Alcohol Use and Intimate Partner Violence with Meagan Brem

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Travis

What do you know about the relationship between alcohol consumption and intimate partner violence? In thinking about how I might answer that question, I can't help but realize that much of what I think about both of these topics and their intersection, I've gained simply from stories I've either heard from people or that I've seen play out in TV or movies, which as we all know, is probably not always the best source for information. So I was curious as to what's actually going on here. And thankfully, Virginia Tech's Meagan Brim has expertise at this very intersection and was kind enough to talk to me about it. Meagan is an assistant professor in the Department of Psychology at Virginia Tech, as well as the director of the REACH Lab, which stands for Research for Alcohol and Couples Health. Meagan and I chatted about what the data actually tells us about this intersection, what some common myths are about these topics, and what some of the current knowledge gaps are and what her lab is doing to help fill those. We also talked about some interventions we could take both on a societal and individual levels to help raise our awareness and hopefully decrease these occurrences. And Meagan shared what in this space gives her hope for the future. I'm Travis Williams, and this is Virginia Tech's Curious Conversations.

Travis

Well, I know that a lot of your work is at this interesting intersection between alcohol misuse and partner violence. And so I guess just to start off with, I'm curious because that seems to be a pretty common thing that I would see as being like agreeing with. I'm curious, what are the benefits to going and investigating and getting the hard data behind these situations?

Meagan

Well, I'm glad that that it seems like it makes sense to you. I, when I think about where I started, the first field that I worked in with intimate partner violence was in Austin, Texas at the National Domestic Violence Hotline. And actually the training that we had there in preparation for that role did not include any conversations around alcohol use. In fact, it was actively kind of discouraged that we reference alcohol use in relation to partner violence for various different reasons.

I think that there's a lot of myths sometimes that exist related to intimate partner violence that come from a lot of different places. So getting some of the hard data on what is the relationship between alcohol use and intimate partner violence? Is there a causal relationship? Is it simply correlational and impulsive people do impulsive things like drinking excessively and lashing out at their partners? we can use hard data to answer some of those questions. Over the past 30 years, we've seen research really support that excessive alcohol use meets all of the epidemiological criteria for causality. And yet, very few state mandated interventions for intimate partner violence, for example, like batterer intervention programs, very few of them actually include any components that explicitly focus on reducing excessive drinking. Similarly, if we look at college -based domestic violence or sexual violence prevention programming, those do not consistently focus on the roles of alcohol use. I think that because we have data that at this point show that there's a causal relationship there, we have data to show that alcohol use is at least as...much of a contributor to IPV as other causes like gender roles, anger, and relationship functioning. We really need to start thinking about refining some of our approaches to preventing intimate partner violence that includes the roles of alcohol use.

Travis

What's one of the biggest myths that you have encountered related to this topic?

Meagan

Gosh, well related to alcohol specifically?

Travis

Yes.

Meagan

Well, I'll use the example that was shared with me when I first started my training and it was I was specifically sort of instructed that alcohol use did not contribute to partner violence because people still know right from wrong whenever they're drinking. And the example, I mean a little bit crude example, but the example that they gave me was you can drink any amount of alcohol and you would never, for example, perpetrate sexual assault against your grandparent. Because even when you're intoxicated, you still kind of know not to do that.

And that made a lot of sense to me at the time. And I thought, yeah, alcohol use can't really be it. And it's true that alcohol use is neither necessary or sufficient for IPV from occurring. There's many folks who drink excessively and never go on to be violent. And there's many folks who are violent who don't drink. But that still doesn't mean that we should undermine the role that we now know that alcohol use does play and sort of pushing many folks over that threshold to where they're willing to perpetrate more severe forms of violence than they would otherwise perpetrate when they're not drinking. I

Travis

t's interesting that people didn't make the connection between alcohol and like decision -making because I feel like, I guess that's why when we started, was kind of like, this seems kind of like a no -brainer because I think that was always been in my mind that like alcohol, you may not make the best decisions when you're drinking, especially in excess.

Meagan

Yeah, yeah, no, that's exactly right. It's, it's the combination of not making the best decisions, right? We don't have full capacity of our prefrontal cortex when we're intoxicated. And it's also a myopic effect that alcohol has on our cognitive capacities and our attentional processes. So when we're intoxicated, we can really only process the most salient cues in our environment at any given time. So if the most salient cue in your environment is one that creates a really pleasant affective state, a lot of joy, a lot of happiness, then probably there's very little chance that you're gonna go on to perpetrate violence when you're drinking. But if the most salient cue in your environment is one that's going to put you in this really negative affective state, one that's going to evoke a lot of anger or stress or sadness or jealousy, then alcohol restricts your attention such that you really get tunnel vision on those salient cues at the expense of being able to process some cues that might dissuade someone from perpetrating violence or sexual assault against someone else.

Travis

Well, what are some of the current knowledge gaps that you all are trying to get more data about? So as I mentioned, in the past 30 years, we now have of established that alcohol has a clear causal and robust relationship with intimate partner violence perpetration. But we are still not clear exactly which processes we should target in different interventions. For instance, we don't know the most critical or the most potent kind of instigatory and inhibitory factors in any given incident that might increase the likelihood of someone perpetrating violence when drinking or decrease the likelihood of somebody perpetrating violence. To be able to get those kind of data, we need event level studies to be planned. So in my lab, we use something called ecological momentary assessment or EMA. And what that does is that it sort of alerts people to complete little surveys on their phones, like brief surveys, five minutes or less, multiple times a day throughout the day, so that we can capture what's happening before these events occur and after these events occur.

We can also capture drinking levels and or drug levels if we wanted to do that at the event level. So we can sort of tease apart, how was somebody feeling towards their partner, you know, in the two hours before this IPV event occurred, how much were they drinking in the hours leading up to this event occurring? So I think, you know, one of the clear gaps is if we are going to do more integrative alcohol informed intimate partner violence prevention, programs, then we're going to need to target some of these processes more clearly. We also are not really clear on how we can best tailor treatments to meet the needs of different types of dyads or partners who are experiencing IPV. Most of the research over the past 30 years has primarily drawn from samples of adult men and women who are in heterosexual relationships and cisgender individuals. We have most of the data right from those populations. It doesn't necessarily generalize to people who are in other kinds of relationships or who have other sexual or gender identities. know, notably we see higher rates of intimate partner violence and higher rates of drinking among LGBTQ plus populations. We see greater IPV related impacts, meaning more mental health symptoms and more resource needs within these populations after IPV. But we don't have good treatment options available to these populations because we don't know much about what IPD looks like in these non -heterosexual relationships. So I think that's a pretty notable gap that the field has been chewing on in recent years. And then there's another thing that sticks out to me in the field is that we've seen this large increase in legalization of cannabis and We don't really know how alcohol use interacts with different drugs to increase or perhaps even decrease the likelihood of IPV in these different situations. So we're probably going to have to do a little bit of figuring out as cannabis continues to be legalized in different areas.

Travis

Yeah, well, it sounds like that you all are trying to maybe get a large holistic picture of all the different factors and how they interplay when it comes to partner violence so that you can then figure out some preventative measures or the appropriate preventative measures.

Meagan

Right.

Travis

What have you all like, have you all gained any significant insights so far?

Meagan

Yes, we have. So as I mentioned, we're doing an EMA study right now. And what that looks like is we are recruiting. We've completed year one of recruitment, but we're going into year two of the study but we're recruiting heavy drinking college students who have told us that they have been aggressive towards a partner at least once in the past six months. And we're having them sign up for a study where they download an app on their phone that asks them questions four times a day. And also we give them portable breathalyzer so they can submit breath samples to us at three different times throughout the night. So that's gonna give us some objective data on exactly how intoxicated people are in relation to their IPV perpetration as well as victimization experiences. Because the study is ongoing, I don't have a clear answer in terms of the processes, but I do have some preliminary data that I could share if you're interested.

Travis

Yes, please.

Meagan

Yeah, okay. So in our first semester of recruitment, we recruited 36 college students. And remember, these are 36 college students that are just completing this study over a 30 day period. So it's really just sort of like a month snapshot into these individuals lives. These folks who drink heavily and have been violent towards their partner recently. Among these 36 participants, we captured 61 discrete IPV perpetration events and 104 victimization events.

More than half of the sample had perpetrated and or experienced IPV during that 30 day period. So it's a pretty alarming number, I think, when we think about our campus. We also saw that most of the intimate partner violence perpetration was happening before 7 p which was actually kind of surprising to me. I think by default, I imagine these events occurring in the evening after some drinking has happened. And we're seeing that most victimization is happening between 7 p and 11 p at night. So that maybe would follow drinking that has happened.

Travis

Yeah. Am I understanding the terminology correctly in that it sounds like that many of those folks had both been involved in being the person that's creating the violence, but also on the receiving end of the violence?

Meagan

Yes, yes. I'm actually really glad you asked that. that's another one of the myths that I like to dispel with folks. So there are certain samples where we do see a very clear perpetrator in the relationship and a very clear victim in the relationship. Those samples tend to be on the more severe end of the spectrum where we're seeing a lot of intimate partner terrorism. They also tend to be more justice -involved populations, so folks who've been arrested for domestic violence or other violent charges, as well as military populations. Those are the samples where we see a clear perpetrator and victim. But in college samples and in just general community samples, so non -treatment -seeking samples, we actually see that it's more likely for both partners to experience both perpetration and victimization.

 

So with these college students, yeah, we're seeing that they're reporting both perpetration and victimization at the daily level.

Travis

Wow, that is very enlightening as well as the timing of the day. found that interesting as well because generally I do think about those types of things maybe happening under the cover of darkness, I guess. So that is fascinating.

Meagan

Yeah, no, think it's great to know. We're only 36 participants into the study, right? We still have a whole other year to go, so it may change. But, you know, this is why I think it's important to collect these data to kind of dispel some of these myths or these images that we maybe have gained from media or stories or whatever about what intimate partner violence might look like. Having the data will provide real evidence on here's what it actually is looking like within this unique sample, at least.

Travis

Do you mentioned that one of the areas that has been a little has been understudied is relationships that fall under that LGBTQ plus umbrella? And so I'm curious what you all are doing related to that topic and that that area that population specifically.

Meagan

Yeah, I'm glad you asked. So this morning I actually received news that the NIH funded another study for our lab where we will be collecting the same kind of data across 60 days among adults who at least one member of the couple identifies as bisexual or multigender attracted. And instead of collecting data from just one person in the relationship, we're recruiting both partners to be involved in the study. So this is going to allow us to capture not just alcohol use and intimate partner violence within these couples, but we are going to be able to capture how supportive partners are towards one another before and after drinking. And we're also capturing different types of sexual minority stressors that these populations experience at the daily level. Specifically, we're asking about things like discrimination and harassment or threats of violence to their well -being. I think what I'm really excited about with this study is that it's going to show us just how common or prevalent this discrimination is for these couples and how it's impacting their drinking as well as their relationship health and intimate partner violence. I think it's also going to point to some very clear ways that we can try to refine our treatments for intimate partner violence to be more inclusive and target some of the unique needs of this population.

Travis

That sounds like it could be quite revealing as well. I'm curious when you do these studies, do you consider the time of year when you do them and specifically, I'm just thinking about like the holiday season and that I feel like that both excessive use of substances and possibly violence around times when there's holidays and there's family tension and stuff, maybe that could play a role. I don't know. I'm not a researcher, but I'm curious.

Meagan

 So it sort of depends on our sample with this population where it's not necessarily college students, it's adults. Then yes, absolutely. want to assess during these high risk times like the holidays when drinking and financial stress, other reasons for relationship conflict could arise. Within college samples though, it's a little bit trickier just because they're college students, they're oftentimes going home for holidays and events, and so they're not necessarily with their partners. So there's fewer opportunities for violence to happen. mean, there can still be obviously verbal and psychological violence that occurs over the phone or FaceTime or whatever it may be. But we're not going to have as many opportunities to capture instances of physical or sexual violence.

Travis

Okay. Well, looking at all this data, and I know that some of it's preliminary, some of it you're just starting, and it sounds like that you're right at the beginning of learning a lot more about this topic. But I'm curious, what are some things we could do at both an institutional or a societal level, and then maybe also at an individual level? But I guess first, maybe, what can we do at a societal level?

Meagan

That's a good question. I'm a psychologist, and so I often think about the individual level. But yeah, I do think that true prevention needs to come in a multi -pronged approach from different domains within society. I think we need to be more thoughtful about our scripts and the way that we talk about intimate partner violence being careful of when we're kind of succumbing to the myths that we believe about intimate partner violence rather than what the data tell us. For instance, right, when I talk about intimate partner violence and I teach a class on this each semester in the psychology department, I think it's pretty common language for people to refer to the male partner as an abuser and a female partner as a victim or survivor forgetting that there are different types of couples, that there are male -male dyads and female -female dyads and non -binary folks, and that we see that one in four men also experience intimate partner violence. We see pretty comparable prevalence of intimate partner violence across national samples of men and women in all categories of violence with the exception of sexual violence. So some of our interventions or prevention as a society needs to be around kind some of the stigma, some of the myths that exist. And changing the way that we think about alcohol in relation to being with a partner and having fun. We need to make sure that our young people are educated on the kind pharmacological effects of alcohol use and the impacts that alcohol use has on your ability to just make sense of stimuli in your environment.

For instance, I think can collectively as a society agree that sexual assault is not a good thing, right? We can kind of collectively agree that if you see something that looks like someone might be at risk that probably someone should intervene. And so we invest a lot of resources in this bystander intervention training, really training witnesses on how they can be good bystanders and go and help people who are in need. But you know what we don't know? We don't know if they remember those skills or know how to do that when they're intoxicated. So we might be spending a lot of time training people on how to do something and they're not able to access any of those skills when they're intoxicated. So think we're gonna need to collect more data on that and do a better job of integrating and thinking about how alcohol might make our intervention programs just less effective.

 

Travis

Yeah, that is that is some fascinating insight. I'd never thought about that. But if you if it impacts just the average person's ability to make decisions, that would go for your decision and your ability to help another person as well.

Meagan

Absolutely. Absolutely. You know, I like to add in the point at least to college students that I teach and work with that when we are drinking alcohol, we can't process and make sense of information in a way that's based in reality.

So for instance, we have experimental studies now that show intoxicated participants are less likely to detect when somebody in a video vignette is not invested in a sexual endeavor with a partner, right? Like they're giving subtle clues that they're not into it relative to sober participants, the intoxicated participants are overestimating how sexually invested their partner is and they're missing those cues that they're not excited about the sexual event happening. So to the extent that we want to protect our young people from perpetrating sexual assault, we're going to have to train them that you might be all about consent and you might have learned everything you need to know, but you're not going to be able to read that in the room when you're intoxicated.

Travis

Yeah, well, it sounds like a lot of what you just said could also be applied on an individual level. But what additional interventions might an individual take or what are the things can an individual do to help?

Meagan

So when I think at the individual level, I think about with, you know, how would I want to prepare my own child for these different situations when they were to, you know, emerge into young adulthood or into college? One of the things that I've been thinking about recently is that we don't, We don't really know what certain levels of intoxication feels like. Right, for instance, we know that we shouldn't drive after drinking to a point where we're at a 0 .08 or higher. But do people know what a 0 .08 feels like for them? Do they know what a 0 .05 feels like? You know, I think recently we've had these technology evolutions where we now have Access to really cheap and affordable portable breathalyzers you can carry on your key chain or you can carry in your pocket. They're like the size of a vape pen. It could probably be helpful for young people and alcohol naive folks who are just maybe starting to drink or who infrequently drink to get used to regularly kind of testing themselves and seeing what different levels of intoxication feel like and pairing that with learning exactly how that level of intoxication might impair their ability to function well in their relationship or manage conflict in their relationship.

Travis

Well, this topic, both of these topics, both alcohol misuse and also partner violence can be a little bit grim. So I'm curious when you're studying this topic, what in this area gives you hope?

Meagan

What gives me hope? I think that over the past few years, there's been a lot more cultural conversations around healthy relationships, toxic relationships, abusive relationships. And I'm seeing the young people, at least that I'm teaching here at Virginia Tech, I'm seeing them just be more willing to have conversations about this really kind of vulnerable topic, this really historically stigmatized topic. They're sharing with their friends, their experiences, their being bolder maybe in their assertion of what they want and don't want in their partners. We've also seen this increase in folks' willingness to take kind of sober alternatives to drinking, right, or sober alternatives to 21st birthdays, drinking mocktails instead of cocktails. And so I'm really hopeful that this younger generation will kind of change the trends and the ways that we've been talking and thinking about relationship safety and relationship health, as well as alcohol use, misuse and safety.

Travis

Thanks to Megan for talking to us about the intersection of alcohol consumption and intimate partner violence. If you or someone you know would make for a great curious conversation, email me at traviskw at vt .edu. I'm Travis Williams and this has been Virginia Tech's Curious Conversations.