Saturday, 15 January 2005 - 12:00 PM

This presentation is part of: Poster Session II

Predictors of Quality of Relationship in Families of Women with Co-Occurring Substance and Mental Disorders

Purpose

Families are the primary source of support to adults with co-occurring substance and mental disorders. Quality of relationships between family caregivers and family members with dual disorders (the client) can impact client well-being and treatment outcomes. There has been little research on the predictors of relationship quality for this population. This paper examines the predictors of relationship quality of family members of women with substance disorders or with co-occurring substance and mental disorders (anxiety, PTSD, depression, dysthymia). Study subjects represent an understudied population.

Methods

This NIDA funded study interviewed women clients in one residential and one outpatient substance abuse treatment program and also a principal family caregiver/significant other designated by each woman. Almost all( 97.2%) of the women who met study eligibility criteria were contacted. Of these, 96.2% (N=87) agreed to participate and provided the name of a family member, and 95% of the family members (N=83) were interviewed. A stress-coping model was utilized to identify the impact of family caregiver stressors (client behavioral, substance abuse, and mental health problems) and caregiver well-being (social support, burden, and depressive symptomatology) hypothesized to impact the quality of relationship between the caregiver and client. Family members’ perceptions of the quality of their relationship with the client were measured by assessing positive qualities (i.e., emotional support received from the client) and negative qualities (i.e., emotional undermining of the caregiver by the client) using modified scales from caregiving research in aging. Bivariate correlation analyses were conducted using variables from the theoretical model and caregiver and care recipient demographic variables. Linear regression analyses for positive and negative relationship quality included predictors that were statistically significant at the bivariate level. Client classification as having a current dual disorder or current substance abuse only disorder, as measured by the CDIS, was entered into both regression equations.

Results

Both six-item relationship scales had good reliability (Alpha= .80). The regression model for emotional support given to the caregiver by the client was statistically significant (p < .001, R2= .25). Greater support was predicted by fewer client substance abuse problems in the past 12 months and lower caregiver burden (Displeasure). The regression model for undermining of the family member by the client was also statistically significant (p < .001, R2= .20). Greater undermining was predicted by more client behavioral problems and greater client substance abuse in the past 12 months. Whether the client had a dual diagnosis was not a significant predictor of relationship quality.

Implications

The finding that substance abuse problems predicted relationship quality is consistent with previous research and supports the continued need to involve family caregivers in clients’ treatment programs. However, having a dual diagnosis was not a predictor of relationship quality, suggesting that future analyses might need to distinguish the impact of specific psychiatric diagnoses on caregiver relationship quality. The finding that more client behavioral problems predicted undermining of the family member by the client suggests the need for interventions to assist caregivers in understanding and addressing client behavioral problems.

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