Re-Empowering Family Members Disempowered by Addiction: Support for Individual or Collective Action?

Just under one hundred million is a conservative estimate of the number of adults whose lives are adversely affected by the alcohol or drug addiction of close relatives. Including children in the figures would add tens of millions more. The particular qualities of the experience of having to cope with excessive drinking or drug taking in the family, in combination, can make it a unique and highly stressful and disempowering experience. A programme of research over a number of years has 1) explored in detail the nature of affected family members’ experiences, and 2) developed and evaluated a method for helping affected family members in their own right. Work in Mexico, England, among indigenous Australians, and in different regions in Italy has suggested the existence of a common core of disempowered experience for family members, with some cross-cultural variations. Predominant cultural norms – individual, familial collective, or community collective – are amongst the factors that modify the core experience. A method of supporting affected family members – the 5-step method – has shown promise in a number of countries. Its emphasis is upon listening carefully to a family member’s story, providing relevant information, discussing coping dilemmas, and building social support. The method is flexible enough to be used in brief forms (including booklet and web forms), with anyone affected by or concerned about another person’s addiction, and it can be used in a wide variety of settings including primary care and other community settings. Examples will be given of the ways in which it can re-empower family members by building their confidence to cope effectively

Re-Empowering Family Members Disempowered by Addiction: Support for Individual or Collective Action?

Just under one hundred million is a conservative estimate of the number of adults whose lives are adversely affected by the alcohol or drug addiction of close relatives. Including children in the figures would add tens of millions more. The particular qualities of the experience of having to cope with excessive drinking or drug taking in the family, in combination, can make it a unique and highly stressful and disempowering experience. A programme of research over a number of years has 1) explored in detail the nature of affected family members’ experiences, and 2) developed and evaluated a method for helping affected family members in their own right. Work in Mexico, England, among indigenous Australians, and in different regions in Italy has suggested the existence of a common core of disempowered experience for family members, with some cross-cultural variations. Predominant cultural norms – individual, familial collective, or community collective – are amongst the factors that modify the core experience. A method of supporting affected family members – the 5-step method – has shown promise in a number of countries. Its emphasis is upon listening carefully to a family member’s story, providing relevant information, discussing coping dilemmas, and building social support. The method is flexible enough to be used in brief forms (including booklet and web forms), with anyone affected by or concerned about another person’s addiction, and it can be used in a wide variety of settings including primary care and other community settings. Examples will be given of the ways in which it can re-empower family members by building their confidence to cope effectively

Excessive Appetites

Abstract Which addictions? Changing the shape of the eld Although 'addiction' is an apt, commonly understood word to use with respect to excessive appetitive behaviours, it has the important disadvantage that it has come to be overly identi ed with drugs that have an effect on the central nervous system. More than that, it has become identi ed with a narrow range of such drugs, particularly those that were outside the law in the West in the late 20th century, and especially with heroin. Not only has this distorted the provision of services for people who might be in need of help in overcoming an excessive appetite, but in my view it has very seriously biased our theoretical understanding. This restricted focus on a particular part of the phenomenon about which we should be theorizing continues to lead us astray, although as this paper will attempt to demonstrate there are some healthy signs that theorizers in our eld are searching for a more comprehensive account. Meanwhile the eld is still frequently con ned to 'drug addiction' or 'substance abuse' in a way that is unhelpful for the development of a complete theory. The starting-point for a view of addiction as excessive appetite is that there exists a range of objects and activities which are particularly risky for humans, who are liable to develop such strong attachment to them that they then nd their ability to moderate their behaviou

Heavy drinking days and mental health: an exploration of the dynamic 10-year longitudinal relationship in a prospective cohort of untreated heavy drinkers.

BACKGROUND: Identifying dominant processes that underlie the development of other processes is important when evaluating the temporal sequence between disorders. Such information not only improves our understanding of etiology but also allows for effective intervention strategies to be tailored. The temporal relationship between alcohol intake and mental health remains poorly understood, particularly in nonclinical samples. The purpose of this study was to disentangle the dominant temporal sequence between mental health and frequency of heavy drinking days. METHODS: We report a 10-year (1997 to 2007) prospective cohort study of 500 respondents (74% male) from the Birmingham Untreated Heavy Drinkers project. Participants were aged 25 to 55 years at baseline, drinking a minimum of 50/35 U.K. units of alcohol for men/women on a weekly basis, and were not seeking treatment for their alcohol use upon recruitment into the study. Heavy drinking days were defined as consuming 10/7+ U.K. units of alcohol in a single day for men/women. Mental health was assessed using the mental health component score of the SF-36 questionnaire. Dynamic longitudinal structural equation models were used to test competing theoretical models (frequency of heavy drinking days leading to changes in mental health scores and vice versa) and a reciprocal relationship (both mental health scores and the frequency of heavy drinking days influencing changes in each other). RESULTS: A model whereby mental health scores were predictors of change in the frequency of heavy drinking days was of best fit. In this model, mental health scores were negatively related to change in heavy drinking days (β -0.80, SE 0.28) indicating that those with higher mental health scores (i.e., better functioning) made larger reductions in the number of heavy drinking days over time. CONCLUSIONS: Mental health appears to be the stronger underlying process in the relationship between mental health and frequency of heavy drinking days

Psykologinen näkökulma addiktioihin

Kirja-arvostelu: Excessive appetites : a psychological view of addictions Jim Orfor

La cohesión y el conflicto en familias que enfrentan el consumo de alcohol y otras drogas una comparación transcultural México-Gran Bretaña

This paper presents a comparison of the results obtaines through the Interpersonal Relations subscale of the Family Environment Scale (Moos & Moos, 1981) in Mexico and England. The main objective is to demonstrate that there are differences between both countries regarding how families perceive cohesion and conflict in the light of the colectivism-individualism construct. The sample studied was integrated by 107 individuals from separate families from Mexico City and 100 individuals from South West England; all of them had lived with an alcohol or drug user. Through exploratory factor analysis two factors were found, one of them related to positive aspects of the family environment (cohesion) and a second factor which denotes conflict. The confirmatory factor analysis demonstrated that both factors are inversely related. Other correlations indicate higher risk for alcohol consumption in families with high cohesion and high risk for drug use in families with a large number of members. Later, variance analysis corroborates that relatives of alcohol users perceive higher cohesion than relatives of drug users. Furthermore, it was observed that English relatives report higher scores in some items of the cohesion subscale while Mexican relatives scored higher on 2 items of the conflict subscale. These results might reflect different situations occurring within the family depending on the number or members and the extent of their agreements to cope with substance use.En este artículo se comparan los resultados obtenidos en México e Inglaterra empleando la subescala de Relaciones Interpersonales de la Escala de Ambiente Familiar (Family Environment Scale [FES], Moos & Moos, 1981). El objetivo principal es demostrar que existen diferencias entre ambos países en cuanto a la forma en que las familias perciben la cohesión y el conflicto a la luz del constructo colectivismo-individualismo. La muestra estuvo integrada por ciento siete familiares en la Ciudad de México y cien en el Sur de Inglaterra, todos ellos habían vivido con un familiar consumidor de alcohol o drogas. A través de un análisis factorial exploratorio se encontraron dos factores, uno de ellos relacionado con aspectos positivos del ambiente familiar (cohesión) y el segundo factor que denota aspectos de conflicto. El análisis factorial confirmatorio demostró que ambos factores están inversamente relacionados. Otras correlaciones indican niveles de asociación entre las familias con alta cohesión y consumo de alcohol, así como asociaciones entre familias con un número de integrantes mayor y consumo de drogas. (Posteriormente se realizó un análisis de varianza en el que se corroboró que los familiares de usuarios de alcohol perciben mayor cohesión que los familiares de usuarios de drogas). Por otra parte, se observó que los familiares ingleses reportan mayores puntajes en algunos reactivos de la sub-escala de cohesión en tanto que los mexicanos tuvieron mayor puntaje en 2 reactivos de la subescala de conflicto. Estos resultados pueden estar reflejando diferentes situaciones que ocurren en el interior de las familias dependiendo del número de integrantes y el grado de acuerdo entre ellos para hacer frente al problema de consumo