نوع مقاله : مقاله پژوهشی
نویسنده
استادیار، گروه روانشناسی، دانشکده علوم انسانی، واحد رشت، دانشگاه آزاد اسلامی، رشت، ایران.
چکیده
کلیدواژهها
عنوان مقاله [English]
نویسنده [English]
Introduction: Due to personality issues, individuals who abuse narcotic substances are more prone to self-harm than the general population. The aim of this study is to compare clinical personality patterns and severe personality pathologies in narcotic substance abusers with and without non-suicidal self-injury.
Method: This descriptive study employed a causal-comparative design. The statistical population for this research includes all individuals who abuse narcotic substances and have been referred to addiction centers. The study participants consisted of 115 individuals who abused narcotic substances and exhibited non-suicidal self-injury, as well as 130 individuals who abused narcotic substances but did not engage in non-suicidal self-injury. Participants were recruited from addiction centers and selected based on their responses to the self-harm questionnaire developed by Sanson et al. (with a score of 5) and through clinical interviews. Research data were collected using the Self-Harm Questionnaire developed by Sanson et al. (1998) and the Millon Clinical Multiaxial Inventory-3 (1994). A multivariate analysis of variance was conducted to analyze the data.
Results: The results indicated significant differences in clinical personality patterns and severe personality pathologies among narcotic substance abusers with non-suicidal self-injury (P < 0.05). In other words, this research indicates that individuals who abuse narcotic substances and engage in non-suicidal self-injury exhibit a greater prevalence of clinical personality patterns (with the exception of narcissistic and sadistic traits) and severe personality pathologies.
Discussion and conclusion: The findings of this research indicate that individuals who abuse narcotic substances and exhibit severe personality pathologies, along with clinical personality patterns, are at a heightened risk for personality and psychological issues. By implementing preventive measures, as well as educational and therapeutic interventions, we can help safeguard these individuals from further complications.
Extended Abstract
Introduction
Personality disorders, particularly narcissistic and antisocial disorders, are associated with self-injurious behavior that includes suicidal intent (15). These disorders can also contribute to non-suicidal self-injury (NSSI) behaviors (18). Individuals exhibiting negative psychological traits in challenging situations are more likely to engage in avoidance and NSSI (21). Also, 15% of the variance in self-injurious behaviors is attributed to symptoms of borderline personality disorder (22). Individuals exhibiting non-suicidal self-injury (NSSI) behaviors demonstrate lower levels of resilience and self-compassion, as well as a higher incidence of early victimization experiences (23). Research indicates that 44.3% of the variance in NSSI is predicted by factors such as exposure, outcome expectations, and avoidance self-efficacy (24). Additionally, self-harm and suicide risk serve a maintenance role in borderline personality disorder (26). In research, the positive impact of severe personality disorders (such as borderline, narcissistic, and antisocial personality disorders) was found to be greater than that of dark personality traits on non-suicidal self-injury (NSSI) behaviors among individuals hospitalized in mental health facilities and those residing in prisons in Tehran (28). Borderline personality traits serve as a mediating factor in the relationship between low social support and self-harm (29). Additionally, symptoms of borderline personality disorder heighten the risk of self-injurious behaviors (30). Although few studies have examined the clinical patterns of personality and severe personality disorders in individuals with addiction, both with and without non-suicidal self-injury (NSSI) behaviors, there is evidence regarding the frequency and severity of NSSI among addicts. Therefore, this study compares the clinical personality patterns and severe personality pathologies in narcotic substance abusers, both with and without non-suicidal self-injury (NSSI).
Method
The research sample consisted of 103 individuals with a history of self-injury and 123 individuals without self-injury. Participants were identified and selected from a group of drug abusers who scored 5 or higher on the self-harm questionnaire developed by Sanson et al. (32) and underwent a clinical interview. The criteria for inclusion in the study were as follows: participants had to be drug addicts, provide consent to participate, have a history of at least 5 years of continuous drug use, be between the ages of 25 and 40, be male, and possess an educational background ranging from a diploma to a bachelor's degree. The criteria for leaving the research study are as follows: the absence of chronic physical and mental illnesses (as determined by a clinical interview) and the failure to complete the required data. After consulting with addiction treatment centers, the consent of the individuals struggling with substance abuse was obtained. Following a clinical interview, they were provided with explanations regarding the confidentiality of the research findings and the importance of answering all questions honestly. Then, the Self-Injury Questionnaire (32) (Sanson et al., 1998) and the Clinical Multi-Axis Questionnaire (Milon-3, 1994) were completed by the participants. Out of the 251 completed questionnaires, 25 were excluded from the study due to incomplete responses and outlier data.
Based on a cutoff score of 5 or higher and a clinical interview, 103 drug abusers with non-suicidal self-injury (NSSI) and 123 drug abusers without NSSI were selected for the comparison group. Finally, the research data were analyzed using MANOVA.
Results
The mean (and standard deviation) age of male drug abusers with and without NSSI behaviors is 36.59 (6.06) and 37.55 (9.07), respectively.
The results of MANOVA showed that 43.1% of the variance of clinical personality patterns and 48.9% of the variance of severe personality damage of drug abusers are caused by NSSI.
Table 1: Results MANOV
OP
Eta2
P
F
Variables
OP
Eta2
P
F
Variables
.22
.004
.37
.89
Sadistic
1
.059
.001
75.75
Schizoid
1
.169
.001
51.34
Obsessiv/Compalsive
1
.088
.001
24.28
Avoidant
1
.123
.001
35.57
Negativity
1
.112
.001
31.85
Depressed
1
.137
.001
18.47
Masochism
1
.136
.001
38.17
Dependet
1
.106
.001
30.04
Schizotypol
.85
.021
.004
5.51
Histrionic
1
.274
.001
95.42
Borderline
.11
.36
.70
.36
Narssism
1
.117
.001
33.66
Paranoid
1
.10
.001
28.20
Antisocial
In Table 1, the results indicate a significant difference between clinical personality patterns (with the exception of narcissism and sadism) and severe personality pathologies in narcotic substance abusers with and without non-suicidal self-injury (NSSI) (P < 0.001). Pairwise comparisons revealed that the mean scores for the schizoid, avoidant, depressed, dependent, histrionic, antisocial, obsessive-compulsive, negative, masochistic, paranoid, schizotypal, and borderline scales were higher in narcotic substance abusers with NSSI compared to those without NSSI (P > 0.001).
Conclusion
The results of this research indicated that the average scores on the scales for schizoid, avoidant, depressive, dependent, histrionic, antisocial, obsessive, negativity, and masochism traits in narcotic substance abusers with non-suicidal self-injury (NSSI) were significantly higher than those in narcotic substance abusers without NSSI (P < 0.001). However, there was no significant difference between the mean scores for narcissism and xenophobia in these two groups. These results align with findings from other research studies (for example, references 20, 22, and 23). This outcome can be explained by the notion that personality influences our emotional and behavioral patterns, which in turn can predict risky behaviors. Individuals with traumatic personality traits often experience confusion, anxiety, helplessness, and elevated stress levels under negative and stressful conditions, which can lead to the expression of negative emotions. Self-injury may occur when the reintegration process in individuals with substance use disorders is not properly managed. This inadequacy can stem from personality disturbances, resulting in detrimental outcomes, one of which is non-suicidal self-injury (NSSI). In these circumstances, individuals with substance use disorders tend to experience heightened tension and negative emotions compared to others, making them more susceptible to engaging in NSSI (37, 38).
In explaining the inconsistency of the results related to the clinical patterns of narcissistic and sadistic personality disorders, it can be stated that individuals with narcissistic personality disorder tend to experience a higher quality of life compared to those with other personality disorders (39). Additionally, individuals with narcissistic personality disorder exhibit traits such as resistance, assertiveness, and a façade of independence. These characteristics enable these individuals to exhibit the least negative reactions to life events, providing them with a psychological advantage (42). The research findings indicated that the average scores on the schizotypal, paranoid, and borderline scales among drug abusers with non-suicidal self-injury (NSSI) are significantly higher than those of narcotic substance abusers without NSSI (P < 0.001). This result aligns with other findings (for example, studies 25, 26, and 27). To explain this finding, it can be stated that self-harm is a significant public health issue among substance abusers, and psychological and personality factors can exacerbate self-harm in this population. Non-suicidal self-injury (NSSI) among drug abusers may stem from various reasons, including a lack of meaning in life, estrangement from the family environment, pessimistic thoughts, feelings of anger and self-criticism, as well as symptoms such as depression, anxiety, and difficulties in mood and impulse control. These factors contribute to a sense of loneliness, powerlessness, and incompetence, ultimately leading individuals to engage in NSSI. Available sampling, the absence of group comparisons based on potential intervening variables, and the lack of control over drug types were limitations of the research. These findings have significant implications for prevention strategies and psychological interventions aimed at addressing non-suicidal self-injury (NSSI) behaviors.
Ethical Considerations
Compliance with Ethical Guidelines: This research was done with the introduction letter Ardabil Branch, Islamic Azad University.
Funding: This study has no financial support.
Authors’ Contribution: Kiamarsi. A: Writing the Article, Conceptualization, Methodology, Data Dollection, Statistical Analysis, Writing–Original Draft, and Review & Editing.
Conflict of Interest: The authors of this study had no conflict of interest.
Acknowledgments: All drug abusers who participated in this research are thanked and appreciated
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