Медицинская психология | Мир педагогики и психологии №04 (69) Апрель 2022
УДК 159.9
Дата публикации 30.04.2022
Взаимосвязь самооценки и межличностных отношений лиц с зависимостью от азартных игр в условиях прохождения комплексной программы реабилитации
Зинина Анна Юрьевна
психолог, Санкт-Петербургский государственный университет, РФ, г. Санкт-Петербург, zininaanna0231@gmail.com
Гуриева Светлана Дзахотовна
доктор психологических наук, профессор, зав. кафедрой социальной психологии Санкт-Петербургского государственного университета, РФ, г. Санкт-Петербург, gurievasv@gmail.com
Аннотация: В данной статье представлены результаты анализа эмпирического исследования, проведенного с целью изучения особенностей взаимосвязи самооценки и межличностных отношений лиц с зависимостью от азартных игр в условиях прохождения комплексной программы реабилитации. В исследовании приняли участие 42 зависимых от азартных игр, проходящих программу реабилитации в реабилитационном центре «ХХХ» (г. Одинцово Московской области и г. Омск). Обоснована и доказана гипотеза о том, что самооценка и связанные с ней представления о себе лиц с зависимостью от азартных игр взаимосвязаны с характером установок в межличностных отношениях. В результате исследования до прохождения программы реабилитации была выявлена взаимосвязь негармоничного состояния самооценки азартных игроков с трудностями в межличностных отношениях. После прохождения программы реабилитации отмечается положительная динамика к повышению самооценки и к стремлению к благоприятным контактам. На основе полученных данных обоснована необходимость дальнейших исследований в данном направлении с целью построения и повышения эффективности лечебно-реабилитационных мероприятий и профилактики игровой зависимости.
Ключевые слова: игровая зависимость, самооценка, межличностные отношения, реабилитация.
psychologist, Saint Petersburg State University, Russia, Saint Petersburg
Sc.D. (psychology), professor heard of Social Psychology Department of Psychology Division Saint Petersburg State University, Russia, Saint Petersburg
Abstract: This article presents the results of an analysis of an empirical study conducted to study the relationship between self-esteem and interpersonal relationships of people with gambling addiction in the context of a comprehensive rehabilitation program. The research involved 42 gambling addicts undergoing a rehabilitation program at the XXX rehabilitation center (Odintsovo, Moscow Region, and Omsk). The hypothesis is substantiated and proven that the self-esteem and the self-perception of gambling addicts are interrelated with the nature of attitudes in interpersonal relationships. As a result of the study, before going through the rehabilitation program, the relationship between the inharmonious state of self-esteem of gamblers and difficulties in interpersonal relationships was revealed. After completing the rehabilitation program, there is a positive trend towards increasing self-esteem and striving for favorable contacts. Based on the data obtained, the need for further research in this direction is substantiated in order to build and improve the effectiveness of treatment and rehabilitation measures and the prevention of gambling addiction.
Keywords: gambling addiction, self-esteem, interpersonal relationships, rehabilitation.
Зинина А.Ю., Гуриева С.Д. Взаимосвязь самооценки и межличностных отношений лиц с зависимостью от азартных игр в условиях прохождения комплексной программы реабилитации // Мир педагогики и психологии: международный научно-практический журнал. 2022. № 04 (69). Режим доступа: https://scipress.ru/pedagogy/articles/vzaimosvyaz-samootsenki-i-mezhlichnostnykh-otnoshenij-lits-s-zavisimostyu-ot-azartnykh-igr-v-usloviyakh-prokhozhdeniya-kompleksnoj-programmy-reabilitatsii.html (Дата обращения: 30.04.2022)
With the development of modern technology and the convergence of digital media and gambling, the gambling industry is taking on new forms and contributing to the development of more serious problems than offline games.
Gambling addiction develops over time, and not everyone who enjoys gambling becomes addicted. The blurry line between healthy and pathological gambling, the lack of external symptoms of a problem, and the societal acceptance of gambling activity all contribute to society's misperception of the problem of gambling addiction.
Authors dealing with the problem of gambling addictions are unanimous in their opinion that in the process of addiction formation, personal changes in gambling addicts undergo profound changes: moral and ethical decline in personality; deformation of the system of value orientations; change in the semantic sphere; building a system of psychological defenses and using non-constructive coping strategies; “decrease” in self-esteem; transformation of time perspective [1-4,7,9,10].
The personal characteristics of patients with gambling addiction are a significant factor in both the addiction itself and the basis for treatment and rehabilitation. Considering the personality of the gambling addict as a system of relations, it is necessary to study the attitude of the gambling addict to himself, as well as the features of interpersonal relationships.
The results of numerous studies have revealed the originality of the self-esteem of gamblers compared to healthy people. Gambling players see themselves and their role in this world differently than other people, their behavior can be compared to pendulum swings between two extremes - "greatness" - "insignificance". This leads to dissociation of the personality and is the cause of long-term states of psycho-emotional stress [5,6]. Gambling addicts suffer from the fact that they do not feel “good people” and are pre-sure of the negative attitude from others. The general public perceives problems of gambling addiction as the presence of negative personality traits, lack of willpower, control, discipline and even intelligence, which increases the self-stigmatization of people with gambling disorder [8,15]. Social stigma is destructive to the self-esteem and self-understanding of people with a gambling disorder [13]. Negative self-perception leads to the formation of protective and manipulative mechanisms, to resistance to self-change and self-improvement, which affects the manner of communication with others [12].
Keeping their gaming habits, gaming addicts experience difficulties with social contacts, show pseudo-responsibility, and eventually irresponsibility in relation to family, relatives, and work. Rapid desocialization creates serious social, financial and psychological problems for players, their families and society [14]. Gambling addicts can show not only manipulative actions in relation to others, but also attacks of aggression, resort to crimes and harm not only to themselves, but also to their loved ones. Although the problem of gambling and domestic violence are interrelated, this topic is understudied [11,16].
It should be noted that as they become addicted to gambling, those affected by this disease do not realize that their behavior is unhealthy. It is difficult for them to ask for help, even if they have lost everything that was once important to them.
For the reintegration of the gambling addict into society, rehabilitation is necessary, which allows working out various aspects of addiction, as well as preventing relapses.
A special micro-society of the rehabilitation environment allows the gambling addict to master the skills of healthy behavior and life in society. The rehabilitation environment becomes for the gambling addict the main source of information about himself, where, on the basis of internal self-esteem, a new “healthy” image of the “I” and value attitudes towards this image are formed.
However, reliable diagnostic criteria for evaluating the recovery of the personality of addicts who have undergone a rehabilitation program have not yet been established. Therefore, studies that consider self-esteem as a psychological factor that determines the characteristics of interpersonal relationships of gambling addicts are of interest both for solving practical problems of effective rehabilitation assistance and for preventing gambling addiction, which determines the relevance of our study.
In our previous study [17] we found that the rehabilitation program and a special type of rehabilitation environment (“microsociety”) contribute to the awareness and internal acceptance of the value of one’s “I”, have a beneficial effect on the reconstruction of interpersonal relationships of game addicts. Based on this, we put forward the main hypothesis of our study: self-esteem and the self-perception of gambling addicts are interrelated with the nature of attitudes in interpersonal relationships.
Our study involved 42 gambling addicts (70% male and 30% female) aged 20-29 years (mean age 24.6 years). The respondents of the study were patients of the XXX rehabilitation center (due to the confidentiality of the information provided by the study participants, the name of the center is encrypted). Comprehensive psychological rehabilitation took place in the city of Odintsovo (Moscow region) and Omsk for six months. Criteria for inclusion of participants in the study: 1) voluntary participation 2) written consent to participate in the study; 3) no data for non-inclusion or exclusion from the study; 4) age 18 years or older; 5) any gender. Participants were informed of the nature, anonymity and confidentiality of the study. Permission was obtained from the management of the center to conduct the study.
The XXX Center's rehabilitation program is designed to provide complete isolation from the object of dependence in a hospital setting (from 3 to 6 months), as well as immersion in a specialized therapeutic environment where patients can learn the skills necessary to achieve and maintain a stable remission. The main goal of the activity is a comprehensive restoration, adaptation and return to a healthy and socially fulfilling life. The main objective of the center's program is the reconstruction (transformation) of the personality of an addict, affecting the spiritual, biological, social and psychological aspects.
The study was conducted using scientifically based, reliable, tested and adapted psychodiagnostic methods: «Diagnostic of interpersonal relations» (DIR) method by T. Leary, adapted by L.N. Sobchik; «Self-Relationship Questionnaire» by Russian scientists V.V. Stolin, S.R. Panteleev.
In our previous study, we revealed the distribution of indicators of self-esteem and interpersonal relationships of gamblers in the conditions of rehabilitation [17]. In the present study, at the primary (before complex psychological rehabilitation) and control stages (after the rehabilitation program), we conducted r-Spearman correlation analysis to identify statistically significant associations between self-esteem scores and measures of the types of interpersonal relationships of people with gambling addiction.
In table. 1 shows a number of statistically significant correlations between the studied indicators at the first stage of the study.
Table 1. The results of the correlation analysis between indicators of self-esteem and interpersonal relationships of gambling addiction before undergoing a rehabilitation program
| Scales | I | II | III | IV | V | VI | VII | VIII | IX | X |
| S – Global Self-Esteem |
|
|
|
| -0.349* |
|
|
| -0.331* | |
| Self-esteem (I) |
| -0.331* | -0,371* |
| -0.302* |
|
|
|
| |
| Autosympathy (II) |
|
|
|
|
|
|
|
| ||
| Expected ratio from others (III) |
|
|
| -0.307* |
|
|
| -0.34* |
| |
| Self-acceptance (3) |
|
|
|
|
| -0.347* |
|
|
| |
| Self-leadership (4) |
|
|
|
| -0.312* |
|
|
|
| |
| Self-incrimination (5) |
|
|
|
| 0.344* |
|
|
|
| |
| Self-interest (6) | -0.334* |
|
|
|
|
|
|
|
|
|
|
|
| -0.315* |
|
|
| -0.331* |
|
|
- p <0,05* - p <0,01** - p <0,001***
relationship types: I-authoritarian; II-selfish; III-aggressive; IV-suspicious; V- submissive; VI-dependent; VII-friendly; VIII-altruistic;
main factors: IX- dominance-submission; X- friendliness-aggressiveness
A large number of negative correlations before going through the rehabilitation program indicates a disharmonic state of self-esteem and interpersonal relationships of gamblers.
In table. 2 shows a number of statistically significant correlations between the studied indicators at the second stage of the study.
Table 2. The results of the correlation analysis between the indicators of self-esteem and interpersonal relationships of gambling addiction after completing the rehabilitation program
| Scales | I | II | III | IV | V | VI | VII | VIII | IX | X |
| S – Global Self-Esteem | 0.349* |
|
|
|
| 0.371* | 0.418** |
| ||
| Self-esteem (I) |
|
|
|
|
|
| ||||
| Autosympathy (II) |
|
|
|
|
|
|
| 0.365* | ||
| Expected ratio from others (III) |
|
|
|
|
|
| 0.324* | |||
| Self-acceptance (3) |
|
|
|
|
| 0.357* |
|
|
| |
| Self-leadership (4) |
|
|
|
|
|
|
|
| ||
| Self-incrimination (5) | -0.332* |
|
|
|
|
|
|
|
| |
| Self-interest (6) |
|
|
| 0.322* |
|
| 0.431** |
|
| |
| Self-understanding (7) |
|
|
|
| 0.42** |
|
|
- p <0,05* - p <0,01** - p <0,001***
Note:
relationship types: I-authoritarian; II-selfish; III-aggressive; IV-suspicious; V- submissive; VI-dependent; VII-friendly; VIII-altruistic;
main factors: IX- dominance-submission; X- friendliness-aggressiveness
The change of negative correlations to positive after the completion of the rehabilitation program indicates a trend towards the formation of positive self-esteem and harmonization of the communicative structure of gamblers.
Correlation analysis showed that prior to the rehabilitation program (Table 1), the propensity of gamblers to dependent interpersonal relationships is associated with a decrease in self-confidence, with a general negative attitude towards one's own "I" (r = -0.349; р <0,05). The lower the self-esteem of gamblers, the more they are characterized by an aggressively competitive position, intransigence, a tendency to blame others for everything, irritability that prevents cooperation («Global Self-Esteem» - friendliness-aggressiveness (r = -0.331; p <0.05)).
In interpersonal relationships, gamblers who lack self-esteem, self-confidence, and the ability to control their own life are distrustful, withdrawn, and conflicted. («Self-esteem» - aggressive (r = -0.331; p <0.05), suspicious (r = -0.371; p <0.05), dependent (r = -0.302; p <0.05)).
The poorly realized negative self-concept of gamblers serves as a source of unwillingness to change attitudes and behavior towards others («Autosympathy» - selfish (r = -0.313; p <0.05)). Indeed, immersed in the process of the game, gamblers lose their awareness of themselves as something separate from the actions they perform, focusing their attention and desire on the game, and not on other aspects of life.
Expecting a negative attitude from others can be the result of a negative perception of oneself in general and an indicator of psychological problems. Game addicts, who believe that they are not able to evoke respect in the eyes of others, have a hard time enduring and perceiving criticism from others, which undermines their self-esteem and causes difficulties in social interaction, disrupts the ability to build harmonious interpersonal relationships («Expected ratio from others» - submissive (r = -0.307; p <0.05), dominance-submission (r = -0.34; p <0.05)).
The most significant indicator of inner integrity and harmony is self-acceptance. The study found that gambling addicts' distorted self-esteem and severe self-criticism are linked to a tendency to avoid communication and caution in developing emotional relationships («Self-acceptance» - friendly (r = -0.347; p <0.05)).
Gambling addict do not consider themselves as fate's arbiters; instead, they concentrate solely on their flaws, indicating an external sort of control (dependent type of relationship - «Self-leadership» (r = -0.312; p <0.05), «Self-accusation» (r = 0.344; p <0.05)). As a result, psychological defenses are formed, which manifest themselves through accusation and self-abasement.
Game addicts underestimate the potential of their personality, which manifests itself in vulnerability and difficulty in establishing contacts due to self-doubt («Self-interest» - authoritarian (r = -0.334; p <0.05)). Uncritical gamblers, who do not understand themselves and the reasons for their actions, perceive the world around them as a threat to their own self-esteem, show indifference towards what is not related to the object of addiction («Self-understanding» - suspicious (r = -0.315; p <0.05), altruistic (r = -0.331; p <0.05)).
After completing the rehabilitation program (Table 2), the research analysis revealed a positive trend towards the formation of a harmonious internal state and social reintegration.
The psychocorrectional effect on the creation of a positive self-attitude allowed the ratio of "for" and "against" feelings to be balanced. Recognition of one's "I" value encourages strong relationships, a focus on group values, social acceptability and approbation, and preparedness for cooperative activities in game addicts («Global Self-Esteem» - authoritarian (r = 0.349; p <0.05), friendly (r = 0.371; p <0.05), altruistic (r = 0.418; p <0.01) relationship types).
Following the end of the rehabilitation program, research found an increase in the participants' self-acceptance and self-confidence, which contributes to the development of a positive self-concept, a drive for self-improvement, and the formation of positive relationships with others («Autosympathy» - friendliness-aggressiveness (r = 0.365; p <0.05)).
Understanding one's own value in the eyes of others forms a tendency for research participants to be emotionally open to interaction («Expected ratio from others» - friendliness-aggressiveness (r = 0.324; p <0.05)). Acceptance of all aspects of oneself, as well as an improved sensation of like for oneself, has a beneficial impact on the desire to form more trusting connections («Self-acceptance» (r = 0.357; p <0.05) and «Self-understanding» (r = 0.42; p <0.01) - friendly type of relationship).
After completing the rehabilitation program, gamblers who are subjectively close to their «I» tend to be communicative, benevolent towards others, and focus on social norms of behavior («Self-interest» - altruistic (r = 0.431; p <0.01)).
Against the background of a decrease in the level of self-accusation, the participants in the study strive for independence, focusing on their own opinion, which prepares them for an independent life in society («Self-accusation» - authoritarian (r=-0.332; p<0.05)).
The results obtained allow us to conclude that, before undergoing a rehabilitation program, difficulties in interpersonal relationships and establishing contacts among game addicts may be the result of a deformed structure of the "I", personal disharmony and intrapersonal conflict, which are important symptoms of social maladaptation and exacerbate addictive behavior.
After completing the rehabilitation program, a tendency to the formation of the personal integrity of game addicts was revealed, which contributes to a more adequate self-perception and normalization of the communicative structure.
Thus, the results of the study demonstrate the presence of qualitative changes and a significant relationship between the indicators of self-esteem and interpersonal relationships of game addicts, which confirms our hypothesis.
Understanding the relationship between self-esteem and interpersonal relationships of people with gambling addiction makes it possible to predict changes in both the addicted person and possible changes in the nature of addiction, more precisely, to choose psychotherapeutic directions in the context of preventing the development of gambling addiction and in rehabilitation work.
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