Emin belongs to an ethnic minority and he migrated with his parents to Germany and being from a different background always warranted frequent, systemic discrimination and marginalization in Bulgaria. The educational background of his parents made it difficult for them to have a stable source of income and it resulted in long-term unemployment. Emin visited a German school and was able to learn the language quickly but he was subjected to severe bullying which was mostly attributed to his family’s socio-economic status. This reflected in his behaviour at school where he was aggressive which resulted in frequent expulsions from the school and by the age of 14 he would skip school days to drink alcohol with young marginalized people in the central park.
This was encouraged by the fact that he felt he was accepted here as no one cared about his background economic or otherwise. Soon afterwards Emin came out as bisexual which was not accepted by his parents and the relationship deteriorated and as he did not want to live with his parents he left home and become marginalized where he was more accepted. He got into the habit of substance use and to cater to the needs of his habit. He had his first sexual before he turned sixteen and later he was involved in sexual acts without the use of protection and contracted HIV, Hepatitis B and syphilis. Emin stated that he fully understood the implications of his actions including dropping from the school and being involved in illegal sexual activity and risk of HIV and other sexually transmitted diseases.
The situation of Emin is complex in terms of causation, development and has interaction between various factors in his internal, external and social environment. The behaviour that is explored is that of substance use which includes consumption of alcohol, smoking cannabis and other injectable substances. Emin started alcohol consumption when he was fourteen with younger people on the street where it was easy for him to be accepted and obtain alcohol illegally. He was being discriminated and the socio-economic status of his family was not good (Fahd & Venkatraman, 2019). Alcohol often is used as a method of escapism and not having to face the reality of one’s life and it is common in adults (Cain et al., 2018). Some cultures have a strong predilection towards alcohol consumption even from younger age group as a part of their culture but that cannot be held good for the case of Emin (Jasper & Polletta, 2018).
The body often become sensitized to a particular habit in this case alcoholism and there is either requirement of large quantity and to get the same level of suppression people often get into other habits for central nervous system depression as a method of escapism from reality (Nona et al., 2018; Cofresí et al., 2019). Emin also started to smoke cannabis and other injectable substances. To suffice the needs he has started the habit of stealing and being engaged in legal sexual activity even though he understood the impact his behaviour might have. It is seen that even though people understand the harms that can be caused by the behaviour due to formation of habit and need for escapism is higher which does not lead to behaviour change (Levison, 2019).
The first theory that can be used for the adequate explanation of the behaviour that is shown by Emin in the case study is the theory of social learning. In the theory as explained by bandura human behaviour is a complexity of nature which is affected by multiple factors like personal preferences, social environment a person lives in (Kruis et al., 2020). The behaviour of a person is related to the environment in which he is living and the observation of how people are living in a world that can be related to his condition.
Emin being from a minority ethnic background in which he has seen marginalization and being subjected to discrimination as a normal life and when after migration same thing was faced by him he did not question it but accepted it and even became a part of a marginalized population. This is closely related to the social cognitive theory which is similar but not same. In social cognitive theory, there is no mere observation of behaviour but also the adoption and maintenance of the same in ones' life (Kruis et al., 2020). Emin after being exposed to alcoholism did not only try but adopted, maintained and developed the habit further to increase and include other substance abuse as well like smoking of cannabis and injectable substances.
The second theory that can explain the behaviour change and adoption in Emin by the use of minority stress theory. It was first developed by Ilan Meyer which explains that people who are from minority background have a different set of social stressors which lead them to take up behaviours which can have adverse health outcomes and is responsible for the existing health disparity (Bos et al., 2016). These social stressors can further be divided into two categories that are proximal and distal. The distal stressors are the ones which are caused by stereotypical thinking of the society which is often expressed by the society in terms of discrimination, rejection in almost all the aspects of one’s life (Pittman et al., 2019). The proximal stressors are the internalization of the stress that is present which is projected as the depiction of behaviours and as per the theory is exhibited in the formation of heterosexuality and homosexuality (Bos et al., 2016). In the case of Emin, he has seen people belonging to his community often undergoing discrimination and when he was subjject4ed to same he did not take any stand which is the proximal stressor. The distal stressor was the internalization of the behaviour in terms of taking up alcoholism and substance abuse so that the social stressors can be avoided.
There are various theories which are used for the explanation of the behaviour change like health belief model, behaviour modification, protection motivation, moral disengagement and others. when Emin is taken into consideration the above-mentioned theories best suit his condition and explain his behaviour which has adverse effects on his health and needs to understand if a change is required and expected.
Bos, H., van Beusekom, G., & Sandfort, T. (2016). Drinking motives, alcohol use, and sexual attraction in youth. The Journal of Sex Research, 53(3), 309-312. https://doi.org/10.1080/00224499.2015.1020355.
Cain, L., Kitterlin-Lynch, M., Cain, C., & Agrusa, J. (2018). Heavy alcohol use, job satisfaction, and job escapism drinking among foodservice employees: a comparative analysis. International Journal of Hospitality & Tourism Administration, 1-21. 1 https://doi.org/0.1080/15256480.2018.1478355.
Cofresí, R. U., Bartholow, B. D., & Piasecki, T. M. (2019). Evidence for incentive salience sensitization as a pathway to alcohol use disorder. Neuroscience & Biobehavioral Reviews, 107, 897-926. https://doi.org/10.1016/j.neubiorev.2019.10.009.
Fahd, K., & Venkatraman, S. (2019). Racial inclusion in education: An Australian context. Economies, 7(2), 27. https://doi.org/10.3390/economies7020027.
Jasper, J. M., & Polletta, F. (2018). The cultural context of social movements. The Wiley Blackwell Companion to Social Movements, 14(4), 63-78.
Kruis, N. E., Seo, C., & Kim, B. (2020). Revisiting the Empirical Status of Social Learning Theory on Substance Use: A Systematic Review and Meta-Analysis. Substance Use & Misuse, 55(4), 666-683. https://doi.org/10.1080/10826084.2019.1696821.
Levison, P. K. (2019). Substance abuse, habitual behavior, and self-control. Routledge.
Nona, C. N., Hendershot, C. S., & Lê, A. D. (2018). Behavioural sensitization to alcohol: Bridging the gap between preclinical research and human models. Pharmacology Biochemistry and Behavior, 173, 15-26. https://doi.org/10.1016/j.pbb.2018.08.003.
Pittman, D. M., Quayson, A. A., Rush, C. R., & Minges, M. L. (2019). Revisiting resilience: Examining the relationships between stress, social support, and drinking behavior among black college students with parental substance use disorder histories. Journal of Ethnicity in Substance Abuse, 1-22. https://doi.org/10.1080/15332640.2019.1707142.
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