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Digital archive of theses discussed at the University of Pisa

 

Thesis etd-10182023-120929


Thesis type
Tesi di specializzazione (4 anni)
Author
FORESI CROWTHER, LARA TERESA
URN
etd-10182023-120929
Thesis title
The relationship between deviant behavior and disorganized attachment in a sample of Colombian young adults with substance use disorder
Department
MEDICINA CLINICA E SPERIMENTALE
Course of study
PSICHIATRIA
Supervisors
relatore Prof.ssa Dell'Osso, Liliana
relatore Dott.ssa Marazziti, Donatella
Keywords
  • substance use disorder
  • emotional dysregulation
  • executive functions
  • deviant behavior
  • young adults
  • disorganized attachment
Graduation session start date
06/11/2023
Availability
Withheld
Release date
06/11/2093
Summary
Background: Youth violence is a serious issue in Latin America, especially among adolescent boys. Understanding the causes of violence in young males is essential for designing effective prevention programs, especially in countries like Colombia dealing with prolonged internal conflicts. The rise in youth incarceration rates is a global concern. Drug-related crimes, terrorism, and armed robberies are major contributors to high incarceration rates worldwide. Unfortunately, minority and disadvantaged individuals are disproportionately affected, impacting their children negatively. Exposure to violence, whether as witnesses within families or as direct victims, is a human rights violation affecting numerous children and young people worldwide. Factors like low education, low socio-economic status, and financial difficulties contribute to higher rates of youth violence and can hamper healthy child development. Additionally, early attachment experiences significantly impact lifelong behavioral development, particularly during adolescence. Attachment serves as a motivational system promoting security in infancy through relationships with caregivers: secure attachment is a protective factor against stress and adverse environments, insecure or disorganized attachments may lead to delinquent behaviors. Nevertheless, scientific studies establish a relationship between self-control, attachment, and criminal behavior, highlighting the significance of early attachment experiences. Early life stressors can induce a toxic stress response, disrupting brain circuitry and metabolic systems during sensitive developmental periods. Moreover, glucocorticoids overproduction during stress affects brain architecture, impacting learning, behavior, and health. The oxytocin-vasopressin system plays a crucial role in social bonding, stress response, and attachment, influencing developmental outcomes. Furthermore, identifying latent traits underlying chronic deviant behavior, such as Attention-deficit/hyperactivity disorder and drug addiction, can clarify the mechanisms driving multiple forms of problem behavior throughout life. Childhood self-control is crucial for early identification and treatment of children exhibiting early co-occurring patterns of deviant conduct. The major components of ADHD involve inattention and hyperactivity/impulsivity, resulting in functional impairment across academic, social, and emotional domains. Cognitive deficits are present, particularly in executive functions such as response inhibition, vigilance, and working memory. Individuals with ADHD exhibit heightened sensitivity to immediate rewards and struggle to regulate impulsive behaviors. In addition, ADHD is strongly associated with substance use disorders, with ADHD patients at a higher risk of substance abuse, earlier substance use initiation, and polysubstance use.

Methods: The study is an observational, cross-sectional analysis conducted at a detention home for young adults (ages 19-23) who committed serious crimes during adolescence. Six questionnaires and clinical interviews were used to collect data, aiming to examine clinical and psychopathological features in young adults with substance dependency problems. Clinical interviews and questionnaires were administered over three months to 40 participants, providing valuable insights into the studied population's characteristics and experiences.

Results: In this study of 40 young adult male substance users with a history of crimes, the average age was 21 years old. Family structures varied, with a high probability of family crisis. The most commonly consumed drugs were cannabis, alcohol, and cocaine. The study found significant correlations between attachment, crimes committed, substance use disorder, and various clinical aspects. Individuals with a family history of substance use disorder exhibited higher scores in specific domains. Those with a positive family history of mood disorders also showed significant differences in certain domains. Regarding substance use, individuals with specific substance use disorders showed significantly higher scores in certain domains. Individuals with a benzodiazepine use disorder had higher scores in domains related to resentment/self-sufficiency and impulsivity.

Conclusions: In individuals with a violent childhood marked by threats and constant violence, greater impulsivity is a notable aspect of emotional dysregulation, often linked to stressful life events. Impulsivity and a struggle to accept negative emotions are positively associated with executive dysfunction, particularly in inhibitory control, emotional regulation, and initiative. Substance use patterns reveal correlations: tranquilizer use (alcohol, benzodiazepines) is linked to authoritarian parenting and self-sufficient childhood, aligning with impulsivity and dysphoric mood swings. Psychostimulant use is associated with authoritarian parenting and difficulties in self-monitoring. In terms of criminal behavior, a correlation was found between murder offenders and a permissive childhood characterized by lack of guidance and boundaries.
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