Emergency Department Alcohol Intervention: Effects on Dating Violence and Depression

• Published in: Pediatrics (Evanston) 2018-07, Vol.142 (1), p.1
• Main Authors: Ngo, Quyen M, Eisman, Andria B, Walton, Maureen A, Kusunoki, Yasamin, Chermack, Stephen T, Singh, Vijay, Cunningham, Rebecca
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Behavior - psychology; Aggression; Alcohol use; Alcoholic beverages; Care and treatment; Chronology; Company business management; Crime Victims - statistics & numerical data; Dating violence; Depression (Mood disorder); Depression - epidemiology; Depression - therapy; Depression, Mental; Domestic violence; Drinking behavior; Emergency medical services; Emergency Medical Services - statistics & numerical data; Emergency service; Female; Follow-Up Studies; Hospital emergency services; Hospitals; Humans; Intimate Partner Violence - prevention & control; Intimate Partner Violence - statistics & numerical data; Male; Management; Mental depression; Motivational Interviewing - methods; Pediatrics; Personal relationships; Psychological aspects; Randomization; Regression analysis; Social aspects; Substance abuse; Substance abuse treatment; Underage Drinking - prevention & control; Underage Drinking - psychology; Victimization; Violence; Young Adult
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2017-3525

With this study, we examined secondary outcomes of an emergency department (ED)-based brief intervention (BI) on dating violence perpetration and victimization and depression symptoms over 3, 6, and 12 months. ED patients (14-20 years) were screened for risk drinking. Patients who received positive screen results were randomly assigned to a computer BI ( = 277), therapist BI ( = 278), or control condition ( = 281). After the 3-month assessment, participants were randomly assigned to receive the post-ED BI or control condition. BIs were used to address alcohol consumption and consequences (eg, dating violence and depression symptoms) by using motivational interviewing. A total of 836 patients were enrolled in the randomized controlled trial of 4389 patients screened and 1054 who reported risky drinking. Regression models were used to examine longitudinal effects of the alcohol BI on dating violence perpetration, dating violence victimization, and depression symptoms. The therapist BI resulted in a significant reduction of dating violence perpetration up to 12 months (incidence rate ratio [IRR] = 0.53; 95% confidence interval [CI]: 0.37-0.77) and depression symptoms up to 3 months (IRR = 0.85; 95% CI: 0.72-1.00) after the intervention. Computer BI resulted in a reduction of dating violence perpetration (IRR = 0.52; 95% CI: 0.35-0.76) and depression symptoms (IRR = 0.78; 95% CI: 0.66-0.94) 6 months postintervention. Post-ED BIs were associated with lower perpetration at 12 months and lower victimization at 6 and 12 months, irrespective of BI intervention randomization at baseline; however, they did not affect depression symptoms. A single-session ED BI revealed previously to show promise in reducing underage drinking also demonstrates promise in preventing dating violence perpetration and depression symptoms. These technology-enhanced BIs could be particularly helpful given the potential for more efficient resource usage and ease of future implementation.