نوع مقاله : علمی- پژوهشی

نویسندگان

• نرجس عامری ¹
• محمود نجفی ²

¹ دانشجوی دکتری تخصصی روانشناسی، گروه روانشناسی بالینی، دانشکده روان‌شناسی و علوم تربیتی، دانشگاه سمنان، سمنان، ایران.

² (نویسنده مسئول)، دانشیار، گروه روانشناسی بالینی، دانشکده روان‌شناسی و علوم تربیتی، دانشگاه سمنان، سمنان، ایران.

چکیده

مقدمه: اشتیاق و آمادگی برای تغییر اولین گام‌های حیاتی در پیشگیری از بازگشت به وابستگی به مواد است. بنابراین، بررسی آن برای مداخلات درمانی موثر ضروری است. از این رو، هدف از پژوهش حاضر تعیین نقش میانجی تمرکززدایی و احساس حقارت در رابطه بین ذهن‌آگاهی با اشتیاق و آمادگی به درمان در افراد وابسته به مواد تحت درمان نگهدارنده با متادون بود.
روش: روش پژوهش توصیفی از نوع همبستگی بود. از میان بیماران وابسته به مواد تحت درمان با متادون مراجعه‌کننده به مراکز ترک اعتیاد شهر شاهرود در سال 1403 با توجه به ملاک‌های ورود و خروج، 312 نفر به شیوه نمونه‌گیری هدفمند انتخاب شدند. ابزارهای مورد استفاده در این پژوهش شامل مقیاس مراحل آمادگی برای تغییر و اشتیاق درمان میلر و تونیگان (1997)، پرسشنامه پنج وجهی ذهن آگاهی بائر و همکاران (2006)، پرسشنامه تجربه‌ها فرسکو و همکاران (2007) و پرسشنامه تلاش برای اجتناب از حقارت گیلبرت و همکاران (2007) بود. به منظور تحلیل مدل پژوهش از مدل‌سازی معادلات ساختاری استفاده شد.
یافته‌ها: یافته‌ها نشان داد که ذهن‌آگاهی بر اشتیاق و آمادگی به درمان اثر مستقیم و معناداری دارد (001/0>P و 276/0β =). همچنین، اثر مستقیم ذهن‌آگاهی بر تمرکززدایی  (416/0β =) و اجتناب از حقارت (468/0β =) به صورت مثبت و اثر تمرکززدایی (237/0β =) و اجتناب از حقارت (403/0β =) بر اشتیاق و آمادگی به درمان نیز به صورت مثبت در سطح (001/0>P) معنادار شدند و تمرکززدایی و احساس حقارت در رابطه ذهن آگاهی و اشتیاق و آمادگی به درمان نقش واسطه‌ای دارد (001/0>P و 287/0β =). در مجموع نتایج نشان داد که مدل از برازش مطلوبی برخوردار بود.
نتیجه‌گیری: این یافته‌ها نشان می‌دهد که افزایش تمرکززدایی، ذهن‌آگاهی و تلاش برای جبران حقارت می‌تواند به طور قابل‌توجهی به افزایش اشتیاق و آمادگی برای تغییر در افراد وابسته به مواد کمک کند.

کلیدواژه‌ها

• اشتیاق درمان
• احساس حقارت
• افراد وابسته به مواد
• تمرکززدایی
• ذهن‌آگاهی
• متادون

موضوعات

• 1. فرایندهای روانشناختی و اجتماعی مرتبط با علائم بیماری ها

عنوان مقاله [English]

Modeling Readiness and Eagerness for Treatment based on Mindfulness with the Mediating Role of Decentralization and Feelings of Inferiority in Substance-Dependent Individuals Undergoing Methadone Maintenance Treatment

نویسندگان [English]

• Narjes Ameri ¹
• Mahmoud Najafi ²

¹ PhD Student in Psychology, Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran..

² (Corresponding Author), Associate Professor, Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Semnan University, Semnan, Iran.

چکیده [English]

Objective: Motivation and readiness to change are critical first steps in preventing relapse into substance dependence. Given the importance of assessing an individual’s motivation to change before initiating any intervention for substance abuse or dependency, it is imperative to understand the potential factors that influence readiness to change in affected individuals. Mindfulness can be considered one of the factors influencing readiness to change. It is defined as the awareness of internal and external experiences without judgment, an openness to both positive and negative experiences, and the acceptance of painful experiences. Striving to compensate for inferiority and decentralization can be considered a factor influencing readiness to change in individuals with substance abuse or dependence. While substantial research has examined mindfulness in individuals with substance abuse issues, there is a limited exploration of how mindfulness intersect with the drive to compensate for feelings of inferiority and decentralization and readiness to change in this population. This study aims to address this gap by investigating the relationships among decentralization, mindfulness, striving to compensate for inferiority, and readiness to change in individuals with substance abuse. Incorporating novel psychotherapy interventions alongside traditional methods and pharmacotherapy may significantly enhance readiness to change among individuals with substance dependency. Should the proposed model be validated, it could inform the development of a targeted inter ventional protocol to increase readiness to change in substance abusers. Method: This research uses a descriptive, correlational approach and has a structural equation modeling. The statistical population consisted of substance-dependent patients undergoing methadone treatment referring in 2024 to addiction treatment centers in Shahrood. To this end, 312 individuals volunteered to participate. Data were collected using the Stages of Change Readiness and Treatment Eagerness Scale Miller  & Tonigan (1997), Five 




Factor Mindfulness Questionnaire Baer et al (2006), Experiences Questionnaire Fresco et al (2007) and the Striving to Avoid Inferiority Scale Gilbert et al (2007). The analysis of the data was carried out using the Pearson correlation test and structural equation modeling by SPSS 26 and AMOS 24 software. Instruments




The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES): The SOCRATES has 19 items, with scores ranging from 19 to 95; a higher score indicates greater motivation and enthusiasm for change. In the present study, a Cronbach's alpha of 0.91 was achieved. Five Factor Mindfulness Questionnaire (FFMQ): The FFMQ has 39 items, with scores ranging from 35 to 195; a higher score indicates greater Mindfulness. In the present study, a Cronbach's alpha of 0.88 was achieved. Experiences Questionnaire (EQ): The EQ has 11 items, with scores ranging from 11 to 55; a higher score indicates greater decentralization. In the present study, a Cronbach's alpha of 0.86 was achieved. Striving to Avoid Inferiority Scale (SAIS): The SAIS has 31 items, with scores ranging from 0 to 124. In the present study, a Cronbach's alpha of 0.90 was achieved. Results: Prior to conducting path analysis, the Kolmogorov-Smirnov test confirmed normality assumptions. Given that structural equation analysis relies on Pearson correlation coefficients derived from the sample correlation matrix, it is noteworthy that all correlations reached statistical significance (P<0.01). Furthermore, results pertaining to fit indices indicated the model's satisfactory alignment with the data in this study. According to the results, mindfulness have a positive relationship with readiness to change in individuals with substance abuse (P < 0.001 and β = 0.276).Also, the direct effect of mindfulness on decentralization (β = 0.416) and avoidance of inferiority (β = 0.468) was positive, and the effect of decentralization (β = 0.237) and avoidance of inferiority (β = 0.403) on willingness and readiness for treatment was also positive and significant at the level of (P < 0.001). Overall, the results showed that the model had a good fit.As per Table 1, the Bootstrap test results reveal a significant mediating role of decentralization and feelings of inferiority in the relationship between mindfulness with readiness and eagerness for treatment  (P < 0.001 and β=0.287). Conclusion: It is inferred from the findings of this study that increase in mindfulness leads to greater awareness of thoughts, behaviors, and feelings, which in turn fosters acceptance of failures and motivates individuals with substance abuse to compensate for these failures. Striving to compensate for feelings of inferiority increases motivation to change in substance abusers, and if this effort is accompanied by mindfulness and decentralization, there is a greater expectation for change. Feelings of inferiority, stemming from negative childhood experiences, play an important role in individuals’ tendency to abuse drugs and develop addiction; Nevertheless, while interventions aimed at overcoming feelings of inferiority and adopting the Adlerian perspective as a holistic treatment can be effective in treating individuals with substance abuse, it would be beneficial for these interventions to incorporate a focus on mindfulness and decentralization. Additionally, an increase in mindfulness leads to greater awareness of thoughts, behaviors, and feelings, which in turn fosters acceptance of failures and motivates individuals with substance abuse to compensate for these failures.

کلیدواژه‌ها [English]

• Decentralization
• Feelings of Inferiority
• Mindfulness
• Methadone
• Substance-dependent Individuals
• Treatment Willingness