Alcohol Use after Combat-Acquired Traumatic Brain Injury: What We Know and Don't Know

Military personnel engage in unhealthy alcohol use at rates higher than their same age, civilian peers, resulting in negative consequences for the individual and jeopardized force readiness for the armed services. Among those returning from combat deployment, unhealthy drinking may be exacerbated by acute stress reactions and injury, including traumatic brain injury (TBI). Combat-acquired TBI is common among personnel in the current conflicts. Although research suggests that impairments due to TBI leads to an increased risk for unhealthy drinking and consequences among civilians, there has been little research to examine whether TBI influences drinking behaviors among military personnel. This article examines TBI and drinking in both civilian and military populations and discusses implications for clinical care and policy.     

The role of military culture in military organizations' responses to woman abuse in military families1

This paper reports on a study of the Canadian Forces' (CF's) response to woman abuse in military families which was conducted using institutional ethnography feminist methodology. A 20‐person multidisciplinary team conducted 126 semi‐structured interviews in four Canadian provinces with: (1) present and former civilian female partners of CF members, who were survivors of abuse [64]; (2) regional civilian and CF social service providers, and CF supervisory personnel [52]; and (3) National Defence Headquarters program administrators and generals in Ottawa [10]. Analyzing these interviews enabled us to identify and elaborate on some of the military social relations in which the experiences of military spouses who are woman abuse survivors are embedded. This paper discusses the difficulties created for military spouses by geographical transfers and military housing neighbourhoods, and establishes the crucial role played by the chain of command in military organizations' responses to spouses who have been abused. The paper then shows how military leaders, especially those who supervise combat units, respond to woman abuse in ways that reflect their participation in the hypervigilance and unit cohesion features of military culture. The paper concludes by reflecting on Western militaries' responses to woman abuse in military families in light of their responses to the events of September 11, 2001.     

EFFICACY OF FAMILY THERAPY FOR DRUG ABUSE: PROMISING BUT NOT DEFINITIVE

Drug abuse is an enormous public health problem with consequences not only for individuals using drugs but also for families, communities, and society. Moreover, research evidence and clinical experience agree that drug abuse is one of the more difficult problems to treat. Despite considerable research on the connection between family factors and drug use, and the existence of family therapy models for drug abuse, comparatively few controlled efficacy studies have been conducted. This article presents a critical review of controlled treatment outcome research in the area of family therapy for drug abuse in both adults and adolescents. A number of studies from different clinical research groups demonstrate that different versions of family intevention can engage and retain drug users and their families in treatment, significantly reduce drug use and other related problem behaviors, and enhace particular domains of prosocial functioning. Moreover, a smaller number of comparative efficacy studies have shown family therapy to be more effective than nonfamily therapies. Family therapy of adolescent drug abuse is more developed at present than family therapy of adult drug abuse. Although the results of the reviewed studies are promising, a blanket confirmation of family therapy's efficacy for drug abuse cannot be made at this time because of the relatively small number of studies and the noted methodological limitations of the studies published to date. Nonetheless, substantial progress in this clinical research area has occurred, and if research and funding support continue or can expand, significant breakthroughs in the treamtment of drug abuse with family-based treatments are possible.     

An intersectional approach to military sexual violence

Despite over 15 years of targeted prevention efforts in the U.S. military, incidence and prevalence rates of sexual violence have remained consistently high. While there has been an abundance of research on military sexual abuse, most studies have explored the issue through reporting isolated demographic variables that correlate with sexual violence vulnerability. However, intersecting oppressions based on race, gender, immigration status, class, sexuality, and other social locations produce diverse risks, experiences, and responses to sexual abuse. In the military context, factors such as branch, rank, unit, deployment status, and combat experience also shape experiences with and responses to sexual harassment and assault. This article argues for an intersectional approach to understand military sexual violence to better unpack the immensely varied sexual abuse experiences that service members may have. Additionally, prior research on the relationship between the military, masculinity, and sexual violence has often ignored the fluidity of masculinity and the myriad of ways in which gender, violence, and victimization are related. In advocating for an intersectional approach to research on military sexual violence, this article also challenges assumptions of a static military masculinity. Finally, an intersectional perspective can reveal the inadequacy of policies, practices, and research that assume a uniform victim experience.     

Educating women about the hidden dangers of alcohol

1. There is mounting research evidence that alcohol use and abuse affects women much differently than men. 2. Research indicates that women absorb and metabolize alcohol differently than men, partly due to body composition differences and the production of less gastric alcohol dehydrogenase by women. 3. Women of child-bearing age who engage in binge drinking are at increased risk of bearing children with fetal alcohol syndrome or alcohol-related neurological deficits. 4. Psychiatric nurses are often in the position to provide education and counseling to women regarding the hidden dangers of alcohol use and abuse.     

Reinstitutionalizing Families: Life Course Policy and Marriage in the Military

The transition to adulthood has become an increasingly telescoped process for Americans, with marital formation occurring increasingly later in the life course. It is therefore striking to find a context like the U.S. military, in which marriage rates bear an anachronistic resemblance to those of the 1950s era. Using narrative data from life history interviews with military affiliates, the authors show that the military has reinstitutionalized military families at the same time that civilian families are becoming deinstitutionalized. Structural conditions of modern military service, such as war deployment and frequent geographical relocation, have created policies that rely on families to make these conditions more bearable for military personnel. These policies are part of an overarching institutional culture that directly and indirectly promotes marriage. The authors bring together life course literatures on turning points, the welfare state, and linked lives to show how the military has reinstitutionalized families in these ways.     

Work-related upper extremity injuries: prevalence,cost and risk factors in military and civilian populations

Persons with musculoskeletal-related disorders represent a prevalent source of outpatient visits, lost work time and disability in the military; however, research concerning the extent of work-related upper extremity disorders (WRUEDs) within this population is lacking. This literature review examined studies in civilian and military settings to ascertain the prevalence, cost and risk factors associated with WRUEDs. The results indicated that the prevalence and cost of WRUEDs in the civilian workforce are significant, justifying the need to research the military population. The literature also outlined physical, individual and psychosocial factors associated with WRUEDs that will help identify potential risk factors within military occupations.     

Belonging: women living with intellectual disabilities and experiences of domestic violence

Women with an intellectual disability are under-represented in domestic violence research, yet they are one of the most vulnerable groups who are at risk of violence and abuse. This article aims to contribute to the domestic violence field by reporting on a narrative dialogic performative study, which utilised a feminist poststructural perspective to explore significant relationships and the concept of belonging in the lives of women with a mild intellectual disability. Four in-depth narrative interviews were conducted. The study found that the women shared similar stories of devaluation and rejection in childhood and hence the women’s search for belonging contributed to their vulnerability to exploitation and abuse in domestic violence relationships. The paper argues that gendered discourses and constructions of intellectual disability regulate domestic violence as a personal problem or way of life for women with intellectual disabilities.     

Partner Abuse Among Women Whose Children Have Been Sexually Abused: An Exploratory Study

ABSTRACT

To explore partner abuse among women in families in which a child has disclosed sexual abuse, 102 mothers completed a measure of partner abuse and the Coping Responses Inventory. Results suggest that, like women in the general population, mothers of children who have been sexually abused have often experienced partner abuse. As expected, physical abuse in a current relationship was found to be related to the use of avoidance strategies in dealing with the sexual abuse disclosure. The implications for practitioners and for future research are discussed.     

Suffering in the Shadows: Interviews with Wives of Combat Veterans Suffering from Post-Traumatic Stress Disorder and/or Traumatic Brain Injury

The body of research examining issues confronting combat veterans of the Afghanistan and Iraq wars continues to grow. However, this research focuses primarily upon veterans with very less attention given to the challenges confronting their spouses. Using a semi-structured interview methodology and a feminist perspective, this study examines what it means to be a wife of a combat veteran who suffers from post-traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI). Our findings indicate these women—who experience tremendous emotional, financial, and social challenges that arise from being the caregiver for their husbands—feel isolated from and abandoned by both the military community and the civilian community. Furthermore, the social and emotional disconnection of these women experience amplify the stresses they confront in daily life—stresses that are unique to their relationship to being with a combat veteran spouse who has PTSD and/or TBI. We argue future research should build upon this exploratory study to better understand how both the military community and the civilian community impact the subjectivity of these women and their efforts to reintegrate themselves and their families into civilian life.     

Domestic violence and women with disabilities: locating the issue on the periphery of social movements

Women with disabilities, like non‐disabled women, are at risk of experiencing abuse perpetrated by those closest to them. This paper reviews what is known about the domestic abuse of disabled women, explores some of the dynamics of that abuse and considers why this issue has not been high on the agenda of either the movement against domestic violence or the disabled people’s movement in the UK, taking into consideration several points that disabled women have raised. In doing so it focuses on the concept of compound oppressions as a potential explanation for the failure of this problem to have widespread recognition as a social issue.     

Do Child Abuse and Interparental Violence Lead to Adulthood Family Violence?

The cycle of violence posits that victimized children grow up to victimize others. Three forms of the cycle have never been tested: whether exposure to physical victimization and interparental violence additively or interactively increase risk for adulthood (a) child abuse perpetration; (b) partner abuse perpetration; or (c) partner abuse victimization. These hypotheses were tested in a nationally representative data set (1985 National Family Violence Survey) comprising 6,002 participants. Dually exposed, compared to singly exposed, women had significantly increased risk for adulthood family violence. Frequency of family‐of‐origin violence predicted adulthood child and partner abuse through both main and interactive effects.     

Domestic Violence and Intergenerational Rates of Child Sexual Abuse: A Case Record Analysis

Using case review at a shelter for battered women and their children, this exploratory study investigated the association between physical abuse, exposure to domestic violence and intergenerational occurrence of child sexual abuse. The charts of 570 children were reviewed in an attempt to explore the relationship between the children's experiences with sexual abuse and their nonoffending parent's own history of having been sexually abused. Results indicated that a significant percentage of nonoffending parents who reported a history of child sexual abuse also had children who were sexually abused. Additionally, we found that most (93%) of the children studied had been exposed to domestic violence, and while the base rate of sexual abuse was relatively low (11%), the rate of physical abuse of the children was substantial (41%). Logistic regression results indicated that children of sexually abused nonoffending parents may be at heightened risk for sexual abuse. Implications for treatment and intervention are discussed.     

Status Compatibility,Physical Violence,and Emotional Abuse in Intimate Relationships

This article analyzing national data (N = 7,408) examines the connection between men's and women's relative economic contributions in families and the risk of husband‐to‐wife physical violence and emotional abuse. Family violence researchers have conceptualized the association between economic variables and the risk of intimate partner violence with respect to the structural dimensions of sociodemographic factors, whereas feminist researchers connect economic power to family dynamics. Marital dependency and stress frustration theories treat income, education, and employment as socioeconomic resources, whereas some feminist research points to the need for research that treats these economic variables as symbolic resources. Although income and educational attainment reduce women's risk of physical violence and emotional abuse by husbands, I find that status incompatibilities between partners that favor women increase the likelihood of emotional abuse.     

Multiple forms of violence and other criminal activities as an indicator of severe child maltreatment

Child protection practice still appears to view child maltreatment as an event largely isolated from other family violence and criminal activities. Research undertaken by the authors suggests that children who have been subjected to the more severe forms of abuse are likely to have come from families who engage in several forms of criminal activity, inside and outside the family, which is often severe in nature. The child who has been maltreated may also become a participant in these activities. The authors recommend that these factors should be investigated in families who have maltreated a child, as the presence or absence of several forms of concurrent violence and other criminal activity may provide an important clue about the welfare of the child. Copyright © 2004 John Wiley & Sons, Ltd.     

A review of research on women's use of violence with male intimate partners

This article provides a review of research literature on women who use violence with intimate partners. The central purpose is to inform service providers in the military and civilian communities who work with domestically violent women. The major points of this review are as follows: (a) women's violence usually occurs in the context of violence against them by their male partners; (b) in general, women and men perpetrate equivalent levels of physical and psychological aggression, but evidence suggests that men perpetrate sexual abuse, coercive control, and stalking more frequently than women and that women also are much more frequently injured during domestic violence incidents; (c) women and men are equally likely to initiate physical violence in relationships involving less serious "situational couple violence," and in relationships in which serious and very violent "intimate terrorism" occurs, men are much more likely to be perpetrators and women victims; (d) women's physical violence is more likely than men's violence to be motivated by self-defense and fear, whereas men's physical violence is more likely than women's to be driven by control motives; (e) studies of couples in mutually violent relationships find more negative effects for women than for men; and (f) because of the many differences in behaviors and motivations between women's and men's violence, interventions based on male models of partner violence are likely not effective for many women.     

Resources,Family Organization,and Domestic Violence Against Married Women in Minya,Egypt

I evaluate the influence of household wealth, women's socioeconomic dependence, status inconsistency, and family organization on physical abuse in the prior year and attitudes about wife abuse and divorce among 2,522 married women in Minya, Egypt. Household wealth is negatively associated with physical abuse. Women who are dependent on marriage because they have sons and less schooling than their husbands are more likely to have experienced physical abuse and to report marginally more tolerance for such abuse. Women who are isolated from natal or biological kin and living with marital relatives are more likely to have experienced physical abuse. Findings underscore the role of women's dependence and social isolation in enabling physical abuse among women of all economic classes.     

Family formation among women in the U.S. military: Evidence from the nLSY

Although female employment is associated with lower levels of completed fertility in the civilian world, we find family formation rates among U.S. military women to be comparatively high. We compare enlisted women with civilian women using the National Longitudinal Survey of Youth (N = 3,547), the only data set to measure simultaneously the nuptiality and fertility of both populations. Using propensity score matching, we show that the fertility effect derives primarily from early marriage in the military, a surprisingly “family‐friendly” institution. This shows that specific organizational and economic incentives in a working environment may offset the more widespread contemporary social and economic factors that otherwise depress marriage and fertility.