Friday, 14 January 2005 - 10:00 AM

This presentation is part of: Substance Abuse, Mental Health and Prostitution

Personal Social Networks of Women with Co-Occurring Substance Use and Mental Disorders: Strengths and Limitations

Purpose

Few studies have examined social network resources of women with substance use disorders. Furthermore, there has been little exploration of co-occurring mental disorders, such as anxiety, depression and post traumatic stress disorder, within this population. This NIDA funded pilot study describes a sample of women with substance use disorders and explores the existence of co-occurring mental disorders, social network characteristics and perceived social support.

Methods

Using a cross sectional survey design, data were collected by trained interviewers from 139 women in face to face interviews. Current substance use disorder and the presence of a co-occurring mental disorder were assessed using the Computerized Diagnostic Interview Schedule. Measures included social network structure (size and composition), perceived social support (emotional, concrete and informational), and social network functioning (network members critical of the respondent, network members using alcohol/drugs, members supporting sobriety, close relationships, reciprocal helping relationships, duration of relationships and frequency of contact). Subjects were recruited from women in the community who had used cocaine during pregnancy and were part of a NIDA funded longitudinal study (n=53), in residential substance abuse treatment (n=41) and in outpatient substance abuse treatment (n=45). Refusal rate was low (2.1%).

Results

Of the 139 respondents, 73(53%) had a substance use disorder only and 66 (47%) had a co-occurring substance use and mental disorder: 15% Generalized Anxiety Disorder, 32% Post Traumatic Stress Disorder, 50% Depression, and 22% Manic Episode. 39% of the sample had more than one mental disorder in addition to a current substance use disorder. Mean age was 35.2 years. 82% identified as African American. 95% had no more than a high school diploma. Mean network size was 13.2 (SD=5.5) including, on average, 4.8 family members, 2.2 friends, 2.1 household members, 1.6 professionals, 1 person from church/organizations, 0.8 from work or school, and 0.6 neighbors. A mean of 5.4 network members provided concrete support, 6.7 provided emotional support, and 5.6 provided informational support. Respondents reported reciprocity in 6.7 of their network relationships. Networks included a mean of 4.1 people who used alcohol and/or drugs and 3.9 people who did not support sobriety; when the overlap was examined, there were approximately 6 network members or 44% of the network who either used alcohol/drugs or did not support recovery. There was a statistically significant correlation between the number of alcohol/drug users and less sobriety support (r = .44, p < .001). In addition, having a higher proportion of family members was associated with the presence of less sobriety support (r = .22, p = .008 ) as well as less reciprocity (.33, p < .001).

Implications for practice

Nearly half the sample had a co-occurring mental disorder, yet were treated in settings only designed for substance abuse. Networks consisted of supportive and non-supportive people, with sobriety support being problematic, suggesting a need for supportive services. Quality of relationships, especially among family members, may be an important feature in supporting recovery.

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