Association of baseline characteristics and motivation to change among patients seeking treatment for substance dependence.
BACKGROUND
The current study evaluated the bottoming out hypothesis by determining the extent to which composite measures of motivation to change are associated with baseline characteristics among patients seeking treatment for substance dependence.


METHODS
Two hundred treatment-seeking substance-dependent veterans were assessed. Motivation to change was assessed using the composite measures of Readiness to Change (RTC) and Committed Action (CA) derived from the University of Rhode Island Change Assessment. Baseline characteristics included recent life stressors, addiction severity, depression, anxiety and hostility. Linear regression was used to determine the association between baseline characteristics and the composite measures of motivation to change while controlling for age, gender and race.


RESULTS
Linear regression indicated that RTC and CA were associated with different baseline characteristics. RTC was associated with anger expression (B=-.28; 95% CI=-.6, -.01) and recent life events (B=1.1; 95% CI=.01, 2.2). CA was associated with alcohol problems (B=-.33; 95% CI=-.62, -.05) and state anxiety (B=-.13; 95% CI=-.21, -.04).


CONCLUSIONS
Our findings suggest that motivation to change was negatively, not positively, associated with greater emotional distress and problem severity. With the exception of recent life events, these findings are contrary to the notion of hitting bottom. Composite measures of RTC and CA also appear to represent different types of motivation to change.
Field
Craig A
CA
Health Promotion and Behavioral Sciences, University of Texas School of Public Health at Houston, Dallas Regional Campus, 5323 Harry Hines Blvd., V8.112, Dallas, TX 75390-9128, United States. craig.field@utsouthwestern.edu
Duncan
Julie
J
Washington
Kim
K
Adinoff
Bryon
B
D000328:Adult; D001294:Attitude to Health; D005260:Female; D015438:Health Behavior; D006801:Humans; D008016:Life Change Events; D008297:Male; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D011795:Surveys and Questionnaires