The Relationship between Dysfunctional Attitudes and Communication Skills of Women with an Addicted Husband on the Verge of Divorce.

BACKGROUND: Divorce and addiction are the source of numerous social damages. The main reasons for divorce include spouse addiction, sexual dissatisfaction, low living and communication skills of couples, dysfunctional beliefs and attitudes, and irrational expectations of marriage. The present study was carried out with the aim to investigate the relationship between dysfunctional attitudes and communication skills among women with an addicted husband on the verge of divorce referring to the forensic medicine and family court.
METHODS: This study was a descriptive and correlational study. The participants were selected from among all women on the verge of divorce with addicted husbands who referred to the forensic medicine and family court from October 2015 to March 2016. Thus, 190 individuals were selected using convenience sampling method. The researcher visited the study environment and after explaining the method and purpose of the study and obtaining informed consent from the subjects, distributed the questionnaires among the women. The questionnaire contained a demographic information form, the Dysfunctional Attitude Scale (DAS) (Weissman and Beck), and the Communication Patterns Questionnaire (CPQ) (Christensen and Sullawa). Data were analyzed using the Pearson test and analysis of variance (ANOVA) in SPSS software.
FINDINGS: There was a significant and inverse relationship between dysfunctional attitudes and communication skills of women. In addition, a significant and inverse relationship was observed between dysfunctional attitudes and constructive interaction among women. Moreover, there was a direct and significant relationship between dysfunctional attitudes and the mutual avoidance relationship among women. Furthermore, a direct and significant relationship was found between dysfunctional attitudes and the expectation/isolation relationship among women.
CONCLUSION: The findings of this study could be used in cognitive training of spouses, the correction of their dysfunctional attitudes, and improvement of their communication skills.

Introduction

Given the transition of our society from a traditional society to an industrial and modern one, family problems, and communicative and role damages are among the major problems in the area of mental health of families. Frequent referrals to family therapy centers, crisis intervention, and increased specialized help-seeking behaviors indicate a serious problem in family mental health.1,2 Divorce is the outcome of the most acute and most serious family communication problems. In terms of divorce to marriage ratio, Iran is one of the top 7 countries in the world.3 Studies have shown that the most common problems of families referring to family therapy centers of Isfahan, Iran, are spouses’ communication problems (34.4%), psychiatric problems (26.7%), and social problems and delinquency (11.2%). The most common complaints about pathologic relationships are emotional problems and substance dependence.2 Addiction is a disastrous social phenomenon. Since family is the social entity most vulnerable to the effects of addiction and an addict householder is unable to play his role as the spouse and father of the family, the importance of the role of women in families with an addict householder multiples. This group of women is one of the most vulnerable groups in society and is subject to serious damage to the family system. Results of a study indicated that 24% of divorce among women in the country was due to husband’s addiction.4

The cognitive model has been recently introduced to explain family problems and has received attention due to its robust theoretical basis and experimental support. According to this model, irrational beliefs are important cognitive distortion factors in the creation and continuity of pathological behaviors. Recent literature has become more specific in this area, focusing on dysfunctional beliefs about relationships. An example of this is thoughts and beliefs about an interpersonal relationship with a spouse, parent relationships, and relationships between children.5,6

The results of a study in explaining a structural model of cognitive factors, sexual satisfaction, and quality of life (QOL) showed that for both men and women, cognitive factors and attitudes had a causal and consecutive relationship with sexual satisfaction, the quality of marital relationship, and marital stability.7 Clinical trials indicated that verbal and nonverbal communication behaviors were modified through the correction of attitudes and cognitive distortions of couples, and one year follow-up showed the sustained effects of modification of attitudes on mental health. Theoretically, these findings point to the relationship between cognitive variables and relationships within the family.8,9 Some studies have revealed that dysfunctional attitudes are associated with maladaptive responses, such as pessimism in interpersonal relationships, and threats regarding separation and divorce.10,11

However, there have been inconsistencies in the literature in this regard. The study by Dye and Eckhardt showed that dysfunctional attitudes and irrational beliefs did not have a significant relationshipý with violence and ýaggression in family relationships.12 Some studies have reported controversial findings that have caused theoretical challenges for researchers. For instance, positive correlations were also seen between irrational beliefs specific to relationships and more marital consistency that is a major paradox.13

Moreover, in recent years, socio-cultural changes have led to changes in the family and increased expectations and needs of couples, especially in emotional and psychological dimensions. Today, couples need to satisfy their emotional needs, especially intimacy, more than ever before. Studies show that the origin of many problems between couples are the lack of intimacy and presence of communication problems.14 Communication is of value in solving interpersonal incompatibilities.15 Although communication difficulties are not the only cause of marital conflict, they are indicative of troubled relationships,16 and seem to exacerbate the existing problems. Constant confusion in relationships often leads to divorce and separation.17

Spouses’ communication skills are of great importance in establishing and maintaining an open and healthy relationship, empowering couples, especially women, to clarify and explain their requirements and desires, and in the ability to pay attention to others, and thereby in reaching marital satisfaction. In addition, communication skills also cause changes in the communication patterns of couples, and create a pleasant and positive feeling and more satisfaction and intimacy between them.18 Given the above facts, and the growing trend of marital dissatisfaction, troubled relationships, and the phenomenon of divorce, the importance and necessity of considering communication skills as an important factor in preventing marital problems and improving QOL and marital status are clear.

Considering the above-mentioned issues, insight into the relationship between dysfunctional attitudes and communication skills of couples can be important both functionally and theoretically. In theoretical perspective, dysfunctional attitudes should be investigated as a prerequisite to couples’ communication skills in order to improve these skills. Furthermore, in various studies, the importance of couples’ functional relationship has been highlighted, because communication skills can affect all the activities of a family. In addition, based on the necessity of reducing dysfunctional attitudes in couples expressed in psychology literature from around the world and taking into account the role that couples’ communication skills can play in marital life satisfaction and resolution to problems such as spouse’s addiction, the scientific and field study of the relationship between these variables in couples, and especially women on the verge of divorce due to the addiction of their spouse, seems necessary.

Methods

This study was a descriptive-correlational study. The statistical population of the study included women with a drug-addicted husband on the verge of divorce who referred to the forensic medicine and family court from October 2015 to March 2016. The number of subjects studied was calculated to be 190 individuals based on similar studies.19-21 It should be noted that of 247 questionnaires distributed among the subjects, 224 questionnaires were returned and 190 completed questionnaires were analyzed. The participants were selected using convenience sampling method.

Inclusion criteria included husband’s addiction during the study (the husband’s addiction was confirmed through tests by the Legal Medicine Organization) and permanent dependence on the drug for the past 6 months, age of 20 to 50 years, education degree of higher than diploma, informed consent to participate in the study, and at least 3 years of marital life. The collected data were analyzed using Spearman’s correlation coefficient test in SPSS software (version 20, IBM Corporation, Armonk, NY, USA).

This DAS (Weissman and Beck) ýis a self-assessment questionnaire with 40 questions and is used to identify the negative attitudes and beliefs that form the basis of psychological disturbances. This scale is considered as a valid scale and its psychometric properties have been reported to be satisfactory. High internal consistency with a Cronbach's alpha of 0.92 and adequate stability (r = 0.73) over 6 weeks are among its prominent features. The reliability of this scale was calculated at 0.84 using the split-half method and Spearman-Brown prophecy formula. A study in Iran has shown the usefulness of this scale in measuring dysfunctional attitudes among patients with obsessive-compulsive disorder (OCD). The internal consistency of this scale in Iran, in all subjects examined, was 0.82, and its reliability was reported to be 0.96 using the split-half method. In order to obtain the validity of this test, its correlation with the Padua questionnaire was assessed, indicating a significant relationship. Beck et al. reported a Cronbach's alpha and validity of 0.92 and 0.79 for this questionnaire, respectively.22 In the study carried out by Rabiei et al., the reliability coefficient obtained using Cronbach's alpha method was 0.88.23

the CPQ (Christensen and Sullaway) included 35 questions measuring communication patterns and skills, with 3 dimensions of expectation/isolation relationship, constructive interaction, and mutual avoidance relationship. Christensen and Shenk reported the validity of the CPQ and its subscales to be suitable.24 In Iran, Ebadatpour standardized the CPQ and reported an appropriate validity and reliability for this questionnaire.25 Moreover, Thanaguee et al. obtained a reliability of 0.63, 0.64, and 0.68 for the components of expectation/isolation relationship, constructive interaction, and mutual avoidance relationship of the questionnaire, respectively.26

Results

According to the information obtained, most of the participants were 26-35 years old (43.4%) with an average age of 30.37 ± 5.6 years.

Regarding the level of education of the participants, the highest percentage was related to high school diploma (37.5%). The education of the spouses of 118 of the women (41.4%) was high school diploma. Family income of 47.3% of the women was less than one million tomans. Moreover, 46% of the women were homemakers, and spouses of 31% of the women were unemployed. Opiate addiction (opium and heroin) and industrial substance (glass and cannabis) addiction were reported among 66.8% and 33.2% of the spouses, respectively.

Data analysis using the Pearson correlation test showed that there was a significant and inverse relationship between dysfunctional attitudes and communication skills of women (rxy = -0.253) (P = 0.001), and a direct and significant relationship between dysfunctional attitudes and the expectancy/isolation relationship of women (rxy = 0.192) (P = 0.034). It also showed a reverse and significant relationship between dysfunctional attitudes and the constructive interaction of women (rxy = -0.174) (P = 0.039), and a direct and significant relationship between dysfunctional attitudes and the mutual avoidance relationship of women (rxy = 0.227) (P = 0.028) (Table 1).

Table 1

Descriptive statistics of study variables

Study variables	Mean ± SD	Maximum	Minimum
Dysfunctional attitudes	154.88 ± 17.24	228	110
Communication skills	137.1 ± 13.37	189	105
Constructive interaction	12.1 ± 4.04	37	7
Mutual avoidance relationship	13.3 ± 4.7	22	6
Expectation/isolation relationship	25.8 ± 3.87	34	12

SD: Standard deviation

The results of analysis of variance (ANOVA) showed that there was no significant difference in dysfunctional attitudes and communication skills of women according to their age. The difference in the mean values of communication skills with respect to the education level of women was statistically significant (P = 0.019), and women with a master’s degree had higher communication skills scores. The results revealed that the difference in the mean levels of dysfunctional attitudes with regard to women’s occupation was statistically significant (P = 0.028), and women laborers and homemakers had higher levels of dysfunctional attitudes.

Discussion

The results of the study indicated that there was an inverse and significant relationship between dysfunctional attitudes and communication skills of women. These results were consistent with the findings of the study by Frisch in explaining a structural model of cognitive factors, sexual satisfaction, and QOL, which showed that cognitive factors and attitudes in both men and women had a causal and consecutive relationship with sexual satisfaction, the quality of marital relationship, and marital stability.7 In addition, the present findings were in line with the findings of Moller et al. in suggesting that dysfunctional attitudes were correlated with destructive responses, such as pessimism in interpersonal relationships, and threats regarding separation and divorce.11 Furthermore, the present study findings were in agreement with the results of the study by Kaiser et al. in showing that by correction of attitudes and cognitive distortions of couples, verbal and nonverbal communication behaviors were corrected.7 In addition, in agreement with the findings of the study conducted by Neenan, the present study results suggested that dysfunctional attitudes affected emotional health and communications among individuals.27 The results of the current study showed that marital satisfaction was correlated with communicational beliefs and irrational expectations of couples which was in line with the result of the study by Shayesteh et al.28

Numerous researchers and theorists consider irrational beliefs as the main cause of conflicts, especially in couple relationships. Irrational beliefs are also seen in disrupted families; this confirms the viewpoint of Ellis indicating that psychological problems are the result of misconceptions of individuals.29 The results of the investigations also indicate the importance of irrational beliefs as a known factor in communication skills and marital conflicts, which result in a reduction in marital adaptiveness.28

Interpersonal communication forms the basis of initial links with others. Effective communication vitalizes people and improves their QOL, while dysfunctional communication is a barrier to prosperity and even a means to a reduction in human comfort and peace. It can be explicitly claimed that one of the main causes of human happiness is his interpersonal communication. When the goal of communication is to achieve peace alongside the life partner and in marital life, “communication” becomes the blood of marital life and plays a decisive role in the quality of marital life. Furthermore, the equipment of spouses with communication skills results in their compatibility and satisfaction, and lack of awareness of this basic skill leads to many misunderstandings, conflicts, and tensions between couples. An examination of the lives of successful and unsuccessful couples suggests that “how to communicate” is one of the important aspects in distinguishing between these two groups. Common life is affected by numerous factors some of which may lead couples to conflict, emotional divorce, and even formal divorce.

The results showed that women with higher education had a higher score of communication skills. In explaining this finding, it can be declared that with increase in the level of education, the information of women and their spouses on communication skills is enhanced, and as a result of their academic education, these couples express their statements effectively and comprehensively, and mutually listen to their partner’s words carefully and comprehend them correctly.

The findings of other studies showed that women laborers and homemakers had higher dysfunctional attitudes. The reason for this issue may be their work stress and difficult working conditions, which lead to dissatisfaction with their marriage and a belief that they and their spouses have serious problems, thus destroying the relationship attitude of the couples.

Furthermore, spouse addiction is associated with numerous social damages in women.30 Women in families suffering from addiction often have low mental health,31 poor communication skills, and high dysfunctional attitudes. This is because these women benefit from little social support and their husbands’ addiction often leads to disruption of family roles and responsibilities and an increase in their burden of responsibility along with increased pressure on them. Women with addicted spouses, instead of security and comfort, experience fear and insecurity in the family, and the inability of women to cope can affect their personal and psychological characteristics.

Conclusion

The results of this study showed that there is an inverse and significant relationship between dysfunctional attitudes and communication skills of women on the verge of divorce due to their husbands’ addiction. Therefore, treatment and counseling centers, cultural and educational centers, and families can take effective steps to improve couples’ relationships through using the study findings and increasing awareness about dysfunctional attitudes and their impact on the communication skills of women with addicted spouses.