1. Conclusions - key points
Prevalence of substance use and attachment dimensions among Czech adolescent girls in residential care
Pavla Dolezalova, Ladislav Kazmer, Barbora Orlikova, Ladislav Csemy
National Institute of Menthal Health
Centre of Epidemiological and Clinical Research of Drug Abuse and Dependence, Klecany, Czech Republic
Table 1: Differences is the last month prevalence (%) of licit substance use among the study group and reference group.
Background
Results
A number of research studies have demonstrated a correlation between substance use disorder (SUD) and dimension attachment with particular evidence for a general link between SUD and insecure attachment (Schindler et al, 2014, Yasmin, 2013). We present results of a study examining possible relationships between licit and illicit substance use. The prevalence of (selected) risk factors related to mental health of girls living in residential care settings. We anticipate that both SUD and insecure attachment patterns are significantly higher among the girls living in residentional care as compared to those from non-residential (general) settings."
The prevalence of drug use among adolescent girls living in residential care was found to be several times higher as compared to the reference group sampled from the Czech school-aged population. In regards to attachment to each of the emotionally close targets, the most prevalent dimensions obtained from the study group were “fearful-avoidant” (attachment to mother and/or father) and “dismissive” (attachment to romantic partner and friend.) The prevalence of these dimensions among adolescent girls living in residential care was several times higher in comparison with common population studies (Donbaek, F. D. et al., 2013, Lecbych, M. & Pospisilikova, K., 2012).
However using any drugs was not significantly linked to dimensions of attachment. No form of substance abuse was correlated with the cited attachments to significant others, not even in cases of individual domains (preoccupied and avoidant). Note is made of the ”The statistical significance" between amphetamine use and friends, resp. Global score, which is given an important correlation with "Friend-Avoidance score". When compared to relationships with other persons and other substances, this correlation would not make sense, and is likely a statistical artefact. Similarly this is the case of Tobacco vs. friend-anxiety or in the case of hallucinogen vs. romantic partner-anxiety.
Table 2: Differences is the last year prevalence (%) of illicit substance use among the study group and reference group.
Methods
Figure 1), 2): Prevalence of attachment types to emotionally close persons among adolescent girls living in residential care
Objectives: To determine the prevalence of both substance use and attachment dimensions amongst adolescent girls living in residential settings. Subsequently, prevalence rates are compared with those obtained from the sample of the Czech adolescent girls coming from an ordinary (non-residential) milieu.
Methods: We conducted a quantitative survey with questionnaires on both substance use and attachment type. With regards to substance use, girls reported on frequency of consumption of several substances: tobacco, alcohol, cannabis, amphetamines and volatiles. As a reference group, sample of the Czech adolescent girls surveyed within the recent 2015 European School Survey Project on Alcohol and Other Drugs (ESPAD, N=2 886) was used (ESPAD, 2016). Regarding attachment dimensions, the standardized Relationship Structures (ECR-RS) Questionnaire by Fraley et al. (2011) was used. Dimensions of attachment to four emotionally bonded targets were determined: attachment to mother, father, romantic partner and close friend.
Sample: A total number of 122 girls were surveyed in a residential setting, ages The target group is generally characterized by high risk behavior, significant comorbidity, use of both licit and illicit substances, as well as by complicated settings of the family environment. These adolescent girls living in institutional setting are excluded from common population research.
Conclusions - key points
Adolescent girls living in residential care have low secure attachment to parents.
Link between dismissive, preoccupied, fearful-avoidant dimensions of attachment to close persons did not predict significant link to use of drugs.
Implication for practice: Adolescent girls in residential care are highly vulnerable individuals with special needs and risks in term of public mental health perspective.
Professionals should consider assessing attachment security of vulnerable adolescents in residential care in Czech Republic.
Emphasizes enhancement of prevention and psychotherapy with attention paid to attachment focused therapy including the family.
Extended screening tools such as standardized Relationship Structures (ECR-RS) Questionnaire, Brief Symptom Inventory (BSI®) within residential school care should be used.
Table 3: Dimension of attachment (%), Both parents.
Table 4 : Prevalence of attachment dimension to emotionally close persons among adolescent girls.
Dimension of attachment (%)
Both parents
Secure to both mother and father
5.7
Fearful-avoidant to both mother and father (insecure)
19.7
Other type (insecure)
74.6
Total (N)
N=122
Type of attachment (%)
Emotional target
Mother
Father
Romantic partner
Friend
Secure
28.8
16.0
17.4
20.9
Dismissive
4.2
11.0
5.5
10.9
Preoccupied
31.4
18.0
59.6
51.8
Fearful-avoidant
35.6
55.0
16.4
Total (N)
N=118
N=100
N=109
N=110
References
ESPAD Report 2015 (2016) Results from the European School Survey Project on Alcohol and Other Drugs. © European Monitoring Centre on
Drugs and Drug Addiction, 2016,. Luxembourg: Publications Office of the European Union.
Fraley, R. C., Heffernan, M. E., Vicary, A. M., & Brumbaugh, C. C. (2011). The Experiences in Close Relationships-Relationship Structures questionnaire: A method for assessing attachment orientations across relationships. Psychological Assessment, 23,
Donbaek, F.. Elklit, D. (2014) A validation of the Experiences in Close Relationships-Relationship Structures scale (ECR-RS) in adolescents. Attach Hum Dev. 2014;16(1):58-76
Lečbych, M., Pospíšilová, K. (2012). Česká verze škály. Experiences in Close Relations (ECR): Pilotní studie posouzení vztahové vazby v dospělosti. E-Psychologie, ÈMPS, 6(3), 1–11. Schindler, A ., Bröning, S. (2014): A Review on Attachment and Adolescent Substance Abuse: Empirical Evidence and Implications for Prevention and Treatment, Substance Abuse.
Yasmin, B. (2013) "Substance Abuse and Insecure Attachment Styles: A Relational Study,"LUX: A Journal of Transdisciplinary Writing and Research from Claremont Graduate University: Vol. 2: Iss. 1, Article 4. Available at:
This work was supported from the Ministry of Education, Youth and Sports of the Czech Republic (under grant numbers 0057/PP/2016 and PRCH-IP-0059/2017), and by the project “Sustainability for the National Institute of Mental Health”, under grant number LO1611, with a financial support from the Ministry of Education, Youth and Sports of the Czech Republic under the NPU I program.