Razi Journal of Medical Sciences

fa نقش شدت وابستگی و حافظه آینده نگر- گذشته نگر در پیش بینی ولع مصرف با توجّه به نقش میانجی حافظه اعتیاد The Role of Addiction Severity and Prospective and Retrospective Memory in Predicting Craving Considering the Mediating Role of Addiction Memory Intensity روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: علیرغم وجود رابطه بین ولع مصرف با شدت وابستگی به مواد و اختلال حافظه در مصرف کنندهگان مواد کمتر به نقش یک حافظه مستقل در اعتیاد پرداخته شده است. بر همین اساس هدف پژوهش حاضر پیشبینی پذیری ولع مصرف مواد از طریق شدت وابستگی و خطای حافظه با توجّه به نقش واسطه‌ای حافظه‌ی اعتیاد بود. روش کار: پژوهش توصیفی_همبستگی و از نوع مدلیابی معادلات ساختاری بود. به روش نمونهگیری تصادفی ساده، تعداد 226 مصرف کننده موادمخدر در مرکز گذری خدمات کاهش آسیب اعتیاد شهرستان رباط کریم استان تهران در مرحله شروع درمان به عنوان نمونه انتخاب شدند. ابزارهای مورد استفاده پرسشنامه سنجش ولع مصرف لحظه‌ای مواد فرانکن و همکاران (2002)، پرسشنامه شدت وابستگی گاساپ و همکاران (1995)، حافظه آیندهنگر–گذشتهنگر اسمیت و همکاران (2000) و مقیاس شدت حافظه اعتیاد چن و همکاران (2018) بود. داده‌های جمعآوری شده به کمک نرم افزار SPSS-24 و AMOS-5 در دو سطح آمار توصیفی و استنباطی تجزیه و تحلیل شدند. یافته‌ها: <a name="_Hlk189292783">نتایج نشان داد رابطه بین شدت وابستگی، حافظه آینده نگر و گذشته نگر  و حافظه اعتیاد با ولع مصرف مثبت و معنیدار است. اما رابطه بین شدت وابستگی با حافظه اعتیاد معنیدار نیست. </a>سایر یافتهها نشان داد شدت وابستگی، حافظه آینده نگر-گذشته نگر و حافظه اعتیاد پیش‌بینی کننده مثبت و معنی‌دار ولع مصرف بودند. روش بوت استروپ نشان داد که اثر غیر‌مستقیم (واسطه‌&zwj;&zwj;‌گری جزیی) حافظه آینده نگر-گذشته نگر از طریق حافظه اعتیاد بر ولع مصرف معنی‌دار است و مدل پژوهش توانسته  25 درصد از واریانس ولع مصرف را تبیین ‌کند. نتیجه‌گیری: به طور کلی می‌توان بیان نمود که هرچند شدت وابستگی بر ولع مصرف تأثیرگذار است، اما این تأثیر می‌تواند از مسیرهای شناختی دیگری مانند حافظه آینده‌نگر و گذشته‌نگر اعمال شود. از سوی دیگر، نقش میانجی حافظه اعتیاد به‌طور کامل تأیید نشد، که می‌تواند نشان‌دهنده پیچیدگی‌های بیشتری در فرآیندهای شناختی مرتبط با ولع مصرف باشد. نتایج این مطالعه اهمیت فرایندهای شناختی را در درک و پیش‌بینی ولع مصرف برجسته می‌سازد.</div> <div style="text-align: justify;"> Background & Aims: Addiction is a social problem that continues to increase despite scientific advances in its harmful effects. Drug addiction leads to more than 14 million deaths per year. According to the National Addiction Survey in 2015, about 2 million 808 thousand people in Iran are addicted to drugs. Addiction is characterized by impaired impulse control or a feeling of compulsion to perform a specific action despite knowing its dangerous consequences. Drug-dependent individuals continue to engage in self-harming drug use behavior regardless of the dangerous consequences of drug use. Dependence in the form of two physical and psychological aspects is one of the most prominent features of substance-dependent disorders and faces the individual with many financial, social, and personal costs. Researchers showed that people with higher dependence severity have higher cravings. Craving is a factor that influences the persistence of addiction and is recognized as one of the diagnostic criteria for substance use disorder. Craving is an unwanted subjective experience that involves the motivation or desire to use a specific substance and is the result of the learning process and the association of cues with the rewarding properties of the addictive behavior. Since craving intensity becomes more intense when trying to change the amount of use, for example, during withdrawal, optimal regulation of craving is associated with less substance use and has beneficial results, such that individuals with lower craving are less likely to drop out of treatment. For this reason, identifying the factors associated with craving is one of the main keys to predicting treatment outcomes and preventing relapse. The main correlates of craving are cognitive deficits such as impaired memory and executive functions. In some definitions, addiction is defined as a syndrome of inhibition destruction in the prefrontal cortex, which is responsible for higher cognitive functions. These cognitive deficits are considered predictors of higher likelihood of relapse and withdrawal from addiction treatment. Prospective memory and retrospective memory are among the cognitive abilities whose destruction interferes with the normal performance of daily activities. Retrospective memory is responsible for remembering events related to the past, and prospective memory is related to our ability to remember our goals in the future. Research has shown that the prospective memory of people who use opioids for a long time is more damaged compared to the control group. In addition, although difficulties in retrospective memory interact with destruction in prospective memory, it is less influential. It is expected that as the duration of addiction increases, the memory of an individual will be further damaged, which will make quitting addiction more difficult and the craving stronger. A review of past research shows that despite the existence of a relationship between memory function, addiction, and craving, most studies have focused more on examining the effect of addiction on overall memory function rather than a specific type of memory or on how addiction affects individuals' performance in recall tasks or comparing neuropsychological differences and executive functions in different groups of users, and have paid less attention to examining an independent memory in addiction. Addiction memory is one of the cognitive factors related to addictive behavior. Addiction memory, which is related to autobiographical memory, is related to personal experiences resulting from a person's history of drug use and seems to be involved in the process related to the euphoria resulting from drug use and drug craving. Even after long-term abstinence, addiction memory can be reactivated by re-exposure to drug-related cues which is associated with craving and ultimately leads to relapse. Also, re-experiencing drug-related memory can reduce craving, attentional bias, or drug-taking behaviors. However, despite the relationship between craving and drug dependence severity and impaired retrospective and prospective memory in addicts, the role of a new and independent construct of addiction memory has received less attention in research. Therefore, the present study aims to assess the predictability of drug craving through dependence severity and memory error, considering the mediating role of independent addiction memory. Methods: This was a descriptive-correlational study using structural equation modeling. Using simple random sampling, 226 drug users were selected as samples at the addiction harm reduction service center in Robat Karim County, Tehran Province, at the beginning of treatment. The instruments used were the Franken et al. (2002) Instantaneous Drug Craving Questionnaire, the Gassop et al. (1995) Dependence Severity Questionnaire, the Smith et al. (2000) Prospective-Retrospective Memory Scale, and the Chen et al. (2018) Addiction Memory Severity Scale. The collected data were analyzed using SPSS-24 and AMOS-5 software at two levels of descriptive and inferential statistics. Results: It was shown that the relationship between the severity of dependence (p < 0.01; r = 0.23), prospective and retrospective memory (p < 0.05; r = 0.14), and addiction memory (p < 0.01; r = 0.35) with craving is positive and significant. However, the relationship between the severity of dependence and addiction memory (p < 0.32; r = -0.06) is not significant. Other findings showed that the severity of dependence (p = 0.001, β = 0.24), prospective-retrospective memory (p = 0.001, β = 0.25), and addiction memory (p = 0.001, β = 0.44) were positive and significant predictors of craving. However, only prospective-retrospective memory has a positive and significant direct effect on addiction memory (p=0.001, β=0.28) and the severity of dependence has not been able to have a direct and significant effect on addiction memory (p=0.42, β=-0.05). The bootstrap method showed that the indirect effect (partial mediation) of prospective-retrospective memory through addiction memory on craving is significant (p=0.007, β=0.12), but the indirect effect of dependence severity through addiction memory on craving is not significant (p=0.37, β=-0.02) and the research model was able to explain 25% of the variance in craving. The results indicate that the proposed model is sufficiently fit, which can be said that craving can be predicted through prospective memory and the mediation of addiction memory. Conclusion: The results of this study showed that the severity of dependence, prospective, and retrospective memory have a positive and significant relationship with craving, but the severity of dependence did not show a direct significant relationship with addiction memory. These findings indicate that although the severity of dependence affects craving, this effect can be exerted through other cognitive pathways such as prospective and retrospective memory. On the other hand, the mediating role of addiction memory was not fully confirmed, which could indicate more complexities in the cognitive processes related to craving. The results of this study highlight the importance of cognitive processes in understanding and predicting craving. These findings can be used in the design of therapeutic interventions, especially in rehabilitation programs that emphasize improving prospective memory and reducing past-related rumination. Also, these results indicate that the perception of craving is not limited solely to the severity of dependence and that cognitive factors can play a key role in this field.  </div> شدت وابستگی, حافظه آینده نگر- گذشته نگر, ولع مصرف, حافظه اعتیاد Dependence Severity, Prospective-Retrospective Memory, Craving, Addiction Memory 1 10 http://rjms.iums.ac.ir/browse.php?a_code=A-10-8454-1&slc_lang=fa&sid=1 Fatemeh Sharifzadeh فاطمه شریف زاده 3900319475328460089802 0009-0003-4393-0240 No M.A., Department of Psychology, Salman Farsi University, Kazerun, Iran. کارشناس ارشد، گروه روانشناسی، دانشگاه سلمان فارسی کازرون، کازرون، ایران. Ali Alahdadi علی اله دادی 3900319475328460089803 0009-0000-3532-0299 No M.A., Department of Psychology, Salman Farsi University, Kazerun, Iran. کارشناس ارشد، گروه روانشناسی، دانشگاه سلمان فارسی کازرون، کازرون، ایران Zahra Tibash زهرا تیباش 3900319475328460089804 3900319475328460089804 No M.A., Department of Psychology, Salman Farsi University, Kazerun, Iran. کارشناس ارشد، گروه روانشناسی، دانشگاه سلمان فارسی کازرون، کازرون، ایران Nezam Oldin Ghasemi نظام الدین قاسمی dr.ghasemi@kazerunsfu.ac.ir 3900319475328460089805 3900319475328460089805 Yes Assistant Professor, Department of Psychology, Salman Farsi University, Kazerun, Iran (Corresponding Author). استادیار، گروه روانشناسی، دانشگاه سلمان فارسی کازرون، کازرون، ایران