Draft Conference Paper - Inter

Does addiction therapy change the hedonistic temporal
orientation and the satisfaction with the patients’ life?1
Przemysław Zdybek2
Abstract
The current presentation deals with the problem of alcohol addicted
patients. During their therapy, they described a sense of emptiness, low level of life
3
satisfaction and difficulties in enjoying their lives . Those problems often caused
4
them to return to psychoactive substance use . A longitudinal study of alcohol
dependent patients (N=45) in the process of addiction therapy was conducted. The
research questionnaires measured selected aspects of psychological well-being
5
6
(operationalized as important areas of life and temporal orientation) . The first
measurement was made at the beginning of a patient’s addiction therapy. The
second measurement was carried out in the last week of the patient's therapy. The
therapy program was focused on stopping the substance use, making aware of
addictions negative consequences and coping with the craving. It was also
designed to help to cope with emotions and to redefine social interactions. The
results show that addiction therapy program can help patients to improve their
satisfaction with life and change their temporal orientation profile and self-esteem
into a more positive one.
Key Words: alcohol addiction, quality of life, temporal perspective, addiction
therapy.
1
The author would like to thank the following therapy centers for the possibility of
conducting research: Wojewódzki Ośrodek Leczenia Uzależnień i
Współuzależnienia w Opolu, Ośrodek Leczenia Odwykowego w Woskowicach
Małych i Samodzielny Wojewódzki Szpital dla Nerwowo i Psychicznie Chorych w
Branicach.
2
University of Opole, Institute of Psychology, [email protected]
3
Norman Kent Denzin, The Alcoholic Society: Addiction and Recovery of the Self
(Transaction Publishers, 1993).
4
Aaron Temkin, Chodkiewicz, Jan Beck and Joanna Witkowska, Terapia
poznawcza uzależnień (Kraków: Wydawnictwo Uniwersytetu Jagiellońskiego,
2007).
5
Przemysław Zdybek and Radosław Walczak, „Badania nad rzetelnością and
trafnością Kwestionariusza Oceny Dobrostanu Psychicznego”, w Psychologia
ilości, psychologia jakości. Uzupełniające się spojrzenia (Wrocław: Atut, 2009),
103–20.
6
Philip G. Zimbardo and John N. Boyd, „Putting Time in Perspective: A Valid,
Reliable Individual-Differences Metric.”, Journal of Personality and Social
Psychology 77, nr 6 (1999): 1271–88, doi:10.1037//0022-3514.77.6.1271.
2
Does addiction therapy change the hedonistic temporal orientation …
__________________________________________________________________
*****
1. Introduction
The aim of presented research is to show the problem of regaining the feeling
of satisfaction with life by patients addicted to alcohol and other substances. These
patients often describe problems connected with their regaining of satisfaction
from different life spheres and the dominant feeling of emptiness which appear
within one year of their abstinence. Objectively, the patients’ situation is
improving but they often cannot be satisfied with it subjectively as they see the
source of relief in the alcohol and drugs. Data concerning the fact whether the
patients stay abstinent after the end of the therapy cannot be the only indicator of
efficacy, thus this article concentrates on selected psychological indicators of the
recovery.
In the research psychological indicators describing the phenomenon were
taken into consideration: 1) the quality of life with taking into consideration 10
areas and 2) the focus on positive vs negative time perspectives (PresentHedonistic vs Negative; Past-Positive vs Negative; Future) 3) self-esteem.
2. Addiction as a disease and treating
Addiction was not always considered to be a disease in the past but nowadays,
scientists agree that addiction (regardless of its kind: drug abuse, alcohol abuse,
gambling, shopping, sex, using the computer or telephone) is a disease.
According to the World Health Organization (WHO), addiction is a disease, the
main criteria of which are six symptoms7. The symptoms of addiction are:
cravings, withdrawal syndrome, change of tolerance, disabled control, using the
substance despite knowing that it is harmful and neglecting alternative sources of
pleasure. When a patient has at least 3 out of 6 symptoms within 12 months, we
can say that this person is addicted. Addicted people usually go to addiction
treatment centers when some consequences of using psychoactive substances
appear and their addiction has had a destructive influence on their life.
Most concepts of addiction and models of its treatment highlight that: 1) as a
result of deepening of addictions the biological, social and mental condition of
addicted people deteriorates; 2) the addicted person is not always conscious of the
destructive role of addiction in his life and the therapy is trying to show it; 3) the
addicted person is not able to stop the use of the substance to which she/he is
addicted without help; 4) the condition necessary to make a successful treatment is
not to use the addictive substance and work to reconstruct health, social relations
and mental health. Unfortunately, despite many analyses concerning the efficacy of
the therapy, the treatment of addiction is still the challenge for scientists and
7
ICD-10: International Statistical Classification of Diseases and Related Health
Problems. (Geneva: World Health Organization, 2011).
Przemysław Zdybek
3
__________________________________________________________________
practitioners. Statistics of many research programs show the efficacy of the therapy
(psychotherapy, pharmacotherapy or combining these two methods) based on
maintaining the abstinence at the level of 20-53 % 8.
A typical approach to addiction is the model of phases of alcoholism
development as a disease in which from the warning phase, through the critical up
to the chronic one there is a gradual deterioration of an addicted person leading to
death or a total abstinence9. The alcoholism treated as a disease resulted in the
creation of the Minnesota treatment model, which assumes that denying problems
and the lack of motivation to undergo treatment is an element of a disease 10. The
Alcoholics Anonymous (AA) movement11, and then the Narcotics Anonymous,
shopaholics, gamblers or sexoholics movements are based on taking part in the
self-help community of addicted people and realization of the 12 steps program by
group meetings and working with the AA sponsor 12. A cognitive behavioral
approach to the addiction therapy is based on the modification of source beliefs
and habits of addicted people in order to make them stop using the substance which
they are addicted to13. An integrative model of addiction highlights the fact that in
the scope of the disease development three mechanisms start to have an influence
on the addicted person14. The illusion and denial mechanism which is responsible
for a defensive denial of a disease, dispersion and dissociation of self-mechanism –
responsible for the self-esteem lowering, deformation and instability of the selfimage. Whereas the addictive regulation of emotions mechanism causes deepening
of the failure to feel life satisfaction. The last, integrative model is the basis of the
8
Jan. Chodkiewicz, Odbić się od dna?: rola jakości życia w przebiegu and
efektach terapii osób uzależnionych od alkoholu (Łódź: Wydawnictwo
Uniwersytetu Łódzkiego, 2012).
9
Jelinek, Elvin, M., The Disease Concept of Alcoholism, (New Haven: CoIlege
and University Press, 1960).
10
Chodkiewicz, Odbić się od dna?.
11
Ireneusz Kaczmarczyk, Wspólnota Anonimowych Alkoholików w Polsce:
alkoholowe dno and co to znaczy trzeźwieć (Warszawa: „Eneteia” - Wydawnictwo
Psychologii and Kultury, 2008).
12
Alexandre B. Laudet, Keith Morgen, and William L. White, „The role of social
supports, spirituality, religiousness, life meaning and affiliation with 12-step
fellowships in quality of life satisfaction among individuals in recovery from
alcohol and drug problems”, Alcoholism treatment quarterly 24, nr 1–2 (2006):
33–73.
13
Beck and Witkowska, Terapia poznawcza uzależnień.
14
Jerzy, Mellibruda and Zofia Sobolewska-Melibruda, Integracyjna psychoterapia
uzależnień: teoria and praktyka (Warszawa: Instytut Psychologii Zdrowia. Polskie
Towarzystwo Psychologiczne, 2006).
4
Does addiction therapy change the hedonistic temporal orientation …
__________________________________________________________________
Polish addiction treatment and is the one most frequently used in the therapy
centers.
Patients who come to the treatment centers, do not arrive here completely
voluntarily. Certainly, they are the ones who mainly make a decision on the
treatment but it takes place as a result of problems which are caused by the
addiction. If someone e.g. drinks alcohol and stops controlling its quantity and
circumstances of its consumption, he starts to experience harmful consequences
such as for example arguments in the family, the loss of job connected with
drinking alcohol in the workplace, health problems (liver, pancreas, hypertension),
the dominant suffering experience in relation to the withdrawal syndrome and legal
proceedings. In each of these cases there is a certain crisis in one of the spheres of
patients’ life. In such a moment of crisis, the quality of patients’ life is theoretically
very low. Addicted people, due to the crisis, decide to choose the lesser evil and
agree to start the therapy, whilst during the therapy, they work on getting their
position right focusing on certain areas which, in reality, are components of the
patients’ life quality.
3. The quality of addicted patients’ life
The onion theory of happiness15 describes luck as an independent component
which is indigenous and stable, whereas life quality is more dependent on external
factors. The life quality (welfare) construct is more adequate to show changes in
the addiction therapy. Scientific research on the life quality go in two directions,
the economic (objective) and psychological (subjective). The first of them
(economic) is based on the assumption that objective, measurable factors, such as
for example a citizen’s income, are an indicator of the life quality. Although
undoubtedly parameters such as income per inhabitant are essential and easy to
measure, they do not prejudice whether we are satisfied with our life or not.
Research showing the independence of the subjective life quality on the income
show that money do not mean satisfaction16. A psychological approach, in
addition, takes into consideration environmental components of the life quality
perception defining it as a deliberate, culturally stable system of values in which a
man lives in a certain relation to his goals, hope and standards of living 17. It
indicates certain components building the feeling of life quality: material status;
environmental quality; community health; quality of education; psychological
15
Jan Czapiński, „Psychologia szczęścia”, Przegląd badań and zarys teorii
cebulowej. Warszawa, Pracownia Testów Psychologicznych PTP, 1994.
16
Ed Diener and Carol Diener, „Most people are happy”, Psychological science 7,
nr 3 (1996): 181–85.
17
Juozas Ruževičius and Dalia Akranavičiūtė, „Quality of life and its components’
measurement”, Inžinerinė ekonomika= Engineering economics, 2007, 43–48.
Przemysław Zdybek
5
__________________________________________________________________
climate; personal security; self-expression possibilities18. An important work
verifying the componential construction of the life quality is the meta-analysis
being the summary of 122 studies on the life quality made in total on 42171
participants19. Authors verify the influence of personality dimensions on the
subjectively perceived life quality level in the above-mentioned meta-analysis. As
a result of the above research, it is visible that the feeling of life quality is not a
uniform factor, but it can have many components. Environmental factors such as
natural resources, social status, money and most importantly health are essential in
the explanation of the life quality.
Frequent substance use is connected with the improvement of self-esteem and
subjective happiness. People use alcohol and drugs in order to feel happier or
suffer less20. Unfortunately, it is an illusion. Using psychoactive substances causes
an inverse effect – the more substance you use, the less able you are to experience
happiness yourself and the bigger consequences of using the substance are and
these consequences lower the life quality perception 21. It results directly from
assumptions of mechanisms of the addiction disease 22. If someone stops taking
drugs or drinking alcohol, it does not cause any improvement of the felt life
quality. In the early period of the therapy, the life quality can be lowered as
patients confront themselves with consequences of their disease. During the
therapy, patients learn that in order to recover, they will have to stay abstinent,
cope with alcohol cravings, avoid relations with friends from the past, work to
improve relations with their family or employer. According to the earlier
research23, and assume that (H1) when the addiction therapy in the center is
over, the patients’ life quality and their self-esteem will increase.
18
Rita Rugiene, Jolanta Dadoniene, and Algirdas Venalis, „[Adaptation of healthrelated quality of life (« SF-36») questionnaire, its validation and assessment of
performance for control group and patients with rheumatoid arthritis].”, Medicina
(Kaunas, Lithuania) 41, nr 3 (2004): 232–39.
19
Kristina M. DeNeve and Harris Cooper, „The happy personality: a meta-analysis
of 137 personality traits and subjective well-being.”, Psychological bulletin 124, nr
2 (1998): 197.
20
Barry Stimmel, The facts about drug use: Coping with drugs and alcohol in your
family, at work, in your community (Consumer Reports Books, 1991).
21
Karl Peltzer and Supa Pengpid, „Alcohol Use and Health-Related Quality of Life
among Hospital Outpatients in South Africa”, Alcohol and Alcoholism 47, nr 3 (1
maj 2012): 291–95, doi:10.1093/alcalc/ags001.
22
Jerzy Mellibruda and Zofia Sobolewska-Melibruda, Integracyjna psychoterapia
uzależnień.
23
Pierre Lahmek, „Determinants of Improvement in Quality of Life of AlcoholDependent Patients during an Inpatient Withdrawal Programme”, International
Journal of Medical Sciences, 2009, 160, doi:10.7150/ijms.6.160.
6
Does addiction therapy change the hedonistic temporal orientation …
__________________________________________________________________
4. What is the role of the psychological time in the addictions therapy?
The second construct connected with addicted patients’ feeling of emptiness
and failure to be satisfied with life is a temporal orientation. This kind of
orientation is a separate dimension of personality dynamics, which depending on
the theory is described from a slightly different view24,25,26. Czesław Nosal and
Beata Bajcar define the temporal orientation as a global representation of time in
the mind (past, presence, future) and the structure of the subject’s oriented
activities. It is a personal engagement and focus of attention on the past, presence
or future together with the scope and organization of the subject’s activity 27. The
concept created by Phillip Zimbardo and John Boyd, apart from the past, presence
and future also includes an emotional approach to these perspectives28.
Some studies showed that the future perspective is connected with a higher socioeconomic status, a low search for experiences, rare occurrence of health-risk
behaviors 29. Whereas the negative past perspective correlates positively with a
higher distress and a higher depressive attitude30. A temporal orientation as a guide
to the presence (hedonistic) is related to the more complete experience of emotion
and a higher declared satisfaction with life 31. Moreover, the present perspective is
connected with a higher self-monitoring what causes higher adaptability and
security in relation to the changing environment 32. The Present-Fatalistic temporal
orientation is negatively correlated with self-control, positively with neurotism,
there are more frequent internal conflicts, a fugitive style of coping with stress, a
higher search for impressions and risk, alcohol and psychoactive substances
24
Kurt Lewin, Field Theory in Social Science Selected Theoretical Papers
(University Of Chicago Press, 1976).
25
Calvin S. Hall et al., Teorie osobowości (Warszawa: Wydawnictwo Naukowe
PWN, 2006).
26
Czesław Sławomir Nosal and Beata Bajcar, Czas psychologiczny: wymiary,
struktura, konsekwencje (Instytut Psychologii PAN, 2004).
27
Ibid.
28
Zimbardo and Boyd, „Putting Time in Perspective”, 1275.
29
J Husman and D Shell, „The multivariate dimensionality of personal control and
future time perspective beliefs in achievement and self-regulation.”, Contemporary
Educational Psychology 26, nr 4 (2001): 481–506.
30
Philip Zimbardo and John Boyd, The time paradox: The new psychology of time
that will change your life (Simon and Schuster, 2008).
31
Małgorzata Sobol and Piotr Oleś, „Orientacja temporalna carpe diem a poczucie
satysfakcji z życia”, Temporal orientation carpe diem and life satisfaction)(Abstr.),
Przegląd Psychologiczny 45, nr 3 (2002): 331–46.
32
Bengi Öner, „Self-monitoring and future time orientation in romantic
relationships”, The Journal of psychology 136, nr 4 (2002): 420–24.
Przemysław Zdybek
7
__________________________________________________________________
abuse33. An optimum temporal profile is a balanced temporal perspective, where
each of perspectives (past, presence and future) is equally represented and
negative emotional components of the past and presence are low. It is thus
interesting to analyze how the addiction therapy is able to modify the patients’
temporal orientation – or even restore it to the level from the period preceding the
disease. (H2) The assumed effect of the short-term therapeutic influence on
addicted patients is a lower focus on negative time perspectives (past and
present) and (H3) a higher focus on positive perspectives (past and present).
Additionally, (H4) a higher patients’ focus on the future temporal perspective
is assumed.
5. Research
Participants.
People taking part in the research. 45 patients from 3 addiction treatment
centers took part in the research. All of them took part in the 6-7 weeks’ long
addiction treatment therapy. Patients were diagnosed mainly with alcohol
addiction. Eleven people did not finish the therapy, what places the indicator of
completing the treatment at the level of 75.6 %. There is also an analysis planned
after 6 months, which will give a more measurable result about effectiveness of
therapy. In the analyzed sample, 26 patients took part in the therapy for the first
time and 15 for the second or another time, 4 patients did not provide information.
The analyzed sample of patients was composed mainly of men (4 women; 41 men).
Such a gender ratio is natural in a stationary addiction treatment in Poland. The
examined patients were 25 – 70 years old and their average age was 45.61
(SD=10.48).
The research procedure.
Patients who took part in the research were invited during the stationary
therapy (on the hospital ward). The analysis was of a voluntary nature and was in
the form of a questionnaire made in the first week of treatment and the last week of
their stay in the treatment center. The analysis in all centers was made by the same
person during group therapy.
Research tools.
In the presented research, closed demographics questions concerning basic
information such as age, sex, the substance abstinence data concerning the
diagnose and the stay in the treatment center were used. What is more, the
standardized psychological questionnaires were used. The mental well-being
33
Zimbardo and Boyd, „Putting Time in Perspective”; Nosal and Bajcar, Czas
psychologiczny: wymiary, struktura, konsekwencje.
8
Does addiction therapy change the hedonistic temporal orientation …
__________________________________________________________________
assessment questionnaire34 makes it possible to analyze satisfaction on the basis of
the following areas: education and science; politics and social life; friends and
acquaintances; religion; family; entertainment and leisure; making money; health;
sexual life; professional life and work. The ZTPI Scale (Zimbardo Time
Perspective Inventory) makes it possible to measure the following temporal
orientation dimensions: Past-Negative, Present-Hedonistic, Future, Past-Positive
and Present-Fatalistic35. What is more, the Rosenberg's Self-Assessment Scale has
also been attached to the Polish adaptation36.
Results
In order to verify the therapy effects, the comparison of the pre-test post-test
type for dependent samples have been made. In the analysis, missing data were
excluded by cases. Table 1, according to the hypothesis (H1), presents the increase
of the patients’ life quality after the end of the therapy. The most interesting in this
scale is the weighted index of the subjective importance of a given area of life
quality of each examined person. Both in the general life quality index and in the
weighted one, a significant improvement of life quality after the therapy has been
presented. Moreover, three detailed areas: family, health and making money have
also improved.
Table 1. Differences in the patients’ life quality level in the first and the last week
of therapy measured by means of the mental well-being assessment
questionnaire37.
The life quality
Before the
After the
t
df
p
index
therapy
therapy
The general index
The subjective index
Chosen detailed areas:
- Health
- Making money
- Family
34
M
5.72
37.34
SD
1.92
9.85
M
6.84
46.43
SD
1.54
6.42
-3.98
-2.25
1;32
1;32
<0.001
<0.05
3.52
4.09
2.63
2.57
2.17
2.90
4.97
6.21
5.36
3.16
2.37
4.17
-2.60
-3.92
-4.03
1;32
1.31
1.29
<0.05
<0.001
<0.001
Zdybek and Walczak, „Badania nad rzetelnością and trafnością Kwestionariusza
Oceny Dobrostanu Psychicznego”.
35
Zimbardo and Boyd, „Putting Time in Perspective”, 1275.
36
Mariola Łaguna, Kinga Lachowicz-Tabaczek, and Irena Dzwonkowska, „Skala
samooceny SES Morrisa Rosenberga-polska adaptacja metody”, Psychologia
Społeczna 2, nr 4 (2007): 164–76.
37
Zdybek and Walczak, „Badania nad rzetelnością and trafnością Kwestionariusza
Oceny Dobrostanu Psychicznego”.
Przemysław Zdybek
9
__________________________________________________________________
Table 2 shows the effect of reducing the focus on the negative dimension
of the past and the presence and the increased focus on the future perspective what
is in accordance with the second hypothesis (H2) and the fourth one (H4). The
third hypothesis (H3) concerning the increased focus on the Present-Hedonistic and
the Past-Positive perspective was not confirmed.
Table 2. Differences in the focus level on particular temporal perspectives
measured by means of a questionnaire for the temporal orientation measurement
ZTPI (Zimbardo Time Perspective Inventory)38.
Before the
After the
t
df
p*
therapy
therapy
M
SD
M
SD
Present-Negative
3.62
0.57 3.32 0.47 2.41
Present-Hedonistic 3.16
0.60 3.32 0.62 -1.27
Future
3.31
0.52 3.46 0.45 -1.96
Past-Positive
3.15
0.61 3.19 0.53 -0.39
Past-Fatalistic
2.78
0.75 2.52 0.70 -1.94
* p level given in order to test two tailed hypotheses
1.24
1.22
1.22
1.21
1.27
p<0.05
n.s.
p<0.05
n.s.
p<0.06
Moreover, according to the hypothesis (H1), an increase in the self-esteem as
the therapy result has been found (M1=27,22 SD1=3,79; M2=28,44 SD2=3,55;
t(1;32)=-1,81; p<0,05).
6. Discussion
This research has been conducted mainly in a group of men addicted to
alcohol and other substances, being treated in the stationary, intensive addiction
therapy program. Despite the fact that psychoactive substances are used by people
in order to make themselves happy, according to the analysis, addicted people do
not have a high life quality level at the moment of the development of fullsymptom addiction, what is in accordance with other analyses39. The addiction
therapy caused the increase of the life quality index measured as an assessment of
satisfaction with life areas as an overall result, a weighted index and in three
detailed areas: health, family and making money. After the therapy, the focus on
negative aspects of the presence and the past as well as the increased focus on the
38
Zimbardo and Boyd, „Putting Time in Perspective”.
Heidi Rudolf and Jay Watts, „Quality of life in substance abuse and
dependency”, International Review of Psychiatry 14, nr 3 (2002): 190–97.
39
10
Does addiction therapy change the hedonistic temporal orientation …
__________________________________________________________________
future could be seen, what leads to the more balanced temporal orientation 40.
Probably the lower focus on the future could be connected with the bigger fear of
it. The therapy helped to build a positive vision of the future and decreased the fear
of the future, what can be a positive motivation to make changes.
This research is an input into the discussion on the therapy efficacy. Some
analyses of the therapy efficacy (in particular the medical ones) focus mainly on
the measurement of the maintained abstinence 41, which as an efficacy indicator
does not reflect complete effects of the psychological therapy. The gathered partial
results give a promising view on the addiction therapy efficacy in the improvement
of the patients’ life quality perception, changing their temporal perspective and self
esteem into a more positive one.
The presented research project has not been finished yet. A more complete
view will be shown by the data taken from the third measurement which is being
carried out (3-6 months after the end of the therapy).
40
Zimbardo and Boyd, The time paradox: The new psychology of time that will
change your life.
41
Shirley A. Murphy and Agnes L. Hoffman, „An empirical description of phases
of maintenance following treatment for alcohol dependence”, Journal of substance
abuse 5, nr 2 (1993): 131–43.
Przemysław Zdybek
11
__________________________________________________________________
Bibliography
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ICD-10: International Statistical Classification of Diseases and Related Health
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Jelinek, Elvin M. The Disease Concept of Alcoholism,. New Haven: CoIlege and
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Kaczmarczyk, Ireneusz. Wspólnota Anonimowych Alkoholików w Polsce:
alkoholowe dno and co to znaczy trzeźwieć. Warszawa: „Eneteia” Wydawnictwo Psychologii and Kultury, 2008.
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International Journal of Medical Sciences, 2009, 160.
doi:10.7150/ijms.6.160.
Laudet, Alexandre B., Keith Morgen, and William L. White. „The role of social
supports, spirituality, religiousness, life meaning and affiliation with 12step fellowships in quality of life satisfaction among individuals in
recovery from alcohol and drug problems”. Alcoholism treatment
quarterly 24, nr 1–2 (2006): 33–73.
Lewin, Kurt. Field Theory in Social Science Selected Theoretical Papers.
University Of Chicago Press, 1976.
12
Does addiction therapy change the hedonistic temporal orientation …
__________________________________________________________________
Łaguna, Mariola, Lachowicz-Tabaczek Kinga, and Dzwonkowska Irena. „Skala
samooceny SES Morrisa Rosenberga-polska adaptacja metody”.
Psychologia Społeczna 2, nr 4 (2007): 164–76.
Mellibruda, Jerzy and Sobolewska-Mellibruda, Zofia. Integracyjna psychoterapia
uzależnień: teoria and praktyka. Warszawa: Instytut Psychologii Zdrowia.
Polskie Towarzystwo Psychologiczne, 2006.
Murphy, Shirley A., and Agnes L. Hoffman. „An empirical description of phases
of maintenance following treatment for alcohol dependence”. Journal of
substance abuse 5, nr 2 (1993): 131–43.
Nosal, Czesław Sławomir, and Beata Bajcar. Czas psychologiczny: wymiary,
struktura, konsekwencje. Instytut Psychologii PAN, 2004.
Öner, Bengi. „Self-monitoring and future time orientation in romantic
relationships”. The Journal of psychology 136, nr 4 (2002): 420–24.
Peltzer, Karl, and Supa Pengpid. „Alcohol Use and Health-Related Quality of Life
among Hospital Outpatients in South Africa”. Alcohol and Alcoholism 47,
nr 3 (1 maj 2012): 291–95. doi:10.1093/alcalc/ags001.
Rudolf, Heidi, and Jay Watts. „Quality of life in substance abuse and dependency”.
International Review of Psychiatry 14, nr 3 (2002): 190–97.
Rugiene, Rita, Jolanta Dadoniene, and Algirdas Venalis. „[Adaptation of healthrelated quality of life (« SF-36») questionnaire, its validation and
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Przemysław Zdybek
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Author’s Bio
Przemysław Zdybek, social psychologist, addiction psychotherapist, coach. Main
scientific interests lie in evolution of attractiveness perception, social psychology,
concept of psychological time, methodology and clinical therapy of addictions. He
works at the Opole University, Institute of Psychology, contact:
[email protected]