Unpacking the Effects of ACEs on IPV Perpetration Among Black Men: The Moderating Role of Alcohol Use

Background and Purpose: Numerous studies have shown an association between adverse childhood experiences (ACEs), alcohol use, and intimate partner violence (IPV) perpetration. However, these studies have primarily used samples of non-Hispanic White males despite findings that Black men perpetrate IPV at higher rates when compared to other racial/ethnic groups; and that children from minority groups have increased risk of experiencing adversities in childhood. This study aims to examine the relationships between ACEs and IPV perpetration and between ACEs and alcohol use; and to examine if alcohol use moderates the relationship between ACEs and IPV perpetration.

Methods: A sample of 2,326 Black men aged ≥20 years were obtained from Wave 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). ACEs were assessed with 10 items: physical and emotional neglect; physical, emotional, and sexual abuse; witnessing mother/caregiver being abused; having a household member with a mental illness, drug and/or alcohol problem, or who was incarcerated before age 18. Alcohol use in adulthood was measured with one question about daily alcohol consumption; and IPV perpetration with five questions about physical perpetration of violence. Descriptive, bivariate, and logistic regression models predicting IPV perpetration and alcohol use were run with weighted data using STATA 16.0.

Results: Among the sample, 68% (n=1,585) reported adversity in childhood, of which 20% (n=458), 16% (n=384), 13% (n=292), and 19% (n=451) experienced 1, 2, 3, and ≥4 ACEs, respectively. The most common ACE factors were emotional (42%, n=985) and physical (39%, n=924) abuse, and physical neglect (32%, n=757). Chi-square analyses showed that physical neglect; emotional, physical and sexual abuse; witnessing mother/caregiver being abused; and having a parent/caregiver with alcohol or drug problem, or who was incarcerated were significantly associated with IPV perpetration. Independent samples t-tests showed that physical and emotional neglect, physical abuse, and having a parent/caregiver with a mental illness, drug or alcohol problem, or who was incarcerated were significantly associated with alcohol use. Findings from the logistic regression showed that alcohol use significantly moderated the relationship between ACEs and IPV perpetration for men exposed to 1 (OR=0.68, p=0.003), 2 (OR=0.67, p=0.012), and ≥4 (OR=0.68, p<0.004) ACEs; however, there was a stronger effect of alcohol on IPV for men without ACEs. Four covariates: age, income, marital status, and perceived stress were also significant in this model.

Conclusions and Implications: Result showed that the majority of Black men had experienced ACEs, most of which were significantly associated with alcohol use and IPV perpetration. Physical neglect and abuse, and having a mother/caregiver with a drug and/or alcohol problem or who was incarcerated were the most consistent factors associated with both alcohol use and IPV perpetration. More importantly, although alcohol use moderated the ACE-IPV relationship there was a greater effect of drinking on IPV for men without ACEs, suggesting that the effects of trauma is greater than alcohol use for men with childhood adversity. These results highlight the effects of ACEs, individually and collectively, on behavioral outcomes among Black men, and the need for trauma screening and culturally-specific intervention.