Finding Peace

Mike and Jane are fighting. Again. There is a lot of screaming and shouting. Punches are thrown. Neighbors hear the noise, get concerned, and call the police. Mike gets arrested and referred to a batterer intervention program. He gets out and the process repeats. And repeats.

This scenario is a very common one. So common, in fact, research shows that men who complete such programs are only five percent less likely to revert back to their old habits than those that drop out of the program or are arrested and never attend the program at all.

stuartThis finding deeply troubled Gregory Stuart, clinical psychologist and Arts and Sciences Excellence Professor and Provost’s Beaman Professor, who wondered, “What can I do to change these outcomes and enhance the safety of victims and their families?”

His action plan involves a two-pronged approach to defeat domestic violence—with a focus on improving treatments and an ultimate goal of a more peaceful world.

The first prong involves potentially changing the treatment that occurs after someone is arrested for domestic violence. When looking at these so-called batterer intervention programs, Stuart noticed something—a lot of the people had drug and alcohol abuse issues which interfered with their implementing the skills they were learning in the program. He wanted to know what would happen if the batterer intervention programs were coupled with substance abuse treatment.

So, he applied to the National Institutes of Health (NIH) for funding, which they provided, in which he randomly assigned men and women to the standard batterer program alone or to the standard batterer program plus a ninety-minute alcohol treatment. The results were promising. Both the men and women who received the alcohol treatment experienced positive outcomes for their domestic violence and their alcohol usage—the men for six months and the women for at least a year.

“This work is critically important given that individuals with alcohol problems are vulnerable to recidivism following batterer intervention programs, and that batter intervention programs in general are only marginally effective at reducing rates of domestic violence,” said Stuart, who aims to further examine this issue by involving longer, more in-depth alcohol adjunct treatments to see if the outcomes are stronger. If they are, then policy change could be on the horizon.

The second part of Stuart’s plan of attack involves peering into our genetic code to develop individualized treatment plans. To do this, he and his team collected DNA from the subjects who consented to participate in the treatment studies to see if people with certain genetic backgrounds would respond better to alcohol and violence intervention than others. He then worked with research collaborators at Brown University to isolate two genes they hypothesized are tied to impulsive and violent behavior. What they found is that men with higher cumulative genetic risk scores with these two genes had better outcomes—as in less physical violence perpetration, less injuries to partners, and less drinking—when they received a brief alcohol intervention compared to men who did not receive the brief alcohol intervention. In other words, the combination of the two genes could be used for the prediction of treatment outcomes. Next, Stuart hopes to cast the net wider into the gene pool to investigate what forty more genes can reveal.

His overall mission for this prong of the attack is the ability to someday match people to the right psychotherapy so they get the best results. “People would be able to take a genetic test and then, based on the results, doctors would choose from a menu of treatments the option that would likely have the most effective outcomes for their domestic and alcohol issues,” explained Stuart.

Stuart hopes to one day see the impact of his work firsthand. As a practicing clinical psychologist, he works with those battling addiction every week. While he is helping them, they return the favor by giving him ideas for new research.

“The work I do with the patients generates hypotheses for my research. My students and I do a lot of research at the clinic. And then, of course, the research will have direct implications for the treatment of the patients,” he shared.

If it seems that Stuart has a lot of ideas for research already, that’s a fair assessment. His work includes close to 300 publications and he has served as the principal investigator on grants totaling almost $6 million and a collaborator on grants totaling $16.0 million.

All these research studies open up opportunities for his students who have ideas of their own such as investigations into child abuse, family of origin violence, technological aggression, sexual coercion, suicidal ideation, etc.

“Mentoring is the most critical element of my professional mission,” said Stuart. “My goal is to figure out what kind of careers students want and maximize opportunities to help them realize their professional goals.”

And, while mentoring the next generation of researchers, he is strengthening his army in battling domestic violence so there are fewer Mike and Jane scenarios in the world.