A motivação para a mudança em adolescentes usuários de maconha: um estudo longitudinal

• Ano de defesa: 2009
• Autor(a) principal: Zambom, Luís Fernando
• Orientador(a): Oliveira, Margareth da Silva
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul; Porto Alegre
• Palavras-chave em Português: PSICOLOGIA CLÍNICA; ADOLESCENTES - USO DE DROGAS; MOTIVAÇÃO (PSICOLOGIA); ENTREVISTA PSICOLÓGICA
• Link de acesso: http://hdl.handle.net/10923/4785

The use of drugs is a very old phenomenon in human history and makes a serious public health problem, with serious personal and social consequences in the future of young people and the whole society. Just like in Brazil, marijuana is the most widely used illicit drug worldwide. This problem has concerned the society and suggested the construction of many methods to combat substance abuse such as self-help groups, psychotherapy, medication, outpatient treatment, hospitalization, care for family. For some authors, the most important implication of their research was the discovery of the need, initially, access the motivation to change the client and only then, adept therapeutic interventions to the same motivational state. In this context came the transtheoretical model of Prochaska and DiClemente (1982) as an important contribution to the understanding of motivational phenomena in patients with addictive behavior. The model describes how the readiness for change stages in which the individual moves. This model is based on the premise that behavioral change occurs over a process in which people have different levels of readiness and motivation to change. This current work is a longitudinal study, a follow-up after three years, which aims to assess if had changes in the consumption of marijuana and other drugs and the stages of motivation to change of adolescents 3 years after participation in a program of motivational assessment and intervention. This dissertation comprises two studies: a literature review and an empirical study. In the first study there was a review of current articles about the technique of Motivational Interview in adolescent marijuana users through the search in the databases Medline, Scielo, PsycInfo and EBSCO between the period 2004 to 2008. The descriptors used were motivational Interview, motivational enhancement therapy, Readiness to Change, Teens, Marijuana, Cannabis and Drug Use. The descriptors on the basis of Portuguese language were: Entrevista Motivacional, Intervenção Motivacional, Prontidão para Mudança, Adolescentes, Maconha e Drogas Psicoativas. It was found in the literature search, most of the English language, describing the theoretical aspects of the Motivational Interview, feasibility and cost studies - benefit of the motivational interview and studies of the impact and effectiveness of motivational intervention with marijuana adolescents users. The data obtained with the different types of study, suggest that the Motivational Interview brings important benefits related to awareness about the problem of drug use, the reduction patterns of substance use, reduction of days of use per month as well as symptoms related with the dependence on marijuana. The empirical study aimed to evaluate if had changes in the consumption of marijuana and other drugs and changes in motivational stages of adolescents after approximately 3 years of participation in a program of motivational assessment and intervention. Five instruments were used in this study: form of socio-demographic data, semi-structured clinical interview, made according to DSM-IV-TR (2002) for the diagnosis of substance dependence or abuse and disruptive disorders, URICA - University of Rhode Island Change Assessment - to measure the stage of motivational and Beck Anxiety Inventory and Beck Depression Inventory - BDI and BAI. The sample consisted of 30 subjects aged between 16 and 22 years with minimal schooling in the 5th grade of elementary school, a total population of 102 offender adolescents referred by the courts for the infringement of use of marijuana to a specialized customer service. It was a quantitative study of the longitudinal type, evaluated and compared the group of adolescents. The evaluation was performed at two different times (before and after): Initial Assessment (IA) conducted during the program of care and intervention, and Final Evaluation (AF) performed 3 years after the initial assessment. And the participants of AF (n = 30) were divided into 2 groups: those who completed (n = 9) the evaluation program and initial (joined) and those who left (n = 21) the evaluation program and initial (non-joined). The findings showed, in comparison between AI and AF, that 50% of adolescents do not use more marijuana today. There was no significant correlation between the stages in different moments of assessment, although there is an important trend related to increasing the score of the stage "action" in AF (p = 0006). In the analysis of interaction between AI and AF and groups (joined and not joined) can be found significant differences with regard to the Contemplation stage (p = 0004), Action (p = 0,005) and Maintenance (p = 0001). This study concludes that there were significant changes in motivational stages of Pre-Contemplation, Contemplation, Action and Maintenance pointing to the importance of programs of care and its impact in long term, in the awareness and behavior of adolescents towards the use of marijuana and other drugs.