Witnessing domestic abuse, diagnoses, and
antisocial traits among substance users: Relationships relating to sober
support and the global assessment of functioning
Madeline J Schlosser 
University of Nebraska-Lincoln
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Abstract
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Methods
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Results
Discussion
As hypothesized, a significant three-way interaction was found between witnessing domestic abuse, psych diagnosis, and level of ASPD scores. Furthermore, for those who witnessed domestic abuse and had no psych diagnosis, significant differences in sober support were found between those with low ASPD scores and those with high ASPD scores, such that those with high ASPD scores received more sober support, which was contrary to the research hypothesis that sober support would decrease as level of ASPD score increased. In addition, for those who witnessed domestic abuse and had a psych diagnosis, significant differences in sober support were found between those with low to moderate ASPD scores, such that those with low ASPD scores reported more sober support, which was supportive of the research hypothesis. An interaction was not found between witnessing domestic abuse and psych diagnosis, and psych diagnosis and ASPD scores. However, a significant interaction was found between witnessing domestic abuse and ASPD scores such that, for those who witnessed domestic abuse, a significant difference in sober support was found between those with moderate and high ASPD scores, with those with high ASPD scores receiving more support. These results were quite interesting, as an opposite trend was hypothesized among levels of ASPD and sober support. It is possible that counselors encouraged those who were higher in ASPD to seek additional sober support due to their antisocial nature.
As hypothesized, no significant difference was found in sober support between those with and those without a psych diagnosis. This was similar to the findings of Moggi and colleagues (1999) who found no relationship between 12-step meeting attendance and psychiatric symptoms. Contrary to the research hypotheses that witnessing domestic abuse and higher ASPD scores would show decreases in sober support, the simple effects of witnessing domestic abuse and ASPD scores were not found to be significant.
Contrary to the research hypothesis that there would be a significant three-way interaction between witnessing domestic abuse, psych diagnosis, and ASPD scores as they relate to GAF change, no significant interaction was found. It was surprising to find that there was no significant three-way interaction between the independent variables and GAF change, due to the significant three-way interaction found between the variables as they relate to sober support, and the high correlation between sober support and GAF. Furthermore, no significant two-way interactions were found between the independent variables as they related to GAF change. As hypothesized, no significant difference was found in GAF change between those with low, moderate, and high ASPD scores. This result is similar to the finding of Hong and colleagues (2005) who found no relationship between ASPD scores and GAF once axis one diagnoses were controlled for. However, contrary to the research hypothesis that witnessing domestic abuse and psych diagnosis would show lower GAF changes, no differences were found between those who did or did not witness domestic abuse, and those who did or did not have a psych diagnosis.
Implications
Among those who witnessed domestic abuse, it appears that those with moderate ASPD scores may be slipping through the cracks, so to speak, because they are not deficient in social skills, yet they may not be as sociable as those with low ASPD scores, and thus less likely to attend AA meetings and other sober support meetings. Administrators, healthcare providers, and especially mental health care providers should make sure those with moderate ASPD scores are receiving the amount of sober support that they need in order to successfully complete treatment and improve functioning.
Limitations
Causality could not be inferred due to the design and lack of experimental conditions in the current study. Furthermore participants volunteered to take part in the study, which may have led to a self-selection bias, such that individuals who were higher in ASPD scores may have been less likely to volunteer in the study. Another limitation in the study stems from the need for participants to self-report their mental health and trauma history. Individuals may have reported self-diagnoses, or may have failed to report any documented mental illness, thus leading to under or over reporting. In addition, there was no formal definition of what it meant to witness domestic abuse. If a participant wished to clarify what it meant to witness domestic abuse, a concise, empirical definition could not be provided. Furthermore, participants did not have an opportunity to describe if they were simply a by-stander during the domestic abuse or if they were an active party in the abuse, either as a victim or perpetrator. Finally, number of times domestic abuse was witnessed was not coded for, which may have allowed for further analyses.
Future Research
Future studies should see if differences in sober support and GAF differ by whether or not participants have comorbid substance use and severe mental illness disorders. One study found 12-step meeting attendance can be increased among those with comorbid severe mental illness and substance use disorders when the 12-step meetings are modified specifically for individuals with comorbid diagnoses (Bogenschutz, 2005). In addition, future studies should investigate why those with low and high ASPD scores reported more sober support than those with moderate ASPD scores.