Predictors of Burden of Family Caregivers of Women with Substance Use Disorders or Co-Occurring Substance and Mental Disorders

ABSTRACT

This study examined the impact of having a female family member with a substance use or co-occurring disorders on family caregivers. Predictors of subjective burden (worry, stigma, and displeasure) and objective burden (family disruption) on caregivers and on types of burden were explored. Subjects were 82 women receiving substance abuse treatment and their family member providing most social support. Behavioral problems of the recipient and lack of social support for caregivers predicted higher levels of family member burden, with different types of social support predicting different types of burden. Having a dual disorder did not predict family member burden. Implications of findings for treatment are discussed.     

Personal Social Networks of Women with Co-Occurring Substance Use and Mental Disorders

ABSTRACT

There has been relatively little examination of the social network resources of women with substance use disorder, and even fewer explorations of women with co-occurring mental disorders, such as anxiety, depression, and posttraumatic stress disorder. This study explores the nature of co-occurring mental disorders, social network characteristics and perceived social support in 136 women with substance use disorders. Respondents reported small personal networks that contained both supportive and non-supportive people. Relatives did provide social support, but those who used alcohol/drugs were viewed as tending to interact negatively. Women with dual disorders perceived less concrete, emotional, and sobriety support from some network relationships than the women with substance use disorders only. Implications for research and practice are presented.     

Co-Occurring Substance Use and Personality Disorders: Current Thinking on Etiology,Diagnosis, and Treatment

ABSTRACT

Despite the high prevalence of personality disorders among substance abusing individuals, the literature on these co-occurring disorders is limited. This paper reviews the literature and provides the most current data on the demographics, the criteria for diagnosing both personality disorders and substance use disorders, and the effects of substance abuse and co-occurring personality disorders, particularly antisocial and borderline, on prognoses and treatment approaches. Recommendations for further research on these co-occurring disorders are provided.     

Barriers to Treatment for Women With Substance Use Disorders

Substance-dependent women are facing tremendous barriers that impede them from entering into treatment programs. Such barriers include the lack of childcare, fear of stigma, lack of family or financial support, denial, and the co-occurring disorders. Strategies are paramount to the removal of these barriers, whereas treatment and relapse prevention aid in the rehabilitation process.     

The Impact of a Substance Abuse Disorder on the Well-Being of Family Caregivers of Adults With Mental Illness

ABSTRACT

The impact that substance use has on an individual with mental illness has been documented; however, little is known about the impact that this may have for a family caregiver. Data was collected in a cross sectional study using mailed questionnaires to a convenience sample of family members of persons with mental illness (n = 110). Hierarchical linear regression analysis was used to determine the impact of substance use status upon four measures of well-being within a stress-coping model. The variables within the model were able to account for a significant proportion of the variance in each of the measures: perceptions of burden, depression, anxiety and physical health status (R² = .419 to .202). However, substance use status was not a significant predictor in any of these equations. Symptomatology and a measure of specific social support were the most significant predictors of burden (β = .345, p < .001 and β = .330, p < .001). Perceptions of caregiver burden were found to be the most significant predictor in each of the other three analyses (β = .515, p < .000; β = .511, p < .000; β = ? .571, p < .000). Results of this study suggest that substance use may not be as important as the other predictors included in the model in determining the well-being of family caregivers.     

Women's Experience of Co-Occurring Substance Abuse and Mental Health Conditions

ABSTRACT

This study explored the relationship between gender and co-occurring substance abuse and mental health conditions among a sample of 754 consumers of behavioral health services in the southwest U.S. Logistic regression was used to determine factors that would predict women's unique experience of dual diagnosis. Women were almost seven times more likely than men in this sample to have a diagnosis of posttraumatic stress disorder in conjunction with substance abuse. Women were also significantly more likely to experience anxiety and mood disorders and to have been married. Implications of these findings for social work practice are suggested.     

Building Trauma Informed Practice: Appreciating the Impact of Trauma in the Lives of Women with Substance Abuse and Mental Health Problems

ABSTRACT

This paper examines the lifetime interpersonal abuse experienced by a substance abuse treatment sample of 1,955 women with co-occurring disorders. Substantial rates of intimate and community-based interpersonal abuse and other life stressors are documented. Regression analysis shows that while trauma severity is significantly related to trauma distress, its impact on psychological symptom distress and drug severity is quite modest. The implementation of a trauma informed approach featuring trauma-specific treatment, service integration and consumer empowerment is described as a promising practice model for assisting women seeking help in substance abuse treatment programs.     

Latent Profiles of Residential Stepfamily Relationship Quality and Family Stability

Stepfamilies are an increasingly common context in which adults and children reside. Past research has examined family processes that promote family resilience, such as dyadic relationships marked by warmth, positive communication, satisfaction, and closeness. What remains less clear is whether various profiles of dyadic relationship quality within stepfamilies exist and operate to influence stepfamily stability. Using data from the National Longitudinal Study of Adolescent to Adult Health, we conducted a latent profile analysis of mother–child, stepfather–child, and stepcouple relationship quality among a sample of 1,646 adolescents residing in married and cohabiting mother–stepfather families. Results favor a 4-profile solution, labeled high-quality, high-quality couple relationship, high-quality parent–child relationships, and low-quality. The identified latent profiles displayed differences with respect to family stability, or rates of remaining an intact family system 1 year later.     

Daytime Sleepiness,Poor Sleep Quality,Eveningness Chronotype,and Common Mental Disorders Among Chilean College Students

Abstract

Objectives: To evaluate whether daytime sleepiness, poor sleep quality, and morningness and eveningness preferences are associated with common mental disorders (CMDs) among college students. Methods: A total of 963 college students completed self-administered questionnaires that collected information about sociodemographic characteristics, sleep quality characteristics, CMDs, and other lifestyle behaviors. Results: The prevalence of CMDs was 24.3% (95% confidence interval [CI] [21.5%, 27.1%]) among all students. Prevalence estimates of both excessive daytime sleepiness and poor sleep quality were higher among females (35.4% and 54.4%) than males (22.0% and 45.8%). Cigarette smoking was statistically significantly and positively associated with having CMDs (p = .034). Excessive daytime sleepiness (odds ratio [OR] = 3.65; 95% CI [2.56, 4.91]) and poor sleep quality (OR = 4.76; 95% CI [3.11, 7.29]) were associated with increased odds of CMDs. Conclusion: Given the adverse health consequences associated with both sleep disorders and CMDs, improving sleep hygiene among college students is imperative to public health.     

The Tempo of Sexual Activity and Later Relationship Quality

Rapid sexual involvement may have adverse long‐term implications for relationship quality. This study examined the tempo of sexual intimacy and subsequent relationship quality in a sample of married and cohabiting men and women. Data come from the Marital and Relationship Survey, which provides information on nearly 600 low‐ to moderate‐income couples living with minor children. Over one third of respondents became sexually involved within the first month of the relationship. Bivariate results suggested that delaying sexual involvement was associated with higher relationship quality across several dimensions. The multivariate results indicated that the speed of entry into sexual relationships was negatively associated with marital quality, but only among women. The association between relationship tempo and relationship quality was largely driven by cohabitation. Cohabiting may result in poorer quality relationship because rapid sexual involvement early in the romantic relationship is associated with entrance into shared living.     

The Roles of Relationship With Family and Life Values in the Housing Choices of Elderly Koreans

Housing choice is a significant factor in forecasting the housing market. In an aging population in which the wealth of the elderly is found mostly in housing equity, the housing choices of the elderly are an increasingly important yet underrepresented research theme. In addition to lower income and greater leisure time, the change of family relationships of the elderly are likely to result in significantly different housing choices from those made by younger groups. This article investigates the roles of family relationships and life values in the housing choices (tenure and location) of elderly Koreans. Subjective life satisfaction and propensity for expenditure were found to be significant determinants in the choice of housing tenure, whereas the choice of location is influenced by circumstances, especially their relationship with their children. These findings provide new insight into the Asian housing market, in which the elderly of traditional large families have a children-oriented mindset and maintain a geographic proximity with their children despite a growing trend toward family nuclearization.     

Women in India: The Context and Impact of HIV/AIDS

ABSTRACT

The response to the HIV/AIDS epidemic on the Indian subcontinent has been hampered by several factors, including societal stigma, lack of educational resources, lack of economic opportunities, and the competing priorities for a nation just growing and developing an infrastructure for education, industry, and health. In particular, Indian women are silent victims in this epidemic because they do not readily have a respected voice in decision making and priority setting for the government. The epidemic is increasingly affecting and infecting Indian women (e.g., female commercial sex workers, married women, and pregnant women). The status of Indian women has placed them at extreme disadvantage because India is a country with socially progressive laws but has been slow to change its social norms. The reported HIV prevalence is low although many researchers agree a large amount of underreporting occurs. For India to address this emerging epidemic among women appropriately, it should focus on three intervention areas: (1) short-term solutions such as treatment options for those already infected with HIV to prevent further infection to sexual partners and children; (2) intermediate solutions such as education for those who are uninfected but engaging in behaviors that may put them at risk, such as injection drug use, engaging in commercial sex work, engaging in extramarital sexual relations, and having sexual partners who are not monogamous; and 3) long-term solutions such as addressing the root causes of inequality (e.g., disparities in education and employment and unwillingness to change social norms).     

Paths to Intimate Relationship Quality From Parent–Adolescent Relations and Mental Health

Using a developmental systems perspective and public‐use longitudinal data from participants currently in a romantic relationship at Wave 4 of the National Longitudinal Study of Adolescent Health (n = 2,970), the current study explored direct and indirect paths from parent–adolescent relationship quality to young adult intimate relationship quality. Structural equation modeling tested whether mental health (depressive symptoms and self‐esteem) in the transition to adulthood mediated the association between parent–adolescent relations and young adult intimate relations. The results indicated that higher quality parent–adolescent relations predicted higher self‐esteem and lower depressive symptoms during the transition to adulthood as well as higher young adult intimate relationship quality, controlling for adolescent mental health and parent–young adult relationship quality. Higher self‐esteem during the transition to adulthood was associated with greater intimate relationship quality, whereas greater depressive symptomatology predicted reduced intimate relationship quality. One significant indirect path emerged: parent–adolescent relationship quality → self‐esteem → intimate relationship quality.     

The Effects of Religion on Remarriage Among American Women: Evidence From the National Survey of Family Growth

The concept of relationship self-regulation (RSR) has been shown to be related to relationship satisfaction, yet the differences in RSR ability based on couple type have yet to be examined. This study compared first married, remarried, and cohabiting individuals on their self-reported ability to implement RSR in their relationship, along with their report of satisfaction, positive communication, and negative communication in their relationships. Data were derived from 6,565 participants who were part of the Relationship Evaluation (RELATE) questionnaire data set. Results showed that although mean differences in RSR were small across couple types, remarrieds reported significantly lower RSR levels than any other group, whereas first marrieds reported significantly higher RSR levels than any other group. Implications for relationship education programs and couple therapy are discussed.     

The Impact of Family Functioning on Caregiver Burden among Caregivers of Veterans with Congestive Heart Failure

A cross-sectional study of 76 family caregivers of older veterans with congestive heart failure utilized the McMaster model of family functioning to examine the impact of family functioning variables (problem solving, communication, roles, affective responsiveness, and affective involvement) on caregiver burden dimensions (relationship burden, objective burden, stress burden, and uplifts). Regression analyses indicated that the five dimensions of family functioning were significantly related (p < 0.01) to relationship burden (R ² = .27) and uplifts (R ² = .29). More specifically, increased relationship burden was associated with problems in family roles, and increased uplifts was related to higher levels of affective responsiveness.     

Effects of Conflict Styles and Conflict Severity on Quality of Life of Men and Women in Family Businesses

Studies show that family businesses need to manage conflict, but there has been little research on different conflict manifestations and their impact on families involved in businesses together. This study investigates the impact of six conflict styles on severity of conflict and quality of life for husbands and wives in 206 farm family businesses. Data analysis was done using structural equation modeling, with independent models for each gender. For men, the assertion style negatively impacted, and aggression positively impacted the severity of conflict; for women, aggression and withdrawal styles positively impacted, and denial negatively impacted severity of conflict. There was a strong negative relationship between severity of conflict and quality of life for both men and women in family businesses.     

The Critical Shapes of Body Image: The Role of Culture and Family in the Production of Eating Disorders

Although research has pointed to the influence of culture and family in the etiology of eating disorders, few studies have examined how these influences conjoin in this process. This research explores how the family mediates cultural ideas about thinness and how the family conveys these messages to family members. Using a grounded theory approach, open‐ended interviews were conducted with 32 White, middle‐class women (with and without eating disorders) on the topic of body image and eating problems. In conjunction with this method, qualitative comparative analysis (QCA) was also performed to identify family characteristics, and their specific combinations, that were associated with eating disorders. The findings indicate that a critical family environment, coercive parental control, and a dominating discourse on weight in the household are salient conditions, and their specific configurations are discussed in relationship to current theoretical conceptualizations regarding the influences of culture and family in the production of eating disorders.     

Beyond the Mommy Track: The Influence of New-Concept Part-Time Work for Professional Women on Work and Family

This study investigates how the option for new-concept part-time work influences the ability of mothers of preschool children working in professional occupations to successfully integrate work and family responsibilities while maintaining career opportunities. Data are from a subset of the 1996 IBM Work and Life Issues Survey in the United States (n = 687). Compared to their counterparts who worked full time, mothers who worked in these part-time positions reported significantly greater work-family balance and did not report significantly less career opportunity. The part-time group reported 47% fewer work hours and 41% lower income than the full-time group. These data support the notion that new-concept part-time work is a viable option to assist women in professional careers to successfully integrate their family career. Implications of these findings are presented.     

From Caregivers to Caretakers: The Impact of Family Roles on Ethnicity Among Children of Korean and Chinese Immigrant Families

Scholars have long examined the effects of family and community on ethnicity, but they have less to say on why some children may be more receptive to the positive influences of ethnic communities than siblings within the same family. As more immigrants struggle to adapt to the needs and demands of the new global economy, many families are turning to alternative caregiving arrangements that significantly impact the long-term ethnic identities of the second generation. The article considers how adult-age children of immigrants negotiate the emotional disconnects created by these varying contexts of care depending on their individual role within the family and how it shapes their views on ethnicity and culture in their own adult lives. The study focuses in-depth on fourteen semi-structured, in-person interviews with adult-age children of Asian immigrant families in the NY-NJ metropolitan area. Depending on their social status, children of immigrants are integrated into their families: as cultural brokers expected to mediate and care for their family members, as familial dependents who rely on their parents for traditional caregiving functions, or as autonomous caretakers who grow up detached from their parents. I argue that because of their intense engagement with family, cultural brokers describe their ethnic-centered experiences as evoking feelings of reciprocated empathy, whereas on the other end, autonomous caretakers associate their parents’ ancestral culture with ethnocentric exclusion. Depending on how they are able to negotiate the cultural divide, familial dependents generally view their parents’ culture and immigrant experiences through the hierarchical lens of emulation.