Visualizing the Influence of Social Networks on Recovery:A Mixed-Methods Social Identity Mapping Study with Recovering Adolescents

BackgroundSocial recovery capital (SRC) refers to resources and supports gained through relationships and is vital to adolescent addiction recovery. Much is known about how substance use relates to social networks, but little is known about how other dimensions of social networks influence recovery (e.g., network size/exposure, degree of conflict). MethodsThis mixed-methods study sampled 28 adolescents who received treatment for alcohol and other drug (AOD) use disorder (14-19 yrs.: 71% male; M=17.32 yrs., SD=1.33; White 82%): 20 were recovery high school (RHS) students. Adolescents completed a social identity map for addiction recovery (SIM-AR), survey, and interview. Qualitative data were content analyzed and the data from the SIM-AR were quantified. ResultsOn average, participants reported belonging to five having 5 distinct groups (Range, 2-9; SD=1.63; M=27.89 people, SD = 20.09) in their network. Of their social network connections, on average, 51% drank alcohol and 46% used other substances. Larger networks involved more conflict (r=0.57). Participants were more likely to spend more time with groups that had greater proportions of non-substance usinge members; these relationships were stronger for RHS than for non-RHS students. Qualitative analyses revealed that youth reported their recovery-oriented groups as supportive, yet some felt their substance-using friends also supported their recovery.DiscussionSIM-AR was a useful measurement tool, and, through qualitative interviews, we identified unique aspects of youth’s social networks important for further examination. Research with recovering youth should examine SRC-related elements within their networks including relationship quality, belonging, and conflict, in addition to the substance use behaviors of network members. <br/

Recovery and youth: an integrative review.

Although rates of alcohol and other substance use disorders in adolescents have been estimated for decades, little is known about the prevalence, pathways, and predictors of remission and long-term recovery among adolescents. This article provides an integrative review of the literature on youth recovery. A final selection of 39 relevant articles was grouped into five sections: treatment outcomes, special emphasis populations, recovery-oriented systems of care, families, and non-abstinence-based approaches. The review recommends more adolescent research in three basic areas: more research about medication-assisted treatment and recovery as well as harm reduction approaches for adolescents; expansion of research on recovery practices for youth who do not receive treatment due to personal choice or societal disparities; and more life course research, which may begin with adolescent participants and extend across the life span. Additionally, the authors suggest the recovery capital model for adolescents and the neuroscience of addiction may provide additional precision and direction for the study of youth recovery

Ease of Marital Communication and Depressive Symptom Severity Among Men and Women in Rural Uganda: Cross-Sectional, Whole-Population Study

Purpose: Depression is a major contributor to the global burden of disease. The extent to which marital communication may influence depression in contexts with little mental health support is unknown. Methods: We conducted a whole-population study of married adult residents of eight villages in a rural region of southwestern Uganda. Depression symptom severity was measured using a modified version of the Hopkins Symptom Checklist for Depression, with \u3e 1.75 classified as a positive screen for probable depression. Respondents were asked to report about ease of marital communication (‘never easy’, ‘easy once in a while’, ‘easy most of the time’ or ‘always easy’). Sex-stratified, multivariable Poisson regression models were fit to estimate the association between depression symptom severity and marital communication. Results: Among 492 female and 447 male participants (response rate = 96%), 23 women and 5 men reported communication as ‘never easy’ and 154 women and 72 men reported it as ‘easy once in a while’. Reporting communication as ‘never easy’ was associated with an increased risk of probable depression among women (adjusted relative risk [ARR], 2.06; 95% confidence interval [CI], 1.08–3.93, p = 0.028) and among men (ARR, 7.10; 95% CI 1.70–29.56, p = 0.007). Conclusion: In this whole-population study of married adults in rural Uganda, difficulty of marital communication was associated with depression symptom severity. Additional research is needed to assess whether communication training facilitated by local leaders or incorporated into couples-based services might be a novel pathway to address mental health burden

Overestimation of alcohol consumption norms as a driver of alcohol consumption: a whole‐population network study of men across eight villages in rural, southwestern Uganda

Background and aimsLittle is known about how perceived norms about alcohol consumption may influence high alcohol consumption rates in Uganda. This study estimated the accuracy of perceived norms about men's alcohol consumption and estimated the association between perceived norms and personal alcohol consumption.DesignCross-sectional, whole-population, sociocentric social network study.SettingEight rural villages in Rwampara District, southwestern Uganda in 2016-18.ParticipantsA total of 719 men aged 18&nbsp;years and older (representing 91% of permanent resident men).MeasurementsSelf-reported frequent (≥&nbsp;4&nbsp;days per week) and heavy alcohol consumption (six or more drinks on one occasion, more than three occasions of intoxication, or spending an excessive amount on alcohol). Participants also reported whether they thought most other men in their village engaged in frequent and heavy alcohol consumption (perceived norms). Using the network study design, we calculated alcohol consumption behavior within villages and social networks. Perceived norms were compared with aggregated self-reports. Multivariable Poisson regression models were used to estimate the association between perceived norms and individual behavior.FindingsThroughout villages, frequent and heavy alcohol consumption ranged from 7 to 37%. However, 527 (74%) participants perceived, contrary to fact, that most other men in their villages frequently consumed alcohol, and 576 (81%) perceived that most others heavily consumed alcohol. Overestimation of alcohol consumption by others was pervasive among socio-demographic subgroups and was present irrespective of the actual consumption behavior at the village level and within social networks. Men who misperceived these alcohol consumption behaviors as being common were more likely to engage in frequent [adjusted relative risk (aRR)&nbsp;=&nbsp;3.98; 95% confidence interval (CI)&nbsp;=&nbsp;1.69-9.34) and heavy (aRR&nbsp;=&nbsp;4.75; 95% CI&nbsp;=&nbsp;2.33-9.69) alcohol consumption themselves.ConclusionsMost men in eight rural Ugandan villages incorrectly thought that frequent and heavy alcohol consumption were common among men in their villages. These misperceived norms had a strong positive association with individual drinking behavior

Overestimation of Alcohol Consumption Norms As a Driver of Alcohol Consumption: a Whole-Population Network Study of Men Across Eight Villages in Rural, Southwestern Uganda

Background and Aims: Little is known about how perceived norms about alcohol consumption may influence high alcohol consumption rates in Uganda. This study estimated the accuracy of perceived norms about men\u27s alcohol consumption and estimated the association between perceived norms and personal alcohol consumption. Design: Cross-sectional, whole-population, sociocentric social network study. Setting: Eight rural villages in Rwampara District, southwestern Uganda in 2016–18. Participants: A total of 719 men aged 18 years and older (representing 91% of permanent resident men). Measurements: Self-reported frequent (≥ 4 days per week) and heavy alcohol consumption (six or more drinks on one occasion, more than three occasions of intoxication, or spending an excessive amount on alcohol). Participants also reported whether they thought most other men in their village engaged in frequent and heavy alcohol consumption (perceived norms). Using the network study design, we calculated alcohol consumption behavior within villages and social networks. Perceived norms were compared with aggregated self-reports. Multivariable Poisson regression models were used to estimate the association between perceived norms and individual behavior. Findings: Throughout villages, frequent and heavy alcohol consumption ranged from 7 to 37%. However, 527 (74%) participants perceived, contrary to fact, that most other men in their villages frequently consumed alcohol, and 576 (81%) perceived that most others heavily consumed alcohol. Overestimation of alcohol consumption by others was pervasive among socio-demographic subgroups and was present irrespective of the actual consumption behavior at the village level and within social networks. Men who misperceived these alcohol consumption behaviors as being common were more likely to engage in frequent [adjusted relative risk (aRR) = 3.98; 95% confidence interval (CI) = 1.69–9.34) and heavy (aRR = 4.75; 95% CI = 2.33–9.69) alcohol consumption themselves. Conclusions: Most men in eight rural Ugandan villages incorrectly thought that frequent and heavy alcohol consumption were common among men in their villages. These misperceived norms had a strong positive association with individual drinking behavior