Abstract
The aim of this study was to explore self-schemas and attachment style among patients in a methadone or buprenorphine maintenance treatment program of opiate dependence, in relation to treatment outcome (relapse in substance use). The study included 84 patients (21 women and 63 men) in a psychiatric clinic in Malmö, Sweden, providing maintenance treatment of opiate dependence. Three self-report instruments were employed, Young Schema Questionnaire Short version (YSQ-S) and Young Parenting Inventory (YPI) for studying self-schemas and Experiences in Close Relationships–Relationship Structures questionnaire (ECR-RS) for studying attachment style. Demographical data and relapse in substance abuse were registered. The study demonstrated, unsurprisingly, that an insecure attachment style was more common in the group of patients compared to available general population reference data. Significant correlations were found between attachment style and core beliefs about the self (self-schemas). Memories of parenting experiences from childhood (YPI) showed correlations with ongoing self-schemas (YSQ-S). Treatment outcome, defined as relapses in substance abuse, was associated to a minor degree with self-schemas but showed no correlation with attachment style. Patients who did not work or study had more maladaptive self-schemas and insecure attachment style, and a higher incidence of relapse in abuse than patients who were working or studying.
Highlights
The abuse of opiates creates problems at both individual and community levels
Significant differences in selfschemas (Table 2) as assessed with Young Schema Questionnaire Short version (YSQ-S) were obtained between patients and controls with respect to Abandonment, Mistrust/abuse, Social isolation, and Enmeshment, where patients scored significantly higher than controls
The current study provides a comprehensive account of self-schema and attachment style in a sample of opiate dependent patients in ongoing treatment (OMT)
Summary
It is important to understand how psychological factors contribute to such abuse and affect the possibility of reducing this through treatment. Previous research on opiate abuse has suggested a number of such factors (Darke et al, 2017; Strang et al, 2020). The present study focuses on cognitive and emotional structures that affect the view of the self and others. We map self-schemas and attachment style in a group of opiate dependent patients in an opiate maintenance treatment unit and examine the relation between these structures and relapse in abuse. The study of self-schema is based on cognitive theory and describes specific assumptions about oneself and one’s personal characteristics and skills.
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