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

v Abstract

v Introduction

v Methods

v Results

v Discussion

v References

v Tables & Figures

Introduction

Substance use is a problem affecting many individuals and families. Previous studies have identified sober support as a predictor of substance use abstinence (Fiorentine & Hillhouse, 2003; Miller, Ninonuevo, Hoffman, & Astrachan, 1999), while low GAF scores have been found to be associated with mortality in substance use addicts (Fridell & Hesse, 2006).

Previous studies have found witnessing domestic abuse and psychological diagnoses to play a role in how much sober support an individual receives. A study in Spain found women who had been victims of intimate partner violence were less likely to receive social support compared to non-victims (Cases, et al., 2014). However, when a similar study was run in the United States, no differences in treatment engagement were found between women who did or did not have a history of intimate partner violence or post-traumatic stress disorder (Myers, Browne, & Norman, 2015). While these studies examine social support and treatment engagement among victims of intimate partner violence, similar relationships may exist among men who have witnessed domestic abuse regarding sober support, a form of social support and a common feature of treatment engagement and compliance. Attending 12-step meetings was found to be related to reduced depression scores, and abstinence from substance use (Worley, Tate, & Brown, 2012). However, no relationship was found between participants who did not have psychiatric symptoms and 12-step meeting attendance (Moggi, Ouimette, Moos, & Finney, 1999).

Furthermore, psych diagnoses and ASPD scores have been found to influence GAF scores. Previous research has found having a diagnosis of anxiety or depression is predictive of a lower GAF score, while adjustment or externalizing disorders, such as ASPD, were not (Bridges, et al., 2015). Substance use and having a personality disorder diagnosis have been found to have an inverse relationship to GAF scores (Gade, et al., 2015). In addition, a study by Hong and colleagues (2005) found negative relationships between nearly all personality disorders, including ASPD, from the DSM-III and GAF scores. However, once axis 1 diagnoses were controlled for ASPD scores were not found to have a relationships to GAF scores (Hong, et al., 2005). In addition, strong relationships were found between having a diagnosis of schizophrenia, bipolar disorder, or major depressive disorder and long term functioning (Gade, et al., 2015).

For the current study, it is hypothesized there will be a significant interaction between witnessing domestic abuse, having a psych diagnosis, and ASPD scores as they relate to sober support, such that individuals who witnessed domestic abuse will receive less sober support, while individuals with a psych diagnosis will receive no more sober support than those without a diagnosis. However, it is believed those with low ASPD scores will receive more sober support than both those with moderate and high ASPD scores, while those with moderate ASPD scores will receive more sober support than those with high sober support. Thus, it is hypothesized those who witnessed domestic abuse and have high ASPD scores will receive the least amount of sober support, regardless of psych diagnosis. Furthermore, it is hypothesized there will be a significant interaction between witnessing domestic abuse, having a psych diagnosis, and ASPD scores as they relate to GAF, such that individuals who witnessed domestic abuse will have a lower GAF than those who did not, individuals with a psych diagnosis will also have a lower GAF than those without, while levels of ASPD scores will not show significant differences in GAF. Thus, it is hypothesized those who witnessed domestic abuse and have a psych diagnosis will have the lowest GAF scores, regardless of ASPD score level.