project staff member was available at all times to answer any questions subjects might have. At the conclusion of the experimental session, the couple was debriefed and remuneration was provided. RESULTS

Group comparisons Preliminary analyses revealed no significant differences between groups on age, education level, and number of years married. Scores on each of the questionnaires were evaluated in a series of one-way analyses of variance. Table 2 presents the means and standard deviations for alcoholism measures completed by husbands and wives about their own drinking as well as wives’ reports of husbands’ alcohol use. Analyses of husbands’ reports indicated a significant group effect on MAST scores, F(2,66) = 8.99, p < .OOl. Scheffe post-hoc comparisons (.05 level) showed that PA husbands had significantly higher scores on this measure than the other two groups. No group differences were found for husbands on the remaining instruments. Analyses of data obtained from wives indicated no between-group differences on any of their selfreport measures. Examination of wives’ reports of husbands’ drinking behavior revealed a significant group difference on the MAST, F(2,61) = 8.73, p < .OOl. Scheffe comparisons

Table 2. Comparison of Groups on Michigan Alcoholism Screening Test (MAST), Quantity-Frequency Index (QFI), and Impairment Index (II) Scores. Group PA

MD

SC

SD

17.02 19.04

3.54 4.38

4.60 3.79

QFI

x SD

.95 1.88

0.61 0.64

0.60 0.65

II

x SD

3.69 3.57

2.40 2.25

3.20 2.34

SD

5.33 11.38

1.85 3.11

1.07 1.28

QFI

x SD

0.24 0.33

0.31 0.44

0.64 1.68

II

r? SD

2.04 2.12

2.12 2.17

1.67 1.54

15.00 17.76

2.88 4.30

2.73 3.60

SD

0.85 1.92

0.53 0.79

0.66 0.90

x SD

3.35 3.22

2.08 2.61

2.53 2.75

Husbands

x

MAST

Wives

x

MAST

Wives regarding

husbands

x

MAST

SD

x

QFI II

Note: PA = Physically Abusive couples; SC = Satisfactorily Married couples.

MD = Maritally

Discordant,

Nonviolent

couples;

132

VINCENT

Table 3.

Correlations

B. VAN HASSELT

between

husbands’

Husbands

Husbands MAST

et al.

and wives’ reports

Wives II

MAST

QFI

II

.05

.I8 .56”*’

.56*** -.lO - .09

-.02 .ll .lO

-.02 .16 .I8

II Wives MAST

.08

QFI II Wives re Husbands MAST

use.

Wives re Husbands

QFI

QFI

of alcohol

.20 .28*

MAST

.88*** .15 .12 .43*** - .05 .ll

QFI .05 .41*** .52*** - .08 .14 .14 .03

QFI

II

.06 .26* .59*** .Ol .17 .51 .16 .60***

II

*p <

.05/**p

< .Ol/“‘p

< .ool.

showed that wives in the PA condition rated their husbands significantly higher than wives in the other conditions. No other significant effects were found. Correlations between husbands’ and wives’ reports One purpose of this study was to examine the correspondence between husbands’ and wives’ reports of drinking behavior. Pearson product-moment correlation coefficients were computed between husbands’ and wives’ scores on the MAST, QFI, and II, as well as wives’ ratings of husbands’ alcohol use on these instruments (see Table 3). As Table 3 indicates, significant correlations were obtained between husbands’ MAST scores and wives’ MAST scores (r = S6, p < .OOl), and wives’ ratings of husbands on the MAST (r = .88, p < .OOl). Husbands’ QFI scores were significantly correlated with wives’ reports of husbands’ drinking on the QFI (r = .41, p < .Ol) and II (r = .26, p < .05). Similarly, husbands’ II scores were significantly correlated with wives’ reports of husbands’ drinking on the QFI (r = S2, p < .OOl), and II (r = S9, p < .OOl). Significant correlations also were obtained between wives’ reports of their own drinking and ratings of their husbands’ drinking behavior on the MAST (r = .43, p < .OOl). Finally, a significant relationship was found between wives’ own II scores and ratings of their husbands’ alcohol use on the same measure (r = .51, p < .OOl). Correlations between alcohol use and frequency of assault Correlation coefficients were computed to examine the association between frequency of physical assault as assessed by the PAQ and alcoholism scores. Of these values, only the correlation between frequency of assault and wive’s II ratings of husband’s drinking behavior was significant (r = .41, p < .OOl). DISCUSSION

The present study assessed alcohol use in abusive couples. This investigation was one of the first to obtain reports of drinking behavior directly from physically abusive males. Further, the relationship between alcohol use and frequency of assaults was examined. Results indicated significantly higher MAST scores in physically abusive males relative to males in maritally discordant but nonviolent, and satisfactorily married

Alcohol use in wife abusers

133

couples. Further, wives’ MAST ratings of their spouses’ drinking also yielded significantly higher scores for physically abusive males. No differences between groups of wives were evident on any of the alcoholism measures. Correlational analyses showed a number of significant relationships between husbands’ self-reports and wives’ responses concerning their husbands’ drinking behavior. These results partially replicate previous efforts which found greater evidence of problem drinking in physically abusive males on the basis of wives’ reports (Fojtik, 1977-78; Gayford, 1975; Labell, 1979; Snell et al., 1964). Indeed, MAST scores of physically abusive males in the present study were well above the cut-off score of 5, which is indicative of alcoholism (Selzer, 1971). Rosenbaum and O’Leary (1981) also found high alcoholism scores on the short form of the MAST, albeit only for abusive males not involved in conjoint therapy. The means of MAST scores for their abusive males receiving treatment did not exceed the alcoholism cut-off. In the present investigation, almost all physically abusive males were involved in some form of therapy. The discrepancy in findings between studies may be a function of different information sources (from husbands directly vs. from wives about husbands) in each. Alternatively, the disparity may be due to actual differential characteristics of the two samples. Analyses of QFI and II scores revealed no significant differences between groups of husbands. This finding may be related to a number of factors. First, these instruments assess amount of alcohol consumed (Quantity-Frequency Index) and alcohol-related behavior problems (Impairment Index) during the past month. As mentioned above, most physically abusive couples were recruited from mental health clinics. Because of their participation in treatment, many of these males may have made recent efforts to reduce their alcohol intake. Data pertaining to wives’ self-reported drinking indicated no differences between groups on any of the alcohol measures. This is consistent with investigations by Star (1978) and Label1 (1979), which found that alcohol was infrequently abused by battered wives. In describing characteristics of battered women, Carlson (1977) also cites the low prevalence of alcohol use in women screened by the NOW Domestic Violence Project. The present study also found a number of significant associations between husbands’ self-reported drinking behavior and wives’ reports of spouses’ alcohol use. These data are in agreement with Rosenbaum and O’Leary (1981), who reported a correlation of .64 between husbands’ and wives’ reports of husbands’ drinking on the MAST short form. The results suggest that wives may be a reliable source of information regarding their husbands’ drinking habits, particularly on measures of drinking history (i.e., MAST responses). The high correspondence between respondent groups also supports the validity of husbands’ reports. Historically, the validity of self-reports by persons with high alcohol or drug use has been suspect (see discussions by Sobell, 1976; Van Hasselt, Milliones, & Hersen, 1981). However, the present data, along with results of other investigations (e.g., Maisto, Sobell, & Sobell, 1979; Sobell & Sobell, 1978) suggest that (a) alcohol abusers often given valid self-reports, and (b) the collection of information from collateral informants is an effective strategy for corroborating selfreports of drinking behavior. Our results also are consistent with previous studies (Fojtik, 1977-78; Labell, 1979; Rosenbaum & O’Leary, 1981; Star, 1978) with respect to alcohol use of wives. These investigations have yielded little evidence of problem drinking in abused wives. Such findings continue to raise serious doubts about the heuristic value of models of wife abuse that focus blame for marital violence on behavior patterns of the wife/victim. To date, no empirical data have been accrued with regard to alcohol use or other areas of

134

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B. VAN HASSELT

et al.

functioning (e.g., Labell, 1979; Morrison, Van Hasselt, & Bellack, 1981; Rosenbaum & O’Leary, 1981) to substantiate this contention. Rather, the findings underscore the need for more extensive examination of characteristics of physically abusive husbands to ascertain relevant etiological variables in marital violence. At this point there is a convergence of data indicating problem drinking in many physically abusive males. However, we agree with Straus (1972) that there are difficulties in positing alcohol use as a primary causative element in wife abuse. As Tinklenberg (1973) cogently states, violence “is usually the culmination of a series of interactions between individuals. Multiple factors operate interdependently to influence these interactions. . . . To think simplistically of violence as resulting from a specific cause such as the use of alcohol is erroneous” (p. 196). Additional research concerning the role of alcohol and its interactive effects with other factors (e.g., early experience of abuse, assertion deficits) in wife abuse clearly is warranted.

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