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Opioid Bağımlılığı Tanısı Alan Bireylerde Suçluluk, Utanç ve Tedavi Motivasyonu Arasındaki İlişki

Yıl 2024, , 398 - 409, 30.12.2024
https://doi.org/10.51982/bagimli.1424031

Öz

Amaç: Bu çalışma, opioid bağımlılığı ile suçluluk, utanç duyguları ve tedavi motivasyonu arasındaki ilişkiyi derinlemesine inceleyerek, bağımlılıkla mücadeledeki en iyi uygulamaları belirlemeyi amaçlamaktadır.
Yöntem: Araştırmanın çalışma grubu Özel Balıklı Rum Hastanesi Vakfı’na başvuran, opioid bağımlılığı tanısı almış 288 hastadan oluşmaktadır. Araştırmanın veri toplama araç̧ları Sosyodemografik Bilgi Formu, Suçluluk-Utanç Ölçeği, Tedavi Motivasyonu Anketidir.
Bulgular: Suçluluk ile içsel motivasyon, tedaviye güven ve tedavi motivasyonu arasında anlamlı ilişki olduğu; utanç ile içsel motivasyon düzeyleri ve genel tedavi motivasyonu arasında anlamlı ilişki olduğu belirlenmiştir. Regresyon katsayıları incelendiğinde ise, sadece suçluluk puanlarının tedavi motivasyonu puanları üzerinde anlamlı bir yordayıcı olduğu görülmektedir. Katılımcıların suçluluk puan ortalamaları, utanç puan ortalamalarından anlamlı şekilde yüksek bulunmuştur.
Sonuç: Suçluluk ile tedavi motivasyonunun çeşitli yönleri arasında önemli bir bağlantı ortaya konulmuştur. Katılımcıların, suçluluk düzeyleri konusunda utanç düzeylerine kıyasla daha yüksek bulunmuştur, bu da suçluluğun tedavi motivasyonunu etkileme potansiyelinde daha büyük bir rol oynayabileceğini göstermektedir. Eroin bağımlılığı tedavisi için psikodrama ve psikoeğitim grup çalışmalarına odaklanmak, bireyin zorlanan olumsuz duygularını ifade etmesini ve grup içinde farkındalık geliştirmesini kolaylaştırabilir.

Etik Beyan

"Eroin Bağımlılığı Tanısı Almış Bireylerde Suçluluk ve Utanç Duygularının Tedavi Motivasyonu ile ilişkisi" konulu çalışma 18.08.2022 tarih 2022/07 sayılı Akademik Araştırma ve Yayın Etiği Kurulunda görüşülmüş olup; Akademik Araştırma ve Yayın Etiği Kurulu üyelerinin değerlendirmesi sonucunda söz konusu çalışmanın etik ilkelere uygun olduğuna karar verilmiştir.

Kaynakça

  • Lander L, Howsare J, Byrne M. The impact of substance use disorders on families and children: from theory to practice. Soc Work Public Health. 2013; 28(3-4): 194-205.
  • Schlag AK. Percentages of problem drug use and their implications for policy making: A review of the literature. Drug Sci Policy Law 2020; 6: 1-9.
  • Dönmezer S, Çetin Ö. Criminal law. Journal of Istanbul University Law Faculty 1975; 28(1): 237-256.
  • Günal HY. Uyuşturucu Madde Suçları. Ankara: İş Basım ve Yayın, 1976.
  • Ögel K, Karal, A, Tamar D, Çakmak, D. Alcohol and Substance Handbook. Istanbul: Bakırköy Psychiatric and Neurological Diseases Hospital, 1998.
  • American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders, 5th edition: DSM-5. Washington DC: American Psychiatric Publishing, 2013.
  • TUBİM Türkiye Drug Report. Ankara: Turkish Drug and Drug Addiction Monitoring Center, 2011.
  • European Monitoring Center for Drugs and Drug Addiction. European Drug Report 2014. Luxembourg: Publications Office of the European Union, 20142014.
  • Kulaksızoğlu B, Kara H, Özçelik Ö, Kuloğlu M. Use of naltrexone implant in the treatment of opioid addiction: A retrospective study. Anadolu Psikiyatri Derg 2019; 20(2): 133-138.
  • Neale J, Nettleton S, Pickering L. Gender sameness and difference in recovery from heroin dependence: A qualitative exploration. Int J Drug Policy 2014; 25(1): 3-12.
  • Kahler CW, Strong DR, Read JP. Toward efficient and comprehensive measurement of the alcohol problems continuum in college students: The Brief Young Adult Alcohol Consequences Questionnaire. Alcohol Clin Exp Res 2005; 29(7): 1180-1189.
  • Room R. Stigma, social inequality and alcohol and drug use. Drug Alcohol Rev 2005; 24(2): 143-155.
  • Treeby M, Bruno R. Shame and guilt-proneness: Divergent implications for problematic alcohol use and drinking to cope with anxiety and depression symptomatology. Pers Individ Diff 2012; 53(5): 613-617.
  • Mcgaffin, Breanna J, Lyons, Geoffrey CB, Deane, Frank P. Self-forgiveness, shame, and guilt in recovery from drug and alcohol problems. Subst Abuse 2013; 4: 396-404.
  • Şahin NH, Şahin N. Adolescent guilt, shame, and depression in relation to sociotropy and autonomy. The World Congress of Cognitive Therapy, Toronto, 1992.
  • Savaşır I, Şahin N. Evaluation in Cognitive Behavioral Therapies: Frequently Used Scales. Ankara: Turkish Psychologists Association Publications, 1997.
  • Evren C, Saatçioğlu Ö, Dalbudak E, Danışmant BS, Çakmak D, Ryan RM. Factor structure, validity and reliability of the Turkish version of the Treatment Motivation Questionnaire in alcohol-dependent patients. Journal of Dependence 2006; 7(4): 117-122.
  • Ryan RM, Plant RW, O'Malley S. Initial motivations for alcohol treatment: Relationships with patient characteristics, treatment involvement, and dropout. Addict Behav 1995; 20(3): 279-297.
  • Tabachnick BG, Fidell LS. Using Multivariate Statistics (6th Ed). California: California State University, 2013.
  • Kleber HD. Pharmacologic treatments for opioid dependence: detoxification and maintenance options. Dialogues Clin Neurosci 2007; 9(4): 455-470.
  • Hachtel H, Vogel T, Huber CG. Mandated treatment and its impact on therapeutic process and outcome factors. Front Psychiatry 2019; 10: 445975.
  • Batchelder AW, Glynn TR, Moskowitz JT, et al. The shame spiral of addiction: Negative self-conscious emotion and substance use. PLoS One 2022; 17(3): e0265480.
  • Sapkota S, Khadka, A, Akela G. Contributing factors to relapse of drug addiction among clients attending rehabilitation centres of Dharan, Nepal. Journal of Chitwan Medical College 2016; 6(3): 20-25.
  • Bilim Şenel G. Comparison of Individuals With And Without Alcohol Problems In Terms Of Feelings Of Guilt And Shame, Styles Of Coping With Stress And Internal-External Locus of Control. (Master's thesis). Maltepe University, Institute of Social Sciences, Istanbul, 2013.
  • McGaffin BJ, Lyons GC, Deane FP. Self-forgiveness, shame, and guilt in recovery from drug and alcohol problems. Subst Abuse 2013; 34(4): 396-404.
  • Kalyoncu ÖA, Mırsal H, Pektaş DÖ, et al. Feelings of guilt and shame in alcohol addicts. Journal of Dependence 2002; 3(3): 160-164.
  • Dearing RL, Stuewig J, Tangney JP. On the importance of distinguishing shame from guilt: Relations to problematic alcohol and drug use. Addict Behav 2005; 30(7): 1392-1404.
  • Rodríguez JM, Murphy K, Stanton C, et al. The composition of the gut microbiota throughout life, with an emphasis on early life. Microb Ecol Health Dis 2015; 26: 26050.
  • Piers G, Singer MB. Shame and Guilt. Springfield, Illinois: Charles C, 1953.
  • Cengiz B. The Relationship between Alcohol Use and Depression, Shame and Guilt in University Students: Examining the Moderating Effect of Religious Attitude. (Master's thesis). Nicosia: Near East University, Department of Clinical Psychology, 2020.
  • Tangney JP, Dearing RL. Shame and Guilt. New York: Guilford Press, 2003.
  • Harder DW. Shame and guilt assessment, and relationships of shame- and guilt-proneness to psychopathology. In JP Tangney & KW Fischer (Eds.), Self-Conscious Emotions: The Psychology of Shame, Guilt, Embarrassment, and Pride (pp. 368-392). New York: Guilford Press, 1995.
  • Lutwak N, Ferrari JR. Moral affect and cognitive processes: Differentiating shame from guilt among men and women. Pers Individ Diff 1996; 21(6): 891-896.
  • Stewart SH, Karp J, Pihl RO, Peterson, RA. Anxiety sensitivity and self-reported reasons for drug use. J Subst Abuse 1997; 9, 223-240.
  • Dodes LM. Addiction, helplessness, and narcissistic rage. Psychoanal Q 1990; 59(3): 398-419.
  • Richter SS, Brown, SA, Mott MA. The impact of social support and self-esteem on adolescent substance abuse treatment outcome. J Subst Abuse 1991; 3(4): 371-385.
  • O'Connor LE, Berry JW, Inaba D, et al. Shame, guilt, and depression in men and women in recovery from addiction. Journal of substance abuse treatment 1994; 11(6): 503-510.

Relationship between Guilt, Shame and Treatment Motivation in Individuals with Opioid Addiction

Yıl 2024, , 398 - 409, 30.12.2024
https://doi.org/10.51982/bagimli.1424031

Öz

Objective: This study aims to identify best practices in combating addiction by thoroughly examining the relationship between opioid addiction and feelings of guilt, shame, and treatment motivation.
Method: The sample of the study consists of 288 patients diagnosed with opioid addiction according to DSM-5 criteria by psychiatrists at Balıklı Rum Hospital. The scales used in the study were the Sociodemographic Form, the Guilt-Shame Scale, and the Treatment Motivation Questionnaire.
Results: There is a significant relationship between the level of guilt and internal motivation, confidence in treatment and treatment motivation and between shame and internal motivation and general treatment motivation. When the regression coefficients are analyzed, it is seen that only guilt scores are a significant predictor of treatment motivation scores. The shame variable does not have a significant effect. The participants' mean scores of guilt were found to be significantly higher than their mean scores of shame.
Conclusion: The study revealed a significant link between guilt and various aspects of treatment motivation, while shame showed a less pronounced association. Participants reported higher mean scores for guilt compared to shame, emphasizing the potentially greater relevance of guilt in influencing treatment motivation. Focusing on psychodrama and psychoeducational group studies for the treatment of opioid addiction can make it easier for the individual to express difficult negative emotions and develop awareness within the group.

Kaynakça

  • Lander L, Howsare J, Byrne M. The impact of substance use disorders on families and children: from theory to practice. Soc Work Public Health. 2013; 28(3-4): 194-205.
  • Schlag AK. Percentages of problem drug use and their implications for policy making: A review of the literature. Drug Sci Policy Law 2020; 6: 1-9.
  • Dönmezer S, Çetin Ö. Criminal law. Journal of Istanbul University Law Faculty 1975; 28(1): 237-256.
  • Günal HY. Uyuşturucu Madde Suçları. Ankara: İş Basım ve Yayın, 1976.
  • Ögel K, Karal, A, Tamar D, Çakmak, D. Alcohol and Substance Handbook. Istanbul: Bakırköy Psychiatric and Neurological Diseases Hospital, 1998.
  • American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders, 5th edition: DSM-5. Washington DC: American Psychiatric Publishing, 2013.
  • TUBİM Türkiye Drug Report. Ankara: Turkish Drug and Drug Addiction Monitoring Center, 2011.
  • European Monitoring Center for Drugs and Drug Addiction. European Drug Report 2014. Luxembourg: Publications Office of the European Union, 20142014.
  • Kulaksızoğlu B, Kara H, Özçelik Ö, Kuloğlu M. Use of naltrexone implant in the treatment of opioid addiction: A retrospective study. Anadolu Psikiyatri Derg 2019; 20(2): 133-138.
  • Neale J, Nettleton S, Pickering L. Gender sameness and difference in recovery from heroin dependence: A qualitative exploration. Int J Drug Policy 2014; 25(1): 3-12.
  • Kahler CW, Strong DR, Read JP. Toward efficient and comprehensive measurement of the alcohol problems continuum in college students: The Brief Young Adult Alcohol Consequences Questionnaire. Alcohol Clin Exp Res 2005; 29(7): 1180-1189.
  • Room R. Stigma, social inequality and alcohol and drug use. Drug Alcohol Rev 2005; 24(2): 143-155.
  • Treeby M, Bruno R. Shame and guilt-proneness: Divergent implications for problematic alcohol use and drinking to cope with anxiety and depression symptomatology. Pers Individ Diff 2012; 53(5): 613-617.
  • Mcgaffin, Breanna J, Lyons, Geoffrey CB, Deane, Frank P. Self-forgiveness, shame, and guilt in recovery from drug and alcohol problems. Subst Abuse 2013; 4: 396-404.
  • Şahin NH, Şahin N. Adolescent guilt, shame, and depression in relation to sociotropy and autonomy. The World Congress of Cognitive Therapy, Toronto, 1992.
  • Savaşır I, Şahin N. Evaluation in Cognitive Behavioral Therapies: Frequently Used Scales. Ankara: Turkish Psychologists Association Publications, 1997.
  • Evren C, Saatçioğlu Ö, Dalbudak E, Danışmant BS, Çakmak D, Ryan RM. Factor structure, validity and reliability of the Turkish version of the Treatment Motivation Questionnaire in alcohol-dependent patients. Journal of Dependence 2006; 7(4): 117-122.
  • Ryan RM, Plant RW, O'Malley S. Initial motivations for alcohol treatment: Relationships with patient characteristics, treatment involvement, and dropout. Addict Behav 1995; 20(3): 279-297.
  • Tabachnick BG, Fidell LS. Using Multivariate Statistics (6th Ed). California: California State University, 2013.
  • Kleber HD. Pharmacologic treatments for opioid dependence: detoxification and maintenance options. Dialogues Clin Neurosci 2007; 9(4): 455-470.
  • Hachtel H, Vogel T, Huber CG. Mandated treatment and its impact on therapeutic process and outcome factors. Front Psychiatry 2019; 10: 445975.
  • Batchelder AW, Glynn TR, Moskowitz JT, et al. The shame spiral of addiction: Negative self-conscious emotion and substance use. PLoS One 2022; 17(3): e0265480.
  • Sapkota S, Khadka, A, Akela G. Contributing factors to relapse of drug addiction among clients attending rehabilitation centres of Dharan, Nepal. Journal of Chitwan Medical College 2016; 6(3): 20-25.
  • Bilim Şenel G. Comparison of Individuals With And Without Alcohol Problems In Terms Of Feelings Of Guilt And Shame, Styles Of Coping With Stress And Internal-External Locus of Control. (Master's thesis). Maltepe University, Institute of Social Sciences, Istanbul, 2013.
  • McGaffin BJ, Lyons GC, Deane FP. Self-forgiveness, shame, and guilt in recovery from drug and alcohol problems. Subst Abuse 2013; 34(4): 396-404.
  • Kalyoncu ÖA, Mırsal H, Pektaş DÖ, et al. Feelings of guilt and shame in alcohol addicts. Journal of Dependence 2002; 3(3): 160-164.
  • Dearing RL, Stuewig J, Tangney JP. On the importance of distinguishing shame from guilt: Relations to problematic alcohol and drug use. Addict Behav 2005; 30(7): 1392-1404.
  • Rodríguez JM, Murphy K, Stanton C, et al. The composition of the gut microbiota throughout life, with an emphasis on early life. Microb Ecol Health Dis 2015; 26: 26050.
  • Piers G, Singer MB. Shame and Guilt. Springfield, Illinois: Charles C, 1953.
  • Cengiz B. The Relationship between Alcohol Use and Depression, Shame and Guilt in University Students: Examining the Moderating Effect of Religious Attitude. (Master's thesis). Nicosia: Near East University, Department of Clinical Psychology, 2020.
  • Tangney JP, Dearing RL. Shame and Guilt. New York: Guilford Press, 2003.
  • Harder DW. Shame and guilt assessment, and relationships of shame- and guilt-proneness to psychopathology. In JP Tangney & KW Fischer (Eds.), Self-Conscious Emotions: The Psychology of Shame, Guilt, Embarrassment, and Pride (pp. 368-392). New York: Guilford Press, 1995.
  • Lutwak N, Ferrari JR. Moral affect and cognitive processes: Differentiating shame from guilt among men and women. Pers Individ Diff 1996; 21(6): 891-896.
  • Stewart SH, Karp J, Pihl RO, Peterson, RA. Anxiety sensitivity and self-reported reasons for drug use. J Subst Abuse 1997; 9, 223-240.
  • Dodes LM. Addiction, helplessness, and narcissistic rage. Psychoanal Q 1990; 59(3): 398-419.
  • Richter SS, Brown, SA, Mott MA. The impact of social support and self-esteem on adolescent substance abuse treatment outcome. J Subst Abuse 1991; 3(4): 371-385.
  • O'Connor LE, Berry JW, Inaba D, et al. Shame, guilt, and depression in men and women in recovery from addiction. Journal of substance abuse treatment 1994; 11(6): 503-510.
Toplam 37 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Madde Bağımlılığı
Bölüm Araştırma
Yazarlar

Nuray Caymaz 0009-0006-1429-9578

Melike Ceylan 0000-0001-8603-8912

Yayımlanma Tarihi 30 Aralık 2024
Gönderilme Tarihi 27 Ocak 2024
Kabul Tarihi 1 Haziran 2024
Yayımlandığı Sayı Yıl 2024

Kaynak Göster

AMA Caymaz N, Ceylan M. Relationship between Guilt, Shame and Treatment Motivation in Individuals with Opioid Addiction. Bağımlılık Dergisi. Aralık 2024;25(4):398-409. doi:10.51982/bagimli.1424031

Bağımlılık Dergisi - Journal of Dependence