The Influence of Social Recovery Capital, Stress, and Relapse On the Mental Health of Individuals Recovering From Addiction
Addiction is a chronic debilitating illness associated with serious consequences across multiple life domains. Over 22 million Americans struggle with addiction, but only 10% of those who need treatment are able to get it. Approximately 72% of those who are able to access treatment for addiction suffer from at least one co-morbid mental disorder. However little is understood about how mental health changes over time for those engaged in the process of recovery from addiction. Guided by the life course perspective, this study examines mental health trends over time as a function of individual and social contextual factors. It was hypothesized that supportive social recovery capital variables would directly influence mental health over time, while structural social network elements would buffer the negative effects of stress on mental health.
Methods
Latent growth curve analysis was conducted utilizing data from the Pathways to Recovery dataset (N=353). The Pathways study utilized a community-based sample design with highly structured computer assisted interview procedures. The majority of participants in this study were male (55.8%), non-white (84.5%), and unmarried (56.3%). Participants ranged in age from 21 to 65 years (M = 43.59, SD = 7.96). Just over half (55.2%) of the sample reported having sustained abstinence for one year or more at baseline. Participants demonstrated long and serious substance use histories with mean use careers lasting 18.7 years (SD = 12.0) and high levels of addiction severity (M = 11.7, SD = 2.4). Mental health was measured using the Symptom Checklist-10R. Analysis evolved from a simple unconditional means models to more complex conditional models incorporating time variant (Level-1) and time invariant variables (Level-2). Model development was guided by theory, hypothesis testing, and comparison of model fit. Decisions about which variables were to remain in the analysis were made based on significance levels of fixed effects and hypothesis testing.
Results
Trajectories of mental health for individuals in recovery are characterized by linear improvement over time with women and older adults demonstrating slower improvements. Those who reported higher levels of stress, more stressful life events, higher levels of addiction severity, and those who relapsed experience poorer mental health over time. When stress levels are high, recovery specific social support was found to buffer mental health from the negative effects of stress.
Conclusions and Implications
These findings confirm that substance abuse and mental health are closely intertwined. While mental health improves for those who pursue recovery from addiction, each relapse has an immediate and negative effect. Although the size of a person’s sober social network has no effect on the mental health of recovering individuals, support for recovery appears to offer a protective effect when levels of stress are high. Outcomes suggest targeting intervention strategies to enhance recovery support during stressful times and targeting relapse prevention may prove particularly beneficial to those struggling with dual diagnosis. This study also calls attention to mental health disparities experienced by women and older adults, suggesting interventions targeting the unique needs of these groups are needed.