Running Head Critique 1Critique2CritiqueAma.docx

Running Head: Critique 1
Critique 2
Critique
Amanda Kroeger
PSY 326
Prof. Luker
June 30, 2014
Critique
The purpose regarding this paper is to discuss the health and
social challenges as a result of drug addiction globally.
Particularly it brings to the attention of the reader the
complexities that arise with the combined forces by diverse
organizations, families, governments, and individuals in striving
to counteract the abuse of drugs within traditional families

whereby jeopardizing significant social virtues and values
creating room for deviant behavior such as crime. The study at
hand, “Familial Risk Factors Favoring Drug Addiction Onset”
by Zimi & Jukic aim at the identification of the familial factors
that favor the onset of drug addiction in the community. The
paper further evaluates and critiques the various scholarly
articles on drug addiction and their effects socially,
economically, and culturally.
From this study’s 146 addicts and around 134
fundamental subjects, the authors discovered that “the families
the addicts were born into, familial risk factors capable of
inﬂuencing their psychosocial progress and favoring drug
addiction onset had been statistically more encountered during
childhood and youth as compared to the controls” (Journal of
Psychoactive Drugs, 2012). In addition, the outcomes from the
study indicate the need to research further into three sections
namely the structure of the drug addict families, familial
interrelations of the families from which the drug addicts come
from and the importance of implementing family-based
approaches to address prevention and therapy for drug
addiction. The hypothesis of the study is the effect of poor
inter-parental relations on the psychological development of
children. This showed that conflicts in marriages have were
linked to the child’s social adjustment, incapacity, and harsh
upbringing regiment which in turn results in risky behavior
patterns including substance abuse (Journal of Psychoactive
Drugs, 2012)]. It is from this understanding that Zimi ´ and
Jukic’s study tries to investigate the familial factors in favor of
drug addiction onset by putting into consideration social,
developmental, and interaction elements as the determinants of
family relations and familial features associated with drug
addicts thus, causing children to turn to drug abuse.
In analyzing both the study at hand, that is, “Familial Risk
Factors Favoring Drug Addiction Onset” and various articles
from the bibliography such as Development: Which Way Now?,
Personal Savings and Anticipated Inflation, Assessment and

management of pain in infants, The capability of
psychodynamic treatment and cognitive behavior therapy in the
nursing of personality disorders: A meta-analysis, Macro
dynamics, Regime Switching and Financial Stress: Hypothesis
and Empirics for the US, the EU and Non-EU Countries, and
Hunger, Human Development, and Health in Canada: Research,
Practice, and Advocacy Dilemmas, the authors of the articles
manifest an absolute perception of the subject in question. For
instance, in their study (Zimi and Jukic, 2012) have employed
the use of various developmental theories addressing addiction
onset namely psychoanalytical theories which consider a family
as the factor number one in personality shaping.
On whether the authors remain based on their selection of the
literature review, there are no apparent biases only that the
focus was on studies relevant to the author’s study. As evident
from the study, the authors confine their research on various
prior studies especially those by NIDA and those published by
the Journal of Psychoactive Drugs. On the other hand, the
literature review of the bibliography, the authors provide clear
and comprehensive review of the topics at hand say the one on
the effectiveness of psychodynamic therapy and cognitive
behavior in relation to therapy treatment of personality
disorders.
The study, “Familial Risk Factors Favoring Drug Addiction
Onset” makes use of varied methods in their research which is a
one year investigation beginning in the year 2008 to the year
2009. The research involved two categories of persons, addict
group and control group with no addiction to drugs. The main
metric tool of the anonymous study was a sixty-seven variable
questionnaire where the addicted group comprised of 146
addicts of 92 men, 51 women and three individuals who
neglected to state their gender. It is to note that the age limit for
the participants was between 18 and 46. However, the majority
were in the bracket of 23 to 28 bringing the average at M=28.18
and SD=5.070 (Zimi & Jukic, 2012). The control group involved
134 individuals 88 of whom were men, 45 women and one

individual who neglected to state their gender and that they
were aged between 17 and 44 but the majority were 22 to 27
years old (average age M = 27.13; SD = 5.224). The assertion
by the authors concerning the groups is that the level of
education among the controls was higher than that under the
addicts p (χ2 = 44.275; df = 4; p < 0.01) and as the authors
explain, it is because prior studies indicate school failure and
poor academic achievement to yield normality in less than
6.5%. Some of the statistical methods used in the study in the
validation of the inter relation of the two mutually comparable
study groups to each other include (χ2 test) where the level of
significance was p < 0.05 and f p < 0.01 together with the
correlation analysis and all together analyzed using the SPSS
statistics software (Zimi & Jukic, 2012). From these, it is clear
that the chosen procedures for the study were appropriate.
The study analyzed above raises numerous ethical issues with
the main being the well-being and social challenges, as a result,
of drug dependence. However, the study also raises challenges
encountered, as a result, of poor parental practices due to
matrimonial conflicts and the effects on children in the addict
families. The researchers addressed the ethical issues in the
article to vehemently as evidence in the various reviews by
government Boards dealing with the sector. Different ethical
practices are questionable in the research including the
deception and coercion. (Newman, 2011)
The results of the study were in four different entities name
familial sociological features, familial interaction features,
familial development features and familial socio-demographic
features. Under the socio-demographic characteristics, the
researchers found that there was no notable difference
statistically in the profiles of the addicts and controls. However,
the marital state of the two groups differed statistically (32% of
addicts emanating from incomplete families that suffered either
parental divorce or death of one of the parents versus 21% of
such cases in the control group, p < 0.05) (Zimi & Jukic, 2012).
The study has the author’s interpretation and judgment

combined in the analysis results as they interpret the results of
every test and gives the outcome as why that happened and the
cause for it.
In their conclusion, the researchers note various points. First,
the study demonstrates that the burden imposed on families of
drug addicts by various familial risk factors capable of
triggering onset psychological disorder is heavier than that on
non-addict families. The study also concludes that the addicts
are under poor parental surveillance in comparison to non-
addicts. The study winds up by finding a causal relationship
between onset drug addiction in later stages of development and
familial risk factors in childhood and adolescence. The
researchers in the study purpose a further study into the familial
relations and structures of addicts’ families and the need for
comprehensive therapeutic oriented approaches toward addicts
plus their families. A limitation of the study is that it
concentrated more on youths aged between 17 and 28 years
leaving out the majority youth between 17 and 40 year olds. The
strengths of the study are that in assessing both addicts and
non-addicts which gave out convenient results. The most
appropriate recommendation to this study is that there should be
research on the effect of onset drug addiction courier wise and
compares it to cultural values and virtues so as to determine
where the effect falls more.

References
Barnard, M. (2007). Drug addiction and families. London:
Jessica Kingsley Publishers.
Cummings, E. M., & Davies, P. (2010). Marital Conflict and
Children: An Emotional Security Perspective. New York:
Guilford Publications.
Edelfield, B., & Moosa, T. J. (2012). Drug abuse. New York:
Rosen Pub.
Jones & Bartlett Learning. (2011). 2011 Nurse's drug handbook.
Sudbury, MA: Jones & Bartlett Learning.
Lamb, M. E. (2004). The role of the father in child
development. Hoboken, N.J: Wiley.
Newman, M. (2011). Research methods in psychology: San
Diego, CA: Bridgepoint Education, Inc.
Zimi, J& Jukic, V. ( 2012). Familial Risk Factors Favoring
Drug Addiction Onset. Journal of Psychoactive Drugs, 44 (2),
173–185, 2012, DOI: 10.1080/02791072.2012.685408. Taylor &
Francis Group, LLC
Journal of Psychoactive Drugs, 44 (2), 173–185, 2012
Copyright © Taylor & Francis Group, LLC
ISSN: 0279-1072 print / 2159-9777 online
DOI: 10.1080/02791072.2012.685408
Familial Risk Factors Favoring

Drug Addiction Onset
Jadranka Ivandić Zimić, Ph.D.a & Vlado Jukić, M.D., Ph.D.b
Abstract — This study, primarily aimed at identification of
familial risk factors favoring drug addic-
tion onset, was carried out throughout 2008 and 2009. The study
comprised a total of 146 addicts
and 134 control subjects. Based on the study outcome, it can be
concluded that in the families the
addicts were born into, familial risk factors capable of
influencing their psychosocial development and
favoring drug addiction onset had been statistically more
frequently encountered during childhood and
adolescence as compared to the controls. The results also
indicated the need for further research into
familial interrelations and the structure of the families addicts
were born into, as well as the need for
the implementation of family-based approaches to both drug
addiction prevention and therapy.
Keywords — drug addiction, family, risk factors
Drug addiction represents a global health and social
challenge faced by the modern world, with ongoing prob-
lems for all parties involved; this is true especially for
the members of the addict’s family, who often have to
admit their inability to cope in an efficient manner. The
ever-growing prevalence of opiate drug abuse has eventu-
ally led to crises in modern society and traditional family
ways; it has jeopardised fundamental social virtues and
values and led to a rise in criminal behavior. Therefore,
drug addiction issue should be viewed as a multidisci-
plinary phenomenon whose causes are to be sought in
the interplay between biopsychological, familial and social
factors, and in the interplay between risk and protective

factors (UNODC 2009; NIDA 2003). Nevertheless, a fam-
ily can‘t be viewed as an isolated entity, but rather as an
integral part of the broader community, so that a family
and society are in constant interaction that strongly affects
aSenior Adviser to the Government and to the Governmental
Office
of the General Programs & Strategies Department, Office for
Combating
Drug Abuse of the Government of the Republic of Croatia,
Zagreb,
Croatia.
bHead of the Hospital, Psychiatric Hospital Vrapče, Zagreb.
Please address correspondence to Jadranka Ivandić Zimić,
Ph.D., Office for Combating Drug Abuse of the Government of
the
Republic of Croatia, Preobraženska 4/II 10000 Zagreb, Croatia;
phone:
+385 1 48 78 130; fax: +385 1 48 78 120; email:
[email protected]
uredzadroge.hr
not only individual behavioral patterns, but the society as
a whole (Georgas 2006). It has been well recognised that,
aside from familial risk factors, addiction onset can also
be influenced by other cultural-social factors, personal-
ity features and genetic predispositions working together
(NIDA 2003). While discussing the fundamental functions
of the family, the American sociologist Talcott Parsons has
mentioned primary and secondary socialisation, the for-
mer defined as going on within the familial frame during
an early childhood, and the latter as taking place outside
family boundaries and developing as a result of social
influences stemming from peers, school and immediate

surroundings (Georgas 2006). Familial sociopathology in
terms of alcohol abuse, domestic violence and especially
child molestation and neglect have adverse effects on the
child’s healthy psychological development and are fre-
quently seen as the primary cause of psychological issues
and risky behaviors, including addiction (Bry et al. 1998;
Haddad, Barocas & Hollenbeck 1991). Studies devoted to
addicts’ families, carried out in Philadelphia, have demon-
strated that the nature of chronic heroin addiction may be
explained by family structure and intrafamilial relations
(Stanton et al. 1978). In several of their studies, Stanton
and colleagues have described the male addict prototype
characterized by a highly involved and considerate, over-
protective mother, indulgent when it comes to the addicted
Journal of Psychoactive Drugs 173 Volume 44 (2), April – June
2012
Ivandić Zimić & Jukić Familial Risk Factors
child or even favoring that child over the others. The father
of the male addict, on the other hand, is pictured as sepa-
rated, uninvolved, weak or distant, or aggressive and brutal,
many among them being alcoholics as well.
Peak incidence for addiction occurs in adolescence
although other forms of addiction may manifest later in
life (NIDA 1999; Nikolić, Klein & Vidović 1990). NIDA
studies have pointed towards poor parental surveillance
and parent-children conflicts as strong predictors of drug
addiction onset (NIDA 1999). Studies have also found that
in retrospect addicts very often viewed their mothers as
more functional than their fathers in terms of involvement,
responsibility and attachment (NIDA 1999. According to

numerous theories, an inadequate fulfilment of the parental
role, the lack of parental surveillance included, can even-
tually result in deviant behavior onset (Stattin & Kerr
2000; NIDA 1999). One study concerned with the relation
between bad parenting and delinquency (often associated
with drug consumption) revealed the delinquents to have
markedly poorer communication with their parents, to lack
trust in them, and to be much less bonded to them as
compared to nondelinquents (Stattin & Kerr 2000).
Parental alcohol abuse, especially that of the father,
can be responsible for children’s issues such as behav-
ior problems, delinquency, toxicomania, school issues or
school quitting, and issues of a psychological nature like
sleep disorders, anxiety and depression (Vitaro, Tremblay
& Zoccolillo 1999; Haddad, Barocas & Hollenbeck 1991).
Numerous studies have shown that poor interparental rela-
tions adversely impact child’s psychological development,
since marital conflicts are linked to a child’s incapacity
for social adjustment and his/her harsh upbringing reg-
imen, later on closely related to risky behavior patterns
including addictive substance consumption (Goddman &
Brand 2009; Haine et al. 2008; Ferić Šlehan 2004; Vukšić
Mihaljević & Grubeša 2004; NIDA 2003; Stanton et al.
1978). Given the hypotheses quoted above, drug addic-
tion may certainly be analysed from the familial dynamics
standpoint, as well as from the standpoint of family struc-
ture and intrafamilial relations (NIDA 1999; Stanton et al.
1978).
In line with the foregoing, this study primarily aimed at
investigating the familial risk factors favoring drug addic-
tion onset, taking into account developmental, interaction
and social aspects, so as to ultimately be able to determine
the existence of certain specific familial characteristics
and a profile of family relations typical of drug addicts

that might be shed light on as risky familial environments
causing some children to be more prone to drug addiction.
DEVELOPMENTAL THEORIES ADDRESSING
ADDICTION ONSET
The most renowned developmental theories address-
ing drug addiction onset are psychoanalytical theories that
view the family as the key factor responsible for personality
shaping. These theories have pointed towards several famil-
ial factors considered of importance not only for the onset
of addiction, but other psychological disorders as well.
Among these factors, those indicated as the most important
are early separation from the parents, unfavourable percep-
tion of the father figure or his absence from the family,
and conflicting, cold and distant relations with the parents
(Oslen 2004; Nikolić, Klein & Vidović 1990).
The family, defined as a core community primarily
responsible for the upbringing of its offspring and expected
to show continuous care for children’s psychophysical
development, may be considered essential for personality
shaping and viewed as a primary social group playing a
crucial role in the upbringing and socialisation of future
generations (Janson 2007). In its efforts to fulfil this role,
a family gets to witness and deal with various emotional
relations and interactions, the dyadic relation between the
mother and the child being the fundamental one (Rudan
1995). According to the psychoanalytical theory, child psy-
chological development runs through psychosexual devel-
opmental stages (oral, anal, oedipal, latency, and adolescent
stages). Should the first three stages run smoothly, i.e. free
of major frustrations and traumas, and under favourable cir-
cumstances, the latency and adolescent stages are likely to
be far less painful (Nikolić, Klein & Vidović 1990). These

theories have also suggested the importance of parental
presence in early childhood, since separation from the par-
ents can be the origin of anxiety and infinite psychological
trauma. Early separations from the parents affect the qual-
ity of relations with the object of affection (the parent/the
parents) and may profile the entire course of the child’s
further psychological development. Traumatic experiences
witnessed in early childhood may compromise ego devel-
opment (Rudan 1995; Klein 1992); separation from the
parents definitely falls into the category of such experi-
ences, since it can induce an overdue defence mechanism
utilisation, personality splitting and projection. Premature
separation from the parents may cause stress and psycho-
logical trauma that become a source of anxiety, which,
in turn, may trigger drug consumption so as to bring
“relief” and “alleviate” psychological symptoms arising
due to traumas and stresses witnessed in the early child-
hood. Psychoanalysts are of the opinion that the quality of
upbringing and well-balanced relations with both parents
are a prerequisite for a healthy and normal development
of a child (Nikolić 1991). Relations with the parents, built
in early childhood, mirror the relations established in the
adolescence. Close emotional relations with the parents are
largely conditioned by emotional relations established in
the first three developmental stages, and close emotional
relations (intimacy) with the parents, established in early
childhood, act as a protective factor hindering drug addic-
tion onset during adolescence (Nikolić, Klein & Vidović
1990; Goddman & Brand 2009).
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Drug addiction onset is closely linked to adolescence.
By definition, adolescence is the time of crisis in the
life of virtually all individuals; however, children com-
ing of age under unfavourable conditions compromising
their emotional development are far more endangered.
Psychoanalysts have taken the position that adolescence
can be best described as the period characterised by a
number of psychological phenomena and issues that an
adolescent needs to resolve. One of the major issues to be
resolved is the oedipal conflict; its final resolution should
be followed by the assumption and the embracing of sex
roles. Major task number two, pending resolution, is social
affirmation in the local milieu and the assumption of social
roles. From where the psychoanalysts stand, definite ful-
filment of these tasks and ultimate resolution of these
conflicts depend on relations established in the primary
childhood (Rudan 1995). Furthermore, since one has to
prove and promote himself/herself within the local com-
munity, the role of peer groups, and their influence on
values an adolescent chooses to adopt and observe, is of
the utmost importance; therefore, such peer groups may
often be directly involved in drug addiction onset. In light
of the foregoing, it is highly likely that a certain number of
adolescents, whose early psychological development was
rich in difficulties and frustrations, would try to resolve
an otherwise normal adolescent crisis by virtue of drug
consumption.
INTERACTION THEORIES—FAMILIAL
RELATIONS AND FAMILY STRUCTURE AS
FACTORS IMPLICATED IN ADDICTION ONSET
Symbolic-interaction theories addressing the role of a
family have acknowledged the importance of communi-

cation between family members not only for the proper
family functioning, but for its survival as well. Marriages
and families are essentially built of individuals having a
long-term mutual interaction (relations), the latter being
dependent on the roles assumed by an individual family
member at a given point (Plunkett 2011: Janković 1994).
Interaction theory greatly resembles conflict theory, which
states that a conflict represents the foundation of each
and every social relation, familial relations included, such
conflict stemming from a desire to assume as powerful
familial role as possible in order to protect one’s interests
(Janson 2007; Farrington & Chertok 1993). This conflict
arises on the grounds of controversial wishes and desires
of two or more groups, or on the grounds of a limited
supply of the objects concurrently targeted by various indi-
viduals or groups. This theory argues that such conflict
represents the basic ingredient of not only the social life
of an individual, but the development and progress of the
society on the whole (Farrington & Chertok 1993). Studies
of the birth families of addicts by Stanton and colleagues
(1978) showed that the causes and nature of chronic heroin
addiction may be explained by analysis of familial rela-
tions, i.e. the analysis of familial interactions and family
structure. These studies attempted to find out the differ-
ences between families dealing with addiction and families
dealing with similar issues. The comparison revealed some
phenomena seen across addicts’ families to be very similar
to those encountered among other disorderly and dysfunc-
tional families and/or families dealing with issues of other
nature. In addition, it was found that the family of an addict
has distinctive features and specificities. For instance, such
families are characterized by high substance (in particular
alcohol) addiction prevalence rates seen across generations,
as well as by a frequent predisposition to other forms
of addiction, for instance pathological gambling disorder.

Of note, other studies carried out within 1975–1979 time-
frame yielded similar results, even though it should be
pointed out that the focus of the later studies devoted to
this problem had mostly been shifted from familial factors,
in particular familial relations favoring drug addiction onset
(Coleman & Stanton 1978; Harbin & Maziar 1975).
Numerous later studies have demonstrated that the
consumption of drugs and other addictive substances can
be associated with familial surroundings characterised by
an insufficiency or lack of parental support and by little
parental knowledge about the persons their adolescent is
associating with. NIDA studies have revealed poor parental
surveillance and parent-child conflicts to be strong predic-
tors of drug addiction onset (NIDA 1999). This research
has suggested the importance of a strong emotional rela-
tionship with the parents and parental support as protec-
tive factors hindering drug abuse. As opposed to that,
parental addiction, parent-child conflicts, a local milieu
favoring drug abuse, and positive peer group attitudes
towards drug consumption are risk factors facilitating drug
addiction onset. According to numerous theories, inade-
quate parental practices, the lack of parental surveillance
included, can ultimately lead to deviant behavior onset
(Stattin & Kerr 2000). These theories support the thesis
that adequate parental surveillance is capable of prevent-
ing deviant behavior including addiction. A study that dug
deeper into the association between poor parental practices
and delinquency showed that delinquents have a far poorer
communication with their parents as compared to non-
delinquents; they have little faith in, and loose bonds with,
their parents (Cernkovich & Giordano 1987). The results
of the research study “The System of Values Observed
by the Young Ones and Social Changes Witnessed in
Croatia” carried out by the Institute for Social Research
in Zagreb, Croatia on the sample of 17,000 young indi-

viduals aged 15 to 29 recruited throughout Croatia showed
that young drug and alcohol addicts express their dissatis-
faction with the quality of their parents’ marital life and
come from structurally impaired families far more often
than their counterparts (Bouillet 2004). In addition, these
young addicts were of the opinion that their family is
2012
of virtually no relevance for their attitudes and beliefs.
In conclusion, numerous studies have shown that the con-
sumption of drugs and other addictive substances can be
related to familial surroundings characterised by a poor
parental support and little parental knowledge about the
persons their adolescent is associating with. An overview
of studies dealing with maladjusted behavior came to the
conclusion that relationships with parents play a key role
in drug addiction prevention, largely due to opened chan-
nels of an intrafamilial communication (Tokić 2008; Berger
& Sather 2007). A number of other studies also have
stressed the importance of favorable interfamilial com-
munication and close emotional relations between parents
and their offspring in the prevention of behavioral disor-
ders including addiction (Ferić Šlehan 2004; NIDA 2003;
Glavak, Kuterovac Jagodić & Sakoman 2003; Kerr et al.
2003; NIDA 1999). Favorable and supportive intrafamil-
ial communication allows family members to express their
needs, and creates a democratic environment full of trust
and warmth in which closer and more cordial relations
between the parents and their children can be established
more easily. In creating such an environment, the roles of

parents and adolescents are equally important; parents, on
one hand, should be warm and supportive and have faith
in their child/children, while children, on the other hand,
should be willing to establish open and sincere communi-
cation with their parents and have faith in them, too (Kerr
et al. 2003).
SOCIOLOGICAL THEORIES—SOCIAL FACTORS
AND FAMILIAL SOCIOPATHOLOGY AS RISK
FACTORS FAVORING ADDICTION ONSET
When discussing a family, it should be borne in mind
that neither any given family nor any given person can be
profiled independent of the entire social context. A fam-
ily can be described as an ever-changing structure whose
functioning, as well as the pathology potentially witnessed
in the later stages, depend on a number of social deter-
minants such as familial financial standing, cultural and
religious values, level of education, migrations, and social
isolation or adaptability, as well as on various larger-scale
events witnessed by the local community—war operations,
economic crises and criminal offences being the most
striking among them (Georgas 2006; Čudina-Obradović
& Obradović 2002; NIDA 1999). The onset of addiction,
which nowadays poses as a global problem, also depends
on a number of psychological and sociological factors
whose interplay eventually triggers an individual drug
addiction onset (Klarin 2002; Kušević 1987). It has been
well established that drug addiction onset can be closely
linked to adolescence—an age in which young people face
numerous, extremely dynamic and intense changes. It is
not uncommon for certain young age groups to express
their rebellion against the culture dominating their local
communities by following novel trends in music, culture

and leisure time spending. By doing so, they also rebel
against parental authority as the primary factor respon-
sible for their socialisation. One of the most prominent
social factors responsible for drug addiction onset is the
ever-growing drug availability (Perasović 2000). Clearly,
should a drug be hard to obtain, it will be sought by
individuals prone to antisocial behavior and rejection of
all social values, as well as by individuals coming from
turbulent or dubious familial and social environments.
Nonetheless, ever-growing drug availability increases the
chances for consumption by young people across all social
strata regardless of presence of risk factors. The social devi-
ation theory views drug addiction as a phenomenon typical
of social environments in which drugs are easy to obtain,
as well as a phenomenon typical of criminal milieus and
environments prone to accept deviant behavior in general
(Hill 1980). Therefore, drug abuse issue witnessed across
young population can not be resolved by virtue of separate
interventions, but rather by virtue of targeted interven-
tions aiming at three psychosocial impact factors: behavior,
personality and surroundings, familial one in particular
(Milkman & Wanberg 2005).
Under the influence of social developments, a fam-
ily may witness changes during which traditional patterns
of its functioning are gradually perishing and new, mod-
ern attitudes and family and marital values are substi-
tuted. The proportion of employed women is constantly
rising, while, at the same time, the traditional institu-
tion of marriage steadily loses its relevance, so that the
number of people determined to establish informal, extra-
marital relations is growing by the day; in turn, attitudes
towards family and children are undergoing changes as
well (Čudina-Obradović & Obradović 2002). The tradi-
tional family featuring a stable group of characters is
gradually decreasing, while an ever-growing number of

young people tend to embrace different trends more attuned
to their generation. In addition, influenced by various
global trends, younger generations gradually establish their
own values, substantially different not only from those
observed by adults but from those socially favorable and/or
acceptable as well (Williams 2003). Lack of public aware-
ness together with the lack of high-quality, well-organised
preventative and therapeutic programmes, in particular
those that are family-oriented, are factors in the con-
stant increase in the number of addicts seen in certain
societies.
THE CURRENT STUDY
A number of studies and theories (NIDA 2003,
1999) have attempted to define familial features that
pose risk factors for drug abuse, as well as those act-
ing as protective factors. The most important protective
familial factors reported by the majority of these studies
2012
were close relations between parents and their children,
positive disciplinary measures exercised within the fam-
ily, continuous parental surveillance, inclusion of children
in the decision-making processes, healthy communication
between parents and children and their mutual trust, inclu-
sion of parents into their children’s lives (familiarity with
children’s friends and habits), strong and affirmative fam-
ily ties, and conventional parental attitudes towards drug
consumption (NIDA 2003). The main familial risk fac-

tors reported by these studies are lack of close emotional
parents-children relations, chaotic familial environments
(especially those featured by parental alcoholism or abuse
of other psychoactive substances), loose bonds between
parents and children, and lack of parental care, as well
as familial attitudes advocating drug consumption (NIDA
2003; Williams 2003). The research in this field of exper-
tise has also shown that drug addiction should be viewed
as a multidisciplinary phenomenon influenced not only by
familial, but also by other cultural-social factors, personal
characteristics and genetic predisposition which together
can lead to drug addiction onset (NIDA 1999).
Nevertheless, in order to uncover and elucidate its
causal background and aetiology, drug addiction can be
analysed from the viewpoint of family dynamics, familial
structure and familial interrelations. Should one take this
path of consideration, three main aspects are to be taken
into account:
1. The developmental aspect, implying an analysis
based on psychosocial developmental stages;
2. The interaction aspect, implying an analysis based
on family dynamics and the quality of family rela-
tions; and
3. The social aspect, implying an analysis based on
social dynamics capable of affecting the family and
pushing it towards familial sociopathology.
In line with the foregoing, the main goals of this study were
to identify possible differences between addicts’ and non-
addicts’ families in terms of developmental, interaction and
social factors, so as to be able to ultimately identify familial
risk factors favoring drug addiction onset.

To that effect, developmental, interaction and social
features of drug addicts’ families and major characteris-
tics of addicts’ psychological development starting from
the earliest childhood up to adolescence have been stud-
ied along with those descriptive of nonaddicts, so as to be
able to identify the differences between the two. The three
main features studied in this regard were:
• Developmental features: separation from the parents
early in life (i.e. prior to the age of seven), parental
divorce or death of one of the parents during the sub-
ject’s childhood and adolescence, self-perception of
one parent as more attentive and more caring, psy-
chological trauma and stressful events in childhood
and adolescence, lack of parental surveillance and
support;
• Interaction features: emotional relations with the
parents established in childhood and existent at
the present moment, relations with the siblings,
interparental relations, distribution of power within
the family, communication with the parents, and
support given by the family;
• Sociological features: family migrations taking place
in the subject’s childhood and adolescence, famil-
ial sociopathology such as harassment and domestic
violence, alcohol abusing and mentally challenged
parents, religious beliefs and attitudes, criminal
offences committed by family members, etc.
METHODS
Throughout 2008 and 2009, an investigation was car-
ried out involving an addict group and a control group not

addicted to drugs, alcohol and other addictive substances.
The study was anonymous, and made use of a 67-variable
questionnaire as the main metric tool. The addict group
was comprised of a total of 146 drug addicts; there were
92 men, 51 women and three individuals who neglected to
state their gender who were aged 18 to 46 (most of them
being 23 to 28 (the average age M = 28.18 SD = 5.070).
At the time, the subjects were undergoing residential treat-
ment either on the premises of the Psychiatric Hospital
Vrapče or on the premises of the Clinical Hospital “Sisters
of Mercy” established in Zagreb. The control group was
comprised of a total of 134 individuals; there were 88 men,
45 women and one individual who neglected to state
his/her gender who were aged 17 to 44, most of them being
22 to 27 (the average age M = 27.13; SD = 5.224). The
main criterion observed in selecting the control group was
to recruit roughly the same number of nonaddicted exam-
inees and to standardise them for their sociodemographic
features such as age, sex, educational background, place
of birth and place of residence; these efforts eventually
yielded a control group fully matching the addict group
as regards sex (χ 2 = 0.132; df = 1; p > 0.05), age
(t = 1.678; df = 268; p > 0.05), magnitude of the place
of birth (t = 0.111; df = 265; p > 0.05), and magnitude of
the place of residence (t = 1.758; df = 263; p > 0.05).
However, it should be noted that the educational back-
ground seen across the controls is generally higher than
that seen across the addict group (χ 2 = 44.275; df = 4;
p < 0.01). The reason for pointing this out is that some
studies have indicated that school failure and poor aca-
demic achievements yield “normality” in not more than
6.5% of cases; in these cases, antisocial behavior, personal-
ity disorders, organic symptoms, etc. are far more common
(Nikolić 1993). Taking this into account, as well as given
that early drug addiction onset (at the age of 13, 14, or
15) and not intellectual or some other deficits represent the

most probable cause of poor education in the addict group,
control group subjects having a somewhat higher level of
2012
education but otherwise matching the addict group were not
excluded from the study. The control group was comprised
of employees of the Psychiatric Hospital Vrapče and the
CHC “Sisters of Mercy,” as well as persons affiliated with
the State Administration and Public Services, unemployed
persons and students.
The members of both groups filled out the question-
naire independently, i.e. without any assistance and in the
absence of researchers. The researchers or medical staff
of the hospitals in reference distributed the questionnaire
among the addicts, explained to them the purpose of the
study, and pointed out that all the answers would be kept
anonymous, but that they should be honest and straightfor-
ward. The questionnaire was given solely to addicts whose
acute therapy had been completed. With the questionnaire,
the addicts were provided with the cover letter contain-
ing an explanation of the study purpose and a request
for as honest answers as was possible. Participation in
the study and questionnaire fulfilment were voluntary; the
addicts reluctant to comply were not forced to do so. The
questionnaire was anonymous, without personal data like
name, date of birth (only year) etc.) and participants were
informed orally and in the written form about all relevant
features of study such as aims, methods and means of using
data . Approval was obtained from the Board of Ethics of

University of Medicine in Zagreb for implementation of
this study and the Boards of Ethics of Hospital Vrapče and
Clinical Hospital Sister of Mercy.
The researchers had also personally delivered the ques-
tionnaire to the control subjects, together with the explana-
tory cover letter describing the purpose and the goal of
the study and requesting as honest answers as was possi-
ble. None of the subjects received his/her questionnaire by
email.
The variables addressed by the questionnaire were
mostly qualitative in their nature and referred to the familial
sociodemographic status, the features of the subject’s early
development, the family structure and the dynamics of its
intrarelations, as well as to the familial sociopathology
witnessed throughout the subject’s childhood and adoles-
cence. For each variable addressed by the questionnaire,
several categories were offered as answers; in addition, the
category “other” was provided as well, offering the respon-
dents the chance to give a descriptive answer/an answer
different from those offered on the menu. The collected
data were entered into the computer database making use
of the SPSS Statistics software. The questions answered
in the descriptive manner (“open category answers”) were
analysed by the researchers, so as to boil them down
to two or three categories (positive, negative and neu-
tral). Within the framework of this study, differences in
sociodemographic, developmental and interaction familial
features and familial sociopathology for the addicted and
the control groups were studied that included the follow-
ing: parents’ marital status, educational background of the
father, educational background of the mother, the number
of family members, severe illnesses that the participant had
recovered from by the age of three, separation from the

mother up until the age of three, separation from the parents
(until the age of seven), emotional relations with the father
during childhood, emotional relations with the mother dur-
ing childhood, perception of a more attentive and more
focused parental care, communication with the father dur-
ing childhood and adolescence, communication with the
mother during childhood and adolescence, clarity of the
messages conveyed by the parents during the upbringing
process, harmony between the parents and the siblings,
free exchange of standpoints and opinions among family
members, parental support, parental surveillance, decision-
making process related to tangible assets and other issues,
interparental relations, parental divorce or death of one
of the parents, indication of the parent the respondent
continued to live with following his/her parents’ divorce
or/and death of one of them, parental alcoholism and men-
tal disorders, harassment and domestic violence witnessed,
religious beliefs and attitudes, and felonies committed by
family members.
Data were analysed using descriptive and parametric
statistics. Variables descriptive of the two mutually compa-
rable study groups were correlated to each other. In order
to validate the interrelations, a nonparametric statistical
method (χ 2 test), deemed significant at the level of signif-
icance of p < 0.05 or, with more substantial differences,
at the level of significance of p < 0.01, was used, together
with correlation analysis. The statistical analysis made use
of the SPSS-Statistics software.
RESULTS
Familial Sociodemographic Features
The results showed no statistically significant differ-
ences between sociodemographic profiles of the addicts’

and the control subjects’ immediate families. Across both
study groups, the subjects mostly came from three- to five-
member families (72%) and were mostly firstborns (39% in
the addicted versus 49% in the control group) who assessed
their family standing as good on a five-point scale (66% in
the addicted versus 62% in the control group). The addicts
and the controls did, however, statistically significantly dif-
fer in their parents’ marital status (32% of addicts coming
from incomplete families that faced either parental divorce
or death of one of the parents versus 21% of such cases in
the control group) (p < 0.05) (see Table 1).
Familial Developmental Features
When it comes to familial developmental features, the
results showed statistically significant differences between
the addicted and control groups. These differences were
seen in a number of developmental aspects, as well as
in a number of childhood and adolescent psychological
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TABLE 1
Parents’ Marital Status
Addicts Controls
Together 68% 79%
Parents Divorced 18% 12%
One Parent Deceased 4% 1%
Single-Parent Family:

Self-Supporting Mother
8% 7%
Single-Parent Family:
Self-Supporting Father
2% 1%
developmental features. The variables differing between
the addicted and the control groups were as follows:
• Separation from the parents prior to the age of
seven: (27% in the addicted vs. 11% in the control
group; p < 0.05 (p < 0.01, χ 2 = 11.377, Df = 1,
p = 0.003)
• Parental divorce or death of one of the parents
experienced in early childhood or adolescence
(35% of the addicts compared to 21% of the con-
trols, p < 0.01 (p < 0.05, χ 2 = 6.962, Df = 2,
p = 0.031). When this occurred, the addicts were also
much younger than their nonaddicted counterparts.
• Psychological trauma and stressful experience:
(46% in the addict vs. 26% in the control group,
p < 0.01 (χ 2 = 11.930, Df = 1, p = 0.001). Among
the addicted subjects who claimed to have experi-
enced a psychological trauma or stress, the greatest
number (addicts 28%, controls 35%) reported expo-
sure to war environment. The most striking differ-
ence in the type of the experienced trauma, seen
between the addicted and the control groups, appears
with physical or sexual harassment; as compared to
the control subjects, the addicts were significantly
more often physically or sexually abused (14 % of
the addicts vs. 3 % of the controls; see Table 2).

• Parental surveillance: (p < 0.01); (χ 2 = 23.457,
df = 11, p = 0.009) The addicts’ parents had estab-
lished a statistically poorer parental surveillance over
their children so that both of the nonaddicts’ par-
ents were much more often fully informed about their
children’s whereabouts, friends and outings as com-
pared to the addicts’ parents. As compared to 38%
of the controls, the parents of only 19% of addicts
were familiar with their children’s friends and hang-
outs during childhood and adolescence. In 30% of
cases, the addicts’ parents did not have a clue about
their children’s friends or outings, either because
they showed no interest in the matter or because the
study subjects deprived them from that information;
for the sake of comparison, this was the case in only
13% of our control subjects (see Table 3).
TABLE 2
Type of Trauma or Stress Experienced
Addicts Controls
Physical or Sexual Harassment 14% 3%
Exposure to War Environment 28% 35%
Fire or Natural Disaster 3% 9%
Great Suffering or Death of an
Immediate Family Member
20% 21%
Parental Divorce 17% 18%
Death of a Parent 12% 12%
• Parental support: ( p < 0.01); χ 2 = 23.457,
df = 11, p = 0.009) The control group was given
a much more substantial and a much more adequate

parental support as compared to the addicted group.
The members of the control group claimed to be ade-
quately controlled and truly loved by their parents
significantly more often (35% as compared to 13%
of the addicts); reports about the conflicts with the
parents were far rarer (4% of controls vs. 14% of the
addicts), as was the choice of the category “other”
offered in the questionnaire (2% of controls vs. 9%
of the addicts). During childhood, adequate parental
support was provided to 60% of addicted study par-
ticipants (parental support and understanding, 47%;
parental control and true love, 13%), as compared to
82% of the controls (see Table 4).
Familial Interaction Features
As regards familial interaction features, especially
emotional relations and communication with the par-
ents, the results showed striking differences between the
addicted and control groups. Variables revealing the most
profound differences between the two were as follows:
• Unfavourable emotional relationship with the
parents, especially with the father, established
throughout childhood and adolescence: When it
comes to the variable that addresses the perception
of emotional relations with the father established
throughout childhood and adolescence, a statistically
significant difference between the addicted and the
control groups was noted (p < 0.05) (χ 2 = 15.142,
df = 1, p = 0.010); the addicts more often described
their relations with their fathers as negative, i.e.
aggressive and harsh (12% vs. 4% of the control
subjects) and cold and indifferent (11% vs. 9%
of the control subjects). In addition, the addicted
study participants more often picked “other” as an

answer (14% vs. 7% of the controls), most com-
monly in order to describe the relationship that was
ultimately classified as negative (the terms most
often used to describe the relationship under this
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TABLE 3
Parental Surveillance
Addicts Controls
Yes, Both of My Parents were Acquainted with my Friends and
Outings 19% 38%
Yes, Only my Mother was Acquainted with my Friends and
Outings 9% 6%
Yes, Only my Father was Acquainted with my Friends and
Outings 1% 1%
Yes, Both of My Parents were Acquainted with Some of my
Friends and Outings 35% 36%
No, Both of My Parents were Unacquainted with my Friends and
Outings
Since They Never Really Cared about Them 3% 3%
No, Both of My Parents were Unacquainted with my Friends and
Outings
Since I Never Bothered to Keep Them Posted 27% 10%
No, my Father was Unacquainted of my Friends and Outings
Since He Never Really Cared about Them 2% 4%
No, my Mother was Unacquainted with my Friends and Outings

Since She Never Really Cared about Them 0% 1%
No, My Father was Unacquainted with my Friends and Outings
Since I Never Bothered to Keep him Posted 2% 1%
No, My Mother was Unacquainted with my Friends and Outings
Since I Never Bothered to Keep her Posted 2% 0%
TABLE 4
Parental Support
Addicts Controls
Support and Understanding 47% 47%
Emotional Coldness and
Indifference
5% 1%
Harshness and Control 8% 7%
Control and Love 13% 35%
Indifference and Freedom 4% 5%
You were Continuously in
Conflict
14% 4%
Other 9% 2%
category were “distant”, “far too harsh” or “nonex-
istent” due to the father’s absence). Statistically sig-
nificant differences between the addict and control
groups (p < 0.01) were also found with the vari-
ables addressing the perception of relations with the
mother established during childhood (χ 2 = 15.288,
df = 5, p = 0.0009). As compared to the controls,

the addicted study participants were far more prone
to describe their relationship with their mothers as
negative, that is to say either aggressive and harsh
(7% vs. 2% of the controls) or cold and indifferent
(4% vs. 0% of the controls) (see Table 5).
• An imbalanced emotional perception of parents
during childhood and adolescence in favor of
the mother was reported by the majority of the
addicts; 87% of them perceived their mothers in a
positive manner (and described them as tolerant and
full of understanding, indulgent and soft, or harsh
TABLE 5
Emotional Relationship with Father or Mother
Throughout Childhood and Adolescence
Father Mother
Addicts Controls Addicts Controls
Aggressive and
Harsh
12% 4% 7% 2%
Indulgent and
Gentle
20% 18% 37% 34%
Tolerant and Full of
Understanding
19% 28% 32% 44%

Harsh (rigid or
strict) but Loving
24% 34% 18% 14%
Cold and
Indifferent
11% 9% 4% 0%
Other 14% 7% 1% 6%
but full of love), while 63% reported a positive per-
ception of the father figure (χ 2 = 4.457, df = 114,
p < 0.01). The correlation between the negative rela-
tion with the father and that with the mother was low,
but still significant (r = 0.21). In addition, the more
negative the relationship was with father, the more
negative the relationship was with the mother too.
This imbalance was not seen in the control group;
80% of the control subjects had a positive relation-
ship with their fathers, and 92% with their mothers
(see Table 5).
• Uneven perception of parental attentiveness and
care, and getting along with the parents at the
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TABLE 6
Perception of Parental Attention and Care Provided

throughout Childhood and Adolescence
Addicts Controls
Father 9% 8%
Mother 60% 37%
Both Parents 31% 55%
TABLE 7
With Which One of your Parents are you Getting
Along Better at the Present Moment
Addicts Controls
Father 16% 7%
Mother 52% 33%
Equally Well with Both Parents 33% 60%
present moment: As opposed to their nonaddicted
counterparts, the majority of the addicts perceived
their mothers as more attentive and more caring (60%
versus 37% of the controls) (χ 2 = 17.274, df = 2,
p = 0.000). Unlike nonaddicts (who mostly got on
well with both parents), addicts continue to perceive
their parents differently even as adults, so that they
mostly got along better with their mothers (52%
of the addicts versus 33% of the control group).
p < 0.01 (χ 2 = 20.276, df = 2, p = 0.000) (see
Tables 6 and 7).
• Negative communication with the father through-
out childhood and adolescence: 62% of the addicts
established a defensive or negative communication
with their fathers, as compared to 24% of their con-
trol counterparts; p < 0.01 (χ 2 = 45.906, df = 6,
p = 0.000). That is the most profound difference

between the addicts and the controls. The relation-
ship in for the addict group was most often described
as defensive – criticising (32%), defensive – supe-
rior (18%), or defensive – negatively interpreted by
participants (12%). As opposed to that, a defen-
sive communication with the father was described
by not more than 24% of the control subjects; this
communication was most often described as defen-
sive – superior (13%) or criticising, blaming and
incomprehensible (8%), while only 3% of the control
subjects described this communication as defensive –
negatively interpreted (see Table 8).
• Negative communication with the mother: Even
though the communication established between the
addicts and their mothers during childhood and ado-
lescence is far better than that with the fathers (70%
had more positive communication with the mother,
TABLE 8
Communication with the Father or Mother
throughout Childhood and Adolescence
Father Mother
Addicts Controls Addicts Controls
Supportive–
Favoring
17% 24% 30% 30%
Supportive–
Empathic
6% 11% 27% 36%

Supportive–
Positively
Interpreted
13% 40% 13% 28%
Defensive—
Superior
18% 13% 10% 0%
Defensive—
Criticising
32% 8 16% 2%
Defensive—
Negatively
Interpreted
12% 3% 0% 2%
TABLE 9
Interparental Relations
Addicts Controls
Good—Full of
Understanding and
Mutual Support
28% 24%
Good, But with
Occasional Arguments

and Misunderstandings
40% 47%
Not So Good—They Were
Often In Dispute
12% 24%
Other 7% 3%
Poor—They Were
Arguing All the Time
15% 2%
as opposed to 36% who had positive communica-
tion with the father), the control group members
perceived their communication with their mothers as
supportive and positive significantly more often than
the members of the addicted group (94% of the con-
trols vs. 70% of the addicts, p < 0.01). (χ 2 = 34.272,
df = 6, p = 0.000) (see Table 8).
• Poor and conflicting interparental relationships fea-
tured by constant arguments and misunderstandings
were reported by 15% of the addicts and 2% of the
controls (p < 0.01) (χ 2 = 45.906, df = 6, p = 0.000)
(see Table 9).
• Unequal distribution of powers in favor of the
father or mother: For the addicts, final decisions
were significantly more often taken either by their
fathers or by their mothers and significantly more
infrequently by both parents, as opposed to the

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TABLE 10
Distribution of Power: Who was in Charge
of Decision Making
Addicts Controls
Father 32% 29%
Mother 25% 16%
Mother and Father Jointly 35% 51%
Whole Family Together 8% 5%
controls, who reported that decisions were mostly
made consensually by both parents. In the addict
group, relevant decisions were taken by the father
in 32% and by the mother in 25% of cases; in
the control group, decisions were made by the
father in 29%, and by the mother in 16% of
cases. Decisions jointly made by the mother and
the father were more often reported by the con-
trol subjects (51% of the controls vs. 35% of the
addicts; p < 0.01) (χ 2 = 11.027, df = 1, p = 0.001)
(see Table 10).
Familial Sociological Features
The results pertaining to the familial sociological fea-
tures showed that the most profound difference between
the addicts and the controls can be seen in familial
sociopathology. As compared to the control group, the
addicts’ families most often had to deal with alcohol abuse

and mental disorders (39% vs. 17% of controls), p < 0.01
(χ 2 = 15.847, df = 1, p = 0.000). It should be noted,
however, that, with a few exceptions, the addicts predomi-
nantly had to deal with parental alcoholism or alcoholism
in the immediate or broader family, while, in addition to
the aforementioned, a substantial percentage of the con-
trols had to deal with mentally-challenged parents as well
(a mentally-challenged mother in 17% of the controls vs.
2% in the addicts, both mentally-challenged parents in
8% of the controls and 0% of the addicts, and the com-
bination of an alcoholic father and a mentally-challenged
mother in 4% of the controls and 2% of the addicts) (see
Table 11; Table 12 lists those who fell into the “other”
category (including one father, who should be in the first
category).
As compared to the controls, the addicts were most
often molested during childhood and adolescence (26%
of the addicts vs. 11% of the controls; (χ 2 = 9.389,
df = 1, p = 0.002), and were more often witnesses to
domestic violence (29% of the addicts vs. 16% of the con-
trols) (χ 2 = 6.937 df = 1, p = 0.008), while their family
members were more often charged with criminal offences
(14% in the addicted vs. 2% in the control arm; p < 0.1)
(χ 2 = 12.796, df = 1, p = 0.000). During their childhood
and adolescence, 49% of the addicted subjects moved at
some point, as compared to 39.7% of their control coun-
terparts, so that no statistically significant difference in this
TABLE 11
Alcohol Abusing and Mentally Challenged Family
Members
Addicts Controls
Alcohol Abuse by Father Only 63% 63%

Alcohol Abuse by Mother Only 7% 0%
Father—Alcohol Abuse,
Mother—Mentally Challenged
2% 4%
Both Parents Mentally
Challenged
0% 8%
Mentally Challenged Mother
Only
2% 17%
Other 26% 8%
TABLE 12
Addicts who Circled the Answer “Other” in
Response to the Item “Alcohol Abuse and Mental
Disorders – which of the Family Members”
Alcohol Abuse Mental Disorders
Grandmother 3 Grandmother 1
Grandfather 7 Brother 1
Father 1 Grandfather’s sister 1
Uncle 1 Other 0
Total 12 Total 3
regard was revealed (p > 0.05). However, there was a sta-
tistically significant difference in their religious upbringing
(p < 0.01), with a religious upbringing more often encoun-
tered among the controls (76% of the controls vs. 57% of

the addicts) (χ 2 = 11.0027, df = 1, p = 0.01).
DISCUSSION
The results of this study demonstrate the burden
imposed on the addicts’ families by various famil-
ial risk factors capable of substantially influencing the
onset of various psychological disorders (drug addiction
included) to be statistically significantly heavier than that
imposed on the families of the nonaddicts; the situation
remained unchanged throughout the subjects’ childhood
and adolescence.
Starting from their early days, the addicts were sta-
tistically more often separated from one or both parents;
according to psychoanalytical theories, this enhances their
vulnerability and proneness to developing various psycho-
logical symptoms and disorders, drug addiction included
(Oslen 2004; Nikolić 1991). Furthermore, the study uncov-
ered the fact that addicts more often came from families
characterised by poor interparental relations, along with
2012
parental divorce or death of one of or both parents experi-
enced in the subjects’ early childhood. In addition, psycho-
logical trauma or stress experienced during childhood and
adolescence were significantly more frequently reported
by the addicts as compared to the controls. It has been
well recognised that unresolved psychological traumas
experienced in childhood are capable of jeopardising ego

development and hindering normal psychological function-
ing (Chilcoat & Breslau 1998; Nikolić, Klein & Vidović
1990). This study also showed the emotional relations and
communication with the parents established by the addicts
throughout their childhood and adolescence to be much
more negative as compared to the nonaddicts, the most pro-
nounced difference appearing in the communication with
the father, which was negative for most of the addicts.
Furthermore, this study revealed another characteristic typ-
ical of addicts’ families—a marked imbalance in emotional
relations and communication with the parents, i.e. sig-
nificantly more negative relationships and communication
with the fathers as compared to those with the mothers, sug-
gesting that the negative role played by the addict’s father
figure represents a key factor in drug addiction etiology and
suggesting other possible studies in the etiology of other
psychological disorders as well (Lamb & Tamis-Lemonda
2004). Namely, 37% of the addicts assessed their child-
hood relationships with their fathers as negative (aggressive
and harsh, cold and indifferent, or “other”); on the other
hand, the relationship established with the mother during
childhood was seen as negative by not more than 12% of
the addicts. Therefore, it is fair to say that negative com-
munication and negative emotional relationships with the
father established during childhood and adolescence can
be risk factors favoring drug addiction onset. These data
support the thesis brought forward by a number of stud-
ies that points towards the crucial role of the father figure
and his presence in the family, especially in early devel-
opmental stages, as important not only for the subsequent
normal development of a child, and later of an adolescent,
but also for the establishment of a healthy and supportive
familial environment and successful parenthood. The sen-
sibility of the father and the degree of his involvement in
the upbringing process substantially impact not just emo-
tional, but also sensory-motor and linguistic development

of a child (Tamis-Lemonda et al. 2004; NIDA1999; Bry
et al. 1998). Our results also indicate that, when it comes
to the addicted study population, a number of fathers failed
to fulfill their roles; together with other negative factors,
this may have led to poor social adaptation and drug addic-
tion onset in their children. Therefore, further research
into the importance of the father figure and its relevance
for the healthy and normal child’s development and the
prevention of his/her risky behaviors, addiction included,
is of extreme importance for preventative programs and
addiction treatment planning.
A statistically significant difference between the
addicted and the control groups was established also in
relation to the variable addressing their perception of the
relationship with the mother established during childhood;
the control group members perceived their mothers as tol-
erant and full of understanding far more often than the
members of the addicted arm (44% of the controls vs. 32%
of the addicts), and far less often saw them as aggressive
and harsh (2% of the controls vs. 7% of the addicts). These
results indicate that, in spite of the fact that the addicts
perceive their relationship with the mother as far more pos-
itive than that with the father, the emotional relationship of
the mother with the child during childhood was far more
negative when the mothers of future addicts were com-
pared to those of the control group members. This leads to
the conclusion that the emotional relationship established
with the parents plays the key role not only in drug addic-
tion onset, but its prevention as well (Berger-Saether 2007).
It is possible that, due to the unresolved emotional issues
with the parents and due to the challenges faced during the
early developmental stages, certain adolescents find it hard
to define, and stick to, their own identities, and have trou-
ble adjusting to the given circumstances; interlaced with

other unfavorable psychosocial factors, this could lead to
psychological issues, social maladjustment and behavioral
deviations, and drug addiction onset. Our results also lead
us to conclude that families of addicts are characterised by
the lack of emotional closeness between the child and the
parents; this is perceived as a risk factor for drug addiction
onset by the present authors and many other researchers
as well.
In addition, the study showed the addicts to be under
significantly poorer parental surveillance as compared to
the non addicts; the same goes for parental support.
According to numerous studies carried out on both national
and international scales, parental surveillance represents
one of the major protective factors shielding from the drug
addiction onset, and the lack of such a continuous parental
surveillance represents a risk factor that favors drug addic-
tion onset (NIDA 1999). Our results further corroborate
that hypothesis; all of our addicted subjects’ friends and
outings were known to not more than 19% of their par-
ents, as compared to 38% of the control subjects’ parents.
Furthermore, a statistically significant difference between
the two study arms was revealed in the variable address-
ing the parental support provided throughout childhood and
adolescence; the control group had far more often reported
their parents to be controlling, but full of love (35% of
the controls vs. 13% of the addicts), while parent-child
conflicts were far rarer for them (4% of the controls vs.
14% of the addicts). In support of that, several interna-
tional and national studies have shown parental acceptance
and support to be closely linked with child’s healthy psy-
chosocial development (Haddad, Barocas & Hollenbeck
1991).
The results also showed that addicts and nonad-
dicts mutually differ when it comes to the distribution of

power within the family. Addicts’ families are typically
2012
featured by a more specific familial pattern and an uneven
distribution of decisionmaking power within the family,
either to the benefit of the father or to the benefit of the
mother.
In addition, our study showed alcoholism, especially
that of the father, to be significantly more frequent in the
addicts’ immediate and broader families. The same goes
for felonies committed by family members, as well as
for domestic abuse and violence. These results led us to
conclude that familial sociopathology such as alcoholism,
domestic violence, and especially child molesting and
negligence, has an adverse impact on child’s healthy psy-
chological development and very often is a primary cause
of risky behavior, drug addiction included (Etz, Robertson
& Ashery 1998).
Also, the addicts were significantly less often brought
up in religious homes—a fact that corroborates the hypoth-
esis that religious beliefs represent a protective factor
against the addiction onset (NIDA 2003, 1999).
We can conclude that family as the fundamental
social construct has a significant impact on shaping of
the child’s personality, so that it represents not only a
developmental frame, but the framework for the preven-
tion of numerous psychological and behavioral disorders

including drug addiction.
The results of this research have demonstrated the exis-
tence of familial risk factors favoring drug addiction onset,
already disclosed by a number of national and international
studies; from our standpoint, this is also the major scien-
tific achievement and contribution of this study. Familial
factors associated with the family structure and famil-
ial interrelations, as well as with familial sociopathology,
make certain children and adolescent groups more prone
to drug addiction as compared to their peers. The results
led us to conclude that there exists a strong causal rela-
tionship between the onset of drug addiction in the later
stages of life and the presence of familial risk factors
throughout childhood and adolescence, such as: separation
from the parent(s) early in life (prior to the age of seven),
parental divorce or death of one of the parents, conflict-
ing interparental relations, familial sociopathology such
as alcoholism and parental addiction, criminal offences,
abuse and domestic violence, lack of parental support and
surveillance, lack of close emotional relationship with the
parents and inadequate parent-child communication, a neg-
ative emotional relation and communication with the father,
as well as a psychological trauma and stressful events
experienced in the childhood and adolescence. Based on
the outcome of our study, it can be concluded that, as com-
pared to the controls, the families the addicts were born
into are far more often witnesses to psychopathological
events and psychosocial factors that, in combined effort,
ultimately create a risky familial environment and therefore
pose as familial risk factors favoring drug addiction onset.
One or all of these familial features make certain
children and adolescents more vulnerable than their peers
living under different circumstances, and put them in a

higher risk of developing a variety of risky behavior pat-
terns including drug addiction. Furthermore, the results
suggest the important role of the father figure in terms
of the emotional relations and communication established
throughout childhood and adolescence in drug addiction
onset.
In line with the foregoing, it is to be expected that
the results of this study may aid in shaping the guide-
lines for further research into familial risk factors favoring
drug addiction onset, as well as in shaping the guide-
lines for designing high-quality preventative programs ori-
ented towards children and adolescents coming from risky
familial environments. In addition, this study provides
compelling evidence on the existence of a distinctive pat-
tern of power distribution and emotional relations within
the addicts’ birth families; family-oriented drug addic-
tion treatments that include withdrawal therapy, rehabili-
tation and resocialisation can be improved based on this
knowledge.
Family-oriented drug addiction prevention represents
a relatively unexplored area and a challenge that should be
addressed in the years to come. The results of this study
suggest that family-oriented addiction prevention should
be initiated as early as possible, while the methods of
approach should involve parents, children and adolescents.
This study also demonstrated the need for further investiga-
tion into the cause-effect relationship between the risk and
protective factors associated with individual drug addiction
proneness.
Healthy psychosocial child development would benefit
from early interventions oriented towards these risk factors
and tailored so as to recruit the whole family. Furthermore,
the results indicate the need for further research into famil-

ial relations and structures of the families addicts were born
into, as well as the need for comprehensive therapeutic
approach oriented towards not only an addict, but his/her
family as a whole; the family clearly plays an essential
role in drug addiction onset, but also in its prevention and
treatment.
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2012

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articles for individual use.
Running Head: Research Methods 1
Research Methods
Amanda Kroeger
PSY 326
Prof. Luker
June 16, 2014
Research Methods
- 1 -
[no notes on this page]
Research Methods 2

The article, “Familial Risk Factors Favoring Drug Addiction
Onset” by Jadranka
and Vlado is a study that is aimed at identification of domestic
risks that favor drug
addiction onset. Based on research carried out, it is evident that
most families are affected
by drugs because of influence within the families. As described
in the article, research
carried out between the year 2008 and 2009 reviews that most
born addicted to drugs are
born into families where the use of drugs is common. It is
evident that the use of drugs
has influenced more than a few issues globally. Most people
addicted to drugs are as a
result of influence from their families. Based on the article, it is
clear that the authors are
seriously trying to find a solution to familial risk factors that
favor drug addiction. Also,
the authors are trying to review appropriate ways that can
eliminate the use of drugs
within families.
Based on the article, it is clear that the authors are trying to
determine particular
questions through their research. Some of these questions

include:
i. What are the major factors that influence or favor the use of
drugs within
families?
ii. What are the possible solutions to drug addiction within
families?
iii. What are the familial risk factors capable of influencing
their psychosocial
development?
Through the research, the authors came up with different
opinions about the cause
and effects of drug addiction within families. As described in
the article, it is clear that
drug addiction is a global issue that has affected and challenged
people over the years.
However, most families have admitted the situation and
resolved to live with the issues.
Clearly, the authors used qualitative research method to carry
out the research. In general,
- 2 -
1
2

3
4
5
1. “Familial Risk Factors
Favoring Drug Addiction
Onset” by Jadranka
and Vlado
include year [Julie Luker]
2. most families are
affected by drugs
reword-- this sounds like you
are saying that most families
are affected by drugs when
this is not actually the case
(or is it?). [Julie Luker]
3. It is evident that the use
of drugs
has influenced more than a

few issues globally.
What do you mean? [Julie
Luker]
4. seriously
would they ever do research
and not be serious? :) [Julie
Luker]
5. article,
Always cite it again in a new
paragraph [Julie Luker]
Research Methods 3
quantitative research methods mainly involve graphs, numbers,
and charts while
qualitative involve data collection, and deals with feelings.
Clearly, based on the article,
research carried out by the two authors was qualitative research
method was qualitative
because it involved collection of data and also described the
feelings of familial members

(Zimić, & Jukić, 2012).
In general, the research is qualitative. There are several
examples in the article
that describe that the research is qualitative. For instance,
“parental alcohol abuse
especially by the father can be responsible for children issues
such as behavior problem,
issues in school, and delinquency behavior”. Clearly, this
describes their feelings. Also,
the article describes the number of affected families as a result
of alcohol. The authors of
the article used data collection method to identify how many
families were affected by
drug addiction. Also, data analysis techniques clearly describes
that the method used was
qualitative method. Unlike quantitative method, qualitative
method deals with emotions,
impact, and number. Throughout the article, it is evident that
the research method used to
carry out the research was qualitative method. Clearly, the
authors analyzed the families
through the use of numbers, impact, and feelings (Zimić, &
Jukić, 2012).
Based on psychology, it is clear that families affected by drugs

have negative
impacts on children. Families that have children who face
domestic violence are likely to
end up on drugs or use other substances. This is as a result of
the impact that the children
face psychologically. Psychologists argue that children in these
kinds of families end up
being criminals or having poor performance in school. The
article addresses several
ethical issues that are influenced by use of drugs or abuse of
substances. The ethical
issues such as delinquency acts, violence, and misconduct have
solutions. Through
- 3 -
1
2
3 4
5 6
7
8
1. Clearly, based

This is not so clear to me,
based on what you said. I
would encourage you to
elaborate more. [Julie Luker]
2. In general, the research
is qualitative.
You just said this in the
previous paragraph a few
times... consider revising it a
bit more. [Julie Luker]
3. behavior”.
always cite with p# all quoted
text. Also, no italics [Julie
Luker]
4. Clearly, this describes
their feelings.
Again, it is not very clear to
me. I would encourage you to

elaborate more. [Julie Luker]
5. Throughout the article, it
is evident that the research
method used to carry out
the research was qualitative
method.
more editing is needed. You
continue to repeat this
statement. [Julie Luker]
6. Clearly,
Try not to use this word so
often. [Julie Luker]
7. Families that have
children who face domestic
violence are likely to end up
on drugs or use other
substances.
cite this statistic [Julie Luker]

8. The article addresses
several
ethical issues that are
influenced by use of drugs
or abuse of substances.
The assignment was actually
to state ethical issues
associated with the article's
methodology. [Julie Luker]
Research Methods 4
counseling, families can eliminate the causes without any
further issues. Other ethical
issues that were not described include domestic violence. This
can be solved through
guidance and thorough advice from psychiatrics (Zimi´c, &
Juki´c, 2012). Becoming a
clean and sober family would be the most important step they
could take.
References

- 4 -
Research Methods 5
Ivandić Zimić, J., & Jukić, V. (2012). Familial risk factors
favoring drug addiction onset.
Journal of Psychoactive Drugs, 44(2), 173-185.
- 5 -

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