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. Author manuscript; available in PMC: 2022 Jan 1.
Published in final edited form as: Addict Res Theory. 2020 Aug 27;29(3):239–246. doi: 10.1080/16066359.2020.1807959

Developing a Latent Coping Resources Factor for Recovery from Substance Use Disorder

Alexandra Porcaro 1,*, Rebecca Nguyen 1,*, Meghan Salomon-Amend 1, Jessica Chaparro 1, Leonard Jason 1
PMCID: PMC8133534  NIHMSID: NIHMS1660104  PMID: 34025332

Abstract

It is crucial for individuals with substance use disorders, especially those with a co-occurring mental health disorder, to access effective coping resources. We quantify coping through four domains of individual resources (self-esteem, self-efficacy, perceived social support, and hope) to examine the extent to which individuals with varying psychiatric severity can access coping-related resources. Since sex is an additionally important consideration in treatment, we also explore both sexes’ access to coping-related resources. We generate a multilevel latent variable of coping resources in class structures, one for males and one for females, to measure (1) the extent individuals with varying psychiatric presentations (types, symptoms, severity) are able to access this latent resource and (2) to control for house level effects.

Our variables of self-esteem, self-efficacy, perceived social support, and hope all coalesced into a latent variable, named coping resources. Furthermore, we find that psychiatric severity is negatively related to coping resources at the individual level, but function differently for males and females at the house level. Treatment guidelines should address the nuanced needs of individuals and consider individual differences, such as sex, that impact access to coping resources.

Keywords: recovery homes, substance use disorder, coping resources, psychiatric severity, sex differences

Substance abuse is a national concern, with more than 19.3 million Americans affected by substance use disorder (SUD) (SAMHSA, 2018). In recent years, treatment options, federal funding, and recovery initiatives have grown dramatically in response to the burgeoning opioid epidemic. Federal agencies have outlined goals to support SUD recovery, which involves moving away from disordered substance use and living self-directed, healthy lives (SAMHSA, 2015, 2017). Although structures and programs have been implemented to support recovery, it is equally important to measure the ways in which these changes take hold within individuals.

The recovery process is akin to one’s ability to draw upon individual resources to cope with sobriety and the stressful recovery process. Individual level changes should align with recovery initiatives to promote, engender, and support future sober living at the individual level, long after external supports end. Coping is a multifaceted process in which individuals manage or minimize negative effects caused by stress (Lazarus & Folkman, 1984). Coping resources are perceptions and individual differences that affect how stressful situations are appraised and then either approached or avoided. In order to cope with the stressful demands of SUD recovery, individuals must draw upon their coping resources (Lazarus & Folkman, 1984). In a review by Taylor and Stanton, four central coping resources were outlined: personal control, self-esteem, social support, and optimism (2007). We sought to expand upon previous research by forming an encapsulating, quantifiable measure of coping resources, specifically related to recovery. The individual level resources that we investigate are self-perceptions that have been associated with sobriety through a wealth of literature: self-efficacy, hope, self-esteem and social support. These factors in the current study are directly related or very similar to the factors reviewed by Taylor and Stanton; personal control is most often measured by self-efficacy, and optimism, the expectancy that good things will happen, is related to hope (Taylor & Stanton, 2007; SAMHSA, 2019). We chose slight variations in variables to more closely align with previous recovery related research and to study coping resources specifically related to SUD recovery.

Self-efficacy is defined as a person’s perception of their ability to successfully complete a goal or behavior (Bandura, 1977). When self-efficacy is measured in individuals in recovery from SUD, it acts as an indicator of an individual’s ability to abstain from drugs during recovery (Senbanjo, Wolff, Marshall, & Strang, 2009). Self-efficacy serves as an effective predictor of future outcomes: individuals with higher self-efficacy at the end of treatment show better future drinking outcomes (Greenfield, Hufford, Vagge, Muenz, Costello, & Weiss, 2000), and the highest levels of self-efficacy at residential treatment discharge was the best predictor of abstinence one year later (Ilgen, McKellar, & Tiet, 2005). One’s perceived self-efficacy should increase during recovery to support long-term sobriety after treatment ends; self-efficacy indicates an individual’s belief in maintaining sobriety and supports coping during recovery.

Related to self-efficacy, hope indicates one’s motivation and ability to overcome challenges that occur during recovery (Stevens, Guerrero, Green, & Jason, 2018). Although self-efficacy and hope have significant similarities, self-efficacy is one’s own confidence in achieving a behavior whereas hope comprises both self-efficacy and additional outcome predictions (Magaletta & Oliver, 1999). Higher levels of hope are associated with positive outcomes, including greater life satisfaction (Gallagher & Lopez, 2009), higher levels of optimism, and greater well-being (Shorey, Little, Snyder, Kluck, & Robitschek, 2007). Previous recovery research has indicated that hope is associated with successful abstinence and higher quality of life (Irving, Seidner, Burling, Pagliarini, & Robbins-Cisco, 1998). High levels of hope in recovery are also associated with preparedness for situational threats, aptitude to generate an increased number of strategies to accomplish goals, and increased utilization of adaptive strategies to combat recovery threats (Mathis, Ferrari, Groh, & Jason, 2009). We expect that having hope is an effective resource of coping during the nonlinear path of recovery.

Self-esteem is the global appraisal of one’s value, based on the self-evaluations of his or herself in different domains of life and is considered a basic component of mental health (Mann, Hosman, Schaalma, & De Vries, 2004). For example, among those with a psychiatric illness, low levels of self-esteem are related to other negative outcomes, such as depression and even greater self-stigmatization (Corrigan, Watson, & Barr, 2006) and, as relevant to the purpose of this paper, is positively associated with substance use (Carvajal, Clair, Nash, & Evans, 1998). Previous studies have demonstrated the long-term, positive effects of self-esteem on both abstinence and major life problems following treatment (Richter, Brown, & Mott, 1991). Additionally, higher levels of self-esteem are related to other positive individual coping resources, such as hope and self-regulation, and has been shown to reflect self-liking, competence, and self-confidence in a recovery population (Ferrari, Stevens, Legler, & Jason, 2012). Given the importance of self-esteem on continued sobriety and its interconnectedness with other domains described so far, we suspect that self-esteem reflects a component of self-evaluation skills and can be an important resource in the recovery process.

In addition to these self-perceptions, it is important to examine perceived external constructs, such as perceived social support, which can serve as a protective factor against stress and depressive feelings (Cohen & Hoberman, 1983). Previous studies have found that those in recovery who endorse more social support report less substance use (Broome, Simpson, & Joe, 2002) and more days abstinent (Longabaugh, Wirtz, Zywiak, & O’Malley, 2010). Individuals with low levels of perceived social support report more substance use and have greater levels of psychological distress after treatment (Dobkin, Civita, Paraherakis, & Gill, 2002). Moreover, recovering individuals who feel socially isolated could be more likely to drop out of treatment and have a greater risk for relapse (Muller, Skurtveit, & Clausen, 2017). Based on these previous findings, we suspect that individuals who have high perceived social support are better able to cope with the stresses found in SUD recovery.

Because abstinence self-efficacy, hope, self-esteem, and perceived social support are all related to positive recovery outcomes, we hypothesize that these four resources will converge into a latent variable measuring individuals’ overall access to coping resources during recovery. The latent coping resources variable will integrate the scores of self-efficacy, hope, self-esteem, and perceived social support to yield a higher order, quantifiable, holistic, construct of the coping resources available to each individual. Further, we suggest that the overall construct of coping resources has important implications towards individuals’ resilience and internalization of recovery.

Additionally, we explored individual differences that may cause certain individuals to have difficulty in accessing coping resources. Understanding the factors related to coping resource access is imperative since individuals who have difficulty accessing coping resources are more vulnerable to unfavorable recovery outcomes. Once these individual differences are identified, recommendations can be made to address inadequate access to coping resources through evidence-based interventions.

First, we explored the relationship between comorbid psychiatric disorders and individual coping resources. Estimates indicate that nearly half of all individuals seeking SUD treatment experience a co-occurring mood- and/or anxiety- related disorder (Langas, Malt, & Opjordsmoen, 2011; Urbanoski, Kenaszchuk, Veldhuizen, & Rush, 2015) such as depression, anxiety, bipolar disorder, or schizophrenia (Drake, Mueser, Brunette, & McHugo, 2004). Despite the prevalence of psychiatric comorbidity in SUD recovery, long term recovery outcomes for these individuals tend to be less positive compared to those with only SUD (Boden & Moos, 2009). The self-medication hypothesis states that the high prevalence of psychiatric and SUD comorbidity may be due to the tendency of individuals with major depression to turn to substances in order to cope and self- soothe (Khantzian, 1997). These maladaptive behaviors may cause euphoria and short-term relief but can eventually manifest into exacerbated depression symptoms or anti-motivation (Grant, 1995). Given that those with mood and substance use disorders are more likely to engage in maladaptive coping behaviors (Holahan, Moos, Holahan, Cronkite, & Randall, 2004), we hypothesize that those with more severe psychiatric symptomatology may have less access to coping resources.

Current literature provides varied evidence as to how sex interacts with coping resources in SUD recovery. On one hand, women have endorsed more coping activities such as negative thinking towards drinking and avoidance (Bischof, Rumpf, Meyer, Hapke, & John, 2005). Women also benefit from greater social support during recovery (Davis & Jason, 2005). On the contrary, women in stressful environments have been shown to be more likely to cope in maladaptive ways, including substance abuse (Skeer, McCormick, Normand, Mimiaga, Buka, & Gilman, 2011). Timko, Finney, and Moos (2005) found that women initially reported greater avoidant coping behaviors compared to men, but post SUD treatment, they fared better in terms of drinking behavior, coping, and social support. Given the lack of conclusive evidence, we make no hypothesis about sex’s relationship with overall coping resources in recovery but explore this relationship in our study.

In summary, we seek to construct a recovery-specific, latent, coping resources variable which integrates four individual coping resources (self- esteem, hope, self- efficacy, social support). We then explore individual differences of sex and psychiatric severity that may impact access to coping resources in SUD recovery. Lastly, we control for and discern house level effects by creating a multilevel model to look at relationships between coping resources, sex, and psychiatric severity.

Method

Participants.

The data were taken from a larger, longitudinal study on Social Networks in Oxford Houses. The Oxford House is the largest network of recovery homes in the United States (Jason, Olson, & Foli, 2008). Oxford Houses utilize democratic and self-run governance while requiring abstinence for all residents. The current sample includes participants from the study’s first wave of data collection 229 participants lived in 42 different Oxford Houses in North Carolina, Texas, and Oregon. The sample of the current study included 88.8% of the current members residing in the 42 different Oxford Houses (actual mean number of members per house was 6.14 and the current sample has a mean of 5.45 members per house). Participants had a mean age of 38.4 years (SD=10.8), with 55% male and 44.5% female. Participants identified as European American (82.1%), African American (9.2%), Hispanic (6.5%), Alaskan Native (6.5%), American Indian (1.3%), and Pacific Islander (.4%). The average length of stay in an Oxford House for participants was 10.3 months (SD = 12.55, range from 7 days to 6.8 years). To test for effects at the house and individual levels, we control for house level effects.

Procedure.

Field research staff recruited participants via face-to-face meetings at Oxford Houses in the three different states (OR, TX, NC). Participants were informed about the purpose, objectives, and methodology of the study and were advised of the study’s voluntary nature before consenting. Interviews were scheduled with participants and included self-report measures of hope, self-esteem, self-efficacy, and social support. Participant compensation was $20 for completing the questionnaires. Permission to conduct this study was reviewed and granted by the DePaul University Institutional Review Board.

Measures.

Perceived Social Support.

Perceived general social support was measured using the Interpersonal Support Evaluation List - Short Version (ISEL; Cohen, Mermelstein, Kamarck, & Hoberman, 1985). The ISEL-12 is a 12-item inventory designed to assess four categories of perceived social support including tangible support, appraisal, and belonging. Each of these subscales included four representative items. Respondents rated their responses on a 4-point Likert-type scale ranging from 0 (definitely false) to 3 (definitely true). The internal reliability for the ISEL-12 total score is very good (α= .81).

Self Esteem.

Self-esteem was assessed utilizing the Rosenberg’s Self-Esteem Scale (RSES; Rosenberg, 1965). RSES is a widely used, 10-item, global self-esteem scale measured on a 4-point Likert Scale ranging from “strongly agree” to “strongly disagree.” Items include “I think I have a number of good qualities” and “I take a positive attitude towards myself”. This scale has strong internal consistency (α= .89).

Hope.

The Hope Scale is a 9-item scale adapted from the 6-point Snyder’s (1991) State Hope Scale to include the domain of “context.” Examples of items include “At the present time, I am energetically pursuing my goals” and “Right now, I don’t feel limited by the opportunities that are available.” Participants rate each item on an 8-point Likert scale ranging from “definitely false” to “definitely true.” The overall scale has good internal consistency (α= .88).

Abstinence Self-Efficacy.

Abstinence self-efficacy was operationalized with the Drug Taking Confidence Questionnaire (DTCQ; Annis & Martin, 1985), in which participants rated how confident they are in resisting using substances in various situations. This measure stems from Bandura’s (1997) cognitive behavioral self-efficacy theory and is based on antecedents of substance abuse relapse (Annis & Davis, 1991). The DTCQ has been used among people with different addiction typologies (Sklar, Annis, & Turner, 1999). Since confirmatory factor analyses support the eight-factor model of the DTCQ’s highly reliable subscales (.79 to .95; Sklar, Annis & Turner, 1997), we used a total confidence score in the present study by collapsing the subscale scores and averaging these scores on a 6-point Likert scale that ranges from 0% (not at all confident) to 100% (very confident). This total score approach to calculating self-efficacy for abstinence has been effectively used in previous studies (Greenfield et al., 2000; Majer, Beers, & Jason, 2014; Miller, Ross, Emmerson, & Todt, 1989). The DTCQ has excellent internal consistency (α= .94).

Psychiatric Severity.

The Addiction Severity Index-Lite (ASI-Lite; McLellan, Cacciola, & Zanis, 1997) is a brief version of the Addiction Severity Index (ASI; McLellan et al., 1992), and is used to assess one’s current severity of problems related to substance abuse, including medical and psychiatric status, drug use, alcohol use, illegal activity, and family relations and history. Psychiatric severity was measured using the Psychiatric Severity Index (PSI), an ASI subscale. The index is calculated by a weighted formula that includes questions regarding a range of current psychiatric symptoms and problems (McLellan et al., 1992). Scores range from .00 to 1.00, with higher scores representing greater current psychiatric severity. It has good internal consistency (> .70; McLellan et al., 1992), and has demonstrated high internal consistency across studies (Makela, 2004). Scores were not weighted for the analysis.

Design.

We performed a two-level confirmatory factor analysis using MPlus (Muthén & Muthén, 2019) on data acquired from 228 individuals who lived in the Oxford House during their recovery. With a multilevel design, we controlled for house- level effects in order to discern both house and individual level coping resources. There were 24 male houses and 19 female houses. All individuals in the analysis self-categorized as “male” or “female” (one participant was eliminated from the analysis for selecting the gender of “other”). PSI scores were entered into the model as a continuous variable, since scores ranged from 0 to 1. PSI was not weighted. We used a maximum likelihood method to account for the missing PSI scores of 12 individuals. The data, gathered from the four scale measures listed above, were submitted to two confirmatory factor analyses, one for males, and one for females, to determine a latent variable of coping resources and its relationship to PSI at both the house and individual levels. These four items have an overall acceptable level of reliability (α = .7).

Results

Male

We examined the effects of PSI on coping resources across the 24 male OHs. This resulted in a latent class analysis clustered by 24 OHs, and examining the effects at the individual and house level. The comparative fit index (CFI) = .97, the Tucker-Lewis fit index (TLI) = .93, and RMSEA = .05 indicated good fit. The data were clustered by house, and the parameter estimates of the individual (Table 1) and house level (Table 2) data are below. At the individual level, self-esteem (β=.79, SE=0.09), self-efficacy (β=.40, SE=0.10), social support (β=.42, SE=0.10), and hope (β=.61, SE=0.09) were all positively associated with a single factor which we label coping resources (all ps<0.001). We find that the effect of psychiatric comorbidities on coping resources is significant and negative (β=−.44, SE=0.10, p<0.001). At the male OH level, effects self-esteem (β=1.03, SE=0.21), self-efficacy (β=.82, SE=0.20), perceived social support (β=.98, SE=0.20), and hope (β=.74, SE=0.19) were all positively associated with this same single factor, which we label coping resources (all ps<0.001). However, at the house level, the effect of psychiatric comorbidities on coping resources is no longer significant (β=−.22, SE=0.75, p=.77). While the relationship between coping resources and psychiatric comorbidities were negative at both levels, it was only significant at the individual level due to lack of power at the house level.

Table 1.

Parameter Estimates: Men Individual-Level

Parameter β B Std. Error p
(Constant)
Self-Efficacy .40 3.86 .10 0.00
Self-Esteem .79 9.03 .08 0.00
ISEL .43 4.15 .10 0.00
Hope .62 6.83 .09 0.00
PSI −.44 −4.41 .10 0.00
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Table 2.

Parameter Estimates: Men Group Level

Parameter β B Std. Error p
(Constant)
Self-Efficacy 1.03 4.89 .21 0.00
Self-Esteem .83 4.05 .20 0.00
ISEL .91 4.55 .20 0.00
Hope .74 3.98 .19 0.00
PSI −.22 −.30 .75 0.76
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Female

We also submitted the female data to the same analysis. There are 19 female OHs (clusters), and effects were examined at the individual and house level. The comparative fit index (CFI) = .95, the Tucker-Lewis fit index (TLI) = .90, and RMSEA = .09 indicated adequate fit. The data were clustered by house, and the parameter estimates of the individual (Table 3) and house level (Table 4) data are below. At the individual level, self-esteem (β=.88, SE=0.04), self-efficacy (β=.29, SE=0.11), perceived social support (β=.62, SE=0.08), and hope (β=.87, SE=0.05) were all positively associated with a single factor, which we label coping resources (all ps<0.001). At the individual level, we also find that the effect of psychiatric comorbidities on coping resources is significant and negative (β=−.71, SE=0.07, p<0.001). At the OH level, none of the effects of self-esteem (β=.99, SE=1.78), self-efficacy (β=.91, SE=1.37), social connectedness (β=.84, SE=1.58), or hope (β=−.97, SE=6.45) were significant (all ps>0.5). Nor was the effect of psychiatric comorbidities on coping resources significant (β=.92, SE=3.03, p=.77). The relationship between psychiatric severity and coping resources was negative only at the individual level. Though insignificant at the house level, due to low power, the relationship between PSI and coping is positive. This change in directional magnitude suggests that OH may provide better coping females with high PSI (or that houses with high PSI are better able to access coping resources as a house). Additionally, hope at the house level had a negative relationship to the latent coping resources variable, unlike the positive relationship found at the individual level. This surprising house level finding may have implications for how coping resources function differently for females at the group level compared to men at the group level, and females at the individual level.

Table 3.

Parameter Estimates: Women Individual-Level

Parameter β B Std. Error p
(Constant)
Self-Efficacy .29 2.66 .11 0.00
Self-Esteem .89 18.66 .05 0.00
ISEL .63 8.36 .08 0.00
Hope .86 19.14 .05 0.00
PSI −.71 −9.97 .07 0.00
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Table 4.

Parameter Estimates: Women Group-Level

Parameter β B Std. Error p
(Constant)
Self-Efficacy .91 .67 1.37 .51
Self-Esteem .99 .56 1.78 .58
ISEL .84 .53 1.58 .60
Hope −.95 −.15 6.45 .88
PSI .92 .30 3.03 .76
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Discussion

At the individual level, the findings of this study indicate that the four factors of coping resources, abstinence self-efficacy, hope, self-esteem, and perceived social support, are all individual components of recovery resources. The current confirmatory factor analyses replicated the factor structure of coping resources outlined by Taylor and Stanton (2007). These four resources all coalesced into a single latent variable. The one nuanced difference between the current study and the review by Taylor and Stanton was that Taylor and Stanton defined optimism as a coping resource, while this construct in the current study was replaced by hope. Hope and optimism have been shown to be very similar constructs since they both attend to outcome expectancies (Magaletta & Oliver, 1999). Optimism is a more general construct that pertains to outcomes due to both internal and external forces (Magaletta & Oliver, 1999). Hope pertains only to outcomes under the individual’s responsibility (Magaletta & Oliver, 1999). Despite these nuances, optimism and hope are similar enough that in the current study, hope was able to contribute to the latent coping resources variable as originally predicted.

Next, this experiment investigated the effects of psychiatric comorbidity on access to coping resources at the individual level. All individuals in the current sample with higher levels of psychiatric severity were found to have more difficulty with accessing coping resources since This is because the relationship between PSI and the latent coping variable was significantly negative for both males and females. These findings align with the vast body of research indicating that many mental disorders and Axis I diagnosis are related to a lack of coping resources (American Psychiatric Association, 1994). Inadequate coping resources may signal a mental disorder, a developmental risk factor for disorder emergence, or an indicator of disorder recurrence and poor prognosis (Taylor & Stanton, 2007). For comorbid individuals recovering from SUD, the particular lack of access to coping resources may be attributed to lower employment rates or less stability during recovery (i.e. lower economic status, low educational attainment, and history of homelessness) (Risser, Cates, Rehman, & Risser, 2010). Because individuals in recovery tend to have disproportionately long-term psychiatric problems compared to the general population, dually diagnosed individuals or individuals with significant psychiatric issues may require additional treatment resources to accommodate their psychiatric diagnoses. We support current practice guidelines which recommend that both mental health and drug use issues be treated simultaneously since comorbid individuals are at increased risk of suicide and lack of social support compared to individuals with just SUD (Vujanovic, Meyer, Heads, Stotts, Villarreal, & Schmitz, 2017; Davis, Uezato, Newell, & Frazier, 2008).

Findings on coping resources in this study differed between the individual and house level. Notably, the relationship between psychiatric severity and coping resources was significantly negative for male houses, but positive and nonsignificant for female houses. Additionally, hope was positively related to coping resources in all analyses except at the female house level where hope was negatively related to the latent coping resources variable. These findings may be attributed to nuances in coping resource access and utilization that differ between males and females. Furthermore, once home dynamics are taken into account, females may have social interactions at the group level that impact the relationship between psychiatric severity, hope, and overall coping resources that are significantly different from group level interactions in male houses. There is literature suggesting that coping mechanisms may operate differently for men and women in recovery (Greenfield, et al., 2000). Women typically engage in more social support- related coping resources when faced with adversity (Hobfoll, 1986). On the other hand, men are more likely to emotionally detach from stressful situations (Lawrence, Ashford, & Dent, 2006). Considering that women engage in more emotion-focused coping and social support, whereas men tend to problem-solve (Ptacek, Smith, & Dodge, 1994), women may find the support from living in a community based environment more helpful, compared to men. Evidence also suggests that there are sex differences in psychiatric disorders among recovering individuals (Majer, Jason, Ferrari, & North, 2002). Women in treatment have a high prevalence of depressive symptoms (Rudolf & Priebe, 2002) and are more likely to be dually diagnosed with depression compared to men (Schmitz, Stotts, Averill, Rothfleisch, Bailley, Sayre, & Grabowski, 2000). If women predominantly draw upon social support as a coping resource and have higher rates of comorbidity in recovery, they may be more acquainted to helping one another with comorbid issues when placed in a group setting. Especially at the group level, men and women may differ in their abilities to access and utilize coping resources; it would be in the best interest for treatment guidelines to reflect this nuanced understanding and for future research to focus on sex differences in coping resources.

There are several limitations to this study. First, both house samples were underpowered. Future studies should include a larger number of male and female houses, for interactions at the house level to be more thoroughly investigated and supported. Additionally, members of the OH are a self-selecting group focused on abstinence-based recovery. The OH is a unique recovery home model and so findings, demographics, and distributions of this sample may be different than populations of traditional recovery homes. In addition, the sample was not ethnically or racially diverse. Further investigations should include participants with more diverse ethnic representations to assess the generalizability of these findings. Another limitation is that the coping measures were self-reported. While we can extrapolate an individual’s feelings or perceptions of coping resources, we cannot measure them objectively. There may be discrepancies between how confident an individual may feel at abstaining from substances and their actual abilities to abstain, for example.

The current study also did not include a comparison group of individuals without a psychiatric diagnosis, but the psychiatric data used in this study was scalar. As such, psychiatric severity in our study had a right-skewed distribution in that many individuals had a 0 PSI score.1 Likewise, it would be helpful if we had information on individuals’ mental health treatments and psychiatric medications or lack thereof. Despite these shortcomings, current findings on psychiatric prevalence and lack of coping resources reflect similar patterns found in previous studies (American Psychiatric Association, 1994; Taylor & Stanton, 2007).

The current study was cross sectional. Future studies should examine how levels of coping resources change throughout the recovery process. It would be important to measure the stability of these recovery resources over time and observe if these individual differences are subject to change throughout recovery interventions. The amount of psychological distress in the first three months of abstinence has been important in predicting overall abstinence over the duration of the first year (Erga et al., 2020); understanding how recovery resources help support individuals during the first stages of abstinence could be particularly important. Future studies should also examine the interventions that would be useful to individuals who lack coping resources or have challenges with practicing positive coping behaviors.

Additionally, the current study did not exhaustively examine all possible individual differences and factors related to coping. There are many other groups which could have limited access to coping resources. One group that may be of particular interest is the veteran population. Veterans in substance abuse treatment who report more anxiety and depressive symptoms are more likely to perceive a lack of control, have more negative affect, and engage in maladaptive coping strategies (i.e. avoidance) (Forsyth, Parker, & Finlay, 2003). Veterans may be particularly vulnerable to low recovery resources, and this group should be more closely studied to better understand its unique struggles. The four factors chosen in this study are also not a comprehensive list of coping resources. Future qualitative studies could capture additional categories of recovery specific, coping resources and help elucidate which coping resources recovering individuals most value or utilize.

Conclusion

This study constructed a latent variable of coping resources for individuals in recovery from substance use disorder. Our findings suggest that individuals with high psychiatric severity have more difficulty accessing coping resources during recovery. However, this relationship is no longer significant at the house level and no longer negative in female houses. Treatment guidelines and providers should take these factors into account to provide adequate support for those with low recovery resources. Research should continue to explore other individual level factors that affect access to coping resources.

Acknowledgements

The authors appreciate the financial support from the National Institute on Alcohol Abuse and Alcoholism (grant number AA022763). We also acknowledge the assistance from members of the Oxford House organization, and in particular Paul Molloy, Alex Snowden, Casey Longan, and Howard Wilkins.

Biographical Note

Alexandra Porcaro, B.S., is a postbaccalaureate research assistant at the Center for Community Research in the Psychology Department at DePaul University. She received her bachelor’s degree in psychology at Loyola University Chicago. Her primary research interests include coping resources and mechanisms, affective disorders, and gender and sexual minority mental health.

Rebecca Nguyen, B.S., is a research assistant at the Center for Community Research in the Psychology Department at DePaul University. She received her baccalaureate degree in psychology with a concentration in neuroscience at the University of Richmond. Her major research interests include meaning making, positive psychology, and coping during stressful life events.

Meghan M. Salomon-Amend, Ph.D., is a postdoctoral researcher at the Center for Community Research in the Psychology Department at DePaul University. Dr. Salomon-Amend received her doctorate in Cognitive Psychology from Northwestern University. Her major research interests include prospective decision-making, reasoning, and language.

Jessica Chaparro, B.A., is a researcher at the Center for Community Research at DePaul University. Jessica received her bachelors in Psychology from Butler University. Her primary research interests include, stress, coping, and psychosocial functioning in high-risk communities.

Leonard A. Jason, Ph.D. is the director for the Center of Community Research and professor of Clinical and Community Psychology at DePaul University. Dr. Jason received his doctorate in Clinical and Community Psychology at the University of Rochester. His research interests include addiction, recovery homes, chronic illness, violence prevention, and community based interventions.

Footnotes

Declaration of Interests

The authors report no conflicts of interest.

Data Availability

Information about the data set associated with this paper can be found by contacting Dr. Leonard A. Jason, Center for Community Research, DePaul University, 990 W. Fullerton Ave., Suite 3100, Chicago, IL. 60614. Ljason@depaul.edu.

1

We could have dichotomized PSI scores to represent low and high PSI individuals, but this could produce confounds and Type II error (Altman & Royston, 2006).

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