Nam Eunji, Fukui Sadaaki
a School of Social Welfare , University of Kansas , Lawrence , Kansas , USA.
J Dual Diagn. 2017 Apr-Jun;13(2):124-132. doi: 10.1080/15504263.2017.1285092. Epub 2017 Jan 20.
Substance use among people with mood and anxiety disorders is highly prevalent. The literature suggests that substance use among people with mood and anxiety disorders is linked to social relational factors, yet it has rarely been the case that studies explicitly examine the differential impact of family and friends. This study investigated the association among family relationships, friendships, and substance use among people with mood and anxiety disorders.
Using the National Survey of American Life, structural equation modeling tested the unique effects of family relationships and friendships on tobacco, alcohol, and drug use (n = 1,076). The quality of family relationships was assessed using 12 items on the frequency of contact with family, received help from family, closeness in feeling toward family, and emotional support from family. The quality of friendships was assessed using four items on the frequency of contact with friends, received and given help, and closeness in feeling toward friends. Substance use was measured using self-reported use of tobacco, alcohol, and drugs.
Findings indicated that family relationships (β = -.101, p = .031) and friendships (β = .142, p = .004) were associated with drug use among people with mood and anxiety disorders, controlling for gender, age, race, education level, employment status, income, and family substance use history. Yet, family relationships and friendships were not significantly associated with tobacco and alcohol use.
People with mood and anxiety disorders who had better family relationships were less likely to use drugs, while those who had better friendships were more likely to use drugs. Practitioners should be attentive to the differential impact of family and friends when working with people with mood and anxiety disorders to reduce the risk of drug use. Family interventions promoting and maintaining quality relationships with family will be helpful. However, friendships may facilitate drug use of people with mood and anxiety disorders. Practitioners should be cognizant of the potential risks of friendship networks for people with mood and anxiety disorders.
情绪和焦虑障碍患者中的物质使用现象极为普遍。文献表明，情绪和焦虑障碍患者的物质使用与社会关系因素有关，但明确考察家庭和朋友的不同影响的研究却很少。本研究调查了情绪和焦虑障碍患者的家庭关系、友谊与物质使用之间的关联。
利用美国生活全国调查，采用结构方程模型检验家庭关系和友谊对烟草、酒精和药物使用的独特影响（n = 1,076）。家庭关系质量通过12个项目进行评估，包括与家人的联系频率、从家人获得的帮助、对家人的亲密感以及来自家人的情感支持。友谊质量通过4个项目进行评估，包括与朋友的联系频率、获得和给予的帮助以及对朋友的亲密感。物质使用通过自我报告的烟草、酒精和药物使用情况来衡量。
研究结果表明，在控制了性别、年龄、种族、教育水平、就业状况、收入和家庭物质使用史后，家庭关系（β = -.101，p = .031）和友谊（β = .142，p = .004）与情绪和焦虑障碍患者的药物使用有关。然而，家庭关系和友谊与烟草和酒精使用没有显著关联。
家庭关系较好的情绪和焦虑障碍患者使用药物的可能性较小，而友谊较好的患者使用药物的可能性较大。从业者在与情绪和焦虑障碍患者合作以降低药物使用风险时，应注意家庭和朋友的不同影响。促进并维持与家人的优质关系的家庭干预措施会有所帮助。然而，友谊可能会促使情绪和焦虑障碍患者使用药物。从业者应认识到友谊网络对情绪和焦虑障碍患者的潜在风险。
