SOWC 6101-5 DISCUSSION WORKING WITH FAMILIES

https://doi.org/10.1177/0886260517723142

Journal of Interpersonal Violence 2020, Vol. 35(23-24) 5624 –5651

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Article

Structural Pathways Between Race/Ethnicity, Substance Use, Military Service, and Male- Perpetrated Intimate Partner Violence in Pre- 9/11 Military Families

Roberto Cancio1

Abstract Along with service members, military families bear the brute consequences of global U.S. military intervention. Various studies have concluded that these deployments put military families at high risk for intimate partner violence (IPV). Using structural equation modeling (SEM) as a novel approach to examine IPV among pre-9/11 military families, this study considers variations of self-reported IPV from the point of the abused partner to test the impact of several life events and demographic factors on the type of IPV most prevalent among perpetrators. The study sample contains information about 599 male perpetrators from the Nature and Scope of Violence Against Women in San Diego, California (1996-1998), a survey about domestic violence from clients admitted to women’s shelters. Perpetrators race/ ethnicity, age, military experience, previous exposure to abuse, income, and education were modeled using SEM procedures to determine the frequency of IPV perpetrated under the influence of certain substances and etiologic characteristics. Particular attention focused on the differences among the

1University of Miami, Coral Gables, FL, USA

Corresponding Author: Roberto Cancio, Department of Sociology, University of Miami, 5202 University Dr. Merrick Building, Rm 120, Coral Gables, FL 33146, USA. Email: [email protected]

723142 JIVXXX10.1177/0886260517723142Journal of Interpersonal ViolenceCancio research-article2017

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military’s racial and ethnic groups and on the overall differences between IPV perpetrations among military families to nonmilitary families. Study findings indicate that (a) irrespective of race, pre-9/11 veteran perpetrators commit verbal/mental abuse more often than other forms of IPV, (b) when taking race/ethnicity into account, for veterans, there are differences with IPV perpetration trends and substance use, and (c) IPV perpetration trends are different between veteran and nonveteran groups, irrespective of race.

Keywords alcohol and drugs, domestic violence, war

Introduction

Intimate partner violence (IPV) is a significant public health crisis in the United States. This is especially true for the U.S. military family. Since 1990, men and women in the United States Armed Forces have been deployed in unprecedented regularity and duration (Hosek, Kavanagh, & Miller, 2006; MacGregor, Han, Dougherty, & Galameau, 2012). These deployments put considerable stress on the service member and their family, and place service members at high risk for IPV perpetration (Finley, Baker, Pugh, & Peterson, 2010; Jakupcak et al., 2007). Data from representative samples suggest that military populations report higher rates of IPV than their civilian peers even when controlling for age and race/ethnicity (Merrill, Stander, Thomsen, Crouch, & Milner, 2006). In addition, the Women’s Justice Project (2011) reported that military-related calls into the National Domestic Violence hot- line increased from 457 in 2006 to over 1,100 in 2010, suggesting that IPV may be getting worse among military families.

IPV has lifelong consequences. For example, many studies have shown that beyond injury and death, IPV victims are more likely to report a variety of acute and chronic health conditions leading the victim to hospitalization, disability, and/or death (Black, 2011; Coker et al., 2002). Furthermore, a number of behavioral factors likely play a role in the link between IPV and substance use, as victims of IPV are more likely to smoke and engage in heavy drinking (Breiding, Black, & Ryan, 2008). From a military perspec- tive, family conflict is also associated with higher health care service utiliza- tion, lower military morale, poorer job performance, and increased mission safety risk (Fontana & Rosenheck, 2010). However, research has yet to investigate the prevalent form of abuse among pre 9/11 military families.

According to a representative sample of 1,853 active duty veterans (61% pre-9/11 and 39% post-9/11 veterans), veterans who served pre-9/11 (96%) are more proud of their service than post-9/11 veterans (61%; Pew Research

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Center, 2011). According to Pew Research Center (2011), pre-9/11 veterans are less likely (25%) than post-9/11 veterans (44%) to say that their readjust- ment to civilian life has been difficult. This may be due in part to the fact that post-9/11 veterans are much more likely than those who served before them to have seen combat. In addition, posttraumatic stress disorder (PTSD) rates among pre-9/11 veterans are double that of post-9/11 veterans. In terms of life satisfaction, pre-9/11 veterans overwhelmingly reported higher satisfac- tion with their family life overall (69%) than post-9/11 veterans (60%). About half (48%) of all post-9/11 veterans say they have experienced strains in fam- ily relations and a little less than half (47%) say they have had frequent out- bursts of anger. Nearly half of all post-9/11 veterans (48%) who were married while in the military say their deployments put a strain on their marriages, compared with 34% of married pre-9/11 veterans. It is clear that these two populations are different. Therefore, it is important to consider only pre-9/11 veterans to present a model exclusive to this population as opposed to the mass volumes of research that has simply grouped these two distinct veteran populations together. Existing data often forced researchers to treat the mili- tary experience as a black box (Dempsey & Shapiro, 2009). This study takes a particular look at military service among pre-9/11 veterans and assessing the IPV dynamics within this group.

The differences in perceptions of the military and experiencing the mili- tary life differently among the two cohorts may possibly manifest differently in terms of how the military affects other aspects of the veterans life (i.e., family dynamics, substance use, IPV perpetration, etc.). The veteran IPV per- petrator is not a universal profile. It seems as though most current studies focus on post-9/11 veterans with little to no reference to possible differences among pre-9/11 veterans. This mistake creates an invalid profile of veteran perpetrators of IPV. Therefore, it is important to focus on pre 9/11 perpetra- tors in hopes to discover other mechanisms of IPV that affect this group.

Studies examining potential risk factors and correlates for IPV perpetra- tion have been limited by a reliance on restricted data designs and an inade- quate investigation into more etiological models for IPV between veteran cohorts. This study first tests a theoretic model of IPV perpetration and sub- stance use of veterans onto a sample of pre-9/11 veterans from first-hand accounts of their victims. In terms of this issue, the present study aims to aggregate IPV using the following steps: (a) validate the dimensions of IPV and their indicators using structural equation modeling (SEM),1 (b) calculate individual coefficients for these dimensions,2 (c) test the determinants of IPV for each dimension, and (d) look for differences between military and non- military families. Finally, this study will use the current data to specify a baseline model on substance use and IPV for pre-9/11 veterans.

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These goals contribute to the literature on IPV and military families in two respects. First, they account for the heterogeneity of substance use, determi- nants of IPV, and violence in military families. Second, they ensure better- targeted policies in the fight against IPV, because they can then be established on the basis of actual shortcomings of particular substance behaviors in rela- tion to IPV. Explicitly research questions are as follows:

Research Question 1: Following current research trends, are pre-9/11 veterans more likely to commit physical IPV and use alcohol over other forms of IPV and substance use; if not. Research Question 2: What form of IPV is most prevalent among pre- 9/11 veterans. Research Question 3: How is this form related to veteran’s substance use.3

Research Question 4: What are the differences between pre-/911 veter- ans perpetrators of IPV to the general perpetrator population?

Literature Review

Understanding the complex relationships among substance use and violence requires an examination into issues of pharmacology and social contexts to understand the specific mechanisms that associate substance use and IPV. In addition to this, understanding the ways in which social contexts themselves might establish conditions where violent behavior takes place. For example, ways in which availability of substances, while itself conditioned to some degree by social class, contributes to the distribution of violence. Since the focus of the study is concerned with the ways in which substance use may contribute to violent behavior among veterans, selective disinhibition theory is ideal as a theoretic sociological approach to examine the relationship between military veterans, substance use, and violence. In addition, it is also important to consider the ways that substance use relates to human behavior. Some empirical advances have contributed to studies on psychological expectancies concerning alcohol’s effect on behavior (Setiawan et al., 2011), the impact of substance use on aggressive behavior in the context of race/ ethnicity (Ballard et al., 2015), and the dynamic developmental effects of early exposure to substance use and violence by race and ethnicity (Peinado, Villanos, Singh, & Leiner, 2014). There are clear relationships between sub- stance use and domestic violence (Friend, Langhinrichsen-Rohling, & Eichold, 2011; Humphreys, Regan, River, & Thiara, 2005; Stuart et al., 2013) and the impact of drug use on the ability to maintain interpersonal relation- ships in the context of race and ethnicity (Nowotny & Graves, 2013).

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Therefore, selective disinhibition theory allows for the examination of the differential impact on behavior depending on the social and cultural contexts of the individual (i.e., military veterans by race/ethnicity).

Military Service: Stress, Mental Health, and IPV

The stress associated with military occupations is significantly different from nonmilitary civilian occupational stress. This difference is amplified by stressors stemming from multiple deployments and mission ambiguity (D. J. Campbell & Nobel, 2009). In addition, during military training recruits are challenged physically and psychologically so that they can operate under a new set of norms, both emotional and physical, including hypervigilance to perceived threats and emotional distancing (Grossman, 1995). Throughout their military careers, service members and veterans have been conditioned to engage in state-sanctioned violence (Reger, Gahm, Swanson, & Duma, 2009). Service-related factors, such as exposure to combat, the number of deployments, and posttraumatic stress disorder (PTSD), may also influence the use of various substances (Gewirtz, Polusny, DeGarmo, Khaylis, & Erbes, 2010) and IPV relationship (Taft, Stafford, Watkins, & Street, 2011). Under these circumstances, service members and veterans learn new ways of responding to perceived threats of hostility (Gonzalez, Novaco, Reger, & Gahm, 2016; Novaco & Chemtob, 2015).

Research suggests that the presence of combat-related PTSD places a vet- eran at a substantially higher risk for experiencing relationship conflict and perpetrating physical and mental IPV, and higher PTSD severity is associated with more severe IPV perpetration (Heyman, Taft, Howard, Macdonald, & Collins, 2012; Taft et al., 2011). Novaco and Chemtob (2015) found that vet- erans are more likely to employ an overly hostile interpretation of events and will override their ability to engage in self-monitoring to lower the risk for aggressive reactions.

Furthermore, existing research suggests that stress and depression among active duty servicemen are also associated with an increased risk of perpetrating IPV. Marshall, Panuzio, and Taft (2005) found more depres- sive symptoms among Army IPV perpetrators, compared with those who were nonviolent. In separate studies, depression severity (Rosen, Kaminski, Parmley, Knudson, & Fancher, 2003) and antisocial personality trait fre- quency (Rosen et al., 2002) were associated with IPV perpetration fre- quency. Other personalities like authoritarianism and attitudes toward women did not distinguish IPV perpetrators from nonaggressive controls in a sample of law enforcement referred active duty service members (Marshall et al., 2005).

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Veterans and active service members with major depressive episodes and diagnoses were higher among partner violent with PTSD than nonviolent active duty and veterans with the disorder (Taft et al., 2011). This is sugges- tive of an additional risk associated with these comorbid diagnoses. Depression frequently co-occurs with PTSD (Seal et al., 2009). Veterans returning from post-9/11 deployments have reported rates of depression around 20% with symptom rates even higher when both PTSD and depres- sion are co-occurring, and over half had severe impairment in close relation- ships with others and social life (Tanielian & Jaycox, 2008).

As with PTSD, a person suffering from depression may have agitated behavior. Additionally, IPV offenders are depressed because of their IPV behaviors (Gerlock, 1999). Depression interferes with focus and concentra- tion, making it challenging for an IPV perpetrator to effectively respond to offender intervention and or consciousness of reality. Hopelessness and help- lessness are two quintessential conditions of depression. When an IPV perpe- trator expresses the belief that there is nothing to lose, and feels jealousy and dependence on the victim, there is a potential increased risk for an IPV-related homicide (J. C. Campbell, 1992).

Beyond psychiatric IPV risk factors, returning service members and veter- ans experience changes in the ways in which they view the world after being exposed to extreme stress, combat, and possible war-related atrocities, including difficulties with respect to trusting others, developing closeness, and struggles with power and control (Taft et al., 2011). There is also some evidence suggesting that IPV perpetration is more frequent among low-rank- ing enlistees than among officers (Rosen et al., 2003). In the context of selec- tive disinhibition theory, a veteran’s depressive or stress-induced tendencies toward IPV stem from the cultural context of military service. The social and cultural environment allows for normatively proscribed behavior against vio- lence to become “disinhibited” by the context of a military culture of sub- stance use and violent behaviors.

Demographic Factors: Age, Ethnicity, Education, and Income

Not controlling for other confounding variables (e.g., socioeconomic status [SES]), findings among large samples of service members suggest that IPV perpetration is most prevalent among non-Whites than White service mem- bers, and is negatively associated with perpetrators age (McCarroll et al., 2003; Rosen et al., 2002). In a study of veterans, Johnson, Giordano, Manning, and Longmore (2015) found that younger age was related to higher IPV per- petration among substance abuse inpatients.

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Consistent with selective disinhibition, the social context of race and eth- nicity influence violent behaviors in the context of substance use. Furthermore, the burden of IPV is not shared equally among men of similar racial/ethnic groups. Native American men, as well as Black and multiracial non-Hispanic men, had a significantly higher prevalence of sexual assault, battery, or stalk- ing compared with White Non-Hispanic (Breiding, Chen, & Black, 2014). These findings follow selective disinhibition in that violence may be a reflec- tion of the many stressors that minority communities experience. For exam- ple, a number of social determinants of mental and physical health, such as limited access to education, economic resources, and social services, likely play important roles.

Another context of behaviors may stem from gender. Male perpetrators of IPV usually have low incomes and have low education outcomes (Breiding et al., 2014). The prevalence of IPV is significantly higher among men with a household income less than $25,000 and between $25,000 and $50,000 than for men with a combined income over $75,000 (Breiding et al., 2014). The median U.S. household income in 2010 was $49,455; therefore, the two lowest income groups roughly make up to the bottom 50th percentile for household income (U.S. Census Bureau, 2011). This finding follows previ- ous studies demonstrating an inverse relationship between income, educa- tion, and IPV prevalence. Demographic factors also offer a social context from which substance use and IPV perpetrations manifest.

Drugs/Alcohol and IPV

Previous research has demonstrated that substance use is both a strong risk factor for and consequence of IPV (Moore et al., 2008; Smith, Hormish, Leonard, & Cornelius, 2012; Stuart et al., 2013). Aforementioned references posit that substance use may be affected by other risk factors (e.g., violence in the family) and substance use may affect risk factors (e.g., belief that violence is appropriate). Moreover, the relationship between substance abuse is only one of the several important factors that increase the risk for IPV, and vice versa (De Bruijn & De Graaf, 2016). Furthermore, regardless of the direction of the relationship between substance use and IPV, the co-occurrence of IPV and substance use is substantial across a series of studies (De Bruijn & De Graaf, 2016; Kenneson, Funderburk, & Maisto, 2013; Shorey, Stuart, Mcnulty, & Moore, 2014). In terms of alcohol use, the proportion of men who partici- pate in IPV-related activities increases with the frequency of inebriation (Shorey et al., 2014). However, drug use is more correlated to IPV than alco- hol (Bennett & Bland, 2008). In spite of the impairment in men’s behavior caused by substance use, IPV remains a matter of choice (Meyer, 2012).

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Selective Disinhibition Theory

Considering the far-ranging deleterious impacts of IPV, it is critical to iden- tify frequent types of abuse among military families and offer health care professionals the possibility to tailor possible intervention(s) needs for this population and to develop effective protocols to meet those needs. This retro- spective study explores the hypothesis that multiple markers including but not limited to substance use, exposure to abuse, income, education, and mili- tary service would be associated with a perpetrators manifestation of abuse (verbal/mental, physical, and sexual) toward their spouse.

Following the literature review, selective disinhibition theory is used to explain substance use, social context, and how they come to affect the mani- festation of violent behaviors. Developed by Parker and colleagues (Parker & Auerhahn, 1998), this theory postulates that the social and cultural context in which substances are consumed strongly affects behavior. For example, in certain drinking cultures, alcohol is a part of daily life and violent drunken behavior is seen as acceptable in some circumstances (Room, 2001). Parker and Auerhahn (1998) argue that in potentially stressful situations, a conscious effort is needed to solve disputes nonviolently. However, people may be less likely to make this effort; specifically, in contexts where violence is more accepted as drunken behavior, such as in the military (Forbes & Bryant, 2013).

Based on the previous literature, a nonrecursive theoretical model (Figure 1) was constructed in hopes to understand how various factors contribute and affect the most prevalent type of partner violence amongst a sample of perpe- trators. Guided by selective disinhibition theory, this article explores the rela- tionship that serving in the military plays for IPV perpetrators, the difference among military perpetrators of IPV to the general population, and how indi- vidual substance use is linked to IPV when comparing any effects of other substances simultaneously.

Method

The study sample contains information regarding 599 male perpetrators from the Nature and Scope of Violence Against Women Study in San Diego, California (1996-1998), a regional, cross-sectional survey about domestic violence from female clients admitted to women’s shelters (Pennell, 1998). The information provided about the male perpetrator is secondhand, in that it is reported by the female victim and from reports to law enforcement. Data were collected over a period of 22 months using a compilation of research and evaluation intake interviews beginning in 1997.

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Measures

The following variables were used as exogenous indicators. Frequency of physical and sexual abuse was measured by creating two different variables, where each form of IPV created as a categorical variable, with four categories describing the frequency of abuse (Varies, Monthly, Weekly, and Daily). Finally, because of the high frequency of daily verbal and mental abuse, per- petrator’s involvement in verbal/mental abuse and the frequency of verbal/ mental abuse was measured by creating a dichotomous variable, 0 indicative of daily or less verbal/mental abuse, and 1 indicating daily verbal/mental abuse or more.

Perpetrator demographic factors as reported by the victim at intake include military service (yes/no), race/ethnicity (White, Black, and Hispanic), and previous exposure or victim of childhood abuse (yes/no). Age of the perpetra- tor was constructed as a continuous variable at the time of victim intake.

A measurement model was used to create an endogenous latent construct SES. SES is manifested by two observed variables: income and education. Income designates annual income of the perpetrator; this variable was con- structed as a categorical ordinal variable using eight categories with increments

Figure 1. Theoretical simultaneous path model of the correlates of IPV. Note. All models were tested using different race and ethnic categories (i.e., Blacks, Hispanics, and Whites). IPV = intimate partner violence; SES = socioeconomic status.

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of $10,000 each, beginning with $5,000 or less to $51,000 and more. Education was created using a single item intake question, education designates the high- est grade completed at the time of the survey; this variable was constructed as a categorical ordinal variable using seven categories beginning with less than a high school diploma and ending at graduate school.

The following three substance abuse categories were created from two observed variables: (a) Hallucinogens, manifested by factoring PCP and LSD, (b) Stimulants, manifested by factoring Crack and Methamphetamines, and (c) Antipsychotics, manifested by factoring two variables on perpetrator medication within the last 30 days. The observed variables were all dichoto- mized where 0 indicated that the individual did not use the specific substance within the last 30 days, and 1 having used the substance within the last 30 days. Also, marijuana, heroin, and alcohol use were examined as single-item indicators, 0 indicated that the individual did not use the specific substance within the last 30 days, and 1 having used the substance within the last 30 days.

Analysis

The analytic strategies of this study were to first use descriptive statistics (means, standard deviations, and category percentages) and compare them with relative Census data (US Census Bureau, 1997) using STATA 13 (Table 1). Second, LISREL 9.2 confirmatory factor analysis and SEM were used to examine the total effects of the simultaneous equation path model of veterans by race/ethnicity, followed by an examination of the similarity among ethnic and racial groups (Table 2). SEM was used to assess the adequacy of measure- ment of the variables and to test whether pre-9/11 veterans of IPV perpetration followed similar patterns of suggested literature on all veterans. The researcher tested a priori specified hypothesis about the underlying structure of the simul- taneous path model and the structure controlling for measurement error (Ullman, 2006). All estimated parameters were hypothesized a priori, intend- ing to estimate a parsimonious and theoretically based model. Finally, to com- pare the general population to veterans and service members, this study tested the equality of factor structures between military and nonmilitary by race/ ethnicity. In addition, group comparison procedure was conducted for the dif- ferent racial/ethnic groups examining veteran and nonveteran models together and then again grouping all veterans with nonveteran perpetrators (Table 3). Finally, results from LISREL regression analysis of the selected variables indicated that multicollinearity did not need to be a concern in this model. Absolute values of correlations among the independent variables are less that 0.3; estimated regression coefficients are positive as expected. Furthermore,

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all standardized coefficients are relatively small, and significance of the regression coefficients is consistent with the significant R2.

Last, the goodness-of-fit was used to specify a baseline model that fits the data’s veteran perpetrators of IPV and substance use.4 The baseline model respecification process took two sequential stages per ethnic group then again per ethnic group by the status of military service. Starting with the “proposi- tional” model shown in Figure 1, the researcher first observed indications of model misspecification. To this end, modification indices were employed.5 The second stage involved systematically trimming out of nonsignificant paths (i.e., coefficient estimates with p values > .05).6 At each step, interim evaluations were carried out in search of any relevant path once the model had been simplified. The process of finding the best-fitting model stopped when no additional paths were suggested by the modification indices, as all remaining paths retained statistical significant given acceptable levels of model fit (Figure 2).

Table 1. Descriptive Statistics and San Diego Census 1996 Estimates.

Descriptive Results San Diego, CA 1996

Exogenous variance Race/ethnicity White 30.00% White 58.90% Black 23.00% Black 7.80% Hispanic 39.00% Hispanic 25.30% Military Serving/veteran 23.20% Serving/veteran 16.80% Age Mean 34.6 Childhood abuse 82.10% Endogenous variance Income Up to 20,999 66.00% Education Grad HS/GED 72.40% Alcohol use Monthly 72.00% Antipsychotic use Monthly 22.00% Hallucinogens use Monthly 0.08% Marijuana Monthly 27.00% Heroin Monthly 0.03% Stimulant use Monthly 20.00% Physical abuse Monthly 46.40% Sexual abuse Monthly 46.60% Mental/verbal abuse Daily 62.00%

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Table 2. Model Analysis of Pre-9/11 Veterans, Substance Use, and IPV Perpetration.

Whites Blacks Hispanics Military

Race/ethnicity → SES 0.088 −0.238** −0.388** — Military service → SES 0.328** 0.392** 0.392** 0.392** Age → SES 0.321** 0.332** 0.257** — Childhood abuse → SES −0.012 −0.008 −0.001 — SES → Hallucinogens −0.083 0.002 −0.05 — SES → Stimulants −0.131** −0.068 −0.132* — SES → Antipsychotic 0.139* 0.126* 0.108* — SES → Alcohol 0.394** 0.286** 0.329** 0.349** SES → Marijuana −0.133* −0.137* −0.086 — SES → Heroin −0.225** −0.286** −0.234** — Hallucinogens → Physical abuse −0.008 −0.048 −0.036 — Hallucinogens → Mental/verbal 0.114* 0.136* 0.083 — Hallucinogens → Sexual abuse −0.19** −0.211** −0.23** — Stimulants → Physical abuse 0.159** 0.121* 0.158** — Stimulants → Mental/verbal 0.185** 0.207** 0.156** — Stimulants → Sexual abuse 0.319** 0.346** 0.337** — Antipsychotic → Physical abuse 0.005 −0.015 0.017 — Antipsychotic → Mental/verbal −0.027 −0.045 −0.058 — Antipsychotic → Sexual abuse −0.043 −0.074 −0.069 — Alcohol → Physical abuse −0.186** −0.215** −0.176** 0.301** Alcohol → Mental/verbal 0.016 −0.026 −0.037 — Alcohol → Sexual abuse −0.022 −0.08 −0.073 — Marijuana → Physical abuse 0.033 0.045 0.003 — Marijuana → Mental/verbal 0.113* 0.134* 0.137* — Marijuana → Sexual abuse −0.225* −0.198** −0.21** — Heroin → Physical abuse −0.132* −0.107* −0.114* — Heroin → Mental/verbal −0.089 −0.117* −0.078 — Heroin → Sexual abuse −0.119* −0.118* −0.102* — Significant coefficients White → Sexual abuse 0.366* — — — Black → Crack — 0.31** — — Crack→ Sexual abuse 0.362** 0.347** — — Physical Abuse → Sexual 0.301** 0.32** 0.311** 0.311** SES → Physical abuse −0.356** −0.306** −0.322** −0.334** Military → Mental/verbal 0.218 0.289** 0.24** 0.319** Goodness-of-fit statistics χ2

8.523 8.724 8.636 6.99 RMSEA 0.1072 0.0803 0.0984 0.0562 GFI 0.821 0.83 0.828 0.994

Note. N = 599; SES = socioeconomic status; RMSEA = root mean square error of approximation; GFI = goodness-of-fit index. *p < .05. **p < .01.

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Findings

Table 1 illustrates the means and category percentages for the data. Based on these results, the mean age of perpetrators was 35 years old. Most (82.1%) perpetrators were exposed to some form of violence as a child. In addition, violence is significantly higher among couples with a combined household income of less than $25,000. Considering education, fewer than three quar- ters of batterers (72.4%) had at least a high school diploma or GED. In terms of substance use, respondents reported that the primary substance used among perpetrators was alcohol (72%). Illegal substances mentioned were depres- sants (27%), stimulants (20%), antipsychotic drugs (22%), and hallucinogens

Table 3. Equality of Factor Structure Analyses.

Hypothesis χ2 df p Value Decision

Black A : HΣ 535.07 120 0.00 Reject B HN: =2 523.78 19 0.00 Reject C H: Λ 1158.86 105 0.00 Reject D H: Λθ 1158.86 105 0.00 Reject E H: ΛΨθ 535.07 86 0.00 Reject

White A : HΣ 454.99 120 0.00 Reject B HN: =2 504.78 19 0.00 Reject C H: Λ 978.78 105 0.00 Reject D H: Λθ 978.78 105 0.00 Reject E H: ΛΨθ 454.99 86 0.00 Reject

Hispanic A : HΣ 626.5 120 0.00 Reject B HN: =2 523.78 19 0.00 Reject C H: Λ 1150.29 105 0.00 Reject D H: Λθ 1150.29 105 0.00 Reject E H: ΛΨθ 626.5 86 0.00 Reject

Note. Five hypotheses were tested: Hypothesis 1: Testing the hypothesis that the simultaneous equation path model between

military and nonmilitary are the same for each ethnic group H MIL NON MIL

∑ ∑ ∑=

 



 

− : .

1 2

Hypothesis 2: Assuming that the path models hold in both groups (military and nonmilitary), test the hypothesis that there are two correlated common factors in both groups ( HN=2 ). Hypothesis 3: Assuming Hypothesis 2, test the hypothesis that the lambda matrix, containing the structural coefficients linking all variables are similar ( HΛ Λ Λ: 1 2= ). Hypothesis 4: Assuming Hypothesis 3, test the hypothesis that the variance/covariance matrix of the measurement residuals associated with the variables are equal between both groups ( HΛθ θ θ: 1 2= ). Hypothesis 5: Assuming Hypothesis 4, test the hypothesis that the variance/covariance matrix of the variables are equal between both groups (veterans and nonveterans) ( HΛΨ Ψ Ψθ : 1 2= ).

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(.08%). Furthermore, 62% of batterers perpetrated mental and verbal abuse, 46.4% of batterers carried out physical abuse, and 46.6% executed sexual abuse onto their intimate partner. In addition, military service members and the veteran population were higher in the data set than that of San Diego, CA, at the time the surveys were administered.

When comparing the ethnic and racial category percentages of the 1996 Census information about San Diego, CA, to the data, the results demonstrate that, within this particular sample, Blacks (23%) and Hispanics (39%) were overrepresented than the relative proportion of ethnic minorities (25.3% and 7.8% respectively). Meanwhile, Whites were underrepresented, 30% in the data as opposed to 58.9%. Although men of color are overrepresented in this data set of San Diego shelter clients, this finding does not imply that minority men are more likely to perpetrate IPV than nonminority men.

When examining the theoretical model by race (Table 2), those that reported being White had the highest significant coefficient in the frequency of sexual abuse (0.319), when compared with other forms of abuse. However, when accounting for substance use, compared with other forms of substance use among Whites, marijuana had the largest significant negative coefficient (−0.225) toward the frequency of sexual abuse. The second model examined Black veterans and found significant relationships with substantially high coefficients, when comparing other coefficients, between being Black and using crack cocaine (0.21), considering other substance use, and using crack cocaine and sexual IPV perpetration (0.347), considering other forms of IPV perpetration. In the Hispanic model, coefficients between being Hispanic and

Figure 2. Pre-9/11 veteran: IPV and substance use baseline model. Note. IPV = intimate partner violence; SES = socioeconomic status.

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types of IPV produced small and insignificant results. This is not to say, how- ever, that IPV is nonexistent among this group. The highest coefficient was between being Hispanic and any form of IPV perpetration was a negative coefficient (−.167) of frequent physical abuse. All other coefficients were too small.

Based on the equality of factor structure analyses (Table 3), five hypoth- eses7 were tested within ethnic/racial groups and between veterans and non- veterans. The analysis was conducted to examine if there were differences among veterans and nonveterans within ethnic/racial groups overall. The five hypotheses were tested and rejected, suggesting there are no similarities among the same racial/ethnic groups between veterans to nonveterans. Model specification results found data-driven common antecedents among military veterans and IPV. Irrespective of race/ethnic, veterans had a higher frequency to commit verbal/mental abuse than nonmilitary perpetrators. The following sections offer theoretically oriented focused discussion on the findings of military veterans and offer a baseline model to demonstrate IPV and sub- stance use among veterans overall (Figure 2).

Discussion

According to the findings, most men were exposed to a form of child abuse and were frequent perpetrators of IPV. This finding is consistent with litera- ture that posits that exposure to intimate violence as a child can increase the risk that an individual will grow up to abuse his partner as adults (Widom, Czaja, & Dutton, 2014). However, this finding should not be interpreted as inevitable. Many individuals exposed to domestic violence as children do not repeat the cycle as adults (Herrera & McCloskey, 2003). In addition, findings of low education and income are also consistent with previous studies dem- onstrating an inverse relationship between income, education, and IPV prev- alence (Breiding et al., 2008; Breiding et al., 2014).

Although men of color seemed overrepresented in the data, this may be at least partly related to SES. In the literature, the racial and ethnic difference in perpetrators seems to be due to a number of factors, including regional varia- tion (Chalk & King, 1998; Clark, Galano, Grogan-Kaylor, Montalvo-Liendo, & Graham-Bermann, 2016). The impact of overrepresentation does not mean that IPV perpetration happens more often among people of color. More so, in terms of this sample, more women of color reported cases of IPV. Prior research points to significant underreporting among IPV victims. It is likely that the frequency of abuse may have been underreported among White women in this sample. This may be because victims may fear reprisal in the event that information is disclosed. This impacts the current study in that

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overrepresentation may lead to the overestimation and or underestimation of the corresponding parameters in the population.

There were five major theoretical findings consistent among all veterans across racial/ethnic groups. They were (a) military service was tied to ele- vated levels of SES, (b) positive relationship between SES and alcohol use, (c) the use of stimulants was related to sexual abuse, (d) physical abuse is related to sexual abuse, and (e) increased SES leads to lower likelihood of physical IPV. These findings helped trim the theoretical simultaneous path model of the correlates of IPV (Figure 1) and help create a new model base- line model specific to veterans irrespective of race/ethnicity (Figure 2).

First, military service was indicative of having higher SES than nonmili- tary. This finding is consistent with Sampson and Laub (1996) who describe the social mechanisms by which military service fosters long-term socioeco- nomic achievement. Their study demonstrated how military service, in-ser- vice skill training, and educational benefits generally enhanced subsequent occupational status, job stability, and economic stability, independent of childhood socioeconomic background. Second, the positive relationship between higher levels of SES and alcohol use. This finding follows Keyes and Hasin (2008) who found that alcohol use had a significant positive rela- tionship with income. In addition, this finding confirms the results of Wennberg, Andersson, and Bohman (2002) who claim that social factors associated with higher levels of SES are important for the initiation of advanced alcohol habits.

Third, this study found that the use of stimulants is related to the perpetra- tion of sexual abuse. This finding is consistent with Chartier, Hesselbrock, and Hesselbrock (2010) who found that high rates of childhood trauma have been reported among hypersexual active men, the association of childhood trauma8 and stimulant use has also been tied to hypersexual men (Lopez- Patton et al., 2016). This is because the use of stimulants evokes profound feelings of euphoria, intensity, and intense sexual drive. Fourth, this study found that physical abuse is related to sexual abuse. Consistent with Basile and Hall (2011) and Stuart et al. (2013) study of IPV intersections found a highly correlated co-occurrence of physical and sexual perpetration and sub- stance use. Finally, increased SES leads to the lower likelihood of physical IPV. This finding is consistent with prior evidence published on the socioeco- nomic patterning of family violence in India, which found that families under stress due to limited finances might be more likely to resort to violence as a form to settle familial disputes about finances or to ascribe blame for the reason behind a lack of resources (Koenig, Stephenson, Ahmed, Jejeebhoy, & Campbell, 2006). In addition, Koenig et al. (2006) suggested that formal edu- cation may impart some understanding to spouses, allowing them tolerance

5640 Journal of Interpersonal Violence 35(23-24)

and optimal ways to settle disputes without resorting to violence. In addition, education may influence the partners in such a way as to make IPV an unac- ceptable form of conflict resolution. The subsequent findings offer potential reasons for the connection between race/ethnicity, IPV, and substance use. The following subsections discuss race/ethnic-specific findings for respec- tive groups.

Whites, Sexual Abuse, and Marijuana

Sex offenders are a heterogeneous population that cannot be categorized by single motivators and or etiological factors (Schwartz, 1995). However, according to a study of sex offender demographics, nearly 99% of sex offend- ers in single-victim incidents were male and three in five were White (Greenfeld, 1997). This finding along with previous empirical literature sug- gests that within couples where one person is a White male, there is a higher likelihood of sexual abuse perpetration than any other form of IPV perpetra- tion when considering race and ethnicity (Leguizamo, Peltzman, Carrasco, Nosal, & Woods, 2011).

However, when accounting for marijuana use, this finding suggests that White military perpetrators are more likely not to participate in sexual abuse when compared with other substance use. There are several possible reasons why this model observed a protective association between marijuana use and IPV perpetration. Among daily users, marijuana may enhance positive affect (Hart et al., 2010), which in turn could reduce the likelihood of aggression. In addition, earlier research has found that chronic user’s exhibit blunted emo- tional reactions to threat stimuli, which may also decrease the likelihood of aggressive behavior (Gruber, Rogowska, & Yurgelun-Todd, 2009; Smith et al., 2014). Moreover, these explanations are speculative, and further research is needed to elucidate whether an association between marijuana use and IPV perpetration are possibly driven by cultural factors, altered affective responses, or other possible etiologic dynamics.

Intersection Between Crack Use and Sexual Abuse Among Blacks

The significant findings of being Black and using cocaine have been studied and offer a potential reason for this empirical relationship. When examining males between the ages of 26 to 34, Peters, Williams, Ross, Atkinson, and Yacoubain (2007) found that using crack cocaine was prevalent amongst Blacks, more than any other racial and gender group. Moreover, when exam- ining court sentences, Hartley and Miller (2010) found that 85% of offenders

Cancio 5641

arrested for crack cocaine were Black. Furthermore, crack use is linked to poor intimate partner relationships (Golub, Dunlap, & Benoit, 2010). Considering the relationship between crack and sexual IPV perpetration, empirical studies on the psychopharmacological aspects of crack have found that use of the substance is correlated to sex drive and libido (Hendricks & Wilson, 2013; Risser, Thimpson, McCurdy, Ross, & Williams, 2006). According to Maranda, Han, and Rainone (2004), a possible interpretation of crack cocaine and the impact it has on sex drives is that males who utilize crack cocaine tend to have a higher level of sexual drives because of the libido-enhancing effects.

Although the results of the study are in line with previously discussed empirical evidence, more research needs to address whether the relationship between crack cocaine use and IPV perpetration are possibly driven by cul- tural factors, hedonic responses, or other social systemic dynamics.This is especially true when discussing crack cocaine use among veterans.9

Hispanics and IPV

The results of this study on Hispanics and IPV are contradictory to empirical studies that posit that Hispanics have more similarities than differences between non-Hispanics participating in IPV (Ingram, 2007; Klevens, 2007). However, Cunradi (2009) when examining physical abuse and being Hispanic found that, when comparing other ethnic and racial groups, Hispanics showed lower levels of physical abuse.

A potential theoretical reason for this particular finding may be found in literature about immigration, acculturation, and the status of citizenship. Of Hispanics in the United States, in the early 2000s, 40% were born in other countries (Ramirez & de la Cruz, 2003) and more than half entered the United States between 1990 and 2002. Immigration often implies acculturation or adapting to new cultural norms and practices, which in turn may have special implications for IPV. The impact of acculturation on IPV has been explored in various studies. For example, Ingram (2007) found that rates of IPV among Hispanics increased the longer they lived in the United States. Other studies using different indicators for acculturation also show that more acculturated Hispanics have higher rates of IPV than the less acculturated (Caetano, Ramisetty-Mikler, & McGrath, 2004; Lown & Vega, 2001). In contrast, other studies have found that the highest levels of IPV tend to occur among Hispanics at medium levels of acculturation (Caetano et al., 2004). However, Kantor, Jasinski, and Aldorondo (1994) found no differences in IPV rates by levels of acculturation once socioeconomic factors were controlled for. Role strain, especially as a result of immigration and acculturation, might be

5642 Journal of Interpersonal Violence 35(23-24)

unique to Hispanics and its importance and the importance of male domi- nance among Hispanic women experiencing IPV deserves more research.

It is important to note that the results of the model examining Hispanic veterans and service members consisted of U.S. residents and citizens, immi- gration status, and levels of acculturation were not examined. Although there might be potential explanations for lower rates of IPV among Hispanics, there is no evidence to suggest low rates of IPV among Hispanic veterans and service members explicitly. More research needs to examine the relationship between being in the military, being Hispanic, and IPV perpetration.

Military and Nonmilitary Perpetrators

As all the equality of factor structure analyses hypotheses were rejected, there are no empirical similarities among similar racial and ethnic groups when compared with military and nonmilitary status. There are differences between veteran IPV and nonveteran IPV. Finally, a common antecedent among pre-9/11 military veterans seems to be the higher frequency to commit verbal/mental abuse than nonmilitary perpetrators. According to a cross- examination of U.S. Navy sailors, reported rates of verbal IPV were higher than any other form of IPV (Merrill et al., 2006). According to Merrill and colleagues (2006), overall 73% of sailors in this particular study reported perpetrating verbal IPV. Although no empirical evidence exists to suggest why verbal/mental abuse is more prevalent among pre-9/11 military perpetra- tors, future studies might consider examining etiological factors of verbal/ mental IPV and military service, comparing combatant versus noncomba- tants suffering from depression, traumatic brain injury, and PTSD between pre- and post-9/11 veterans. This finding is also indicative of the differences in IPV perpetration among pre-9/11 veterans than post-9/11 veterans. As there are major differences in military experiences between pre and post-9/11 veterans, it is important to understand the differences between IPV perpetra- tion and symptoms of mental health from era-specific veterans and how these mental health factors impact IPV perpetration respective of the veteran cohort.

Using the theoretical foundation set forth by selective disinhibition theory, this study examined the complex relationships among substance use, military veterans, and how they relate to IPV perpetration. The impact of substance use on aggressive behavior in the context of race/ethnicity for veterans showed that there are clear differences among pre-9/11 veteran perpetrators of IPV than what the literature suggest. Furthermore, there are clear relation- ships between substance use and domestic in the context of race and ethnicity.

Cancio 5643

Overall, there were five major theoretical findings consistent among all veterans: (a) military service is tied to higher levels of SES, (b) there exists a positive relationship between SES and alcohol use, (c) the use of stimulants was related to sexual abuse, (d) physical abuse is related to sexual abuse, and (e) increased SES leads to lower likelihood of physical IPV. Specific to the research questions of this study, findings suggest that (a) pre-9/11 veterans are not more likely to commit physical IPV and use alcohol over other forms of IPV and substance use, (b) pre-9/11 veterans are more likely to perpetuate verbal/mental violence over physical, (c) racial and ethnic identity is more salient to substance use for veterans, and (d) irrespective of race, veteran perpetrators of IPV follow different IPV trends and substance use than the general IPV perpetrator.

Conclusion

Study findings focused on the theoretical rational about military veterans, service members, substance use, and IPV. Although there were differences between race and ethnicity among service members and veterans, an overall characteristic of military perpetrators demonstrated that military partners were more likely to carry out higher levels of verbal/mental IPV. While this study presents a significant contribution to the literature on IPV perpetration, it has some limitations.

As information collected was self-reported from the point of the abused partner, it may be reasonable to assume that a victim’s understanding of demographic and present day life events is accurate for the most part for the perpetrator. However, in some cases, the information may be incomplete. In addition, from an empirical standpoint, prior research points to significant underreporting among IPV victims; it is likely that the frequency of abuse may have been underreported. Victims may fear reprisal in the event that information is disclosed, especially if it may lead to unemployment or further financial strain within the family. Further limitations of this study derived from the restrictions of the data set where social support, depression, PTSD, and TBI were not explicitly asked. Information regarding the status of mental health factors might explain why certain military ethnic and racial groups had significantly distinctive confidence. Furthermore, the study was not able to differentiate between types of military service (e.g., reservist, active duty, retired, or prior service). Knowing about the military career of an individual might allow for a closer examination of the lasting effects of exposure to the military lifestyle in the form of military career. Further, this sample of men is not representative of all men in abusive relationships, but only those whose female partner choose to go to a shelter (O’Sullivan, Wise, & Douglass,

5644 Journal of Interpersonal Violence 35(23-24)

1995). Thus, the results can be generalized only to this specific area of the country. In all cases, the victim was female and the abuser male. The data did not include violence occurring between partners of the same gender or where female perpetrators were violent toward men.

Despite these limitations, this research is an important step in understand- ing the nature of military service and its impact on the outcomes of IPV per- petration. The theoretical findings suggest that there is something about the military and its effect on IPV perpetration. Further studies should consider other possible correlates of IPV and military factors. The effect of military service on the relationship of IPV perpetration suggests an expansion in the understanding of violence in the context beyond theories of substance use and race/ethnicity. These findings warrant further investigation to understand the differences in patterns and dynamics of IPV associated with military ser- vice and nonmilitary service–related IPV. The differences may highlight opportunities for potential interventions and have implications for the design of perpetrator programs.

The central position of considering military service in the pathways to IPV perpetration spells out potential contributions to public health in response to military trauma and in the prevention of violence. The evidence from this study supports the need to develop integrated prevention interventions that incorporate mental and physical health components which build emotional resilience and coping mechanisms of participants with military service. This may decrease the psychological impact of past trauma (i.e., military combat) while preventing future violence perpetration. The collaboration of health practitioners and researchers can co-create a design of future integrated treat- ments that take a holistic approach and focus on addressing IPV perpetration. These findings highlight the need for the development of more positive inter- ventions which break the intergenerational transmission of violence in this context of past abuse and military service for perpetrators.

Future studies on military IPV should focus on extrapolating how other military-related factors (i.e., PTSD, depression, and TBI) contribute to IPV per- petration individually. Furthermore, although there were relative ethnic and racial differences on IPV perpetration, these findings cannot be generalizable to the whole group. Researchers on IPV perpetration should consider examining other possible social structural forces that push and pull IPV perpetrators.

Finally, as the original data had been collected almost 20 years ago, future studies on IPV perpetration among veterans should consider examining how IPV dynamics have changed through the years. In addition, as much has changed in the military, including increased women’s presence, scholars should consider discussing how this change may have different influences in today’s military or among veterans overall.

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Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publi- cation of this article.

Notes

1. Statistically, structural equation modeling (SEM) allows one to operationalize a conceptual theoretical framework and its validation indices can verify several dimensions simultaneously measuring various aspects of intimate partner vio- lence (IPV).

2. The calculated scores for these dimensions are measures that can serve as a basis for studying violence in the military family.

3. When comparing any effects of other substances simultaneously. 4. Goodness of fit was evaluated using three indices (Kline, 2011). The root mean

square error of approximation (RMSEA) incorporates a penalty function for poor model parsimony (Hu & Bentler, 1999). Values under 0.06 suggest close approximate (adequate) fit, whereas values above 0.10 signify a poorly fitting model and that the model should be rejected (Kline, 2011). The comparative fit index (CFI) and goodness-of-fit index (GFI) represent incremental fit indi- ces contrasting the hypothesized theoretical model to a more restricted nested baseline model (Kline, 2011). Both range from zero to one and values >0.9 are indicative of adequate fit (Tucker & Lewis, 1973).

5. A modification index reflects how much the overall model chi-square decreases or improves if a constrained parameter is freely estimated. Candidate paths involving conspicuous values (modification indices > 10) were then examined for the actual amount of model fit improvement and for the magnitude of the fol- lowing freed estimated coefficients. The decision to explore and keep new paths also followed their theoretical meaningfulness.

6. This process adheres to the hierarchical principle advocated in the theoreti- cal model. The trimming process thus moved from left to right, starting with paths beginning from <Race/Ethnicity>, followed by <Age/Exposure to Abuse/ Military Service>; then <Hallucinogens, Antipsychotic Drugs/Alcohol/Heroine/ Marijuana/Stimulants>, and finally <Physical/Mental-Verbal/Sexual>.

7. Five hypotheses were tested:

Hypothesis 1: Testing the hypothesis that the simultaneous equation path model between military and nonmilitary are the same for each ethnic group

H MIL NON MIL

∑ ∑ ∑=

 



 

− : .

1 2

Hypothesis 2: Assuming that the path models holds in both groups (military and

5646 Journal of Interpersonal Violence 35(23-24)

nonmilitary), test the hypothesis that there are two correlated common fac- tors in both groups ( HN=2 ).

Hypothesis 3: Assuming Hypothesis 2, test the hypothesis that the lambda matrix, containing the structural coefficients linking all variables are similar ( HΛ Λ Λ: 1 2= ).

Hypothesis 4: Assuming Hypothesis 3, test the hypothesis that the variance/ covariance matrix of the measurement residuals associated with the variables are equal between both groups ( HΛθ θ θ: 1 2= ).

Hypothesis 5: Assuming Hypothesis 4, test the hypothesis that the variance/ covariance matrix of the variables are equal between both groups (veterans and nonveterans) ( HΛΨ Ψ Ψθ :

1 2= ). 8. In all, 82% of study respondents reported having exposure to child abuse. 9. Service members are excluded because the military exercises a zero tolerance for

illegal substance use and immediate separation from the military if substance use is detected in servicemen.

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Author Biography

Roberto Cancio is a PhD candidate in the Department of Sociology at the University of Miami, specializing in the areas of psychiatric epidemiology, medical sociology and race/ethnic relations. Mr. Cancio is a first-generation college student and second- generation Mexican American. His research agenda intersects his life and the lives of other military veterans as a US veteran.