The Experience of Alcohol Use amongst Individuals with an

Intellectual Disability in Aotearoa/New Zealand

Grahame Gee, RN

Background

• Limited research in the area of alcohol and substance use for people with an intellectual disability

• No NZ based research• Increasingly important with the movement to

community living• Overseas research suggests that for people with

an intellectual disability who drink alcohol, there are a number of risk factors

• Alcohol misuse is associated with a number of negative outcomes

Research objective

• Objective: Investigate alcohol use amongst individuals with a mild intellectual disability in Aotearoa/New Zealand

Research Methods

• Small scale qualitative study utilising semi-structured interviews

• Qualitative approach chosen due to – Potential difficulties in recruiting large number of participants– Qualitative approach has been utilised in overseas research– Wanted to hear from participants directly rather than utilise

informants

• Purposeful sampling approach utilised• Service providers and client advocacy groups approached

to assist with recruitment • Thematic analysis of interviews based on Braun and Clarke

Sample characteristics

< 30 years50%

30 to 40 years20%

> 40 years20%

No Age10%

Age Distribution

• 10 participants interviewed

• Participants lived in a variety of non-forensic community settings

• 60% male, 40% female

• 40% lower NI, 60% mid South Island

• 80% Pakeha, 20% mixed Polynesian/Pakeha

Main Themes

Ecosystem of alcohol use

Person

Ecosystem of alcohol use

Context &

Location

Choices and Influences

Drinking Behaviour

Person

Formal Support Network

Restaurant & pubs

Cultural, Sporting, & Leisure

Events

HomeSpiritual Network

Social Network

Whanau/

family

Community Living

Drinking Culture

Patterns of consumption

• Patterns of consumption followed a different trajectory from that of equivalent non-disabled peers with later age of initiation

• Initiation was primarily in the context of family celebrations

• While there were some instances of binge drinking most consumption was at low levels (1- 2 drinks per session)

• While there was some evidence of a generational shift, drinking patterns tended to follow Valentine, Holloway and Jayne’s (2010) mid generational pattern of social drinking.

Protective factors

• Family, social, spiritual, and support networks:- These networks modelled low level’s of alcohol consumption and

prosocial behaviour- This modelling of prosocial behaviour by the participant’s family,

support and social networks is consistent with a social learning perspective

• Developing internal rules:- Participants developed strong internal rules over alcohol

consumption - It was found that the orientation of “keeping the rules” closely

conformed to Kohlberg's (1973) stage three and four of moral development

Protective factors

• Learning from negative personal experiences: - Participants reflected and learned from negative experiences of

alcohol consumption- These experiences were either from an episode of excessive

alcohol consumption or from observing the experiences of other people in their social and family network

• Keeping safe:- Participants exhibited a strong risk aversion focusing on the need

to maintain their personal safety when making choices about drinking alcohol

- Risk aversion related to the developmental pathway of participants

Limitations

• Small qualitative study

• Limited generalisability

• No Asian or Maori participants

• No participant who consistently consumed alcohol to hazardous levels

• No participants who are in the criminal justice system

• Communication difficulties with participants

Areas for further research

• Structure and role of social, support and peer networks

• What are the differences with clients in a forensic service

• Screening tools and intervention targeted for the needs of this population

• Role and influence of media and the culture of drinking

Conclusions

• Drinking behaviour occurred within a complex social-ecological system

• Low levels of consumption due to the presence of a number of protective factors

• Patterns of drinking reported by participants followed a different trajectory from non-disabled peers