Motivation to change and factors influencing motivation in alcohol dependence syndrome in a tertiary care hospital

Prima Cheryl D'Souza, P John Mathai, Prima Cheryl D'Souza, P John Mathai

Abstract

Context: Motivation plays an important role in the treatment of alcohol dependence syndrome (ADS) by influencing the patient to seek and comply with treatment as well as make successful long term changes.

Aim: The aim of this study is to study the motivation for change in inpatients with ADS.

Settings and design: One hundred consecutive patients admitted for the treatment of ADS in a medical college hospital were evaluated.

Materials and methods: The International Classification of Disease 10th Revision - AM symptom checklist for mental disorders screener and appropriate modules were used to establish ADS. The assessment of motivation was done using the University of Rhode Island Change Assessment scale at baseline and after 2 weeks of admission. The Severity of Alcohol Dependence Questionnaire and Kuppuswamy's scale for socioeconomic status were used.

Statistical analysis: Paired and unpaired t-test, Fisher's exact test, and Wilcoxon signed-rank test were used to analyze data.

Results: The assessment of motivation showed 60% of patients in precontemplation (PC) stage at baseline, compared to 34% of the patients in PC, 57% in contemplation, and 9% in action stage after 2 weeks of inpatient stay. A highly significant change was seen in the levels of motivation toward contemplation and action stage after 2 weeks of inpatient stay (Z = 5.745, P < 0.001). Motivation to change had a significant association with complications of alcohol use, medical comorbidity, onset and severity of alcohol dependence, socioeconomic status, religion, and mode of referral.

Conclusions: The study concludes that certain patients with ADS may have low pretreatment levels of motivation, with significant improvement in the motivation levels after a short duration of inpatient treatment.

Keywords: Alcohol; factors; motivation to change.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Distribution of sample across precontemplation, contemplation, and action stages of motivation at week 1 (purple) and week 2 (blue), reflecting a significant improvement in the motivation to change after 2 weeks, Wilcoxon signed-ranks test Z = 5.745, P ≤ 0.001

References

    1. Girish N, Kavita R, Gururaj G, Benegal V. Alcohol use and implications for public health: Patterns of use in four communities. Indian J Community Med. 2010;35:238–44.
    1. Murthy P, Manjunatha N, Subodh BN, Chand PK, Benegal V. Substance use and addiction research in India. Indian J Psychiatry. 2010;52(Suppl 1):S189–99.
    1. DiClemente CC. Conceptual models and applied research: The ongoing contribution of the transtheoretical model. J Addict Nurs. 2005;16:5–12.
    1. DiClemente CC, Doyle SR, Donovan D. Predicting treatment seekers’ readiness to change their drinking behavior in the COMBINE Study. Alcohol Clin Exp Res. 2009;33:879–92.
    1. Isenhart CE. Pretreatment readiness for change in male alcohol dependent subjects: Predictors of one-year follow-up status. J Stud Alcohol. 1997;58:351–7.
    1. Borsari B, Murphy JG, Carey KB. Readiness to change in brief motivational interventions: A requisite condition for drinking reductions? Addict Behav. 2009;34:232–5.
    1. Bombardier CH, Rimmele CT. Alcohol use and readiness to change after spinal cord injury. Arch Phys Med Rehabil. 1998;79:1110–5.
    1. Forsberg L, Ekman S, Halldin J, Rönnberg S. The readiness to change questionnaire: Reliability and validity of a Swedish version and a comparison of scoring methods. Br J Health Psychol. 2004;9(Pt 3):335–46.
    1. Freyer-Adam J, Coder B, Ottersbach C, Tonigan JS, Rumpf HJ, John U, et al. The performance of two motivation measures and outcome after alcohol detoxification. Alcohol Alcohol. 2009;44:77–83.
    1. Shealy AE, Murphy JG, Borsari B, Correia CJ. Predictors of motivation to change alcohol use among referred college students. Addict Behav. 2007;32:2358–64.
    1. Williams EC, Kivlahan DR, Saitz R, Merrill JO, Achtmeyer CE, McCormick KA, et al. Readiness to change in primary care patients who screened positive for alcohol misuse. Ann Fam Med. 2006;4:213–20.
    1. Prasad S, Murthy P, Subbakrishna DK, Gopinath PS. Treatment setting and follow-up in alcohol dependence. Indian J Psychiatry. 2000;42:387–92.
    1. Witkiewitz K, Hartzler B, Donovan D. Matching motivation enhancement treatment to client motivation: Re-examining the Project MATCH motivation matching hypothesis. Addiction. 2010;105:1403–13.
    1. Bauer S, Strik W, Moggi F. Motivation as a predictor of drinking outcomes after residential treatment programs for alcohol dependence. J Addict Med. 2014;8:137–42.
    1. DiClemente CC, Bellino LE, Neavins TM. Motivation for change and alcoholism treatment. Alcohol Res Health. 1999;23:86–92.
    1. DeMartini KS, Devine EG, DiClemente CC, Martin DJ, Ray LA, O’Malley SS. Predictors of pretreatment commitment to abstinence: Results from the COMBINE study. J Stud Alcohol Drugs. 2014;75:438–46.
    1. Rice SL, Hagler KJ, Tonigan JS. Longitudinal trajectories of readiness to change: Alcohol use and help-seeking behavior. J Stud Alcohol Drugs. 2014;75:486–95.
    1. NCCH. ICD-10 AM Symptom Checklist for Mental Disorders: ICD-10 AM Mental Health Manuel Appendices; Appendix-two. 1st ed. NSW, Australia: University of Sydney; 2002.
    1. McConnaughy EA, Prochaska JO, Velicer WF. Stages of change in psychotherapy: Measurement and sample profiles. Psychotherapy: Theory, Research & Practice. 1983;20(3):368–75.
    1. Stockwell T, Murphy D, Hodgson R. The severity of alcohol dependence questionnaire: Its use, reliability and validity. Br J Addict. 1983;78:145–55.
    1. Kuppuswamy B. Manual of socioeconomic status (Urban) 1st ed. Delhi: Manasayan; 1981. pp. 66–72.
    1. Kumar N, Shekhar C, Kumar P, Kundu AS. Kuppuswamy's socioeconomic status scale-updating for 2007. Indian J Pediatr. 2007;74:1131–2.
    1. Ilgen MA, McKellar J, Moos R, Finney JW. Therapeutic alliance and the relationship between motivation and treatment outcomes in patients with alcohol use disorder. J Subst Abuse Treat. 2006;31:157–62.
    1. Rumpf HJ, Hapke U, Meyer C, John U. Motivation to change drinking behavior: Comparison of alcohol-dependent individuals in a general hospital and a general population sample. Gen Hosp Psychiatry. 1999;21:348–53.
    1. Lau K, Freyer-Adam J, Gaertner B, Rumpf HJ, John U, Hapke U. Motivation to change risky drinking and motivation to seek help for alcohol risk drinking among general hospital inpatients with problem drinking and alcohol-related diseases. Gen Hosp Psychiatry. 2010;32:86–93.
    1. Rimm E. Alcohol and cardiovascular disease. Curr Atheroscler Rep. 2000;2:529–35.
    1. Kendler KS, Gardner CO, Prescott CA. Religion, psychopathology, and substance use and abuse; a multimeasure, genetic-epidemiologic study. Am J Psychiatry. 1997;154:322–9.
    1. Clark BJ, Jones J, Cook P, Tian K, Moss M. Facilitators and barriers to initiating change in medical intensive care unit survivors with alcohol use disorders: A qualitative study. J Crit Care. 2013;28:849–56.
    1. de Oliveira Júnior HP, Malbergier A. Assessment of motivation for treatment in alcohol dependent patients who sought treatment at a specialized medical service. Rev Bras Psiquiatr. 2003;25:5–10.
    1. Barnett NP, Lebeau-Craven R, O’Leary TA, Colby SM, Rohsenow DJ, Monti PM, et al. Predictors of motivation to change after medical treatment for drinking-related events in adolescents. Psychol Addict Behav. 2002;16:106–12.
    1. Hosier SG, Cox WM. Personality and motivational correlates of alcohol consumption and alcohol-related problems among excessive drinking university students. Addict Behav. 2011;36:87–94.
    1. Cloninger CR, Bohman M, Sigvardsson S. Inheritance of alcohol abuse. Cross-fostering analysis of adopted men. Arch Gen Psychiatry. 1981;38:861–8.
    1. Sarkar S, Patra BN, Kattimani S. Substance use disorder and the family: An Indian perspective. Med J DY Patil Univ. 2016;9:7–14.

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera