Academic journal article Indian Journal of Psychiatry

Resilience in Wives of Persons with Alcoholism: An Indian Exploration

Academic journal article Indian Journal of Psychiatry

Resilience in Wives of Persons with Alcoholism: An Indian Exploration

Article excerpt

Byline: Pradeep. Johnson, Carl. Britto, Kevin. Sudevan, Ashish. Bosco, Priya. Sreedaran, Mysore. Ashok

Context: Mental health has currently shifted focus from "deficit" to strength-based approaches such as Resilience. Coping styles and personality factors have been well studied in Wives of persons with Alcoholism (WopA) but not Resilience. Alcohol dependence in spouse is seen as an adversity. Aims: To evaluate Resilience in the WopA and explore its relationship with marital quality and clinical variables of Alcohol Dependence in their husbands. Settings and Design: A cross-sectional study in a tertiary care hospital in Bangalore, Karnataka. Subjects and Methods: WopA (n=34) between 25-55 years, were assessed for Resilience using Resilience Scale for Adults (RSA), while marital quality was assessed using Marital Quality Scale (MQS). The Severity of Alcohol Dependence, Age of onset of Initiation, Age of onset of Problem Drinking, and Age of onset of Dependence were evaluated in their husbands. Statistical Analysis: Independent sample t-test, Chi-square test, and Pearson's correlation were used. Results: Majority of the WopA (82%) scored low on the RSA. Low Resilience (LR) WopA scored significantly lower on all factors of RSA except the perception of future; in comparison to High Resilience (HR) WopA. Additionally, the LR WopA reported significantly poorer marital quality. Conclusions: Most WopA had low Resilience. LR WopA also had significantly poor marital quality. These findings need to be studied further in a larger population with culturally appropriate scales. The low scoring Resilience factors amongst WopA may be utilized in strength-based psychotherapeutic approaches. There is a need to improve the understanding of Resilience and its assessment in this population.

Introduction

Alcoholism affects not only the consumer but also all their family members. In India, it has been estimated that there are 10.6 million dependent alcohol users among 62.5 million alcohol users.[1] While some help for them is getting initiated at least in urban areas of the country, their spouses and children continue to be the "forgotten victims."[2] The wives of persons with alcoholism (WopA) are known to have significant problems such as marital dissatisfaction, poor social interaction, communication problems, physical problems, and mental health disorders.[3]

Various models of coping, personality, stress response, and family interaction in WopA have been described from the "disturbed personality" model of Futterman [4] to the "stress model" of Jackson [5] and later the "Psychosocial model" of Orford and Guthne.[6] All have stressed the "deficits" in WopA in coping with their husband's alcoholism. Most of the literature concludes that the predominant coping behaviors used by WopA around the world include avoidance, withdrawal or termination from marital relationship, co-dependency of alcohol, and feelings of helplessness and distress.[7],[8],[9]

In India, marriages are usually endogamous in nature, arranged by the family, carried out based on the caste and religious considerations compared to western marriages. Alcohol use is widely and variedly viewed as a symbol of economic status, caste, gender privilege, and a person's Karma. It is used during a period of turmoil or as an obligation during family and social occasions such as marriage and death.[10] There have been a series of studies [11],[12],[13],[14] on coping behavior in WopA in India too. They have reiterated that women used avoidance predominantly as their coping behavior while using assertion, sexual withdrawal, discord, or taking special course of action in moderation. Codependency of alcohol was found in WopA who were young (<30 years), with poor social support and lesser coping resources. A study from Eastern India in a sample of 1718 women found that age, occupation, longer marital duration, and husband's alcoholism were significant predictors of physical, psychological, and sexual violence. …

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