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Pre15-14 – International Drug Prevention And Rehabilitation Conference (Prevent 2015)
STUDY ON SERIOUSNESS OF ADDICTION AND AGGRESSIVE BEHAVIOUR INFLUENCED BY TYPE OF DRUGS AND DURATION OF ADDICTION AMONG
INMATES IN CURE AND CARE REHABILITATION CENTRE, PAHANG.
Suhaizak bin Ab. Wahab1, Mohd Faizal bin Mat Yaacob2 , Rozana binti Arjo3, Mohd Rizam bin Surani4
ACREDA
Universiti Sains Islam Malaysia
Abstract: seriousness of addiction and aggressive behaviour is the key factor to predict the success of the inmates undergoing rehabilitation in the centre thus to prevent relapse after completing rehabilitation program. This study is to measure the level of seriousness of addiction and the level of aggressiveness for each study are using Drug Abuse Screening Test (DAST-20) and Aggressive Questionnaires (AQ).
A total of 213 respondents from 4 drug rehabilitation centre in Peninsular Malaysia were chosen using random sampling. Data were analysing using descriptive analyses. Results demonstrated that majority of the respondents are in the moderate and severe addiction. Whereas as far as aggressive are concerned, majority of respondents are vulnerable for aggressive behavior. The result also demonstrated that seriousness of addiction are correlated with the aggressive behaviour of the inmates.
Keywords:
Seriousness of Addiction and Aggressive Behaviour
Introduction
In Malaysia, drug has been considered as the major enemy in 1890s and ever since then, the fight against drugs was conducted aggressively by widening the awareness scope at all age level Error! Reference source not found..
Based on the National Drug Agency of Malaysia, statistics showed that both gender were involved in the addiction, however male gender were the group that abused drug the most. This can be supported by statistics from AADK showing that the number of drug addicts detected from 2009-2013 stated that most of the drug abuse are among male (Chemi, Abdullah, Singh, Fadzli, & Isa, 2014). According to the 2013 statistic the most familiar substance abused by addicts were Heroin (3509), Morphine (2446) and followed by Marijuana (1255). This types of
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substance are giving difference effects of aggressiveness and leave different effects on seriousness of addiction.
The importance of study on seriousness of addiction and aggressive behaviour of inmates are the key point to determine the success of the rehabilitation program. As far as the rehabilitation program are concerned, it is the major consideration in determine the rate of relapse among the inmate after release from the centre Error! Reference source not found.. Thus, to determine the success of rehabilitation program and to reduces rates of relapse, it is crucial for every rehabilitation centres to assess the state of addiction and aggressive behaviour of the inmates at the first place. There are several factor contribute to the failure of rehabilitation that cause relapse among the addicts in the centres. The factors are because of ineffective screening and assessment during the admission of the addicts. (Chemi et al., 2014). This ineffectiveness will definitely will cause inappropriate of addressing treatment module for the clients that contributes to the failure of the rehabilitation program.
The purpose of the study is to identify the seriousness and aggressiveness of addiction among inmates in CCRC (Cure and Care Rehabilitation centre) in Pahang. This study is using Drug Abuse Screening Test (DAST-20) and Aggressive Questionnaires (AQ) as instruments. A total of 213 male respondents from 3 drug rehabilitation centre in Peninsula Malaysia were chosen using random sampling.
Research Question
Do type of drugs and duration of addiction influence seriousness of addiction and aggressiveness among inmates in Cure and Care Rehabilitation Centre (CCRC) Pahang? More specifically, the research objectives are:
1. To measure the seriousness of addiction among inmates in Cure and Care Rehabilitation Centre (CCRC) Pahang.
2. To compare the mean of the seriousness of addiction based on types of drug abused among inmates in Cure and Care Rehabilitation Centre (CCRC) Pahang.
3. To measure the aggressiveness among inmates in Cure and Care Rehabilitation Centre (CCRC) Pahang.
4. To compare the mean of aggressiveness based on duration of addiction among inmates in Cure and Care Rehabilitation Centre (CCRC) Pahang.
5. To investigate relationship between seriousness of addiction and aggressiveness among inmates in Cure and Care Rehabilitation Centre (CCRC) Pahang.
Methodology Research design
In this cross-sectional correlational field study, data on the two independent variables and two dependant variables were collected from two hundred and thirteen inmates located in 3 rehabilitation centre in Pahang through personal administered questionnaires.
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Population and Samples
The population for the study comprised all male inmates in the state of Pahang. Then through a simple random sampling procedure, 3 rehabilitation centers from the state were being selected.
Data were collected from all inmates in each rehabilitation centers so chosen. The total sample size was 213 from CCRC Sungai Ruan (n = 80), CCRC Karak (n=50) and CCRC Gambang (n=83). The unit of analysis was the individuals who responded to the survey. Their ages ranged from 26 to 45. Most of the respondents are Malays which is 84.4%. From 213 respondents, majority of them are single which represents 65.3% of the respondents. Majority of respondents’ level of education is Sijil Pelajaran Malaysia (SPM) which is 91.6%. From the total respondents, 86.3% was entered the rehabilitation centre for twice or less and 82.2% are opioid substance abuser 82.2%.
Instruments
A questionnaire was consisted of 3 parts namely Demographic, Drug Abuse Screening Test (DAST-20) and Aggressive Questionaires (AQ).
1) DAST-20
The Drug Abuse Screening Test (DAST) was designed by (Skinner, 1982) to provide a brief instrument for clinical and non-clinical screening to detect drug abuse or dependence disorders. It is most useful in settings in which seeking treatment for drug use problems is not the patient's stated goal. The DAST provides a quantitative index of the severity of problems related to drug abuse other than alcohol. DAST scores are highly convincible with respect to a DSM (Diagnostic Statistical Manual) diagnosis of psychoactive drug dependence. Previously, DAST-10 was selected in 2012 by a group of researchers from the National Drug Abuse Treatment Clinical Trials Network (CTN) to serve as the recommended assessment tool for use in general medical settings Error! Reference source not found..
2) AGGRESSIVE QUESTIONAIRES (AQ)
The Aggression Questionnaire (sometimes referred to as the AGQ or simply the Aggression Questionnaire) was designed by Arnold Buss and Mark Perry, professors from the University of Texas at Austin in a 1992. It is a 29 item questionnaire where participants evaluate themselves by certain statements along 5 point continuum from "extremely uncharacteristic of me" to "extremely characteristic of me." The scores are normalized on a scale of 0 to 5, with 5 being the highest level of aggression. The questionnaire returns scores for 4 dimensions of aggression Physical Aggression, Verbal Aggression, Anger and Hostility. However in our research the score are sum up altogether and relabelled as Low, Medium and High.
Reliability
The most popular test of reliability is the Cronbach’s coefficient alpha(Cronbach & Meehl, 1955). The higher the coefficients, the better the measuring instrument. The reliability of instruments used in this study is as below:
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Table 1 Reliability for DAST-20 Originality
Reliability
Current Reliability
Cronbach’s Alpha N of items Cronbach’s Alpha N of items
0.92 20 .759 20
Refers to Table 1, the reliability for current study is acceptable (0.7)Error! Reference source not found..
Table 2 Reliability for AQ Originality
Reliability
Current Reliability
Cronbach’s Alpha N of items Cronbach’s Alpha N of items
0.94 29 .870 29
Refers to Table 2, the reliability for current study is strong (0.8) (Cavana et al, 2001) Results
1. To measure the seriousness of addiction among inmates in Cure and Care Rehabilitation Centre (CCRC) Pahang.
According to the Drug Abuse Screening Test (DAST-20), there are three categories of seriousness level of drug addiction. The three categories was based on the below indicated score.
Table 3 Categories of seriousness level of drug addiction
Category Score
Low level 1 to 6
Moderate level 7 to 15
Severe level 16-20
Figure 1 Frequency of Level of Seriousness of Drug Addiction
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Figure 1 shows the results of a frequency analysis in a bar chart. From the bar chart, it shows that 124 respondents were categorizing under moderate level which represent 58.2% of the total respondents. It was followed by 84 respondents were categorizing under severe level and 5 respondents were categorizing under low level. The percentage for both severe and low is 39.4% and 2.3% respectively.
2. To compare the mean of the seriousness of addiction based on types of drug abused among inmates in Cure and Care Rehabilitation Centre (CCRC) Pahang.
Group Statistics
Types of drug N Mean Std. Deviation Std. Error Mean
Seriousness of
addiction
Opioid 175 14.2514 3.50774 .26516
Non-opioid 38 12.9474 4.02658 .65320
Figure 2 Independent samples test
t-Test for Equality of Means Levene’s
Test for Equality of
Variances
95% Confidence Interval of the
Difference
F Sig t df Sig
(2- tailed)
Mean Difference
Std. Error Difference
Lower Upper
Seriousnes s of addiction
Equal variances
assumed
3.35 9
.068 2.02 2
211 .044 1.30406 .64503 .03253 2.5755 9
Equal variances
not assumed
1.85 0
49.911 .070 1.30406 .70497 -.11197 2.7200 9
Data was analyzed using SPSS package and the output appears as Figure 2. For an independent sample t-test, two tables are generated by SPSS. The first contains the descriptive statistics for each of the variables tested. This table shows that the average for opioid is 14 and the average for non-opioid is 12, which certainly indicates that the drug addicts for opioid type were more than the drug addicts for type non-opioid.
We also notice from the SPSS output (group statistics table) that the standard deviations for opioid and non-opioid are about the same, hence the variance (the standard deviation squared) are also similar. This is confirmed by the Levene’s test for equality of
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variances (p=0.068, which is greater than 0.05) (Cavana et al, 2001). Hence, we can use the results for the t-test with equal variances assumed.
3. To measure the aggressiveness among inmates in Cure and Care Rehabilitation Centre (CCRC) Pahang.
According to the Aggressiveness Questionnaire (AQ), there are three level of aggressiveness which is low, medium and high. Below are the level of aggressiveness and the indication of score presented in Table 2.
Table 4 Level of aggressiveness for drug addicts Level of aggressiveness Score
Low 1-48
Medium 49-97
High 98-145
Figure 3
Figure 3 shows the results of a percentage analysis in a pie chart. From the pie chart, it shows that 81.2% were categorizing under medium level of aggressiveness. It was followed by high level of aggressiveness which is 14.1% and low level of aggressiveness is 4.7%.
4. To compare the mean of aggressiveness based on duration of addiction among inmates in Cure and Care Rehabilitation Centre (CCRC) Pahang
Group Statistics Duration of
Addiction
N Mean Std.
Deviation
Std. Error Mean Level of
Aggressive ness
5 years and below
116 79.1810 17.75515 1.6452
6 years and above
97 79.0000 19.02411 1.93161
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Figure 4 Independent samples test
t-Test for Equality of Means Levene’s
Test for Equality
of Variances
95% Confidence Interval of the
Difference
F Sig t df Sig
(2- taile
d)
Mean Differen
ce
Std.
Error Differen
ce
Lower Uppe r
Level of Aggressi
ven-ess
Equal varianc
es assume
d
.01 7
.89 8
.07 2
211 .943 .18103 2.52380 4.79405 5.156 12
Equal varianc es not assume
d
.07 1
198.
755
.943 .18103 2.53944 4.82666 5.188 73
We have analysed the data with the SPSS package and the output appears as Figure 4.
For an independent sample t-test, two tables are generated by SPSS. The first contains the descriptive statistics for each of the variables tested. This table shows that the average for 5 years and below is 79.2 and the average for 6 years and above is 79, which certainly indicates that the duration of addiction among 5 years and below are slightly higher than the duration of addiction among 6 years and above group.
We also notice from the SPSS output (group statistics table) that the standard deviations for 5 years and below and 6 years and above are slightly different. This is confirmed by the Levene’s test for equality of variances (p=0.898, which is greater than 0.05) (Cavana et al, 2001). Hence, we can use the results for the t-test with equal variances assumed.
5. To investigate the relationship between seriousness of addiction and aggressiveness among inmates in Cure and Care Rehabilitation Centre (CCRC) Pahang.
Table 5
Addiction Aggressiveness
Addiction Pearson Correlation 1 .146
Sig. (2-tailed) .033
N 213 213
Aggressiveness Pearson Correlation .146 1 Sig. (2-tailed) .033
N 213 213
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Based on Table 5, the numeric values for the Pearson Correlation Coefficient is 0.146.
SPSS output indicates that the relationship between seriousness of addiction and aggressiveness was correlated among inmates in Cure and Care Rehabilitation
Centre (CCRC) in Pahang.
DISCUSSION
Seriousness of addiction
Research finding shows that the majority of the inmate are in the moderate level of addiction during the research is conducted. Most of them are among the inmates who used to enter rehabilitation centre not more than twice and majority of them are opioid type drug user. Therefore seriousness of addiction are interrelated with the types of drug used where most of the inmates are in vulnerable for aggressive behaviour and most of them are opioids user. The use of heroin and morphine (opioid) was also the most dangerous of drugs with a higher potential to cause an addiction
Rehabilitation program that going to be conducted in the rehabilitation centre should take into account the inmate seriousness level of addiction. This will assist counsellor to establish good interaction between them. This would also be an indication for the counsellors to predict the relapse rate of the centre. For the example, if the level of addiction is severe, therefore the relapse rate would higher. The seriousness of addiction also reflects the motivational level of the inmates during rehabilitation program. Therefore, if level of addiction is lower, inmates level of motivation would be higher and lower the risk of relapse among the inmates. This will indicate the ability of inmates to remain abstinence throughout his life. Although it is beyond the centre’s control, it is preferable if the inmates admitted in the rehabilitation centre are in moderate or low level seriousness of addiction.
Aggressiveness of inmates
Research finding shows that majority of client are in the moderate aggressiveness and majority of them were involved in the drug addiction not more than five years. This indicates it just only take within 5 years to put the addicts are in the state of aggressive behaviour. It may influence the ability of inmate rehabilitation process and rehabilitation centre. The aggressiveness level will reflect the tendency to be aggressive of inmate during rehabilitation program, it may even induce the tendency of suicide, self-harm and harming others .
According to the research, it is proven that substance-related factors and aggressiveness were factors to commit suicide among inmates (Hawton & van Heeringen, 2009) as well as self-harm (Skegg, 2005). The study will help rehabilitation authority to come out with contingency plan and precaution when aggressive behaviour of the inmates were properly addressed and attended the aggressiveness level might reflect inmates concerns and openness in accepting rehabilitation planned for them. The openness will secure the effectiveness of the rehabilitation plan.
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Therefore every rehabilitation centres, mostly CCRC Pahang, should alerts and pay extra attention if their inmate are having serious aggressive behavior. The centre’s authority should play extra role especially in creating treatment plan to reflect their aggressiveness level. The important of the accurate treatment plan will reduce the negative risk behaviour of inmates such as escaping, quarrelling, ignoring orders or even worse vandalism on the centre done by inmate.
However a finding also shows that types of drug were interrelated with aggressive behaviour of respondent. This is supported by Boles that range of drugs, particularly cocaine and amphetamines (including methamphetamine) are associated with increased violent and aggressive behaviours Error! Reference source not found.
and (Hoaken & Stewart, 2003). Meanwhile, the effect of some drugs including cocaine, amphetamines and benzodiazepines have been found to increase violence and aggressive behaviours and can also influence them negatively when they are seeking employment opportunities (Fauziah et al., 2011)
CONCLUSION
It is important for the centres management to evaluate and assess the seriousness of addictions and the aggressiveness of the inmate during their pre-administration. This is because most of the inmate who had entered the centre is in the state of dissatisfaction with the court order at the first place. This dissatisfaction will always inflict the tendency to be aggressive while in the centre, with additional level of addiction it will leave the centre at risks. It should be noted from the finding that aggressiveness and seriousness addiction are correlate each other. National Anti-Drug Agency should start to find an alternative treatment plan to address these two issues.
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Reference
Abdul Ghafar, T. (2005). Joint War Against Drugs. Sri Kenanga Sdn Bhd Publisher.
Baron, R. A., & Richardson, D. (1994). Human aggression. Plenum Pres.
Berman, M., Gladue, B., & Taylor, S. . (1993). The effects of hormones, Type A behavior pattern, and provocation on aggression. Motivation and Emotion, 125-138.
Boles M., & Miotto K. (2003). Aggression and Violent Behavior. Substance use and violence: A review of the literature, 55-174.
Cavana R.Y, Delahaye B.L, Sekaran U. (2001). Applied Business Research: Qualitative and Quantitative Methods. New York: John Wiley & Sons.
Coie, J. D., & Dodge, K. A. (2000). (2000). Aggression and antisocial behavior. In W. Damon (Series Ed.) & N. Eisenberg (Vol. Ed.). Handbook of child psychology, 29-37.
Fauziah Ibrahim, Mustaffa Omar, Lukman Zawawi Mohamad, Khadijah Alavi, Norulhuda Sarnon, Salinan Nen & Nasruddin Subhi. (2011). Employement Barriers Against People with Drug Use History. Pertanika Journal of Social Sciences & Humanities, 109-114.
HA, S. (1982). The Drug Abuse Screening Test. Addict Behavior, 363-367.
Hughes, K., Bellis, M. A., Calafat, A., Juan, M., Schnitzer, S., & Anderson, Z. (2008).
Predictors of violence in young tourists: A comparative study of British, German and Spanish holidaymakers. European Journal of Public Health, 569-574.
Jamaludin, H. A. (2007). Modul & kaunseling penyalahgunaan dadah. Serdang Universiti Putra Malaysia.
Journal, M. L. (2014). Prison Acts 1995. Kuala Lumpur: MLJ.
Lesley, W. R., Elifson, & Sterk, C.E. (2007). Hug Drug or Thug Drug? ecstacy use and agressive behavior. Violence and Victims, 22(1), 104-119.
Mahmud Mazlan, Richard S Schottenfeld, & Marek C. Chawarski. (2006). New challenges and opportunities in managing substance abuse in Malaysia. Drug and Alcohol Review, 473- 478.
Reid, L. W., Elifson, K. W., & Sterk, C. E. (2007). Hug drug or thug drug? Ecstasy use and aggressive behavior. Violence and Victims, 104-119.
Taylor, S.P., & Hulsizer, M.R. (1998). Psychoactive drugs and human aggression. Academic Press.
Xu X., Fengchuan, R. N., Patricia, M. A., Victoria, M., & Jacquelyn, C. (2005). Prevalence of and risk factors for intimate partner violence in China. American Journal of Public Health, 78-85.
