INTEGRATIVE PSYCHOTHERAPY IN ADDICTIVE DISORDERS

Dr. Humberto Guajardo S. *

Psychiatrist. Facultad de Ciencias Mdicas. Universidad de Santiago de Chile. Instituto Chileno de Psicoterapia Integrativa.

Vernica Bagladi L. (PhD)

Psychologist. Instituto Chileno de Psicoterapia Integrativa. Universidad Catlica de Chile.

Diana Kushner L.
Antropologist. Universidad de Santiago de Chile

* Marchant Pereira 446 Providenicia Santiago Chile e-mail: icpsi@terra.cl

Abstract

In most countries the addictive disorders have increased considerably in the last
years, becoming a main problem of Public Health for governments. One approach
towards the rehabilitation of people with addictive disorders are Therapeutic
Communities. In such communities ex-addicts actively collaborate in the
rehabilitation of people on treatment. The characteristics of the rehabilitation
process are presented from the perspective of the Supra-paradigmatic Integrative
Model proposed by Roberto Opazo. The application of an Integrative Clinical
Evaluation Record (Ficha de Evaluacin Clnica Integral, FECI), helps to
understand, through the different subsystems of the Model, the presenting
problems of persons entering rehabilitation, the etiological role of each subsystem
and the modification that take place along treatment. Biological predisposing
factors such as Extroversion and Neurological Immaturity are resistant to be
modified by treatment; however, alterations acquired during the addictive process,
in all the subsystems of the Model, are modifiable in non less than 9 months of
Integrative Psychotherapy. Based on our observations and on the
Supraparadigmatic Integrative Model, an etiological approach of Addictive
Disorders is suggested.

Key words: Addiction; Integrative Psychotherapy; Therapeutic Communities.

INTRODUCTION

The last century was characterized by the proliferation of diverse schools and
approaches in the fields of clinical psychology and psychotherapy. (Opazo 1997)
It has been estimated that there are more than 400 schools developed within the
field of psychotherapy (Karasu 1986).

Unfortunately, in such prolific scenario, antagonisms and controversies

dominated over agreements. Thus the clinical psychotherapists have witnessed
shortcoming in the different approaches or schools, which have been unable to
provide the global and finished answers pledged in their beginnings. (Prochascka
& Di Clemente 1992) In this context, increasing driving force has been placed on
the search of a more integrative approach to reach improved results in the
psychotherapeutic field.

An example of such effort and search for integration has been the work of the
psychologist Roberto Opazo (1992, 1997, 2001). His Supraparadigmatic
Integrative Model brings the conceptual grounds for the Chilean Institute of
Integrative Psychotherapy. Besides, some members of the Institute have helped to
develop the Model beyond its original formulation.

The model is based on the scientific research towards the recovery of the six most
genuine paradigms at already validated: biological, environment-behavioral,
cognitive, affective, unconscious and systemic (Freud 1948, Skinner 1953, Bateson
1972, Ellis 1977, Greenberg & Safran 1984, and Eysenck 1990); all of those
paradigms have been organized around the Self system as the integrative point of
the psychological system. Figure 1 brings a diagrama of the Supraparadigmatic
Integrative Model.

FIGURE 1

The Model states that the Self system integrates the influences comming from 6
paradigms: biological, cognitive, affective, unconsciouss,
environmental/behavioral and systemic. An external stimulus turns into an
effective stimulus through a process where the SELF system translates the
experience, giving meanings under the differential influence of each paradigm of
the Model.
Coming from a Supraparadigmatic Integrative Model, Integrative Psychotherapy
goes beyond traditional narrow theories. Being the Model a complete theory,
Integrative Psychotherapy goes beyond an eclectic approach, which has no
guidelines to drive research and to organize the data. Forces of change coming
from biology, cognition, affection, awareness, environment and behavior, help to
movilize the SELF system of the patient toward the desirable change. Summing
up, the Supraparadigmatic Integrative Model brings deepness to comprehension
and strenth to intervention.

Both, a particular type of Integrative Psychotherapy and a Record of Integrative

Clinical Evaluation (FECI), have been developed from the Supraparadigmatic
Integrative Model. FECI is a record of auto-forbear that allows to evaluate, in
each individual, the different sub-systems already mentioned. This record has been
applied to different types of patients to obtain the profiles of the different
pathologies. (Rojas & Alliende 1992)

In the last years there has been in the world, and specifically in Chile, a growing
concern about the increase of illicit drug consumption. This tendency is common to
most Latin-American countries, U.S.A and Europe (Arias 2000). Data from the
Chilean health organizations show a rate of 20% to 30% of illicit drugs
consumption in school children between 13 and 18 years old. (CONACE 2000)

Even though substantial investment has been made on prevention and

rehabilitation, many questions remain unanswered on the issue of which one is the
most efficient treatment procedure to accomplish better results. Despite the above,
some agreement exists. First, at a prevention level, a certain consensus has been
achieved on the need to identify risk factors in children and young people to
promote preventive actions (Weinberg 1999). On the other hand, and with
regards to rehabilitation, none of the therapeutic procedures applied has attained a
definitive success on the treatment of drug addiction and there is general
agreement about the need to approach the disorder from an integrating perspective.
(Musacchio & Ortiz 1996).

One of the most complete and interesting treatment for the rehabilitation of
addictive disorders is the one applied, for many years, by the Therapeutic
Communities institutions that, in many cases, have achieved extremely
encouraging results. A main peculiarity of such treatment is the participation of ex
addicts on the rehabilitation process of the addicts attending these communities.
Further, a basic postulate of these institutions is that a long-term reeducation
process is required to generate significant changes of the addict personality. This
appears as a very significant way to improve treatment success. (Kooyman 1993,
De Leon 1995).

In Chile the Ministry of Health has officially accredited the Therapeutic

Communities and their further development has been proposed, effectively to face
the problem of drugs.
The Chilean Institute of Integrative Psychotherapy has established a researching
and teaching joint project with the Faculty of Medical Sciences of the University of
Santiago of Chile and with CREA Chile, an institution that operates five
Therapeutics Communities for the rehabilitation of men with addictive disorders.
Main objectives of the above project/agreement are: to deeply investigate the
psychological characteristics of addict subjects; to identify risk factors related to
addiction evolvement; to evaluate if the treatment applied at the Therapeutic
Communities induces changes in different areas of the personality; and finally, to
assess whether the Supraparadigmatic Integrative Model could helps to improve
the applied treatment.

METHODOLOGY.

The Card of Integral Clinical Evaluation, FECI, was used for the analysis of the
different subsystems of the person (environmental, behavioral, biological,
cognitive, affective, unconscious and systemic). The FECI has approximately 50
pages and is an instrument that in addition to compile general performances data
such as identification, anamnesis, consultations history, expectations and
motivation before the processing, has 19 self-report scales, some of them applied
internationally like the Eysenk questionnaire or the Toronto test for Alexitimia, and
other have been generated by the ICPSI and standardized with a sample of more
than 3000 subjects

All the scales give results derivable to High, Average and Low values, being the
average value the one considered suitable .

The card was applied at 3 male homes that CREA Chile operated at the time of this
study. During two months, 30 of the 90 residents were selected at randomly and
then distributed in three groups:
(i) Entrance group: residents at the institution up to 45 days, a period
considered of adaptation and of commitment to change and that may be
equivalent to a consolidation of the patient-therapist relationship.
(ii) Advanced Group: residents with 5 to 7 months of treatment at the
community and
(iii) Group of Educators: individuals that had more than 9 months of treatment
and that collaborated in the rehabilitation of previous groups.

RESULTS

The Table 1 shows the characteristics of the sample under study, conformed by
males with age average under 30 years in each of the three groups.

TABLE 1
SAMPLES PROFILE
Patientes in Residential Treatment (CREA CHILE)

TABLE 1

As shown in the Table 2 the most frequent drug used by the studied sample (33%
of subjects) was Cocaine sulfate (Pasta Base) which produces a very short
period of euphoria followed by a state of great anguish. This drug is the one most
consumed in Chile. Cocaine followed closely with 30% of the sample.

TABLE 2
Specific Drug abuse at the Beginning

TABLE 2

Table 3 shows that most of the subjects under treatment (77%) had a multi-drugs
addiction profile (consumption of several drugs).
 TABLE 3
Samples Profile
Patient in Residential treatment

TABLE 3

Table 4 shows the periods of addiction of each subject under treatment. It can be
seen that more than 90% have more than 3 years of drugs consumption, a
condition we consider as severe addiction.

Table 4
Samples Profile
Patients in Residential treatment

TABLE 4

Table 5 shows how the consultation decision was made.

TABLE 5

Table 6 shows the fact that Mental Health specialists (psychiatrists or

psychologists) previously treated a significant part of the sample. Being so, we can
conclude that previous addiction treatments have failed

TABLE 6
The results of the scales of the biological paradigm show Table 7 - that at the
beginning of the treatment all the scores are in the high ranks. Along the following
stages of the treatment the scores of immaturity and extroversion remain high. On
the other hand, we can see a decrease in the neuroticism, psychoticism, anxiety and
depression scores. It is important to note that score of single psychoticism is
modified in individuals when they reach the final stages of treatment.
Immaturity corresponds to indicators of organicity in the FECI. Neuroticism,
extroversion and psychoticism correspond to Eysenk EPQ scales . Anxiety and
depression correspond to the symptomatic scales of the FECI.

TABLE 7
BIOLOGICAL PARAGIGM

TABLE 7

Table 8 shows some neurological background of the sample, with predominance of

individuals with school misbehavior (80%), childhood developmental upheavals
(ADD, 70%) and pathological child delivery (63%).

Table 8
Neurological Background of the sample

TABLE 8

In Table 9 it can be observed that 66% of the addicts studied have attended at least
three schools during his educational life.

TABLE 9
A retrospective survey of symptoms of the Attention Deficit Syndrome is shown in
Table 10 which indicates that 70 % of the individuals of the sample, during
childhood, had developed personalities in accord with the Deficit of Attention
Syndrome.

Table 10
Retrospective DSM IV simptoms for Deficit Atention Syndrome

TABLE 10

The results of the scales related to the environmental behavioral paradigm, are
shown in Table 11. Overall, the results indicate that the individuals initiated
treatment with a low behavior repertoire, they show limited needs contentment
towards the environment surrounding and perceived themselves with a low
capacity or self-efficiency. The satisfaction of needs increases to the maximum in
the first stages of the treatment and the behavioral repertoire and the assertively
reached their maximum after 9 months of treatment.

Table 11
Environmental / Behavioral Paradigm

TABLE 11

Table 12 shows the results related to the cognitive subsystem, in which the most
important changes are observed, at scale of the cognitive irrationality, after 9
months of treatment.
 Table 12
Cognitive Paradigm

TABLE 12

Tables 13 and 14 present the results of the scales related to the affective subsystem.
In the Table 13 we notice that the individuals start therapy with high alexitimia (a
score of 42) but they improve along treatment, with alexitimia decrease to a score
of 35. Positive changes in the degree of tolerance to frustration and self-esteem
are also observed. There are no important changes in the scale of emotional
disturbance. Table 14 indicates that initially, most of the individuals (60%)
acknowledge low empathy towards other people. This disposition reverts along
treatment, at the end of which most of the individuals have managed to develop
empathy capacity.

Table 13
Affective Paradigm

TABLE 13

TABLE 14

Tables 15 to 19 show characteristics of family relationships of the individuals of

the sample. Altogether (i.e.communication, affectivity, stability) the individuals
have better relationship with mothers when compared with fathers (Table 15).
 Table 15
Systemic Paradigm
Relationship with Parents

TABLE 15

40% of the parents of the sample were separated.

Table 16
Divorsed Parents

TABLE 16

Only 23% of the individuals acknowledged punishment prevailing through their

educational process (Table 17).

Table 17
Relatioship Punishment and Reward in education

TABLE 17

Most of the parents (77%, table 18) were portrayed like having inconsistent
policies with regards to children education.
 Table 18
Parents Educational Consistency

TABLE 18

At the beggining of therapy, only 3 % of the individuals regarded their family life
as bad (table 19), 57 % defined family life as regular and 40 % as good.

TABLE 19

DISCUSSION.

The sample average age of 27 years. This agrees with official studies made in Chile
that established a greater occurrence of illegal substances consumption under the
age of 40 years. (CONACE 1994, 1996, 1998)

Most of the individuals of the sample (90%) had more than 3 years of drugs
consumption and 77% were multi-drug consumers. The latter testifies addicts
increase of drugs consumption level along time. Frequently, is curiosity that
induces addicts to try new drugs so developing multi-drug addiction.

It is interesting to observe that personal motivation is the main reason by which

individuals initiate therapy (61%) followed by familiar pressure (29%). Previous
therapy by professionals seems to have little influence in the decision to initiate
treatment because 80% of the subjects have already had previous therapy without
success.
The analysis of the results obtained in the scales of the biological subsystem Table
7, indicates that all the scores are located at high levels at the time treatment
started. Two variables - Immaturity and Extroversion remain high along therapy
which would indicate that they are congenital personality variables/characteristics
non modifiable during the therapy. On the other hand, the values of variables
neuroticism, depression, anxiety and psychoticism decrease along treatment. This
fact supports the hypothesis that these characteristics may have originated from the
process of consumption of drugs. It is fundamental to point out that the more
important changes are observed in the group of educators after 9 months of
treatment. This is specially meaningful in the case of psychoticism which only
recedes in the group of educators. The results obtained in the biological paradigm
support our belief that treatment periods less than 9 months long would not
consolidate the necessary changes of personality to achieve success on the
rehabilitation of addicts.

Regarding the biological subsystem results (Table 7) is of great relevance to

emphasize that the biological variables of immaturity and extroversion could be
related to a childhood pathology of the Attention Deficit Syndrome.
It has been indicated (Guajardo 2000) that even small difficulties during pregnancy
and childbirth (fetal, premature childbirth, Caesarian stress, forceps application,
etc.) are responsible of the Attention Deficit Syndrome pathology.

Our study shows a positive correlation between the individuals background (Table
8: 63% of the sample registered some kind of difficulty at birth, being normal
values around 20% of the population) and the frequency of misbehavior at school
(80%) and with the frequency of developmental disorders such as Attentions
Deficit Syndrome, dyslexia or dreaming alterations (70% of the sample) . The
above agrees with the results shown on Table 9 in the sense that more of a 60% of
the sample attended at least 3 schools during childhood and it is also in agreement
with the fact that a retrospective survey shows that 76% of the sample gave
positive values for Attention Deficit Syndrome (Table 10).

Overall, our results agree with previous investigations (Guajardo 2000) that state
relationship between the Attention Deficit Syndrome and Addiction. Therefore, the
results obtained point to a group of risk individuals which may be detected early
during school time, so allowing beforehand the application of measures preventing
drug consumption.

The results obtained in the environmental behavioral sub-system (Table 11) show
a low satisfaction of needs, which is concordant with the fact that addicts are
isolated from their family group and frequently cast aside and lacking good friends
cherishing with affection. The entry into a therapeutic community provides them
with a warm atmosphere in association with a strong affective component and a
place where they can obtain physical and psychological care.

The low score of social conduct shown by the entrance sub-group (Table 11) is
probably due to fact that individuals with a background of a poor social behavior
turn to apoint where such behavior is deteriorated even more as a result of drugs
consumption. (Monti 1999) The deficiency of assertive conducts would prevent
them for instance, to successfully hold out against consuming mates, to search for
assertive alternative groups of friends or to experience different social
atmospheres. This low level of behavioral repertoire agrees with the low score of
self-efficacy shown by the entrance group, which changes positively along
treatment. Again, and like in the biological sub-system, the changes tend to
consolidate about the 9th month of therapy.

The cognitive subsystem Table 12 - shows that scores in the scale that measures
cognitive irrationality are high in individuals of the entrance group. These results
agree with those informed by other authors (Beck 1993; Kamner & Burleson,
1999) who have reported serious cognitive alterations in addicts, such as irrational
ideas and automatic thoughts which are used to justify drugs consumption levels.
During the 9 months treatment, the score decreases to low values of cognitive
irrationality. The perfectionism scale is not importantly modified although shows
decreasing tendency, which is expected because one of the aims of treatment is to
achieve in addicts low levels of self-demand so to subjectively decrease their
levels of anxiety. From the cognitive point of view an improvement in personal
self-image evaluation -deteriorated at treatment initiation- is observed.

Scores of the affective sub-system, Tables 13 and 14, shows that addict initiating
treatment report high levels of alexitimia and very low empathy capacity. These
results could be related to: (i) the development of defense mechanisms as opposed
to environmental criticism, and (ii) an increase of the sensorial thresholds, as a
result of drugs consumption, which may blackout the affective keys generated by
other people. The high alexitimia seen at the initial stages of treatment reaches
normal values towards the end of the therapy while empathy rises to 60%. In the
advanced group we can see a progress on frustration tolerance and self-esteem,
described like the capacity to love itself.

The results related to the familiar group (Tables 15 to 19) show that relationships
with mothers are better evaluated than with fathers, judging mothers as closer
affectionate and non conflictive. It is important to point out that the above does not
necessarily means a positive connotation because mothers, when over-protecting
addict children to avoid them the negative consequences of their consumption,
will undertake the role of co-addict reported by Battie (1992) and Teichman &
Basha (1996). Such attitude, although unconscious, will favor addict drugs
consumption.

Forty percent of the parents of treated addicts were registered as divorced (Table
16). This percentage is similar to the one shown by the total population of the
country (Montenegro 1981).

23% of the individuals of the sample mentioned punishment during childhood

(Table 17) and 3% of them described their family life/environment as bad (Table
18). Both the above are in disagreement with numerous reports (Westmeyer 1999)
stating that childhood abuse is accountable for the development of addictive
disorders.

On the other hand, inconsistencies of parents educational policies, as reported by

77% of the individuals of the sample (Table 19), seem to have more importance as
a factor triggering addictive behavior.

A global analysis of the results allow us to sustain that male starting treatment in a
therapeutic community, have alterations in all the subsystems according to the
Opazos Integrative Model (Opazo 1997, 2001).

These alteration will also interfere with the normal development of the SELF
functions.

Aside from the scales of extroversion and immaturity, which result from the
individuals structural characteristics and from certain genetic components that
seem not modifiable by rehabilitation, our study shows that the treatment applied
at the therapeutic communities modify most of the scales after 9 months of
therapy.
Hence, although the changes produced in most of the sub-systems would result in
protection factors, extroversion and immaturity require a permanent post-treatment
surveillance of the addict because they are risk factors relating the self-control of
SELF functions.

Moreover, the applied treatment would contribute to the development of the SELF
functions stated by the Supraparadigmatic Integrative Model: personal identity
functions, the personal meaning and self-organization and the search for a sence of
life function, as a consequence of which SELF autocontrol functions could
partially be optimized during the therapeutic process.
From the above results and observations it can be postulated that all six paradigms
or sub-systems of the Supraparadigmatic Integrative Model are involved on
addictive disorders. Based on such Model, we propose (Figure 2) an integrative
approach to the etiology of addictive disorders.

FIGURE 2

Though each one of the variables involved in Figure 2 may have an etiological
influence, they are usually interacting in a circular way so its difficult to determine
when each one is a cause and when an effect.
It is important to state that none of the etiological factors detected through the
Supraparadigmatic Integrative Model (figure 2) is able to cause just by itself an
addictive disorder; more often, a profile of factors is needed. By the other hand, it
is not necessary the influence of all the etiological factors detected. So, each addict
becomes addict through an idiosincratic way which combine some specific profile
of etiological factors. So, what the Model provides is a complete source of
potencial etiologies, coming from different paradigms and detected through
research and clinical practice. The Model provides a comprehensive view and a
systematic review, of the most important factors at an etiological level.

Having these factors in mind, is a pressure to evaluate how are they working (or
not working) in any patient. This integrative diagnosis is extremely useful in terms
of the clinical practice, helps to develop the therapeutic strategies and / or the
preventive actions. Thereby, the integrative diagnosis is a very significant support
when working with addicts within the framework of a therapeutic community.

A close-up to figure 2 shows how at the level of the environmental/behavioral

paradigm behavioral deficits, agresive behaviors, mal adaptive and sociopatic
behaviors and non asertive behaviors, are influencing an individual unaware of
the long-term consecquences. The individual drives his actions based on immediate
consecquences, most of them coming from the drugs effects: relax, pleasure,
affective intensity and / or increased energy.

To the above described view, the environment adds drugs availability, modeling,
social pressure toward using drugs and very often unemployment, poorness,
violence, social rejection and significant others acting as co-dependants. An
important result of our research is that family disfunction frecquently associated
with drug abuse seems to influence more oftenly through a non consistency
between father and mother, and not as much through divorce, family violence or
punishment.

The above fits well, if we take into account the fact that the biologic paradigm
influences through high levels of neuroticism, extroversion and neurological
inmature. All these biological factors are demanding consistency from the
environment, specially in childhood; otherwise, the problems are increased.
The described biological and behavioral/environmental factors, shake hands
within addictive disorders wit an affective paradigm characterized by altered
thresholds, depressive mood, anxiety, agression, impulsiveness, intolerance to
frustration, emotional lability and most important a poor motivation toward
change. In our opinion, this last is the main problem is terms of the prognosis.

Within the cognitive paradigm, our research shows that patients have cognitive
irrationality, non realistic self efficacy expectations, poor self image,
withdrawal of authority, pro addictive beliefs (drugs dont hurt, drugs bring
security, drugs make me more friendly). Besides, and closely connected with
the low motivation toward change, patients show a poor perception of risks and a
poor evaluation of the long-term consecquences of behavior.

The profile shown by affective and cognitive paradigms is highly consistent with
the profile showed at the level of the unconsciouss paradigm: poor awareness of
the relationships between behavior and long term consecquences, affective
repression and high scores in alexitimia. These unconscious influences help to
maintain impulsiveness, emotional maladjustment, and a low motivation toward
change. From each paradigm of the Supraparadigmatic Integrative Modelo,
everything fits to maintain the addictive behavior.

From each paradigm comes an influence which has a negative impact in the SELF
system. Thats why the addict is weak in terms of SELF systems functions:
identifity is vague and changeable, self organizing mechanisms dont work well,
meaning is distorted and the sense of life is poor or emply. So, life goes
everywhere or nowhere, and self-control without goals, motivation and strenth
is poor and weak. Within this negative circularity, vicious circles emerge
everywhere, being difficult to perceive what is cause and what effect.
CONCLUSIONS

The application of a Record of Integral Clinical Evaluation (FECI) to the results

obtained from the sample of addict treated at the therapeutic homes CREA
CHILE allows us to reach the following conclusions:

1. Most of the individuals that attend a therapeutic community are

poly-adicts and have more than 3 years of consumption of illegal
substances.
2, The recorded data points to the little influence of previous therapy -
of single and ambulatory type - on the treatment of addictive
behavior, even though individuals with severe addiction attend
therapeutic communities by their own will.

3. The data recorded in the biological subsystem scales point to a sub-

group of patients of high risk with characteristics of Immaturity
and Extroversion. This is supported by a background of difficulties
such as childbirth stress, deficit of attention, behavioral disorders
and frequent changes of schools during childhood.

4. It is important to note that alterations at family level do not seem to

be meaningful in the triggering of addiction behavior drugs
consumption, but would be fundamental when factors as over-
protection and inconsistency in educational procedures occurs in
individuals of the high risk sub-group described in point 3.

5. The entrance group environmental behavior sub-system is altered as

far as satisfaction of needs, lack of social repertoire and low
capacity of self-efficacy. Being all these factors acquired during the
developmental process. It is feasible that they are a consequence
and not a cause of drug consumption.

6. The most important features of the affective sub-system level

alterations are alexitimia and lacks of empathy capacity, factors
that increase during the periods of drug consumption.

7. At the cognitive sub-system level, the personality of the addict is

dominated by irrational thoughts, mainly of the kind that would
 lean to justify and maintain consumption. Concurrently, this
develops a negative self-perception.

8. The therapy applied at the therapeutic communities is directed to achieve

important changes at the: (i) biological (anxiety, depression,
neuroticism, and psychoticism), (ii) environmental behavior
(satisfaction of needs, behavioral repertoire and self-
effectiveness/efficiency), (iii) cognitive (cognitive irrationality and
self- image), and (iv) affective (empathy, alexitimia, tolerance to
frustration) scales/levels.

9. The changes in the different subsystems achieved along treatment at

CREA CHILE allow us to suggest that a strengthening of the SELF
takes place, which result in future restrain from consumption. The
application of an integrative model allows to envision that it is
possible to optimize the therapy enriching the applied procedures.

10. Detecting sub-group of high risk persons will assist preventive

programs focused on young people at school level with SDA
immaturity and extroversion.

11. We conclude that FECI is a effective instrument both for the

diagnosis and for the evaluation of individuals on rehabilitation
from addictive disorders .

12. The results obtained with this study suggest the advantage of the
application of the Supraparadigmatic Integrative Model to the
etiology and psychopathology of addictive disorders

13. Being these data interesting, significant and useful, replies are
needed, so we can be aware of now much of all these is confirmed
and what parts claim to be modified.
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*****************************************************
 FIGURE 1

TABLE 1

Starting Middle Leaders Total

Group Group group
Males 0 to 45 5 to 7 Upon 9 30
days (n=10) month (n-10) month (n=10)
Age Mean 23 24 30 27
 TABLE 2

N %
Cocaine Sulfate 10 33 %
Cocaine 9 30 %
Cannabis 7 23 %
Anfetamine 4 14 %

TABLE 3

Adictions type N %
Multiadictive 23 77 %
1 or 2 drugs 7 23 %

TABLE 4

Consuming period N %
(N of years)
0-2 2 7%
3-5 8 26 %
6-9 8 26 %
10-12 3 10 %
13-15 2 7%
16-20 4 14 %
21-... 3 10 %
Total 30 100 %

TABLE 5

Own Family Other

initiative Pressure (proffesionals)
Cocnsultation 61 % 29 % 10 %
Decision
 TABLE 6

Psychiatrist/ No
Psychologist Treatment
Previous 81 % 19 %
Treatments

TABLE 7

Starting Middle Leaders

Group Group Group
Neurological 26 21 17
Inmadurity High High High
Neuroticism 17 15 11
High Middle Middle
Extrovertion 15 14 15
High High High
Psychoticism 9 6 4
High High Middle
Depression 11 8 4
High Middle Low
Anxiety 10 6 3
High Middle Low

TABLE 8

Yes Not
Behavioral problems 80 % 20 %
at School
Developmental Disorders 70 % 30%
(Sndrome of Attention Dficit,
Dislexia, Night Terrors,
Sonambulism)
Pathological Parturition 63 % 36 %
(Cesarean operation, Premature,
Forceps)
 TABLE 9

1 school 2 school 3 or more schools

4% 30 % 66 %

TABLE 10

N= %
Combined type 12 40 %

Predominance Attention 5 16 %
Deficit
Predominance 6 20 %
Hiperactivity +
Impulsivity
Total Attention Deficit 23 76 %

Do not fulfill 7 24 %
Criteria

TABLE 11

Starting Middle Leaders

Group Group Group
Satisfastion of 29 37 37
necessities Low High High
Social 44 51 45
Abilities Low Middle High
Self-efficacy 17 20 21
Low Middle High
 TABLE 12

Starting Middle Leaders

Group Group Group
Cognitive 45 42 36
Irrationality High Middle Low
Self-Image 28 28 37
Low Low Middle

TABLE 13

Starting Middle Leaders

Group Group Group
Alexithimia 42 38 35
High Middle Middle
Low Tolerance of 14 13 8
Frustration Middle Middle Low
Self-esteem 34 38 40
Middle Middle High
Emotional 52 50 42
Disturbance Middle Middle Middle

TABLE 14

Empathy Starting Middle Leaders

Group Group Group
High 0% 30 % 60 %

Middle 40 % 70 % 40%

Low 60 % 0% 0%
 TABLE 15

1= Bad...5= Good Father Mother

Close 2.9 4,6

Warm 3.1 4.7

Good 2.8 4.6

Communication
Stable 2.7 4.5

Non 2.9 4.1

Conflictive

TABLE 16

Yes 12 40 %

No 18 60 %

TABLE 17

N= %
Predominance of Rewards 13 43 %

Equivalence rewards and 10 33 %

Punishment
Predominance of 7 23 %
Punishment
 TABLE 18

N= %
Consistency 7 23 %

Non Consistency 23 77 %

TABLE 19

Family Life N= %
Good 12 40 %

Regular 17 57 %

Bad 1 3%
FIGURE 2