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Predictors and Trajectories of Negative and Positive Interpersonal Dynamics in Remission From Alcohol Use Disorder
Samuel F Acuff1,2, Samuel N Meisel3, Emily A Hennessy1,2
1Recovery Research Institute, Massachusetts General Hospital, Boston, Massachusetts, USA.
Background:
Research has established social networks as a critical determinant of recovery from alcohol use disorder (AUD), yet limited research exists investigating quality of interpersonal dynamics, especially during the transition to remission from AUD. Positive interpersonal dynamics (friendship and emotional support) may reinforce recovery, whereas negative interpersonal dynamics (hostility and rejection) may undermine it. Identifying determinants of interpersonal dynamic trajectories, including remission, may guide the development of personalized interventions.
Method:
Naturalistic prospective study of individuals with moderate-severe AUD initiating a new recovery attempt (N = 501, Mage = 41.42, 57.5% female) who were assessed at baseline, and 1.5, 3, 6, 9, and 12 months later on measures of recovery capital, negative and positive interpersonal dynamics (NIH toolkit scales), and other measures assessing demographic, clinical, and psychological process variables (e.g., abstinence self-efficacy). Latent growth models examined trajectories and time-invariant predictors of positive and negative interpersonal dynamics.
Results:
Negative interpersonal dynamics declined at the first follow-up and flattened over the remainder of the year. These results differed by remission status, with the greatest reduction in negative interpersonal dynamics among those who achieved abstinent remission at 12-month follow-up. Positive interpersonal dynamics did not change significantly throughout the study period. In covariate models, baseline recovery capital predicted positive and negative interpersonal dynamic intercepts and slopes, and there were differences in significant predictors across remission groups.
Conclusions:
Among those achieving AUD remission (abstinent or non-abstinent) at 12 months, early recovery is marked by reductions in negative interpersonal dynamics, in contrast to those who do not achieve remission. Regardless of outcome, little change was observed in positive interpersonal dynamics. The predictive utility of recovery capital highlights a modifiable outcome that could help improve the quality of interpersonal dynamics in recovery, although confirmation of this relationship is warranted.
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