戒癮動機評估之探討—以“觀察勒戒”個案為例

Abstract

本研究主要在探討毒品犯觀察勒戒制度的評估結果與毒品犯戒癮動機間的關係，受試者為470位接受觀察勒戒的毒品犯，以自填問卷、「觀察勒戒評估紀錄」及「戒癮動機階段評估表」為工具，由精神科醫師進行半結構式會談，進行動機狀態的評估與資料收集。研究結果：（一）毒品犯戒癮動機以處於懵懂期最多（78.82%）；（二）戒瘾動機與有無繼續施用毒品傾向間無顯著相關；（三）在11個評估項目中，僅「毒品犯罪相關司法紀錄」以及「戒斷症狀」兩個項目就解釋評估總分變異量的69％，但是只有「短期內再犯」與「注射使用毒品」兩個項目與戒癮動機間呈現顯著的相關；（四）不同動機狀態的毒品犯，在自填問卷中只有「認知」的分量表，達到統計上的差異。由研究結果發現，目前觀察勒戒評估的結果，無法反應出毒品犯的戒癮動機，其中「毒品犯罪相關司法紀錄」以及「戒斷症狀」兩個項目評分比重過大，明顯影響繼續施用毒品傾向之判定，但「毒品犯罪相關司法紀錄」和「戒斷症狀」這兩個因素與戒癮動機的關連性卻不顯著。未來在修訂評估分數時建議增加與動機有關連的「短期內再犯」與「注射使用毒品」兩個項目的評分比重。

Objectives: To evaluate the relationship between the tendency to relapse of drug addicts in detention centers and their motivation to change addictive behaviors. Methods: Semi-structured interviews using two instruments, the "Relapse Tendency Assessment Record" and the "Stage of Motivation Form", were conducted by senior psychiatrists to assess 470 drug addicts. Results: 1. Most of the drug addicts were found to be in the pre-contemplation stage (78.82%). 2. The tendency to relapse and their motivation to change addictive behaviors were not significantly correlated. 3. Among the 11 assessment items, the "drug-related criminal justice records" and "withdrawal symptoms" accounted for 69% of the variance in tendency to relapse, but only "short-term recidivism" (p <0.05) and "injection drug use" (p <0.01) were significantly correlated to motivation to change. 4. Drug addicts in different motivational stage, only "cognitive" subscale in the self-rating questionnaire, reaching statistical difference. Conclusions: The tendency to relapse did not clearly reflect the drug addicts’ motivation to change. The scores for the "drug-related criminal justice records" and "withdrawal symptoms" items were excessively weighted, had no significant correlation with motivation to change, and affected the result of assessment. In the future, we suggest more weighting of the scores for "short-term recidivism" and "injection drug use" in the "Relapse Tendency Assessment Record" to increase the accuracy of the overall assessment.