2Bakirkoy Prof. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Istanbul, Turkiye
3Istanbul Medipol University, Department of Psychology, Istanbul, Turkiye
Objective: Self-related problems and psychological inflexibility, which can also lead to a vulnerability to depression, often accompany substance use disorders. This study examined whether psychological inflexibility and self-criticism mediated the relationship between depression and addiction severity.
Method: We examined 111 patients with Substance use disorders (SUDs) using the Addiction Profile Index (API), Beck Depression Inventory (BDI), Forms of Self criticizing/Attacking and Self reassuring Scale (FSCRS), and Acceptance and Action Questionnaire-Substance Abuse (AAQ-SA). Mediation analysis was conducted to examine the mediating role of psychological inflexibility on the relationship between depression and addiction severity.
Results: API total score was negatively correlated with AAQ-SA and positively correlated with BDI and FSCRS. Because FSCRS did not have a significant predictive effect on addiction severity (p=0.966), only AAQ-SA was included in the mediation analysis. According to the results of the mediation analysis, depression was found to directly
affect addiction severity (direct effect,
p=0.007), and it constitutes 54.5% of the total effect. Also, depression predicted addiction severity (indirect effect, p<0.001) through psychological flexibility, and it constitutes 45.5% of the total effect.
Conclusion: According to our findings, psychological inflexibility is an important variable between depression and addiction severity. Although patients with SUDs may have negative evaluations about self, they may not use self-criticism as a coping strategy. Psychological inflexibility may be a substantial target for interventions in patients who use substances to avoid depressive symptoms.