A
Descriptive Study to Assess Depression and Codependency among Wives of
Alcoholics in a Selected Rural Community of Gurdaspur,
Punjab.
Sumanpreet Kaur
Khalsa College of
Nursing, Amritsar, Punjab
*Corresponding
Author Email: skaur201989@gmail.com
ABSTRACT:
The extent of alcoholism is
very grave, which calls for immediate attention from the society and health professionals as alcohol
related problems cost heavily for family and form a major public health
problem. They not only effect
the individual but also the one who surrounds him and involved with person in
form of personal relationship. The wives who do not drink but are victimized by
chemical abuse, are called codependents. Codependency is an unconscious
addiction to another person’s abnormal behavior which effects badly adaptation
skills of wives of alcoholics resulting in depression and various marital
problems. Statement of problem: A Descriptive Study to assess Depression and Codependency
among Wives of Alcoholics in a selected
Rural Community of Gurdaspur, Punjab. Objectives of study: To assess the level of depression among wives of
alcoholics. 1. To assess the level of codependency among wives of alcoholics. 2.
To ascertain the correlation between codependency and depression among wives of
alcoholics. 3. To determine the association of codependency and depression
among wives of alcoholics with selected socio-demographic variables.4. To
prepare and distribute the guidelines on prevention of codependency and
depression among wives of alcoholics. Method: The aim
of the study is to combat with codependency and depression among wives of
alcoholics by preparing and distributing guidelines for prevention of
codependency and depression. The present study assesses the level of
depression and codependency among wives of alcoholics in village Saroopwali Kalan of district Gurdaspur, Punjab. Total Enumerative sampling technique was
followed to select sample. Level of depression was assessed by Modified Zung Self- Rating Depression Scale and level of
codependency was measured by Modified Span
Fisher Codependency Assessment Scale. Result:
The results showed that among 212 wives of alcoholics, majority (32.1%)
were having mild depression level whereas majorities (72.2%) were having medium
level of codependency. Pearson’s coefficient of correlation showed positive
(r=+0.763) correlation between codependency and depression. ANOVA was applied
to assess association of codependency and depression with selected
socio-demographic variables Age, occupation, monthly family income, number of
year of marriage, number of children were found associated with level of
codependency and depression whereas number of years of alcohol dependence of
partner was found associated with
codependency only at p<0.05. Conclusion:
Pearson’s coefficient of correlation showed positive (r=+0.763) correlation
between codependency and depression.
KEYWORDS: Wives of
Alcoholics, Depression, ANOVA, Total Enumerative sampling technique, Codependency.
INTRODUCTION:
Health is a resource for life, not the object of living; It is a
positive concept emphasizing social and personal resources, as well as physical
capacities. All communities have highly variable, unique strengths and health
needs and is a common theme in most cultures. A number of studies have shown
that psychosocial factors particularly behaviour can
greatly contribute to enhancing or compromising health which may include
unhealthy dietary habits, sedentary lifestyles, cigarette smoking, abuse of
different substances including alcohol and non-adherence to effective
medication regimens. The unemployment problem, modern family set up
and the metamorphosis of the cultural values have led to frustrations among the
youth. This had prompted individuals to fall prey to various unhealthy behaviour pattern such as drugs, substance abuse especially
alcohol which is easily available and give them temporary solace as elucidated
by Park K (2001)1.
Co-dependence was originally defined in the early
1980s to help families and spouses of individuals with alcohol and drug abuse
related problems. When the wife is a co-dependent it will ‘interfere’ with the
recovery of the alcoholic usually leading to poor prognosis. Wives enabling behaviour
have positive effect on the drinking pattern of the alcoholic partner and
increases the episode of relapse whereas frequency of deaddiction
treatment also subsides with chronicity of alcohol
consumption as explained by Srinivasan P
(2006)2.
The alcoholic
beverages have been used in human societies since the beginning of recorded
history. The patterns of alcohol intake around the world are constantly
evolving and alcohol is ubiquitous today. Research has contributed
substantially to our understanding of the relation of drinking to specific disorders
and health outcomes. Increase in the average volume of drinking are predicted
for the most populous regions of the world in Southeast Asia including India as
mentioned by Timmon L Cermark (2004)3.
Alcoholism is a chronic behavioral disorder as stated by
Tiwari Ranjana
(2005)4manifested by repeated drinking of alcohol beverages, in
excess of the dietary social use of community and to an extent that interferes
with drinker’s health, familial or social and economic functions. The impact of alcohol on
marriage is profound as indicated by high divorce rate in alcoholic families. Studies by Orford
et al (1996)5 showed a strong correlation between various coping behaviours and alcoholic symptoms, hardship, job status,
wife's age and neuroticism score. There are considerable number of anecdotes
report and research findings by suggested that individuals who are married to
alcoholics have poor overall physical
and mental health. Studies of alcoholics clearly indicated that their spouses
are often more anxious, involved in fewer social activities, involved in fewer
social activities and report more stressful life events were associated with
partners depression. It was also found that there was significant correlation
between husbands alcoholism and wives depression. Although nearly all of
research documenting an association
between heavy drinking and partner’s depression sympatomatology was cross-sectional. It was usually presumed that heavy drinking as a
causal factor in non-alcoholic partners
depression.
The effect of alcohol dependence on the
family of alcoholic is negative one for the drinkers themselves and
for their families. Alcohol is known as family disease because it is
responsible for more family problems. Each member of the family may be affected
by alcohol differently. Adjustment to an alcohol problem of husband may result
in an increase in the wives emotional and physical illness and altered familial
function. The most negatively affected family members are spouse and children
of an alcoholic as stated by Schoenborn CA (2008)6.
Codependency was
a controversial concept as stated by Martsolf DS et al (2000)7 especially for
feminist scholars who are concerned about pathologizing
traditional female roles. This study's purpose was to determine: (1) the
prevalence of codependency in a sample of older women who because of age may
ascribe to traditional roles; (2) how the Hughes-Hammer/Martsolf
theoretical model of codependency relates to other health variables; and (3)
whether previous findings about the relationship between codependency and
depression replicate. Survey design was used with a sample of 238 women (ages
65 to 91) attending a flu shot clinic. Subjects completed the Codependency
Assessment Tool, Beck Depression Inventory, Quality of Life Scale, Perceived
Health Report, Measurement of Patient Functional Abilities, and Illness Prevention
Screening Behaviors Checklist. Of these women, 99% had low codependency scores.
Statistically significant correlations existed between codependency and
perceived health (p < .01), and functional ability (p < .01).
Codependency was not significantly correlated with illness prevention behaviors
and quality of life. Codependency and depression, as in previous studies, were
significantly correlated (r = .446, p = .0001). Using analysis of variance, 3
codependency subscales had significant positive effect on depression: Low
Self-Worth, Medical Problems, and Hiding Self. Further studies should examine
the degree of ascribing to traditional female roles in women dealing with
codependency issues.
Singh Lal (2003)8
explicated that the wives who do not drink but are victimized by
chemical abuse are called codependents. Most alcoholics have periods when they
stop drinking for a short while and seemingly do well, leading the codependent
person to believe that the problem can be solved. The alcoholic’s codependent
family members do everything possible to hide the problem, preserve the
family’s prestige and project the image of a “perfect couples”. Codependent
members often forget about their own needs and desires. Unknowingly,
codependent family members often become “enablers”. An enabler is “a person who
unknowingly helps the alcoholic by denying the drinking problem exists and
helping the alcoholic to get out of troubles caused by his drinking”. The
enabler lies for the alcoholic and thus enables the alcoholic to continue
drinking.
Upmesh K Talwar (2011)9
conducted a study in RINPAS to examine
the marital adjustment and codependency in 30 subjects, 12 male and 18 female
with depression. BDI, Marital Adjustment Questionnaire and Span-Fisher
Co-Dependency scale were used to assess the marital adjustment and
codependency. Only married couples were included from both the OPD and
IPD. Such couples in which one partner diagnosed for the current depression
according to ICD- 10 criteria were assessed. The purposive sampling was used
and 30 couples were included in the study. Study result indicated that there is
significant correlation between social and emotional adjustment in marital
adjustment domain at the 0.01 level and there is no statistically significant
correlation among rest of all. There is no significant correlation between
depression and marital adjustment, depression and codependency and marital
adjustment and codependency.
Renju James (2012)10conducted a descriptive correlational study on wives of alcoholics to assess the
codependency and depressive symptomns in Mysore on a sample size of
Gangadhariah H
(2002)11conducted a study to explore the problem of depression,
domestic violence and neurotic disorders experienced by wives of alcohol
dependent individuals. The study was carried out in de-addiction centre in
NIMHANS, Bangalore on a sample size of 220 using Hamilton depression rating
scale, Yales scale and conducted Structured
interview. The results indicated that intellectual violence was the commonest
variety of violence (69%) followed by emotional violence (58.6%) and social
violence (57.8%). Physical violence was found in 47% of the women and economic
violence in 41.6%. The least commonly reported violence was sexual violence
(27.4%). Wives with higher levels of domestic violence showed higher level of
depression. The major coping styles adopted were avoidance (53%), discard
(51.5%), fearful withdrawal (40.4%) and sexual withdrawal (25.8%) which makes
them prone to codependency.
The
nurse play a major role in identifying these groups, rendering counseling and
support and motivating them to utilize help from various self-help groups .
Nurses working in community have responsibility of understanding their needs
and problems and rendering care by giving them an opportunity to ventilate
their bottled emotions. She can also act as a counselor and as a facilitator
for wives’ of alcoholics and self-help groups. Therefore the researcher felt
that it is important to assess the depression and codependency among the wives
of alcoholic in community settings and thus the present study was designed to
determine the level of depression and level of codependency among the wives of
alcoholics.
The
researcher has personal experience with families of alcoholics and came across
the problems faced by them. Researcher has seen many families with alcoholics
leading to various problems in their family members including depressive
features and codependency in their partners. During the community postings also
the researcher found certain families in which the wives were facing lot of
psychosocial problems leading to depression. This made the researcher curious
to study about the depression and codependency among wives of alcoholics.
RESEARCH PROBLEM:
A Descriptive Study to assess Depression
and Codependency among Wives of Alcoholics
in a selected Rural Community of Gurdaspur,
Punjab.
AIM OF
STUDY:
The aim of the
study was to combat with codependency and depression among wives of alcoholics
by preparing and distributing guidelines for prevention of codependency and
depression.
OBJECTIVES:
1. To assess the level of
depression among wives of alcoholics.
2. To assess the level of codependency among
wives of alcoholics.
3.
To ascertain the correlation between codependency and depression
among wives of alcoholics.
4.
To determine the association of codependency and depression among
wives of alcoholics with selected socio-demographic variables.
5.
To prepare and distribute the guidelines on prevention of
codependency and depression among wives of alcoholics.
MATERIALS AND METHODS:
For the present study
Non-Experimental Research Approach and Descriptive
Research Design was used
as it aims to assess the relationship of depression and codependency Pilot study was started from October 17, 2013 to October 18, 2013 at the selected setting i.e. village Sankarpura, district Gurdaspur.
The data collection procedure for the main study was conducted in the month of
January,2014; from January 3,2014 to January 27,2014 in selected rural community i.e. Village Saroopwali Kalan of district Gurdaspur, Punjab. Prior to data collection, permission was
obtained from the village Sarpanch for conducting the
research study. First phase of sample selection was screening of accessible
population on the basis of inclusion criteria of research study. Total sample
size of 212 wives of alcoholics was selected by Total Enumerative Sampling
Technique. The research tool was divided into three parts: Part 1: Socio-demographic Profile. Part 2: Modified Zung Self- Rating Depression Scale.(WWK
Zung,1965) Part 3: Modified The
Span-Fischer Codependency Assessment Scale.(Fischer J, 1991)
RESULTS:
Sample Characteristics
Ø According to age, majority of wives of
alcoholics (28.3%) were in age group of 25-29 years.
Ø Regarding education, most of wives of
alcoholics (34.0%) were educated upto 10th
class.
Ø Majority of wives of alcoholics were
(42.9%) homemakers.
Ø As per type of family, majority (61.8%) of
wives of alcoholics were from nuclear family.
Ø In context of source of income, majority
(33.5%) belonged to income group 5001-10000/- rupees per month.
Ø As per number of years of marriage,
majority (35.4%) of the wives had been married for 6 to 10 years.
Ø As per number of years of alcohol
dependence of partner, majority (57.1%) of husbands were consuming alcohol from 2 to 9 years.
Ø In context of deaddiction
treatment of partner for alcohol, majority (59.4%) were previously treated.
Ø According to frequency of treatment, equal
number (40.6%) were in group who received no treatment and who received
treatment for once.
Ø Regarding the number of children most of
wives of alcoholics (37.7%) had two children.
Objective 1: To assess the level of depression among wives of
alcoholics.
Majority (32.1%) of wives of alcoholics were having
mild level of depression followed by
those having moderate depression 30.7% .
Objective 2: To assess the level of codependency among wives of
alcoholics.
Majority (72.2%) of wives of alcoholics were having
medium codependency level followed
by those having high codependency level
(20.3%).
Objective 3: To ascertain the correlation between codependency and
depression among wives of alcoholics.
Coefficient of correlation was found to be +0.763
which depicted that codependency and depression had high positive correlation
at p <0.001.
Objective 4: To determine the
association of codependency and depression among wives of alcoholics with
selected socio-demographic variables.
With regard to
association of codependency and depression among wives of alcoholics with
selected socio-demographic variables such as age (in years), educational
status, occupation, monthly family income, number of years of marriage, number
of years of alcohol dependence of partner (in years), deaddiction
treatment of partner, frequency of treatment in years and number of children.
Association of codependency and depression with
age, occupation, monthly family income, number of children and number of
year of marriage was found statistically significant at p<0.05. Whereas
number of years of alcohol dependence of partner was found associated with
codependency only at p<0.05.
ETHICAL
CONSIDERATIONS:
A formal permission to conduct the
research study was taken from village Sarpanch and
informed written consent was also taken from wives of alcoholics. Keeping in
mind the legal rights of the subjects, only those wives of alcoholics who were
willing to participate were included in the study. Anonymity of study subjects
and confidentiality of information was also maintained.
DISCUSSION:
Objective 1: To
assess the level of depression among wives of alcoholics.
The analysis of data regarding level of depression among
wives of alcoholics revealed that out of 212 wives of alcoholics, majority of subjects were found suffering
with mild (32.1%) to moderate (30.7%) level of depression. Nearly
one-fourth (24.1%) of wives of
alcoholics had no sign of depression. Very few were seen with severe depression
level (13.2%) with mean ± SD for depression was 56.34± 13.02. These findings are consistent with results of study
conducted by Cooper et al (2000)12
who found that majority of wives (70%) had mild depression and moderate
codependency among wives of alcoholics.
Objective 2: To assess the level of codependency among wives of
alcoholics.
The analysis of data regarding level of
codependency among wives of alcoholics revealed that out of 212, nearly three-fourth (72.2%) of the subjects had medium level of codependency as
compared to those with high level of codependency (20.3%). Low level of codependency was shown by very few subjects (7.5%) with overall mean ± SD for codependency was 63.72± 12.91. This study is consistent with results of Murthy VA (2010)13 who found
that 80% wives of alcoholics were having moderate level of codependency.
Objective 3: To
ascertain the correlation between codependency and depression among wives of
alcoholics.
The analysis of data regarding the
relationship between codependency and depression revealed that coefficient of
correlation was found to be positive (r=+0.763) and it was statistically
significant at p<0.001. The study findings is supported by Renju James(2012)10study results which revealed the mean of codependency was
65.8 and SD was ±14.4. the findings further show that means depression was 53.1
and SD was ±15.6. The Karl Pearson’s correlation coefficient
was +0.838 which show that there exists a positive correlation between
codependency and depression.
Objective 4: To
determine the association of codependency and depression among wives of
alcoholics with selected socio-demographic variables.
With regard to
association of codependency and depression among wives of alcoholics with
selected socio-demographic variables such as age (in years), educational
status, occupation, monthly family income, number of years of marriage, number
of years of alcohol dependence of partner, deaddiction
treatment of partner, frequency of treatment in years and number of children.
Whereas association of codependency and depression with age, occupation,
monthly family income, number of children, number of year of marriage was found
statistically significant at p<0.05. Whereas number of years of alcohol
dependence of partner was found associated with codependency only at p<0.05.
Similar results were reported by Janet H Wilks (2013)14
who reported that depression in wives of alcoholics was found to be associated
with age, family income, employment,
kids and housing statistically significant at p <0.05.
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Received on 28.07.2015 Modified on 22.08.2015
Accepted on 01.09.2015 ©
A&V Publications all right reserved
Asian J. Nur. Edu. and Research. 2016; 6(2): 183-187.
DOI: 10.5958/2349-2996.2016.00033.1