Dissertation on Family Rituals & Psychopathology by Lacresha Kinnebrew at Xavier University

A Dissertation Submitted to the Faculty of Xavier University in Partial Fulfillment of the Requirements for the Degree of Doctor of Psychology by Lacresha Kinnebrew Approved: Christine Dacey, Ph. Chair, Department of Psychology W. Michael Nelson, III, Ph., ABPP Dissertation Chair Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.

Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. The Relationship Between Family Rituals and Psychopathology in Families with a Substance-Abusing Parent Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.

UMI Number: DP20219 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. UMT OissMlation UMI DP20219 Published by ProQuest LLC (2013).

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789 East Eisenhower Parkway P. Box 1346 Ann Arbor, Ml 48106 - 1346 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Dissertation Committee Chair W.

Michael Nelson III, Ph., ABPP Professor of Psychology Member Kathleen Burlew, Ph. Professor of Psychology University of Cincinnati Member Norman Barry, Ph. Professor of Psychology Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.

Acknowledgements There are a number of people that I would like to take the time to extend a heartfelt thanks to. I would first like to formally thank Dr. Michael Nelson for his guidance and mentorship throughout the creation of this dissertation. Without his commitment, time, and effort, this project would not have been possible.

I would also like to thank the members of my dissertation committee. Kathleen Burlew and Dr. Specifically, I extend my gratitude and appreciation to Dr. Burlew for allowing me to use her data set as well as taking the time to serve on my dissertation committee.

She was also very instrumental with the completion of my dissertation. Additionally, I thank Dr. Norman Barry for his insight and willingness to work with me on this project. Finally, if it were not for God, my family and friends, I would not have made it through graduate school.

I have had an extensive amount of support over the years and I am very thankful to have those special people in my life. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Table of Contents Acknowledgements.i Table of Contents.ii List of T ables.iii List of Appendices.

Review of Literature.93 11 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. List of Tables Table Page 1. Reliability Coefficients for the Parental Stress Index (PSI).

Test Retest and Internal Reliability Coefficients for the PSI Short Form. Correlations Between the PSI Short Form & the PSI. Internal Consistency of the Children’s Depression Inventory Factors. Test Retest Reliability of the Children’s Depression Inventory.

Test-Retest Reliability of the CDI. Demographic Characteristics of Participants. Reliability Analysis of the FR/S (Correlation Matrix). Correlations Between Family Rituals, CDI, PSI, and POCA Subscales.

Correlations of FR/S Items with the CDI, PSI, & Subscales o f the PO C A .91 111 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. List of Appendices Appendix Page A. Parent Intake F o rm.

Family Functioning S cale.57 Parent Observation of Classroom Adaptation.57 Parental Stress Index. Children’s Depression Inventory. University o f Cincinnati’s Institutional Review Board Approval. Xavier University’s Institutional Review Board Approval.93 IV Reproduced with permission of the copyright owner.

Further reproduction prohibited without permission. Family Rituals 1 Introduction Substance abuse bas an all-encompassing damaging impact on family life. Research has shown that substance abuse contributes to marital and family discord, difficulties sustaining employment, monetary problems, violence, and inadequate parenting (Rotunda, Scherer, & Imm, 1995). Specifically, a recent report using data from the 1996 Substance Abuse and Mental Health Services Administration National Household Survey on Drug Abuse indicated that approximately 8.3 percent of children in the United States under the age of 18 are living in households where one or both of the parents are currently or has been actively alcohol dependent within that past year (Huang, Cerbone, & Gffoerer, 1998).

Although most of the literature to date is usually attributed to alcohol, it is reasonable to assume that much of it can be generalized to other drugs. In order to understand family dynamics that are associated with drug addiction, it is important to entail a description of the interactive processes that occur throughout the life cycle of the family. Within the drug-addicted family, chronic drug addiction (i., alcohol, cocaine, heroine, etc.) is the central organizing theme for the family. Drug addiction evolves from an individual problem, to a family condition that becomes a part of every aspect of the family life.

Due to the erratic and unpredictable behaviors of the drug-addicted individual, family members begin to respond to the drug-addicted individual in an impaired manner. In short, the family alters their behavior in order to make them more compatible with avoiding stress and conflict associated with drug use. However, this behavior contributes to the perpetuation of the drinking behavior, thus creating a circular, reciprocal pattern within the family (McNeece & DiNitto, 1998). According to Reproduced with permission of the copyright owner.

Further reproduction prohibited without permission. Family Rituals 2 Steinglass and colleagues (1987) “family rituals offer the clearest opportunity to investigate this developmental process because they are considered the most meaningful shared activity.” Family rituals can be important within a family because of the meaning that may be attached to specific interactions. These rituals may include family dinners, vacations, holidays and many other traditions that are practiced within a family. Current literature suggests that when family rituals are practiced in a deliberate fashion and are distinct from the drug-related behaviors of the parent, the offspring are less likely to develop drug-related problems themselves (Fiese, 1993).

Furthermore, practicing family rituals can lead to an increased bond between parent and child—which in turn can lead to healthier parent-child interaction and communications. However, drug use can negatively impact familial rituals and bonding due to the stress that the parent may be experiencing (Sher, 1991). Depending on the demands that the parent’s environment places upon the individual, s/he can find the act o f parenting very stressful. Parental stress can include mental health problems, physical health problems, parent-child interactions, and a range of other contexts (Harmer, Sanderson, & Mertin, 1999).

Drug use tends to perpetuate the stress o f the parent due to the negative effects and outcomes of using drugs. Many times the drug-abusing parents find themselves involved with the legal system, residential treatment facilities, and child protective agencies. These situations usually lead to the separation between the parent and child, which may cause a strain on the family. Children who have a chemically dependent parent are at risk for poor emotional regulation, negative affectivity, and internalizing symptomatology (Colder & Chassin, Reproduced with permission of the copyright owner.

Further reproduction prohibited without permission. Furthermore, children of alcoholics/substance abusing parents constitute an identifiable high-risk group for the development of alcoholism/drug addiction and addiction-related problems (Sher, 1997). There has been great research and clinical interest in children of substance abusers. However, little is known about the role of family rituals and how they might affect the relationship between parent and child.

Therefore, this study is designed to explore the influence that family rituals have on the relationship between parental stress and the child’s emotional and acting out behaviors. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Family Rituals 4 Chapter I Review of the Literature “Substance abuse is defined as a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances” (American Psychiatric Association, 1994).

A substance-abusing individual is less likely to fulfill major obligations and will continue to use substances despite the fact that it is physically hazardous and tends to lead to multiple legal, social and interpersonal problems. While it is true that some individuals use, misuse, and abuse substances without becoming dependent or being defined as addicts, these patterns contribute a great deal to health problems, criminal behavior, family dysfunction and other adverse consequences (McNeece & DiNitto, 1998). Therefore, it is evident that substance abuse problems are not limited to the individuals themselves. People do not behave separately from the systems within which they are embedded (Cox & Paley, 1997).

These systems can include work and/or school settings, therapeutic communities, and family life. However, the bond between family members is unique and distinguishes a family from other systems. Furthermore, viewing the individual apart from their family can only give an incomplete picture of the person. Experimental observation of family systems have found that substance abuse in a family is not an individual matter, but is dynamically related to events within the family system (Kaufman & Kaufmann, 1992).

In order to understand the effects of substance abuse on the family, it is first important to understand the ways in which the family system work. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Family Rituals 5 Family Systems The composition of families can be different.

Specifically, families can have two parents versus one parent, grandparents may be present and may also serve as the primary caretaker or guardian, and depending upon the culture, friends may be characterized as family. Despite the make up o f the family, it is important to understand that the family is more than just a collection of people. The family should be viewed as a system, with each individual within the family working as a subsystem. Within the family system there lies family boundaries, coalitions, homeostasis, and role selections (Johnson, Cowan, & Cowan, 1999).

Family boundaries can be viewed as the relationship the family has with outside influences (Bratter & Forrest, 1985). These boundaries define a family structure and connote a proximity or distance between members or subsystems. For example, a parent and child can have a relationship in which they are very close, which does not allow outside influences into their lives. Moreover, some families have very open boundaries with the outside world and may allow social and societal events to permeate and affect their households.

The family that appropriately allows outside influences may be viewed as adapting, with abilities to change when needed. However, on the other hand, the family may become cut off from other outside systems and become interdependent on one another—which at times can become very unhealthy and limits the family’s potential to adapt (Preli, Protinsky, & Cross, 1990). Although most families try to avoid extremes o f total disengagement or total enmeshment, even these extremes can be adaptive for the family if this is a shared functioning preference (Olson, 1993; Patterson, 2002). Reproduced with permission of the copyright owner.

Further reproduction prohibited without permission. Family Rituals 6 Within each family, members usually form coalitions. This is characterized as two or more members “teaming up” or joining together in order to affect the power distribution in the family (Sheridan & Green, 1993). For instance, a child wanting to go to a certain event may form a coalition with a parent who wants to attend the same event.

Therefore, the likelihood of attending that event is increased due to the effects of numbers. However, it should be noted that coalitions that are intergenerational (i., between parent and child) could be problematic at times. These coalitions could allow the child to have too much power in situations and allows the child to pit the parents against one another.