What's at the Root of Alcohol-Related Aggression? a Systematic Review of Emotion Regulation, Alcohol Use, and Aggressive Behavior

Background/Purpose: Alcohol use is a predominant risk factor for aggressive parenting behaviors; however, there is controversy around whether this association is causal, spurious, or indirect. We conducted a systematic review to clarify this unclear relationship with a focus on emotion regulation as a potential underlying mechanism. Our aims were to identify present gaps in knowledge specific to these constructs and to explore how these findings may be applied to intervention strategies targeting parental aggression among alcohol-using populations.

Methods: Three electronic databases (PsycINFO, PubMed, & Social Science Citations Index) and reference lists were searched during February 2017 to identify relevant records. Due to the dearth of literature addressing emotion regulation, alcohol use, and aggressive parenting behaviors simultaneously, we expanded our search to include any relational aggression. The final literature search included all studies published between 2000 and 2016 that met the following criteria:  1) participants were age 18+ years, 2) outcome variable measured aggressive behavior, and 3) key independent variables measured a) emotion regulation and b) alcohol use. Of the 71 unduplicated studies identified through our search, 8 studies met these criteria and were included in the final sample. Each screened in article was coded by at least 2 researchers for study components and methodological quality. Discrepancies were addressed through a team-based consultation.

Results: All 8 studies focused on interpersonal violence (IPV) with 1 study also assessing for parenting behaviors. There were a mix of research designs with 5 cross-sectional studies (including 2 surveys, 1 case control, and 2 experimental) and 3 longitudinal studies (including 1 prospective and 2 retrospective). The study samples were predominantly non-clinical, young adults (n = 5). The majority of studies observed one of two dynamics: (1) alcohol use partially mediating the relationship between emotion regulation and aggressive behaviors (n = 3) or (2) alcohol use moderates the relationship between emotion regulation and aggressive behaviors (n = 3). Further, these relationships were observed to differ by gender, by focus on physical or psychological aggression, by drinking pattern (i.e. heavy vs. light), and by the time period being observed in the study.

Conclusion/Implications: There is only 1 study that explicitly looked at aggressive parenting behaviors, suggesting a clear gap in knowledge about the role of emotion regulation in alcohol-related aggression among parents. There are mixed results regarding the nature of the relationship between these constructs, and this is further complicated by other differences likely existing for men versus women, types of drinking behaviors, and types of aggressive behaviors. In addition, very little of this work has been conducted with clinical or high-risk populations, so applicability to the social work field is limited. Future research should explore parental emotion regulation to better understand the role of alcohol use in the creation of parent-child aggression. Applying already-established emotional regulation therapeutic strategies has the potential to address aggressive parenting behaviors better than AUD treatment alone.