Over-arousal as a Mechanism Between Alcohol and Intimate Partner Violence

Intimate partner violence (IPV) is a significant public health problem for which there are
currently no effective treatments. Alcohol use is present in most instances of IPV and is
associated with an increase in the frequency and severity of IPV. The investigators believe
that alcohol may be related to the increase in frequency and severity of IPV through a
process of over-arousal that results from the cortically and psychophysiological arousing
effects of alcohol during the ascending limb of intoxication and at peak Blood Alcohol
Concentration (BAC) compounded by the unique behavioral and affective patterns of violent
couples. The first aim of the proposal is to determine if increases in arousal after alcohol
exposure is potentiated by evocative partner stimuli and is greater for distressed violent
(DV) partners than distressed nonviolent (DNV) partners. A second aim is to determine if
alcohol induced arousal interferes with DV partners' ability to regulate emotion in response
to evocative partner stimuli compared to DNV partners. The proposed study is an experimental
comparison of the effects of alcohol on arousal and emotion regulation between 35 DV and 35
DNV partners. One partner from each DV couple will be pseudo-randomly selected and yoked to a
DNV partner of the same sex and comparable relationship satisfaction for participant in the
experiment. To test the overall hypothesis that over-arousal is a mechanism through which
alcohol is associated with increases in the frequency and severity of IPV, the selected
partners will participate in a counter-balanced placebo session and an alcohol administration
session during which electroencephalography (EEG), psychophysiology and pupillary response
measurements of arousal will be collected during an emotion regulation task. The data will be
analyzed using a repeated measures ANOVA with a between-subjects factor. The investigators
expect that DV partners will experience significantly greater arousal than DNV partners
during the evocative stimuli condition. The investigators also expect that DV partners will
experience greater difficulty regulating emotion during evocative stimuli than DNV partners
and that this effect will be compounded during the alcohol administration condition. Findings
from this study will provide firm evidence that alcohol is associated with IPV through a
mechanism of over-arousal and provide key targets for intervention to prevent future IPV. The
data from the current proposal will be used to test biofeedback as an adjunct to a novel
behavioral intervention to reduce drinking and increase behavioral flexibility in couples
with a history of IPV.

Inclusion Criteria:

- English-speaking

- Heterosexual,

- Be in a distressed relationship

- consume at least one to two alcoholic drinks per sitting each week for females and
three to four alcoholic drinks for males

- report two binge drinking episodes (>4 drinks for males, >3 drinks for females) in
month prior to assessment

- be married or cohabitating for at least six months

- both partners must be willing to participate

- must have a breath alcohol level of 0.0 g% at all visits.

- Distressed Violent couples must have a history of at least mild physical aggression in
the past six months (e.g.,twisted partner's arm or hair).

Exclusion Criteria:

- currently separated

- an order of protection in place

- facing violence-related criminal charges

- currently in a domestic violence shelter

- evidence of psychosis or severe personality disturbance

- pregnant

- taking a medication contraindicated for use with alcohol

- currently taking insulin or oral hypoglycemic medication,

- an AUDIT score greater than 19 indicating dependent drinking

- illicit drug use (except marijuana)

- provide a positive urinalysis at first emotion-regulation session