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. 2023 Feb 21;13(3):512-524.
doi: 10.3390/ejihpe13030039.

An Integrated Approach to Addictive Behaviors: A Study on Vulnerability and Maintenance Factors

Alessio Gori  1   2 , Eleonora Topino  3 , Marco Cacioppo  3 , Giuseppe Craparo  4 , Adriano Schimmenti  4 , Vincenzo Caretti  3
Affiliations

An Integrated Approach to Addictive Behaviors: A Study on Vulnerability and Maintenance Factors

Alessio Gori et al. Eur J Investig Health Psychol Educ. .

Abstract

This study aimed to explore the relationships among the variables involved in a Comprehensive Model of Addiction (CMA), which posits that the presence and severity of addictive behaviors are related to the configuration of seven psychological variables, namely childhood trauma, insecure attachment, affect dysregulation, dissociation, impulsivity, compulsiveness, and obsessiveness. A vulnerability model was proposed, in which it was suggested that affect dysregulation and complex trauma mediated the association between insecure attachment and dissociation. Furthermore, a maintenance model was elaborated, in which it was hypothesized that dissociation influenced affect dysregulation via impulsivity, compulsiveness, and obsessiveness. A clinical sample of 430 individuals with substance use disorder was involved. All participants received a DSM-5 clinical diagnosis of Substance-Related and Addictive Disorders and were recruited from the Italian National Health System. A parallel mediation emerged, confirming the vulnerability model, with complex trauma and affect dysregulation mediating the relationship between insecure attachment and dissociation. Furthermore, a mixed serial-parallel mediation described the maintenance model, where impulsiveness, compulsiveness, and obsessiveness significantly mediated the relationship between dissociation and affect dysregulation. Our findings offer a better understanding of the variables associated with addictive disorders, thus providing important indications for both treatment and preventive interventions.

Keywords: behavioral addiction; mental health; prevention; risk factors; substance abuse; substance use.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The Vulnerability model: a collateral mediation. Note: The paths indicate the regression coefficients that make the model [27,28].
Figure 2
Figure 2
The Maintenance model: a mixed serial–parallel mediation. Note: The paths indicate the regression coefficients that make the model [27,28].
See this image and copyright information in PMC

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