The role of adverse childhood experiences in the motivation for treatment of mental disorders: secondary analysis of a cross-sectional study.

Background Motivation for treatment is an essential component of patients’ compliance for mental disorders therapy, and it can be influenced by factors such as adverse childhood experiences (ACEs), temperament and character, and internalized stigma. In this study we aim to determine the associations between ACEs, temperament, character, and internalized stigma with motivation for pharmaco-psychotherapy in psychiatric patients. Methods We conducted a cross-sectional study including Russian patients aged over 18 years with severe mental disorders. Adverse Childhood Experience (ACE) were assed with the ACE Questionnaire (ACE-10) and the WHO ACE International Questionnaire (ACE-IQ). Correlation and variance analyses were conducted with personality traits (Internalized Stigma of Mental Illness scale (ISMI), Cloninger’s Temperament and Character Inventory (TCI)), and treatment motivation (Treatment Motivation Assessment Questionnaire (TMAQ)). Thereafter a logistic regression model was constructed. Results 133 patients were included, of which 102 patients were used for analyses. Diagnoses coded according to ICD-10 in categories of F2, F3, F6. ACE-10 showed stronger correlations with patient’s clinical-anamnestic characteristics and more sensitivity regarding the quantity of ACE than the WHO ACE-IQ (ACE-10: low ACEs = 27, high ACE = 36; WHO ACE-IQ: low ACEs = 31 , high ACEs = 32; χ2=11,7; df=1; р=0,001). The logistic regression models showed that higher education (B=1.955; Exp(B)=7.067; p=0.011) and a history of more ACEs (B=0.337; Exp(B)=1.4; p=0,016) are associated with higher motivation for treatment. Different types of ACEs had opposite effects: a history of emotional abuse (B= -2.353; Exp(B)=0.095; p=0.015) was associated with a lower motivation for therapy, while frequent observation of violence towards the mother or stepmother (B=2.725; Exp(B)= 15.262; p=0.011) with higher motivation for treatment. Conclusion Adverse childhood experiences in clinical groups can be informative for a more comprehensive understanding of treatment motivation.