The Impact of Clinical Rotation in Addiction Treatment Centers (AMATEM) on Attitudes and Behaviors of Psychiatry Residents Toward Individuals with Addiction

Yıl 2025, Cilt: 7 Sayı: 1, 178 - 186, 15.01.2025

Mustafa Danışman , Gamze Zengin İspir , Kübra Sezer Katar

https://doi.org/10.37990/medr.1595001

Öz

Aim: Psychiatry residents often feel unprepared and may exhibit negative attitudes toward individuals with substance use disorders, which can undermine treatment access and outcomes. This study examined the impact of a three-month Alcohol and Drug Treatment Center (AMATEM) rotation on residents’ attitudes and explored factors influencing these attitudes.
Material and Method: Ninety-one psychiatry residents who applied for a three-month rotation training on addictions at Ankara Training and Research Hospital AMATEM Clinic completed a personal information form and the Attitudes and Behaviors Toward Substance Users Scale at the start and end of the rotation.
Results: Residents’ stigmatizing attitudes significantly decreased post-rotation. Those who felt unsafe before the rotation reported higher stigma scores, and residents who believed they needed more education had fewer negative attitudes initially. Paradoxically, participants who anticipated referring patients to AMATEM due to insufficient training showed increased stigma after completion of the rotation.
Conclusion: Overall, structured, practical, and case-based training—delivered under experienced supervision—can reduce negative attitudes and help residents feel safer. Further research should clarify how specific training processes influence the knowledge, attitudes, and beliefs of future psychiatrists regarding substance use disorders.

Anahtar Kelimeler

Addiction , psychiatry residents , addiction training , attitudes and stigma , healthcare education

Kaynakça

• Robinson SM, Adinoff B. The classification of substance use disorders: historical, contextual, and conceptual considerations. Behav Sci (Basel). 2016;6:18.
• American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 3rd edition. Washington, DC: American Psychiatric Association. 1987.
• Barnett AI, Hall W, Fry CL, Dilkes‐Frayne E, Carter A. Drug and alcohol treatment providers’ views about the disease model of addiction and its impact on clinical practice: A systematic review. Drug Alcohol Rev. 2018;37:697-720.
• Auriacombe M, Fatséas M, Daulouède J-P. Réduction des risques, gestion des dommages, soins de l’addiction. Comment s’y retrouver et faire au mieux? Soyons responsables: simplifions!. Alcoologie et Addictologie. 2017;39:99-100.
• Brickman P, Rabinowitz VC, Karuza J, et al. Models of helping and coping. Am Psychol. 1982;37:368-84.
• Barry CL, McGinty EE, Pescosolido BA, Goldman HH. Stigma, discrimination, treatment effectiveness, and policy: public views about drug addiction and mental illness. Psychiatr Serv. 2014;65:1269-72.
• Schomerus G, Lucht M, Holzinger A, et al. The stigma of alcohol dependence compared with other mental disorders: a review of population studies. Alcohol Alcohol. 2011;46:105-12.
• Yang LH, Wong LY, Grivel MM, Hasin DS. Stigma and substance use disorders: an international phenomenon. Curr Opin Psychiatry. 2017;30:378-88.
• Ford R, Bammer G, Becker N. Improving nurses' therapeutic attitude to patients who use illicit drugs: workplace drug and alcohol education is not enough. Int J Nurs Pract. 2009;15:112-8.
• Gilchrist G, Moskalewicz J, Slezakova S, et al. Staff regard towards working with substance users: a European multi‐centre study. Addiction. 2011;106:1114-25.
• McLaughlin D, McKenna H, Leslie J, et al. Illicit drug users in Northern Ireland: perceptions and experiences of health and social care professionals. J Psychiatr Ment Health Nurs. 2006;13:682-6.
• Au G. A review of attitude of medical professionals toward substance abuse. In: Au G, ed. International Conference on Tackling Drug Abuse. Hong Kong: The Government of the Hong Kong Special Administrative Region. 2006;citeseer.
• Kelleher S, Cotter P. A descriptive study on emergency department doctors’ and nurses’ knowledge and attitudes concerning substance use and substance users. Int Emerg Nurs. 2009;17:3-14.
• May JA, Warltier DC, Pagel PS. Attitudes of anesthesiologists about addiction and its treatment: a survey of Illinois and Wisconsin members of the American Society of Anesthesiologists. J Clin Anesth. 2002;14:284-9.
• Giannetti VJ, Sieppert JD, Holosko MJ. Attitudes and knowledge concerning alcohol abuse: curriculum implications. J Health Soc Policy. 2002;15:45-58.
• Russell C, Davies JB, Hunter SC. Predictors of addiction treatment providers' beliefs in the disease and choice models of addiction. J Subst Abuse Treat. 2011;40:150-64.
• Ball SA, Carroll KM, Canning-Ball M, Rounsaville BJ. Reasons for dropout from drug abuse treatment: symptoms, personality, and motivation. Addict Behav. 2006;31:320-30.
• Neale J, Tompkins C, Sheard L. Barriers to accessing generic health and social care services: a qualitative study of injecting drug users. Health Soc Care Community. 2008;16:147-54.
• Corrigan PW. Mental health stigma as social attribution: Implications for research methods and attitude change. Clin Psychol Sci Pract. 2000;7:48.
• Corrigan PW, Green A, Lundin R, et al. Familiarity with and social distance from people who have serious mental illness. Psychiatr Serv. 2001;52:953-8.
• McGillion J, Wanigaratne S, Feinmann C, et al. GPs' attitudes towards treating drug misusers. Br J Gen Pract. 2000;50:385-6.
• Howard V, Holmshaw J. Inpatient staff perceptions in providing care to individuals with co‐occurring mental health problems and illicit substance use. J Psychiatr Ment Health Nurs. 2010;17:862-72.
• Ding L, Landon BE, Wilson IB, et al. Predictors and consequences of negative physician attitudes toward HIV-infected injection drug users. Arch Intern Med. 2005;165:618-23.
• Strobel L, Schneider NK, Krampe H, et al. German medical students lack knowledge of how to treat smoking and problem drinking. Addiction. 2012;107:1878-82.
• Orsolini L, Rojnić Palavra I, Papanti GD, et al. Psychiatry trainees' attitudes, knowledge, and training in addiction psychiatry—a European survey. Front Psychiatry. 2021;11:585607.
• Danışman M, Zengin İspir G, Sezer Katar K, Uçar Hasanlı Z. Evaluation of services for combating addiction in Turkey within the scope of the twelfth development plan (2024-2028). Turk J Clin Psychiatry. 2024;27:254-6.
• Kline RB. Principles and practice of structural equation modeling. New York: Guilford Publications; 2023;426.
• Wakeman SE, Pham-Kanter G, Donelan K. Attitudes, practices, and preparedness to care for patients with substance use disorder: results from a survey of general internists. Substance Abuse. 2016;37:635-41.
• Avery J, Zerbo E. Improving psychiatry residents’ attitudes toward individuals diagnosed with substance use disorders. Harv Rev Psychiatry. 2015;23:296-300.
• Ford R. Interpersonal challenges as a constraint on care: the experience of nurses' care of patients who use illicit drugs. Contemp Nurse. 2011;37:241-52.
• Gary LE, Berry GL. Predicting attitudes toward substance use in a Black community: implications for prevention. Community Ment Health J. 1985;21:42-51.
• Spigner C, Hawkins WE, Loren W. Gender differences in perception of risk associated with alcohol and drug use among college students. Women Health. 1993;20:87-97.
• Meltzer EC, Suppes A, Burns S, et al. Stigmatization of substance use disorders among internal medicine residents. Subst Abuse. 2013;34:356-62.
• van Boekel LC, Brouwers EP, van Weeghel J, Garretsen HF. Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: systematic review. Tijdschr Psychiatr. 2015;57:489-97.
• Cazalis A, Lambert L, Auriacombe M. Stigmatization of people with addiction by health professionals: current knowledge. A scoping review. Drug Alcohol Depend Rep. 2023;9:100196.
• Bahji A, Smith J, Danilewitz M, et al. Towards competency-based medical education in addictions psychiatry: a systematic review. Can Med Educ J. 2021;12:126-41.
• Avery J, Knoepflmacher D, Mauer E, et al. Improvement in residents' attitudes toward individuals with substance use disorders following an online training module on stigma. HSS J. 2019;15:31-6.
• Jha MK, Abele MK, Brown JA, et al. Attitudes towards substance use disorders and association with motivational interviewing education: a survey of psychiatry chief residents. Acad Psychiatry. 2016;40:523-4.
• Agrawal S, Capponi P, López J, et al. From surviving to advising: a novel course pairing mental health and addictions service users as advisors to senior psychiatry residents. Acad Psychiatry. 2016;40:475-80.
• Bywood P, Lunnay B, Roche A. Effective dissemination: a systematic review of implementation strategies for the AOD field. Adelaide: National Centre for Education and Training on Addiction; 2008.