Effect of the social environment on alcohol involvement and subjective well-being prior to alcoholism treatment (original) (raw)

1993, Journal of Studies on Alcohol

This article describes a conceptual model developed to explain abusive use of alcohol and reports results of an initial test of that conceptualization. General social support is hypothesized to affect the level of subjective well-being, while alcohol-relevant social support affects the degree of alcohol involvement. A cross-sectional test of two models derived from this formulation was made using data from 148 alcoholic clients entering treatment at a private nonprofit psychiatric facility. Results indicate that a model in which no direct relationship between alcohol involvement and subjective wellbeing is specified provides a more parsimonious explanation of interrelationships at the time of treatment entry. Alcohol involvement is explained by alcohol-relevant affiliative and instrumental support (al-beit weakly), and subjective well-being is explained by general affiliative and instrumental social support. There is virtually no interrelationship between alcohol involvement and subjective well-being once the support variables are taken into account. The findings indicate that treatment should more often incorporate others from a client's social network, using significant others first to provide general social support and later alcohol-relevant support as well. Further analyses involving samples with more heterogeneity in levels of social investment and exploring the utility of these variables for treatment matching categorization decisions are warranted. (J. Stud. Alcohol 54: 283-296, 1993) LCOHOLISM TREATMENT has a poor track record: lapses and relapses of patients are common, and in as short a time as 1 to 2 years following treatment less than half of the patients have maintained abstinence (see, e.g., Armor et al., 1978; Emrick and Hansen, 1983; Nathan, 1986; Saxe et al., 1983). Studies may have shown low treatment effectiveness, however, because samples included both those for whom a given intervention strategy or component would be beneficial (matches) and those for whom it would not (mismatches) (Gibbs, 1981). The search for matching factors that affect shortand long-term outcome-deficits that may be actively addressed in a given treatment modality, or characteristics that seem to make a client more receptive to one form of treatment and not others-has been largely post hoc (see review in Longabaugh, 1986; Miller and Hester, 1985; and cf., McLellan et al., 1983). The need to address this