An estimated 7.5 crore Indians are drug addicts and the number is going up significantly, spreading to semi-urban and backward areas, according to official figures.
Considering the significant prevalence of substance abuse in India, there naturally arises a question as to its effects not only on the immediate user, but on the family as well.
However, study of maladaptive behavior has been restricted to western families dealing with substance abuse. This study aims to shed light on Indian families and their subsequent family pathologies. Keeping this in mind, the significance of the proposed research is stressed.
This research sets forth the following hypotheses:
There is a greater degree of maladaptive behaviour present in families of substance abusers than in families of non-abusers.
There is a difference in the degree of maladaptive behaviour exhibited by men and that by women.
This study defines families who have been affected by substance abuse as those families where one or both spouses are substance abusers.
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To test the above hypothesis, 60 married couples who have been directly affected by addiction, were required to fill out a scale (the Veeraraghavan and A. DograÂ Family Pathology Scale). The questionnaire tests 10 dimensions indicating an FIS (Family Incongruence Score), which is indicative of family pathology.
The sample is drawn from different parts of India and reflects diversity in their socio-economic backgrounds. Participants were required to sign a consent form in order to participate in the study.
The results showed that while there is a statistically significant difference in the maladaptive behaviour of families of substance abusers and those of non-abusers, there is no such significant difference between men and women.
The family environment is of utmost importance, which exercises a profound influence on an individual's life in many spheres. There have been many studies on family influence on the individual and from various perspectives.
Humans need parents like no other beings and for longer than any other species. Children need assistance from parents and caretakers (Flinn and England, 1995) to develop social skills. Relationships within the family are essential to the child's development (Bowlby, 1969; Kagan, 1984).
In a study by John D. Hundleby and G. William Mercer, it has been found that 'lack of parental affection, concern, involvement and modeling appeared to be central factors in the family's influence', which accounted for up to 22% of variance of drug use.
All studies point toward one pertinent question: How much are we influenced by our parents? The following study helps to illustrate the same:
This study entitled 'Effects of the Family Environment on Adolescent Substance Use, Delinquency, and Coping Styles' examines the overall and relative contributions of a variety of family environment measures to a child's alcohol, marijuana and other drug use, delinquent activity, and dysfunctional methods of coping with problems. The family environment variables tapped aspects of parental behaviors and attitudes, parenting styles, and family harmony and cohesion.
It was generally found that hostility and lack of warmth on the part of the parents contributed most to these outcomes in subjects. Finally, hostility displayed by both parents helped to determine the incidence of delinquency among sons and the use of dysfunctional coping methods among sons and daughters. (Johnson, V. & Pandina, R. J., 1991)
As is seen by the studies already mentioned, drug use in children seems to be related to dysfunction within the family. However, what about parental drug abuse leading to a dysfunctional or maladaptive family?
Drug Abuse and Maladaptive Families
After a careful analysis of previous research and studies, this study endeavors to hypothesize that there is a greater degree of maladaptive behaviour present in families who have been directly affected by addiction (wherein one of the spouses have been affected, or both) than in families who have not been directly affected, which is what this study aims to do.
Another aspect of this study which makes it unique is that it aims to study the degree of maladaptive behavior in Indian families. While most studies are seen from the western perspective, many socio-cultural influences unique to the Indian culture may render these studies and their findings inapplicable to the Indian scenario.
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This study deals with substance abuse and its effect on the family, the dependence of one person to abusive substances and the resulting effects of such a dependence of the family pathology, shown by presence of maladaptive behaviours.
Let us begin by defining substance abuse disorders which for the purposes of this study are categorized under the broad definition of 'addiction'.
According to the currentÂ Diagnostic and Statistical Manual of Mental DisordersÂ (DSM-IV), substance dependenceÂ is defined as:
"When an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed. Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped. This, along with substance abuseÂ are considered Substance Use Disorders...."
Â An estimated 7.5 crore Indians are drug addicts and the number is going up significantly, spreading to semi-urban and backward areas, according to official figures.
As per the National Survey on Extent, Pattern and Trends of Drug abuse in India conducted by the Centre in collaboration with United Nations Office on Drugs and Crime (2006), it is estimated that there are about 6.25 crore alcoholics, 90 lakh Cannabis and 2.5 lakhs opiates and nearly 10 lakh illicit drug users in the country.
Considering the relatively significant prevalence of substance abuse disorders in India, there naturally arises a question as to its effects not only on the immediate user, but on the family as well.
Previous research done on this subject shows that the effects of any addiction on the family is significant.
Maladaptive behaviorsÂ refer to types of behaviors that inhibit a person's ability to adjust to particular situations. This type of behavior is often used to reduce one's anxiety, but the result is dysfunctional and non-productive.
In Introduction to Addictive Behaviors,Â by Dennis L. Thombs, addiction is a behavioral disorder. It is important to understand the value played on objectivity in the behavioural sciences. When alcoholism (or addiction) is described as a 'maladaptive behaviour' it is very different from describing the condition as 'misbehaviour' (a moral perspective).
The partner of an alcoholic or addict is also, and usually the one most severely affected. The spouse may have feelings of hatred, self-pity, avoidance of social contacts, may suffer exhaustion and become physically or mentally ill (Berger, 1993)
Thus in view of the above findings, this researcher stresses upon the importance of such research today. This is especially significant in the cultural context, which this researcher feels differentiates this particular study from previous ones. So far, study of maladaptive behavior has been restricted to western families dealing with substance abuse. This research aims to shed light on Indian families and their subsequent family pathologies.
The scale used in this study is the Veeraraghavan and A. DograÂ Family Pathology Scale, developed in 1999. It measures 10 dimensions, which are:
Intellectual cultural orientation
Active recreational orientation
Moral religious emphasis
Independent Variable: Presence of substance abuse in one of the parents
Dependent Variable: family pathology
Intervening Variables: Dishonesty, inadequate understanding of the questionnaire, self-reporting bias.
The kind of sampling used was nonprobability sampling.
Nonprobability samplingÂ involves the selection of elements based on assumptions regarding the population of interest, which forms the criteria for selection.
Sample comprised of 40 couples, divided into 2 groups. Total sample size of 80 subjects.
First group: comprised of 20 couples of whom the husband is a substance abuser for more than a period of 12 months.
Second group: comprised of 20 couples who have no direct influence of addiction or substance abuse in their family.
The sample for the first group is obtained through rehabilitation centers and self-help groups such as Al-Anon; sample is from all over India for more accuracy.
Samples are taken from Hyderabad, Ahmedabad, Mumbai, Gurgaon, Gulbarga, Kerala, Goa, Nagpur, Pune, Surat, Kolkata, Jaipur, Mysore and Bhatinda.
Table 1 Showing the Difference in Means between Families of Substance Abusers and Families of Non-Abusers
Table 2 Showing the Difference in Means between Men and Women
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Thus the results have indicated:
The hypothesis that families of substance abusers will show a greater degree of maladaptive behaviour is proved.
The hypothesis that there is a difference between men and women in the degree of maladaptive behaviour is not proved.
The results of this study show that families of substance abusers show a greater degree of maladaptive behavior in their interaction with each other. This is keeping in accordance with earlier studies on families of substance abusers.
The results have also shown that there is no statistically significant difference between the degree of maladaptive behavior exhibited by men and that by women. It is important to note also that these results were consistent across all tested ages (30-50 years)
(1) "There is a greater degree of maladaptive behaviour present in families of substance abusers than in families of non-abusers."
The above hypothesis was supported for the taken sample and the t-value was significant at 0.01 level. Thus, the taken hypothesis is significant for 99% of the population.
(2)There is a difference in the degree of maladaptive behaviour exhibited by men and that by women.
The above hypothesis was not supported for the taken sample and the t-value was not significant.
So the results suggest that there is no significant difference in the maladaptive behavior exhibited by men and that of women.
This was surprising as since most of the questions in the questionnaire dealt with the parent's relationship with their child, one would expect mothers to obtain a higher score as a consequence of their increased interaction with the child, at least in the Indian scenario. However, it is seen that men and women exhibit almost the same degree of maladaptive behavior in their interaction within the family.
The possible limitations of this study would have been self-reporting bias(as participants were asked to fill out the answers themselves) and/or dishonesty in answering the questionnaire.
The results are keeping in accordance with studies conducted earlier on families of substance abusers, and the effect of an addict's drug use on the people around him. While most studies are seen from the western perspective, many socio-cultural influences unique to the Indian culture may above render these studies and their findings inapplicable to the Indian scenario. However, this study focused on Indian population and is as such relevant and unique in the cultural context.