Hostname: page-component-848d4c4894-m9kch Total loading time: 0 Render date: 2024-05-12T00:22:18.048Z Has data issue: false hasContentIssue false
  • English
  • Français

The Cohesiveness of Alcoholism-Complicated Marriages and its Influence on Treatment Outcome

Published online by Cambridge University Press:  29 January 2018

Jim Orford ,
Edna Oppenheimer ,
Stella Egert ,
Celia Hensman  and
Sally Guthrie
Jim Orford
Affiliation:
Addiction Research Unity Institute of Psychiatry, 101 Denmark Hill, London, S.E.5
Edna Oppenheimer
Affiliation:
Addiction Research Unity Institute of Psychiatry, 101 Denmark Hill, London, S.E.5
Stella Egert
Affiliation:
Addiction Research Unity Institute of Psychiatry, 101 Denmark Hill, London, S.E.5
Celia Hensman
Affiliation:
Addiction Research Unity Institute of Psychiatry, 101 Denmark Hill, London, S.E.5
Sally Guthrie
Affiliation:
Addiction Research Unity Institute of Psychiatry, 101 Denmark Hill, London, S.E.5
Get access Rights & Permissions [Opens in a new window]

Summary

One-hundred husbands, diagnosed as suffering from alcoholism, and their wives, were followed up twelve months after initial consultation and assessment. Follow-up information was complete in 89 cases. On the basis of both husband and wife accounts of the husband's drinking behaviour during the follow-up period, and their assessment of the drinking problem at twelve-months follow-up, 28 were classified as having a ‘good’ outcome and 29 as having a ‘bad’ outcome. In the remaining 32 cases outcome was considered ‘equivocal‘.

A composite measure of marital cohesion was predictive of twelve-month outcome classification, cohesive marriages being significantly more likely to have a good outcome. The measure of marital cohesion was based upon husband and wife reports of mutual affection and of husband involvement in family tasks, favourable spouse perceptions and meta-perceptions, and optimism about the future of the marriage. Composite measures of dominance balance within the marriage were not predictive of outcome.

Husband's job status, husband's self-esteem, and wife's reported hardship were not independent of marital cohesion, and were themselves predictive of twelve-months outcome. When these variables were partially controlled it was found that marital cohesion remained predictive for husbands with relatively low status jobs and husbands with relatively low levels of self-esteem. It is an over-simplification to state that either the marriage, the spouse, or the severity of the patient's condition is alone the cause of variation in outcome.

It is possible to integrate these findings with those of other studies on the influence of family variables on the outcome of conditions other than alcoholism. Together these studies suggest a general hypothesis linking a breakdown in the cohesiveness, or mutual rewardingness, of family relationships and unfavourable outcomes following treatment or consultation for psychological disorder.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 128 , Issue 4 , April 1976 , pp. 318 - 339
Copyright
Copyright © Royal College of Psychiatrists, 1976 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agulnik, P. L. (1970) The spouse of the phobic patient. British Journal of Psychiatry, 117, 59—67.CrossRefGoogle ScholarPubMed
Bailey, M. B. (1961) Alcoholism and marriage: a review of research and professional literature. Quarterly Journal of Studies on Alcohol, 22, 81—97.CrossRefGoogle Scholar
Bailey, M. B., Haberman, P. and Alksne, H. (1962) Outcomes of alcoholic marriages: endurance, termination or recovery. Quarterly Journal of Studies on Alcohol, 23, 610—23.CrossRefGoogle ScholarPubMed
Blood, R. W. & Wolfe, B. M. (1965) Husbands and Wives; the Dynamics of Married Living. London: Collier-Macmillian.Google Scholar
Brown, G. W., Monck, E. M., Carstairs, G. M. & Wing, J. K. (1962) Influence of family life on the course of schizophrenic illness. British Journal of Preventive and Social Medicine, 16, 55—68.Google Scholar
Brown, G. W., Birley, J. L. T. & Wing, J. K. (1972) Influence of family life on the course of schizophrenic disorders: a replication. British Journal of Psychiatry, 121, 241—58.CrossRefGoogle ScholarPubMed
Bullock, S. C. & Mudd, E. H. (1959) The inter-relatedness of alcoholism and marital conflict. Symposium, 1958, 2. The interaction of alcoholic husbands and their non-alcoholic wives during counselling. American Journal of Orthopsychiatry, 29, 519—27.CrossRefGoogle Scholar
Carson, R. C. (1969) Interaction Concepts of Personality. London: Allen and Unwin.Google Scholar
Cheek, F. E. (1965) Family interaction patterns and convalescent adjustment of the schizophrenic. Archives of General Psychiatry, 13, 138—47.CrossRefGoogle ScholarPubMed
Collins, J., Kreitman, N., Nelson, B. & Troop, J. (1971) Neurosis and marital interaction: III. Family roles and function. British Journal of Psychiatry, 119 233–42.CrossRefGoogle Scholar
Dicks, H. (1967) Marital Tensions: Clinical Studies towards a Psychological Theory of Interaction. London: Routledge and Kegan Paul.Google Scholar
Drewery, J. & Rae, J. B. (1969) A group comparison of alcoholic and non-alcoholic marriages using the interpersonal perception technique. British Journal of Psychiatry, 115, 287—300.CrossRefGoogle ScholarPubMed
Edwards, P., Harvey, C. & Whitehead, P. C. (1973) Wives of alcoholics: a critical review and analysis. Quarterly Journal of Studies on Alcohol, 34, 112—32.CrossRefGoogle ScholarPubMed
Edwards, G., Mitcheson, M., Egert, S., Guthrie, S., Hensman, C., Oppenheimer, E. & Orford, J. A controlled trial of alcohol dependence employing ‘maximum’ and ‘minimum’ therapeutic modalities. In preparation.Google Scholar
Freeman, H. E. & Simmons, O. B. (1963) The Mental Patient Comes Home. New York, Wiley.Google Scholar
Haberman, P. W. (1965) Some characteristics of alcoholic marriages differentiated by level of deviance. Journal of Marriage and the Family, 27, 34—6.CrossRefGoogle Scholar
Hall, J. & Jones, D. C. (1950) Social grading of occupations. British Journal of Sociology, 1, 31—55.CrossRefGoogle Scholar
Herbst, P. G. (1954) Conceptual framework for studying the family. In: Oeser, O. A. & Hammond, S. B. (Eds.) Social Structure and Personality in a City. London, Routledge and Kegan Paul. Google Scholar
Jackson, J. K. (1954) The adjustment of the family to the crisis of alcoholism. Quarterly Journal of Studies on Alcohol, 15, 562—86.CrossRefGoogle Scholar
Jackson, J. K. & Kogan, K. L. (1963) The search for solutions: help seeking patterns of families of active and inactive alcoholics. Quarterly Journal of Studies on Alcohol, 24, 449—72.CrossRefGoogle ScholarPubMed
Kogan, K. L., Fordyce, W. E. & Jackson, J. K. (1963) Personality disturbances in wives of alcoholics. Quarterly Journal of Studies on Alcohol, 24, 227—38.CrossRefGoogle ScholarPubMed
Kogan, K. L. & Jackson, J. K. (1961) Some role perceptions of wives of alcoholics. Psychological Reports, 9, 119—24.CrossRefGoogle Scholar
Kogan, K. L. & Jackson, J. K. (1963) Role perceptions in wives of alcoholics and of non-alcoholics. Quarterly Journal of Studies on Alcohol, 24, 627—39.CrossRefGoogle Scholar
Kogan, K. L. & Jackson, J. K. (1964) Patterns of atypical perceptions of self and spouse in wives of alcoholics. Quarterly Journal of Studies on Alcohol, 25, 555—7.CrossRefGoogle ScholarPubMed
Kogan, K. L. & Jackson, J. K. (1965) Stress, personality and emotional disturbance in wives of alcoholics. Quarterly Journal of Studies on Alcohol, 26, 486—95.CrossRefGoogle ScholarPubMed
Kreitman, N. (1968) Married couples admitted to mental hospitals. I. Diagnostic similarity and the relation of illness to marriage. II. Family history, age and duration of marriage. British Journal of Psychiatry, 114, 699—718.CrossRefGoogle Scholar
Kuder, G. F. & Richardson, M. W. (1937) The theory of the estimation of test reliability. Psychometrika, 2, 151—60.CrossRefGoogle Scholar
LaForge, R. & Suczek, R. F. (1955) The interpersonal dimensions of personality: an interpersonal checklist. Journal of Personality, 24, 94.CrossRefGoogle Scholar
Laing, R. D., Phillipson, H. & Lee, A. R. (1966) Interpersonal Perception: a Theory and a Method of Research. London: Tavistock.Google Scholar
Leary, T. (1957) Interpersonal Diagnoses of Personality: a Functional Theory and Methodology for Personality Evaluation. New York: Ronald Press.Google Scholar
Lemert, E. M. (1960) The occurrence and sequence of events in the adjustment of families to alcoholism. Quarterly Journal of Studies on Alcohol, 21, 679—97.CrossRefGoogle ScholarPubMed
Lemert, E. M. (1962) Dependency in married alcoholics. Quarterly Journal of Studies on Alcohol, 23, 590—609.CrossRefGoogle ScholarPubMed
Lorr, M. & McNair, D. M. (1965) Expansion of the interpersonal behaviour circle. Journal of Personality and Social Psychology, 2, 823—30.CrossRefGoogle ScholarPubMed
Mehrabian, A. (1971) Non-verbal communication. Cole, J. K. (Ed.), Nebraska Symposium on Motivation, 19, 107—61, Lincoln, Nebraska: University of Nebraska Press.Google Scholar
Morrow, W. R. & Robins, A. J. (1964) Family relations and social recovery of psychotic mothers. Journal of Health and Human Behaviour, 5, 14—24.CrossRefGoogle ScholarPubMed
Olson, D. H. (1969) The measurement of family power by self report and behavioural methods. Journal of Marriage and the Family, 31, 545—50.CrossRefGoogle Scholar
Orford, J. (1975) Alcoholism and marriage: the argument against specialism. Journal of Studies on Alcohol. (In press).CrossRefGoogle Scholar
Rae, J. B. (1972) The influence of the wives on the treatment of alcoholics: follow-up study at 2 years. British Journal of Psychiatry, 120, 601—13.CrossRefGoogle Scholar
Rae, J. B. & Drewery, J. (1972) Interpersonal patterns in alcoholic marriages. British Journal of Psychiatry, 120, 615—21.CrossRefGoogle ScholarPubMed
Rae, J. B. & Forbes, A. R. (1966) Clinical and psychometric characteristics of wives of alcoholics. British Journal of Psychiatry, 112, 197—200.CrossRefGoogle ScholarPubMed
Ryle, A. (1966) A marital patterns test for use in psychiatric research. British Journal of Psychiatry, 112, 285—93.CrossRefGoogle ScholarPubMed
Safilios-Rothschild, C. (1970) The study of family power structure: a review 1960—1969. Journal of Marriage and the Family, 32, 539—51.CrossRefGoogle Scholar
Smith, C. G. (1967) Marital influences on treatment outcome in alcoholism. Journal of Irish Medical Association, 60, 433—4.Google ScholarPubMed
Taylor, S. D., Wilbur, M. & Osnos, R. (1966) The wives of drug addicts. American Journal of Psychiatry, 123, 585—91.CrossRefGoogle ScholarPubMed
Turk, J. L. & Bell, M. W. (1972) Measuring power in families. Journal of Marriage and the Family, 34, 215—22.CrossRefGoogle Scholar
Welsh, G. S. & Dahlstrom, W. G. (1956) Basic Readings on the MMPI in Psychology and Medicine. Minneapolis: University of Minnesota Press. New York: Harper.Google Scholar
Whalen, T. (1953) Wives of alcoholics: four types observed in a family service agency. Quarterly Journal of Studies on Alcohol, 14, 632—41.CrossRefGoogle Scholar
Winch, R. S. (1958) Mate Selection: a Study of Complementary Needs. New York: Harper.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.