The Role of Sociodemographic, Clinical, Psychological, and Emotional Characteristics in the Shaping of the Motivation for Change and Readiness for Treatment in Patients with Alcohol Dependence
Authors:   V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russian Federation, Gromyko D. I. , Nechaeva A. I. ,   V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russian Federation, Alekseeva Y. V. ,   V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russian Federation, Tikhomirov D. I. ,   V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russian Federation, Kiselev A. S. ,   V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russian Federation, Krupitsky E. M. ,   V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russian Federation; Pavlov First St. Petersburg State Medical University, St. Petersburg, Russian Federation, Ilyuk R. D. ,   V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russian Federation
Published: October 2024

Introduction. Motivation for treatment is a complex and multidimensional phenomenon significantly impacting the effectiveness of medical assistance for patients with addictive disorders. An integrative assessment of biopsychosocial functioning and systematic analysis of the factors determining readiness for treatment are important directions of research aimed at understanding the formation of motivational processes in patients with alcohol dependence. Aim of the study is to determine sociodemographic, clinical, psychological and emotional characteristics of patients with alcohol dependence and with varying levels of motivation for treatment, as well as to identify predictors of readiness for change and treatment. Methods and Materials. A total of 138 patients with alcohol use disorder (F10.20; F10.21) were recruited for this cross-sectional study. Research instruments included: patients’ clinical charts, «The Stages of Change Readiness and Treatment Eagerness Scale» (SOCRATES), Differential Emotions Scale (DES), The State-Trait Anxiety Inventory (STAI), Hamilton Depression Rating Scale (HDRS), and State-Trait Anger Expression Inventory (STAXI), Attitude toward the disorder (TOBOL), Toronto Alexithymia Scale (TAS), Tests of anticipatory validity (TASPK), and Purpose-in-Life test (PIL). Results. The median age of the subjects was 27.0 years [20.0; 35.0]. Patients with low motivation for treatment (LMT), compared to subjects with medium (MMT) and high (HMT) motivation scores, were younger, displayed greater negative attitudes toward relatives, had shorter durations of substance use disorder and withdrawal symptoms, and reported fewer treatments and spontaneous remissions (p≤0.05). HMT patients had skilled jobs, longer duration of remission after treatment, and a higher ratio of remission duration to disease duration compared to LMT and MMT patients (p≤0.05). In contrast to the MMT group, the LMT participants demonstrated significantly higher levels of the emotion of contempt, alexithymia and a neurasthenic attitude toward the disorder (p≤0.05). Subjects with HMT, as opposed to LMT and MMT, had significantly lower levels of «depression», «trait anger», «trait anxiety»; while the levels of the emotion «surprise», «trait-situational anticipatory validity», «general anticipatory validity», «life performance», «I-locus of control» were significantly higher (p≤0.05). The following predictors for the readiness for change and treatment were identified: ratio of remission duration to disease duration (B1 = 57.05), skilled occupation (B2 = 2.10), emotions «surprise» (DES) (B3 = 1.81) and «contempt» (DES) (B4 = -1, 11), «trait anger» (STAXI) (B5 = -1, 72), neurasthenic attitude toward the disorder (TOBOL) (B6 = – 0.31), «general anticipatory validity» (TASPK) (B7 = 1.93), (B1, B2, .... , Bn – numbers and coefficients of predictors; multiple regression equation constant B0 = 92.35; adjusted R2 = 0.753). Conclusion. A benign course of alcohol use disorder progression, employment in a skilled job, prognostic abilities in assessing the development of life situations, and personal responsibility for one's life, as well as higher level of the emotion of surprise and low levels of anxiety, depression, anger, contempt, alexithymia, and neurasthenia, increase motivation for change and treatment in individuals with alcohol dependence.