|Year : 2019 | Volume
| Issue : 2 | Page : 151-155
Comparison of emotional-behavioural and functional states of children aged 6–16 years old with addicted and non-addicted parents in Qom
Ahmad Masoumi1, Zahra Hosseini2, Mojtaba Javadi1, Esmail Soltani3, Tahereh Ramezani4, Zabihollah Gharlipour4
1 Department of Medical Sciences, Faculty of Medicine, Islamic Azad University, Qom, Iran
2 Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
3 Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
4 Department of Health Education and Promotion, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
|Date of Web Publication||8-May-2019|
Department of Health Education and Promotion, Faculty of Health, Qom University of Medical Sciences, Qom
Source of Support: None, Conflict of Interest: None
Context: The addiction problem negatively affects the addicted person's mental health and his/her family. Aims: The aim of this study was to compare the emotional-behavioural and functional states of children aged 6–16 years old with addicted and non-addicted parents. Settings and Design: In this case–control study, using convenience sampling method, a total of 50 addicted parents with children aged 6–16 years old were selected from among people in addiction treatment centres in Qom; in addition, using simple random sampling, 50 non-addicted parents with children aged 6–16 years old were selected as the control group. Subjects and Methods: Data were collected using two questionnaires, including standard Child Behaviour Checklist questionnaire and Children's Global Assessment Scale questionnaire. Statistical Analysis Used: Data were analysed by SPSS version 20 using Chi-square, independent t-test and ANOVA. Results: There was a significant difference between children with addicted and healthy parents in terms of functional disorders (P < 0.001), as a higher percentage of children with addicted parents (as compared with those with healthy parents) had a functional disorder. Different types of behavioural disorders, except for physical problems, were significantly more prevalent in children with addicted parents than in children with healthy parents (P < 0.05). Internalisation and extrapolation of problems were more prevalent in children with addicted parents than in children with healthy parents (P < 0.05). Conclusions: Based on the results, children with addicted parents have undesirable emotional, behavioural and functional states. This suggests that the parents' addiction has a great impact on the health of the family, including children.
Keywords: Addiction, children, emotional and behavioural states, parents
|How to cite this article:|
Masoumi A, Hosseini Z, Javadi M, Soltani E, Ramezani T, Gharlipour Z. Comparison of emotional-behavioural and functional states of children aged 6–16 years old with addicted and non-addicted parents in Qom. Adv Hum Biol 2019;9:151-5
|How to cite this URL:|
Masoumi A, Hosseini Z, Javadi M, Soltani E, Ramezani T, Gharlipour Z. Comparison of emotional-behavioural and functional states of children aged 6–16 years old with addicted and non-addicted parents in Qom. Adv Hum Biol [serial online] 2019 [cited 2020 Jan 22];9:151-5. Available from: http://www.aihbonline.com/text.asp?2019/9/2/151/257817
| Introduction|| |
Nowadays, drug addiction has become a dangerous, complex and global problem. Given the strategic position of our country, since it is in the vicinity of two major sites of drug production, we are witnessing an increasing prevalence of drug use and drug addiction in the country. Addiction is a chronic and recurrent disorder that threatens the health and life of humankind. In addition, it has very broad and profound destructive effects on family life, economy, security and cultural development of society. According to statistics, about 230 million adults in the world, who are aged between 15 and 64 years old, are consuming illicit drugs at least once a year; moreover, about 27 million women and men are drug users. Drug abuse affects addicted person's personality and increases depression, anxiety and pessimism in addicted person. Drug addiction complications not only affect the addicted person but also lead to various types of mental disorders in his or her relatives, spouse and children. The addiction in parents has long-term harmful effects on children. Accordingly, children of addicted parents show emotional, cognitive, social and behavioural problems. Studies have shown that a high percentage of specific problems, including aggression, depression and low self-esteem, are observed in these children. Children of such families are often exposed to physical violence, emotional abuse or neglect. These children learn from their parents to use maladaptive coping strategies when confronted with stress and life problems. According to previous studies, this group of children shows a higher level of anxiety, depression, coping behaviours, behavioural problems and aggressive behaviours; on the other hand, their self-esteem, social adequacy and emotional adjustment are lower than those without addicted parents. In fact, addicted parents do not provide the right opportunities to create a proper environment for growing and promoting self-esteem in their children. Therefore, their children have a lower level of educational achievement and cognitive development, as compared with their peers. In general, substance abuse in parents is associated with poor educational performance, low cognitive development, higher levels of internalisation (anxiety, depression and low self-esteem) and extrapolation symptoms (behavioural problems and aggression). The results of a study by Kordmirzai et al. showed that the addiction in parents exacerbates physical, emotional and behavioural problems in their children. Furthermore, the results of a study by Bakhtiari et al. entitled 'Comparison of depression in adolescents with drug addicted and non-addicted parents' showed a positive and significant relationship between depression in adolescents and the duration of addiction in parents. In addition, Hoseinian et al. conducted a study to assess the relationship between family functioning and mental health of teenagers running away from the home, as compared with normal adolescents; the results showed a significant relationship between family function and mental health of adolescents. Given the above-mentioned items and considering the negative effects of drug abuse in the incidence or recurrence of mental illness (other than addiction) on both the addicted persons and other family members, this study aimed to compare the emotional-behavioural and functional states of children aged 6–16 years old with addicted and non-addicted parents in Qom.
| Subjects and Methods|| |
Study design and study population
This study was conducted as a case–control study. The members in the experimental group were selected through multistage sampling method. To conduct the sampling, different regions of Qom were divided into four clusters and an addiction treatment centre was randomly selected from each cluster. Then, using the sample size formula, from among the participants covered by the centres located in the four clusters, 50 addicted parents with children aged 6–16 years old were randomly assigned to the case group and 50 non-addicted parents with children aged 6–16 years old were randomly assigned to the control group. This study covered children aged 6–16 years old; in cases where the parents had several children aged 6–16 years old, only one of the children was randomly chosen for the study. Using the sampling formula, taking into account, the prevalence of emotional-behavioural disorders that is, 24% as reported by Bahari Gharehgoz, and considering the first type errors of 0.05, d = 0.1, and the probability of sample loss of 30%, the sample size was calculated as 100 people. The inclusion criteria were: having a child aged 6–16 years old and consent to participate in the study. The exclusion criteria for this study were: addicted and non-addicted parents without children aged 16–16 years old and lack of consent to participate in the study.
After obtaining an approval from Qom University and coordinating with addiction treatment centres, the questionnaire was distributed. During the data collection process, the objective of the research was explained to the participants, consent was obtained and the collected data were kept confidential.
The required data were collected using a self-reported three-part questionnaire. The first part of the questionnaire was used to collect demographic information, including demographic variables such as age, spouse's age, child's age, parents' level of education and the child's level of education. The second questionnaire included the Child Behaviour Checklist, which is used to assess the behavioural problems and social adequacy of children aged 6–18 years old, it was completed by the parents. If the parents were literate, they were given a questionnaire to complete; if the parents were illiterate, each item of the questionnaire was read by the researcher and the answers were entered into the questionnaire. This questionnaire examines behavioural-emotional states in eight domains of isolation, physical complaints, anxiety/depression, social problems, attention problems, thinking problems, criminal behaviours and aggressive behaviours. Each question had three options, including the following: no (zero score), sometimes (with a score of one) and yes (with a score of two). This questionnaire was used to identify three categories of problems as follows: (1) internalisation of problems (covering a set of three domains of isolationism, physical complaints and anxiety/depression), this category examines horrendous behaviours and overcontrol of emotions; (2) extrapolation of problems (including a set of two domains of criminal behaviour and aggressive behaviours), it examined aggressive, antisocial and uncontrolled behaviours and (3) general behavioural problems (obtained through calculating the total score of all the questions). In Minaee's study, the validity and reliability of this questionnaire had been already confirmed by Cronbach's alpha coefficient, the test–retest method and factor analysis.
The third part of the questionnaire included the Children's Global Assessment Scale (CGAS). Using this scale, the function was measured based on a combination of three main domains as follows: (1) social function, (2) job function and (3) psychological function. CGAS is based on a range starting from mental health ending to mental illness and has a scale of 0–100, with a score of 100 indicating the highest level of functioning in all areas. It was completed by the researcher. Validity and reliability of this tool had already been confirmed by numerous studies through Cronbach's alpha coefficient test, formal validity and content validity tests and factor analysis.,
The collected data were analysed by SPSS software V.20 (SPSS Inc., Chicago, Illinois, USA) using independent t-test, ANOVA, Pearson's correlation coefficient and Chi-square test, at a statistical significance level of 0.05.
| Results|| |
Based on the results, the mean age of the addicted and non-addicted parents, respectively, was 41.26 ± 7.6 and 35.92 ± 5.73 years, and the mean age of the spouse and their children, respectively, was 36.50 ± 5.88 and 10.34 ± 3.09 years. In this study, the most common types of abused drug were heroin (70%) and opium (60%) and the least common abused drug was amitriptyline (4%). The review of the juridical history of the cases showed that, 38% of drug addicts had a history of detention and imprisonment, while this rate was only 2% among non-addicts. Moreover, there were no significant differences between the children with addicted or non-addicted parents in terms of the demographic variables (P > 0.05).
Of all the addicts, 62% were illiterate or had a primary education level, while of all the non-addicts, 46% had a bachelor degree and higher level of education. Of all the studied children, most of them were male with a primary education level [Table 1].
|Table 1: Distribution of demographic characteristics of participants in the two groups of children with addicted and non-addicted parents|
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All the children with non-addicted parents had no major or moderate functional disorder, whereas all the children with addicted parents did not have an excellent functioning. In general, the most frequent disorder observed in children of addicted people was related to one domain of functional disorder, but in children with non-addicted parents, the highest frequency was related to excellent functioning [Table 2].
|Table 2: Frequency and percentage of functional disorders in children in the two groups with addicted and non-addicted parents|
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The prevalence of all types of emotional-behavioural disorders, except for physical complaints (P > 0.05), was significantly higher in children with addicted parents than in children with non-addicted parents (P < 0.05) [Table 3].
|Table 3: Mean and standard deviation of different types of emotional-behavioural disorders in children in the two groups with addicted and non-addicted parents|
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Concerning the type of response to disorders, the mean score of internalisation of problems and extrapolation of problems in children with addicted parents was higher than that in children with non-addicted parents (P < 0.05) [Table 4].
|Table 4: Comparison of mean and standard deviation of the types of responses to disorders in children in the two groups with addicted and non-addicted parents|
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| Discussion|| |
This study was conducted to compare the emotional-behavioural and functional states of children with addicted and non-addicted parents. The results of this study showed significant differences between children's addicted and non-addicted parents in terms of emotional-behavioural states of children, including isolationism, depression, social problems, thinking problems, attention problems, criminal behaviours and aggressive behaviours, as these problems were more prevalent in children with addicted parents. In line with our study, the results of a study by Koohi showed that all behavioural-emotional problems, including isolation, physical complaints, depression, social problems, thinking problems and attention problems, were more prevalent in children with addicted fathers than in those with non-addicted fathers. The results of a study by Azimi et al. showed that the daughters of addicted parents had higher scores in the domain of blaming others as well as in personal control problems, physical problems, anxiety and depression; however, the daughters of non-addicted parents obtained higher scores in the domains of positive reassessment, positive refocus, emotional-cognitive regulation, problem-solving and social relationships. Moreover, concerning the educational performance, the mean score of adolescents with addicted parents was lower. Therefore, it can be said that children with addicted parents are more depressed, lonely and taciturn than children with non-addicted parents. In other words, children with addicted parents are more likely to develop behavioural-emotional problems due to family problems. The results of a study by Kaheni et al. showed that the prevalence of criminal behaviours in children with disconnected families was significantly higher than that in children with intimate families. In addition, the risk of depression and anxiety in adolescents with disconnected families is 1.5 times more than that in intimate families.
Nonetheless, the results of a study by Raiisi et al. entitled 'comparison of mental health and parenting practices among addicted and non-addicted people' showed that the addicted individuals, as compared with non-addicted people, had a higher score in terms of psychotic problems, phobia, aggression, anxiety, depression and interpersonal sensitivity; however, there was no significant difference between the two groups in terms of the scale of physical complaints, obsession and paranoid thoughts. However, there was a significant difference between two groups in terms of parenting style (warm/cold), which led to a decrease in self-esteem and caused various fears and various psychological disorders in the children with addicted parents. This controversy may be due to differences in the target group, in type of instrument, and differences in the demographic and socioeconomic variables.
Furthermore, the results of this study showed that children with non-addicted parents had no major and moderate disorder in functioning and children with addicted parents had no excellent functioning. On the other hand, the highest frequency of excellent functioning was observed in children with non-addicted parents. In addition, all the studied functional disorders, except for physical complaints, were significantly more prevalent in children with addicted parents than in children with non-addicted parents. The results of a study by Bennett et al. showed that misconduct and neglect could have a negative impact on emotional stability, problem-solving skills and the ability to cope with new and stressful situations. These attributes may be developed because this group of children do not have a healthy attachment to their caregivers, and therefore, leaves others to avoid them. Attachment disorders in these children lead to subsequent communication problems.
In addition, in this study, in terms of the type of response to disorders, the mean score of internalisation of problems and extrapolation of problems in children with addicted parents was higher than that in children with non-addicted parents. The results of a study by Etemadi and Masteri Farahani entitled the 'comparison of mental health status and locus of control in adolescent girls with addicted and non-addicted family members' showed a significant difference between the mental health of adolescents with addicted and non-addicted parents in terms of the internal locus of control. Accordingly, the adolescents with an internal locus of control in non-addicted families had a better status of mental health. Finally, adolescent with addicted families and external locus of control and adolescents with non-addicted families and with internal locus of control, respectively, had the lowest and the highest levels of mental health. Thus, growing and strengthening the internal locus of control is one of the appropriate methods for preventing and reducing vulnerability. The results of a study by Behfar et al. showed that internalising disorders and dissatisfaction in adolescents were more prevalent in adolescents with disconnected families, as compared with those with connected families. Therefore, children with addicted parents may be exposed to a variety of behavioural and emotional disturbances and therefore would be psychologically, socially and physically vulnerable. As one of the strengths of this study, we investigated and compared the types of emotional-behavioural and functional disorders in two groups of children with addicted and non-addicted parents. Our study also had some limitations; for instance, we were not able to conduct a causal study and we used a self-reporting tool, thus the results of this study cannot be generalised to other areas.
| Conclusion|| |
Based on the findings, the children with addicted parents have an unfavourable behavioural, emotional and functional status. This suggests that the addiction in parents has a great impact on the mental health of family members, including children. Therefore, the behavioural-emotional state of this group requires special attention and intervention. Thus, it is suggested to conduct further studies to investigate the necessary educational interventions for controlling and preventing physical, psychological and social harm in children with addicted parents.
The authors would like to express our thanks to the Research Deputy of the Islamic Azad University of Qom, as well as all the parents who participated in this study.
Financial support and sponsorship
This study was financially supported by Islamic Azad University, Qom Branch, Iran.
Conflicts of interest
There are no conflicts of interest.
| References|| |
Zare GH, Shakeri MT, Hejazi A, Zeid Abadinejad MB. Epidemiologic study of deaths related to opiate abuse in Khorasan legal medicine center from March 20, 2004 to March 20, 2006. Med J Mashhad Univ Med Sci 2009;52:101-6.
Vazirian M. A review on drug demand reduction in Iran and recommendations for strategic development programs. Soc Welfare 2003;3:145-201.
Fallahzadeh H, Hosseini N. The study of the causes of relapse in addicts referning to behzisti of Yazd, 2002. TB 2006;5:67-73.
Meysamieh A, Faramarzi B, Holakouei Naeini K. How addicts think about addiction and community problems? Tehran Univ Med J 2006;64:34-43.
Haug S, Núñez CL, Becker J, Gmel G, Schaub MP. Predictors of onset of cannabis and other drug use in male young adults: Results from a longitudinal study. BMC Public Health 2014;14:1202.
Hasani J, Tajodini E, Ghaedniyaie-Jahromi A, Farmani-Shahreza S. The assessments of cognitive emotion regulation strategies and emotional schemas in spouses of people with substance abuse and spouses of normal people. J Clin Psychol 2014;6:91-141.
Burns AR, Solis JM, Shadur JM, Hussong AM. Comparing psychiatric symptoms among children of substance-abusing parents with different treatment histories. Vulnerable Child Youth Stud 2013;8:258-71.
Pleg-Oren N. Group intervention for children of drug-addicted parents-using expressive techniques. Clin Soc Work J 2002;30:403-18.
Bröning S, Wiedow A, Wartberg L, Ruths S, Haevelmann A, Kindermann SS, et al.
Targeting children of substance-using parents with the community-based group intervention TRAMPOLINE: A randomised controlled trial – Design, evaluation, recruitment issues. BMC Public Health 2012;12:223.
Lin YR, Shiah IS, Chang YC, Lai TJ, Wang KY, Chou KR. Evaluation of an assertiveness training program on nursing and medical students' assertiveness, self-esteem, and interpersonal communication satisfaction. Nurs Educ Today 2004;24:656-65.
Solis JM, Shadur JM, Burns AR, Hussong AM. Understanding the diverse needs of children whose parents abuse substances. Current Drug Abuse 2012;5:135-47.
Kordmirzai E, Salimi H, Shafiei M. The comparison of drawing family and the house-tree-person test in children with addicted and non-addicted parents. J Res Addict 2013;7:137-48.
Bakhtiari M, Hatami H, Tavakoli Fard M. A comparison of depression between adolescents with addicted parent and non-addicted parents. J Sch Med Shahid Beheshti Univ Med Sci 2016;40:63-7.
Hoseinian S, Zahraie SH, Khodabakhshi A. Relationships between family function and runaway adolescent mental health compared with normal adolescents. Res Consult 2005;4:16-25.
Bahari Gharehgoz A. Prevalence of affective-emotional disorders in exceptional children. Except Educ 2016;4:39-51.
Minaee A. Adaptation and standardization of child behavior checklist, youth self-report, and teacher's report forms. JOEC 2006;6:529-58.
Shaffer D, Gould M, Braise J, Ambroshini P, Fisher P, Bird H, et al
. Children's global assessment scale (CGAS). Arch Gen Psychiatr 1983;40:1228-31.
Lundh A, Kowalski J, Sundberg CJ, Gumpert C, Landén M. Children's global assessment scale (CGAS) in a naturalistic clinical setting: Inter-rater reliability and comparison with expert ratings. Psychiatry Res 2010;177:206-10.
Koohi L. A comparative study of the psychological status of children with parents addicted and non-addicted children with father. Soc Welfare 2003;3:295-305.
Azimi M, Nori R, Mohammadkhani SH. A comparison of the cognitive emotion regulation, general health, problem solving styles and academic performance of adolescent girls with addicted and non addicted parents. RPH 2016;10:38-48.
Kaheni S, Hasanabadi H, Sadat JS. Study of the juvenile anxiety, depression, aggression and delinquency in divorced and non-divorced families. J Sabzevar Univ Med Sci 2001;7:22-8.
Raiisi F, Anisi J, Yazdi S, Zamani M, Rashidi S. Mental health and child-rearing styles between candidate adult for addiction withdrawal in comparison with non-addict adults. JBS 2008;2:33-41.
Bennett DS, Sullivan MW, Lewis M. Neglected children, shame-proneness, and depressive symptoms. Child Maltreat 2010;15:305-14.
Etemadi A, Masteri Farahani F. The comparison of mental health status and locus of control of female adolescents of addicted and non addicted families. J Instr Eval 2016;4:137-52.
Behfar Z, Agha Mohammadian H, Mahram B. Family functioning and adolescent girls with internalizing disorders tiny compared with the normal group. Cogn Sci 2007;8:21-30.
[Table 1], [Table 2], [Table 3], [Table 4]