Adverse childhood experiences and level of self-esteem as predictors for motivation to change among adults with methamphetamine use residing in rehabilitation centers

INTRODUCTION: Methamphetamine use has been on the rise, which is particularly alarming among younger generations and poses a risk to public health. This study aimed to determine the relationship between adverse childhood experiences (ACE), self-esteem, and treatment motivation among individuals undergoing rehabilitation for methamphetamine use. METHODS: This cross-sectional study recruited 684 participants from Malaysian drug rehabilitation centers using a randomized selection process. Data collection was conducted utilizing validated instruments, such as the Adverse Childhood Experiences International Questionnaire (ACE-IQ), the Rosenberg Self-Esteem Scale, and the Treatment Motivation Scale. Statistical analyses involved Spearman's correlation and multiple linear regression to explore the relationships between ACE, self-esteem, and treatment motivation. RESULTS: The motivation scores of respondents who were Malay were significantly higher than those of non-Malay respondents (p = 0.009). Increased motivation scores were linked to higher parental education, particularly the secondary education of the mother (p = 0.004) and the father (p = 0.006). Several ACE were significantly associated with lower motivation scores, including contact sexual abuse (p = 0.008), living with a persistently sad or mentally ill person (p = 0.023), exposure to domestic violence (p = 0.007), physical neglect (p = 0.020), and bullying (p = 0.010). Conversely, exposure to community violence was positively correlated with motivation scores (p = 0.033, confidence interval: 0.292 to 6.756,r = 0.22), suggesting that individuals exposed to such environments might develop increased motivation for treatment. CONCLUSIONS: The study concludes that treatment motivation among methamphetamine users is significantly impacted by parental education, ACE, and sociodemographic variables. Approaches that are trauma-informed, culturally aware, and family-inclusive are essential to improve recovery and participation.