An addictive disorders severity model: a chained mediation analysis using structural equation modeling

Abstract

Background

The clinical relevance of the degree of severity in addiction disorders supports the need to investigate the variables underlying this aspect of the phenomenon.

Objective

This study aimed to explore the relationships between factors that may influence the severity of addiction disorder, with a particular focus on temperamental disinhibition, emotion dysregulation, interpersonal vulnerability, and their interactions.

Methods

A clinical sample of 502 (77% males and 22% females) was involved. All participants received a DSM-5 clinical diagnosis of “Substance-Related and Addictive Disorders” and were recruited from the Italian National Health System. The collected data were analyzed by implementing a chained mediation model using structural equation modeling.

Results

The statistical appropriateness of the hypothesized latent 4- factors model was confirmed. Specifically, temperamental disinhibition (composed of impulsiveness, compulsiveness, and obsessiveness), emotion dysregulation (composed of affect dysregulation, alexithymia, and dissociation), interpersonal vulnerability (composed of traumatic experiences, preoccupied, avoidant and unresolved attachment), and Addictive Disorders Severity (composed by substance use severity, alcohol use severity, gambling severity, and Internet use severity) were the four factors which have been identified. Furthermore, a total chained mediation model emerged, where emotion dysregulation and interpersonal vulnerability mediated the relationship between temperamental disinhibition and Addictive Disorders Severity.

Conclusions

Our findings offer a better understanding of the variables associated with addictive disorder severity, providing important indications for therapeutic interventions.

Keywords:

• Mental health
• addiction severity
• substance abuse
• substance use
• behavioral addiction

Disclosure statement

The authors report there are no competing interests to declare.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The research was approved by the Ethical Committee of the Integrated Psychodynamic Psychotherapy Institute (ethical approval number 001/2019)

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Additional information

Notes on contributors

Alessio Gori

A.G., A.S., and V.C. conceptualized the study. A.G., M.C., A.S., and V.C. contributed to define the theoretical framework, and chose the measures to be used in the study. A.G. and E.T. analyzed the data and wrote the first draft of the manuscript. A.G., E.T., M.C., A.S., V.C., and G.C. contributed to the revision of the manuscript and approved its final version.