268 JOURNAL OF STUDIES ON ALCOHOL AND DRUGS / MARCH 2012
Husband and Wife Alcohol Use as Independent or
Interactive Predictors of Intimate Partner Violence
MARIA TESTA, PH.D.,a,* AUDREY KUBIAK, M.A.,a BRIAN M. QUIGLEY, PH.D.,a REBECCA J. HOUSTON, PH.D.,a
JAYE L. DERRICK, PH.D.,a ASH LEVITT, PH.D.,a GREGORY G. HOMISH, PH.D.,a,b AND KENNETH E. LEONARD, PH.D.a,c
aResearch Institute on Addictions, University at Buffalo, Buffalo, New York
bSchool of Public Health and Health Professions, University at Buffalo, Buffalo, New York
cDepartment of Psychiatry, University at Buffalo, Buffalo, New York
ABSTRACT. Objective: Men’s heavy drinking has been established as
a risk factor for their perpetration of intimate partner violence (IPV);
however, the role of women’s drinking in their perpetration of IPV is less
clear. The current study examined the relative strength of husbands’ and
wives’ alcohol use and alcohol dependence symptoms on the occurrence
and frequency of husbands’ and wives’ IPV perpetration. Method: Mar-
ried and cohabiting community couples (N = 280) were identifi ed and
recruited according to their classifi cation in one of four drinking groups:
heavy episodic drinking occurred in both partners (n = 79), the husband
only (n = 80), the wife only (n = 41), and neither (n = 80). Husband and
wife alcohol consumption, alcohol dependence symptoms, and IPV
perpetration were assessed independently for both partners. Results:
Husband and wife consumption and alcohol dependence symptoms
contributed to the likelihood and frequency of husband IPV, both inde-
pendently and interactively. Husband, but not wife, alcohol dependence
symptoms contributed to the occurrence of any wife IPV , although both
partners’ alcohol dependence symptoms predicted the frequency of wife
aggression. Couples with discrepant drinking were not more likely to
perpetrate IPV . Conclusions: Findings for husband IPV support previous
research identifying alcohol use of both partners as a predictor. However,
for wives, alcohol appears to play less of a role in IPV perpetration,
perhaps refl ecting that women experience less inhibition against physical
aggression in their intimate relationships than do men. (J. Stud. Alcohol
Drugs, 73, 268–276, 2012)
Alcoholism Grant R01 AA016829 (to Kenneth E. Leonard).
*Correspondence may be sent to Maria Testa, Research Institute on Ad-
dictions, University at Buffalo, 1021 Main Street, Buffalo, NY 14203, or via
email at: firstname.lastname@example.org.
Received: June 10, 2011. Revision: October 5, 2011.
This research was supported by National Institute on Alcohol Abuse and
their perpetration of intimate partner violence (IPV;
Foran and O’Leary, 2008; Lipsey et al., 1997). Signifi cant
cross-sectional relationships between alcohol use and IPV
have been observed among representative community or
household samples (Kantor and Straus, 1989; White and
Chen, 2002), people seeking primary or emergency medical
care (Coker et al., 2000; Kyriacou et al., 1999), and couples
in which the husband is seeking alcohol treatment (O’Farrell
et al., 2003).
Because IPV was initially conceptualized as involving
male-to-female violence (Straus and Gelles, 1986), fewer
studies have considered female-perpetrated IPV. In a recent
meta-analysis of alcohol and IPV, there were only 8 studies
that considered female-perpetrated IPV compared with 47
studies that examined male-perpetrated IPV (Foran and
O’Leary, 2008). This meta-analysis concluded that the
effect size for men’s alcohol use and perpetration of IPV
was signifi cant and of medium size, whereas for women
the effect was small, based on a limited number of studies.
More research considering women’s perpetration of IPV
SUBSTANTIAL BODY OF RESEARCH INDICATES
that men’s alcohol use and alcohol problems predict
would increase confi dence regarding the role of women’s
alcohol use in their perpetration of IPV . However, examining
women’s alcohol use separate from the alcohol use of their
male partners poses diffi culties because of the associations
between men’s and women’s drinking. That is, on average,
men drink more than women (Keyes et al., 2008), resulting
in many couples in which the husband but not the wife is
a heavy or problematic drinker. In contrast, most heavy
drinking women are married to heavy drinking men
(Leonard and Eiden, 1999), making it diffi cult to isolate the
effects of a woman’s alcohol use on her perpetration of IPV
separate from the effects of her partner’s use.
Although it is typical to consider alcohol use as a
precursor to one’s own perpetration of aggression (Ito et
al., 1996), one partner’s alcohol use may also increase the
likelihood that the other partner will perpetrate IPV . Several
studies have shown an association between women’s alcohol
use and experiencing victimization, that is, male-to-female
IPV (Golinelli et al., 2009; Kantor and Asdigian, 1997;
Lipsky et al., 2005). White and Chen (2002) also found
an association between male partner problem drinking and
female IPV perpetration; in fact, male partner drinking fully
mediated the effect of female problem drinking on female
IPV perpetration. A heavy drinking partner may increase
relationship stress, thereby contributing to the other partner
behaving aggressively (Leonard, 2000). There is also limited
evidence suggesting that the interaction of husband and wife
drinking may be important to consider. Longitudinal studies
suggest that couples in which partners’ drinking patterns are
TESTA ET AL. 269
discrepant experience greater declines in marital satisfaction
compared with those with congruent drinking, even after
controlling for heavy drinking (Homish and Leonard, 2005,
2007). Accordingly, discordant drinking has been associated
with physical aggression after accounting for the effects of
drinking level (Leadley et al., 2000).
Another important issue in examining the effect of
alcohol use on IPV involves the type of alcohol measure
used. Measures range from quantity and/or frequency of
consumption to measures of alcohol problems, abuse, or
dependence. Some have suggested that the effects of alcohol
consumption are not linear, but rather are more consistent
with a threshold effect, whereby only high or problematic
levels are associated with the perpetration of IPV (Leonard,
2008; O’Leary and Schumacher, 2003). In their meta-
analysis, Foran and O’Leary (2008) found that effect sizes
were signifi cantly larger for studies using measures of
alcohol consequences compared with measures of alcohol
The current study was designed to examine the role of
alcohol consumption and alcohol dependence symptoms
in predicting husband-to-wife and wife-to-husband IPV
within a community sample of couples. As noted above,
examining the independent effects of women’s drinking
poses challenges because of the relative rarity of couples
in which the wife but not the husband is a heavy drinker.
Consequently, in recruiting the current community sample,
we deliberately oversampled couples in which (a) the wife
but not the husband met criteria for heavy episodic drinking
(HED), (b) the husband but not the wife met criteria for
HED, and (c) both husband and wife met criteria for HED.
We hypothesized that the alcohol dependence symptoms of
each partner would contribute to the likelihood of husband-
to-wife and wife-to-husband physical aggression. We also
considered separately whether the alcohol consumption of
each partner positively predicted both husband and wife
IPV. Prior research suggests that alcohol dependence is
likely to be a stronger contributor to IPV than consumption
(Foran and O’Leary, 2008). Finally, we also considered the
interaction between husband and wife alcohol consumption
and husband and wife dependence symptoms, allowing us to
determine whether a discrepancy between partners’ drinking
increases the likelihood or frequency of physical aggression
(Leadley et al., 2000).
via a mailed survey of health behaviors in the community.
Using a list of residents that was developed by Survey
Sampling International (Shelton, CT) and largely based
on public phone records with information supplemented
A community sample of couples (N = 280) was recruited
from other databases, we identifi ed households in Erie
County, NY, likely to contain a married couple between
the ages of 18 and 45 years. We mailed 21,000 screening
questionnaires to these households. The letter accompanying
the questionnaire indicated that the purpose of the study was
to help us estimate the number of different kinds of families
and to determine eligibility and interest in participating in
research on families and health. Based on a pilot study that
indicated a 10% improvement in return rates (Homish and
Leonard, 2009), we included a nonconditional $1 incentive
in the questionnaire and provided a stamped envelope to
return the questionnaire. We received 5,463 responses, for a
26% response rate (226, or about 1%, were returned because
of an incorrect address). Of the 5,463 responses, 10.7% were
minorities, with 7.6% being African American, similar to
census data for married couples in Erie County (i.e., 90%
White, 6% African American; U.S. Census Bureau, 2009).
The purpose of the mailed questionnaire was to assess
eligibility criteria and to determine husband and wife HED
status. Couples were eligible if they were between the ages
of 18 and 45 years and married or living together as married
for at least 1 year. Because one aim of the study involved
executive cognitive functioning, we excluded couples if
either member had a current medical condition that would
impair executive cognitive functioning or if either reported
having had a seizure or epilepsy or a 10-minute loss of
consciousness because of an accident or head injury. To
ensure adequate numbers of heavy drinking husbands and
wives, we used disproportionate sampling to recruit couples
in which either the husband or the wife, both, or neither
engaged in regular HED. HED was defi ned as engaging in at
least weekly consumption of fi ve or more drinks at one time
for men (four drinks for women) or becoming intoxicated
at least weekly. Our goal was to recruit 75 couples in each
of four groups: (a) husband and wife both engaged in HED
(Both), (b) only the husband engaged in HED (Husband
Only), (c) only the wife engaged in HED (Wife Only), and
(d) neither engaged in HED (Control).
Of the 5,463 responses, 3,477 met eligibility criteria. Of
those meeting eligibility criteria, three quarters (75%) of the
couples were Controls. The prevalence of Husband Only, Wife
Only, and Both were 12.3%, 4.1%, and 8.5%, respectively. We
also asked whether the couple was interested in participating
in one of our ongoing studies, interested in hearing more
about the study, or not at all interested. Across the four
groups, 68% (N = 2,347) were interested in participating or
hearing more about the studies. Surprisingly, the proportion
of those who were interested was signifi cantly higher for
Husband Only (72%), Wife Only (74%), and Both (76%)
than for Control (67%), χ2(3) = 16.32, p < .01. We sampled
from the four groups at different rates to achieve the goal of
75 couples in each of the four groups. This disproportionate
sampling was by design and has implications for our data
analyses. We were able to recruit 80 Control, 80 Husband
270 JOURNAL OF STUDIES ON ALCOHOL AND DRUGS / MARCH 2012
Only, 79 Both, and 41 Wife Only couples. This was a 43%
success rate from those we attempted to recruit, a rate that
did not differ across the four groups, χ2(3) = 2.78, p > .40.
This indicates that the diffi culty that we experienced fi lling
the Wife Only cell refl ected the rarity of this group in the
population and not any difference in willingness to participate
among these couples.
The average age of the fi nal sample was similar between
husbands and wives (36.9 years, SD = 5.8, and 35.4, SD =
5.9, respectively). The majority of men and women in the
sample were White (91% each). They were well educated
(58% of husbands and 67% of wives had completed a
college education compared with 39% for the county), and
most were employed at least part time (91% of husbands and
80% of wives). The majority of couples were married (87%)
as opposed to cohabiting, for an average of 9.84 years (SD =
5.41). Approximately 79% had children. Among those with
children, 15% had one child, 38% had two, 19% had three,
and 7.5% had four or more children. The median income for
wives was in the $20,000–$29,999 range, and the median
income for husbands was in the $40,000–$54,999 range,
making the median household income somewhat higher than
that for the county ($52,000).
participate in the research. Before attending a laboratory
assessment, each partner independently completed a series
of questionnaires sent and returned through the mail. Mailed
questionnaires, sent separately to the husband and wife,
consisted of background information, attitudes and beliefs
about alcohol, and personality measures. These measures
were included in the mailed questionnaires because they
were not particularly sensitive for the participants to answer
and hence were unlikely to precipitate marital confl icts.
Participants were instructed to complete the questionnaires
independently and not to discuss the questionnaires until
both had been returned. After return of the questionnaires,
couples were scheduled for an in-person assessment.
At this laboratory assessment, partners independently
completed computerized questionnaires that addressed
relationship issues and alcohol and drug use. In addition,
we administered measures of executive cognitive functioning
and conducted a semistructured face-to-face interview
regarding one or more episodes of confl ict. Participants were
assured that their responses were confi dential and would not
be shared with their partners. Only measures relevant to the
present analyses are described below.
Participants provided written informed consent to
IPV over the past 12 months was assessed using the physical
Intimate partner violence. Husband- and wife-perpetrated
aggression subscales of the revised Confl ict Tactics Scales
(CTS2; Straus et al., 1996). Each partner reported on the
frequency of 12 aggressive acts perpetrated by him/herself
(e.g., “I slapped my partner”) and the same 12 acts as
perpetrated by his/her partner (“my partner slapped me”).
The frequency of each act was recorded using the following
scale: never (0), once (1), twice (2), 3–5 times (3), 6–10
times (4), 11–20 times (5), and more than 20 times (6).
Following standard scoring procedures (Straus et al., 1996),
these values were converted to the number of acts based on
the midpoints of each category: 0, 1, 2, 4, 8, 15, and 25.
The number of acts was then summed to create separate
perpetration and victimization subscales, as reported by the
husband and wife. Because severe violence perpetration
and victimization were rarely reported, we opted to combine
minor and severe physical aggression items to create a single
IPV score. As expected, the CTS2 scores were positively
skewed. To reduce skewness, outliers were Winsorized by
recoding extremely high values to the next highest value in
the distribution (Reifman and Keyton, 2010).
Alcohol consumption. Respondents were asked about
their typical quantity and frequency of consumption of beer,
wine, and distilled spirits over the past 12 months. First, for
each type of drink, the respondent reported the frequency of
consumption using a 9-point scale ranging from not at all
(0) to every day (9). We used the beverage with the highest
frequency score as a measure of frequency of consumption.
For each beverage consumed, the respondent indicated the
typical quantity of consumption, using a 10-point scale
ranging from 1 drink to 18 or more drinks. We used the
highest typical number of drinks reported, whether for beer,
wine, or distilled spirits, as a measure of quantity.
Alcohol dependence. The 25-item Alcohol Dependence
Scale (ADS; Skinner and Horn, 1984) was used to assess
self-reported occurrence of symptoms such as blackouts
and seeing things that were not really there. As expected, the
distribution of ADS scores was highly skewed, with 41.9%
of men and 55.2% of women reporting ADS scores of 0 but
just 4.7% of men and 1.9% of women scoring greater than
9. Scores were Winsorized to reduce the impact of extremely
Demographics. Information collected from each
partner included age, race, years married and/or years
living together, number of children living in the home,
and education. Partner reports of age (r = .83), total years
living together (r = .96), and number of children living in
the home (r = .97) were highly correlated. To reduce the
number of control variables in the analyses, we used the
maximum report of the number of children (coded as 0, 1,
2, 3, 4 or more) and years together and the average couple
age. Husband and wife education (r = .53) were entered
separately as control variables. Because the vast majority
of couples were White and married, we did not use race or
marital status as covariates.
TESTA ET AL. 271
Agreement between partner reports of intimate partner
in husband (M = 1.09, SD = 3.29) versus wife (M = 0.92,
SD = 2.52) reports of wife-perpetrated IPV, t(279) = .94,
p = .35. Nor were there differences in husband (M = 0.56,
SD = 2.02) versus wife (M = 0.72, SD = 2.55) reports of
husband-perpetrated IPV, t(279) = -.92, p = .36. Husband
and wife reports of wife-perpetrated IPV were signifi cantly
but modestly correlated (r = .43, p < .001), as were husband
and wife reports of husband-perpetrated IPV (r = .28, p <
Collapsing CTS2 subscales to determine whether any IPV
was reported, 191 partners agreed that there was no wife-
perpetrated IPV, 43 agreed that there was wife-perpetrated
IPV, and 25 women and 21 men reported wife-perpetrated
IPV that was not corroborated by the partner. Similarly, 216
couples agreed that there was no husband-perpetrated IPV,
24 agreed that there was husband-perpetrated IPV, and 22
wives and 18 husbands reported husband-perpetrated IPV
that was not corroborated by the partner. Previous research
has suggested that women are more likely to report IPV
than men and that victims are more likely to report IPV
than perpetrators (Archer, 1999; Heyman and Schlee, 1997;
Schafer et al., 2002). To test whether the proportion of
husbands reporting wife-perpetrated IPV differed from the
proportion of wives reporting wife-perpetrated IPV , we used
McNemar’s test. This test was not signifi cant, χ2(1) = 0.196,
p = .66, indicating that husbands and wives were equally
likely to report wife-to-husband IPV . Likewise, there was no
bias in the proportion of husbands versus wives reporting
versus not reporting husband-to-wife IPV, χ2(1) = 0.23, p
= .64. Because of the absence of systematic bias in partner
reports and a desire to minimize underreporting thought to
occur with IPV, all subsequent analyses use the maximum
report of husband- and wife-perpetrated IPV, regardless of
whether it was reported for self or for partner.
Using continuous CTS2 scores, there were no differences
Association between husband- and wife-perpetrated
intimate partner violence and alcohol measures
were generally positively correlated, within respondent
and within couple. As expected, husbands reported higher
quantity, frequency, and ADS scores compared with their
wives (all ps < .01). Also as expected, husband- and wife-
perpetrated IPV were signifi cantly correlated (r = .61, p <
.001), with the high correlation refl ecting that the majority of
couples reported no IPV over the past year. A paired sample
t test comparing husband-perpetrated and wife-perpetrated
IPV within couples revealed higher wife (M = 1.55, SD =
3.72) compared with husband (M = 1.04, SD = 2.98) CTS2
perpetration scores, t(279) = 2.77, p = .006. A comparison
of the proportion of husbands who perpetrated IPV with the
proportion of wives who perpetrated IPV revealed a similar
pattern. That is, although the majority of couples included
partners who were both nonviolent (N = 182) or engaged
in mutual violence (N = 55), McNemar’s test revealed that
couples with wife- but not husband-perpetrated IPV (N = 34)
were more common than the reverse (N = 9), χ2(1) = 13.40,
p < .001. Because of the high within-couple correspondence
in IPV perpetration, analyses were conducted without
controlling for perpetration by the other partner.
As shown in Table 1, husband and wife alcohol variables
and wife ADS scores and alcohol consumption on both
perpetration of any IPV and on the frequency of IPV
occurrence, using continuous CTS2 scores. Because the
frequency of consumption was not correlated with IPV
(Table 1), we focused on quantity rather than frequency
of consumption as a predictor. Because our analyses
used continuous measures of alcohol consumption and
dependence symptoms rather than specifi c groups, we took
into account the disproportionate sampling of the couple
drinking groups by weighting the different groups to refl ect
their prevalence among the eligible respondents to our
Substantive analyses considered the impact of husband
TABLE 1. Pearson correlations among husband and wife alcohol variables and IPV
1. 2. 3. 4. 5. 6. 7.
1. H frequency
2. H quantity
3. H ADS
4. H-to-W IPV
5. W frequency
6. W quantity
7. W ADS
8. W-to-H IPV
.032 .213*** 1.55 (3.72)
Notes: Using unweighted data. IPV = intimate partner violence; H = husband; ADS = Alcohol Dependence Scale; W
*p < .05; **p < .01; ***p < .001.
272 JOURNAL OF STUDIES ON ALCOHOL AND DRUGS / MARCH 2012
mailed survey. This use of weights is common when simple
random sampling has not been used and minimizes the
potential of bias (Korn and Graubard, 1995; Pfeffermann,
1993). Analyses using weighted data were conducted
separately for husband-to-wife and wife-to-husband IPV.
Predicting the occurrence of intimate partner violence
was used to examine the impact of ADS scores on the
occurrence of husband- and wife-perpetrated IPV. We
entered control variables (age, years together, number of
children, and husband and wife education) and husband and
wife ADS on the fi rst step, followed by the interaction of
husband and wife ADS on the second step. The results are
shown in Table 2. In the equation predicting wife-perpetrated
IPV, higher husband ADS scores signifi cantly increased
the odds of IPV; wife ADS was marginally signifi cant (p
= .06). For husband-perpetrated IPV, both husband ADS
and wife ADS predicted the occurrence of aggression;
however, these main effects were qualifi ed by a signifi cant
interaction between husband and wife ADS. The nature of
the interaction, depicted in Figure 1, reveals that when wife
ADS was at the mean or below, there was a steep increase
in the odds of husband-perpetrated IPV associated with
increasing husband ADS. In contrast, when the wife’s ADS
was high, the odds of husband-perpetrated IPV were high
at all levels of husband ADS; that is, husband ADS did not
increase the probability of his aggression.
The above blockwise logistic regression analyses were
then repeated using the quantity of husband and wife alcohol
consumption instead of ADS scores as predictors of the
occurrence of husband- and wife-perpetrated IPV . The results
(not shown) revealed that the husband’s alcohol quantity was
the only signifi cant predictor of husband IPV (odds ratio
[OR] = 1.16, CI [1.07, 1.28], p < .001) and wife IPV (OR
In the fi rst set of analyses, blockwise logistic regression
= 1.09, CI [1.01, 1.18], p < .05). The interaction was not
signifi cant in either equation.
Predicting the frequency of intimate partner violence
use predict the frequency of husband-to-wife and wife-to-
husband aggression. Because these outcomes are count
variables (the number of physically aggressive acts) with
a positively skewed distribution, a Poisson family can be
specifi ed in analyzing such data. However, because Poisson
models have restrictive assumptions that can be easily
violated, resulting in misleading results, negative binomial
models have been advocated as a more appropriate choice
(Byers et al., 2003; Gardner et al., 1995). Thus, negative
binomial regression, with Stata (version MP 11.2; StataCorp,
LP, College Station, TX) was used in models predicting the
frequency of husband- and wife-perpetrated IPV.
Table 3 presents risk ratios for the main effects model
followed by the full model, including the Husband × Wife
ADS interaction term. Risk ratios greater than 1 represent
an increased risk; risk ratios less than 1 a decreased risk.
For the frequency of husband IPV, the pattern of fi ndings
for husband and wife ADS was identical to the logistic
regression results presented above. That is, there were
signifi cant main effects for husband and wife ADS as well
as a signifi cant interaction. However, the nature of this
interaction, depicted in Figure 2, differed from the logistic
interaction. That is, the combination of high husband and
wife ADS led to especially large increases in the frequency
of husband-perpetrated aggression. For the frequency of
wife-perpetrated aggression, both husband and wife ADS
contributed independently to the frequency of aggression;
however, their interaction was not signifi cant.
Negative binomial regression was also used to examine
whether the quantity of husband or wife alcohol consump-
We also considered whether husband and wife alcohol
TABLE 2. Hierarchical logistic regression predicting occurrence of husband- and wife-perpetrated IPV from alcohol dependence
Husband-perpetrated IPV Wife-perpetrated IPV
No. of children
Wife ADS ×
1.20*** 1.24*** [1.12, 1.38]
0.74* [0.58, 0.94] 0.86 [0.69, 1.07]
Nagelkerke R2 .257 .153
Notes: IPV = intimate partner violence; OR = odds ratio; CI = confi dence interval; ADS = Alcohol Dependence Scale.
*p < .05; **p < .01; ***p < .001.
TESTA ET AL. 273
tion predicts the frequency of aggression (not shown). For
husband-perpetrated IPV , the husband quantity was the only
predictor that was signifi cant (risk ratio = 1.15, CI [1.05,
1.25], p < .01). For wife-perpetrated IPV, neither the hus-
band nor wife quantity nor their interaction predicted the
frequency of occurrence.
husbands’ and wives’ drinking on husband-to-wife and wife-
The current study considered the combined impact of
FIGURE 1. The probability of the occurrence of husband-to-wife aggression as a function of husband and wife Alcohol Dependence Scale (ADS) scores
TABLE 3. Negative binomial regression predicting frequency of husband- and wife-perpetrated IPV from alcohol dependence symptoms
Husband-perpetrated IPV Wife-perpetrated IPV
Main effects model Interaction model Main effects model Interaction model
Variable RR [95% CI] RR [95%CI] RR [95% CI] RR [95%CI]
No. of children
0.63*** [0.48, 0.83]
1.37* [1.00, 1.88]
1.29*** [1.12, 1.47]
1.20*** [1.08, 1.33]
1.38*** [1.15, 1.66]
1.24*** [1.11, 1.38]
0.59*** [0.46, 0.76]
1.49** [1.15, 1.92]
1.16*** [1.07, 1.26]
1.11* [1.00, 1.22]
0.59*** [0.46, 0.77]
1.45** [1.12, 1.87]
1.19*** [1.08, 1.31]
1.12* [1.01, 1.25]
Wife ADS ×
Husband ADS 0.74** [0.59, 0.91] 0.87 [0.74, 1.04]
Notes: IPV = intimate partner violence; RR = risk ratio; CI = confi dence interval; ADS = Alcohol Dependence Scale.
*p < .05; **p < .01; ***p < .001.
to-husband IPV in a community sample. By oversampling
couples containing heavy episodic drinkers, we were able
to examine the role of women’s drinking on IPV with more
precision than has typically been the case. Although research
has fi rmly established the relationship between male drinking
and male-to-female partner violence, fi ndings with respect
to female drinking and female-to-male violence have been
more equivocal, particularly in general population samples.
Such samples usually include very few heavy drinking
women, and even fewer heavy drinking women married to
lighter drinking men. As a consequence, estimates of the
274 JOURNAL OF STUDIES ON ALCOHOL AND DRUGS / MARCH 2012
effect of women’s heavy drinking may be heavily dependent
on a small number of observations. For example, even in one
of the largest general population samples of couples to date
(Leadley et al., 2000), out of more than 1,600 couples, there
were only 18 couples in which both the husband and wife
engaged in HED and 27 couples in which the wife, but not
the husband, engaged in HED. We examined the relationship
with a substantially larger sample of heavy drinking women
(n = 120).
Results predicting husband aggression generally support
prior research in showing that husbands’ and wives’ ADS
scores were independently and interactively associated with
both the occurrence and frequency of husband-perpetrated
IPV. However, the nature of these interactions differed. The
interaction that emerged in prediction of the occurrence of
husband aggression suggests that a high ADS score in either
the husband or the wife increases the likelihood of IPV, but
high ADS scores by both do not lead to a further increase
in the likelihood of husband perpetration. The fi ndings are
consistent with the notion that there are a limited number of
individuals who are at risk for partner aggression and that
the threshold for the occurrence of any husband aggression
can be reached by either husband or wife heavy drinking.
In contrast, in the equation predicting the frequency of
husband-to-wife aggression, the nature of the interaction
between husband and wife ADS suggested an exacerbation
FIGURE 2. Risk ratio for husband-to-wife aggression as a function of husband and wife Alcohol Dependence Scale (ADS) scores
in the increased frequency of aggression when both partners
had high ADS scores. The differential implications of
the occurrence versus frequency analyses are crucial to
understand. Although the heavy drinking of the wife, for
example, may not increase the likelihood of one episode
of aggression if her husband is also a heavy drinker, it may
increase the likelihood of multiple episodes. The importance
of this with respect to clinical issues is readily apparent: in a
heavy drinking couple, reducing one partner’s drinking may
not eliminate all occurrences of violence, but it may lead
to fewer occurrences. This also raises the possibility that
processes linking drinking patterns and violence may differ
in terms of crossing the threshold to becoming physically
aggressive and the occurrence of frequent or severe violence,
a possibility discussed by O’Leary (1993).
The results for the prediction of wife-perpetrated
aggression support a somewhat weaker role of alcohol. In
equations predicting the occurrence of any wife-perpetrated
aggression, husband ADS and alcohol quantity signifi cantly
increased the odds of occurrence, whereas neither wife
quantity nor wife ADS were signifi cant. These fi ndings
suggest that women’s drinking is not a critical trigger for
their perpetration of IPV, a conclusion that is consistent
with experimental studies on alcohol and perpetration
of aggression in the laboratory, in which men’s but not
women’s aggression is increased following administration
TESTA ET AL. 275
of alcohol (Giancola et al., 2002, 2009). Because women’s
aggression has a lower potential for physical harm than
men’s, women may be less inhibited in expressing at least
low levels of aggression (Cross et al., 2011). Women in
this sample perpetrated IPV at a higher rate than their
husbands, a fi nding consistent with several previous studies
of community samples (O’Leary et al., 1989; Schumacher
and Leonard, 2005). Consequently, the occurrence of female
physical aggression may not be easily predictable from the
woman’s own characteristics (Magdol et al., 1997) but rather
may refl ect any number of different situational or partner-
based provocations (including a heavy drinking partner).
On the other hand, once the threshold of perpetration has
been crossed, both wife and husband ADS contribute to the
frequency of wife aggression.
Several additional aspects of the results warrant
consideration. First, the pattern of results for ADS scores
versus quantity of consumption differed somewhat. Our
fi ndings are generally consistent with previous research
suggesting that it is heavy episodic or problematic drinking
that is particularly associated with men’s perpetration of IPV
toward their partners (Leonard, 2008; Leonard et al., 1985;
O’Leary and Schumacher, 2003). Effect sizes for measures
of consumption are typically smaller than those for alcohol
problems (Foran and O’Leary, 2008). Although men’s
quantity of consumption was positively associated with
the occurrence of both husband- and wife-perpetrated IPV
and the frequency of husband (but not wife) IPV, women’s
quantity was not associated with husband or wife IPV in
any of the analyses. Previous research has also concluded
that alcohol is a stronger predictor of male as opposed
to female IPV (Foran and O’Leary, 2008). We recruited
a substantial number of heavy drinking women, but the
drinking quantities of these women were still substantially
less than those of their male partners and may be insuffi cient
to trigger aggression by either partner.
Although our fi ndings provide additional evidence that
one’s own drinking as well as the drinking of one’s partner
contribute to the likelihood of perpetration of IPV (White
and Chen, 2002), results failed to support the hypothesis that
discrepant drinking patterns increase either the odds or the
frequency of IPV perpetration. A growing body of research
has documented the negative effects of discrepant drinking
patterns on marital satisfaction (Homish and Leonard,
2005, 2007), but low satisfaction does not necessarily lead
to IPV (Baker and Stith, 2008; Testa et al., 2011). Given
the association between low relationship satisfaction and
relationship dissolution (Karney and Bradbury, 1995),
couples in which drinking discrepancy was most problematic
may not have been included, given that this was a sample of
We note several limitations. First, analyses were
deliberately limited to examining the direct relationship
of alcohol use to the perpetration of IPV. It is possible
that alcohol dependence or consumption plays an indirect
or moderated role in the perpetration of IPV or that the
association is spurious, refl ecting the effects of a common
third variable. Subsequent analyses are planned to consider
these possibilities. In addition, although our deliberate
sampling resulted in a substantial proportion of heavy
drinking men and women, the sample size was still relatively
modest and may not generalize to other geographic areas
or samples. Although demographic characteristics of our
sample matched those of the county fairly well, it is likely
that our method of recruitment resulted in omission of
couples without stable addresses and those with the highest
levels of marital violence or problems with alcohol. Finally,
it is important to remember that these are not event-level
analyses; hence, although results indicate that heavy drinkers
were more likely to perpetrate aggression, we do not know
whether aggression occurred while couples were drinking
alcohol. Nonetheless, the current study provides further
evidence that in community samples of couples, husband and
wife alcohol dependence symptoms are predictive of both
husband-to-wife IPV and, to a lesser extent, wife-to-husband
IPV. More refi ned research focusing on the processes that
link distal drinking habits or problems to instances of partner
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