Relatives of alcoholics. Studies of hardship, behaviour, symptomatology and methods of intervention

Abstract: This thesis concerns relatives of alcoholics. The aims were to investigate relatives’ situation concerning hardship, coping behaviour and psychiatric wellbeing. Two different information techniques (one standardized technique and one individually adjusted technique) were compared in order to reach relatives of alcoholics for information of available support. No significant differences were found in relatives’ attendants, 20/112 (18%) and 21/104 (20%), respectively. Ten males and 19 female spouses were studied concerning gender differences in hardship, coping behaviour and psychiatric symptoms. Females showed a tendency towards higher rates on the avoidance coping component, which also was positively related to depression, obsessive-compulsive symptoms and hostility. Forty-one relatives were investigated concerning co-dependence. With a modified version of the Cermak operationally defined criteria 44% (83% females and 17% males) met the criteria of co-dependence, which was related to hardship and fear withdrawal. In order to study the efficacy of different interventions, 39 spouses (36 females and 3 males) were randomly assigned to three different interventions, standard information (1 session), individual coping skills training (4 sessions) and group support (12 sessions). At the 12 months follow up there were significant changes in all three groups concerning hardship, coping behaviour and psychiatric symptoms. The two longer interventions showed a stronger decrease in psychiatric symptoms (p = 0.1), but no differences in coping style or hardship. Finally, 289 patients (234 males and 55 females) in the emergency clinic were studied concerning social contact with relatives/sober friends in relation to treatment frequency and mortality after 2 and 7 years, respectively. Males, who were living alone and reported no contact with relatives/sober friends, showed higher treatment frequency during the follow-up period. However, they did not differ in rates of mortality compared to those who were living alone, but had contact with relatives/sober friends or those who were married/cohabiting.