نقش سبک‌های دلبستگی و سیستم‌های مغزی رفتاری در عود سوء مصرف مواد معتادان وابسته به مواد افیونی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دکترای تخصصی روان شناسی بالینی، دانشیار دانشگاه حکیم سبزواری، سبزوار، ایران

2 کارشناسی ارشد مشاوره توانبخشی، دانشگاه آزاد اسلامی قوچان، قوچان، ایران

چکیده

مقدمه: هدف از پژوهش حاضر بررسی نقش سبک­های دلبستگی و سیستم­های مغزی رفتاری در عود مصرف معتادان وابسته به مواد افیونی بود.
روش کار: در این پژوهش علی-مقایسه ای، 50 نفر معتاد مبتلا به عود مصرف مواد افیونی از بین مراجعه کنندگان به کلینیک­های ترک اعتیاد امید، رهایی و واحد MMT دولتی شهر سبزوار به شیوه نمونه­گیری تصادفی،50 نفر معتاد با پاکی بالای یک سال از بین شرکت­کنندگان در گروه­های NA و50 نفر از افراد غیرمعتاد شهر سبزوار در سال 1395 به شیوه نمونه­گیری در دسترس انتخاب شدند. تمام آزمودنی­ها پرسشنامه­های سبک دلبستگی بزرگسالان (AAI) و شخصیت گری ـ ویلسون (GWPQ) را تکمیل نمودند. برای تجزیه و تحلیل داده­ها از آزمون تحلیل واریانس یک متغیری و چندمتغیری، آزمون کروسکال والیس و آزمون U من ویتنی در نرم افزار23SPSS- استفاده شد.
یافته­ها: نتایج نشان داد که افراد مبتلا به عود مصرف مواد نسبت به گروه غیر مبتلا و نسبت به افراد با پاکی بالای یک سال بیشتر دارای سبک دلبستگی ناایمن دوسوگرا بودند (001/0P=). افراد عادی نسبت به افراد پاک نیز از دلبستگی دوسوگرای کمتری رنج می­برند(012/0P=). اگر چه بین افراد پاک و مصرف­کننده از لحاظ سیستم­های مغزی رفتاری تفاوت معناداری وجود نداشت اما فعالیت مؤلفه­ی روی­آوری سیستم فعال ساز رفتاری (BAS)، مؤلفه­ی اجتناب انفعالی فعالیت سیستم بازدارنده­ی رفتاری (BIS) و مؤلفه­ی گریز سیستم ستیز-گریز در دو گروه مبتلا به عود مصرف مواد و پاک بیشتر از گروه افراد عادی بود (05/0p <).
نتیجه­گیری: به نظر می­رسد سبک دلبستگی ناایمن و سیستم­های مغزی-رفتاری نقش مهمی در عود مصرف مواد دارند.

کلیدواژه‌ها


  1. Delavarpoor MA, Soltani M, Hosseinchari M. [Prediction of recovery or relapse from substance abuse based on the emotional intelligence and religious coping]. Journal of psychiatry and clinical psychology 2008; 3: 307-15. (Persian)
  2. Bahrami Ehsa H. [Addiction and process of prevention]. 4th ed. Tehran: Samt; 2011: 17-26. (Persian)
  3. Matinnejad SA, Mousavi SA, Shams Esfandabad H. [Comparison of problem solving methods and thinking styles in addicted and non-addicted people]. Journal of research on addiction 2005; 3(11): 11-24. (Persian)
  4. Yassini Ardakani SM, Banaei-Boroujeni S, Dastjerdi G. [Psychiatric disorders prevalence comparison in opiate-dependent and non-opiate dependent individuals]. Journal of addiction research and therapy 2013; S8: 005. (Persian)
  5. Hajihasani M, Shafiabadi A, Pirsaghi F, Bashirpour M. [Prediction of addiction tendencies based on aggression and assertiveness in university students]. Journal of research on addiction 2007; 5(4): 41-54. (Persian)
  6. Farzam H, Farhadi KH, Rezaie M, Tolouie AR. [Comparing ultra rapid opiate detoxification with methadone in recurrent of self- introduced addicted subjects]. Journal of Kermanshah University of Medical Sciences 2010; 3(14): 14-18. (Persian)
  7. Lawental E. Ultra rapid opiate detoxification as compared to 30-day inpatient detoxification Program: A retrospective follow-up study. J Subst Abuse 2000; 11(2): 173-81.
  8. Ekhtiyari H, Behzadi A, Oghabiyan MA, Edalati H, Mokri A. [Illustrative signs inducing craving for injecting heroin]. Journal of advances in cognitive sciences 2006; 3: 43- 51. (Persian)
  9. Weinstein A, Feldtkeller B, Malizia W, Bailey N. Integrating the cognitive and physiological aspects of craving. J Psychopharmacol 1998; 12: 31-8.
  10. Henningfield JE, Shiffman S, Ferguson SG, Gritz ER. Tobacco dependence and withdrawal: Science base, challenges and opportunities for pharmacotherapy. Pharmacol Ther 2009; 123: 1-16.
  11. Gray JA. Brain systems that mediate both emotion and cognition. Special issue: Development of relationships between emotion and cognition. Cogn Emot 1990; 4: 269-88.
  12. Gray JA. Neural systems, emotion and personality. In: Madden J. (editor). Neurobiology of learning, emotion, and affect. 4th ed. New York: Raven; 1991: 273-306.
  13. Gray JA. Framework for taxonomy of psychiatric disorders. In: Cozen SHMV, Poll NEV, Sergeant J. (editors). Emotions: Essays on emotion theory. New Jersey: Erlbaum; 1994: 29-59.
  14. Gray JA, McNaughton N. The neuropsychology of anxiety: Reprise. In: Hope DA. (editor). Nebraska Symposium on Motivation. Perspectives on anxiety, panic, and fear; 1996: 61-134.
  15. Gray JA, McNaughton N. The neuropsychology of anxiety. An enquiry into the functions of the septohippocampal system. New York: Oxford University; 2000: 14-32, 48-61.
  16.  Corr PJ. Reinforcement sensitivity theory and personality. Neurosci Biobehav Rev 2004; 28: 317-32.
  17. Corr PJ, Pickering AD, Gray JA. Personality and reinforcement in associative and instrumental learning.  Pers Individ Diff 1995; 19: 47-71.
  18. Meyer B, Johnson SL, Winters R. Responsiveness to threat and incentive in bipolar disorder: Relations of the BIS/BAS scales with symptoms. J Psychopathol Behav Assess 2001; 23: 133-43.
  19. Fowles DC. Biological variables in psychopathology: A psychobiological perspective. In: Adams HE, Sutker PB. (editors). Comprehensive handbook of psychopathology. New York: Plenum Press; 1993: 85-141.
  20. Feldon J, Gary JA, Hamersley DR, Smith AD. The neuropsychology of schizophrenia. Behav Brain Sci 1991; 14-9.
  21. Franken IHA, Muris P, Georgieva I. Gray's model of personality and addiction. Addict Behav 2006; 31(3): 399-403.
  22. Hundt NE, Kimbrel NA, Mitchell JT, Nelson-Gray RO. High BAS, but not low BIS, predicts externalizing symptoms in adults. Pers Individ Diff 2008; 44(3): 563-73.
  23. Kimbrel NA, Nelson-Gray RO, Mitchell JT. Reinforcement sensitivity and maternal style as predictors of psychopathology. Pers Individ Diff 2007; 42(6): 1139-49.
  24. O’Connor RM, Stewart SH, Watt MC. Distinguishing BAS risk for university student’s drinking, smoking, and gambling behaviors. Pers Individ Diff 2009; 46(4): 514-19.
  25. Loxton NJ, Dawe S. How do dysfunctional eating and hazardous drinking women perform on behavioral measures of reward and punishment sensitivity? Pers Individ Diff 2007; 42(6): 1163-72.
  26. Franken I H A. Behavioral Approach System (BAS) sensitivity predicts alcohol craving. Pers Individ Diff 2002; 32(2): 349-55.
  27. Fowles DC. A motivational theory of psychopathology. In: Spaulding W. (editor). Integrated views of motivation and emotion. Nebraska Symposium on Motivation. Lincoln: University of Nebraska; 1994: 181-238.
  28. Franken IHA, Muris P. BIS/BAS personality characteristics and college students’ substance use. Pers Individ Diff 2006; 40(7): 1497-503.
  29. Loxton N J, Nguyen D, Casey L, Dawe S. Reward drive, rash impulsivity and punishment sensitivity in problem gamblers. Pers Individ Diff 2008; 45: 167-73.
  30. Pourmohseni Koluri F, Haghshenas A, Asadi S. [A comparison of brain-behavioral systems and gender differences among addicted and non-addicted persons]. Advances in cognitive science 2011; 13(2): 9-22. (Persian)
  31. Shiller VM. The attachment bond: Affectional ties across the lifespan. Lexington: Lexington Books; 2017: 23-39.
  32. Cassidy J, Shaver PR. Handbook of attachment: Theory, research, and clinical applications. 3rd ed. New York: Guilford; 2016: 15-42.
  33. Ainsworth MD, Bleher MC, Waters E, Wall S. Patterns of attachment: A psychological study of the strange situation. New York: Erlbaum; 1978: 35-57.
  34.  Mikulincer M, Shaver PR. Attachment in adulthood: structure, dynamics, and change. New York, NY: Guilford; 2007: 63-85.
  35. Thorberg FA, Lyvers M. Attachment in relation to affect regulation and interpersonal functioning among substance use disorder in patients. Addict Res Theory 2010; 18(4): 464-78.
  36. Molnar DS, Sadava SW, De Courville NH, Perrier CPK. Attachment, motivations, and alcohol: testing a dual-path model of high-risk drinking and adverse consequences in transitional clinical and student samples. Can J Behav Sci 2010; 42 (1): 1-13.
  37. Jones RA. Relationships between attachment styles, offense history, and substance abuse in jail populations. Unpublished dissertation. Regent University; 2009: 58-82.
  38. Thorberg FA, Lyvers M. Attachment, fear of intimacy and differentiation of self among clients in substance disorder treatment facilities. Addict Behav 2006; 31(4): 732-7.
  39. Caspers KMCadoret RJLangbehn DYucuis RTroutman B. Contributions of attachment style and perceived social support to lifetime use of illicit substances. Addict Behav 2005; 30(5): 1007-11.
  40. Bargh JA, Gollwitzer PM. Environmental control of goal-directed action: Automatic and strategic contingencies between situations and behavior. In: Spaulding WD. (editor). Integrative views of motivation, cognition, and emotion: Nebraska symposium on motivation. Lincoln, NE: University of Nebraska Press; 1994: 71-124.
  41. Andersen TE. Does attachment insecurity affect the outcomes of a multidisciplinary pain management program? The association between attachment in security, pain disability, distress, and the use of opioids. J Soc Sci Med 2012; 74: 1461-8.
  42. American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013.
  43. Collins NL, Read SJ. Adult attachment working models an relationship quality in dating couples. J Pers Soc Psychol 1990; 58(4): 644-63.
  44. Collins NL. Working models of attachment: Implications for explanation, emotion, and behavior. J Pers Soc Psychol 1996; 71(4): 810.
  45. Feeney J, Noller P. Adult attachment. California: Sage; 1996: 146-79.
  46. Collins N, Read SJ. Cognitive representation of attachment. The structure and function of working models. In: PerImon D, Olomew KB. (editors). Advances in personal relationships. London: Jessica Kingsley; 1994: 73-84.
  47. Pakdaman Sh. [The study of attachment and society seeking in adolescents]. Ph.D. Dissertation. Tehran: Tehran University, 2001: 102-29. (Persian)
  48. Wilson RD, Gray GA, Barrett PT. A factor analysis of Gray-Wilson personality questionnaire. Pers Individ Diff 1990; 11(10): 1037-44.
  49. Ashrafi A. [Evaluation of psychometric properties of Gray-Wilson personality questionnaire.] M.A. Dissertation. Tehran: Tarbiat-Modares University, 2006: 67-89. (Persian)
  50.  Van Wormer KS, Davis DR. Addiction Treatment: a strength perspective. 4th ed. Boston: Cengage Learning; 2003: 59-70.
  51. Bowlby J. Attachment and loss. 2nd ed. New York: Basic Books; 1999: 89-112.
  52. Kohut H. The analysis of the self: A systematic approach to the psychoanalytic treatment of narcissistic personality disorders. New York: International Universities Press; 1971: 64-82. 
  53. Mikulincer M, Shaver PR. Boosting attachment security to promote mental health, prosocial values, and inter-group tolerance. Psychol Inquir 2007; 18(3): 139-56.
  54. Birnbaum GE. Attachment orientations, sexual functioning, and relationship satisfaction in a community sample of women. J Soc Pers Relat 2007; 24(1): 21-35.
  55. Weiss F, Porrino LJ. Substance use disorders. In: Hersen M, Ammerican RD. (editors). Advanced abnormal child psychology. New Jersey: Lawrence Erlbaum Associates Publishers; 2000: 153-71.
  56. Gamble SA, Roberts JE. Adolescents' perceptions of primary caregivers and cognitive style: The roles of attachment security and gender. Cogn Ther Res 2005; 29: 123-41.
  57. Cole-Detke H, Kobak R. Attachment processes in eating disorder and depression. J Cons Clin Psychol 1996; 64: 282-90.
  58. Warren SL, Huston L, Egeland B, Sroufe LA. Child and adolescent anxiety disorders and early attachment. J Am Acad Child Adolesc Psychiatry 1997; 36: 637-44.
  59. McNally AM, Palfai TP, Levine RV, Moore BM. Attachment dimensions and drinking related problems among young adults the meditational role of coping motives. Addict Behav 2003; 28: 1115-27.
  60. Taylor J, Reeves M, James L, Bobadilla L. Disinhibitory trait profile and its relation to cluster B personality disorder features and substance use problems. Eur J Pers 2006; 20: 271-84.
  61. Heinz A, Löber S, Georgi A, Wrase J, Hermann D, Rey E-R, et al. Reward craving and withdrawal relief craving: Assessment of different motivational pathways to alcohol intake. Alcohol Alcoholism 2003; 38(1): 35-9.
  62. Nolen-Hoeksema S. Gender differences in risk factors and consequences for alcohol use and problems. Clin Psychol Rev 2004; 24(8): 981-1010.
  63. Ekhlas Al-Gamal E, Alzayyat A, Ahmad MM. Prevalence of Internet addiction and its association with psychological distress and coping strategies among university students in Jordan. Perspect Psychiatr Care 2016; 25(1): 49-61.