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Di Maggio, Ilaria (2017) Substance Use Disorder and Future Life Prospective. [Ph.D. thesis]

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Abstract (english)

The aim of this research project is to provide a better understanding of the mechanisms involved in the promotion of life satisfaction in adults with Substance Use Disorder (SUD). Life satisfaction can be considered an important diagnostic and outcome criterion in substance use disorder issues but also in vocational rehabilitation issues (Assari & Jafari, 2010; Laudet, Morgen, & White, 2006; Smith & Larson, 2003; Rudolf & Watts, 2002; Savickas et al., 2009). The treatment aims to reach patients’ recovery, which is defined as abstinence plus improved life satisfaction (Laudet, 2011). Moreover, to have a satisfying future life, it is also the principal future goal of people with SUD (e.g., Laudet, Savage, & Mahmood, 2002; Laudet, Morgen, & White, 2006). However, re-designing, and getting positive future scenarios after treatment is not always easy for people with SUD because of the many barriers that they can experience, such as barriers at level of client (for example, the lack of work’s experiences, unrealistic career goals, low levels of self-esteem, low problem-solving skills) of program (for example, rigidity of treatment) and of social context (prejudice against drug users, problems of the labor market, economic crisis) (Earnshaw, Smith, Chaudoir, Amico, & Copenhaver, 2013; European Observatory on Drugs, 2013; Graham, 2006; Richardson, Wood, Montaner, & Kerr, 2012; Sgaramella, Ferrari, & Ginevra, 2015).
Considering this, vocational rehabilitation interventions have a crucial role to help people with Substance Use Disorder to design a new and satisfying life. For this reason, and based on the Life Design paradigm that can be considered a career and vocational parading for all people with and without a specific vulnerability or disorder, the role of career adaptability, hope, courage on life satisfaction was investigated in adults with and without SUD. With this aim, two studies were carried out.
In the first study, the attention was focused on career adaptability and hope and their relationship with life satisfaction in individuals with SUD. More specifically, based on Porfeli and Savickas’s suggestions (2012) and based on Rudolph, Lavigne, and Zacher’s (2017) meta-analysis and Santilli, Nota, Ginevra, and Soresi’s study (2014) using a multi-group method, the mediating role of hope on the relationship between career adaptability and life satisfaction in a group of individuals with SUD was tested and simultaneously the invariance of this model across individuals with and without SUD was verified. The results obtained showed that despite adults with SUD have lower levels of carer adaptability, hope and life satisfaction in respect to adults without SUD, the mediation model tested was invariant in adults with and without SUD.
In the second study, attention was focused on courage. Specifically, based on Peterson, Ruch, Beermann, Park, & Seligman’ study (2007), the predictive role of courage on life satisfaction was tested, using a multivariate regression analysis, beyond the addiction condition. The analysis carried out showed that courage predicts in positive ways life satisfaction beyond the addiction variable and other control variables such as “age” and “years of education”. These results are in line with Seligman and colleagues (Seligman, 2002; Seligman & Csikszentmihalyi, 2014; Savickas et al., 2009) that affirm the need to bring the building of strength to the forefront in the treatment of mental illness and in vocational programs. Additionally, personal stories of courage reported by a group of individuals with SUD were analyzed in order to identify themes, meanings, and types of courage performed. The qualitative and quantitative analysis carried out showed that individuals with SUD described more frequently courageous behaviors in overcoming psychological risks than physical and moral risks, especially when these stories were referred to the addiction rather than to other life situations. These results were in line with Putman’s assumptions (2004; 2010). More specifically, for Putman, taking on addiction requires more psychological courage in respect to moral and physical courage, in particular to face challenges related to their past experiences and choices but also to face challenges related to personal and professional future planning.
The main theoretical implication of this research project was to study the positive and predictive role of relevant constructs in vocational rehabilitation intervention such as career adaptability, hope, courage on life satisfaction, for the first time, in adults with SUD. Considering that life satisfaction is believed to be an important diagnostic and outcome criteria in substance use disorder issues (Assari, & Jafari, 2010; Laudet et al., 2006; Rudolf & Watts, 2002; Smith & Larson, 2003), it is possible to hypothesize that the results obtained in this research project can provide a main theoretical implication in substance use disorder issues. As regards the applicative implication, this research project provide useful information to plain intervention to increases life satisfaction and core ability for future life designing in people with SUD.

Abstract (italian)

Lo scopo del seguente progetto di ricerca è stato quello di studiare i meccanismi coinvolti nella promozione della soddisfazione di vita in adulti con Disturbo da Uso di Sostanza (Subastance Use Disoerder – SUD). La soddisfazione di vita può essere considerata un importante criterio diagnostico e di efficacia del trattamento nel Disturbo da Uso di Sostanza e nei programmi di riabilitazione professionale (Assari & Jafari, 2010; Laudet, Morgen, & White, 2006; Smith & Larson, 2003; Rudolf & Watts, 2002; Savickas et al., 2009). Di fatto, i differenti trattamenti nel campo delle dipendenze mirano al recupero, definito come il raggiungimento di uno stato di astinenza e una maggiore soddisfazione di vita (Laudet, 2011). Inoltre, il desiderio di una vita futura soddisfacente e di qualità è anche uno dei principali obiettivi futuri delle persone con SUD (e.g., Laudet, Savage, & Mahmood, 2002; Laudet et al., 2006). Tuttavia, “ridisegnare” e “immaginare” scenari futuri positivi dopo il trattamento non è sempre facile per le persone con SUD a causa delle molte barriere che possono sperimentare a livello personale (ad esempio, la mancanza di esperienze lavorative, obiettivi irrealistici, bassi livelli di autostima, basse abilità di problem solving), a livello degli interventi riabilitativi (ad esempio, rigidità del trattamento) e a livello del contesto sociale (ad esempio: pregiudizi contro i consumatori di sostanze, problemi del mercato del lavoro, crisi economica) (Earnshaw, Smith, Chaudoir, Amico, & Copenhaver, 2013; European Observatory on Drugs, 2013; Graham, 2006; Richardson, Wood, Montaner, & Kerr, 2012; Sgaramella, Ferrari, & Ginevra, 2015).
In considerazione di ciò, gli interventi di riabilitazione professionale hanno un ruolo cruciale per aiutare le persone con SUD a progettare una vita nuova e soddisfacente. Per questa ragione, basandosi sul paradigma del Life Design, che può essere considerato una modello teorico-pratico di orientamento e progettazione professionale pensato per tutte le persone, siano essi con e senza una specifica vulnerabilità o sindrome, è stato indagato in adulti con e senza SUD il ruolo dalla career adaptability, della speranza e del coraggio sulla soddisfazione di vita. A tale scopo sono stati condotti due diversi studi.
Nel primo studio ci si è focalizzati sull’analisi delle relazioni esistenti tra la career adaptability, la speranza e la soddisfazione di vita in persone con SUD. Nello specifico, basandosi sulle teorizzazioni di Porfeli e Savickas (2012), sul lavoro di metanalisi di Rudolph, Lavigne, e Zacher’s (2017) e infine, sullo studio di Santilli, Nota, Ginevra, e Soresi (2014), utilizzando un metodo di analisi multi-gruppo, è stato analizzato l’invarianza del modello di mediazione tra la career adaptability, la speranza e la soddisfazione di vita in adulti con e senza SUD. I risultati ottenuti mostrano che nonostante le persone con SUD presentino più bassi livelli di career adaptability, speranza e soddisfazione di vita rispetto al gruppo di adulti senza SUD, il modello di mediazione analizzato risulta essere invariante nei due gruppi.
Nel secondo studio, ci si è focalizzati invece sul coraggio, una nuova dimensione positiva enfatizzata recentemente all’interno del paradigma del Life Design. Basandosi sullo studio di Peterson, Ruch, Beermann, Park, & Seligman (2007) si è analizzato il ruolo predittivo del coraggio e della dipendenza da uso di sostanze sulla soddisfazione di vita. Le analisi di regressione multipla condotte mostrano come il coraggio, al di là di variabili di controllo come l’età e gli anni di studio e al di là della condizione di dipendenza, sia un forte predittore dei livelli di soddisfazione di vita delle persone con e senza SUD. Questi risultati sono in linea con Seligman e colleghi (Seligman, 2002; Seligman & Csikszentmihalyi, 2014; Savickas et al., 2009) i quali sottolineano il bisogno di puntare allo sviluppo di punti di forza, come il coraggio, nei programmi di cura e riabilitazione.
Inoltre, sono state analizzate le storie personali di coraggio riportate da un gruppo di adulti con SUD, al fine di indentificare i temi, i significati e i diversi tipi di coraggio ad esse sottostanti. Le anali qualitative e quantitative condotte mostrano come le persone con SUD riportino più frequentemente comportamenti coraggiosi al fine di superare rischi psicologici rispetto a quelli fisici e morali, in particolare quando le loro storie sono riferite alla loro condizione di dipendenza da sostanze rispetto ad altre situazioni di vita. Tali risultati sono in linea con le teorizzazioni di Putman, (2004; 2010), il quale afferma che affrontare una dipendenza richiede principalmente un coraggio di tipo psicologico rispetto ad altri tipi di coraggio in quanto accettare la propria condizione di dipendenza richiede di affrontare sfide legate ad un passato difficile e ad un futuro imprevedibile; tali sfide possono mettere a dura prova la stabilità psicologica della persona.
La principale implicazione teorica di questo progetto di ricerca è stata quella di analizzare, per la prima volta, il ruolo predittivo dei costrutti rilevanti all’intervento dei programmi di riabilitazione professionale come la career adaptability, la speranza, il coraggio sulla soddisfazione di vita in adulti in trattamento con SUD. Considerando che la soddisfazione di vita è definita come un importante criterio diagnostico e di efficacia dei programmi di riabilitazione e cura all'uso di sostanza (Assari, & Jafari, 2010; Laudet et al., 2006; Rudolf & Watts, 2002; Smith & Larson, 2003), è possibile ipotizzare che i risultati ottenuti nel seguente progetto di ricerca possano fornire importanti implicazioni teorico pratiche nelle campo delle dipendenze. Per quanto riguarda, più nello specifico, il risvolto applicativo del seguente progetto di ricerca, gli studi condotti forniscono informazioni utili per la messa a punti di interventi in materia di orientamento e progettazione professionali volti ad aumentare la soddisfazione di vita e la capacità di progettazione futura delle persone in trattamento per SUD.

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EPrint type:Ph.D. thesis
Tutor:Nota, Laura
Ph.D. course:Ciclo 30 > Corsi 30 > SCIENZE PSICOLOGICHE
Data di deposito della tesi:09 January 2018
Anno di Pubblicazione:09 January 2017
Key Words:Substance Use Disorder, Future Life Prospective, Life Design Approach
Settori scientifico-disciplinari MIUR:Area 11 - Scienze storiche, filosofiche, pedagogiche e psicologiche > M-PSI/04 Psicologia dello sviluppo e psicologia dell'educazione
Struttura di riferimento:Dipartimenti > Dipartimento di Filosofia, Sociologia, Pedagogia e Psicologia Applicata
Codice ID:10584
Depositato il:25 Oct 2018 15:47
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