INTRODUCTION:

Adolescence is the most important period of human life which is called the transitional period of life. It is during adolescence that rapid physical growth and changes in physiological processes take place. Adolescence is also a period of progress towards mental, intellectual and emotional maturation.. The interaction of adolescent with the existing socio-cultural milieu results in some new developments. It initiates a process of redefining their social relationships. Society generally does not define a distinctively definite role for adolescents. And hence, they are caught in the ambiguous overlap between the categorically defined roles of childhood and adulthood. Their psychological needs also are not appreciated in proper perspective by the society. This at times generates among them aggressive and reactionary behavior which many a time is socially disapproved. So, they need proper guidance to fulfill their emotional, social and educational needs. (Gehlawat, 2009)¹

Adolescents account for about 1/5th of India’s population (Anon, 2004)².Recent researches suggest that more young people are beginning to report of mental health problems, as they perceive more stress. It is estimated that six to nine million children and adolescents in the United States have mental or behavioral problems. Indian Council of Medical Research reported that about 12.8 per cent of children (1-16 years) suffer from mental health problems. According to findings 69.56 per cent of adolescents had suicidal behavior due to parent-child problems, about 17.39 per cent due to partner relational problems, 8.69 per cent due to adjustment disorders and 4.35 per cent of children due to depression. Adolescents in disadvantaged communities are at elevated risk for exposure to multiple stressors, indicating high rates of crime and victimization, family poverty, family conflict, increased prevalence of deviant peers and school with inadequate resources (Gonzales et al., 2001)³.

Adjustment in adolescence:

Duncan (1949)⁴ defined adjustment as a means of state of harmonious relationship between a person and his environment. It also refers to a continuous process by which a person changes his own behavior or tries to change the environment or brings changes in both to produce satisfactory relationship with his environment Adjustment therefore has been considered as an index to integration; a harmonious behavior of the individual by which other individuals of the society recognize the person as well adjusted (L Preeti and E. Arnold, 2012)⁵. Coping during adolescence is therefore essential in the modern society as life is becoming very complex and conflicting day by day. This trend is alarming and therefore it is important that we pay attention to adolescent adjustment processes.

With respect to adolescent adjustment, parental warmth/involvement and behavioral control are associated with greater social competence, autonomy, positive attitudes toward school and work, academic achievement and self-esteem, as well as with less depression, school misconduct, delinquency and drug use (Lamborn et al., 1996)⁶. Therefore, the family plays a pivotal role in providing the most congenial atmosphere in which the child forms his style of life and basic patterns of behavior. Most of the children who are successful and well adjusted come from homes where a wholesome relationship existed between them and their parents, whereas children who were discouraged and rejected at home, lacked concentration in school work (Bowlby, 1969)⁷. They failed to establish desirable skills in academics and sports. Psychological control has also been found to be negatively related to healthy functioning. Cohesion and harmony in parent-adolescent interactions appear to be linked to relationships that are more positive.

There is strong evidence to suggest that family dysfunction during childhood can negatively influence later life experiences and adjustment (Werner and Broida, 1991)⁸. Drinking behavior may interrupt normal family tasks, cause conflict and demand adjustive and adaptive responses from family members who do not know how to appropriately respond. In brief, alcoholism or substance use creates a series of escalating crises in family structure and function, which may bring the family to a system crisis. As a result, the members may develop dysfunctional coping behaviours observes Ranganathan (2004)⁹.

Signs of maladjustment among adolescence of substance users:

Substance use and dependence are among the most prevalent psychiatric disorders (Kesseler RC et al 2005 and Kringlen E, Torgersen S, Cramer V: 2001)^10,11 also among parents (Lieb R et al and Maloney E, Hutchinson D, Burns L, Mattick R)^{12, 13} . An extensive amount of research has been conducted on the psychological functioning of children of alcohol abusers, although relatively few studies have addressed these children’s school adjustment.

Parental alcohol abuse or substance use is an independent risk factor for attention and conduct problems at school, which is not fully mediated by adolescent mental distress. While the association between parent-reported drinking and school adjustment seems to be modest when alcohol abuse occurs without co morbid disorders, witnessing the parents drunk was a stronger predictor for poor adjustment. The association between school adjustment and both parents’ alcohol use seem to be mediated by seeing the parents drunk. We cannot exclude that direct exposure to drunken parents partially causes the problems. Maternal drinking may be worse for children than paternal drinking, and maternal drinking may have an effect partially mediated by adolescent mental distress. Only the externalizing dimensions were associated with parental alcohol abuse. Despite more attention and conduct problems, children of alcohol abusers enjoy school as much as other children. ( Fartein A Torvik, 2011) ¹⁴.

Harter (2000)¹⁵ reports that Children of Alcholics faced difficulties in family relationships, and experienced generalized distress and maladjustment. Hall and Webster (2002)¹⁶ found that Adult Children of Alcoholics had more symptoms of personal dysfunction than the control group while Casas-Gil and Navarro-Guzman (2002)¹⁷ report that more COAs than comparison offspring were experiencing serious problems in the areas of educational and social functioning. Sher et al (1991)¹⁸ observe that COAs also evidenced lower academic achievement and less verbal ability than nCOAs. Lower quality of life scores in children of alcoholics has been reported in another study by Oravecz (2002)¹⁹. Haugland (2003)²⁰ also reports that children of alcohol abusing fathers were found to have more adjustment problems compared to a general population sample. His findings further suggested that child adjustment in families with paternal alcohol abuse is the result of an accumulation of risk factors rather than the effects of the paternal alcohol abuse alone. Both general environmental risk factors (psychological problems in the fathers, family climate, family health and conflicts) and environmental factors related to the parental alcohol abuse (severity of the alcohol abuse, the child’s level of exposure to the alcohol abuse, changes in routines and rituals due to drinking) were related to child adjustment.

Prior research has found that characteristics of the family (e.g., parental monitoring, parental discipline, family conflict, family rituals) may mediate and/or moderate the relationship between parental alcoholism and offspring adjustment (Sher, 1991; Windle and Tubman, 1999)^{21, 22}. However, it should be noted that the majority of investigations that have examined characteristics of COA families have examined the family at a family systems level.

Findings from this study have important implications for prevention and intervention programs that target offspring of alcoholic parents. First, these results suggest that it is particularly critical to target children of alcoholic mothers, especially daughters of alcoholic mothers. Results from this study also indicate that programs should aim to teach these vulnerable youth to use more effective coping strategies (e.g., instead of avoidance) when they are upset by their parent’s drinking. The findings also suggest that prevention programs should target ways to help girls from alcoholic families to become less emotionally entrenched in their dysfunctional family system. Importantly, this study has demonstrated the usefulness of adopting a micro-level approach when examining the relationship between parental substance use and adolescent adjustment. Researchers within the field should seriously consider taking a similar approach since the more that we understand the underlying processes involved in alcoholic families, the more that we will be able to help those who are affected.

The Longitudinal associations between fathers' heavy drinking patterns and children's psychosocial adjustment results demonstrated significant and meaningful associations between these drinking patterns in fathers and adjustment problems in children over time. Overall, children whose fathers remained mostly abstinent following their treatment showed lowest and decreasing adjustment problems, while children whose fathers continued and increased heavy drinking following their treatment showed greatest and increasing adjustment problems over time. (Andreas JB and O'Farrell TJ, 2007)²³

Interventions for adolescents of substance users:

Currently, many COAs remain unidentified within schools and may not be receiving the counseling services that they deserve and require. The family dysfunctionality of such children places them at high risk for adverse academic, physiological, emotional, and social consequences observe Lambie and Sias (2005)²⁴. It then becomes an important task for the school counsellor to identify such children in distress and to provide them with supportive services besides intervention with families to the extent possible. Knowledge of fathers’ alcohol use and its time of onset may be used to determine children who are at added risk of problematic alcohol use later in life and so special guidance, support and treatment can be targeted to these families observe Seljamo et al (2006)²⁵. In the Indian scenario where the majority of schools do not have a professional counsellor, this important task needs to be addressed by teachers who are in a position to identify such children.

It is therefore important that the therapeutic needs of these children are addressed through individual psychotherapy and other supportive therapies by providing an opportunity for ventilation of feelings and integrating elements that will boost their self esteem and promote their psychosocial adjustment in deficient areas. Normal difficulties and dilemmas associated with adolescence in general could be worked through in these sessions besides focusing on issues pertaining to parental alcoholism. A study from Korea reports that stress management program helps children of alcoholics by enhancing self-esteem, providing information about alcohol, and improving emotional and problem focused coping abilities, eventually enhancing their mental health (Yang and Lee, 2005)²⁶. Hence stress management techniques and relaxation modalities could be an important component of working with COAs.

Kuhns (1997)²⁷ observes that both group psychotherapy and self-help groups for COAs were effective in decreasing levels of depression while Kingree and Thompson (2000)²⁸ found that participation in the mutual help group promoted perceived status benefits, which in turn led to reductions in depression and substance use. The need to strengthen the social support available to such children has been highlighted by Werner and Johnson (2004)²⁹ whose data showed that individuals who coped effectively with the trauma of growing up in an alcoholic family and who became competent adults relied on a significantly larger number of sources of support in their childhood and youth than did the offspring of alcoholics with coping problems. Intervention with COAs must hence involve resolution of individualised issues pertaining to adolescence as well as parental alcoholism. Elements to enhance their self esteem and adjustment across various domains need to be consciously included besides involving them in family therapy sessions. Strengthening their social support systems, fortifying familial bonds besides facilitating their participation in self help groups comprising of other COAs, could go a long way in enhancing their mental health. Christine MO., Victor MH., Kyrianna R, and John K.(2006)³⁰ These efforts must be concurrently initiated along with other therapeutic procedures that focus on the alcoholic per se.

CONCLUSION:

Parental alcohol use damages and disrupts the lives of countless children and families in all areas of society, spanning all social classes. It blights the lives of whole families and harms the development of children trapped by the effects of their parents problematic drinking. It is time to take the next step and prioritize support in order to meet the specific needs of children of substance using parents, as well as providing support directly to parents themselves.

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Received on 09.08.2015 Modified on 24.08.2015

Int. J. Nur. Edu. and Research 3(4): Oct.-Dec., 2015; Page 428-432

DOI: 10.5958/2454-2660.2015.00036.8