Rethinking treatment motivation in addiction care: executive functions and personality over clinical severity- a cross-sectional study.

Abstract

Background: Alcohol and substance use disorders are chronic mental disorders characterised by high relapse rates, and treatment motivation is one of the most important determinants of success in the treatment process. However, in clinical practice, significant differences in treatment motivation are observed among individuals with similar levels of addiction severity. This suggests that motivation may be closely related not only to clinical severity indicators but also to cognitive and personality-related processes.

Aim: The aim of this study is to examine the relationships between treatment motivation and executive functions, emotional-behavioural characteristics, and personality dimensions in individuals undergoing inpatient treatment at the Alcohol and Drug Addiction Treatment and Center (ADATC).

Methods: This study, conducted between April and August 2025 using a descriptive and cross-sectional design, included 190 individuals undergoing inpatient treatment at ADATC for alcohol and substance use disorders. Data were collected using the Sociodemographic Data Form, Treatment Motivation Questionnaire, Eysenck Personality Questionnaire-Revised Short Form, Addiction Profile Index-Clinical Form, and Solution-Focused Inventory. Analyses were performed using correlation analyses and hierarchical multiple regression analyses with SPSS v26.

Results: It has been determined that the severity of addiction does not significantly predict treatment motivation. In contrast, executive functions, particularly goal-directedness, have been found to be among the strongest and most significant predictors of treatment motivation. When executive functions were included in the model, the effects of addiction severity and emotional-behaviouralsymptoms on treatment motivation lost their significance. In terms of personality traits, neuroticism and extraversion were associated with higher treatment motivation, while psychoticism traits were found to be associated with lower motivation levels in individuals.

Conclusion: This study demonstrates that treatment motivation is more closely related to an individual's executive function capacity and personality traits than to clinical severity indicators. The findings emphasise the importance of considering cognitive and personality-based variables in assessing motivational processes in addiction treatment and contribute to the development of more individualised treatment approaches.

Clinical trials id: Not applicable.