The Relationship of Substance Abuse with Attachment and Emotion Regulation

Öz

Objective: The purpose of this study to examine the characteristics of substance use (SU) and its relationship with psychiatric symptoms, emotion regulation and attachment in youth and young adults with substance abuse in the southeast region of Turkey who have been exposed to repetitive trauma. Method: Forty-four patients with substance use complaints completed Sociodemographic Form, Addiction Profile Index (BAPI), BAPI-Clinical Form. Association of SU disorder diagnosis with both emotion regulation as measured by the Emotion Regulation Questionnaire (ERQ) and the attachment style as measured by Parent Attachment Tool is evaluated. Results: Our sample consists of 44 male patients a mean age of 23.77 years. All of them can read and write, but none of them are university graduates. The rate of being single in marital status is 66%. 60% of them have a low income level. 45% of them do not work. 25% of the sample meets the addiction criteria. Compared to the addicted and non-addicted groups, the addicted groups had significantly higher scores on inadequate anger control, lack of safe behavior, pleasure-seeking behavior, impulsivity, depression, and anxiety. The non-addicted group had a higher mean for cognitive reappraisal. The non-addicted group had a higher mean for cognitive reappraisal. Inadequate anger control, pleasure seeking behavior and duration of anxiety about substance use were found to be risk factors for addiction. Conclusions: The addicted group is different from the non-addicted group for BAPI subscales and ERQ subscale- a cognitive reappraisal. The current findings expand our understanding of the psychological and behavioral aspects of addiction, especially in provinces such as Şırnak, where traumatic life events are repeated, as there are many risk factors for SUD.

Anahtar Kelimeler

• addiction
• attachment
• emotion regulation

Kaynakça

1. 1.Parker G. Parental Overprotection: A Risk Factor inPsychosocial Development. 1983.https://books.google.com.tr/books/about/Parental_Overprotection.
2. 2.Mücadele. Emniyet Genel Müdürlüğü NarkotikSuçlarla. "Türkiye Genel Nüfusta Tütün, Alkol veMadde Kullanımına Yönelik Tutum ve DavranışAraştırması Raporu; Ankara: Emniyet GenelMüdürlüğü. 2018; 1-13.
3. 3.Ünübol H, Hlzll Sayar G. Prevalence andSociodemographic Determinants of Substance Use inTurkey. Eur Addict Res. 2021;27(6):447-56.
4. 4.Yıldırım I. Şirnak Merkezinin Yeniden InşasiÜzerinden Toplumsal Ve Kültürel Bir Değişim Analizi.Sos Bilim Aktüel Araştırmalar - Etkiler-Sonuçlar 2023.
5. 5. Simsek I. Yaşanan travmatik olaya bağlı alkol/maddekullanımı olan tutuklu/hükümlü bireylerde travmasonrası stres belirtileri ile travma sonrası bilişlerinincelenmesi 2018.
6. 6.Cozolino L. The Neuroscience of HumanRelationships: Attachment And the Developing SocialBrain. The_Neuroscience_of_Human_Relationships, WW Norton & Co 2006.
7. 7.Gill R. Addictions from an Attachment Perspective :Do Broken Bonds and Early Trauma Lead to Addictive... Behaviours?. ROUTLEDGE; 2019.
8. 8.Meulewaeter F, De Pauw SSW, Vanderplasschen W.Mothering, Substance Use Disorders andIntergenerational Trauma Transmission: AnAttachment-Based Perspective. Front Psychiatry.2019;10.

9. 9.Mullin BC, Hinshaw S. Emotion Regulation andExternalizing Disorders in Children and Adolescents. ASystematic Review and Meta-Analysis of theIntergenerational Transmission of Criminal BehaviorView Project Berkeley Girls with ADHD LongitudinalStudy View Project 2007.
10. 10.Estévez A, Jáuregui P, Sánchez-Marcos I, López-González H, Griffiths MD. Attachment and emotionregulation in substance addictions and behavioraladdictions. J Behav Addict. 2017;6(4):534-44.
11. 11.Alvarez-Monjarás M, McMahon TJ, Suchman NE.Does maternal reflective functioning mediate associations between representations of caregiving with maternal sensitivity in a high-risk sample? Psychoanal Psychol. 2019;36(1):82-92.
12. 12.Isosävi S, Flykt M, Belt R, et al. Attachmentrepresentations among substance-abusing women intransition to motherhood: implications for prenatalemotions and mother–infant interaction. Attach HumDev. 2016;18(4):391-417.
13. 13.Rutherford HJV, Booth CR, Crowley MJ, Mayes LC.Investigating the relationship between workingmemory and emotion regulation in mothers. J CognPsychol. 2016;28(1):52-9.
14. 14.Suchman NE, Decoste C, Rosenberger P, McmahonTJ. Attachment-based intervention for substance-usingmothers: A preliminary test of the proposedmechanisms of change. Infant Ment Health J.2012;33(4):360-71.
15. 15.Fonagy, P., & Target M. Attachment, trauma, andpsychoanalysis: Where psychoanalysis meetsneuroscience. https://psycnet.apa.org/record/2007-19477-001.2008.
16. 16.Ögel K, Evren C, Karadag F, Tamar Gurol D.Bağımlılık Profil İndeksi’nin (BAPİ) Geliştirilmesi,Geçerlik ve Güvenilirliği. Türk Psikiyatri Dergisi. 2012;23(4):264-73.
17. 17.Ogel K, Koc C, Basabak A, Ismen E. M, Gorucu S.Development of Addiction Profile Index (Bapi) ClinicalForm: Reliability and Validity Study. Bağımlılık Dergisi.2015; 16(2):57-69.
18. 18.Kapçi EG, Küçüker S. The parental bondinginstrument: evaluation of psychometric propertieswith Turkish university students. Turk. J. Psychiatry.2006; 17(4):1-10.
19. 19.Gross JJ, John OP. Individual Differences in TwoEmotion Regulation Processes: Implications for Affect,Relationships, and Well-Being. J Pers Soc Psychol.2003;85(2):348-62.
20. 20.Totan T -. Duygu düzenlenme anketi Türkçeformunun geçerlik ve güvenirliği. Bilişsel DavranışçıPsikoterapi ve Araştırmalar.https://www.jcbpr.org/fulltext/77-1434977667.pdf.
21. 21.Doğan B, Arıkan Z. Adult Attention DeficitHyperactivity Symptoms In Alcohol And SubstanceDependent People. Balıkesır Heal Sci J. 2014;3(3):141-6.
22. 22.Calvete E, Estévez A. Substance use inadolescents:The role of stress, impulsivity, and schemas related tolack of limits. Adicciones. 2009;21(1):49-56.
23. 23.Shirazi M, Janfaza M. The Predictive Role ofDifficulties in Emotion Regulation and Self-Controlwith Susceptibility to Addiction in Drug-DependentIndividuals. Research on Addiction; 2015; 9(33):57-69.
24. 24.Turkey - Unemployment rate 2019 Statista.https://www.statista.com/statistics/263708/unemployment-rate-in-turkey/. Individuals with SubstanceUse Disorders. Community Ment Health J.2019;55(7):1236-45.
25. 26. Yurtseven A, Turan C, Yuncu Z, Annette Akgur S, Saz EU. Substance use frequency and relatedcharacteristics among adolescents presenting to anemergency department in Turkey. J Ethn Subst Abuse.2019.
26. 27.McCaul ME, Svikis DS, Moore RD. Predictors ofoutpatient treatment retention: Patient versussubstance use characteristics. Drug Alcohol Depend.2001;62(1):9-17.
27. 28.Miettunen J, Murray GK, Jones PB, et al.Longitudinal associations between childhood andadulthood externalizing and internalizingpsychopathology and adolescent substance use.Psychol Med. 2014;44(8):1727-38.
28. 29.Khodarahimi S, Ghadampour E, Pourkord M,Sheikhi S, Mazraeh N. The Roles of Attachment Style,Self-Efficacy, and Impulsivity on the Prediction ofAttitudes toward Substance Use in Male Adolescents. JPsychoactive Drugs. 2022;54(3):217-23.
29. 30.Schreiber LRN, Grant JE, Odlaug BL. Emotionregulation and impulsivity in young adults. J PsychiatrRes. 2012;46(5):651-8.
30. 31.Stellern J, Xiao KB, Grennell E, et al. Emotionregulation in substance use disorders: a systematicreview and meta-analysis. Addiction. 2023;118(1):30-47.