The role of ADHD in the development of motivation for change in persons with SUD treated in Czech therapeutic communities

Abstract

Fluctuations in motivation to change in persons with substance use disorder (SUD) may lead to their dropping out of treatment. ADHD in SUD persons is known to have a negative effect on motivational processes in general. Residents with comorbid ADHD may therefore experience more fluctuations in motivation during treatment. We assessed the development of motivation to change within the initial three months of treatment in a sample of 80 residents treated in certified therapeutic communities in the Czech Republic. ADHD was assessed by means of a DIVA 2.0 diagnostic interview and motivation to change by the Change Questionnaire. We found that motivation decreased between the first and the second wave: t(79)=2.09, p=.040, Cohen’s d = 0.23. The persons with ADHD did not differ from the rest in terms of their first-wave motivation (Bayes factor 10 = 0.235). The interaction between ADHD and between-waves differences in motivation was not confirmed (F(1;78)=2.65, p=.108); however, a Tukey post hoc test showed a significant between-waves decrease in motivation in the ADHD group, while in the clients without ADHD between-waves differences in motivation were not found. We found a small decrease in motivation to change after three months. Our data suggested that ADHD may affect the development of motivation.

Keywords:

• ADHD
• SUD
• development of motivation
• treatment entry
• treatment process
• therapeutic community
• predictors of effective treatment

Acknowledgements

The authors thank the certified therapeutic communities participating in the research project: TK Renarkon, TK Advaita, TK White Light I., TK Fénix, and TK Fides.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the GAČR Project under Grant No. 14-07822S; Institutional programme PROGRES (1st Faculty of Medicine, Charles University) under Grant No. Q06 and Specific University Research (1st Faculty of Medicine, Charles University), Grant No. 260500.