An upbringing with substance-abusing parents: Experiences of parentification and dysfunctional communication

The elephant in the room: Metaphors in women's accounts of life with a family member with problematic substance use

Background: Research has shown that a family member's problematic substance use has significant deleterious mental and physical health impacts on other members of the family. Women are more often affected than men. These negative health effects persist as the person with problematic substance use ages, and they vary according to the relationship status. Aim: The aim of this study was to gain a deeper understanding of how women experience and are affected by their family member's substance use problems. Method: A metaphorical analysis of narrative interviews with 11 daughters and five wives of older adults (>65 years) with problematic substance use. Results: We identified four areas of signification in which metaphors were employed: (1) experiences (chaos and crash and walking on eggshells); (2) strategies (complicity and silencing); (3) dilemmas (deceit or a disease and open or closed dilemmas); and (4) consequences (obtaining or retaining an identity, health and different types of help). Conclusion: Family life with a parent or spouse with a substance use problem was described as chaotic, unsafe, uncertain and with no prospects of change. The study illustrates how metaphors are used to mediate experiences and worldviews pertaining to existential matters founded in deep negative emotions, deceit, shame and stigma. Metaphors make up a crucial material for communicating emotions and themes that are difficult to convey due to shame and stigma.

Barns upplevelser av en intervention i familjer där vuxna har ett problematiskt bruk av alkohol och droger

Aim: To investigate children's experiences of the intervention Me and my Family. Me and my Family is an intervention, for families with parental substance use problems (SUP) provided by Swedish social services outpatient care, includes eight weekly sessions where family members communicate how the SUP affects the family. Method: Data consists of 17 qualitative interviews with children, 7 to 19 years old. The qualitative data were analysed using a thematic approach, initially inductively and then discussed by adding salutogenic perspective. Results: The results are presented in three themes. Regardless of the children's varying ages, the results indicate that participating in the intervention has helped the family break the taboo surrounding parental substance use and enabled the young participants to communicate with their family members differently. The intervention also contributed to stronger bonds between children and their parents.

Emerging adult college students' descriptions of exposure to childhood emotional abuse and associated factors: A qualitative exploration

BACKGROUND

Growing evidence on the long-term deleterious impacts of emotional abuse highlights the need to further understand childhood emotional abuse and its context to strengthen prevention efforts.

OBJECTIVE

To describe emerging adults' experiences of emotional abuse in their childhoods and the household context surrounding that abuse.

PARTICIPANTS AND SETTING

Fifty-eight interviews were conducted with emerging adults, ages 18-25, recruited from four 2- and 4-year institutions of higher education.

METHODS

Thematic analysis was conducted to identify and describe patterns in the data. A cyclical approach to codebook development and data analysis was followed by a team of four coders.

RESULTS

Themes related to participants' experiences of emotional abuse included: inability to meet parent expectations; parent attacks on the child's character; parent negative comparisons to siblings and others; parent invalidation of the child's emotions and mental health needs; and evolution over time in the parent-child relationship. Aspects of childhood family environments contemporaneous with the childhood emotional abuse included: financial stress; parent mental illness; parent divorce, separation, or volatile relationship; parent adversity or trauma; physical abuse; and young parent age. Many participants identified these aspects of their family environment, most of which could potentially be improved with sufficient support, as playing causal roles in the emotional abuse they experienced.

CONCLUSION

This descriptive qualitative study provides additional insight into child emotional abuse and its associated factors, providing invaluable insights that can enhance current measurement and intervention approaches.

Sibling Experiences of Adverse Childhood Experiences: A Scoping Review

Adverse childhood experiences (ACEs) are traumatic events during childhood known to affect health and well-being across the life span. The detrimental impact ACEs have on children and young people is well-established. It is also known that 85 to 90% of children have at least one sibling. Using this as the foundation for our inquiry, the purpose of this scoping review was to understand what we currently know about the experiences of siblings living with ACEs. Sibling relationships are unique, and for some the most enduring of experiences. These relationships can be thought of as bonds held together by love and warmth; however, they can also provide scope for undesirable outcomes, such as escalation of conflicts and animosities. This scoping review was conducted following Arksey and O'Malley's (2005) methodological framework, complemented by the PAGER framework (Bradbury-Jones et al. 2021), offering a structured approach to the review's analysis and reporting through presenting the Patterns, Advances, Gaps, and Evidence for practice and Research. In June 2020, we searched 12 databases, with 11,469 results. Articles were screened for eligibility by the review team leaving a total of 148 articles meeting the inclusion criteria. Included articles highlighted overwhelming evidence of older siblings shielding younger siblings, and the likelihood that when one sibling experiences adversity, other siblings will be experiencing it themselves or vicariously. The implications of this in practice are that support services and statutory bodies need to ensure considerations are given to all siblings when one has presented with experiencing childhood adversity, especially to older siblings who may take far more burden as regards care-giving and protection of younger siblings. Given that more than half of the included articles did not offer any theoretical understanding to sibling experiences of ACEs, this area is of importance for future research. Greater attention is also needed for research exploring different types of sibling relationships (full, step, half), and whether these influence the impact that ACEs have on children and young people.

Courage, camaraderie and compassion: a qualitative exploration into UK military veterans' experiences of self-compassion within the context of alcohol use disorders and recovery

INTRODUCTION

UK veterans are at increased risk of mental health and alcohol use disorders (AUDs), experiencing specific challenges such as combat exposure and re-integration which may contribute to treatment barriers. Experiences of shame and AUDs, which may precede or become exacerbated during military service, may be mitigated by self-compassion (SC). This study sought to understand how UK veterans make sense of their SC experiences within the context of their relationships with alcohol and recovery.

METHODS

Interpretative phenomenological analysis was used to interpret the SC experiences of five ex-military veterans (one female). Semistructured face-to-face interviews were audio-recorded and transcribed verbatim, with a double hermeneutic approach used to interpret meaningful issues which influenced participants' self-perceptions in relation to their alcohol use and wider social world.

RESULTS

Two key themes were identified. 'Searching for Safety', which illustrated veterans' SC sense-making within the context of their evolving lifeworld and alcohol use, and 'Healing with Honour' which reflected the significance of purpose and identity within experiences of recovery and SC. Findings were interpreted through the lens of the six bipolar elements of SC, which identified SC as salient within veterans' experiences of AUD and recovery. Although experiences of SC were sometimes perceived as challenging or incongruent to military identity, this was influenced by positive reframing and meaning-making, supported by compassionate narratives and informed trusted relationships.

CONCLUSIONS

Veterans' AUD recovery and support-seeking may be impacted by the experience of SC and enhanced by the early implementation of acceptable and feasible interventions which draw on veterans' unique military identities and experience. This may include compassion-focussed interventions which reframe SC as fierce SC, peer support models and educational strategies which support healthcare professionals to understand and identify veterans' military experiences.

Parentification Vulnerability, Reactivity, Resilience, and Thriving: A Mixed Methods Systematic Literature Review

Parentification occurs when youth are forced to assume developmentally inappropriate parent- or adult-like roles and responsibilities. This review thoroughly examines current empirical research on parentification, its outcomes, and related mechanisms to outline patterns of findings and significant literature gaps. This review is timely in the large context of the COVID-19 pandemic, when pandemic-induced responsibilities and demands on youth, and the shifting family role may exacerbate parentification and its consequences. We used the 2020 updated Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) framework to identify 95 studies (13 qualitative, 81 quantitative, 1 mixed methods) meeting eligibility criteria. Representation from six continents highlights parentification as a global phenomenon. Using thematic analysis, we identified five themes from qualitative studies and five from quantitative studies. These were further integrated into four common themes: (1) some parentified youth experienced positive outcomes (e.g., positive coping), albeit constructs varied; (2) to mitigate additional trauma, youth employed various protective strategies; (3) common negative outcomes experienced by youth included internalizing behaviors, externalizing problems, and compromised physical health; and (4) youths' characteristics (e.g., rejection sensitivity, attachment style), perceived benefits, and supports influenced parentification outcomes. Future methodological and substantive directions are discussed.

Family' members experiences of their older relative's alcohol and substance misuse

BACKGROUND

Alcohol consumption in Norway and much of the western world has increased during the past decades, in particular among older adults (> 65 years). Although living with a family member's alcohol misuse has been shown to have a significant deleterious health impact, research on this topic is both lacking and urgently needed to develop targeted health services.

AIM

To generate knowledge of how family members are affected by their older relatives' alcohol and other substance misuse problems.

METHOD

In 2020, 17 individual interviews were carried out with the wives and adult children of older adults with alcohol and other substance misuse problems. Data were analysed using content analysis.

FINDINGS

Analyses revealed two main themes; the impact of living with psychological stress over time, and the impact over time on family relationships and functioning. Both included four subthemes, representing different dimensions of participants' experiences of the impact of their older relative's alcohol and substance misuse.

CONCLUSION

The challenges family members experienced through ongoing exposure to their relatives' alcohol and/or other substance misuse increased over time. These experiences had significant negative consequences for their health and life situation.

Parent-Child Role Confusion: Exploring the Role of Family Processes in the Context of Parental Depression

OBJECTIVE

Parent-child role confusion has been shown to influence developmental outcomes for children whose parents have a history of depression; however, more research is needed to understand the pathways by which parental depression increases risk of role confusion. The current study aimed to extend previous literature by evaluating how different family processes (e.g., interparental conflict, guilt induction, family cohesion, and positive parenting practices) contribute to the development of emotional role confusion in families with a history of parental depression.

METHOD

The sample was comprised of 90 parent-child dyads (parent Mage = 42, 90% female, 83.3% White; child Mage = 11.51, 51.1% female, 75.6% White) participating in the control group of a randomized controlled trial. All parents had a history of depression. A longitudinal path analysis was conducted to evaluate prospective associations in the multiple mediator model.

RESULTS

Findings from the current study suggest that parental depressive symptoms are not directly related to the development of parent-child emotional role confusion, but are instead indirectly related through increased interparental conflict observed by youth. Although not identified as significant mediators, guilt induction and positive parenting practices emerged as predictors of emotional role confusion. Lastly, family cohesion did not appear to influence the development of role confusion.

CONCLUSION

Findings suggest that parenting behaviors and coparenting relationship quality play important roles in the development of parent-child emotional role confusion, with interparental conflict emerging as the strongest predictor in families with a history of parental depression.

Differences in perceived parental practices across attachment styles in adult children of alcoholic fathers

Background

Alcoholism is a growing problem in Pakistan. Problems related to alcoholism affects the family members especially children of alcoholics who are likely to have biased perceptions of parental practices which in turn affects their attachment patterns.

Objective

To analyze the differences in perceptions of parental practices across three attachment styles namely avoidant, anxious/ambivalent, and secure attachments of the adults who are children of alcoholic parents.

Method

The study is a correlational research design with a sample of 330 participants selected through purposive sampling technique. The participants were adults who are children of alcoholics from nuclear family systems, whose fathers were admitted in a rehabilitation center for the treatment of alcoholism for the second time.

Results

MANOVA computed to examine differences in perception of parental practices across attachment styles was significant [F(12, 632) = 53.130, p < .001, Pillai's Trace = 1.003, partial eta squared = .501], indicating that those with different attachment styles perceive parental overprotectiveness, emotional warmth, and rejection differently.

Conclusion

Perceptions about parental practices for father can be linked with alcoholism, while for mother the perceptions about parental practices are a product of attachment mainly.

Implications

The findings can be used to devise counseling and therapeutic plans for adults who are children of alcoholics and help in educating them about the condition of alcoholism.

Adverse childhood experiences among females in substance use treatment and their children: A pilot study

Women with substance use disorder (SUD) often have experienced adverse childhood experiences (ACEs). The intergenerational nature of ACEs also put their children at risk for experiencing ACEs. However, no research has explored the prevalence of ACEs in children whose mothers have SUD. This study assessed ACE scores in mothers with SUD and their children and compared them with non-SUD participants. Females with SUD were recruited from a treatment center (n = 50) and compared to females without SUD from the same area (n = 50). The ACE scores of the participants and their children were measured as well as sociodemographic variables. ANOVA and Fisher's Exact tests were used to examine univariate differences. Multivariate regression models assessed the difference in ACE scores between the groups and their children and the relationship between maternal and child ACE scores while including sociodemographic confounders. The mean ACE score was significantly higher in SUD participants (4.9, SD = 2.9) when compared to non-SUD participants (1.9, SD = 2.0) after controlling for sociodemographic variables (p < .01). Children of treatment participants also had significantly higher mean ACE scores (3.9, SD = 2.3) than children of comparison participants (1.3, SD = 2.0, p < .01). Maternal ACE score was positively related to children's ACE score after controlling for sociodemographic variables. Given the intergenerational nature of ACEs and their high burden in both mothers and children in substance use treatment, these preliminary findings suggest that mother-child trauma-informed interventions may be appropriate for this population.

Exploring Resiliency and Parentification in Polish Adolescents

Parentification is a form of distorted division of roles and responsibilities in the family where the roles of parent and child are reversed. A situation that goes beyond the child’s capabilities and exhausts resources usually yields numerous negative consequences. Nevertheless, in some circumstances, parentification may be beneficial by shaping resiliency. The main aim of the study was to examine the relations between parentification characteristics and resiliency. There were 208 adolescents (M_age = 14.55; SD_age = 1.00) who participated in the study. Resiliency was evaluated using the Polish Scale for Children and Adolescents SPP-18. Parentification level was measured with the polish Parentification Questionnaire for Youth. The analyses revealed significant relations between parentification and resiliency dimensions. The relations were different based on the participant’s gender. The obtained results underline the role of resiliency in shaping the perception of family role dysfunctions such as parentification.

The Relations Among Types of Parentification, School Achievement, and Quality of Life in Early Adolescence: An Exploratory Study

Children who experience parentification may have trouble performing developmental tasks due to being overwhelmed by their family caregiving roles and responsibilities. Past studies have found that parentification is negatively associated with academic achievement. However, most of these studies are limited in that they are retrospective and examine the association but not the mechanisms shaping them. The aim of the study was to explore to what extent diverse types of parentification relate to academic achievement and to what extent these relations are mediated by self-reported quality of life among adolescents. The study sample was composed of Polish early adolescents (N = 191; age: M = 14.61; SD = 1.26). Types of parentification were measured with the Parentification Questionnaire for Youth, and quality of life was assessed with KidScreen27. School achievement was measured based on mean semester grade. We explored the associations among study variables and performed six mediation models in the planned analyses. Overall, bivariate relations were significant in a theoretically expected way, although the effect sizes for these associations were rather small. In the mediation analyses, the results showed that four of the six models were not significant. Different from previous studies, instrumental parentification was positively related to school achievement. Additionally, this positive association was mediated by adolescents' general quality of life. Taken together, the findings were similar and different from the empirical literature base on types of parentification and select outcomes.