Codependency and Prefrontal Cortex Functioning: Preliminary Examination of Substance Use Disorder Impacted Family Members

Abstract

Background and Objectives Substance use disorders (SUDs) have negative impacts on an entire family system and each family member may be at risk to develop a “codependency” on their SUD loved‐one. Research has demonstrated that SUDs in the family environment associate with altered brain functioning of family members; however, research has not examined specific associations between codependency and brain functioning. Methods Prefrontal cortex (PFC) activation of family members (n = 38) was assessed using functional near‐infrared spectroscopy as they viewed images of a SUD loved‐one (experimental group; n = 26) or of a “target family member” (control group; n = 12). Correlations between PFC activation and codependency were examined. Results A significant negative association was found between codependency and left dorsomedial PFC activation in response to images of a loved‐one with a SUD. This association was significantly larger than that found in the control group in response to a target family member, and that found in response to other affective images. Discussion and Conclusions The left dorsomedial PFC is associated with executive functioning during responses to emotional and social situations. Findings may suggest that family members experiencing codependency may be limited in effectively responding to their SUD loved‐one, and highlight the importance of systemic treatment and family member recovery. Scientific Significance Codependency is often discussed as a learned condition and research has only recently examined brain processes of family members with a loved‐one with a SUD. This research is the first to demonstrate an association between codependency and PFC functioning. (Am J Addict 2019;28:367–375)

Investigation of factors associated with low adherence to treatment of codependency in family members of psychoactive substance users

“…Emotional overload, the severity of psychological symptoms, and the frequency with which the mental health issues were reported can be indicators of low adherence (Vederhus et al, 2019). It should be noted that depressive symptoms have been related, in the literature, to predictive factors for low adherence to treatments of other diseases (Arlt, 2017;Zielinski et al, 2019) and also for increased antidepressant treatment drop out (Rohden et al, 2017).…”

“…The suffering caused to family members is described in a similar way in different cultures; with symptoms of physical and psychological illnesses, changes in family relationships, situations of violence, and economic problems (Ahmad-Abadi et al, 2017;Askian, Krauss, Baba, Kadir, & Sharghi, 2016;Bortolon et al, 2017;Lampis, Cataudella, Busonera, & Skowron 2017;Panaghi, Ahmadabadi, Khosravi, Sadeghi, & Madanipour, 2016;Tamutiene & Laslett, 2016;Ulusoy & Guçray, 2017). The need for treatment of family members is evidenced by the range of physical and psychological symptoms pointed out in numerous studies (Askian et al, 2016;Lima et al, 2019;Silva Oliveira, Silva, Algeri, & Soares, 2019;Zielinski et al, 2019). Interventions directed to the specific demands of family members who are affected by the problem use of drugs of a loved-one are effective in reducing physical and psychological symptoms and the characteristic symptoms of codependency (Ahmad-Abadi et al, 2017;Bortolon et al, 2017).…”

“…Brazil has more than 8 million people who use alcohol and/or other drugs (5.7% of the population) (Laranjeira, Madruga, Pinsky, Caetano, & Mitsuhiro, 2014). The use of psychoactive substances, in addition to causing significant losses in the user's life, generates negative and lasting effects on members of the family system, and there may be many people in distress living with this problem drug user (Ahmad-Abadi et al, 2017;Lima et al, 2019;Vederhus, Kristensen, & Timko, 2019;Zielinski et al, 2019).…”

Mediator Role of the Need for Social Approval in the Relationship between Perfectionism and Codependency: A Structural Equation Modeling Study

“…Ançel (2017) stressed that the prevalence of codependency in Turkey is not known as the subject has not been researched widely enough. When the international literature is reviewed, it is seen that a large number of studies have focused on the subject (Hillborg, 1995;Martsolf, Sedlak and Doheny, 2000;Chang, 2010;Reyome and Ward, 2007;Parker, Faulk and Lobello, 2003;Chang, 2018;Bereza and Isaeva, 2018;Bacon et al, 2018;Zielinski et al, 2019). Beattie (2012) defined the characteristics of codependency as follows: Codependent people strive for other people's contentment rather than their own contentment.…”

Evaluating an intervention for family members of people who use drugs in Vietnam

“…Chronic substance dependence places an enormous strain on families, and family members of people who use drugs (PWUD) face many psychosocial challenges (Mattoo et al, 2013;Morita et al, 2011;Nebhinani et al, 2013;Zielinski et al, 2019). Literature has documented that family members typically experience a variety of mental stress, such as chronic depression, guilt, denial, shame, anger, and grief (Gethin et al, 2016;Oxford, Velleman, Copello, Templeton & Ibanga, 2010;Schafer, 2011).…”