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ROLE OF PARENTING STYLE AND FAMILY SUPPORT IN READINESS TO CHANGE CANNABIS USE AMONG YOUNG ADULTS

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CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

According to 2010 report of the United Nations on drugs and crime estimated that between 155 and 250 million people approximately or 3.5% to 5.7% of the world population aged 15-64 have used drugs at least once in the last 12months, There is increasing trend in psychoactive substance use and abuse in African countries (Adelekan, Ndom, Makajuola, Parakoyi, Osagbemi, Fabgemi, & Pute 2000 and Ready, Resnicow, Omardien, & Kambara, 2007). In this trend, cannabis use and abuse is taking its fair share and mostly young adults are trapped down in the mess.

This trend seems to be very common or conversant during adolescent period spanning though early adulthood and causing social, physical, health, and mental complications; previous empirical studies indicate that both males and females engage in the use of cannabis (World Drug Report, 2008). Nigeria for example, where cannabis abuse was uncommon many decades ago, there is today ample visual evidence of cannabis use on the roadsides and motor parks of most urban centers where young adults could be seen using cannabis (Rasheed & Ismaila, 2010). These increased usage, no doubt has a number of implications. Cannabis use and abuse has continued to increase both social and public health issues.

World Drug Report (2008) statistics held that about 200,000 peoples die from drug use worldwide, affecting not only drug user but also the family members, friends, co-workers and communities. Drug use (including the use of illicit drugs, alcohol, tobacco, and marijuana/cannabis etc.) is widespread and this wide distribution increases the burden of disease related and behavior related drug use problem. According to World Health Organization Global status report on marijuana and health, the harmful use of marijuana (cannabis) is a causal factor in 60 types of diseases and injuries, resulting in appropriately 15 million deaths every year. These death make up almost 3% of all death worldwide e.g. marijuana has been indicated to be responsible for 5 million deaths annually, for most  European and Asian countries, opiates continue to be the main drug of abuse and account for 62% of all treatment demand, in south America, drug related treatment continues to be mainly linked to the use of cocaine (59% of all treatment demand), but in African, the bulk of all treatment demand is link to cannabis 64% (WHO, 2004).

Cannabis, commonly known as marijuana and numerous other names (India hemp, ganja, bush, igbo, we-we, gbanaa, hashish etc.), is a preparation of the cannabis plant intended for use as a psychoactive drug and as medicine (Harcout, 2007). Pharmacologically, the principle of psychoactive constituent of cannabis is tetrahydrocannabinol, it is one of the most 283 known compounds in the plant (Russo, 2013) including at least 84 other cannabinoids, such as cannabidiol, cannabinol, tetrahydrocannabivarin, (El-Aify, Ivery, Robison, Ahmed, Radwan, Slade, Khan, Elsohly & Rossb, 2010) and cannabigerol according to United nation of drug commission UNODC (2009). The three main forms of cannabis products are the flower, resin (hashish) and oil (hash oil). The UNODC (2009) states that cannabis flower is often 5%tetrahydrocannabivarin, (THC) content, resin can contain up to 20% THC content while, cannabis oil may contain more than 60% THC content.

Cannabis is being consumed in many different ways (Golubi, 2012): smoking, which typically involves inhaling vaporized cannabinoids (smoke) from small pipes, bongs (portable versions of hookahs with water chamber), paper-wrapped joints or tobacco leaf-wrapped blunt, roach clips and other items (Tasman, Kay, Lieberman, First & Maj, 2011). It has a proactive and physiological effects when consumed (Conaivi, Sugiura, & Marzo, 2005). The immediate desired effects of consuming cannabis include relaxation and mild euphoria (the “high or stoned” feeling), while some immediately undesired side-effects include a decrease in short-term memory, dry mouth, impaired motor skills and reddening of the eyes, feeling of paranoid or anxiety (Hall & Paula, 2003). Aside from a subjective change in perception and mood, the most common short-term physical and neurological effects include increased heart rate, increased appetite and consumption of food lowered blood pressure, impairment of short-term or working memory, (Mathre, 1997; Riedel & Darvies, 2005), impaired psychomotor co-ordination and concentration.

Other ways of using cannabis is as recreational or medicinal drug, and as part of religious or spiritual rites. The medicinal value of cannabis is disputed; the American Society of Addiction Medicine (2005) dismisses the concept of medical cannabis because of concerns about its potential for dependence and adverse health effects and that significant aspect such as content, production and supply are unregulated. The FDA approves of the prescription of two products (not for smoking) that have pure THC in a small controlled dose as the active substance (Scholastic, 2012).

Cannabis use became a public health issues in Nigeria in the 1960s with the discovery of cannabis farm in the country, arrests of Nigeria cannabis trafficker abroad, and reports of psychological disorders suspected to be associated with cannabis use, (Obot, 2003). By the 1980s the abuse of cocaine and heroin was added to the public health burden Soldiers and the sailors returning from Second World War introduced cannabis in Nigeria (Obot, 2003). The most abused illicit drug in Nigeria is India hemp mainly in its herbal form. This is due to the fact that cannabis is home grown and relatively cheap, the price of one unit of cannabis is often about the same as that of a bottle of beer (UNODC, 2013). At 14.3%, the country has the highest one year prevalence rate of cannabis use in Africa (UNOGC, 2011, Onifade, Somoye, Ogunwale, Akinhanmi, &Adason, 2013).

The burden of use and effects of marijuana and other psychoactive substances on the youth is assuming a dangerous dimension (Eneh, 2004; Pela, 1989 and Stanley & Saline 1991). In a study by Eneh (2004) among secondary schools students in River State Nigeria, the prevalence rate of cannabis use was found to be 20%. However, like study among young adult and high school in Zambia and Santiago Chile bad prevalence rate of 10% and 7.3% respectively (Haworth 1982: Florenzo, Mautelli, Madrid, Martini & Salazar, 1982).

In a neurological study by Albert, Bhattacharyya, Yucel, Poli, Crippa, Nogue, Torrens, Puyol, Farre and Santors, (2013) comparing different structural and functional imaging studies showed morphological brain alteration in the long-term cannabis users which were found to possibly correlate to cannabis exposure, further more study by Santors, Fagundo, Crippa, Atakan, Bhattacharyya and Allen (2010) found resting blood flow to be lower globally and in prefrontal areas of the brain in cannabis users, when compared to non-users. It was also shown that giving cannabis correlate with increased blood flow in these areas, and facilitated activations of the anterior cingulated cortex and frontal cortex when participants were presented with assignment demanding use of cognitive capacity. Both reviews noted that some of the studies that they examined had methodological limitations, for example, small sample size, or not distinguishing adequately between cannabis and alcohol consumption.

Within the treatment field, there is growing recognition that individuals vary in their readiness to change (Carey, Purnine, Maisto&Carey, 1999A). For instance, Prochaska, Diclements & Norcross (1992) have provided a useful heuristic for understanding varying levels of motivation for change, within their trans-theoretical model, they represent the continuous and cyclic process by which people change addictive behaviors as Pre-contemplation, Contemplation, Preparation for action and Maintenance. It is noted that the vast majority of persons addicted to substance are not in the action stage (Prochaska & Diclements, 1992). Even persons admitted to alcohol and drug treatment programs vary in their level of motivation for change (Diclement, & Hughes, 1990).

Readiness to change may be considered a motivational state that is strong influence by cognitive, affective, environmental and interpersonal events (Diclemente, 1993). In addition, the notion of decisional balance (eg, subjective pro and cons or benefits and cost of certain behavior) has been identified as a related construct that is a sensitive marker of normal movement through the early stages of change (Prochaka, Velicier & Rossi, 1999a). It is important to distinguish between readiness to change and motivation for change.

Readiness to change is the overarching construct motivation for change and can be considered an internal cognition, affective state considered necessary for behavior change (or maintenance of change). Motivation to change, on the other hand, can be considered a broader construct, reflecting a number of factors that combine to indicate the likelihood that someone will begin (continue) to engage in behavior associated with cannabis use reduction (eg, including therapy, self-initiated quit attempts, or other behavior in support of reduced use) (Carey, Purnine, Maisto, Carey & Barnes 1999b). Readiness to change, therefore includes motivation for change as well as other factors, Relevant behavioral skills and barriers may be presumed to affect motivation, through various paths e.g, a patient may be more likely to engage in change related behaviors if he/she willing to change and if he/she has acquired the skills that make success more likely and he/she receives support and reinforcement from change efforts, a person with low motivation and few resources may first benefit from a motivational intervention, followed by skills training (Carrol,1998).

It is estimated that approximately one in six problem cannabis user accesses treatment each year (United Nation on Drug and Crime, 2014). However there are large regional disparities, with approximately 1 to 8 problem drug users receiving treatment in African (primarily for cannabis use), compared to one in five problem drug users receiving treatment in western and central Europe, one in four in Oceania and one in three in north America, (United Nations on Drugs and Crime, 2014).

The present study seeks to examine the contribution of role of parenting style and family support in readiness to change cannabis use among young adults. Within the field of addictive behaviors, a growing number of studies have assessed efficacy of parenting style based on interventions for problematic substance use (Chiesa & Serretti, 2013). Neurobiological mechanisms in areas associated with craving, negative effect, and substance use relapse may be affected by parenting style of training (Witkiewits, Lustyk, & Bowen, 2012) altering basic neurological process related to reactive behaviors (Brewer, Elwafi & Davis, 2012).

Parenting style is a psychological construct representing standard strategies that parents use in their child rearing. The quality of parenting can be more essential than the quantity of time spent with the child. For instance, a parent can spend an entire afternoon with his or her child, yet the parent may be engaging in a different activity and not demonstrating enough interest towards the child. Parenting styles are the representation of how parents respond to and make demands on their children. Parenting practices are specific behaviors, while parenting styles represent broader patterns of parenting practices.

Darling and Steinberg (1993) in Spera (2005)suggest that it is important to better understand the differences between parenting styles and parenting practices: “Parenting practices are defined as specific behaviors that parents use to socialize their children”, while parenting style is “the emotional climate in which parents raise their children”.

Baumrind (1967) considered four basic elements that could help shape successful parenting: responsiveness vs. unresponsiveness and demanding vs. undemanding. Parental responsiveness refers to the degree to which the parent responds to the child’s needs in a supportive and accepting manner. Baumrind identified three parenting styles: Authoritative parenting, authoritarian parenting and permissive parenting. Baumrid (1996) described three styles as follow:

  • The permissive parent: attempts to behave in a non-punitive, acceptant and affirmative manner towards the child’s impulses, desires, and actions (e.g. poor emotion regulation etc.). The parent is responsive but not demanding. Children of permissive parents may tend to be more impulsive and as adolescents may engage more in misconduct such as cannabis use (Osorio, Alfonso, González-Cámara and Marta, 2015).
  • The authoritarian parent: attempts to shape control and evaluate the behavior and attitudes of the child in accordance with a set standard of conduct, usually an absolute standard, theologically motivated, and formulated by a higher authority, the parent values obedience as a virtue and favors punitive, forceful measures to curb self-well at points where the child’s actions or belief conflict with what she think is right conduct (Anxious, withdrawn, and unhappy disposition etc). The parent is demanding but not responsive. Children raised by authoritarian parents tend to be conformist, highly obedient, quiet, and not very happy, these children often suffer from depression and self-blame.
  • The authoritative parent: attempts to direct the child’s activities but in a rational, issue oriented manner. The parent is demanding and responsive.Authoritative parents will set clear standards for their children, monitor the limits that they set, and also allow children to develop autonomy. They also expect mature, independent, and age-appropriate behavior of children. Punishments for misbehavior are measured and consistent, not arbitrary or violent (1996:889).

1.2 Statement of Problem

Cannabis use in Nigerian Society has become an issue of serious concern and constitutes one of the most important risks taking behavior among young adult. According to Boryelt, Franson, Nassbaum and Wang (2013), safety concerns regarding cannabis use include the increased risk of developing schizophrenia with adolescent use, impairment in memory and cognition, accident pediatric ingestions and lack of safety packaging for medical cannabis formulations. The same thing implies Gordon and Conley (2013) report that exposure to cannabis have biologically-based physical, mental, behavior and social health consequences and was associated with diseases of the liver (particularly with co-existing hepatitis C), lungs, heart and vasculature.

In the area covered by the present study- Enugu metropolis, there are many cannabis users almost in all the layouts, streets and suburbs irrespective of the continual outlook of the law enforcement agencies National Drug Law Enforcement Agencies (Police and NDLEA) for them. Almost everybody within places like Abakpa, Emene, Obiagu, Thinkers’ Corner, Ugwuaji fly-over axis, Monarch, Achalla Layout, New Haven Extension/Old Artisan, ESUT axis of Independent Layout and many other places have either a personal or learned story to tell about the menace of cannabis (“igbo”) users.

The series of problems associated with the use of cannabis have raised serious concern for awareness and treatment. Notwithstanding the worldwide concern and education about cannabis uses (the effects to both the person and the society at large), many users have limited awareness of their abuses’ consequences (Eneh, 2004) and very few of the users assess treatment or develop the willingness to assess treatment. This raises research concern for the evaluation of social factors that can influence young adults’ readiness to change from the use of cannabis and hence the drive of the present study. There is need to see the position of the behaviors of authority figures in the home (parents) and the support perceived to come from all the component members of the home in pushing or motivating young adults to engage in the change process from the use of cannabis.

Specifically, the present study intends to address the following problems.

  1. Would role of parenting style significantly influence readiness to change cannabis use among young adults?
  2. Would family support significantly influence readiness to change cannabis use among young adults?

1.3 Purpose of the Study

  1. Examine whether parenting style (authoritative, authoritarian and permissive) of the father will influence readiness to change cannabis use among young adults.
  2. Examine whether parenting style (authoritative, authoritarian and permissive) of the mother will influence readiness to change cannabis use among young adults.
  3. Examine whether level of family support will influence readiness to change cannabis use among young adults.

1.4 Operational Definitions Of Terms.

Parenting style: parenting style represent the overall climate of parent child interactions or standard strategies that parents use in their child rearing measured using the Parental Authority Questionnaire by Buri (1991) which was developed in line with the Baumrind’s three dimension of

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