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Alcoholism and Domestic Violence in Saudi Society

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Alcoholism and Domestic Violence in Saudi Society Alcoholism and Domestic Violence in Saudi Society by Abdulaziz A. Albrithen Thesis submitted in accordance with the requirements of the University of Liverpool for the degree of Doctor of Philosophy in Social Work September 2006 ii Abstract Domestic violence is a common social problem throughout the western world, resulting in a great many deaths and physical and psychological injuries every year. Previous studies show that alcohol use and intoxication, by both the perpetrators and victims, are frequently implicated in violent events. Although the association or correlation between alcohol and domestic violence is still open to discussion in all countries, its investigation has never previously been attempted in Saudi Arabia where alcohol is not allowed and domestic violence is not yet officially acknowledged. This, therefore, is the first investigation into the association in Saudi Arabia between alcohol (ab)use and domestic violence. Western explorations into the extent and causes of domestic violence have taken many different approaches. For example, some researchers have undertaken surveys of violence in communities while others have interviewed the victims of violence. Others have tested individual subjects on their interpersonal aggression, while yet others have inspected police records and/or hospital data. Following a review of international research, this thesis then explains why, in Saudi Arabia, it was decided that surveying alcoholic men and interviewing women married to alcoholic men, plus comparison groups, would be the best way to begin exploring the connections between alcohol and domestic violence. This present study is based on interviews with 144 male alcoholic patients who had sought treatment at Al-Amal hospitals in Riyadh, Jeddah, Dammam, and Qaseem, 25 women married to alcoholic men, 25 women married to drug user men, and 25 women married to ‘ordinary’ men. These surveys were complemented by narrative biographical interviews with four alcoholic patients and three focus groups with a total of 18 alcoholic patients. The study, therefore, gathered quantitative and qualitative evidence. Alcoholism among the alcoholic patients was measured using an adapted version of the Michigan Alcoholism Screening Test (MAST), and marital conflict by an adapted Conflict Tactics Scales (CTS). The results suggest that alcoholism has a highly significant relationship with domestic violence in Saudi Arabia, and that the specific circumstances - prohibition, illegality and social stigma - that currently prevail in Saudi society could well be exacerbating the effects of alcohol (ab)use within families. The study has found high levels and frequencies of aggression committed by alcoholic men particularly those who consumed alcohol heavily and the violent incidents were more likely to occur at the time of drinking or intoxication. The violence was against numerous family members including sisters, brothers, children, parents, and in few cases grandparents, but the married woman was far and away the most likely victim. The women married to alcoholic men were experiencing many types of violence - verbal, psychological, physical and sexual. The alcoholics and their families were enduring economic difficulties, poor quality family lives, neglected duties and obligations, high levels of guilt feelings, and sexual difficulties. There were obstacles inhibiting women married to alcoholics from leaving their husbands. The husbands themselves ran constant risks of being arrested and imprisoned. The thesis concludes with suggestions for further research, and for changes in policy and practice in Saudi Arabia vis-à-vis alcohol and domestic violence. iii Contents Abstract ………………………………………………………………………..…….. ii Table of contents …………………………………………………………………….....…………..…. iii List of tables and figures ……………..…………………………………………………….……..…… v Acknowledgments ………………………………………………………………..………………..…. vii Chapter one Introduction …………………………………………………………………………………............… 1 Section one: Alcohol in Saudi Arabia ……………………………………………………….………... 3 Increased alcohol in Saudi Arabia ……………………………………………………………............. 3 Alcohol treatment ……………………………………………………………………………............... 7 Alcohol studies …………………………………………………………………………………….….. 9 Religious and legal issues ………………………………………………………….………………… 11 Sociological issues ……………………………………………………………………….………….. 13 Section two: Family life in Saudi society …………………………………………………….……… 15 Social issues ……………………………………………………………………………………….…. 17 Education issues ………………………………………………………………….………………….. 22 Economic issues ……………………………………………………………………….…………….. 23 Section three: Domestic violence …………………………………………………………….……… 25 Historical background ……………………………………………………………………………..…. 26 Theoretical explanations ……………………………………………..………………………………. 29 Domestic violence in Saudi Arabia: religious and legal issues ……………..……………………….. 33 Conclusions ………………………………………………………………..……….……………….. 36 Chapter two: Previous studies of alcohol abuse and domestic violence ………………….…………. 39 Introduction …………………………………………………………………………………….……. 39 Victim and treatment programme samples ……………………………………………………….…. 40 Experimental and quasi-experimental studies …………………………………………………..…... 49 General population studies ……………………………………………………………….……….…. 52 Summary ……………………………………………………………………………………….……. 59 Chapter three: Research design and methods ……………………………….……………………….. 62 Introduction ……………………………………………………………………….……………….…. 62 Aims and objectives …………………………………………………………………….……………. 62 Conceptual framework ……………………………………………………………………….………. 63 Main methods …………………………………………………………………………………….….. 64 Key instruments ……………………………………………………………………………………… 65 The subjects ………………………………………………………………………………………….. 71 Testing and adapting the measurements …………………………………………………………….. 75 Data collection and analysis …………………………………………………….………………...…. 79 Difficulties …………………………………………………………………………………………… 80 Conclusion …………………………………………………………………………………………… 81 Chapter four: The three samples of married women ……………………………….....……………… 82 Closed questions ………………….……………………………………………………….………….. 82 Open questions ……………………………………………………………………………………….. 88 CTS results …………………………………………………………….………………………….….. 96 Summary …………………………………………………………………….……………………….. 99 Chapter five: Alcoholic patients and women married to alcoholics ……..……………..……….…. 101 Demographical data …………..…………………………………………………….……………… 101 Alcoholic patients comparison ……….…………….……………….………………….………….. 104 MAST ……………………………………………………………………………………….…….. 116 Comparing alcoholic patients with women married to alcoholics ……………………………..…... 118 iv Alcohol and aggression ………………………………………………………………….……...…… 120 Discussion ……………………………………………………………………………….…………... 131 Chapter six: Narrative interviews with alcoholic patients …………………………………………... 134 Never married patient, Riyadh region ………………………………………………….……..…….. 134 Currently married patient, Jeddah region ……………………………………………….………..…. 138 Separated patient, Dammam region …………………………………..…………………………….. 141 Divorced patient, Qaseem region ………………………………………..………………………….. 145 Conclusions ………..………………………………………………………...……………………… 148 Chapter seven: Focus groups with alcoholic patients …………………………..………………….. 150 Never married patients ……………………………………………………………..……………….. 151 Married patients ……………………………………………………………………..……………… 155 ‘Other’ patients …………………………………………………………………………..…………. 161 Discussion …………………………………………………………………………………..………. 165 Chapter eight: Conclusions …………………………………………………………………….…… 168 Main findings ………………………………… …………………………………………………..... 168 Reviewing the study’s original questions ……………………………...………………………........ 177 Recommendations …………………………………………………………………………………... 181 Recommendations for future research ………………………………………………….…. 182 Recommendations for policy makers …………………………………………………….... 183 Recommendations for alcohol and violence treatments ……………………………..……. 184 End note ………………………………………………………………………….………………..… 181 Appendices Appendix 1: Michigan Alcoholism Screening Test ………..……………………………………..… 185 Appendix 2: Conflict Tactics Scales …………………………..……………………………….…… 186 Appendix 3: Questionnaire for alcoholic patients …………………………………………….…..… 188 Appendix 4: Tables and figures of alcoholic patients sample……………..……………………...…. 195 Appendix 5: Semi-structured interview with ‘ordinary’ women…………………………..……….. 207 Appendix 6: Semi-structured interview with women married to drug users …………………...….. 211 Appendix 7: Semi-structured interview with women married to alcoholics…………………….…. 215 Appendix 8: Tables and figures of ‘ordinary’ women sample……………………….………….…. 219 Appendix 9: Tables and figures of the sample of women married to drug users…….………….…. 223 Appendix 10: Tables and figures of the sample of women married to alcoholics……….…….…… 227 References ………………………………………………………………………………..……….... 231 Bibliography ………...……………………………………………………………………...…..….. 249 v List of Tables and Figures Table 1.1: Alcohol-related incidents discovered by the police in selected years …………………….... 4 Table 1.2: Alcohol-related incidents presented by the type of crime ………………………………….. 5 Table 1.3: Alcohol crimes by nationality, gender and age …………………………………………….. 6 Table 3.1: Number of Admitted Alcohol-Related and Drug-Related Patients in three Al-Amal Hospitals between 1991-199…...……………………………………………………………………… 72 Table 3.2: Number of Alcohol Related Incidents Discovered by Police ……………………………... 72 Table 3.3: Total number of respondents included in and excluded from the study …………………... 73 Table 4.1: Respondents’ husbands’ experiences of being arrested …………………………………… 83 Table 4.2: Respondents’
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