Abstract
Background
Substance use disorder (SUD) is a growing public health concern in Sweden. Various treatments for SUD exist, with motivational treatment, cognitive behavioral therapy, and relapse treatment being the nationally recommended approaches. Attachment theory and the salutogenic theory with its core concept, sense of coherence (SOC) provides valuable insights into individuals’ available personal resources and their potential for adherence to treatment. The aims of the present study were to examine attachment styles (secure, insecure-avoidant, and insecure-anxious) and levels of SOC (comprehensibility, manageability, and meaningfulness) in individuals with SUD, explore potential correlations between the dimensions of these two frameworks, and assess the ability of these two frameworks to predict treatment completion.
Methods
The study employed a quantitative design. Clinical data were collected using validated self-report instruments (the Attachment Style Questionnaire and the Sense of Coherence Questionnaire) from individuals with SUD at a Swedish outpatient clinic for addiction. Statistical analyses included descriptive statistics, correlation analysis, and logistic regression.
Results
Individuals with SUD predominantly exhibited an insecure-avoidant attachment style. The four dimensions of an insecure attachment correlated negatively with overall SOC and with its dimensions, while the dimension of a secure attachment correlated positively with SOC. The strongest associations were found between the manageability dimension of SOC and all attachment styles. The insecure-anxious attachment style showed the strongest association with early dropout from treatment, while a stronger manageability was significantly associated with a higher likelihood of treatment completion.
Conclusion
The predominance of an insecure-avoidant attachment style among clients undergoing intensive, integrated treatment for SUD underscores the significance of reinforcing a secure attachment and enhancing SOC to facilitate treatment completion. This highlights the importance of comprehensive and integrated social and psychiatric care for individuals with SUD.