Relationship between Family Expressed Emotion and Relapse Occurence among Inpatient Alcoholics in Nairobi County, Kenya
Githae, Eunice Njango
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Alcoholism is a family illness that requires treatment of the whole family, because recovery after rehabilitation seems mostly achievable when both the individual and their family are involved in relapse prevention. While studies have demonstrated that family plays an important role from diagnosis to treatment of alcoholism, few studies have focused on the interpersonal dynamics of family members which would maintain the alcoholic behaviours and lead to relapse. Such interpersonal dynamics would include the family emotional expression (EE) and how it may relate to relapse. In this study, the relationship between family EE (characterized by hostility, criticism and emotional over-involvement) and the occurrence of relapse in alcoholism was examined. The Family Systems Theory informed the current study in helping understand the complex dynamics of interactions of family members and how such interactions maintained maladaptive behaviours such as alcoholism. Samples were derived from populations of inpatient alcoholics (N=186) and their family members (N=135) in Nairobi County, Kenya. The instruments used in the study were the Alcohol Use Disorders Identification Test (AUDIT) to assess for alcoholism. The Family Member Attitude Scale (FMAS) and the Individual Attitude Perception Scale (IAPS) were used for assessing family EE. In addition, individual interview schedules were developed to assess how both the alcoholic and family members perceived family EE and how this may have contributed to relapse. Pearson correlations were used to test the relationship between the dependent variable (relapse) and the independent variables (hostility, criticism, and emotional over-involvement). Regression analyses were used to clarify the nature of the relationship of the variables, and to assess the statistical significance using the Statistical Package for the Social Sciences (SPSS). The study found out that EE was statistically significant at p=0.000<0.05 and had a predictive power of 34%. While hostility was found to have an inverse relationship with relapse (β=-.133), criticism was found to predict relapse at 28.2% and overinvolvement at 47.1%. This could mean that EOI was the major EE predictor variable for relapse among recovering alcoholics. The EE/relapse association was also evidenced by interviews by the participants. It was concluded that high levels of family EE were a contributing factor to returning to heavy drinking after treatment of an alcoholic.