Perceived Harmful Criticism in Family Interactional Patterns and Relapse Risk among Recovering Inpatients with Alcohol Use Disorder in Kiambu County, Kenya

Githae, Eunice Njango, Ph.D., Kenyatta University, Kenya.


The family environment in which recovery is nurtured can become a potent trigger of relapse for an individual undergoing treatment of alcohol use disorder (AUD). A growing body of evidence suggests that families characterized by high expressed emotion (EE), particularly those described to have high criticism, play a major role in determining whether or not a recovering alcoholic will maintain abstinence from substance use and hence not return to heavy drinking after treatment. This study examined the perceptions of harmful and non-harmful criticisms as predictors of relapse after treatment of the individual suffering AUD. The study also examined goals of treatment for 119 alcoholics admitted in inpatient rehabilitation centers in Kiambu County in Kenya. A Self-Rated Questionnaire, including, demographics and goals of treatment was administered to the participants. Relapse risk was measured using the Alcohol Relapse Situation Appraisal Questionnaire (A-RSAQ), while indicators of perceived criticism were measured using Attributions of Criticism Scale (ACS) and the Perceived Criticism Measure-Type (PCM-T). All the 119 participants were screened for alcohol use disorder using the Alcohol Use Disorders Identification Test (AUDIT). The study hypothesized that there was a relationship between perceived harmful criticism of close family members and relapse of the recovering individuals from alcohol use disorder. Pearson correlations and regression analyses supported the study hypothesis by demonstrating that perceived harmful criticism was statistically significant (p=0.000<0.05) and had a high predictive value (r2=.285) to relapse risk. It is recommended that stakeholders involved in alcohol treatment should target family interactional patterns and relational dynamics into their programs in order to enable sustainable recovery for individuals suffering AUDs.

Keywords: harmful criticism, expressed emotion, treatment goal, patient, abstinence, relapse, rehabilitation

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