The Importance of Social Support in Recovery Populations: Toward a Multilevel Understanding.

Although social support is commonly investigated in the context of substance recovery, researchers have widely neglected its multilevel nature, thus limiting what we know about its measurement across levels of observation. The current study used multilevel confirmatory factor analyses (MCFA) on 229 individuals living in 42 recovery homes to investigate the structure of single factor of social support at the individual and house-levels. Multilevel structural equation model (MSEM) was then conducted to examine whether the social support factor was associated with stress at the individual and house-levels. MCFA results showed that within individuals, all social support measures were significant and positive while at the house-level, there were a few discrepancies (e.g., IP was negative). Stress was significantly negatively related to the social support factor at the individual-level, but this association was positive at the house-level. These findings suggest that on an individual-level, a person's perception and source of social support is particularly important -even if the source of support comes from someone who is not abstinent. On a house-level, social support is more sensitive to outside influences than within individuals. Implications for future research and substance use interventions targeting social support are discussed.

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

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.