How do psychological characteristics of family members affected by substance use influence quality of life?

Abstract

Purpose Addiction is a major health stressor for families, representing an under-researched area with important policy implications. The current aim was to validate the Composite Codependency Scale, which captures the psychological characteristics of affected family members, and assess quality of life as mediated by family functioning. Methods Close relatives ( n = 271) of patients in treatment for substance use disorder (SUD) participated in a 4-day psychoeducational program. We also recruited a general population sample ( n = 393) via an online social media site. Data were analyzed using multigroup confirmatory factor analysis (MGCFA) and a latent regression model. Differences in subscale latent means were applied to ascertain how the scale discriminated the two populations. Results MGCFA yielded a shortened, nine-item partial scalar invariant scale (SCCS) that allowed comparison of latent means. The SCCS discriminated between family members and the general population, with family scoring higher on all three scale dimensions. By effect size, family had higher means (mean differences; 95% confidence intervals) for ‘emotional suppression’ (0.48; 0.36–0.59; p < 0.001; effect size, 0.92), ‘interpersonal control’ (0.47; 0.36–0.59; p < 0.001; effect size, 0.97), and ‘self-sacrifice’ (0.20; 0.10–0.29; p < 0.001; effect size, 0.43). Higher SCCS scores were associated with greater family dysfunction ( β = 1.00, 95% CI 0.63–1.36; p < 0.001) and worse quality of life ( β = − 0.23, 95% CI − 0.30 to − 0.16; p < 0.001), confirming the concurrent validity of the SCCS. Conclusion When family members of people with addictions had the psychological characteristics of suppressing their emotions, believing they could fix others’ problems, and neglecting their own for others’ needs, they also had more family dysfunction and poorer quality of life. The SCCS offers a valid instrument for addressing the life situation of affected families. This scale can help clinicians focus on family members within health services, especially within SUD treatment services. Electronic supplementary material The online version of this article (10.1007/s11136-019-02169-x) contains supplementary material, which is available to authorized users.

Investigation of factors associated with low adherence to treatment of codependency in family members of psychoactive substance users

“…Complaints of intense tiredness, sleep deprivation, and worrying, were symptoms reported by family members in this study and other reports (Bortolon et al, 2017;Lampis et al, 2017;Lima et al, 2019;Sakiyama et al, 2015), demonstrating the problems posed to these family members of problem drug users relatives and their suffering. Low adherence may be related to the characteristics of the codependency framework of these individuals, such as self-sacrifice, where family members neglect their own needs to prioritize the demands of the substance user (Askian et al, 2016;Silva et al, 2019;Vederhus et al, 2019).…”

“…In our sample, depression was the most frequent mental health problem of the codependent individuals, but it was not associated with adherence to the teleintervention. Emotional overload, the severity of psychological symptoms, and the frequency with which the mental health issues were reported can be indicators of low adherence (Vederhus et al, 2019). It should be noted that depressive symptoms have been related, in the literature, to predictive factors for low adherence to treatments of other diseases (Arlt, 2017;Zielinski et al, 2019) and also for increased antidepressant treatment drop out (Rohden et al, 2017).…”

“…Brazil has more than 8 million people who use alcohol and/or other drugs (5.7% of the population) (Laranjeira, Madruga, Pinsky, Caetano, & Mitsuhiro, 2014). The use of psychoactive substances, in addition to causing significant losses in the user's life, generates negative and lasting effects on members of the family system, and there may be many people in distress living with this problem drug user (Ahmad-Abadi et al, 2017;Lima et al, 2019;Vederhus, Kristensen, & Timko, 2019;Zielinski et al, 2019).…”

Functioning of Concerned Others When Adults Enter Treatment for an Alcohol Use Disorder

“…The conceptual model also identifies functioning criterion variables including COs’ mental health symptoms. Since its development and applications, the model has been informed by studies of COs to now include criterion variables of COs’ quality of life and problem management (Timko et al., , , ; Trivedi et al., ; Vederhus et al., ). The model incorporates the mutual influence of COs’ functioning and its determinants over time.…”

Evaluating an intervention for family members of people who use drugs in Vietnam

“…Substance use poses notably more substantial psychological burdens on families in a collective-oriented culture in Asian countries, such as Vietnam, because the stigmatized identity of substance abuse could bring dishonor and shame to the entire family (Go et al, 2016;Rudolph et al, 2012;Salter et al, 2010;Tomori et al, 2014). Societal stigma and isolation could significantly exacerbate family members' mental health challenges and jeopardize their quality of life (Dao et al, 2018;Salter et al, 2010;Tomori et al, 2014;Vederhus et al, 2019). A recent study revealed that mild to extremely severe depressive symptoms are prevalent among family members of HIV-positive PWUD in Vietnam (Dao et al, 2018).…”