الفهرس 
Significance of the StudyOnly 14 pages are availabe for public view
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Abstract
Drug addiction is a chronic, pervasive and relapsing condition marked by obsessive drug seeking, prolonged use despite negative effects, and permanent brain alterations. Patients who are drug addicts experience abrupt changes in their mental and psychological states, such as anxiety. Anxiety levels increase for a person if they stop using the drug, which can lead to physical dependence and severe addiction. Drug addiction and anxiety are interrelated. Addictive substances cause symptoms of depression and/or anxiety or make an existing problem worse, while making recovery much harder. Individuals with SUDs also demonstrate a reduced ability to regulate negative moods compared to healthy adults.
Drug abuse has increased dramatically in Egypt during the last few years. Almost9 million Egyptians, or a startling 10% of the population, take narcotics, according to the minister of social solidarity in Egypt. Similarly, it was noted that the most frequently abused substance appeared to be the painkiller tramadol, which is illegal to consume in Egypt without a prescription. This was followed by heroin (addiction rate:
26%) and cannabis (addiction rate: 23.3%). Even if the number of drug users has increased recently, there isn’t enough research regarding how to control anxiety symptoms, regulate emotions, and avoid other negative effects in Egypt. Therefore, the purpose of this study was to evaluate the effect of a dialectical behavioral therapy on anxiety and emotional regulation among drug addict patients.
Purpose of the study
The purpose of the study is to evaluate the effect of a dialectical behavioral therapy on anxiety and emotional regulation among drug addict patients.
Research design
A quasi-experimental research design two groups (study and control group) was used to achieve the study purpose.
Research hypotheses - The patients who will participate in dialectical behavioral therapy (study group) will have lower mean scores of anxiety after implementation of the therapy than patients who don’t participate (control group). - The patients who will participate in dialectical behavioral therapy (study group) will have higher mean scores of emotional regulation after implementation of the therapy than patients who don’t participate (control group).
Research setting
This study was conducted at inpatient ward in the psychiatric and addiction treatment hospital in Mit-khalf, Menoufia Governorate, Egypt.
Research Subject
A purposive sample of 80 drug addicted patients who attend inpatient clinic in the psychiatric and Addiction Treatment Hospital in Mit-Khalf.
Data collection instruments
Instrument One: Structured interview questionnaire: - it is designed by the researcher to assess the patients’ socio demographic characteristics and disease history from records such as age, gender, occupation, marital state. In addition to comprehensive mental history including the onset, course, duration, and existence of substance misuse risk factors, family history admission to psychiatric hospital and prescription of medications was done.
Instrument Two: Depression, Anxiety and Stress Scale-Anxitey (DASS-A -7); it is taken from Depression, Anxiety, and Stress Scale, which developed by Lovibond & Lovibond, (1995). The DASS consists of 21 items, is a self-report screening tool which measures the frequency of behaviors or intensity of feelings based on three subscales; anxiety (DASS-A) 7 items, depression (DASSD) 7 items and stress (DASS-S) 7 items.
A DASS total score computed from the three subscales. Scores of items rated on a three degrees of depression, anxiety and stress. In this study, the researcher used anxiety self- reported subscale. The anxiety scale assesses autonomic arousal, skeletal muscle effects, situational anxiety, and subjective experience of anxious effect. Researcher calculated the score for anxiety by summing the scores for the relevant items. A higher score indicates negative emotional status. NB Scores on the (DASS-A -7) will need to be multiplied by 2 to calculate the final score .Anxiety scoring comprises normal (0 7), mild (8 9), moderate (10 14), severe (15 19), and extremely severe (20+).
Instrument three: Emotion Regulation Scale:
This questionnaire was designed by Gross and John (2003) based on the process model of ER, The ERQ is a 10-item self-report questionnaire, designed to measure the use of two ER strategies: an antecedent focused strategy called cognitive reappraisal (6 items 1, 3, 5, 7, 8, 10) where an individual attempts to change how they consider a situation to change its emotional impact; a response-focused strategy, called expressive suppression (4 items 2, 4, 6, 9). where subject attempts to inhibit the behavioral expression of their emotions. The two subscales can be scored separately; with higher scores indicating greater use of that strategy. Respondents answer each item on a 3- point Likert-type scale ranging from 0 (disagree) to 2(agree).
The main findings of the study revealed the following:
Bad friends constitute the primary causes of drug addiction and account for 25.0% and 35.0%, respectively, in both the study and control groups. In terms of the causes of drug addiction, there is no statistically significant difference between the study and control groups (p value) (0.965).
There is no statistical difference between study and control group regarding anxiety symptoms before dialectical behavior therapy.
There is a statistically significant difference in anxiety symptoms of study group before and after therapy as well as between before therapy and 2 months follow up therapy; where p value (p= 0.001).
There is a statistically significant difference in the study group’s total anxiety mean score between before and after therapy, as well as between before and 2 months follow-up therapy; where p value (p= 0.001)
There was a statistically significant reduction in anxiety symptoms among the study group, after dialectical behavior therapy There is a statistically significant difference in the study group’s total emotional experience mean score and levels between before and after therapy, as well as between before and 2 months follow-up therapy; where p value(p = 0.001).
There is a statistically significant difference in the study group between before and after therapy as well as between before and 2 months follow up therapy regarding both emotional expression items (as they control their emotions by not expressing it and when they are feeling negative emotions, they make sure not to express it) There is a statistically significant difference in the study group’s total emotional
expression mean score and levels between before and after therapy, as well as between before and 2 months follow-up therapy There is a statistically significant negative correlation between total anxiety mean score and total emotional regulation mean score among the study group after dialectical behavioral therapy
Conclusion:
Based on the result of this study: It was concluded that:
The dialectical behavioral therapy has a positive effect on reducing anxiety level and improving level of emotional regulation among drug addict patients .There was statistically significant negative correlation between level of anxiety and emotional regulation
Recommendations:
Based on the findings of the present study, it could be recommended that:
1) Screening for high-risk patients with substance addiction should be done and referral when necessary.
2) Psychiatric nurse should incorporate dialectical behavioral therapy (DBT) as a treatment modality within a daily routine care for drug addict patients to reduce anxiety levels and improve emotional regulation.
3) Provide additional resources and support for drug addict patients undergoing DBT treatment to ensure successful implementation of therapy.
4) Raise awareness about the benefits of dialectical behavioral therapy and its potential to help individuals struggling with anxiety and related emotional regulation disorders.
In further research:
1. Future research is recommended for evaluating the effects of a Dialectical tolerance , psychological well-being and flexibility
2. Replication of the study using a larger sample in different settings for further confirmation and generalizability of the result