5th Edition of Addiction World Conference 2026

Abstract

Codependency in caregiving has been increasingly conceptualized as a form of behavioral or relational addiction; however, its clinical implications in elder abuse remain insufficiently explored. This study aimed to examine whether codependency functions as a predictor of elder abuse and a structural barrier to intervention.A questionnaire survey was conducted among 40 professionals working in community comprehensive support centers in Japan. Variables included experiences of codependency assessment, suspected elder abuse cases, perceived barriers to intervention, and required support. Data were analyzed using descriptive statistics, partial correlation (controlling for the number of assigned households), and chi-square tests. Qualitative responses were analyzed using content analysis. A remarkably strong positive correlation was found between the number of cases assessed as codependent and suspected elder abuse cases (r = .989, p < .001), suggesting that codependency may be a critical predictor of abuse. The most common barriers to intervention were lack of problem recognition by family members (90.0%) and distrust of external agencies (52.5%), indicating a closed relational system. Notably, 79.5% of respondents reported that caregivers appeared to derive a sense of self-worth from caregiving, suggesting an addictive reinforcement mechanism. Furthermore, 80.0% identified the need for structured intervention programs, particularly in separation strategies, assessment of codependency, and boundary-setting. No significant differences were found across professions or experience levels (p > .05), indicating that the difficulty is structural rather than individual.Qualitative findings supported these results, highlighting themes of resistance to intervention, mutual dependency, and prolonged case entanglement.These findings suggest that codependency in caregiving may operate as a form of hidden behavioral addiction that sustains abusive dynamics and resists intervention. Addressing this issue requires a paradigm shift from individual skill-based approaches to structural intervention models, including early identification, boundary-setting, and separation strategies.