DEPRESSION AND ANXIETY LEVEL OF HEROIN ADDICTS
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1 ISSN: DEPRESSION AND ANXIETY LEVEL OF HEROIN ADDICTS K. S. Pathak* and A. Mukhopadhyay** ABSTRACT Present investigation is an attempt to examine the affective components i.e. anxiety and depression among the heroin addicts (N=50) and its comparison with their normal counterparts (N=50). Anxiety Scale and Beck-Depression Inventory (BDI) tests were administered on both the samples of heroin addicts and normal groups. Test Scores were analysed using one way ANOVA. The results showed significant differences between heroin addicts and normal groups. Key Words: Addiction, Depression, Anxiety. Drug addiction has become an universal concern of each society to be specific and of the world in general in the past few decades. Addiction for an extended period of time often continues to set in detrimental long term diseases such as, bacterial skin infection, infection in the heart lining, liver disease, abscess, collapsed veins, etc. The nature of addiction directly hits the person leaving impact to his behavioural and social domains. Drugs that are being commonly abused are narcotics (heroin, morphine and pethedene), stimulants (cocaine, amphetamine), depressants (alcohol, sedatives), hallucinogens (LSD, PCP) and cannabis (bhang, marijuana). Heroin, the narcotics group of drug is the most practiced abuse in India and is a very serious addiction that has a high rate of mortality. Addicts are motivated to take drugs by a desire to experience the pleasure. The use of addictive drugs is increased when access to other pleasures is reduced and vice-versa. Heroin produces its sudden intense feelings of pleasure and a sense of well being and calm drowsiness that follows by * Lecturer, Department of Psychology, Dr. Ram Manohar Lohia P. G. College, Bhairav Talab, Rajatalab, Varanasi ** Professor of Psychology, Mahila Mahavidyalaya, BHU, Varanasi ,
2 76 K. S. Pathak and A. Mukhopadhyay working on the limbic system. This usually lasts for 3 or 4 hours but the after effect is the opposite which includes restlessness, agitation and cravings. Luty and Lawrence (2009) examined the rating of heroin addicts and found that they get more pleasure from children, sex, friends and goodmeal than heroin. Heroin addiction was again rated as the second most disruptive condition after lung cancer. There are many severe health concerns that coincide with heroin addiction includes the fatal overdose as well as collapsed veins injecting heroin. It has a capacity to produce physiological as well as psychological dependence. Craig (1979, 1982), Dores and Senay (1980) studied the affective aspects of heroin addicts and found that heroin addicts are generally described as anxious or depressed on personality dimension. Narayan, Shyam, Jain and Gupta (1997) studied the affective aspects of heroin addicts and found high neuroticism. De Moza (1992) observed positive correlation for the drug use with anxiety and depression. However, it do not confirm that depression and anxiety imply greater drug use. Viney, Westbrook & Preston (2006) observed shame as the chief element of anxiety that differentiated the addict group from alcoholics. The study also reported more guilt loneliness, fear of death and vague worries in the addicts than their matched alcoholic group. Lejuez and Zvolensky (2006) observed a unique association between anxiety sensitivity and heroin as the primary heroin users evidenced higher levels of anxiety sensitivity than all other groups of drug users i.e. crack/cocaine, alcohol, nicotine, marijuana and hallucinogens. In an attempt to explore the affective temperaments in heroin addiction, Marremmani et al., (2009) proposed that sensation seeking (and novelty seeking) to be the main personality characteristics of addiction. There is a common underlying mechanism to anxiety and depression (Kaneda & Fujii, 2000).The authors studied 60 normals, 15 anxiety disorder and 12 mood disorder patients and administered STAI and SDS inventories. Both state trait anxiety scores and depressive symptoms were found to be significantly higher in patients than normals. Significant positive correlations were also reported between total trait state anxiety and total depression symptom scores. Young children of substance abusers were assessed in terms of depression and anxiety. The investigation suggested that young children are at risk for certain symptoms of anxiety and depression following their parents addiction (Drucker, et al., 1997). The Present study attempts to explore the depression level and anxiety scores of heroin addicts and also the pathological anxiety of addicts. Hypotheses 1. Heroin addicts would report higher trait, state and free floating anxiety levels than their comparative normal counterparts. 2. Heroin addicts would report higher depression level than their comparative normal counterparts.
3 Depression and Anxiety Level of Heroin Addicts 77 Sample METHOD The sample of study consisted of 100 male subjects of 19 to 25 age group, heroin addicts (N=50) and normal control (N=50). The addicts were selected from Nav Chetana drug de-addiction centre, Kamachha, Varanasi (U.P.). The sample of control group was selected from different colleges of Varanasi city. The inclusion criteria for control group (the nonaddict group) was demographically matched subjects who were not habituated with any type of drug, cigarette smoking and even chewing pan or khaini. Tools Following tools were selected to test the hypotheses framed for the present study. 1. Self Evaluative Anxiety Scale (Tripathi & Rastogi, 1983). The test measures anxiety state, anxiety trait and free floating anxiety. The test contains 20 items for state, 28 items for trait and, 24 items for free floating anxiety. The reliability and validity for state anxiety, trait anxiety & free floating anxiety are.798,.892,.901 and.533,.794,.421, respectively. 2. Beck Depression Inventory - The Hindi adaptation of Beck Depression Inventory (BDI) by Arora, Kumari and Enright (1988) was chosen to assess depression. It is an undimensional instrument. This inventory measures cognitive behavioural, affective and somatic aspect of depression. It contains 20 symptoms attitude categories. One rates him self on four point levels, i.e. none(0), mild(1), moderate(2) and severe (3) depression. Procedure Subjects were selected for the sample only after their registration and diagnosis by the consultant in the rehabilitation centre. The information datasheet was filled as a first step for each case when the subjects satisfied the screening criteria, rapport was established with the subjects followed by the administration of the scales. The test first administered in order was the self evaluation scale answerable in Beck Depression Inventory was administered in the next step. The scale contain a list of certain group of statements. The subjects had to express their feelings which fitted most appropriately. RESULTS Table 1 shows the means and SDs of heroin addicts and normal controls for the three dimensions of Anxiety. The mean anxiety scores of heroin addict Journal of Indian Health Psychology
4 78 K. S. Pathak and A. Mukhopadhyay group are quite high in case of state, trait and free floating anxiety in comparison to normal group. TABLE 1 Means and SDs of state, trait and free floating anxiety scores of heroin addicts and normal controls. Group State Anxiety SD Trait Anxiety SD Free Floating SD Mean Mean Anxiety Mean Heroin Addicts n=50 Normal Group n=50 TABLE 2 Summary of analysis of variance (ANOVA) in heroin addicts and control group for anxiety Sources of Variation SS df MS F P< Anxiety State Between Group Within group Total Anxiety Trait Between Group Within Group Total Free Floating Anxiety Between Group Within Group Total Table 2 shows the F values for state anxiety, trait anxiety and free floating anxiety are highly significant. Heroin addicts thus have shown high anxiety level in comparison to control group bringing complete acceptance of hypothesis 1. TABLE 3 Means and SDs of depression scores of heroin addicts and normal group. Groups Mean SD Heroin Addicts n= Normal Group n= Mean score for the heroin addicts reflect high depression level in comparison to normal control group.
5 Depression and Anxiety Level of Heroin Addicts 79 TABLE 4 Summary of analysis of variance (ANOVA) in depression scores for the heroin addicts and normal controls. Sources of Sum of df MS F P Variation Squares Between Group Within Group Total This shows that there is significant difference between heroin addicts and normal group for depressive scores. Hypothesis 2 thus gains complete corroboration with the obtained result. DISCUSSION Anxiety and depression, the affective temperaments are possibly having some common underlying, mechanism (Kaneda & Fujii, 2000). Fieldman, Woolfolk and Allen (1995) suggested that personality psychopathology in drug addicts is associated with lower self esteem, more negative self evaluation and longer duration of use. Present study establishes that heroin addicts are more depressive and anxious than their normal counterparts. Apart from state and trait anxiety the psychopathology is being reflected through the significantly high free floating anxiety. Lejuez et al., (2006) also revealed that heroin addicts are anxiety sensitive which establishes the present outcome. Anxiety symptoms involve thoughts of the future uneasiness or distress about future uncertainties. Depression is often refered to as anger turned inward. It is a wasted negative energy which are toxic to the soul and relationships. The strong positive correlation between addiction and depression (De Moza, 1992) with its documental evidence, suggests as per current trend that addicts are motivated to take drugs by a desire to experience the pleasure (Luty & Lawrence, 2009), they are in a euphoric state of mind in which they simply become numb to any sort of emotional or physical pain sensation. Prolonged addiction problems generate anxiety or apprehension as addicts face variety of emotional, social and physiological problems such as, loss of job, broken relations, financial loss, discontinuity in studies, etc. As a concluding remark anxiety and depression, these two root causes of heroin addicts are required to be treated which contribute the addiction problem. If left untreated this may create a vicious circle and consequence will be the relapse of addictive problem. REFERENCES Arora, M., Kumari, A., & Enright, R. (1988). Adolescents stress in India. Age and Sex differences. Psychological Reports, 62, 30 Journal of Indian Health Psychology
6 80 K. S. Pathak and A. Mukhopadhyay Craig, R.J. (1979). Personality characteristics of heroin addicts. A review of the empirical literature with critique. International Journal of the Addiction, 14, Craig, R.J. (1982). Personality characterstics of heroin addicts. Review of empirical research International Journal of the Addiction, 17, De Moza, C.A. (1992). Longitudinal survey of anxiety and depression in drug users and addicts. Psychological Reports, (70), 738 Dores, W., & Senay, E.C. (1980). Depression demographic-dimensions and drug abuse. American Journal of Psychiatry, 137, Drucker, P.M., Greco-Vigorito, C., Coil, G. Moore-Russell, M., & Avaltroni, J. (1997). Depression and anxiety in young children of substance abusers. Psychological Reports, 80, Fieldman, N.P., Woolfolk, R.L., & Allen, L.A. (1995). Dimensions of self concept : A comparison of heroin and cocaine addicts. American Journal of Drug Alcohol Abuse, 21, Kaneda, Y., & Fujii, A. (2000). The relation between anxiety and depressive symptoms in normal subjects and patients with anxiety and /or mood disorder. Journal of Medical Investigation, 47, Lejuez, C.N., Paulson, A., Daughters, B., Bornovalova, M.A., & Zvolensky, M.J. (2006). The association between heroin use and anxiety sensitivity among innercity individuals in residential drug use treatment. Behaviour Research Therapy, 44, Luty, J., & Lawrence, A. (2009). Prefered activities of opiate dependent people. Journal of Substance Use,14, Marremmani, I., Pacini, M., Popovic, D., Romano, A., Marremmani, A.G., Perugi, G., Deltito, J., Akiskal, K., & Akiskal, H. (2009). Affective temperaments in heroin addiction. Journal of Affective Disorder, 44, Narayan, R., Shyam, G.K., Jain, R., & Gupta, B.S. (1997). Personality characteristics of persons addiction of heroin. Journal of Psychology, 13, Tripathi, R.R., & Rastogi, A. (1983). Manual for Self Evaluation Scale (An anxiety scale for state, trait and free floating anxiety) Varanasi, Raghuvir Sharan Publications. Viney, L.L., Westbrook, M.T., & Preston, C. (2006). Drug abuse and alcoholism sources of anxiety in drug addiction. Journal of Clinical Psychology, 41,
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