The relationship between family intimacy and relapse tendency among people who use drugs: a moderated mediation model

Effect of family intervention on relapse rate of Chinese patients with alcohol-dependent

Objective

This study explored the impact of a family intervention on the relapse rate of Chinese patients with alcohol dependence.

Methods

A total of 151 male patients with alcohol dependence who were discharged from the Substance Dependence Department of the Wenzhou Seventh People's Hospital from January to December 2020 were selected. They were divided into the control (n = 73) and experimental (n = 78) groups. Patients in both groups received routine alcohol cessation treatment. Moreover, patients in the experimental group were followed up by a professional psychiatrist to carry out individual family intervention. The Family Function Rating Scale (FAD), a Self-made general information questionnaire, and the Chinese version of the Family Intimacy and Adaptability Scale (FACESI-CV) were performed. Re-drinking rate and readmission rate were assessed.

Results

Family intervention could reduce relapse rate (31, 39.74%) and rehospitalization (27, 34.62%) compared with the control group. After family training, FAD factor scores were improved in the experiment group in comparison with the control group. Family training improved communication (18.2 ± 3.7), role (20.8 ± 2.5), emotional response (10.8 ± 1.8), emotional involvement (13.7 ± 1.2), behavioral control (19.8 ± 1.2), and overall functionality (23.5 ± 2.1) in the experiment group in comparison with the control group. After family training, intimacy (70.5 ± 8.7) and adaptability (64.1 ± 6.9) in the experiment group was higher than in the control group. After family intervention, Michigan Alcohol Dependence Scale (MAST) (9.21 ± 0.68) and Short-Form 36 (SF-36) (80.32 ± 4.47) in the experiment group were higher than the control group.

Conclusion

Family intervention for families of patients with alcohol dependence can improve their family function, increase their family intimacy and adaptability, and reduce the rate of relapse.

Amr M, A. Simon M. Family-Based Contributors in Relapse and Relapse Prevention Among Patients with Substance Use Disorder: An Exploration of Risk and Prognostic Factors

Background

Substance use disorder (SUD) remains a significant public health issue, with a high relapse rate even after detoxification treatment. Family dysfunction has been identified as a closely related factor contributing to relapse in individuals with SUD. The objective of this study was to investigate the mediating role of family climate in the relapse tendency among patients with SUD.

Methods

The study employed a case-control design using the survey method. A total of 103 patients from the addiction unit daycare at Mansoura University Hospital were divided into 2 groups: the relapsed group and the abstinent group. The Relapse Tendency Questionnaire, the Family Climate Scale, and a structured interview were administered to collect sociodemographic data.

Findings

The results revealed significant differences between the study groups in terms of sociodemographic risk factors, including marital status (P≤0.001), employment (P=0.043), and economic status (P=0.028). Additionally, a significant difference was observed between the study groups in terms of the Family Climate Scale (P=0.038). Female participants reported that familial factors had a greater influence on their relapse compared to male participants (P=0.005).

Conclusion

A statistically significant difference was found in the family climate subscale scores between the relapsed patients and the abstinent patients with SUD, confirming the influential role of family climate in the relapse process of SUD.

Understanding the laps and relapse process: in-depth interviews with individual who use methamphetamine

OBJECTIVE

The high rate of treatment failure is a common problem in the treatment of methamphetamine use. Therefore, the aim of this research is to identify the most common causes of relapse in methamphetamine users.

METHOD

This is a qualitative study and of content analysis type. Information was collected using purposeful sampling and through semi-structured interviews and focus group discussions. The statistical population consisted of all people with the methamphetamine-use disorder in 2022 who were in the abstinence phase and participated in the meetings of the Narcotics Anonymous (NA) Center of Bojnord. Theoretical sampling continued until data saturation. A total of 10 one-on-one interviews were conducted, each lasting between 45 to 80 min. Additionally, two focus group interviews were conducted with six members in each group, lasting between 95 to 110 min and data saturation was achieved through these interviews. Data analysis was done using the content analysis method (Sterling). Recoding and Holsti's method were used to measure reliability; validity was then calculated through content validity assessment.

FINDINGS

The results of the thematic analysis showed that laps and relapse factors were identified and categorized into 5 organizing themes, including negative emotional states, positive emotional states, negative physical states, interpersonal factors, and environmental factors, consisting of 39 basic themes.

RESULT

Identifying the risk factors leading to laps and relapse in methamphetamine users and increasing the knowledge in this field can lay the groundwork for preventive therapeutic interventions in this community.

Family intimacy and adolescent peer relationships: investigating the mediating role of psychological capital and the moderating role of self-identity

According to existing research, family intimacy affects the formation of peer relationships among adolescents; Parent-child relationships may influence children's relationships with peers, but the mechanism of its influence is still unclear due to the uncertainty of its effect. According to the ecological systems theory, this study examines how family intimacy affects adolescent peer relationships through psychological capital and how self-identity moderates this effect. These hypotheses were tested based on a survey of 414 adolescents, which showed that family intimacy positively affects adolescent peer relationships; The relationship between family intimacy and adolescent peer relationships is mediated by psychological capital; Self-identity positively moderates the direct effects of family intimacy and adolescent peer relationships; Self-identity not only positively moderates the direct effect of psychological capital and adolescent peer relationship, but also positively moderates the indirect effect of family intimacy on adolescent peer relationship through psychological capital. This study provides new perspectives on the relevant mechanism of family intimacy and adolescent peer relationships.

Association of mental health status between self-poisoning suicide patients and their family members: a matched-pair analysis

BACKGROUND

The objective of this study was to examine the relationship of mental health status between self-poisoning suicide patients and their family members, and it also sought to identify potential patient's risk and parental factors for the prediction of suicide attempt, anxiety, and depression.

METHODS

In this study, 151 poisoned patients were prospectively included, and they were matched 1:1 with 151 family members. We gathered information on patient's and their matched family member's demographics, lifestyle choices, mental health status, level of intimacy, and history of psychiatry disease. The relationship of patient's and their family member's mental health state was investigated using a correlation matrix. Multivariable analyses (multiple logistic regression) were conducted among patients and their matched family members, to identify potential risk factors for self-poisoning suicide, anxiety, and depression.

RESULTS

Of the total patients, 67.55% (102/151) attempted self-poisoning suicide. Poisoned patients had more severe anxiety and depression symptoms than their matched family members, and this difference was even more pronounced among patients with self-poisoning suicide. Generalized anxiety disorder-7 (GAD-7) score for family members was significantly and favorably correlated with patient's GAD-7 score after eliminating non-suicide patients and their matched family members. The patient health questionnaire-9 (PHQ-9) score showed a similar pattern, and the family member's PHQ-9 score was strongly and favorably associated with patient's PHQ-9 and Beck hopelessness scale-20 (BHS-20) score. Multivariable analysis showed that married marital status (P = 0.038), quitting smoking (P = 0.003), sedentary time of 1 to 6 h (P = 0.013), and participation in a sports more than five times per week (P = 0.046) were all significantly associated with a lower risk of suicide by self-poisoning, while a more serious anxiety state (P = 0.001) was significantly associated with a higher risk of self-poisoning suicide. Multivariable analysis demonstrated that, specifically among self-poisoning suicide patients, married marital status (P = 0.011) and no history of psychiatry disease (P < 0.001) were protective factors for anxiety, while divorced or widowed marital status (P = 0.004), a sedentary time of 1 to 3 h (P = 0.022), and a higher monthly income (P = 0.027) were significant contributors to anxiety. The propensity of additional family-matched characteristics to predict patient's suicidality, anxiety, and depression was also examined.

CONCLUSIONS

Self-poisoning suicide patients have severe mental health issues. Patients who self-poison have a close connection to their family member's mental health, particularly their levels of anxiety and depression. According to the findings, being married and adopting healthy lifestyle habits, such as quitting smoking and drinking, increasing their physical activity levels, and managing their idle time, are able to help patients with mental health concerns and even suicidal thoughts.

Implicit Attitudes of New-Type Drug Abstainers towards New-Type Drugs and Their Relapse Tendencies

Over the last decade, new-type drugs have been replacing traditional-type drugs in China. However, studies of implicit attitudes towards new-type drugs are insufficient and contradictory results exist. Previous studies have suggested that implicit attitudes and relapse tendencies are a dual structure model, but that is for traditional or mixed drug addicts. For new drug addicts, is the dual structure model completely suitable or partially supported? This study attempts to explore this point. At a drug rehabilitation center, we randomly selected 50 abstainers (25 males and 25 females; age range: 21–41 years) who only took new-type drugs prior to abstention to participate in this study. Participants complete the General Situation Questionnaire, the Drug Use Characteristics Questionnaire, the Drug Relapse Risk Scale (DRRS), and the Single Category Implicit Association Test (SC-IAT). The relationship between implicit attitudes and relapse tendencies of new-type drug abstainers towards new-type drugs was investigated. The results showed: (1) abstainers had negative attitudes towards new-type drugs, and the data had statistical correlation with abstainers’ drug use characteristics and each relapse risk index; (2) females held relatively positive implicit attitudes towards new-type drugs; (3) being female and divorced could significantly predict abstainers’ implicit attitudes; (4) there is no significant correlation between implicit attitudes and relapse tendencies of new-type drug abstainers towards new-type drugs, which partially supports the dual structure model; (5) fender influences the self-assessment of relapse probability. Compared with traditional or mixed drug addicts, the dual structure model is only partially supported for new-type drug abstainers towards new-type drugs. That is because being female and divorced are the main factors influencing implicit attitudes and relapse tendencies. A few women or divorced people regard consuming new drugs as the source of happiness and forget the harm brought by the drugs themselves in their implicit attitude, which leads to more drug abuse in their explicit behavior. Therefore, we should pay more attention to women who have become new-type drug addicts and pay special attention to the impact of divorce.

A Mediation Moderation Model between Self-Evaluative Emotions and Relapse Rate among Polysubstance Users: A Comparative Cross-Sectional Study

A substantial portion of drug abuse research has concentrated on people with a single-substance-use disorder (SSUD), but many people abuse more than one drug. Studies have yet to examine how those with polysubstance-use disorder (PSUD) differ from those with an SSUD on the risk of relapse, self-evaluative emotions (e.g., shame and guilt), and personality factors (e.g., self-efficacy). Eleven rehab facilities in Lahore city, Pakistan were randomly chosen to provide a sample of 402 males with PSUD. For comparison, 410 age-matched males with SSUD were enlisted using a demographic form with eight questions, the State Shame and Guilt Scale, and the General Self-Efficacy Scale. Mediated moderation analysis was performed using Hayes' process macro. The results demonstrate that shame-proneness is positively associated with relapse rate. Guilt-proneness mediates the relationship between shame-proneness and relapse rate. Self-efficacy buffers the influence of shame-proneness on relapse rate. Although the mediation and moderation effects were found in both study groups, these effects were significantly stronger among people with PSUD than those with SSUD. To be more specific, people with PSUD reported a higher overall score on shame, guilt, and relapse rate. Additionally, people with SSUD indicated a higher score on self-efficacy than those with PSUD. The findings of this study suggest that drug rehab facilities should implement a variety of strategies to raise drug users' levels of self-efficacy, which will help to reduce their risk of relapse.

Resource-Strengthening Training for Parents of Adolescents with Problematic Gaming (Res@t-P): A Clinical Pilot Study

Background: Problematic gaming (PG) has become an increasing mental health issue among adolescents during the preceding years. The role of parents and the family environment in the development of PG has been repeatedly emphasized. However, the structured involvement of parents in the therapy is still largely insufficient. Resource-strengthening training for parents of adolescents with PG (Res@t-P) is a new parent-centered 8-week group intervention to fill this substantial gap. The present pilot study aimed to collect first information on its potential effectiveness in improving parental and family factors. Methods: The study was conducted in a clinical setting with N = 43 parents of adolescents with PG, applying a pre- and post-follow-up design. Standardized questionnaires on psychological stress perception, family communication, family functioning, media rules, and adolescent PG symptoms were applied at three measurement points (before, at the end of, and 6 weeks after the training). Conditional growth models were estimated. Results: Over time, an improvement in parental and family aspects as well as a reduction in adolescent PG symptoms could be observed. Conclusions: The results of the present pilot study on the effectiveness of Res@t-P are promising. No causal inferences can be drawn at this stage. A randomized-controlled intervention study is highly warranted.

Family Function Impacts Relapse Tendency in Substance Use Disorder: Mediated Through Self-Esteem and Resilience

BACKGROUND

Substance abuse has been a public health concern, and even after detoxification treatment, the relapse rate is still high. Family function is closely related to substance dependence. However, studies on psychological mechanisms between them are rare.

OBJECTIVES

We aimed to explore the mediating role of self-esteem and resilience in the pathway that family function impacts the relapse tendency among patients with substance use disorder (SUD).

METHODS

A total of 282 SUD patients were recruited, and standard questionnaires were administered for each patient. The relapse tendency, family function, self-esteem and resilience were assessed by the family care index questionnaire, the Connor-Davidson resilience scale, the Rosenberg self-esteem scale and the relapse tendency questionnaire. Bootstrap method was conducted for mediation analysis to test the effects of how family function affects relapse tendency mediated through self-esteem and resilience.

RESULTS

The average score of relapse tendency of the patients was 28.47 (SD = 11.89). Intermediary analysis found that self-esteem played an intermediary role in the relationship between family function and relapse tendency. Resilience plays an intermediary role in the relationship between family function and relapse tendency. Further, the path analysis showed that family function not only had a direct association with relapse tendency, but also indirectly related to relapse tendency through self-esteem and resilience.

CONCLUSIONS

Self-esteem and resilience are the key factors in the relationship between family function and relapse tendency of SUD patients.

How to Enhance the Motivation for Drug Detoxification: Consciousness Guidance and Behaviour Restriction of Family Intergenerational Ethics

Assisting substance users to recover from the behaviour of drug addiction and maintain long-term rehabilitation is a long and complicated process, in which the motivation to undergo drug rehabilitation plays a decisive role. So far, the cultural connotation of family and its mechanism of promoting behavioural change of substance users have not been fully explored. Through in-depth interviews with 15 drug rehabilitants, among which there were 7 women and 8 men, it is found that the motivation for drug rehabilitation is stimulated under the guidance and restriction of family ethics based on obligation and responsibility, which is mainly reflected in the longitudinal intergenerational responsibility. On the one hand, negative consequences such as intergenerational liability deficit and reputation damage lead substance users to reflect on ethical values. On the other hand, disciplines such as intergenerational responsibility and obligation and mutual assistance can correct the actual behaviour of substance users in ethical practice. In contrast to Western countries, which focus on external environmental factors such as family function, family relationships and family support, the motivation for drug rehabilitation in China places more emphasis on their identity and role as family members and corresponding responsibilities, which provides inspiration for developing social work services for substance users from family cultural norms.

The difference between inpatient and outpatient programs regarding trait -anxiety, social support and state-anxiety in during the covid-19 pandemic in Israel

Purpose

COVID-19 pandemic is affecting the well-being and the psychological resilience of different populations, particularly in the addiction field. This study aims to assess anxiety and its severity among patients and staff from different types of addiction services in Israel during this emergency.

Design/methodology/approach

The study was conducted during the period from March–July 2020. Participants included patients and staff (N = 282) from three different types of addiction services, were administered the State-Trait Anxiety Inventory, the multi-dimensional scale of perceived social support and demographic variables. In addition, a logistic regression model was applied to identify predictors of state anxiety by using statistical package for the social sciences software.

Findings

The results show that therapeutic communities clients reported more social support compared to other subjects. State anxiety has a positive strong correlation with trait anxiety both among patients and staff, and it was found as a crucial predictor of state anxiety in the regression equation. There is no statistically significant correlation between state anxiety and social support, gender or education among clients and staff as one. The state anxiety remains relatively stable and characterizes most people, staff and patients, men and women, medical staff members and other professionals.

Research limitations/implications

The current study has some contributions to the addiction field by understanding the psychological distress of a vulnerable population: substance users in treatment settings. The study population relied on convenient samples and future studies should be planned using a cross-sectional design and should take into account substance use measures. The findings are reinforcing the assumption that state anxiety was likely to increase during the coronavirus pandemic.

Practical implications

Adequate services should be planned to avoid relapse or mental deterioration of people who use drugs during health emergencies.

Originality/value

The research points out the unique and real difficulties of SUD clients, as well as the complexity and risks in their staff members’ works. The authors also saw that staff members need attention and maintenance; they are in the front line.