Evaluation of motivation for the treatment of drug addicts with personality disorders

  1. José M. Martínez-González 1
  2. Alfonso Caracuel 2
  3. Raquel Vilar-López 2
  4. Elisardo Becoña 3
  5. Antonio Verdejo-García 4
  1. 1 Centro Provincial de Drogodependencias de Granada (Spain)
  2. 2 Universidad de Granada
    info

    Universidad de Granada

    Granada, España

    ROR https://ror.org/04njjy449

  3. 3 Universidade de Santiago de Compostela
    info

    Universidade de Santiago de Compostela

    Santiago de Compostela, España

    ROR https://ror.org/030eybx10

  4. 4 Monash University
    info

    Monash University

    Melbourne, Australia

    ROR https://ror.org/02bfwt286

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Revista:
The Spanish Journal of Psychology

ISSN: 1138-7416

Ano de publicación: 2020

Número: 23

Páxinas: 1-9

Tipo: Artigo

DOI: 10.1017/SJP.2020.13 DIALNET GOOGLE SCHOLAR lock_openAcceso aberto editor

Outras publicacións en: The Spanish Journal of Psychology

Obxectivos de Desenvolvemento Sustentable

Resumo

Lack of motivation for the treatment of drug addiction is associated with dropout and relapses. Further, personality disorders (PD) have traditionally been linked to low motivation and therapeutic failure. Thus, the present study aims to analyze the structure of the Motivation for Treatment Questionnaire (MTQ–8), as well as to determine differences in motivation due to the presence of PD and the impact of psychological adjustment on motivation. The sample included 125 patients (84% male) who started a treatment for their addiction to cocaine and alcohol. Rasch analysis was applied for the first objective, and means contrast and regression analysis for the others. The two subscales of the MTQ–8 fit the Rasch model, with appropriate psychometric characteristics when merging Items 5 and 7. The presence of PD was not associated with reduced motivation. Motivation for treatment was greater when abstinence was less than three weeks, and psychological distress predicted motivation for treatment. The present study confirms that MTQ–8 subscales are suitable for measuring motivation for treatment and readiness for change in drug-dependent patients. It is noted that the presence of PD should not be associated with a lower level of motivation, and that psychological distress influences motivation.

Referencias bibliográficas

  • American Psychiatric Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders (5th Ed.). Arlington.
  • Ball, S. A., Carroll, K. M., Canning-Ball, M., & Rounsaville, B. J. (2006). Reasons for dropout from drug abuse treatment: Symptoms, personality, and motivation. Addictive Behaviors, 31, 320–330. http://doi.org/10.1016/j.addbeh.2005.05.013
  • Bartak, A., Andrea, H., Spreeuwenberg, M. D., Thunnissen, M., Ziegler, U. M., Dekker, J., Bouvy, F., Hamers, E. F., Meerman, A. M., Busschbach, J. J., Verheul, R., Stijnen, T., & Emmelkamp, P. M. (2011). Patients with Cluster A personality disorders in psychotherapy: An effectiveness study. Psychother Psychosom, 80, 88–99. http://doi.org/10.1159/000320587
  • Bartak, A., Spreeuwenberg, M. D., Andrea, H., Holleman, L., Rijnierse, P., Rossum, B. V., Hamers, E. F., Meerman, A. M., Aerts, J., Busschbach, J. J., Verheul, R., Stijnen, T., & Emmelkamp, P. M. (2010). Effectiveness of different modalities of psychotherapeutic treatment for patients with cluster C personality disorders: Results of a large prospective multicenter study. Psychotherapy and Psychosomatics, 79, 20–30. http://doi.org/10.1159/000254902.
  • Bateman, A., & Fonagy, P. (2000). Effectiveness of psychotherapeutic treatment of personality disorder. British Journal of Psychiatry, 117, 138–143.
  • Bond, T., & Fox, C. M. (2015). Applying the Rasch Model: Fundamental measurement in the human sciences (3rd Ed.). Routledge.
  • Cox, W. M., & Klinger, E. (2002). Motivational structure relationships with substance use and processes of change. Addictive Behaviors, 27, 925–940.
  • de Weert-van, G. H., Gongora, V., von Sternberg, K., & de Jong, C. A. (2015). Motivation for treatment and motivation for change in substance-dependent patients with co-occurring psychiatric disorders. Journal of Psychoactive Drugs, 47, 393–400. http://doi.org/10.1080/02791072.2015.1079669
  • DiClemente, C. C., Corno, C. M., Graydon, M. M., Wiprovnick, A. E., & Knoblach, D. J. (2017). Motivational interviewing, enhancement, and brief interventions over the last decade: A review of reviews of efficacy and effectiveness. Psychology of Addictive Behaviors, 31, 862–887. http://doi.org/10.1037/adb0000318
  • Elder, H., Czuba, K., Kersten, P., Caracuel, A., & McPherson, K. (2017). Te Waka Kuaka, Rasch analysis of a cultural assessment tool in traumatic brain injury in Māori. F1000Research, 6, Article 1034. https://doi.org/10.12688/f1000research.11500.1
  • First, M., Spitzer, R., Gibbon, M., & Williams, J. (1996). Structured clinical interview for Axis I Disorders-patient edition. New York Biometrics Research.
  • Goldberg, D. P., & Hiller, V. F. (1979). A scaled version of the General Health Questionnaire. NFER Publishing Company.
  • González-Saiz, F. M., Carulla, S., Martínez J, M., López, A., Ruiz, J., & Guerra, D. (1997). Indicador del tratamiento de la adicción a opiáceos [Indicator of opioid addiction treatment]. Servicio de Publicaciones de la Universidad de Cádiz.
  • Hadjipavlou, G., & Ogroduiczuk, J. S. (2010). Promising psychotherapies for personality disorders. The Canadian Journal of Psychiatry, 55(4), 202–2210. http://doi.org/10.1177/070674371005500403
  • Hagquist, C., Bruce, M., & Gustavsson, J. P. (2009). Using the Rasch model in nursing research: An introduction and illustrative example. International Journal of Nursing Studies, 46(3), 380–393. http://doi.org/10.1016/j.ijnurstu.2008.10.007
  • Hendershot, C. S., Witkiewitz, K., George, W. H., & Marlatt, G. A. (2011). Relapse prevention for addictive behaviors. Substance Abuse Treatment, Prevention and Policy, 6, Article 17. http://doi.org/10.1186/1747-597X-6-17
  • Kizilkurt, O. K., & Giynas, F. F. (2019). Factors affecting treatment motivation among Turkish patients receiving inpatient treatment due to alcohol/substance use disorder. Journal of Ethnicity in Substance Abuse. Advance online publication. http://doi.org/10.1080/15332640.2018.1548324
  • Linacre, J. M. (1994). Sample size and item calibration stability. Rasch Measurement Transactions, 7(4), 328–329.
  • Linacre, J. M. (2002). Understanding Rasch measurement: Optimizing rating scale category effectiveness. Journal of Applied Measurement, 3(1), 85–106.
  • López-Ibor, J. J., Pérez, A., & Rubio, V. (1996). I.P.D.E. Examen Internacional de los Trastornos de la Personalidad [The International Personality Disorder Examination (IPDE)]. Organización Mundial de la Salud: Meditor.
  • Marlatt, G. A. (1985). Relapse prevention: Theoretical rationale and overview of the model. In Marlatt, G. A. & Gordon, J. R. (Eds.). Relapse prevention. Guilford Press.
  • Martínez-González, J. M., Munera, P., & Becoña, E. (2013). Drogodependientes vs. usuarios de salud mental con trastornos de personalidad: Su relación con la calidad de vida, la psicopatología en Eje I, el ajuste psicológico y dinámica familiar [Drug addicts vs. mental health users with personality disorders: Their relationship with quality of life, psychopathology on the I–Axis, psychological adjustment and family dynamics]. Anales de Psicología, 29, 48–54. http://doi.org/10.6018/analesps.29.1.161901
  • Martínez-González, J. M., & Verdejo-García, A. (2014). Drogodependientes con trastornos de la personalidad. Guía de intervenciones psicológicas [Drug addicts with personality disorders. Guide to psychological interventions]. Desclée de Brower.
  • Masters, G. N. (1982). A rasch model for partial credit scoring. Psychometrika, 47(2), 149–174. https://doi.org/10.1007/BF02296272
  • Miller, W. R. (1985). Motivation for treatment: A review with special emphasis on alcoholism. Psychological Bulletin, 98, 84–107. http://doi.org/10.1037/0033-2909.98.1.84
  • Miller, W. R., & Rollnick, S. (2012). Motivational interviewing. Helping people change (3rd Ed.). Guildford Press.
  • Mulder, C. L., Jochems, E., & Kortijk, H. (2014). The motivation paradox: Higher psychosocial problem levels in severely mentally ill patients are associated with less motivation for treatment. Social Psychiatry and Psychiatric Epidemiology, 49, 541–548. http://doi.org/10.1007/s00127-013-0779-7
  • Ostergaard, M., Jatzkowski, L., Seits, R., Speidel, S., Weber, T., Lübke, N., Höcker, W., & Odenwald, M. (2018). Integrated treatment at the first stage: Increasing motivation for alcohol patients with comorbid disorders during inpatient detoxification. Alcohol and Alcoholism, 53, 719–727. http://doi.org/10.1093/alcalc/agy066
  • Pallant, J. F., & Tennant, A. (2007). An introduction to the Rasch measurement model: An example using the Hospital Anxiety and Depression Scale (HADS). British Journal of Clinical Psychology, 46(1), 1–18. http://doi.org/10.1348/014466506X96931.
  • Pérez Moreno, P., Lozano Rojas, O. M., & Rojas Tejada, A. J. (2010). Propiedades psicométricas del GHQ–28 en pacientes con dependencia a opiáceos [Psychometric properties of the GHQ–28 in patients with opiate depencency]. Adicciones, 22, 65–72.
  • Rubenis, A. J., Fitzpatrick, R. E., Lubman, D. I., & Verdejo-García, A. (2018). Sustained attention but not effort-based decision-making predicts treatment motivation change in people with methamphetamine dependence. Journal of Substance Abuse Treatment, 95, 48–54. http://doi.org/10.1016/j.jsat.2018.09.007
  • Smith, R. M., & Miao, C.Y. (1994). Assessing unidimensionality for Rasch measurement. In Wilson, M. (Ed.), Objective measurement: Theory into practice (Vol. 2, pp. 316–327). Ablex.
  • Tennant, A., & Conaghan, P. G. (2007). The Rasch measurement model in rheumatology: What is it and why use it? When should it be applied, and what should one look for in a Rasch paper? Arthritis Care and Research, 57, 1358–1362. http://doi.org/10.1002/art.23108.
  • Tennant, A., & Pallant, J. F. (2006). Unidimensionality matters! Rasch Measurement Transactions, 20, 1048–1051.
  • van Beek, N., & Verheul, R. (2008). Motivation for treatment in patients with personality disorders. Journal of Personality Disorders, 22, 89–100. http://doi.org/10.1521/pedi.2008.22.1.89
  • van den Bosch, L., & Verheul, R. (2007). Patients with addiction and personality disorder: Treatment outcomes and clinical implications. Current Opinion in Psychiatry, 20, 67–71. http://doi.org/10.1097/YCO.0b013e328011740c
  • van Manen, J. G., Helene, A., van den Eijnden, E., Meerman, A. M., Thunnissen, M. M., Hamers, E. F., Huson, N., Ziegler, U., Rtijnen, T., Busschabach, J. J., Timman, R., & Verheul, R. (2011). Relationship between patient characteristics and treatment allocation for patients with personality disorders. Journal of Personality Disorders, 25, 656–667. http://doi.org/10.1521/pedi.2011.25.5.656.
  • Verheul, R. (2001). Comorbidity of personality disorders in individuals with substance use disorders. European Psychiatry, 16, 274–82.
  • Verheul, R., van den Bosch, L. M. C., & Ball, S. A. (2005). Substance abuse. In Oldham, J. M., Skodol, A. E., & Bender, D. S.. (Eds.), The American Psychiatric Publishing textbook of personality disorders (pp. 463–477). American Psychiatric Publishing.
  • Wilkinson, D. A., & LeBreton, S. (1986). Early indications of treatment outcome in multiple drug users. In Miller, W. R. & Heather, N. (Eds.), Treating addictive behavior. Processes of change (pp. 239–261). Plenum Publishing Corporation.
Fonte de datos: Dialnet