Impact of Family History in Persons With Dual Diagnosis

Abstract

Objective: This study examined relationships among family history of alcohol, drug, and psychiatric problems and substance use severity, interpersonal relationships, and service use in individuals with dual diagnosis. Methods: Data were collected with the family history section of the Addiction Severity Index administered as part of three studies of individuals with dual disorders (N = 413). Participants were categorized into family history risk groups for each problem domain based on the number of first- and second-degree relatives with alcohol, drug, or psychiatric problems. Results: Rates of alcohol, drug, and psychiatric problems were high across family member categories and highest overall for siblings. More than two-thirds of the sample was categorized in the high-risk group in the alcohol problem domain, almost half of the sample was categorized as high-risk in the drug problem domain, and more than a third of the sample was categorized as high-risk in the psychiatric problem domain. Across problem domains, individuals in the high-risk group reported more relationship problems with parents and siblings and higher rates of lifetime emotional, physical, and sexual abuse than did those in the low- or moderate-risk groups. Conclusions: Family history of alcohol, drug, and psychiatric problems is associated with greater rates of poor family relationships and history of abuse. Assessment of these different forms of family history in multiple family members can aid treatment providers in identifying individuals with dual disorders who may benefit from trauma-informed care as part of their overall mental health and substance abuse treatment services.

Keywords:

• dual diagnosis
• family history
• serious mental illness

ACKNOWLEDGMENTS

The research reported in this manuscript was supported by NIDA grant R01 DA11753 (The Process of Change in Drug Abuse by Schizophrenics, A. S. Bellack, PI), NIDA grant R01 DA 012265 (Behavior Therapy for Substance Abuse in Schizophrenia, A. S. Bellack, PI), and NIAAA grant R21 AA014231 (Treatment of Alcohol Use Disorders In Schizophrenia, M. E. Bennett, PI).

Notes

1. As defined by Lehman et al. (1997): Diagnosis of schizophrenia or schizoaffective disorder or other serious mental disorder including bipolar disorder, major depression, or anxiety disorder; for non-schizophrenia diagnoses, individual has worked 25% or less of the past year and/or receives benefits for mental disability.