The relationship between family variables and adolescent substance abuse: a literature review.
Family Drug Usage Patterns
Family drug usage is one category that may influence adolescent substance abuse. Table 1 shows that the use of mind-altering chemicals by family member(s) significantly increases the chance that other family members will use drugs (Adler & Lotecka, 1973; Beardslee, Son, & Valliant, 1986; Blum, 1972; Craig & Brown, 1975; Needle, McCubbin, Wilson, Reineck, Lazar, & Mederer, 1986; Tec, 1974; Tolone & Dermott (1975). The overall influence of family members can be seen in the results of a study by Craig and Brown (1975) who found that a high percentage of adolescent substance users reported drug use in the immediate family.
Table 1 Studies of Family Drug Usage Patterns Investigator S(*) NS(**) Finding Tec x positive association between (1974) parent's and children's consumption of drugs x more parental drug use among adolescents who use marijuana regularly than nonusers x less parental drug use among adolescents who are abstainers than regular marijuana users Tolone & x positive relationship between Dermont parental smoking and drinking (1975) habits and adolescent's use of marijuana x no relationship between parental smoking and drinking habits and adolescent's use of hallucinogens x perceived seriousness of parental drinking relates positively to adolescent use of marijuana x perceived seriousness of parental smoking does not relate to adolescent's use of drugs x parental use of sleeping pills and tranquilizers relates positively to adolescent's use of marijuana and somewhat relates to adolescent's use of hallucinogens Craig & x adolescent drug users report more Brown drug users among family (1975) members than nonusing adolescents Needle, x mothers' and fathers' use of McCubbin, drugs does not relate to Wilson, adolescent use Reineck, Lazar, & x older sibling substance use relates Mederer positively to adolescent's use (1986) Adler & x adolescent drug users report a Lotecka higher percentage of parental (1973) drug usage than adolescent nonusers Beardslee, x positive relationship between Son, & parental and child alcoholism Vaillant (1986) Blum x parents of "high-risk" adolescents (1972) tend to be regular drinkers x "high-risk" adolescents report more maternal alcohol problems than "low-risk" adolescents x fathers of "high risk" adolescents report using alcohol for "escapist" purposes x siblings of drug users tend to be users themselves Cannon x offspring of drug-abusing families (1976) are allowed or encouraged to find escape rather than to cope with problems x offspring of drug-abusing families tend to show a pattern of feeling unprepared to cope adequately Jurich, x adolescent drug abusers report Polson, more parental use of drugs and Jurich, & denial as crutches than adolescent Bates users (1985) x high frequency of parental hypocritical morality among adolescent drug abusers * S = Significant as reported by researcher ** NS = Not significant as reported by researcher
Parents' habits and attitudes toward mind-altering chemicals are significantly related to those of their children (Adler & Lotecka, 1973; Cannon, 1976; Tec, 1974; Tolone & Dermott, 1975). This influence varies according to the type of drug used by the parent. For example, it has been found that parental alcoholism increases the probability of problem drinking and even chemical dependency in children (Beardslee et al., 1986; Needle et al., 1986; Tec, 1974; Tolone & Dermott, 1975), but that parental use of marijuana seems to have no relationship with children's use (Needle et al., 1986).
Family members who abuse drugs seem to be using them as a "psychological crutch" to cope with their problems. For example, adolescent substance users report that their parents use drugs and denial to cope with stress (Jurich, Polson, Jurich, & Bates, 1985). Similarly, fathers of drug-abusing adolescents report using alcohol for "escapist" purposes. Cannon (1976) found that children are "allowed or encouraged" to use these same coping strategies. As a result, the adolescent of a drug-using family tends to become chemically dependent as well.
Jurich et al. (1985), on the other hand, suggest that a "hypocritical morality" exists in many drug-using families. Parents tell their teenagers to avoid using drugs, yet continue to use drugs themselves. Their actions tend to play a more significant role than do their verbal messages (Cannon, 1976; Tec, 1974). Thus, regardless of whether parents encourage or discourage use of drugs, their children are more likely to be substance abusers than are children of parents who do not use drugs or alcohol.
Sibling drug usage is also significantly related to adolescent drug usage patterns (Craig & Brown, 1975; Needle et al., 1986). A high percentage of chemically dependent adolescents report having siblings who are regular users as well (Craig & Brown, 1975). It is assumed that availability and modeling increase the likelihood that a younger sibling will also use drugs. For example, Needle et al. (1986) report that adolescents with older drug-abusing siblings start using drugs at an earlier age and that adolescents with siblings who do not use drugs are less likely to be users.
Family atmosphere is a second bread category that may influence adolescent substance abuse. Adolescents who abuse drugs frequently report poor family environments (Adler & Lotecka, 1973) and often suggest that weak family relationships have contributed to their drug problems (Svobodny, 1982). Family atmosphere includes family composition, family interaction, and discrepancies in family perceptions of each other.
Composition of Family. The composition of the family has been found to have a significant relationship to adolescent substance abuse. Parental absence due to break-ups, death, or divorce increase the chances that children will abuse drugs (Blum, 1972; Cannon, 1976; Craig & Brown, 1975; Johnston, 1973; Jurich, Polson, Jurich, & Bates, 1985; Tec, 1974; Tolone & Dermott, 1975).
Research indicates that a significant number of teenage drug users are raised in single-parent homes (Cannon, 1976; Craig & Brown, 1975) or in families where parents are absent due to break-ups (Johnston, 1973). This relationship between family composition and adolescent substance abuse may be modified by the type of drug used by the adolescent. For example, Tolone and Dermott (1975) found that adolescents who used marijuana tended to be from less intact homes, whereas this was not the case for adolescents who used hallucinogens. Generally, however, parental absence is typically found to relate to adolescent substance abuse. This is particularly disconcerting, since the number of single-parent families has increased in recent years. The implication is that a large number of children from separated families can be considered at high risk and in need of proactive services to help them adjust to the problems associated with single-parent homes. Thus, educators, counselors, and administrators must identify resources to meet this need.
Family Interaction. Family interaction is another variable that seems to influence adolescent chemical dependency. Aspects of family interaction are involvement with family, communication, and discipline. Findings pertaining to these relationships are presented in Table 3.
According to Reardon and Griffing (1983), positive child-parent association is vital to the development of a strong self-concept and to the prevention of drug abuse. This finding has been supported by Tec (1974) who found that a high percentage of adolescents who abuse drugs often mention low satisfaction with their families. For example, although there seem to be no major differences between families of teenage drug abusers and nonabusers in decision-making abilities (Gantman, 1978) and in time needed to make decisions, adolescent substance abusers and their parents have shown significant dissatisfaction in the decisions made (Meade & Campbell, 1972).
Table 2 Studies of Family Atmosphere: Composition Investigator S(*) NS(**) Finding Tolone & x adolescents who use a greater Dermott amount of marijuana tend to (1975) come from less intact families x adolescents who used hallucinogens do not tend to come from less intact families Craig & x adolescent drug users tend to be Brown from single-parent homes (1975) Tec x a higher proportion of regular (1974) marijuana users tend to come from broken homes than do nonusers Blum x adolescents who abuse drugs tend (1972) to come from families with separated or divorced parents Johnston x adolescents who abuse drugs tend (1973) to come from homes broken due to divorce or death * S = Significant as reported by researcher ** NS = Not significant as reported by researcher Table 3 Studies of Family Atmosphere: Interaction Investigator S(*) NS(**) Finding Tec x higher percentage of regular (1974) marijuana users reports low family satisfaction than nonusers x higher percentage of regular marijuana users reports more parental deprivation than nonusers x higher percentage of regular marijuana users considers family to be less salient than do nonusers x higher percentage of marijuana users reports parental pressure especially in education than do nonusers x a high percentage of regular marijuana users reports parental reaction to be "non-caring" with no anger or punishment for the substance use Gantman x more scapegoating by family (1978) members of the drug-abusing adolescent than by nondrug- abusing families x no significant difference among drug abusing and nondrug- abusing families on decision- making abilities x nondrug-abusing families engage in more positive communication than drug-abusing families x nondrug-abusing families give same amount of suggestions or opinions as drug-abusing families x more freedom of expression among nondrug-abusing families than drug-abusing families x more cooperation among nondrug-abusing families than drug-abusing families x more equal participation and more clarity in communication in discussions among the nondrug- abusing families than by drug- abusing families Mead & x more agreement among nondrug- Campbell abusing families than drug- (1972) abusing families x no difference in time needed to make a decision between drug- abusing and nondrug-abusing families x drug-abusing families show less choice fulfillment than nondrug- abusing families Pandina & x adolescent drug abusers perceive Schuele their parents more negatively than (1983) nondrug abusers x both adolescent drug abusers and abstainers describe their family environment as controlling and hostile x adolescents who abuse drugs heavily report mere parental control than do moderate users x adolescents with higher level of drug usage report a lack of parental love and a hostile family environment Streit, x most adolescent drug users, Halsted, & excluding those who use Pascale amphetamines, perceive hostility (1974) from both parents and view their parental environment as "hostile with autonomy" x adolescent nonusers give more love from both parents than adolescent users Hamburg, x adolescent drug abusers tend to Kraemer, & report that mothers "seldom, Jahnke never" understand them (1975) x adolescent drug abusers frequently report that parents do not know their friends Rees & x drug-abusing teenagers tend to Wilborn describe their parents on one (1983) hand as neglectful, selfish, and nonaffectionate while on the other hand as intrusive, possessive, and controlling by guilt x parents of drug-abusing adolescents indicate more of a lack of open relevant communication than nondrug users x drug-abusing adolescents report more of a lack of parental direction x parents of drug-abusing teenagers report more child-rearing problems and view parenting as a job requiring suffering and sacrifice than nondrug users x parents of drug-abusing teenagers tend to believe that changing their children's behavior is impossible Blum x regular teenage drug users report (1972) less family cohesiveness than nonusers x no difference in the amount of affection shown between families with users and nonusers x parents of teenagers who use drugs regularly put less emphasis on child-rearing and adapt a permissive attitude regarding freedom of choice than parents of nondrug users x parents of drug-abusing adolescents describe themselves as less confident in child-rearing and uncertain as to how to raise a child compared to parents of nondrug-abusing adolescents Adler & x high percentage of habitual drug Lotecka users report lack of or negative (1973) contact within home x habitual drug users report parents having less influence in determining drug usage than do nonusers Wechsler & x teenage drug users are less likely Thum to report feeling close to family (1973) than nonusers x adolescent drug users frequently feel less able to talk about drugs with parents than nonusers Tolone & x no relationship between use of Dermott marijuana and perceived (1975) closeness to family x negative relationship between teenage use of hallucinogens/speed and perceived family closeness x negative relationship between adolescent drug usage and consulting with parents x students who use drugs show a lower quality parent-child relationship than students who do not Jurich, x no significant difference between Polson, abusers and occasional users Jurich, & regarding who they saw as Bates closest family member (1985) x high frequency of scapegoating among families with drug-abusing teenagers x adolescent drug abusers report more of a communication gap between themselves and their parents than nonusers x parents of drug-abusing adolescents are more likely to report a laissez-fair or authoritarian discipline than parents of nonusers Steier, x families with drug-abusing Stanton, & adolescents display greater Todd rigidity in decision making and (1982) conflict resolution than nonabusing adolescents x families with drug-abusing adolescents show more rigid communication patterns regarding who follows whom and who allies whom than families of nonabusing adolescents * S = Significant as reported by researcher ** NS = Not Significant as reported by researcher
Although dissatisfaction varies according to the type of drug used by the adolescent, the family environment is generally described by the teenager as hostile (Pandina & Schuele, 1983; Streit, Halsted, & Pascale, 1974), void of understanding (Hamburg, Kraemer, & Jahnke, 1975; Rees & Wilborn, 1983), lacking love (Pandina & Schuel, 1983; Streit et al., 1974), lacking cohesiveness (Adler & Lotecka, 1973; Wechsler & Thum, 1973), and lacking cooperation (Gantman, 1978). Only one study (Tolone & Dermott, 1975) found that the amount of quarreling between mothers and fathers is not significantly related to adolescent drug abuse.
There is a sense of alienation (Tolone & Dermott, 1975; Adler & Lotecka, 1973; Wechsler & Thum, 1973) and a feeling that parents are self-centered and nonsupportive (Rees & Wilborn, 1983). Although Jurich et al. (1985) found that teenage substance abusers and nonabusers were similar in their ability to identify their closest family member, Adler and Lotecka (1973) reported a high frequency of negative or no contact.
A second aspect of family interaction is communication. Jurich et al. (1985) suggest that there is a communication gap between family members of adolescents who are chemically dependent. This is supported by findings that teenagers who abuse drugs typically describe their communication with parents as closed and unclear (Rees & Wilborn, 1983; Cannon, 1976; Gantman, 1978), and by observations of rigid patterns of communication (Steier, Stanton, & Todd, 1982). A study by Cannon (1976) revealed that a low percentage of drug-abusing adolescents and their families considered the others to be honest about their thoughts and feelings. Parents have also reported communication problems. A significant number of these parents indicate that they are inadequate in communicating trust, acceptance, and understanding (Rees & Wilborn, 1973).
A third aspect of family interaction is discipline. Researchers have found that parents with drug-abusing adolescents view parenting as a job requiring suffering and sacrifice, and frequently report a lack of confidence in raising a child (Rees & Wilborn, 1983; Blum et al., 1976). They perceive changing their child's behavior as impossible (Rees & Wilborn, 1983). These feelings may relate to the type of discipline they use.
Findings have been inconsistent regarding discipline in the home. Some studies have found that parents assume a permissive attitude, while others have found them to practice excessive control. Jurich et al. (1985) suggest that there is a tendency for parents of drug-abusing teenagers to use either a laissez-faire or authoritative discipline. Some parents are unable to set rules and limits (Rees & Wilborn, 1983) and typically adopt a permissive attitude or handle problems by taking away privileges (Blum, 1972). For example, adolescents who use drugs regularly have reported a lack of parental direction (Rees & Wilborn, 1983) and believe that their parents do not care about their actions (Tec, 1974). A low percentage see their parents as reacting to their drug usage with anger and punishment (Tec, 1974).
Conversely, adolescents who abuse drugs frequently have been found to consider their parents to be controlling (Pandina & Schuele, 1983; Rees & Wilborn, 1983). One form of control is parental pressure. Tec (1974), for example, found that drug-using adolescents typically come from homes where there is much parental pressure, especially in the area of education. In general, adolescent substance abusers who come from controlling families tend to see themselves as lacking autonomy and independence (Pandina & Schuele, 1983). They view their parents as "intrusive, possessive, overprotective, and controlling by guilt" (Rees & Wilborn, 1983). So, although most studies find significant relationships between discipline and adolescent substance abuse, the findings are contradictory. Because of these varying findings, the relationship between discipline and adolescent substance abuse is not yet clear.
Overall, certain types of family interaction seem to encourage adolescents to reject the family unit and turn to other resources to meet their needs. It has been found that a high percentage of drug users considered the family to be less significant in comparison to school friends and themselves (Tec, 1974) and that parental disapproval tends to have no significant influence on chemically dependent adolescents (Needle et al., 1986; Adler & Lotecka, 1975).
The implications of the relationship between family interaction and adolescent substance abuse are that proactive parent/child counseling and education may be needed to help families interact in more healthful ways. Knowledge of the significant relationships between adolescent drug use and dissatisfaction, poor communication, and discipline can offer the counselor/educator direction for developing programs for all members of the family.
Discrepancies in family perceptions. Discrepancies in family members' perceptions of each other have been found to relate to adolescent substance abuse. Much of the hostility and misunderstanding described earlier may be the result of inaccurate perceptions of family members. Parents' perceptions of their chemically dependent children seem to be less accurate than the perceptions of those who do not have chemically dependent children (Gantman, 1978). Despite agreement between drug-abusing children and their parents regarding "the ideal child" and the extent to which the child meets this ideal, there is a discrepancy in how parents and children describe the "real child" (Alexander & Dibb, 1977). Concurrently, a significant proportion of adolescent drug abusers describe their parents as lacking trust and understanding even though parents feel they have these qualities (Rees & Wilborn, 1983). These findings imply that practitioners may need to help families communicate more openly in order to understand each other.
Table 4 Studies of Family Atmosphere: Discrepancies in Perception Investigator S(*) NS(**) Finding Gantman x families with nonabusing (1978) teenagers seem to be more accurate in their perceptions than families of drag abusers Alexander & x parents and their drug-abusing Dibb teenagers tend to see the teenager (1977) as discrepant from the ideal child x parents of drug-abusing teenagers do not agree with child when describing the real child Rees & x more disagreement among Wilborn drug-using adolescents and their (1983) parents on perceived parental behavior than nonusing adolescents and their parents * S = Significant as reported by researcher ** NS = Not significant as reported by researcher
Many adolescents live in a drug-oriented society and sometimes in drug-oriented families. Studies have demonstrated that there is a relationship between adolescent drug abuse and particular familial characteristics, namely, family drug usage patterns and family atmosphere. Professionals must closely examine this relationship in order to incorporate a family perspective in plans for intervention, treatment, and prevention. For example, schools and communities can educate both children and parents about the facts of drug abuse. Programs within the school and/or community (i.e., mental health clinics and treatment centers) can be devised to aid children "at risk" of chemical dependency. Finally, the community can create "drug-free" centers and activities that draw families together to enjoy being a part of the community. Recognizing these family influences and developing programs from a family perspective is an important step in managing the dilemma of adolescent substance abuse.
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