The phenomenon of codependency: psychological and medical genetic aspects

Addictive behavioral disorders are multifactorial diseases with clinical, neurophysiological, and genetic heterogeneity, a high comorbidity with other disorders, and a low curability. The etiopathogenetic mechanisms of non-chemical forms of addictive behavior have not been sufficiently studied, which makes it difficult to search for effective therapeutic procedures.

Objective: to study the psychological and genetic components of a non-chemical addictive disorder as the phenomenon of codependency.

Patients and methods. The investigation enrolled 256 women who were divided into three comparison groups: 1) those with the phenomenon of codependency, 2) phenotypically healthy women; 3) a population sample. Psychometric testing was carried out using the «Hand Test» by E. Wagner (adapted by A.I. Gerasimov and S.N. Enikolopov) and the clinical and genealogical characteristics of women with the phenomenon of codependency were studied. Results and discussion. There was a statistically significant predominance of the level of aggressiveness as autoaggression in the structure of the personality profile of women with the phenomenon of codependency (t=2.924–3.015; p=0.004–0.005). The clinical and genealogical characteristics of persons with addictive behavioral disorder as the phenomenon of codependency suggest that there is a statistically significantly high frequency of secondary alcoholism among first-degree and second-degree relatives or both and first-degree male relatives (p<0.001).

Conclusion. The phenomenon of codependency as a non-chemical addiction includes psychological and genetic components. Women with codependency had autoaggressive destructive behavior patterns and a family history of alcoholism. The identified psychogenic characteristics can be considered as a risk for an addictive disease and somatoform disorders.

1. Global health estimates 2016: disease burden by cause, age, sex, by country and by region, 2000–2016 [online database]. Geneva: World Health Organization; 2018. Available from: http://www.who.int/healthinfo/global_burden_disease/estimates/en/index2.html (accessed 15.04.2020).

2. Bisaliev RV, Veshneva SA. Suitsidal'noye povedeniye u addiktov i ikh rodstvennikov [Suicidal behavior in addicts and their relatives]. Astrahan': FGBOU VPO AGTU; 2013 (In Russ.).

3. Beattie M. Codependent no more: How to stop controlling others a. start caring for yourself. Center City (Minn.): Hazelden; 1992.

4. Young E. Co-alcoholism as a Disease: Implications for Psychotherapy. J Psychoactive Drugs. Jul-Sep 1987;19(3):257-68. doi: 10.1080/02791072.1987.10472410

5. Rozhnova TM, Asanov AYu. The psychogenetics principles of co-dependence. Formulation of the problem. Narkologija. 2010;7(103):84-90. Available from: http://www.narkotiki.ru/50_1182.htm (accessed 18.04.2020) (In Russ.).

6. McGrath MG, Oakley BA. Codependency and Pathological Altruism. In: Oakley B, Knafo A, Madhavan G, Wilson DS, editors. Pathological altruism. New York: Oxford University Press; 2011. P. 49-74. doi: 10.1093/acprof:oso/9780199738571.003.0045

7. Selye H. The General Adaptation Syndrome and the Diseases of Adaptation (two parts). J Allergy [later and Clinical Immunology] 1946;17(4):231-47 and 1946;17(6):358-98. doi: 10.1016/0021-8707(46)90148-7 and (conclusion). Accessed April 18, 2020. https://www.jacionline.org/article/0021-8707(46)90159-1/pdf

8. Selye H. Stress and the General Adaptation Syndrome. Brit Med J. 1950 Jun 17;1(4667):1383-92. doi: 10.1136/bmj.1.4667.1383

9. Schuckit MA, Smith TL. Correlates of unpredicted outcomes in sons of alcoholics and controls. J Stud Alcohol. 2001 Jul;62(4):477-85. doi: 10.15288/jsa.2001.62.477

10. Grisel JE. Quantitative trait locus analysis. Alcohol Res Health. 2000;24(3):169-74. Available from: https://www.researchgate.net/publication/12132372_Quantitative_trait_locus_analysis (accessed 21.04.2020).

11. Potter-Efron RТ, Potter-Efron PS. Assessment of co-dependency with individuals from alcoholic and chemically dependent families. Alcohol Treat Quart. 1989;6(1):37-57. doi: 10.1300/J020V06N01_04

12. Fischer J, Spann L, Crawford D. Measuring codependency. Alcohol Treat Quart. 1991;8(1):87-99. doi: 10.1300/J020V08N01_06

13. Bogina EV. Voprosy dly samodiagnostiki po sozavisimosti [Questions for self-diagnosis on codependency]. Available from: http://metanoia.msdm.ru/statiy/psiholog/20-support-and-documentation.html (accessed July 30, 2020) (In Russ.).

14. Dvorynchikov NV, Gerasimov AV, Enikolopov SN. Possibilities of psychological research in forensic sexology. In: Uridicheskay psyhologiya. Mezhvuzovskiy nauchno-prakticheskiy sbornik [Legal psychology. Interuniversity scientific and practical collection]. Stavropol; 2001. P. 68-78 (In Russ.).

15. Gunko B, Viltsaniuk O, Stepaniuk A. The problem of co-dependence among hivinfected drag-addicted family members. Georgian Med News. 2019 Jan;1(286):87-90.

16. Oxford J, Velleman R, Natera G, et al. Addiction in the family is a major but neglected contributor to the global burden of adult illhealth. Soc Sci Med. 2013;78:70-7. doi: 10.1016/j.socscimed.2012.11.036

17. Borges Bortolon C, Signor L, de Campos Moreira T, et al. Funcionamento familiar e questoes de saude associados com codependencia em familiares de usuarios de drogas. Cienc Saude Coletiva (Rio de Janeiro). Jan 2016;21:1. doi: 10.1590/1413-81232015211.20662014

18. Moreira TC, Rizzieri LF, Fernandes S, et al. Qualidade de vida em usuarios de substancias psicoativas, familiares e nao usuarios por meio do WOOQOL BREF. Cien Saude Colet. 2013;18(7):1953-62. doi: 10.1590/S1413-81232013000700010

19. Karpushina SF. Autoaggression codependemt wives of men suffering from alcogolism. Tyumenskiy medicinskiy journal. 2017;2(19):21- 4 (In Russ.).

20. Bashmanov VV, Kalinihenko OYu. The phenomenon of co-dependency: the medico-phsycho-social aspect. Vetstnik novyh medicinskih tehnologij. 2015;(1):36-43. Available from: http://www.medtsu.tula.ru/VNMT/Bulletin/E2015-1/5093/pdf (accessed 24.07.2020) (In Russ.)].

21. Merinov AV, Shitov EA, Lukashuk AV, Somkina OYu. Autoaggressive characteristics of women who are married to men who suffer from alcoholism. Rossijskij mediko-biologicheskij vetstnik imeni I.P. Pavlova. 2015;(4):81-6 (In Russ.).

22. Merinov AV, Shitov EA, Lukashuk AV, et al. Spouses of men with alkogol dependence who have a history of suicidal allempi: their advanced clinical suicidological and psychological characteristics. Suicidology. 2015;6(3):49-54 (In Russ.).

23. Noriega G, Ramos L, Medina-Mora ME, Villa AR. Prevalence of codependence in young women seeking primary health care and associated risk factors. Am J Orthopsychiat. 2008 Apr;78(2):199-210. doi: 10.1037/0002-9432.78.2.199

24. Hunt G. «The too-good wife»: alcohol, codependency, and politics of nurturance in Postwar Japan. Am Ethnol. 2008;35(3):3038-41. doi: 10.1111/j.1548-1425.2008.00088.x

25. Doba K, Nandrino JL, Dodin V, Antoine P. Is there a family profIle of addictive behaviors? Family functioning in anorexia nervosa and drug dependence disorder. J Clin Psychol. 2014 Jan;70(1):107-17. doi: 10.1002/jclp.21977. Epub 2013 Jun 21.

26. Beattie M. The new codependency: help and guidance for today's generation. New York: Simon & Schuster; 2009.

27. The mental health context. Geneva: World Health Organization; 2007. Available from: https://www.who.int/mental_health/Mental%20Health%20Context_rus.pdf (accessed 18.04.2020) (In Russ.).

28. Koshkina EA, Kirzhanova VV, Guseva OI, et al. Delivery of drug dependency treatment to the population of the Russian Federation in 2012. Voprosy narkologii. 2013;(4):3-18. Available from: https://www.elibrary.ru/item.asp?id=20159390 (accessed 21.04.2020) (In Russ.).

29. Schuckit MA. Overview: Epidemiology of alcoholism. In: Schuckit MA, ed. Alcohol patterns and problems (Series in Psychosocial Epidemiology). New Brunswick: Rutgers University Press; 1985. P. 1-42. Available from: https://www.goodreads.com/book/show/5482301-alcohol-patterns-and-problems (accessed 21.04.2020).

30. Dear G, Roberts C. The validation of the holyoake codependency index. J Psychol. 2005 Jul;139(4):293-313. doi: 10.3200/JRLP.139.4.293-314

31. Bortolon CB, Ferigolo M, Grossi R, et al. Avaliacao das crencas codependentes e dos estagios de mudanca em familiares de usuarios de drogas que ligaram para um servico de teleatendimento. Rev AMRIGS. 2010;54(4):432-6.

32. Sanchez-Roige S, Palmer AA, Fontanillas P, et al. Genome-Wide Association Study Meta-Analysis of the Alcohol Use Disorders Identification Test (AUDIT) in Two Population-Based Cohorts. Am J Psychiatry. 2019 Feb 1;176(2):107-18. doi: 10.1176/appi.ajp.2018.18040369. Epub 2018 Oct 19.

33. Verhulst B, Neale MC, Kendler KS. The heritability of alcohol use disorders: a meta-analysis of twin and adoption studies. Psychol Med. 2015 Apr;45(5):1061-72. doi: 10.1017/S0033291714002165. Epub 2014 Aug 29.

34. Rozhnova TM. Sposob opredeleniy predraspolozhennosti k addiktivnym rasstroystvam v forme alkogolnoy zavisimosti i/ili sozavisimosti [Method for determining predisposition to addictive disorders in the form of alcohol dependence and/or codependency]. Patent RU 2296994C1; April 10, 2007 (In Russ.).

35. Rozhnova TM. Sposob prognozirovaniy riska razvitiy rasstroystv povedeniy addiktivnogo haraktera [A method for predicting the individual risk of developing addictive behavior disorders]. Patent RU 2621171C1; May 31, 2017 (In Russ.).

36. Schaef AW. Co-dependence: Misunderstood – mistreated. San-Francisco: Harper and Row; 1986.