Аннотация:
Introduction. Motivation for treatment is a complex phenomenon that affects the effectiveness of treatment provided to patients with substance use disorders. The systemic studies of the factors that define treatment readiness are needed for achieving a greater understanding of the mechanisms underlying the development of motivational processes in patients with stimulant use disorder.
Aim: the assessment of socio-demographic, clinical, psycho-emotional characteristics and personality factors in the development of motivation for treatment in individuals with stimulant use disorder.
Methods. For this cross-sectional study 102 patients with stimulant use disorder (F15.20; F15.21) were recruited. The following instruments were used: The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), The Differential Emotions Scale (DES), The State-Trait Anxiety Inventory (STAI), Hamilton Depression Rating Scale (HDRS), The State-Trait Anger Expression Inventory (STAXI), The Toronto Alexithymia Scale (TAS), The Type of Attitude toward Illness Scale (TATIS), The Scale of Anticipatory Competence (SAC), and The Purpose-in-Life Test (PIL).
Results. The median age of participants was 23.0 y.o [18,0; 34,0]. The results of cluster analysis allowed us to divide participants into three groups based on their level of motivation for treatment: high levels of readiness for treatment (HLRT) were observed in 44.1% of participants, moderate levels (MLRT) and low levels (LLRT) - in 25.5% and 30.4% participants, respectively. The individuals in the HLRT group, as compared to MLRT and LLRT, were more likely to have completed a university degree (p≤0,05). The individuals from LLRT were significantly younger as compared to MLRT and HLRT, tended to have fewer instances of seeking treatment, shorter duration of the stimulant use disorder, and had a younger age of the onset of the withdrawal syndrome (p≤0,05). The patients with HLRT reported a greater duration of remission following treatment and the ratio of the remission duration to the duration of the disorder as well as a lower anosognostic type attitude toward illness, as compared to LLRT and MLRT (p≤0,05). The high levels of Alexithymia, Feeling angry, Trait Anxiety, and Feel like Expressing Anger were more frequently observed in patients from the LLRT group. The participants with HLRT displayed higher levels of emotion “interest”, “personal-situational anticipatory competence”, and “internal locus of control” as compared to individuals with LLRT; at the same time, participants with HLRT reported greater levels of “shame” as compared to LLRT and MLRT (p≤0,05). The following predictors of readiness for in patients with stimulant use disorder were identified: the ratio of remission duration to disorder duration (В1 = 90,99), the duration of withdrawal syndrome (В2 = 2,46), the anosognostic type of attitude toward illness (TATIS) (В3 = –0,71), education (В4 = 0,65), alexithymia (TAS) (В5 = –0,13), anger (DES) (В6 = –2,88), age (В7 = 1,61) (B0 = 68,78; corrected R2 = 0,87).
Conclusion. The results of the study allowed us to identify a set of biopsychosocial factors that contribute to the development of low, moderate, and high motivation levels for treatment in patients with stimulant use disorder. In addition, the predictors for the readiness for seeking substance use treatment were determined. The observed levels and prognostic factors of motivation for treatment should be taken into consideration in providing medical and rehabilitation services to individuals with stimulant use disorder.
Ключевые слова:
stimulant use disorder, motivation for treatment, emotions, clinical and social factors.