Interaction Patterns in the Families of Individual with Cannabis Dependence

INTERACTION PATTERNS IN THE FAMILIES OF INDIVIDUAL WITH CANNABIS DEPENDENCE

Nirmala Kumari Ahirwar1 & Manisha Kiran2

1Ph. D Scholar (PSW), Department of Psychiatric Social Work, Ranchi Institute of Neuro-Psychiatric and Allied Science, Jharkhand India. 2Associate Professor & Head, Department of Psychiatric Social Work, Ranchi Institute of Neuro-Psychiatric and Allied Science, Jharkhand India Correspondence: Nirmala Kumari Ahirwar, e-mail: nirmalakumariahirwar@gmail.com

ABSTRACT

Background:
Cannabis dependency is often due to prolonged and increasing use of the drug. Increasing the strength of the cannabis taken and an increasing use of more effective methods of delivery often increase the progression of cannabis dependency. Interaction pattern in a family has been found critical tasks in keeping family development, system and well-being as well as maintaining its integrity.

Aim:
This study was planned to see the family interaction pattern of individuals with cannabis dependence in Indian setting.

Method:
The study was a cross sectional, hospital based and the samples were selected through purposive sampling technique. This study was included 30 individuals (patients diagnosed with cannabis dependence as per ICD -10) and 30 individuals from family of normal controls (i.e., a family without any cannabis dependence member). Age, education and family income matched with either group.GHQ-12 & Family Interaction Pattern Scale were applied on all the selected individuals in the study.

Results and Conclusion:
Dysfucntional interaction was found in the domains of “reinforcement”, “social support”, “roles”, “communication”, & “total FIPS” in the families of individual with cannabis dependence as compared to families of normal controls.

Keyword: Family interaction pattern, cannabis dependence, indian families.

INTRODUCTION
Family interaction patterns were defined as those various social psychological transactions occurring in the family as a system, to evolve process for decision making, emotional expressions and personal view, assigning tasks and social status, enabling the family member to contribute for the growth of the family by generating morphogenesis at emotional, intellectual and social levels through the manipulation of internal and external social milieu of the family as a whole. According to the evolutionary point of view every family has patterns of leadership, communication, role, cohesiveness, and social support system which were defined as follows. Leadership: A family member engaged in decision making through consensus for the growth of the family as a system is the leader of the family. Communication: Processes through which the family members convey their feelings, emotions and personal views. Roles: Socioculturally prescribed and ascribed tasks to be performed by different family members according to their age and sex . Reinforcement: Processes adopted by the family to enable the members to imbibe socially approved behavior. Cohesiveness: Process adopted by the family for a firm degree of mutual trust and interpersonal commitment. Social support: Social support system refers to manipulation of internal and external social milieu of the family for its existence and growth (Bhatti et al., 1986). Family interactions of substance use, and the potential effect of cannabis on those interactions, has been a consistent concern in both the clinical and research literature for more than 20 years. Some authors like Jacob et al (1981) suggests that cannabis and other substance families differ from without cannabis families in affective expression, as reflected in lower rates of positive affect and higher rates of negative affect. These differences seem to characterize parent child interactions. However some studies also characterize interactions between the male cannabis and his spouse (Jacob & Krahn, 1988). Thus it was evident that cannabis consumption not only causes disturbance in interactional pattern between parent’s children but also between marital couples. In those studies family distress and marital distresses were equally emphasized. Although most studies in the cannabis smoke and marriage literature have emphasized the personality traits and characteristics of spouses, behavioral systems theories of the past decade have directed increasing attention toward interaction variables that might elicit and maintain cannabis abuse. The most elaborate of these models, proposed by Steinglass (1981), has incorporated the provocative hypothesis that cannabis can serve adaptive functions in some families and as a result be reinforced and perpetuated through change in family processes. Most relevant to this, is a cross sectional finding by Jacob et al (1978) that revealed a negative relation between the husband’s substance consumption and the wife’s psychiatric symptomatology and a positive relation between the husband’s alcohol consumption and the wife’s marital satisfaction, findings that emerged only with steady drinkers and not with binge drinkers. In a study by Frankenstein et al (1985) found that cannabis increased positive interactions, whereas two studies by Jacob and his colleagues found that substance use (i.e. alcohol & cannabis) increased negative interactions of alcoholics and their spouses (Jacob et al, 1981; Jacob & Krahn, 1988) indicating that alcohol does exert an impact on marital interactions of alcoholics, although the direction of such effects has not been entirely consistent across studies. Various cross-study differences in methodology could be related to these discrepant findings, including differences in experimental task, dose level, administration format, and the presence or absence of comparison groups (Chakravarthy, 1990).

AIM
The present study was carried out to examine the family interaction patterns in Indian families with individual of cannabis dependence.

MATERIALS AND METHODS
Design
This was a cross-sectional study and carried out among families of patients who came at Ranchi Institute of Neuro-Psychiatry and allied science (RINPAS), a state government- owned psychiatric hospital situated in the Ranchi district of Jharkhand State in India.The ‘purposive sampling method’ was used.

Participants
The sample consisted of 30 families of male patients diagnosed with cannabis dependence syndrome (CDS) using the criteria laid out in the ICD-10 (WHO, 1993) and 30 families of appropriately matched males (control group) with no history of cannabis dependence, who scored less than 3 on the GHQ-12. Inclusion and exclusion criteria were as follows. The experimental group was made up of families diagnosed as having ‘Mental and behavioural disorders due to use of cannabis’ from the RINPAS according to the ICD-1 0 Classification of Mental and Behavioural Disorders – Diagnostic Criteria for Research (ICD-10 DCR). Those who had been married for 2 or more years, scored less than 3 in the General Health Questionnaire–12 (GHQ-12), were free from major physical illnesses, and who gave their informed consent to participation in the study were included. The families of control group were selected after matching their ages, educational and income levels with the experimental group and scored less than 3 in the GHQ-12, no history of major physical illnesses, and gave their informed consent to participation in the study.