How does the common core to the harm experienced by affected family members vary by relationship, social and cultural factors?

Abstract

This paper takes an international perspective on the harm to close family members caused by addiction. It draws on data collected by the Addiction and the Family International Network (AFINet), England, and their colleagues in other countries. It includes qualitative data based on semi-structured interviews in Mexico, England, Australia (an Indigenous sample), Nigeria, and India; quantitative data based on the use of a standard set of questionnaires specifically designed or chosen for use with family members affected by addiction problems collected in Mexico, England, Italy, Brazil and the USA. The results are interpreted to suggest that, although there is a common core to the harm experienced by all affected family members (AFMs), the family harm is variable, dependent in important ways on relationship, social and cultural factors. Specifically, it is hypothesised that AFMs experience greater coping difficulty and higher levels of strain under conditions of: greater accumulated burden; a family position of structural subordination and dependence; and lack of good quality social support.

Keywords:

• Family harm
• international
• mixed methods
• culture
• family relationships

Acknowledgements

I would like to acknowledge the contributions of many colleagues to the research referred to in this article, most notably Caterina Arcidiacono, Alex Copello, Akan Ibanga, Abhijit Nadkarni, Guillermina Natera, Fatima Padin, Anil Rane, Lorna Templeton and Richard Velleman.

Declaration of interest

None to declare.

Notes

1. At risk of oversimplification, I use the commonly used word “addiction” throughout to mean a continuing use of alcohol, drugs or gambling which is sufficiently excessive to cause problems for the individual concerned and his or her family members.

2. We have mostly used the term “withdrawal coping” but we have recognised that the most important element is what we are increasingly referring to as “independent coping”. This latter has several elements: not worrying, doing what the family member wants to do, getting involved in other activities, escaping or getting away, sorting oneself out, taking what was happening less personally and getting a new and better life for oneself and other members of the family (Asher, 1992; Orford et al., 2005a).

3. Engaged coping covers a diverse group of actions. One sub-group (engaged-emotional) consists of AFMs getting emotional with their relatives or interfering in their relatives’ substance use or gambling in an effort to control it. It is that sub-group of engaged-emotional coping which is likely to reflect difficulty in coping, in contrast to other forms of engaged coping such as assertive and supportive coping (Holmila, 1997; Yang, 1997).

4. Much of our group’s work, and all the examples of research cited in this paper, have concerned adult AFMs, although other work by members of the group has been with child AFMs (now children or now grown up) (Templeton, 2010; Velleman & Orford, 1999).

5. At one time, we thought that the individualism-collectivism dimension, prominent in cross-cultural psychology (Hofstede, 1994), might be particularly useful. But as a unique dimensional concept that has been criticised on a number of grounds. Although we have now concluded that no single dimension, such as traditional versus modern family gender roles, or individualistic versus collectivistic culture, is likely to provide more than a partial explanation of the variations that we are seeing, a component of traditional family collectivism which may serve to capture some of the variation is one that has been termed “belief in hierarchy” or “power distance” (Georgas, Berry, van de Vijver, Kağitçibaşi, & Poortinga, 2006; Smith et al., 2006).