Impact on AFMs: Relationship

While negative effects of someone’s addiction on family members are common, different research findings are available regarding children, partners, or parents. This chapter is a narrative review of quantitative studies that explores if relationship status to a person with addiction results in specific forms of stress and strain for offspring, partners, and parents. Studies on the topic are mostly cross-sectional when targeting adult relatives. More longitudinal evidence is available for underage offspring. While investigations on offspring explore the impact of addiction largely in terms of psychiatric morbidity, studies targeting partners and parents focus predominantly on stressors, burden, and broader subthreshold strain. Offspring of patients with addiction are at higher risk for psychiatric disorders, including internalizing and externalizing problems and full-blown psychiatric diagnoses. Partners experience high burden and reductions in social and work adjustment. Parents frequently report negative emotional experiences, such as grief, and increased psychological distress. Both partners and parents also experience increased violence and antisocial behavior from their relatives with addiction. Only few studies compare family member’s stress and strain according to their relationship status to the relative with addiction, with relatively scarce evidence of specificities. However, family members cohabiting with the person with addiction, regardless of their relationship status, seem to be at particularly high risk of experiencing stress and strain. Critical considerations are proposed, with recommendations for future research. We conclude that routine practice in mental health care for addiction should include prevention to reduce offspring’s long-term consequences of parental addiction, and information and support for parents and partners to improve coping strategies and reduce strain.