The Relationship of Social Stress, Economic Hardship, and Psychological Distress to Follow-up Addiction Severity Among Kentucky Substance Abuse Treatment Participants
Methods: Secondary data from baseline and 12-month follow-up interviews with a broad, statewide sample of Kentucky substance abuse treatment participants (n=1123) was used for the analyses. Univariate and bivariate analyses were conducted to examine variables and ensure data satisfactorily met assumptions of multivariate analysis. Then, hierarchical ordinary least squares (OLS) regression was used to test the conceptual model’s ability to predict follow-up addiction severity, and comparisons were noted between the model’s ability to predict alcohol and drug addiction severity individually.
Results: The overall model significantly predicted both alcohol (F (17, 1096) = 20.97, p < .001) and drug (F (17, 1103) = 39.45, p < .001) follow-up addiction severity, although more variance in drug addiction severity (R2 = .38) was explained by the model than alcohol addiction severity (R2 = .25). The only social characteristic significant when predicting alcohol addiction severity was gender, with women having lower addiction severity than men. For drug addiction severity, gender, economic hardship, and perceived stress were significant predictors, and the relationship between perceived stress and drug addiction severity was significantly mediated by efficacy, self-control, and recovery support. The strongest predictors for both alcohol and drug addiction severity were efficacy, self-control, and recovery support.
Conclusions and Implications: Findings demonstrate the importance of treatment providers attempting to increase participants’ efficacy, self-control, and recovery support in order to decrease future addiction severity. Findings also suggest that stress may be more important for explaining the drug relapse process than the alcohol relapse process and these relationships should be studied further in future research. Although lack of significant findings for many predictors associated with social disadvantage may be due to measurement error in the secondary dataset used, identifying a potential unique role of social stress in the relapse process should also be studied further in future research after adjustments to the current model or measurements are made.