Research
Comparative analysis of psychoemotional, clinical and social correlates of motivation for treatment in alcohol versus stimulant dependence
Gromyko D. I., Nechaeva A. I., Alekseeva Yu. V., Roerich D. S., Vuks A. Ya., Krupitsky E. M., Ilyuk R. D.
Introduction. The presence of treatment motivation determines the likelihood of achieving positive outcomes in substance use treatment. An integrative study of the correlates of motivation for treatment in patients with alcohol and stimulant dependence may help identify common and specific biopsychosocial characteristics associated with the need for substance use treatment.
Objective: To study and conduct a comparative analysis of the correlations between motivation for treatment and sociodemographic, clinical, and psychological characteristics in patients with alcohol dependence (AD) and stimulant dependence (SD).
Materials and Methods. A cross-sectional study included 138 patients with alcohol dependence (F10.20; F10.21) and 102 patients with stimulant dependence (F15.20; F15.21). The study used data from the following sources: patients’ clinical charts, the «Stages of Change Readiness and Treatment Eagerness Scale» (SOCRATES), the Differential Emotions Scale (DES), the State-Trait Anxiety Inventory (STAI), the Hamilton Depression Rating Scale (HDRS), the State-Trait Anger Expression Inventory (STAXI), the «Type of Attitude Toward Illness» questionnaire (TOBOL), the Toronto Alexithymia Scale (TAS), and the Purpose-in-Life Test (PIL).
Results. For both groups, common positive correlates of motivation for treatment were identified, including older age, later age of onset of withdrawal syndrome, number of previous treatment episodes, duration of remissions following treatment, the ratio of remission duration to illness duration, and the «Life Productivity» (PIL) score. A negative correlation between motivation for treatment and the severity of «Depression» (HDRS) was observed in both groups. In patients with SD, motivation for treatment was associated with a good relationship with the father, longer illness duration, and the explicit emotions of «Guilt» (DES) and «Interest» (DES). In patients with AD, treatment motivation was correlated with a positive attitude toward relatives, family demands to stop substance use, awareness that substance use interferes with work, and the «Life Process» (PIL) score. Additionally, in the AD group, treatment motivation negatively correlated with the severity of «Alexithymia» (TAS-26), «Trait Anxiety» (STAI), «Anger Proneness» (STAXI), and an anxious type of attitude toward illness (TOBOL). Comparative analysis indicates that in the SD group, motivation for treatment is more strongly associated with the duration of withdrawal syndrome and the emotion «Interest» (DES) than in patients with AD. In patients with AD, motivation for treatment is more strongly positively associated with the age of onset of withdrawal syndrome and the «Life Productivity» (PIL) score. The AD group shows a significantly stronger negative correlation between readiness for treatment and «Anger Proneness» (STAXI) compared to the SD group.
Conclusion. The identified common and specific correlates of motivation in patients with AD and SD justify the need for a differentiated approach to treatment and rehabilitation interventions.