Аннотация:
Introduction. Motivation for treatment is a complex multicomponent phenomenon that impacts the effectiveness of medical treatment obtained by patients with substance use disorders. Comprehensive research and systematic analysis of factors determining readiness for treatment are needed for achieving a deeper understanding of the mechanisms underlying the development of motivational processes in patients with polysubstance use.
Objective: to evaluate the role of socio-demographic, clinical, psychological factors, and personality characteristics in the development of motivation for treatment in patients with polysubstance use disorder.
Methods. For this cross-sectional study127 patients with polysubstance use dependence (F19.20; F19.21) were recruited. The materials included: participants’ clinical charts, «Stages of Change Readiness and Treatment Eagerness Scale « (SOCRATES), Differential Emotions Scale (DES), The State-Trait Anxiety Inventory (STAI), Hamilton Depression Rating Scale (HDRS) State-Trait Anger Expression Inventory (STAXI), Toronto Alexithymia Scale (TAS), Tasks of Anticipatory/Prognostic Competency (TASPK), and Purpose in Life test (PIL).
Results. The median age of the subjects was 26.0 years [18.0; 37.0]. Patients with high motivation for treatment (HMFT) compared to subjects with medium (MMFT) and low (LMFT) motivation were more likely to describe their relationships with their relatives as «good»; their relatives’ intransigence toward substance use rated stronger as compared to LMFT group (p≤0.05). LMFT patients were younger and had a shorter duration of substance use disorder and withdrawal syndrome (p≤0.05) than MMFT and HMFT patients. The participants with HMFT compared to LMFT and MMFT started experiencing withdrawal syndrome at a later age and had a higher number of treatment engagements, longer periods of remission after treatment, and a higher ratio of remission duration to disease duration (p≤0.05). High levels of depression, anger emotion, alexithymia, and low anger-control scores were observed more frequently in the LMFT group than in the HMFT group; and their trait anxiety was greater in comparison with MMFT and HMFT (p≤0.05). In patients with HMFT compared to LMFT and MMFT, «trait anger» had a lower value, and the indicators of the emotion «interest», «personalty-situation anticipatory competence», «goals in life», and «locus-control-I» had a higher value (p≤0.05). The following predictors of readiness for change and treatment were identified: the ratio of remission duration to disorder duration (B1 = 78.13), «personality-situation anticipatory competency» (TASPK) (B2 = 0.45), age (B3 = 0, 69), «trait anxiety» (STAI) (B4 = -0.53), family conflicts due to substance use (B5 = 4.42), «anger» (DES) (B6 = -5.29), «alexithymia» (TAS) (B7 = -2.01) «interest» (DES) (B8 = 1.25) (B0 = 52.20; adjusted R2 = 0.84).
Conclusion. The presence of conducive social and prognostically favorable clinical characteristics, greater ability to identify life goals and feeling of being in control, more effective skills for conflict resolution, as well as higher levels of emotion of interest, lower levels of anxiety, anger, and alexithymia increase motivation for change and treatment in patients with polysubstance use disorder.
Ключевые слова:
polysubstance use disorder, motivation for treatment, emotions, clinical and social factors.