The Relationship of Personality Organization and Resilience With Treatment Motivation and Early Recovery Rates in Patients With Opioid and Polysubstance Use Disorders

Introduction: Personality organization, defense mechanisms, psychological resilience, and treatment motivation are key psychological constructs that influence both the development and treatment outcomes of substance use disorders (SUD). The aim of this study is to investigate the relationships between treatment motivation, acute remission rates, personality organization, and psychological resilience in patients diagnosed opioid use disorder (OUD) and polysubstance use disorder (PSUD). Method: The study included 30 patients with opioid use disorder (OUD), 30 with polysubstance use disorder (PSUD), all diagnosed according to DSM-5 criteria, and 30 healthy controls (HC). Participants with OUD and PSUD were receiving inpatient treatment in this prospective case-control study. The study utilized the following instruments: Sociodemographic Data Form, Resilience Scale for Adults (RSA), Personality Organization Diagnostic Form, Motivation for Treatment Scale (MfTS), and Addiction Profile Index. MfTS and RSA were administered once more during follow-up assessments for patients who had achieved early remission. Results: PSUD group exhibited significantly higher scores for immature defense mechanisms compared to both OUD and HC groups, while mature defenses were significantly lower in both SUD groups relative to controls (p < 0.001). A significant positive correlation was identified between mature defenses and both treatment motivation and resilience levels (p < 0.05), while mature defenses showed a negative correlation with addiction severity (p < 0.05). Resilience levels emerged as a significant predictor of early remission (p = 0.011), and mediation analysis confirmed that resilience mediated the relationship between mature defenses and addiction severity (β= -0.151, 95% CI: -0.266 to -0.042). Conclusion: Mature defense mechanisms and resilience predict early remission and reducing addiction severity.