To sum, maladaptation is the outcome of a combination of risks, such as psychological trauma, personality features, and lack of support. Trauma impacts personality development and increases the likelihood for inner fragmentation and feelings of emptiness that pose risk factors for ensuing substance problems and isolation. By accommodating the main psychoanalytic concepts under investigation into a resilience framework, this study is able to integrate intrapsychic processes with ecological dynamics. Such an approach is best suited for addressing disturbances in adolescence and for recognizing the fluidity of risks and strengths that swiftly alter pathways into positive or negative directions. Resilience model. In order to organize internal and external resilience factors it is helpful to draw upon a framework that is able to capture the interrelations of risk and protective factors, contexts, and outcomes. A framework proposed by Cicchetti and Rogosch advocates for a developmental perspective from which to assess resilience. According to this framework, risks arise whenever stage- and age-salient tasks were not mastered, so that the child progresses to the next developmental stage with a specific vulnerability. This study applies this model to the psychoanalytic account of schizoid personality and substance problems. For example, a child experiencing abuse by a family member may develop a chronic low sense of self, a general mistrust of other people,cannabis grow supplier as well as a restricted range of emotional expression preventing him from forming satisfying interpersonal relationships.
Hence, early trauma set in motion a pathway to schizoid traits, which in turn may negatively impact the subsequent developmental stage of adolescence when peer group interaction is central for mastering autonomy and individuation tasks. This framework suggests that psychological well being rests upon the successful transition through developmental stages and the mastery of stage-specific demands to develop crucial capacities. Moreover, it suggests that individuals develop along trajectories, which describe adaptive or maladaptive functioning. Importantly, individuals can change their trajectory and move from maladaptive pathways to more adaptive ones. This framework helps to explain how early traumatic experiences are vulnerabilities that may heighten the risk for developing certain personality types that isolate and emotionally detach from their surroundings. Individuals with such vulnerabilities may continue on a maladaptive trajectory toward substance problems, or, they may change their trajectory in the face of protective factors, i.e., social support. The developmental psychopathology perspective suggests a successive, hierarchical arrangement of developmental components that interact with contextual stressors placing the individual at risk for maladaptation. This does not imply that early functioning causes a particular, adaptive pathway; rather it increases the probability of a certain pathway that leads to positive outcomes. Also, different pathways can yield similar outcomes, so that adolescents with a diversity of risks and strengths can achieve similar positive outcomes, i.e., academic success, emotion regulation, self-efficacy, or negative outcomes, i.e., high school drop-out, conduct disorder, substance abuse, and delinquency. This has been termed “equifinality” whereby different pathways, processes, and personality traits lead to the same outcome. What kind of pathway an individual’s development takes depends on the interplay of biological and psychological predispositions as well as on external factors .
I believe that merging a resilience framework with a psychoanalytic model of personality is beneficial, particularly when studying youths, because it includes strengths as well as the concept of malleable trajectories. This section reviewed some of the personal and external attributes of resilience. Although those factors should not be considered in isolation of each other and of the developmental context, they represent principal factors involved in adaptation. To sum up, resilience processes describe how early traumatic experiences predispose individuals to risk factors of low ego strengths and emotion regulation difficulties. Schizoid traits may emerge as a result when adolescents prefer spending time alone and create internal self-self object experiences that make them appear self-sufficient. While examination of schizoid symptom presentation is rarely found in the criminal justice literature that tends to focus on antisocial personality types, it is of critical importance because of the high prevalence rates of mental illness for individuals with a criminal record in general . The “equifinality” of substance problems demands the expansion of the research lens to investigate other possible trajectories. From a psychoanalytic perspective the use of illicit substances serves to uphold self-regard and fill an inner emptiness that resulted from insufficient mirroring by objects. Illicit substances mimic object relations’ functions when they provide the user with experiences of merging with something omnipotent and being mirrored by something grandiose, i.e., the drug . But addiction is also looked at as the result of an attachment disorder whereby dissatisfying interpersonal relationships created an inner emptiness that leads to high levels of discomfort and distress that drugs can help soothe . People suffering from addictions generally display deficits in interpersonal functioning and have difficulty navigating mutuality, intimacy, and responsibility in their relationships . As a result, many addiction treatment programs implement opportunities for forming new, positive, and potentially corrective interpersonal relationships. Whereas experimentation with illicit substances is normative during adolescence, behaviors of hiding it or having friends and family complaining about the adolescent’s use, reflect a more serious level of risk.
Moreover, the threshold for treating vulnerable youths should include subdiagnostic substance use behaviors due to the presence of developmental pathways that have long-term consequences. The association between substance use and criminal behavior is another reason for the importance of intervening in the potentially negative trajectory of a teenager who has suffered abuse, displays schizoid personality features, and reports smoking marijuana daily or more frequently. Participants came from a cross-national sample of juveniles with a criminal history who had been recently released into their local communities. The sample was part of a national, multisite juvenile offender reentry grant awarded by the Substance Abuse and Mental Health Services Administration. I obtained permission to use crossnational data from Chestnut Health Systems and all the sites included in the analyses prior to conducting the current study. Only sites with complete data were included in the study. Fewer than 5% of the respondents had missing data on the independent variables and the outcome variable. According to Acuña and Rodriguez 5% of missing data is considered manageable and does not require sophisticated methods to handle. Entire sites for which missing data exceeded 5% were removed from the sample in order to avoid biasing results due to data not missing at random. The GAIN is a standardized, evidence-based, biopsychosocial assessment of eight areas of functioning: background, substance use, physical health, risk behaviors and disease prevention,cannabis drainage system mental and emotional health, environment and living situation, legal, and vocational . It includes over 100 scales that were normed on adults and adolescents, and it has over 1,500 questions . The GAIN’s validity has been demonstrated by multi-method studies integrating urine or saliva tests and self-report measures . Discriminant validity was assessed by using GAIN scales to predict independent and blind-staff psychiatric disorders . It has been validated for adults and adolescents as an assessment and decision-making tool for drug use behaviors, diagnosis, treatment planning and allocation . In regard to adolescents, the GAIN scales’ internal reliability is acceptable to excellent . Predictors. Severity and type of historical abuse were measured by two sub-scales of the General Victimization sub-scale of the GAIN . The GVS is a 15-item self-report measure developed to asses past and current abuse; the two selected sub-scales capture past abuse only including type of abuse and number of traumagenic factors. All 10 items of the two sub-scales were dichotomously coded with 1 = yes and 0 = no. The GVS has good internal consistency, r = .88 . Higher scores indicate a more severe trauma history. Because of low item endorsement for two questions about sexual abuse, only eight of the ten trauma items were selected; those were: “was ever attacked with a weapon,” “was ever beat to the point it left bruises,” “was ever emotionally abused,” “did previous trauma happen for several times,” “did previous trauma occur with more than one perpetrator involved,” “was a person of trust involved in previous trauma,” “you were afraid for your life,” and “did people told about previous trauma not believe you.” In the current study the eight items had good internal consistency, r = .78. Schizoid personality traits were assessed using the Cautious Personality Index , a sub-scale of the Personality Coping Style Scale of the GAIN. The CPI consists of six items rated dichotomously where 1 = yes and 0 = no, and it assesses the extent to which the participant handles emotional issues by avoidance, distrust, or escaping.
Items were: “could not trust people,” “rather than mad, get even,” “tried to space out world,” “didn’t care to be around people,” “not emotional about people,” and “afraid you were crazy.” The CPI corresponds with criteria of the schizoid type outlined in clinical case studies presented in the preceding section. In previous empirical studies the CPI has been used to evaluate the interpersonal relationship in therapy, also called working alliance. In this study the CPI had good internal consistency, r = .73. Social support was measured by the General Social Support Index that counts the number of sources of social support identified by the participant including professionals, family, friends, school mates or work colleagues over the past 12 months. Higher scores on this variable indicate a greater number of social supports. Items include: “a professional counselor or other health provider to talk to,” “friends or colleagues from other companies or schools you could talk to without worry about things getting back to others at work or school,” “people at work or school you could talk to about day-to-day things,” “people at work or school who could help you get your assignments done,” “family members or close partners you could talk to and rely on,” “friends you could just hang out with and not talk about work or family issues,” “a hobby or activity that you enjoyed and did for yourself,” “someone you felt like you could talk to about needs and emotions,” “someone you felt could help you figure out how to cope with any problems you were having or might have.” All nine items were dichotomously coded by 1 = yes and 0 = no. The GSSI has been used in studies on therapeutic alliance where individuals with more social support reported closer connections with their therapist . Internal consistency of the GSSI in this sample was good . Outcome. Substance problems were measured by the Substance Issues Index lifetime , a sub-scale of the Substance Problem Scale Lifetime . The SPSL was previously shown to have good internal consistency for adolescent respondents, r = .90 . For this sample, the SIIL had good internal consistency, r = .71. The SIIL was measured at intake; participants were asked about recency of drug use, with higher values reflecting more recent use, and thus a worse outcome. The SIIL counts symptoms of substance related problems, including two items on substance-induced health and psychological problems, and three items on severity symptoms of use . The first three questions are commonly used in alcohol and drug screeners. A list of all the items can be obtained from the Appendix. Each item was continuously rated on a 4-point Likert scale where 0 = never, 1 = more than one year ago, 2 = 2-12 months ago, and 3 = past month. This outcome measure was conceptualized as a resilience construct, so that current struggles with substance use represent a maladaptive outcome, and fewer struggles indicate an adaptive outcome. For research question two a confirmatory factor analysis was run using Mplus 6.0 . Because the factor structures of trauma, social support, schizoid personality, and substance problems were adopted from existing scales, an exploratory model was unnecessary. The mean- and variance-adjusted weighted least squares estimation method was used, which is a default in Mplus for analyzing categorical variables. In general, weighted least squares is an estimator that has a fit function weighted by variances, covariances, and kurtosis. It requires a large sample size . Additionally, the WLSMV can be used to estimate regressions for both, binary and continuous factor indicators . Model fit for CFA and the subsequent structural analysis was evaluated referring to fit statistics , significance of path coefficients, parsimony, and alternative models based on theoretical underpinnings.