Attachment, mentalization, and substance-related problems in a sample of patients with substance use disorders

Abstract

Substance Use Disorder is a debilitating disorder affecting the individual on several aspects of life, rending them poorly functional (APA, 2013). The UNODC (2017) estimated a number of 250 million people who have used an illegal drug at least once in 2015. Drug use is a widespread problem in Lebanon (Arbid, 2016). The rate of substance use is increasing in the Lebanese youth (MOPH, 2017). Wills et al. (2002) emphasized the importance of studying the consequences of substance use in research. The aim of this research is to examine the relationship between attachment styles, severity of substance-related problems, and mentalization abilities in adults in treatment for SUDs. Our sample (N=75) consisted of 65 males and 10 females. Our findings showed a significant relationship between the attachment anxiety dimension (ECR-R anxiety) and hypomentalizing strategies (RFQu). Attachment anxiety dimension and hypomentalizing strategies significantly predicted the level of substance-related problems. RFQu was found to mediate the relationship between scores on attachment anxiety and the level of substance-related problems. Our study provides evidence to a relationship between insecure attachment and mentalizing deficiencies in a sample of patients with SUDs, with mentalizing abilities mediating the relationship between insecure attachment and negative consequences experienced due to substance use. Our findings are discussed through the lens of attachment theory and the clinical implications for the treatment of SUDs.