Department of Nursing, University of West Attica, Ag. Spiridonos, Athens, Attiki, 11521, Greece.
Alcohol Treatment Unit, Psychiatric Hospital of Attica, Athens, Greece.
J Psychiatr Ment Health Nurs. 2021 Apr;28(2):285-290. doi: 10.1111/jpm.12668. Epub 2020 Aug 11.
WHAT IS KNOWN ON THE SUBJECT?: Addiction has a devastating impact in the lives of millions of people worldwide. Siblings constitute a hidden population. Siblings' attitudes to addiction in the family vary widely from overinvolvement to disengagement among different individuals and across time-line points during the long history of addiction. Female siblings report more negative feelings and attitudes towards drugs and alcohol. Previous research has described the process of a sibling's substance abuse through the eyes of a co-sibling but did not focus on how co-siblings are affected personally. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Addiction can have a damaging traumatic impact on female siblings which is enhanced by social and self-stigmatizing processes related to the "code of silence." The anxiety provoking secret may devour the ability to communicate and connect with other members of their family and community if selective revelation proves to be unsuccessful. Ambiguous loss can occur when one's sibling abuses substances, as the sibling may be physically present yet be psychologically absent in terms of the co-sibling (and the family). Ambiguous loss is connected to the lack of understanding of the real impact of addiction on a sibling's personal development. Addiction constitutes a family trauma which may severely shake the siblings' beliefs and values and undermine their self-esteem, security and trust in life and the future. Lack of focus on a sibling's feelings during addiction may severely impact on his/her psychological health and identity development. IMPLICATIONS FOR PRACTICE: Understanding the experience of siblings may help health and social care professionals to develop compassion, patience and empathy towards family members of persons with addictions. Mental health nurses need to be aware of the devastating impact of addiction on all family members in order to validate their experiences and support them in recovering from trauma and loss in the family. Due to the current context of addiction services i.e. individualized approaches and limited resources, organizations should consider the need to provide effective clinical supervision to young mental health professionals at an individual, group or multidisciplinary level.
关于该主题已知的信息有哪些？：成瘾对全球数百万人的生活产生了毁灭性影响。兄弟姐妹构成了一个隐蔽群体。在成瘾的漫长过程中，不同个体以及不同时间节点上，兄弟姐妹对家庭中成瘾问题的态度差异很大，从过度介入到疏离。姐妹报告称对毒品和酒精有更多负面感受和态度。以往研究从共同兄弟姐妹的视角描述了兄弟姐妹的药物滥用过程，但未关注共同兄弟姐妹自身受到的影响。
本文对现有知识的补充有哪些？：成瘾会对姐妹造成具有伤害性的创伤影响，而与“沉默准则”相关的社会和自我污名化过程会加剧这种影响。如果选择性披露不成功，引发焦虑的秘密可能会吞噬她们与家人和社区其他成员沟通与联系的能力。当一个人的兄弟姐妹滥用物质时，可能会出现模糊损失，因为从共同兄弟姐妹（以及家庭）的角度来看，该兄弟姐妹可能身体在场但心理缺席。模糊损失与对成瘾对兄弟姐妹个人发展的实际影响缺乏理解有关。成瘾构成了一种家庭创伤，可能会严重动摇兄弟姐妹的信念和价值观，损害他们的自尊、安全感以及对生活和未来的信任。在成瘾过程中缺乏对兄弟姐妹感受的关注可能会严重影响其心理健康和身份认同发展。
了解兄弟姐妹的经历可能有助于健康和社会护理专业人员对成瘾者的家庭成员产生同情、耐心和同理心。心理健康护士需要意识到成瘾对所有家庭成员的毁灭性影响，以便认可他们的经历，并支持他们从家庭创伤和损失中恢复。鉴于当前成瘾服务的背景，即个性化方法和资源有限，各组织应考虑有必要在个体、小组或多学科层面为年轻的心理健康专业人员提供有效的临床督导。
