|Titre :||Stratégies de coping, activités compensatoires et rechutes chez les alcooliques abstinents (2009)|
|Titre traduit :||(Ways of coping, addictive overlaps and relapses amongst abstinent alcoholics)|
|Auteurs :||G. DECAMPS ; N. SCROCCARO ; N. BATTAGLIA|
|Type de document :||Article : Périodique|
|Dans :||Annales Médico-Psychologiques, Revue psychiatrique (Vol.167, n°7, September 2009)|
|Article en page(s) :||491-496|
Thésaurus mots-clésCCAA ; ETUDE CLINIQUE ; ALCOOL ; STRATEGIE ACTIVE D'ADAPTATION ; ABSTINENCE ; RECHUTE ; ANCIEN BUVEUR ; QUESTIONNAIRE
Le maintien de l'abstinence à l'alcool est un comportement de santé qui met en jeu les capacités adaptatives des patients alcooliques. Il s'accompagne parfois de l'apparition de ce que certains auteurs vont considérer comme des co-addictions qui vont avoir pour fonction de venir compenser le comportement supprimé. Cette étude menée sur 28patients alcooliques abstinents a dans ce cadre permis de tester les liens entre ces compensations, les stratégies de coping et les expériences de rechute au cours de la prise en charge de ces patients. Les résultats montrent que les rechutes sont généralement associées à un faible recours aux stratégies de coping centrées sur le problème. Par ailleurs, la recherche de soutien social semble favoriser le maintien de l'abstinence. Enfin il semblerait que les comportements de compensation les plus fréquemment observés au cours de la période d'abstinence soient ceux présentant le plus grand degré de similarité avec le comportement de consommation d'alcool, notamment du point de vue de la dimension orale de la conduite. Ces résultats confortent les théories supposant la présence d'un noyau addictif chez certains patients et soulèvent la question de la pertinence des critères d'évaluation des addictions.
Objectives: To be abstinent alcoholics must control their behaviour and adapt it. We may therefore consider that this stressful situation could involve the use of coping strategies. Several authors have established that avoidance or emotional coping strategies are dysfunctional while proactive strategies seem to increase the strength of abstinence behaviours. It has, however, been stated that the restriction of alcohol use is frequently complemented by the apparition of new addictive behaviours also considered as co-addictions or as overlaps . This statement was first based on observations concerning the frequently reported use of tobacco amongst alcoholic people. Since then other authors have reported that an increase of the consumption of coffee, candy and food could be observed when alcoholics try to reduce their use of alcohol. Drug uses have also been reported. Moreover, the co-addictions that appear amongst alcoholics do not only concern the use of other substances. These addictive overlaps sometimes take place with an increase of the involvement in activities such as sport practice, work or the use of the Internet. The objective of this research is first to study the addictive overlaps that can be observed amongst alcoholics, and their influence on the relapses. Then, the links between such behaviour with coping strategies will be tested.
Method: Twenty eight alcoholics (16 men, 12 women, average age: 47) were involved in the study. All of them were abstinent when answering the questionnaires. First, the participants were asked to fill a grid assessing the addictive overlaps and their frequency since the beginning of the cure. This grid was adapted from a questionnaire assessing the overlaps related to addictive behaviours amongst sportsmen. The overlaps are divided into two categories: addictive substance use overlaps and addictive activity overlaps. Then, coping strategies were measured with the use of the Ways of Coping Checklist (WCC). The questionnaire provides three scores referring to the three categories of coping strategies: proactive strategies, emotional strategies and social support seeking. Finally, referring to the medical files, the number of relapses since the beginning of the cure was reported for each of the participants.
Results: The number of relapses experienced by an alcoholic is related to two of the three coping strategies. The higher the number of relapses, the lower the score of proactive strategies (r = -0.719). Moreover, social support seems to be a useful strategy in order to maintain abstinence (r = -0.489). The three most frequently reported overlaps refer to substance use behaviours. These substances are: food, coffee and tobacco. Moreover, these overlaps are frequently associated: a strong link is observed for coffee and food (r =0.668) and for coffee and tobacco (r=0.464). However, there is no difference concerning the addictive overlaps between the alcoholics who have always maintained abstinence, and those who experienced one or several relapses. Finally, the results allow us to consider the hypothesis that addictive activity overlaps could be considered as sort of proactive coping strategies: this category of overlaps is negatively linked with social support seeking (r= -0.420).
Conclusions: The most frequently reported overlaps are those which seem to be similar to the behaviour that is supposed to be replaced: an oral dimension is observed in the overlaps of alcoholics. The terms of "addictive core" is proposed in order to describe the weakness of such people concerning addictive behaviours. However, other explicative psychological factors have been identified by several authors and may influence the results, such as alexithymia that is frequently related to addictive behaviours. In addition to this study, a longitudinal study of the addictive overlaps is relevant in order to examine their diachrony and their functional or dysfunctional role upon the relapses. Finally, the links between addictive overlaps and coping strategies should require further investigation in order to determine if these overlaps are part of the coping strategies.
|Domaine :||Alcool / Alcohol|
|Refs biblio. :||29|
|Affiliation :||Laboratoire de psychologie, santé et qualité de vie EA4139, université Victor-Segalen Bordeaux-2, 3ter place de la Victoire, 33076 Bordeaux cedex, France|