Indian Journal of Health Social Work
PSYCHOSOCIAL FACTORS FOR ALCOHOL USE
Narendra Kumar Singh
Alcohol dependence is a disease of the family. The impact of substance abuse goes beyond the individual abuser and magnitudes of Alcohol dependence often result in chaotic, unsystematic, and dysfunctional family systems. Alcohol dependence is associated to disrupt family roles, violence, dysfunctional communication, physical and psychological illness.
EMPLOYMENT RELATED FACTORS
The role of employment in the etiology of alcohol misuse is considered somewhat differently in the case of males and females (Gorman,1988). In the case of the latter, research into the role of employment factors arose in response to two observations: first, that alcohol consumption and alcohol-related problems among women started to increase as more began to enter the labor market; and, second, that both regular drinking and alcohol-related problems appeared to be more common amongst employed than unemployed women. Explanations of the increase in alcohol misuse amongst women focus on the changes and conflicts in social roles that have resulted from greater participation by women in the labor force, although these have yet to be substantiated by convincing empirical data concerning work and home environments(Ferrence,1984), Many of the studies purporting to demonstrate the etiological significance of role conflict depend on data derived from simple self-completed questionnaires and projection tests (Gorman,1988).
Moreover, at a conceptual level, the idea that one variable –role conflict-will have explanatory power across all categories of working women and all types of occupations is somewhat simplistic. Instead, it is probable that the effect of employment on female alcohol misuse is not direct but mediated by a range of other variables, such as age, marital status, number of children, quality of non-occupational environment, and quality of employment relationships. Indeed, for a woman from an adverse home environment, employment might provide respite from domestic discord and thereby protect alcohol abuse rather than increasing risk (Gorman,1988).
As for the role of employment in male alcohol misuse, the emphasis has been on identifying occupations which contain a high proportion of problem drinkers and identifying specific factors which elevate risk. Research indicates that heavy drinking tends to be more common in certain types of occupations (e.g., those in the alcohol industry and the armed forces), and that these exhibits an organizational structure characterized by such factors as availability of alcohol, social pressure to drink, separation from normal social relationships, freedom from supervision, and collusion from colleagues(Plan, 1979).
It is difficult to say that all, or even a majority, of those in structured employment will develop a problem. Rather such occupational risk probably interacts with and exacerbates pre-existing vulnerability to produce alcohol misuse. Plant(1979) found that even an entry into a high-risk occupation can led to an increase in alcohol consumption and alcohol-related problems, such occupations attracted a disproportionate number of individuals with poor work histories and already established patterns of heavy drinking. Thus, unlike environmental factors that affect individuals in their formative years and over which they have no influence (e.g., being born into extreme poverty), adults tend, within the constraints of prevailing economic circumstances, to exercise some control over where they work, and those who are already vulnerable may select into high risk occupations, thereby further predisposing themselves to develop a problem.
STRESS RELATED FACTORS
The relationship between stress and alcohol misuse has been studied at both the micro and macro levels. Linsky et al. (1987) found a strong correlation between the aggregate level of stress within American states (as measured by such indicators as the number of divorces per 1000 population) and the level of per capita alcohol consumption and alcohol-related problems such as deaths from liver cirrhosis. The main problem with such macro-level analysis is that one cannot be sure that the variables measured also correlate at the individual level – that is, is it the same individual who is experiencing stress and is also, drinking heavily and dying of liver cirrhosis?
Studies at an interpersonal level allow exploration of this issue. Unfortunately, the quality of research in this area has been poor, in that the onset of alcohol abuse is seldom accurately dated, and life events tend to be measured using simple questionnaires that are relatively inaccurate. Studies, which have employed more sophisticated measurement techniques suggest that stressful life evens are frequently preceded by the onset of alcohol abuse (Gorman,1990). Further research should attempt to identify which specific types of events are important, and why some individuals are more vulnerable to their effects than others. Concerning the latter point, it is reasonable to assume that individuals who exhibit the type of temperament traits that are thought to predispose towards alcohol abuse (e.g., emotional volatility or risk-taking) is also likely to generate more stressful life events (e.g., through the type of interpersonal relationship that they develop) and be more susceptible to their arousing effects. Thus, as with employment factors, interpersonal stress probably interacts with constitutional vulnerability in subtle ways, rather the direction of causality being simply unidirectional.
PEER RELATED FACTORS
Another area in which predisposing individual-level vulnerability and environmental risk interact is that of peer group influences. Risk factor studies show that adolescents with friends who use drugs are more likely to use drugs themselves than those who associate with non-users (Hawkins et al., 1992). In much of the substance abuse literature (especially that concerned with prevention), this correlation between an individual’s use and that of their friends has been interpreted so that adolescents are conceived of as malleable creatures subject to the corrupting influences of ‘deviant’ peers. Group affiliation is always assumed to precede drug use, and personal motivations to use or affiliate with certain types of peers are largely ignored. However, while peer pressure is undoubtedly significant in the etiology of alcohol
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(Narendra Kumar Singh)