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.