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A Comparative Study of Retrospective Attachment and Current Attachment Style in Nontreatment Heroin

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Title: A Comparative Study of Retrospective Attachment and Current Attachment Style in Nontreatment Heroin


1
A Comparative Study of Retrospective Attachment
and Current Attachment Style in Nontreatment
Heroin Users
Rivkah Lapidus Fielding Graduate Institute School
of Psychology rivkahlapidus_at_yahoo.com
This study has been supported in part by a
research grant From the Fielding Graduate
Institute
2
2
3
Conceptual problems in the addictions field!
What makes some substances licit and some
taboo???
What is a substance, anyway?
Is there an acceptable level of substance use?
  • Is all substance use substance ABUSEor only if
    its ILLEGAL??

4
2 Perspectives in the Literature Drug, Set and
Setting
Zinberg Social setting is critical determinant
in drug use, drug effect, and drug
behavior. Controlled use of addictive substances
is possible Population controlled nonaddicted
(but regular) heroin users
Khantzian Self-medication hypothesis Drug of
choice Preferential heroin users seek the
powerful, muting action to medicate rage and
aggression. Population severely addicted
  • IS THIS A DICHOTOMY?

5
Literature on nonstereotypic patterns of heroin
use
  • Users who maintain longterm use of heroin with
    conscious and deliberate measures to avoid
    symptoms of physical addiction
  • Shewan (1998) Nontreatment heroin users in the
    U.K.
  • Lindesmith (1947) the joy popper
  • The Vietnam research (Robins Helzer, 1974)
  • Chein (1961) youths who had used for years and
    stopped- on their own
  • Zinberg Controlled
  • heroin users in England and U.S.

6
A dope fiend is a man in total need of dope.
Beyond a certain frequency, need knows absolutely
no limit or control. (Burroughs, 1959)
7
(No Transcript)
8
Two in the summer afternoon and I was making my
breakfast cappuccino Dave and I had been up till
six snorting dope. He didn't drink coffee...for
health reasons (he was also a vegetarian).
(Marlowe, 2000)
HEROIN WIDENS ITS APPEAL!
9
Attachment Theory
Kalin and Shelton (1993) research with non-human
primates on the role of endogenous opiate system
on the attachment process.
Flores (1995) Addictive Behaviors stem from
disorders in early attachment processes
10
Conventional wisdom Heroin use and heroin
addiction are the same phenomenon, because all
users eventually become addicts. Heroin addiction
is a progressive, degenerative disease. All
junkies are pretty much alike. All swans are
white.
11
Problem
  • Clinical research and theory psychological/develo
    pmental impairments of heroin addicts, which they
    self-medicate
  • Addicts suffer impairment of attachment, and find
    in heroin a secure base.

BUTDO THESE CONCLUSIONS APPLY TO LESS SEVERE
USERS? (Can there even be some attachment
strengths in users who remain in better control?)
12
Naming the black swans What to call the group I
am studying
New User?
hidden user?
atypical user?,
recreational user?,
High functioning user?,
controlled user?,
unexpected user?
middle class professional user?,

13

N O N T R E A T M E N T H E R O I N U
S E R S


13
14
Research Questions
  • Is there a difference in retrospective attachment
    and current attachment style between nontreatment
    heroin users, (NTHU) a clinical population of
    heroin addicts (CHU), and a nonheroin using,
    nonabusing control group (NU)?
  • Do NTHUs report more secure retrospective
    attachments than CHUs? Are they similar to NUs in
    retrospective attachment?
  • Do NTHUs demonstrate greater security in current
    attachments than CHUs? Are they similar to NUs in
    current attachment security?

Parental Acceptance-Rejection Questionnaire
(PARQ)-Rohner 1990 Relationship Questionnaire
(RQ)- Bartholomew Horowitz, 1991
15
Hypotheses
I. NTHUs current attachment will be more secure
than CHUs, and less secure than NUs, as
determined by scores on the Relationship
Questionnaire. NTHU score on the RQ will fall
between NU, who will score highest, and CHU, who
will score lowest.
II. NTHUs retrospective attachment will be more
secure than CHUs, and less secure than NUs, as
assessed by the Parental-Acceptance-Rejection
Questionnaire, Mother and Father Versions. NTHU
scores will fall between CHU scores (lowest) and
NU scores (highest) on both versions.
16
Operationalization of terms
  • Independent variable heroin use
  • Dependent variables maternal attachment
  • paternal attachment
  • adult attachment style
  • NTHU nontreatment heroin users
  • CHU clinical heroin users
  • NU nonheroin using, normal use control group
  • Instruments PARQ and RQ

17
Inclusion/exclusion criteria for NTHU, CHU, and NU
  • NTHU opiates (heroin) drug of choice. No
    history of treatment for substance abuse. No
    criminal history due to substances. No medical
    consequences of substance use
  • CHU opiates (heroin) drug of choice. History of
    treatment for opiate addiction and/or criminal
    and/or medical history related to heroin
    addiction
  • NU no heroin use at all, present or past.
    (Social use of alcohol, experimental use of
    recreational drugs possible.) No history of
    substance related treatment, arrest, or medical
    problems. No family members with above.

18
HEROIN USERS 105 people

CHU91
NTHU14
19
CHUs All Alike?
?
20
Step 1The 14-17-15 solution
  • 14 NTHUs, 17 of the worst-case CHUs 15 NUs were
    selected at random for analysis! Butthe SMALL
    NUMBERS meant that the POWER of the study WOULD
    be WEAK!

21
Step 2 What to do with the remaining users The
redistribution plan (NTHU-R)
  • Sort CHUs into levels of severity with new
    criteria
  • 1.More than 6 years of use, only treatment
    consisting of short term detox
  • 2. No more than one detox in a year, and if has
    arrest record, the charge was possession only
  • 3. Must be currently employed

22
Now my groups were more evenly matched
I now had 42 NTHU-R
  • 43 nonusers


63 CHU
23
INVESTIGATOR WORKS ROUND THE CLOCK TO SEARCH OUT
SOME CONNECTION BETWEEN ATTACHMENT AND ANY HEROIN
USE AT ALL!
RESULTS
ANOVAS REVEAL NO SIGNIFICANT DIFFERENCES BETWEEN
3 GROUPS IN EITHER RETROSPECTIVE PARENTAL
ATTACHMENT OR CURRENT RELATIONSHIP STYLE
NU
NTHU/NTHU-R
CHU
STUDYS HYPOTHESES NOT CONFIRMED
23
24
Supplementary analyses PARQ subscales, mother
and father versions
  • In the full sample there were no significant
    differences between groups in subscales on Mother
    and Father PARQ

25
T-TESTS SHOW HEROIN USERS AS A GROUP MORE ANXIOUS
IN CURRENT RELATIONSHIP STYLE THAN NONUSERS in
both small large samples
  • Finding Leads to Dispute among Experts

Why are they anxious?
26
Table Relationship Style Scores By Users vs.
Nonusers (large n)
27
Critical attachment related demographic variables
  • Stepwise regression analyses found no differences
    across groups in
  • marital status,
  • 2 parent family of origin (though more NUs came
    from 2 parent family, the difference was not
    significant)
  • Trend more CHUs raised by single mom than NTHU
    or NU, but not statistically significant.
  • Counter trends More maternal deaths in NUs,
    though not significant. More NUs had been
    adopted. More NUs were upper middle class
    backgrounds, but there was no difference in low
    income background among groups
  • Less employment among CHUs, but no difference
    between NU and NTHU
  • Chi square analyses found significant differences
    between groups in
  • substance abuse in mother ?2 ((2, N 128)
    16.22, p lt .05.
  • substance abuse in the father, ?2 (2, N 134)
    15.18, p lt .05.

28
EDUCATION, EDUCATION EDUCATION




Regression Analysis show education level to be
the best predictor of group membership



29
Conclusions and Discussion
  • Is attachment theory still worth exploring as a
    factor in problematic or nonproblematic substance
    use?

30
NTHU Where are they hiding?
31
Hidden Populations and the Case for Ethnography
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