Intervención grupal para reducir la violencia de género entre consumidoras de drogas. Resultados de un estudio piloto en un centro comunitario de tratamiento de adicciones

• Judit Tirado-Muñoz ^[1] ; Gail Gilchrist ^[1] ; Eva Lligoña ^[3] ; Louisa Gilbert ^[2] ; Marta Torrens ^[1]
  1. [1] Institut Hospital del Mar d'Investigacions Mèdiques

     Institut Hospital del Mar d'Investigacions Mèdiques

     Barcelona, España

     
  2. [2] Columbia University

     Columbia University

     Estados Unidos

     
  3. [3] Instituto de Neuropsiquiatría y Adicciones

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• Localización: Adicciones: Revista de socidrogalcohol, ISSN 0214-4840, Vol. 27, Nº. 3, 2015, págs. 168-178
• Idioma: español
• DOI: 10.20882/adicciones.703
• Títulos paralelos:
  • A group intervention to reduce intimate partner violence among female drug users. Results from a randomized controlled pilot trial in a community substance-abuse center
• Enlaces
  • Texto completo
• Dialnet Métricas: 5 Citas
• Resumen
  • español

    Antecedentes: Las mujeres usuarias de drogas son víctimas de violencia de género en mayor proporción que las mujeres en población general; sin embargo, pocas intervenciones se han desarrollado para reducir la violencia de género entre mujeres usuarias de drogas. Métodos: Una versión adaptada de la intervención “Women’s Wellness Treatment” para reducir violencia de género y síntomas depresivos, ha sido evaluada mediante un ensayo clínico piloto en un centro de tratamiento ambulatorio en Barcelona, España. Catorce mujeres que recibían tratamiento ambulatorio para un trastorno por consumo de sustancias y que declararon ser víctimas de violencia en el mes anterior fueron incluidas en el ensayo clínico. Las participantes fueron asignados al azar para recibir 10 sesiones grupales de terapia cognitivo-conductual (IPaViT-CBT) o tratamiento habitual. La frecuencia de violencia, síntomas depresivos, consumo de sustancias, calidad de vida y estado de salud fueron evaluados al inicio del estudio y 1, 3 y 12 meses después de la intervención. Se realizó análisis por intención de tratar. Resultados: Se encontraron efectos moderados de la intervención en la reducción de maltrato psicológico, aumento de la asertividad y la reducción de la agresividad en la relación de pareja, y reducción en la frecuencia de consumo de alcohol hasta 3 meses después de la intervención. La intervención no redujo significativamente la probabilidad de ser víctima de cualquier tipo de violencia de género, los síntomas depresivos, calidad de vida o el estado de salud auto-referido, hasta 12 meses después de la intervención. Conclusiones: Los resultados de este estudio piloto indican que es factible realizar una intervención de 10 sesiones grupales de TCC entre las víctimas de violencia de género que reciben tratamiento por uso de sustancias en un centro comunitario de tratamiento de adicciones. Se requiere un ensayo clínico más robusto para replicar estos resultados.

  • English

    Background:

    A greater proportion of drug dependent women are victims of intimate partner violence (IPV) than women in the general population; however, few interventions have been developed to reduce IPV among drug dependent women.

    Methods:

    An adapted version of the Women’s Wellness Treatment, to address IPV and depressive symptoms, was piloted in a randomized controlled trial conducted in outpatient treatment program in Barcelona, Spain among 14 women receiving outpatient treatment for a drug use disorder who screened positive for IPV in the previous month. Participants were randomly assigned to receive the 10 session cognitive behavioral therapy (IPaViT- CBT) group intervention or treatment as usual. The frequency of IPV, depressive symptoms, substance use, quality of life and health status were assessed at baseline and 1, 3 and 12 months post intervention.

    Intention to treat analysis was performed.

    Results:

    Moderate effects for the intervention were found in reducing psychological maltreatment, increasing assertiveness of IPV and reducing aggressiveness in the partner relationship, and in reducing the frequency of drinking up to 3 months post intervention. The intervention did not significantly reduce the likelihood of any IPV, depressive symptoms, quality of life or self-reported health status, up to 12-months post intervention.

    Conclusion:

    This pilot trial suggests some initial support for the 10-session CBT group intervention among IPV victims who received treatment for drug use. Study findings indicate that it is feasible to deliver the intervention in a community substance abuse center. An adequately powered trial is required to replicate these results

• Referencias bibliográficas
  • Beck, A. T., Steer, R. A., y Garbin, M.G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation....
  • Boer, A. G., Lanschot, J. J., Stalmeier, P. F., Sandick, J. W., Hulscher, J. B., Haes, J. C., y Sprangers, M. A. (2004). Is a single-item...
  • Bonicatto, S., Dew, A. M., y Soria, J. J. (1998). Analysis of the psychometric properties of the Spanish version of the Beck Depression Inventory...
  • Bourgois, P., Prince, B., y Moss, A. (2004). The everyday violence of hepatitis C among young women who inject drugs in San Francisco. Human...
  • Campbell, J. C. (2002). Health consequences of intimate partner violence. Lancet, 359, 1331-1336. doi: 10.1016/s0140-6736(02)08336-8
  • Campbell, J. C., Baty, M. L., Ghandour, R. M., Stockman, J. K., Francisco, L., y Wagman, J. (2008). The intersection of intimate partner violence...
  • Carpenter, K. M., Aharonovich, E., Smith, J. L., Iguchi, M. Y., y Nunes, E. V. (2006). Behavior therapy for depression in drug dependence...
  • Castillo-Camiglia, A., Pizarro, E., Luengo, D., y Soto-Brandt, G. (2014). Consumo de alcohol y autoinforme de eventos violentos en Chile....
  • Cohen, L. R., Field, C., Campbell, A. N., y Hien, D. A. (2013). Intimate partner violence outcomes in women with PTSD and substance use: A...
  • Cohen, L. R., y Hien, D. A. (2006). Treatment outcomes for women with substance abuse and PTSD who have experienced complex trauma. Psychiatric...
  • Connelly, C. D., Hazen, A. L., Baker-Ericzen, M. J., Landsverk, J., y Horwitz, S. M. (2013). Is screening for depression in the perinatal...
  • El-Bassel, N., Gilbert, L., Witte, S., Wu, E., y Chang, M. (2011). Intimate partner violence and HIV among drug-involved women: contexts linking...
  • El-Bassel, N., Gilbert, L., Wu, E., Go, H., y Hill, J. (2005). Relationship between drug abuse and intimate partner violence: a longitudinal...
  • Fearday, F., Clark, C., y Edington, M. (Eds.) (2001). Triad Women’s Project Group Facilitator Manual and Workbook. Tampa, FL: Louis de la...
  • Fowler, D. N., y Faulkner, M. (2011). Interventions targeting substance abuse among women survivors of intimate partner abuse: a meta-analysis....
  • Gilbert, L., El-Bassel, N., Manuel, J., Wu, E., Go, H., Golder, S., . . . Sanders, G. (2006). An integrated relapse prevention and relationship...
  • Gilchrist, G., Blazquez, A., y Torrens, M. (2011). Psychiatric, behavioural and social risk factors for HIV infection among female drug users....
  • Gilchrist, G., Blazquez, A., y Torrens, M. (2012). Exploring the relationship between intimate partner violence, childhood abuse and psychiatric...
  • Harris, M., y Community Connections Trauma Work Group (Eds.) (1998). Trauma Recovery and Empowerment: A Clinician’s guide for working with...
  • Hearn, K. D., O’Sullivan, L. F., El-Bassel, N., y Gilbert, L. (2005). Intimate partner violence and monogamy among women in methadone treatment....
  • Hegarty, K., Bush, R., y Sheehan, M. (2005). The composite abuse scale: further development and assessment of reliability and validity of...
  • Hegarty, K., O’Doherty, L., Taft, A., Chondros, P., Brown, S., Valpied, J., . . . Gunn, J. (2013). Screening and counselling in the primary...
  • Hegarty, K., Sheehan, M., y Schonfeld, C. (1999). A Multidimensional Definition of Partner Abuse: Development and Preliminary Validation of...
  • Higgins, S. T., Alessi, S. M., y Dantona, R. L. (2002). Voucher-based incentives. A substance abuse treatment innovation. Addictive Behaviors,...
  • Higgins, S. T., Budney, A. J., Bickel, W. K., Foerg, F. E., Donham, R., y Badger, G. J. (1994). Incentives improve outcome in outpatient behavioral...
  • Howard, L. M., Trevillion, K., Khalifeh, H., Woodall, A., Agnew-Davies, R., y Feder, G. (2010). Domestic violence and severe psychiatric disorders:...
  • Illangasekare, S. L., Burke, J. G., McDonnell, K. A., y Gielen, A. C. (2013). The impact of intimate partner violence, substance use, and...
  • Kaysen, D., Dillworth, T. M., Simpson, T., Waldrop, A., Larimer, M. E., y Resick, P. A. (2007). Domestic violence and alcohol use: trauma-related...
  • Liebschutz, J. M., Mulvey, K. P., y Samet, J. H. (1997). Victimization among substance-abusing women. Worse health outcomes. Archives of Internal...
  • Miller, D., y Guidry, L. (Eds.) (2001). Addictions and Trauma Recovery: Healing the Body, Mind, and Spirit. New York: W.W. Norton and Co.
  • Miller, B. A., Downs, W. R., y Testa, M. (1993). Interrelationships between victimization experiences and women’s alcohol use. Journal of...
  • Najavits, L. M. (Ed.) (2009). Psychotherapies for trauma and substance abuse in women: review and policy implications. Trauma, Violence &...
  • Najavits, L. M. (2002). Seeking Safety: A Treatment Manual for PTSD and Substance Abuse. Nueva York: Guildford Press.
  • Najavits, L. M., Sonn, J., Walsh, M., y Weiss, R. D. (2004). Domestic violence in women with PTSD and substance abuse. Addictive Behaviors,...
  • O’Leary, K. D., y Curley, A.D. (1986). Assertion and family violence: Correlates of Spouse Abuse. Journal of Marital and Family Therapy, 12,...
  • Okuda, M., Olfson, M., Hasin, D., Grant, B. F., Lin, K. H., y Blanco, C. (2011). Mental health of victims of intimate partner violence: results...
  • Peters, E. N., Khondkaryan, E., y Sullivan, T. P. (2012). Associations between expectancies of alcohol and drug use, severity of partner violence,...
  • Singer, M. (1996). A dose of drugs, a touch of violence, a case of AIDS: Conceptualizing the SAVA syndemic. Free Inquiry in Creative Sociology,...
  • Sobell, L. S., y Sobell, M. B. (1992). Timeline follow-back: A technique for assessing self-reported ethanol consumption. Measuring Alcohol...
  • Sobell, L. C., Maisto, S. A., Sobell, M. B., y Cooper, A. M. (1979). Reliability of alcohol abusers’ self-reports of drinking behavior. Behaviour...
  • Testa, M., Livingston, J. A., y Hoffman, J. H. (2007). Does sexual victimization predict subsequent alcohol consumption? A prospective study...
  • Tirado-Muñoz, J., Gilchrist, G., Farré, M., Hegarty, K., y Torrens, M. (2014). The efficacy of cognitive behavioural therapy and advocacy...
  • Tolman, R.M. (1989). The development of a measure of psychological maltreatment of women by their male partners. Violence and Victims, 4,...
  • Tolman, R. M. (1999). The validation of the Psychological Maltreatment of Women Inventory. Violence and Victims, 14, 25-37.
  • Torrens, M., Gilchrist, G., y Domingo-Salvany, A. (2011). Psychiatric comorbidity in illicit drug users: substance-induced versus independent...
  • Trevillion, K., Oram, S., Feder, G., y Howard, L. M. (2012). Experiences of domestic violence and mental disorders: a systematic review and...
  • Wagner, K. D., Hudson, S. M., Latka, M. H., Strathdee, S. A., Thiede, H., Mackesy-Amiti, M. E., y Garfein, R. S. (2009). The effect of intimate...
  • World Health Organization. (2013). Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines....