Family Functioning and its Association with Alcohol Use Disorder among Adolescents in Southwestern Uganda: A Cross-Sectional Study
Abstract:
This study investigates
the association between family functioning and the severity of alcohol use
disorders (AUD) among adolescents in Southwestern Uganda. Focusing on
dimensions such as family cohesion, adaptability, communication, and
satisfaction, the research explores how familial relationships and
sociodemographic factors influence adolescent alcohol use. A cross-sectional
study was conducted from September to December 2019 in Ibanda District,
involving 308 adolescents aged 10 to 19 years. Participants were selected
through multistage sampling, and data were collected using the Alcohol Use
Disorders Identification Test (AUDIT) and the Family Adaptability and Cohesion
Evaluation Scale IV (FACES IV). Ordered logistic regression was used to assess
predictors of AUD severity. The findings revealed that 21.1% of participants
were classified as hazardous drinkers, 9.1% as harmful drinkers, and 9.7% as
dependent drinkers. Higher levels of family cohesion were associated with
increased odds of more severe AUD classification (OR = 1.14, p<0.001), suggesting possible
enabling or permissive dynamics in certain family contexts. In contrast, higher
levels of adaptability (OR = 0.79, p<0.001) and satisfaction (OR = 0.82, p= 0.003) were protective
against severe alcohol use. Additionally, lower household income, non-nuclear
living arrangements, and unstable family structures were significantly
associated with greater AUD severity. These findings underscore the critical
role of family dynamics and socioeconomic conditions in shaping adolescent
alcohol use behaviours. The study highlights the need for family-centred and
context-sensitive interventions that strengthen adaptability and satisfaction
within the family unit, while also addressing underlying structural
vulnerabilities.
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