Top

Quality of Life Research

Published in:

Open Access 01-08-2019

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

Authors: John-Kåre Vederhus, Øistein Kristensen, Christine Timko

Published in: Quality of Life Research | Issue 8/2019

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.

Available only for authorised users

Orford, J., Velleman, R., Natera, G., Templeton, L., & Copello, A. (2013). Addiction in the family is a major but neglected contributor to the global burden of adult ill-health. Social Science & Medicine, 78, 70–77.

Casswell, S., You, R. Q., & Huckle, T. (2011). Alcohol’s harm to others: Reduced wellbeing and health status for those with heavy drinkers in their lives. Addiction, 106(6), 1087–1094.PubMed

Dawson, D. A., Grant, B. F., Chou, S. P., & Stinson, F. S. (2007). The impact of partner alcohol problems on women’s physical and mental health. Journal of Studies on Alcohol and Drugs, 68(1), 66–75.PubMed

Ray, G. T., Mertens, J. R., & Weisner, C. (2009). Family members of people with alcohol or drug dependence: Health problems and medical cost compared to family members of people with diabetes and asthma. Addiction, 104(2), 203–214.PubMedPubMedCentral

Cullen, J., Carr, A., & Id (1999). Carr AOhoo: Codependency: An empirical study from a systemic perspective. Contemporary Family Therapy: An International Journal, 21(4), 505–526.

Dear, E. G., Roberts, C. M., & Lange, L. (2005). Defining codependency: A thematic analysis of published definitions. In S. P. Shohov (eds) Advances in Psychology Research (Vol. 34, pp. 189–206). New York: Nova Science Publishers, Inc.

Beattie, M. (1992). Codependent no more: How to stop controlling others and start caring for yourself (2. ed.). Center City: Hazelden.

Granello, D. H., & Beamish, P. M. (1998). Reconceptualizing codependency in women: A sense of connectedness, not pathology. Journal of Mental Health Counseling, 20(4), 344–358.

Timko, C., Young, L. B., & Moos, R. H. (2012). Al-anon family groups: Origins, conceptual basis, outcomes, and research opportunities. Journal of Groups in Addiction & Recovery, 7, 279–296.

10.

Caputo, A. (2018). The experience of therapeutic community: Emotional and motivational dynamics of people with drug addiction following rehabilitation. International Journal of Mental Health and Addiction. https://doi.org/10.1007/s11469-018-0008-4.CrossRef

11.

Springer, C. A., Britt, T. W., & Schlenker, B. R. (1998). Codependency: Clarifying the construct. Journal of Mental Health Counseling, 20(2), 141–158.

12.

Marks, A. D. G., Blore, R. L., Hine, D. W., & Dear, G. E. (2012). Development and validation of a revised measure of codependency. Australian Journal of Psychology, 64(3), 119–127.

13.

Ministry of Health and Care Services: Public Helth Report. (2015). Coping and possibilities [Folkehelsemeldingen: Mestring og muligheter]. In MeldSt 19(2014–2015). Oslo: Helse- og omsorgsdepartementet (HOD).

14.

Helsedirektoratet. (2015). Priority guidelines for substance use disorder treatment [Prioriteringsveileder—Tverrfaglig spesialisert rusbehandling]. Oslo: Helsedirektoratet.

15.

Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186–3191.PubMed

16.

Reigstad, B., Jorgensen, K., Sund, A. M., & Wichstrom, L. (2010). Prevalences and correlates of sleep problems among adolescents in specialty mental health services and in the community: What differs? Nordic Journal of Psychiatry, 64(3), 172–180.PubMed

17.

Byles, J., Byrne, C., Boyle, M. H., & Offord, D. R. (1988). Ontario Child Health Study: Reliability and validity of the general functioning subscale of the mcmaster family assessment device. Family Process, 27(1), 97–104.PubMed

18.

Lindholt, J. S., Ventegodt, S., & Henneberg, E. W. (2002). Development and validation of QoL5 for clinical databases. A short, global and generic questionnaire based on an integrated theory of the quality of life. European Journal of Surgery, 168(2), 107–113.PubMed

19.

Vederhus, J. K., Birkeland, B., & Clausen, T. (2016). Perceived quality of life, 6 months after detoxification: Is abstinence a modifying factor? Quality of Life Research, 25(9), 2315–2322.PubMedPubMedCentral

20.

Ventegodt, S., Merrick, J., & Andersen, N. J. (2003). Measurement of quality of life II. From the philosophy of life to science. ScientificWorld Journal, 3, 962–971.PubMed

21.

Fayers, P. M., & Hand, D. J. (2002). Causal variables, indicator variables and measurement scales: An example from quality of life. Journal of the Royal Statistical Society, 165(2), 233–253.

22.

Byrne, B. M., Shavelson, R. J., & Muthen, B. (1989). Testing for the equivalence of factor covariance and mean structures: The issue of partial measurement invariance. Psychological Bulletin, 105(3), 456–466.

23.

Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55.

24.

Little, T. D. (2013). Longitudinal structural equation modeling. New York: Guilford Press.

25.

Brown, T. A. (2006). Confirmatory factor analysis for applied research. New York: Guilford Press.

26.

Stevens, J. P. (2009). Applied multivariate statistics for the social sciences (5th ed.). New York: Routledge.

27.

Steenkamp, J. E. M., & Baumgartner, H. (1998). Assessing measurement invariance in cross-national consumer research. Journal of Consumer Research, 25(1), 78–107.

28.

Steinmetz, H., Schmidt, P., Tina-Booh, A., Wieczorek, S., & Schwartz, S. (2009). Testing measurement invariance using multigroup CFA: Differences between educational groups in human values measurement. Quality & Quantity, 43(4), 599–616.

29.

Muthén, L. K., & Muthén, B. O. (2017). Mplus. statistical analysis with latent variables—user’s guide (8th. ed.). Los Angeles: Muthén & Muthén.

30.

Cheung, G. W., & Rensvold, R. B. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling, 9(2), 233–255.

31.

Hancock, G. R. (2001). Effect size, power, and sample size determination for structured means modeling and MIMIC approaches to between-groups hypothesis testing of means on a single latent construct. Psychometrika, 66(3), 373–388.

32.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: L. Erlbaum Associates.

33.

Peterson, R. A., & Kim, Y. (2013). On the relationship between coefficient alpha and composite reliability. Journal of Applied Psychology, 98(1), 194–198.PubMed

34.

Brown, T. A. (2015). Confirmatory factor analysis for applied research (2nd ed.). New York: Guilford Press.

35.

Davidov, E., Meuleman, B., Cieciuch, J., Schmidt, P., & Billiet, J. (2014). Measurement equivalence in cross-national research. Annual Review of Sociology, 40, 55–75.

36.

Birkeland, B., Weimand, B. M., Ruud, T., Hoie, M. M., & Vederhus, J. K. (2017). Perceived quality of life in partners of patients undergoing treatment in somatic health, mental health, or substance use disorder units: A cross-sectional study. Health and Quality of Life Outcomes, 15(1), 172.PubMedPubMedCentral

37.

Corrigan, P. W., Watson, A. C., & Miller, F. E. (2006). Blame, shame, and contamination: The impact of mental illness and drug dependence stigma on family members. J Fam Psychol, 20(2), 239–246.PubMed

38.

Educational level in the Norwegian population. Retrieved February 1 2019 from https://www.ssb.no/utdanning/statistikker/utniv.

39.

Rossow, I., Natvig, H., & Moan, I. S. (2009). Close relatives of persons with harmful use of alcohol—how many are they and how are they affected? [Nære pårørende av alkoholmisbrukere: hvor mange er de og hvordan berøres de?]. Oslo: SIRUS.

40.

Salvatore, J. E., Larsson Lonn, S., Long, E. C., Sundquist, J., Kendler, K. S., Sundquist, K., & Edwards, A. C. (2019). Parental alcohol use disorder and offspring marital outcomes. Addiction, 114(1), 81–91.PubMed

41.

Caputo, A. (2017). Social desirability bias in self-reported well-being measures: Evidence from an online survey. Universitas Psychologica, 16(2), 1–13.

42.

Holahan, C. J., Moos, R. H., Holahan, C. K., Brennan, P. L., & Schutte, K. K. (2005). Stress generation, avoidance coping, and depressive symptoms: A 10-year model. Journal of Consulting and Clinical Psychology, 73(4), 658–666.PubMedPubMedCentral

43.

Gordoni, G., Schmidt, P., & Gordoni, Y. (2011). Measurement invariance across face-to-face and telephone modes: The case of minority-status collectivistic-oriented groups. International Journal of Public Opinion Research, 24(2), 185–207.

Title: How do psychological characteristics of family members affected by substance use influence quality of life?
Authors: John-Kåre Vederhus
Øistein Kristensen
Christine Timko
Publication date: 01-08-2019
Publisher: Springer International Publishing
Published in: Quality of Life Research / Issue 8/2019
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-019-02169-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 8/2019

Beyond care burden: associations between positive psychological appraisals and well-being among informal caregivers in Europe

Quality of life is substantially worse for community-dwelling older people living with frailty: systematic review and meta-analysis

Comparison of three generic quality-of-life metrics in peripheral arterial disease patients undergoing conservative and invasive treatments

Food-related quality of life in patients with inflammatory bowel disease and irritable bowel syndrome

Correction to: Eculizumab improves fatigue in refractory generalized myasthenia gravis

A qualitative study investigating the meaning of participation to improve the measurement of this construct