Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-23T16:52:20.399Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of Motivation for the Treatment of Drug Addicts with Personality Disorders

Published online by Cambridge University Press:  16 June 2020

José M. Martínez-González Open the ORCID record for José M. Martínez-González [Opens in a new window] ,
Alfonso Caracuel Open the ORCID record for Alfonso Caracuel [Opens in a new window] ,
Raquel Vilar-López Open the ORCID record for Raquel Vilar-López [Opens in a new window] ,
Elisardo Becoña Open the ORCID record for Elisardo Becoña [Opens in a new window]  and
Antonio Verdejo-García Open the ORCID record for Antonio Verdejo-García [Opens in a new window]
José M. Martínez-González
Affiliation:
Centro Provincial de Drogodependencias de Granada (Spain)
Alfonso Caracuel
Affiliation:
Universidad de Granada (Spain)
Raquel Vilar-López*
Affiliation:
Universidad de Granada (Spain)
Elisardo Becoña
Affiliation:
Universidad de Santiago de Compostela (Spain)
Antonio Verdejo-García
Affiliation:
Monash University (Australia)
*
Correspondence concerning this article should be addressed to Raquel Vilar López. Universidad de Granada. Departamento de Personalidad, Evaluación y Tratamiento Psicológico. Centro de Investigación, Mente y Comportamiento. 18071 Granada (Spain). E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

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.

Keywords

drug dependencemotivationpersonality disorderspsychological adjustmenttreatment
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 23 , 2020 , e15
Copyright
© Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders (5th Ed.). Arlington.Google Scholar
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.2005.05.013CrossRefGoogle ScholarPubMed
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/10.1159/000320587CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
Bateman, A., & Fonagy, P. (2000). Effectiveness of psychotherapeutic treatment of personality disorder. British Journal of Psychiatry, 117, 138–143.CrossRefGoogle Scholar
Bond, T., & Fox, C. M. (2015). Applying the Rasch Model: Fundamental measurement in the human sciences (3rd Ed.). Routledge.CrossRefGoogle Scholar
Cox, W. M., & Klinger, E. (2002). Motivational structure relationships with substance use and processes of change. Addictive Behaviors, 27, 925–940.CrossRefGoogle ScholarPubMed
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/10.1080/02791072.2015.1079669CrossRefGoogle Scholar
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/adb0000318CrossRefGoogle ScholarPubMed
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.11500.1CrossRefGoogle Scholar
First, M., Spitzer, R., Gibbon, M., & Williams, J. (1996). Structured clinical interview for Axis I Disorders-patient edition. New York Biometrics Research.Google Scholar
Goldberg, D. P., & Hiller, V. F. (1979). A scaled version of the General Health Questionnaire. NFER Publishing Company.CrossRefGoogle ScholarPubMed
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.Google Scholar
Hadjipavlou, G., & Ogroduiczuk, J. S. (2010). Promising psychotherapies for personality disorders. The Canadian Journal of Psychiatry, 55(4), 202–2210. http://doi.org/10.1177/070674371005500403CrossRefGoogle ScholarPubMed
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.2008.10.007CrossRefGoogle ScholarPubMed
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-6-17CrossRefGoogle ScholarPubMed
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/10.1080/15332640.2018.1548324CrossRefGoogle Scholar
Linacre, J. M. (1994). Sample size and item calibration stability. Rasch Measurement Transactions, 7(4), 328–329.Google Scholar
Linacre, J. M. (2002). Understanding Rasch measurement: Optimizing rating scale category effectiveness. Journal of Applied Measurement, 3(1), 85–106.Google Scholar
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.Google Scholar
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.Google Scholar
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.29.1.161901CrossRefGoogle Scholar
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.Google Scholar
Masters, G. N. (1982). A rasch model for partial credit scoring. Psychometrika, 47(2), 149–174. https://doi.org/10.1007/BF02296272CrossRefGoogle Scholar
Miller, W. R. (1985). Motivation for treatment: A review with special emphasis on alcoholism. Psychological Bulletin, 98, 84–107. http://doi.org/10.1037/0033-2909.98.1.84CrossRefGoogle ScholarPubMed
Miller, W. R., & Rollnick, S. (2012). Motivational interviewing. Helping people change (3rd Ed.). Guildford Press.Google Scholar
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/s00127-013-0779-7CrossRefGoogle ScholarPubMed
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/agy066CrossRefGoogle ScholarPubMed
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.CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
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.2018.09.007CrossRefGoogle Scholar
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.Google Scholar
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.CrossRefGoogle Scholar
Tennant, A., & Pallant, J. F. (2006). Unidimensionality matters! Rasch Measurement Transactions, 20, 1048–1051.Google Scholar
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.2008.22.1.89CrossRefGoogle ScholarPubMed
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.0b013e328011740cCrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
Verheul, R. (2001). Comorbidity of personality disorders in individuals with substance use disorders. European Psychiatry, 16, 274–82.CrossRefGoogle ScholarPubMed
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.Google Scholar
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.CrossRefGoogle Scholar