Resilience as a mediator of amphetamine dependence and psychological symptoms in patients with methamphetamine use in Taiwan

C-C. Hung1,2,3, M-C. Huang4, L-Y. Chen5,6, K-H. Wu7, C-Y. Huang8, S-C. Fang9, C-H. Chen10, C. Lin4, Y-L. Lin7, L-W. Su11, Y-J. Wu4, E. Chao1,3, Y-L. Lai12, T. Szu-Hsien Lee1,3,13. 1CTBC Center for Addiction Prevention and Policy Research, National Taiwan Normal University, Taiwan; 2Department of Psychology and Counseling, University of Taipei, Taiwan; 3Taiwan Harm Reduction Association, Taiwan; 4Department of Addiction Sciences, Taipei City Psychiatric Center, Taipei City Hospital, Taiwan; 5Kunming Prevention and Control Center, Taipei City Hospital, Taiwan; 6Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taiwan; 7Department of Addiction Psychiatry, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taiwan; 8Department of Community Psychiatry, Bali Psychiatric Center, Ministry of Health and Welfare, Taiwan; 9Department of Nursing, Mackay Medical College, Taiwan; 10Department of Public Administration, National Taipei University, Taiwan; 11Department of Psychiatry, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, Taiwan; 12Department of Crime Prevention and Corrections, Central Police University, Taiwan; 13Department of Health Promotion and Health Education, National Taiwan Normal University, Taiwan

Resilience is considered a protective factor of mental illness and substance use disorder in literature. However, little is known about the mechanism of resilience between substance use disorder and psychological symptoms. The study aim is to examine if resilience can alleviate the amphetamine dependence on psychological symptoms. A total of 516 individuals who used amphetamine were recruited in Taiwan between August 2021 and May 2022. A semi-structured interview was used to collect demographics, severity of dependence scale, Brief Symptom Rating Scale (BSRS-5) and resilience. Structural equation modeling was performed to examine the mediation/moderation of resilience between severity of dependence and BSRS-5 while age and gender were controlled. Of participants, 448 (86.8%) were male. Other characteristics assessed included: mean age 40.31 (9.47); marital status (285 (55.6%) single); and, education (165 (32.8%) less than junior high, 222 (44.1%) high school). For clinical diagnosis, 180 (45.2%) were severely dependent. Based on the score of BSRS-5, 39 (8.7%) has serious psychological symptoms and 60 (13.4%) had moderate symptoms. Results from the structural equation model of resilience as a partial mediator between severity of dependence and psychological symptoms showed a great model fit (?2/df=2.06; CFI = 0.964; RMSEA= 0.052; SRMR=0.031) after controlling for age and gender. Specifically, psychological symptoms were predicted by the severity of dependence (?=0.319, p<0.01) and resilience (?=-0.303, p<0.01) while resilience was predicted by the severity of dependence (?=-0.204, p<0.01). These results strongly suggest the severity of amphetamine dependence may aggravate participants’ psychological symptoms but can be alleviated by personal resilience.