Considering cumulative trauma among women who experience intimate partner violence: The impact on alcohol use

Background: Although an association between alcohol use and intimate partner violence is well established, less is known about the role of cumulative traumas in this relationship. Methods: This study utilizes demographic and interview data collected from 383 adult female participants enrolled in an on-going NIAAA-funded RCT of a brief motivational intervention with emergency department patients screening positive for IPV and heavy drinking. Participants were assessed for childhood sexual abuse utilizing questions from the Gender, Alcohol and Culture: An International Study (GENACIS) and for PTSD using the Primary Care Post-Traumatic Stress Disorder (PC PTSD) screener. We used standard descriptive statistics and logistical regression to control for demographics and other significant variables. Results: Of the 383 female ED patients, ninety participants (24%) were positive for both CSA and PTSD. Adjusting for demographics, women who were +CSA had 3.47 times (CI: 2.13-5.69) the odds of screening +PTSD than those -CSA. There was a statistically significant difference of mean drinking scores between participants +CSA (M=9.06, SD=8.67) and those –CSA (M=8.29, SD=5.69). A higher percentage of +CSA participants (19.4%) met criteria for alcohol dependence than –CSA (12.9%). Conclusion: CSA was an important predictor of PTSD symptoms among female ED patients who screened positive for IPV. Women who were positive for both IPV and childhood sexual abuse reported greater alcohol use and dependence than women who only screened for IPV. Incorporating strategies that address cumulative trauma may help to strengthen screening and intervention practices for women who have experienced IPV.