The Narrative of Persons with Gambling Problems and Substance Use: A Multidimensional Analysis of the Language of Addiction

Abstract

Several studies have shown that the analysis of the narrative dimension may represent a useful instrument to shed light on certain critical psychological aspects; to this extent, it might also be fruitful to understand better the addiction disorder. The present study aimed to investigate the critical psychological-narrative aspects involved in Gambling Disorder (GD). A semi-structured interview, one which invited participants to narrate the various phases of addiction (addiction definition, onset, chronicization, relapse, desire, loss of control, control strategies, treatment, future behaviours with respect to the object of addiction), was administered to two groups of subjects in treatment: thirty with GD and eighteen with Substance Use Disorder (SUD). A quali-quantitative multidimensional analysis of this interview was performed. The dependent variables were psychological aspects (agency, passivity, locus of control, motivation) and narrative variables (global narrative coherence and self-projection into the future). The main findings showed that the GD presented a higher sense of agency, passivity, external locus of control and external motivation compared to SUD. Both groups showed a lower global narrative coherence score during the narration of desire (craving) compared to other phases. Moreover, both groups showed an absent self-projection into the future. The findings could be linked to possible impairment of the integration of the self, emotional dysregulation and low self-control typical in addiction. In conclusion, the present study highlighted the importance of the narrative dimension to detect certain critical points in the addiction condition on which to potentially address the treatment.RésuméPlusieurs études ont montré que l’analyse de la dimension narrative peut apporter un éclairage utile sur certains aspects psychologiques cruciaux; en ce sens, elle peut aussi contribuer à une meilleure compréhension des troubles de dépendance. Notre étude visait à examiner les aspects à la fois psychologiques et narratifs intervenant dans les troubles de dépendance. Nous avons réalisé des entrevues semi-structurées qui invitaient les participants à raconter les différentes phases de la dépendance (définition de la dépendance, début, chronicisation, rechute, désir, perte de maîtrise, stratégie de régulation, traitement, comportements futurs en ce qui a trait à l’objet de la dépendance). Nous avons mené ces entrevues auprès de deux groupes de personnes en traitement : 30 ayant une dépendance au jeu (DJ) et 18 ayant un trouble lié à l’usage d’une substance (TUS), puis nous en avons effectué une analyse multidimensionnelle quali-quantitative. Les variables dépendantes étaient des aspects psychologiques (agentivité, passivité, lieu de contrôle, motivation) et des variables narratives (cohérence narrative globale et projection de soi dans l’avenir). Les principaux résultats ont indiqué que, comparativement au groupe TUS, le groupe DJ présentait une meilleure perception sur les plans de l’agentivité, de la passivité, du lieu de contrôle externe et de la motivation extrinsèque. Par rapport aux autres phases, les deux groupes ont montré une cohérence narrative globale inférieure durant la narration relative au désir (envie irrésistible). En outre, les deux groupes ont montré une absence de projection de soi dans l’avenir. On peut lier ces résultats à l’intégration déficiente du moi, à la dysrégulation émotionnelle et au faible autocontrôle qui caractérisent la dépendance. En conclusion, notre étude souligne l’importance de la dimension narrative pour déceler certains aspects cruciaux de l’état de dépendance susceptibles d’orienter le traitement.

An evolutionary account of impairment of self in cognitive disorders

“…Another fruitful way to analyze both the construction and alteration of self in reference to language use in conditions like ASD, SCZ and synesthesia is to investigate the narrative dimension (e.g., Giddens, 1991 ; McAdams & McLean 2013 ; Allé et al 2015 ; Adornetti and Ferretti 2021 ). This view is founded on the position that human beings construct their own identities by means of stories, e.g., by producing autobiographical narratives (Schechtman 1996 ; McAdams 2001 ; Habermas & de Silveira 2008 ; Altavilla et al 2020 ; Canali et al 2021 ). Paradigmatic of this perspective is Bruner’s constructivist model of personal identity (e.g., Bruner 2003 , 2004 ).…”

Narrative identity in addictive disorders: a conceptual review

“…In this sense, since narrative coherence is related to the ability to establish temporal and causal links between events in order to provide continuity to the narrative plot (e.g., Reese et al, 2011), the processing of temporality represents a central element for the narrative dimension (Suddendorf and Corballis, 1997;Corballis, 2011), which has been studied in other clinical populations, such as autism (Ferretti et al, 2018;Marini et al, 2019). Interestingly, as we mentioned, in both the Canali et al (2021) and Altavilla et al (2020) studies, the analysis of linguistic markers related to temporal factors, especially to selfprojection into the future, i.e., the self-referential ability to imagine oneself in personal future scenarios (Atance and O'Neill, 2001;Buckner and Carroll, 2007), revealed an absence of reference to the future, showing that people with an addictive disorder failed to integrate their experience with possible self-based future scenarios different from the addiction condition.…”

“…To the best of our knowledge, out of a total of 18 studies identified in literature that explored narratives of addiction, only two studies have explicitly examined structural features in personal narratives of individuals diagnosed with an addictive disorder: one study focused on the assessment of narrative global coherence ( Canali et al, 2021 ), the other on narrative complexity and its relation to recovery ( Rowlands et al, 2021 ). As for the second variable we considered, namely agency in the framework of narrative identity, only a few studies have examined it in self-narratives of people with an addictive disorder ( Altavilla et al, 2020 ; Canali et al, 2021 ) and in recovery context ( Rowlands et al, 2019 ; see also an exploratory stud by Rowlands et al, 2020 ), while other investigations have proposed to analyze agency in autobiographical narratives in addiction using a sociological approach based on actor-network theory ( Törrönen and Tigerstedt, 2018 ; Törrönen et al, 2020 ; Törrönen, 2023 ). Finally, one study has analyzed the emotional dimension in autobiographical narratives of people with GD ( Altavilla et al, 2020 ).…”

“…Finally, one study has analyzed the emotional dimension in autobiographical narratives of people with GD ( Altavilla et al, 2020 ). These investigations adopted a top-down approach by evaluating the selected narrative variables, i.e., coherence, complexity, agency, and emotion, in autobiographical narratives using a qualitative ( Rowlands et al, 2019 , 2021 ; Canali et al, 2021 ) or a quantitative ( Altavilla et al, 2020 ) analysis. In this section, we briefly describe the methodology and results of these studies.…”

“…Regarding structural analysis of the narratives, Canali et al (2021) have investigated global coherence in a group of people with GD and in a group with SUDs. The qualitative analysis was conducted on autobiographical narratives obtained through a semi-structured interview that explored the main phases of the addiction experience (onset, maintenance, relapse, desire, loss of control, control strategies and treatment).…”