Research That Matters (January 17 - 20, 2008)

Purpose: This study investigated the relationship between stressful life experiences and coping-type motives for substance use, along with the patterns and consequences of that use. Motivational factors have been seen as key to both the initiation and perpetuation of alcohol and drug consumption. Rather than representing a unitary phenomenon, substance use has been viewed as serving multiple, psychologically distinct functions which are characterized by unique antecedents and outcomes (Cooper, Frone, Russell, & Mudar, 1995). Stressful life events have been predictive of more intensive patterns of substance use (Fouquereau, Fernandez, Mullet, & Clay, 2003) and coping motives have been a consistent predictor of both increased consumption and adverse effects (Carey & Carey, 1995). Until now, the contribution of specific life experiences to coping-related substance use has yet to be fully explored.

Methods: This study utilized a cross-sectional survey design employing face-to-face interviews based on a semi-structured questionnaire. The sample consisted of 68 men (75%) and women (25%) recruited from a residential substance abuse treatment program to which clients were predominately referred by the criminal justice system. Measures included an assessment of stressful life events, quantity and frequency of alcohol or drug use, and the Consequences of Alcohol and Drug Use Indices (Kulka et al, 1990). Motives for use were elicited through questions as to the main reasons that the respondents drank or used drugs. Qualitative data from the participants' narratives were analyzed using an inductive methodology of constant comparisons (Glaser & Strauss, 1967), aggregated, and incorporated into a series of discriminant analyses.

Results: Qualitative analyses yielded three principal motivational categories: coping, social reinforcement, and enhancement. Eighty-two percent of the respondents reported using substances for coping reasons such as to block out or change disagreeable thoughts, feelings, or psychiatric symptoms; or to deal with relational conflict or environmental stressors such as homelessness, unemployment, or a lack of opportunities. Discriminant analysis (X2[7] = 31.61, p < .0001) revealed that coping motives were associated with drinking in larger quantities [F(1,66) = 7.15, p < .009] and with greater frequency [F(1,66) = 6.11, p < .016], along with a broader variety of adverse alcohol-related consequences [F(1,66) = 15.40, p < .0001]. Also significant were self-assessed alcohol dependence [F(1,66) = 4.15, p < .046], parental divorce or separation [F(1,66) = 6.72, p < .012], later onset of childhood neglect [F(1,66) = 7.92, p < .006], and experiencing conditions analogous to war [F(1,66) = 5.40, p < .023].

Implications: Results from this study lend support to the viability of models that frame substance using behaviors around specific antecedents and consequences. As such, conducting a comprehensive motivational assessment at the initiation of treatment, along with that of stressful life experiences, might help in targeting the most relevant focal areas for intervention. More severe patterns of use and a broader variety of adverse consequences might point towards coping-type motivations. In addition, as reflected in these respondents' narratives, interventions that decrease homelessness or unemployment and expand overall life opportunities might also play a role in reducing coping-based substance abuse.