Transgenerational dependence and family homeostasis as etiological dimensions of substance abuse chronicity : a descriptive study of cross-generation involvement patterns in the families of an addict population



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Traditional understandings of substance abuse chronicity have concentrated on the pharmacophysiologic stimulus of the drug agent. As an alternative appreciation of the addiction syndrome this family systems model posits that drug dependence may be interrelated with transgenerational familial dependence. Previous studies have suggested that a transgenerational emotional bond is perpetuated by certain dependence maintaining behaviors between the adult addict and the family of origin. This dependence includes such measurable behaviors as contact, communication, and cohabitation with the family of origin. This research has also suggested that extreme separation between the addict and the family of origin may represent an inverse manifestation of the same dependence pathology. Research for this model is incomplete in two dimensions. First, most historical addiction research has excluded or addressed only limited female addict populations. Second, the specific premise that both underinvolvement and overinvolvement between the addict and the family of origin represent polar extremes of the same failure to individuate has not been empirically described for an addict population. This descriptive study examined both the male and female crossgeneration dependence patterns in a population of adult opiate addicts on out-patient methadone maintenance treatment in a large urban area. The study established three categories for the type of family of origin involvement: (a) appropriate involvement; (b) overinvolvement; and (c) underinvolvement. Over involvement and under involvement were classified as dysfunctional. The study further described the male and female addict subjects across the dimensions of family of procreation, age, and duration of treatment. A structured questionnaire addressing patterns of involvement with the family was orally administered by the subject's primary counselor. Of the 56 female and 44 male subjects completing the questionnaire, 71 percent were classified as dysfunctional. The 71 percent classified as dysfunctional constituted a significant difference from the proportion expected if there had been an equal distribution between the classifications. Therefore, the involvement classification data support Hypothesis A: there is a significantly greater proportional membership of the combined male and female addicts in the dysfunctional than in the normal classification. Gender comparison results revealed significant differences between the male and female distributions across both the involvement categories and the involvement classifications with a greater proportion of males than females in all the dysfunctional classifications. These results support Hypothesis B: there is a significant difference between the male and female addicts relative to proportional membership in the dysfunctiona and normal involvement classifications. Other sex difference findings provide only partial support for Hypothesis C: there are significant differences between the male and female addicts relative to membership in the involvement categories and classifications, family of procreation, age, and duration of treatment. Involvement categorization and classification and age were valid discriminators. Although gender was significantly associated with differences between involvement classifications, other variables were not significant discriminators. Therefore, the findings do not support the comprehensive statement of Hypothesis D: there are significant differences among the involvement categories relative to gender, family of procreation, age, and duration of treatment. The findings of this study confirm the presence of gender-specific patterns for cross-generation involvement in an adult addict population. The higher incidence of male dysfunction may reflect cultural pressures for women to select more oblique expressions of antisociaIity. Also, female addicts may effect a more complete transfer of dependence needs from the family of origin to the family of procreation, and this transfer may mask unresolved cross-generation dependence issues.



Drug abuse, Drug addicts