پیش بینی عود مصرف مواد بر اساس آسیب های دوران کودکی : نقش میانجی بیگانگی روابط موضوعی، سازمان شخصیت مرزی و افسردگی

نوع مقاله: مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری مشاوره، دانشگاه آزاد اسلامی واحد قم، قم، ایران

2 استادیار، گروه روانشناسی عمومی، دانشگاه آزاد اسلامی واحد قم، قم، ایران

3 استادیار، گروه روانشناسی سلامت، دانشگاه آزاد اسلامی واحد قم، قم، ایران

10.22075/jcp.2020.19478.1806

چکیده

مقدمه: اثرات مخرب عود مصرف مواد همواره یکی از چالش­ های عمده در درمان اعتیاد بوده است. هدف این پژوهش تبیین مدل عود مصرف مواد بر اساس آسیب­ های دوران کودکی، با در نظر گرفتن نقش میانجی بیگانگی روابط موضوعی، سازمان شخصیت مرزی و افسردگی در گروهی از معتادان تحت درمان با متادون بود.
روش: پژوهش حاضر توصیفی - همبستگی است. جامعه آماری شامل کلیه معتادان مرد تحت درمان با متادون شهرستان کاشان در بهار 1398 بودند. تعداد 170 نفربه روش نمونه­ گیری در دسترس و بر اساس ملاک­­­­­ های ورود و خروج انتخاب شدند. جمع­ آوری داده­­ ها از طریق مقیاس عود مصرف، آسیب­ های دوران کودکی، پرسشنامه افسردگی بک، پرسشنامه روابط موضوعی بل، و سیاهه سازمان شخصیت کرنبرگ انجام شد. تحلیل داده‌ها به روش تحلیل مسیر از نوع مدل­ یابی معادلات ساختاری انجام شد.
یافته­ ها: مدل­ یابی روابط ساختاری میان متغیرهای آسیب­ های کودکی، بیگانگی روابط موضوعی، سازمان شخصیت مرزی و افسردگی با عود مصرف مواد به صورت مستقیم و غیرمستقیم، برازندگی خوبی نشان داد ( RMSEA=0/0489). در میان مسیرهای غیرمستقیم، متغیرهای میانجی روابط موضوعی و افسردگی معنادار بودند. در مجموع این مدل 49/6 درصد از عود مصرف مواد در میان معتادان تحت درمان متادون را تبیین می­کند.
نتیجه­ گیری: آسیب­ های دوران کودکی، می‌تواند به شکل تاثیر بر سازمان شخصیت، احساس بیگانگی و بالتبع افسردگی در دوران­ های بعدی زندگی افراد معتاد بروز کند و عود مواد راهبردی جهت رهایی از این رنج است. از این منظر شناسایی و پرداختن به عوامل مذکور، درک عمیق ­تری از عود ارائه می نماید. پیشنهاد می­ گردد متخصصین در یک بستر درمانی مؤثر به متغیرهای مذکور در قالب پروتکل­ های درمانی بپردازند.

کلیدواژه‌ها


عنوان مقاله [English]

Predicting the Substance Use Relapse according to Childhood Trauma: Mediating Role of Object Relations Alienation, Borderline Personality Organization & Depression

نویسندگان [English]

  • Hamzeh Arbab 1
  • Hasan Mirzahosini 2
  • Nader Monirpoor 3
1 Department of Psychology, Ghom Branch, Islamic Azad University, Ghom, Iran
2 Department of Psychology, Ghom Branch, Islamic Azad University, Ghom, Iran
3 Department of Psychology, Ghom Branch, Islamic Azad University, Ghom, Iran
چکیده [English]

Introduction:  Harmful effects of ubstance use relapses has been long a greate challenge in the treatment of addiction. The purpose of this study was to explain the substance use relapse model in addict individuals based on the childhood trauma, regarding the mediating roles of object relations alienation, borderline personality organization and depression in a group of Methadone-treated addicts.
Method: Applying a descriptive - correlational design, among all male methadone-treated  addicts of kashan city in 2019, a sample of 170 subjects were selected by available sampling method and inclusion/exclusion criteria were controlled for. Data were collected through the Relapse Prediction Scale, Childhood Trauma Questionnaire, Beck Depression Inventory, Bell's Object Relations Inventory, and the Kernberg’s   Inventory of Personality. Data analysed by a path analysis of structural equation modeling.
Results: The structural equation modelling of childhood trauma, alienation, personality organization and depression with substance use relapse directly and indirectly demonstrated significant fitness (RMSEA: 0.0489). Among indirect paths, mediator variables including object relations and depression were significant. Overall, this models explained %49/6 of the variances of substance use relapse among Methadone-treated male addicts.
Conclusion: Childhood trauma impact personality organization, feelings of alienation, and depression in later life periods, and relapse is a style to get rid of these suffering. From this perspective, identifying and addressing these factors provides a deeper understanding of relapse. It is suggested that in an effective treatment context address the variables expressed in the form of treatment protocols.

کلیدواژه‌ها [English]

  • substance use relapse
  • childhood trauma
  • Object relation
  • personality organization
  • depression
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