Madde Kullanım Bozukluğu Olan Hastalarda Bilinçli Farkındalığın Tedavi Motivasyonu Üzerindeki Etkisi

Yıl 2024, , 286 - 294, 30.09.2024

Ali Baran Tanrıkulu , Kübra Kayaoğlu

https://doi.org/10.51982/bagimli.1396776

Öz

Amaç: Bu çalışma madde kullanım bozukluğu olan hastalarda bilinçli farkındalık düzeylerini ve bunun tedavi motivasyonuna etkisini değerlendirmek amacıyla yapılmıştır.
Yöntem: Tanımlayıcı ve kesitsel tipteki bu çalışma 184 madde kullanım bozukluğu olan hastayla gerçekleştirildi. Veri toplama sürecinde Kişisel Bilgi Formu, Bilinçli Farkındalık Ölçeği (BİÖ), Tedavi Motivasyonu Anketi (TMA) kullanılmıştır.
Bulgular: BİÖ ile TMA düzeyleri arasında pozitif yönde yüksek düzeyde bir ilişki olduğu görüldü (r: 796, p<0.01). Ayrıca tespit edildi ki, bilinçli farkındalık yordayıcı değişkeninin tedavi motivasyonu yordanan değişkenindeki varyansın %63’ünü açıklamıştır (R2: 0.634, p<0.001). Regresyon modeline dâhil edilen yordayıcı değişkenin Beta katsayısı 0.796’dır. Buna göre bilinçli farkındalığın tedavi motivasyonu üzerine pozitif yönde anlamlı bir etkisinin olduğu görülmektedir (p< 0.001).
Tartışma: Çalışmaya katılan hastaların bilinçli farkındalık düzeylerinin ortalamanın altında olduğu tespit edilmiştir. Bilinçli farkındağın madde kullanım bozukluğu tedavisi için uygun bir odak noktası olabileceği düşünülmektedir. Bunun yanında bilinçli farkındalığı yüksek olan hastaların tedavi motivasyonunun yüksek olduğunu tespit etmiştir. Bu bulgular madde kullanım bozukluğu olan hastaların bilinçli farkındalıklarını arttıran uygulamaların kliniklerde rutin olarak uygulanmasını desteklemektedir.

Anahtar Kelimeler

Bilinçli farkındalık, motivasyon, madde kullanma bozukluğu

Effect of Mindfulness on Treatment Motivation in Patients with Substance Use Disorder

Öz

Objective: This research aimed to assess the mindfulness levels among individuals with substance use disorder (SUD) and investigate its influence on treatment motivation.
Method: A descriptive and cross-sectional study was carried out involving 184 SUD patients. Data collection utilized a Personal Information Form, The Mindful Attention Awareness Scale (MAAS), and the Treatment Motivation Questionnaire (TMQ).
Results: A strong positive correlation was identified between MAAS and TMQ levels (r: 0.796, p<0.001). Furthermore, the mindfulness predictor variable was found to account for 63% of the variance in the treatment motivation predicted variable (R2: 0.632, p<0.001). The Beta coefficient of the predictor variable in the regression model was 0.795, indicating a significant positive impact of mindfulness on treatment motivation (p<0.001).
Conclusion: The study revealed that the conscious awareness levels of participants were below average, suggesting that conscious awareness may be a suitable target for SUD treatment. Additionally, individuals with high mindfulness exhibited elevated treatment motivation, emphasizing the importance of incorporating mindfulness-enhancing practices in clinics for individuals with SUD.

Anahtar Kelimeler

Mindfulness, motivation, substance use disorder

Kaynakça

• Simpson EH, Balsam PD. The behavioral neuroscience of motivation: an overview of concepts, measures, and translational applications. Curr Top Behav Neurosci 2016; 27: 1-12.
• Ryan RM. Self-Determination Theory: Basic Psychological Needs in Motivation, Development, and Wellness. New York: Guilford Press, 2017.
• Di Domenico SI, Ryan RM. The emerging neuroscience of intrinsic motivation: A new frontier in self-determination research. Front Hum Neurosci 2017; 11: 145.
• Diclemente CC, Nidecker M, Bellack AS. Motivation and the stages of change among individuals with severe mental illness and substance abuse disorders. J Subst Abuse Treat 2008; 34(1): 25-35.
• Miller WR. Motivation for treatment: a review with special emphasis on alcoholism. Psychol Bull 1985; 98(1): 84-107.
• Laudet AB, Stanick V. Predictors of motivation for abstinence at the end of outpatient substance abuse treatment. J Subst Abuse Treat 2010; 38(4): 317-327.
• Philips B, Wennberg P. The importance of therapy motivation for patients with substance use disorders. Psychotherapy (Chic) 2014; 51(4): 555-562.
• Andersson HW, Steinsbekk A, Walderhaug E, et al. Predictors of dropout from inpatient substance use treatment: a prospective cohort study. Subst Abuse 2018; 12: 1178221818760551.
• Groshkova T. Motivation in substance misuse treatment. Addict Res Theory 2010; 18(5): 494-510.
• Millere A, Pūce A, Millere E, et al. Treatment motivation factor analysis of patients with substance use disorders in Latvia. Procedia Soc Behav Sci 2014; 159: 298-302.
• Ogrodniczuk JS, Joyce AS, Piper WE. Strategies for reducing patient-initiated premature termination of psychotherapy. Harv Rev Psychiatry 2005; 13(2): 57-70.
• Zgierska A, Rabago D, Chawla N, et al. Mindfulness meditation for substance use disorders: A systematic review. Subst Abus 2009; 30(4): 266-294.
• Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol 2003; 84(4): 822-848.
• Bowen S, Chawla N, Grow J, et al. Mindfulness-based Relapse Prevention for Addictive Behaviors. New York: Guilford Press, 2021.
• Tiffany ST. A cognitive model of drug urges and drug-use behavior: role of automatic and nonautomatic processes. Psychol Rev 1990; 97(2): 147-168.
• Garland EL, Manusov EG, Froeliger B, et al. Mindfulness-oriented recovery enhancement for chronic pain and prescription opioid misuse: results from an early-stage randomized controlled trial. J Consult Psychol 2014; 82(3): 448-459.
• Shapiro SL, Brown KW, Biegel GM. Teaching self-care to caregivers: Effects of mindfulness-based stress reduction on the mental health of therapists in training. Train Educ Prof Psychol 2007; 1(2): 105-115.
• Tırışkana M, Onnarb N, Çetinc YA, et al. The importance of mindfulness in preventing substance-abuse relapse: A literature review. Addicta 2015; 2(2): 123-142.
• Elwafi HM, Witkiewitz K, Mallik S, et al. Mindfulness training for smoking cessation: Moderation of the relationship between craving and cigarette use. Drug Alcohol Depend 2013; 130(1-3): 222-229.
• Dakwar E, Mariani JP, Levin FR. Mindfulness impairments in individuals seeking treatment for substance use disorders. Am J Drug Alcohol Abuse 2011; 37(3): 165-169.
• Bowen S, Witkiewitz K, Dillworth TM, et al. The role of thought suppression in the relationship between mindfulness meditation and alcohol use. Addict Behav 2007; 32(10): 2324-2328.
• Witkiewitz K, Bowen S. Depression, craving, and substance use following a randomized trial of mindfulness-based relapse prevention. J Consult Clin Psychol 2010; 78(3): 362-374.
• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 5th edn. Washington DC: American Psychiatric Association, 2013.
• Özyeşil Z, Arslan C, Kesici Ş, et al. Bilinçli farkındalık ölçeği’ni Türkçeye uyarlama çalışması. Eğitim ve Bilim. 2011; 36(160): 224-235.
• Ryan RM, Plant RW, O'malley S. Initial motivations for alcohol treatment: Relations with patient characteristics, treatment involvement, and dropout. Addict Behav 1995; 20(3): 279-297.
• Evren C, Saatcioglu O, Dalbudak E, et al. Tedavi Motivasyonu Anketi (TMA) Türkçe versiyonunun alkol bağımlısı hastalarda faktör yapısı, geçerliği ve güvenirliği. Bağımlılık Dergisi 2006; 7(3): 117-122.
• Lindenberg CS, Reiskin HK, Gendrop SC. The social stress model of substance abuse among childbearing-age women: a review of the literature. J Drug Educ 1994; 24(3): 253-268.
• Mariani JJ, Khantzian EJ, Levin FR. The self‐medication hypothesis and psychostimulant treatment of cocaine dependence: an update. Am J Addict 2014; 23(2): 189-193.
• Sher KJ, Levenson RW. Risk for alcoholism and individual differences in the stress-response-dampening effect of alcohol. J Abnorm Psychol 1982; 91(5): 350-367.
• Kluwe-Schiavon B, Viola TW, Grassi-Oliveira R, Tractenberg SG. Editorial: polysubstance abuse and cognitive dysfunction. Front Behav Neurosci. 2022;16: 916921..
• Abé C, Mon A, Durazzo TC, et al. Polysubstance and alcohol dependence: unique abnormalities of magnetic resonance-derived brain metabolite levels. Drug Alcohol Depend 2013; 130(1-3): 30-37.
• Ryan RM, Deci EL. A self-determination theory approach to psychotherapy: The motivational basis for effective change. Can Psychol 2008; 49(3): 186-193.
• Cogswell J, Negley SK. The effect of autonomy-supportive therapeutic recreation programming on integrated motivation for treatment among persons who abuse substances. Ther Recreation J 2011; 45(1): 47-61.
• Tekin MS, Özdemir N, Şahin ŞK. Effect of attachment styles, emotional regulation difficulty and mindful attention levels on treatment motivation in patients with substance use disorder. J Subst Use 2021; 26(4): 441-448.
• Bozdağ N, Çuhadar D. Internalized stigma, self-efficacy and treatment motivation in patients with substance use disorders. J Subst Use 2022; 27(2): 174-180.
• Battjes RJ, Gordon MS, O'grady KE, et al. Factors that predict adolescent motivation for substance abuse treatment. J Subst Abuse Treat 2003; 24(3): 221-232.
• Cahill MA, Adinoff B, Hosig H, et al. Motivation for treatment preceding and following a substance abuse program. Addict Behav 2003; 28(1): 67-79.
• Li LY, Meng X, Hu WT, et al. A meta-analysis of the association between mindfulness and motivation. Front Public Health 2023; 11: 1159902..
• Elphinstone B, Egan P, Whitehead R. Greater autonomous motivation for study and basic psychological need satisfaction by being presently aware and ‘letting go’: An exploration of mindful attention and nonattachment. Motiv Emot 2021; 45(1): 1-12.
• Liu YC, Li IL, Hsiao FH. Effectiveness of mindfulness‐based intervention on psychotic symptoms for patients with schizophrenia: A meta‐analysis of randomized controlled trials. J Adv Nurs 2021; 77(6): 2565-2580.
• Körükcü Ö, Kukulu K. Beden-zihin-ruh bütünlüğünü korumaya yönelik bir program: farkındalık temelli stres azaltma programı. Psikiyatride Güncel Yaklaşımlar 2015; 7(1): 68-80.
• Desbordes G, Negi LT, Pace TW, et al. Effects of mindful-attention and compassion meditation training on amygdala response to emotional stimuli in an ordinary, non-meditative state. Front Hum Neurosci 2012; 6: 292.
• Chiesa A, Serretti A. Are mindfulness-based interventions effective for substance use disorders? A systematic review of the evidence. Subst Use Misuse 2014; 49(5): 492-512.