American Journal of Community Psychology, Vol. 36, Nos.

3/4, December 2005 (

C 2005)

DOI: 10.1007/s10464-005-8625-z

Sex Differences in Social Support and Self-Efficacy

Within a Recovery Community

Margaret I. Davis1,3 and Leonard A. Jason2

This study examined similarities and differences in social support and self-efficacy for absti-
nence between women and men recovering from substance addiction. The sample consisted
of 87 residents of Oxford House (OH) self-run, community-based recovery homes. Analyses
revealed similarities between women and men in terms of the composition and utilization of
support networks and abstinence self-efficacy. Also, for both sexes, length of residency in OH
was significantly related to decreased social support for alcohol and drug use and increased
self-efficacy for abstinence. However, multiple-group SEM analyses demonstrated that social
support for alcohol/drug use fully mediated the link between length of residency and absti-
nence self-efficacy for women, but not for men. Findings suggest that the process of gaining
self-efficacy to remain abstinent is distinct for women and men, and that social support plays
a different role in womens recovery than it does in mens.

KEY WORDS: substance abuse; addiction; recovery; social support; self-efficacy; sex differences.

Substance abuse and addiction incur significant
costs to the individual user, their family, and society
as a whole. Such costs comprise increased incidence
of many individual health problems and mortality
(Finney & Moos, 1991; Julien, 1985); disruption to
employment as well as interpersonal and family re-
lations (Fields, 1998); and economic costs related to
treatment, health care, lost earnings, accidents, and
criminal justice services borne by state and federal
governments, insurance companies, as well as sub-
stance abusers and their households (see NIDA &
NIAAA, 1998). The gravity of these detriments un-
derscore the heavy toll these problems exact and
why alcohol and drug abuse continue to be consid-
ered one of the most serious problems facing the
United States (Leshner, 1998a). Despite increased
knowledge regarding physiological and etiological
1 Dickinson College, Psychology Department, Carlisle, PA 17013.
2 DePaul University, Center for Community Research, 990 West
Fullerton Avenue, Suite 3100, Chicago, Illinois.
3 To whom correspondence should be addressed at Dickinson
College, Psychology Department, P.O. Box 1773, Carlisle, PA
17013; e-mail: davismar@dickinson.edu.
factors related to substance use, and the harmful con-
sequences that result, as well as persistent efforts
to combat these problems, data from the National
Household Survey on Drug Abuse (SAMHSA, 2000)
reveals that rates of use and abuse of legal and illicit
psychoactive-substances have remained stable. The
enduring high prevalence of alcohol and drug use and
dependence accentuates the need for finding more
innovative and effective ways to prevent and treat
these problems.
Although significant progress has been made
through research in this area over the past several
decades, presently there remain important gaps in
our knowledge. This appears particularly true with
respect to knowledge about substance abuse disor-
ders among women and the way that sex differences
may impact treatment outcome and the recovery
process (Blumenthal, 1998; Mactas, 1998). Because
of societys historical denial of womens drug abuse
and the fact that males have consistently presented
with higher prevalence rates of alcohol and drug
abuse, the majority of substance abuse and treat-
ment research to date has been conducted on males
(Blumenthal, 1998; Leshner, 1998a). However, given

259
0091-0562/05/1200-0259/0

C 2005 Springer Science+Business Media, Inc.
260
that rates of womens use and abuse of a number of
psychoactive substances is escalating at a relatively
rapid rate and indications that female, compared
to male, substance abusers tend to suffer greater
medical, family, and social consequences (Gomberg,
1999), this paucity of knowledge is a particular cause
for concern. Although research on women in all areas
of substance abuse is relatively lacking, accumulat-
ing evidence suggests that these disorders may dif-
fer in etiology, have different consequences, and re-
quire different prevention and treatment approaches
for women and men (Leshner, 1998b). The liter-
ature also indicates the inadequacy of traditional
treatment approaches to address womens unique
needs (Wallen, 1998). Several studies suggest a num-
ber of potentially significant areas that may impact
womens recovery that have not received sufficient
attention, but which demonstrate the necessity for
increased research regarding sex-related differences
that may impact the effectiveness of service delivery
and the process of recovery (Gomberg, 1999; NIDA,
1999).
Additionally, much of the research on substance
abuse treatment in general, and the research on
substance-abusing women in particular, has focused
primarily on discrete vulnerabilities and character-
istics of individuals (Blumenthal, 1998; McCrady &
Raytek, 1993). Because substance abuse and addic-
tion are the result of complex interactions between
individual, social, and environmental factors (Fields,
1998), it is reasonable to speculate that effective
treatment approaches will also be composed of these
interacting factors. Unfortunately, although the field
advocates a biopsychosocial model of addiction and
recovery, much of the theory and research to date
has tended to neglect the social and environmental
aspects and focuses primarily on micro-level factors.
Because a narrow individualistic mentalistic view of
individuals is assumed, resulting interventions nec-
essarily focus on this level as well (Hobfoll, 1998).
Evidence regarding the efficacy of traditional ap-
proaches to treatment for addiction suggests that the
adoption of this narrow focus and approach may limit
our understanding, as well as the success of interven-
tion efforts.
Appreciating the crucial need to develop more
effective and comprehensive interventions, which
also address womens issues related to substance
abuse, research by Jason and his colleagues (see
Jason, Davis, Ferrari, & Bishop, 2001, for a re-
view) suggests that Oxford House (OH)a national
network of self-supported and democratically oper-
Davis and Jason
ated homes that provide community-based mutual-
help settings for individuals recovering from sub-
stance abusemay provide an effective alternative
to traditional treatment approaches through foster-
ing both social and individual resources. Further, it
has been suggested that the OH environment may
be ideally suited to meet the special needs of women
(Dvorchak, Grams, Tate, & Jason, 1995).
The literature on mutual-help and social sup-
port emphasizes the importance of both individual
resources (such as autonomy and respect) and so-
cial resources (such as social support) as essential
to the healing process (Cassel, 1974; Hobfoll, 1998;
Holahan & Moos, 1991; Kaniasty & Norris, 2001;
Sarason, 1974). Research in the area of addiction
and recovery similarly highlights the important im-
pact of social support networks on both individu-
als substance use and abstinence (e.g., see Beattie &
Longabaugh, 1997; Humphreys, Mankowski, Moos,
& Finney, 1999; Longabaugh, Beattie, Noel, Stout, &
Malloy, 1993; Longabaugh, Wirtz, Beattie, Noel, &
Stout, 1995; Longabaugh, Wirtz, Zweben, & Stout,
1998). With respect to recovery, this research has
found that specific social support for abstinence (vs.
general social support) is directly and positively re-
lated to maintaining abstinence (Longabaugh et al.,
1993, 1998; Mohr, Averna, Kenny, & Del Boca, 2001;
Rice, Longabaugh, & Stout, 1997) and that this ef-
fect is strongest when the individuals are highly in-
vested in these supportive networks (Longabaugh
et al., 1993, 1998). Additionally, qualities of friend-
ship networks such as trust, respect, and frequency
of contact have also been reported to be associated
with better outcomes amongst recovering individu-
als (Humphreys et al., 1999). Conversely, a number
of studies have found social support for alcohol con-
sumption to be a consistent negative prognostic indi-
cator of drinking outcomes (Longabaugh et al., 1993;
Beattie & Longabaugh, 1997). Yet, even in this case,
if individuals simultaneously engage in a network of
people (such as Alcoholics Anonymous) who share
a similar goal of maintaining abstinence and support
one another in achieving and maintaining this goal, it
may buffer them from the negative effects of having
a network that is more generally supportive of con-
sumption (Longabaugh et al., 1998).
Based on these findings, it is likely that resid-
ing in an abstinent communal living setting such as
OH, which relies solely on mutual-help among re-
covering peers, should provide residents an opportu-
nity for gaining specific support for abstinence in an
environment that facilitates high social investment.
Social Support and Self-Efficacy for Recovery
Thus, by residing in OH, individuals social support
for substance use should decrease and their invest-
ment in those networks should increase, and this pos-
itive restructuring of social support should become
more prominent over time.
It is also likely that by living in an OH
recovery environment with peers who have suc-
cessfully maintained abstinence and who serve as
role-models, fellow residents have an opportunity to
acquire crucial knowledge and skills related to ef-
fectively coping with stressors and high-risk relapse
precipitants. Gaining this knowledge and these skills
should promote residents abstinence self-efficacy
(i.e., the belief that one can effectively cope and
refrain from substance use in stressful situations).
Thus, as well as leading to changes in support net-
works, time spent as a resident in OH should lead
to increases in abstinence self-efficacy, such that the
longer an individual resides there, the greater his
or her abstinence self-efficacy will become. Facilitat-
ing this personal resource is important, given indica-
tions that abstinence self-efficacy appears to be re-
lated to successful abstinence and coping activities
during recovery maintenance (DiClemente, 1986;
DiClemente, Carbonari, Montgomery, & Hughes,
1994; DiClemente, Fairhurst, & Piotrowski, 1995;
Marlatt & Gordon, 1985). For example, a study by
Greenfield et al. (2000) found that greater abstinence
self-efficacy prior to discharge from inpatient alcohol
treatment was related to more positive drinking out-
comes during a 12-month follow-up period and that
reports of abstinence self-efficacy reliably predicted
the median number of days to posttreatment relapse.
Several studies also indicate that recovery programs
may serve to increase an individuals abstinence self-
efficacy and in so doing increase an individuals abil-
ity to resist the urge to relapse in high-risk situ-
ations following treatment (Annis & Davis, 1991;
Miller, Ross, Emmerson, & Todt, 1989; Morganstern,
Labouvie, McCrady, Kahler, & Frey, 1997).
The present investigation explored these rela-
tionships through the testing of a proposed model.
The model predicted that time spent as a resident
in an OH would be related to social support for
alcohol/drug use, social investment, and abstinence
self-efficacy such that longer stays would be as-
sociated with decreased support for substance use
and increased network investment and self-efficacy.
However, based on Beattie et al.s (1992, 1993)
work that suggests a complex theoretical relation-
ship between abstinence support and maintaining
abstinence, and Jason and Kobayashis (1995) sug-
261
gestion that it is through participation and invest-
ment in abstinence-promoting social networks that
an individuals self-efficacy improves, it is likely that
OH residents affiliation with and investment in net-
works that do not support substance use actually
contributes to increases in abstinence self-efficacy.
Thus, in the proposed model, the social support vari-
ables are conceived of as mediating the relationship
between length of residency in OH and abstinence
self-efficacy. Additionally, in line with Longabaugh
et al.s (1993) research, the model predicts that the di-
rect effect of social support for substance use on self-
efficacy will vary as a function of (i.e., will be mod-
erated by) the level of investment individuals have in
those support networks. As such, social support will
more strongly impact the self-efficacy of individuals
who are highly invested in their networks, than it will
impact the self-efficacy of individuals who are less in-
vested in their networks.
Although research on gender differences in so-
cial support specific to substance use or abstinence
is sparse, it suggests that there may be important
differences between men and women in terms of
the composition and impact of support networks
on attaining and maintaining abstinence, which are
worthy of further investigation. For example, anal-
yses from Project MATCH (Mohr, Averna, Kenny,
& Del Boca, 2001) revealed that at both baseline
and follow-up, men, compared to women, revealed
a higher proportion of their friendships and most im-
portant friends were alcoholics; while women (com-
pared to men) reported drinking friends as being
more important to them at baseline and nondrinking
friends as being more important to them at follow-
up. Research on women in recovery and measures of
general social support also suggests that women tend
to have higher levels of support from friends (Rice &
Longabaugh, 1996; Robles et al., 1998; Rubin, Stout,
& Longabaugh, 1996), while men are more likely to
report family members as primary sources of sup-
port (Rice & Longabaugh, 1996; Robles et al., 1998).
Further, in an investigation of gender differences
in stressors and resources among problem drinkers,
Skaff, Finney, and Moos (1999) found that friend-
ships had a stronger impact on women than men
and that greater support from friends had a positive
impact on womens functioning (i.e., decreased de-
pression and alcohol consumption) whereas friend-
ship stressors tended to have a negative impact on
functioning. Based on these findings, it is reasonable
to expect differences between women and men in
terms of the composition of their support networks
262
(viz., that friends comprise females most important
sources of support, whereas family members fill these
roles for males), as well as possible differences with
regards to the utilization and effects of these net-
works on individuals recoveries from substance use.
Thus, with respect to the variables under consid-
eration in this study, it was of interest to explore the
composition of womens and mens support networks
and to examine whether the relationships between
length of residency, social support, and abstinence
self-efficacy were similar or different for women and
men. Subsequently, the proposed mediational model
was tested independently for females, then males.
METHOD
Research Participants
All participants in the investigation were cur-
rent residents of OHs. The final sample consisted
of 87 residents (38 females, 49 males). The average
age of the sample was 38 years old (range = 1959).
Approximately 63% of the sample was African
American, 31% was Caucasian, and 6% represented
other (including Latino and Native American) eth-
nicities. Forty-one percent of the sample came from
Mid-Atlantic states (viz., Maryland and Virginia),
54% from the Midwest (viz., Illinois), and 5% resided
in other states (viz., North Carolina and Washing-
ton). Roughly 56% were single, 33% were divorced,
8% were separated, and 3% were married. Most
of the sample (92%) had a high school diploma or
GED, with an average of 12.5 years of education
(SD = 2.5). Seventy-eight percent were employed
full-time, 6% were employed part-time, 2% were
unemployed, 6% were disabled, and 5% were both
working part-time and receiving disability. All indi-
viduals in the sample reported histories of depen-
dence on and abuse of more than one psychoactive
substance.
Procedure
Participants for the study were recruited by a
founder and C.E.O. of Oxford House, Inc. and by
the investigator and a colleague while in attendance
at OH administration meetings. At these assem-
blies, the study was announced and residents were
invited to volunteer to participate. Twenty partici-
pants were recruited in conjunction with another De-
Paul University OH study. Of those invited, approx-
imately 98% volunteered to participate. Of the 119
Davis and Jason
(51 women, 68 men) persons who volunteered to par-
ticipate in the study, 73% or 87 participants com-
pleted the survey in its entirety, whereas 32 partici-
pants failed to provide information for some items on
the rather lengthy social support network inventory
(IPA, described below). Because every item on this
inventory is needed to calculate the indices, which
are then used to compute the composite scores, the
social support variables could not be calculated for
these participants and they were thus dropped from
analyses. t-Test and chi-square analyses were con-
ducted to determine whether there were any impor-
tant differences (e.g., in terms of age, education, in-
come, drug and alcohol history, length of time in
OH, abstinence self-self-efficacy, etc.) between par-
ticipants who did versus did not furnish complete
IPA information. These analyses yielded significant
differences with regards to education and ethnicity
suggesting that European Americans and individuals
with greater years of education were more likely to
complete all items of the survey (2 (1, 120) = 5.93,
p < .02; and t(115) = 2.13, p < .05, respectively).
Otherwise, the 87 participants were representative of
the overall sample.
For individuals who agreed to participate in the
study, surveys were administered via phone or in-
person by means of paper and pen. All individuals
were asked to sign an officially sanctioned Consent
to Participate in Research form and were assured
that their responses would remain anonymous and
confidential. For those surveyed by phone, verbal
consent was obtained provisionally and then written
consents were obtained by mail. The survey took ap-
proximately 40 min to complete. Participants were
then thanked for their voluntary participation, sup-
plied with written educational feedback explaining
the purpose of the research project, and given con-
tact information if they had future questions about
the study. It was also noted that when the research
project was completed, both OH, Inc. and participat-
ing OHs would be provided a report summarizing the
studys findings.
Because participants were recruited and
surveyed using alternate strategies, analyses were
conducted to determine whether there were any
significant differences between participants based on
recruitment and/or method of administration of the
survey. Results yielded no evidence to suggest that
these groups of individuals, based on the different
modes of recruitment and survey administration,
significantly differed in ways that impacted the
results of the study.
Social Support and Self-Efficacy for Recovery
Instrumentation
The survey was composed of four measures.
First, participants were asked to complete a brief Per-
sonal Information survey. This measure solicited per-
sonal and sociodemographic data. The information
requested included sex, age, race, marital and fam-
ily status, employment history and income, education
level, and information regarding the individuals his-
tory of involvement with the criminal justice system
(e.g., arrests, convictions, and incarceration). Second,
participants completed the Treatment Involvement
survey. This measure solicited information regarding
participants substance abuse treatment history and
targeted involvement in five treatment areas: detox-
ification, inpatient treatment (other than detoxifica-
tion only), outpatient treatment (other than detoxi-
fication only), long-term residential treatment (other
than OH) and Oxford House. Individuals were asked
to supply information on the number of times they
have participated in each of these forms of treatment,
as well as the number of times they have completed
or not completed the treatment programs. This mea-
sure also asked participants to provide information
on receipt of mental health services, participation in
and identification with 12-Step programs such as AA
and NA, and prior alcohol and drug use habits (in-
cluding substance abuse and dependence).
Third, participants were asked to complete
Annis and Grahams (1988) 39-item Situational Con-
fidence Questionnaire (SCQ-39), which assesses par-
ticipants self-efficacy to remain abstinent in the face
of high risk situations for relapse (Rubin et al., 1996).
Respondents are asked to imagine themselves in
each of 39 situations and indicate how confident they
are that they would be able to resist the urge to
drink or use drugs altogether in that situation (rang-
ing from 0% [not at all confident] to 100% [very con-
fident]). The measure yields an overall mean score
of situational confidence and eight factor subscores,
representing eight categories of high-risk intra- and
interpersonal relapse precipitants. The SCQ-39 has
been demonstrated to effectively discern differing
levels of situational confidence between individu-
als with short-term versus longer-term abstinence
(e.g., Miller, Ross, Emmerson, & Todt, 1989) and
has been demonstrated to be predictive of posttreat-
ment drinking outcomes (Greenfield et al., 2000).
In the present investigation, analyses supported ex-
cellent reliability (.90.96) for the eight subscales
and a Cronbachs alpha of .99 for the total SCQ-39
scale.
263
Finally, participants completed Clifford and
Longabaughs (1991) Important People and Activi-
ties Inventory (IPA), which solicits information re-
garding individuals social support networks related
to substance use and abstinence. This scale provides
information that is relevant to measuring constructs
proposed in Longabaugh and colleagues (1993)
model and the model proposed in the present study,
as well as useful descriptive information regarding
the composition and utilization of individuals sup-
port networks. Respondents also provide informa-
tion on how often others use alcohol or drugs dur-
ing activities that are important to the participant
(Beattie et al., 1993). The measure yields 11 indices,
two composite scores, and an overall Composite
Support Index (CSI). The 11 indices are presented
in results as shown in Table I. The two composite
scores are: (a) social investment, which is a score rep-
resenting the extent to which an individual is invested
in his or her identified network, and (b) support for
drinking/drug use, which is a score representing the
extent to which an individuals network is support-
ive of substance use versus abstinence. Although the
original IPA scale elicits information with respect to
alcohol use only, in the present study, support for al-
cohol/drug use was assessed.
The social investment score is computed using
information drawn from the participants description
of the overall network and of the four most important
people in this network. The specific items taken from
the IPA that are used to determine a persons level of
social investment include the number of people listed
in an individuals overall social network, the number
of people in the network with whom an individual has
daily contact, and the subjective importance ratings
of the people included in an individuals list of most
important people (Longabaugh et al., 1998).
To compute the support for drinking/drug use
score, information is drawn from the participants de-
scription of the substance use behavior and status
of their identified network (up to 12 people), and
the reactions of the four most important people to
the participants alcohol and drug use (Longabaugh
et al., 1998). The specific items of the IPA measure
that are used to determine how supportive a per-
sons network is for substance use include the drink-
ing and drug use status of people listed in an in-
dividuals overall social network and the frequency
of contact an individual has with these people, the
frequency with which network members use alcohol
and/or drugs, the maximum substance use of network
members when they use, the percentage of heavy
264 Davis and Jason

Table I. Mean Scores (and SDs) of Social Support Network Characteristics of the Sample
and Comparisons by Gender
Descriptor variable Women Men
IPA social investment score 11.1 (3.3) 10.4 (2.6)
IPA CSI score 0.0 (1.3) 0.0 (0.7)
Subjective value of M.I.P. 36.3 (6.3) 36.2 (6.2)
IPA activities scores
Number of activitiesup to 8 3.8 (1.6) 3.7 (1.4)
Percentage of acts for which individual is abstinent 73.9 (42.0) 85.8 (29.1)
Percentage of acts for which others are abstinent 73.9 (38.1) 72.1 (30.3)
Characteristics of social support network1
Number of people in networkup to 12 (Index 1) 7.5 (3.6) 6.5 (2.7)
Number of years known people 10.1 (8.4) 8.7 (7.6)
Amount of contact (Index 2)a 5.7 (0.8) 5.7 (0.7)
Number with whom has daily contact 2.8 (2.9) 2.4 (2.3)
Number of M.I.P.sup to 4 3.4 (1.0) 3.8 (0.6)
Average importance of M.I.P.s (Index 3)b 5.6 (0.6) 5.5 (0.6)
Average substance use status (Index 4)c 2.1 (1.3) 1.9 (0.7)
Average frequency of substance use (Index 5)d 1.7 (2.2) 1.4 (1.6)
Average amount of substance used 1.1 (1.6) 1.2 (1.3)
by members who use (Index 6)e
Percentage of heavy users in network (Index 7) 6.2 (14.0) 4.7 (11.1)
Percentage of abstainers and recovering (Index 8) 73.7 (31.6) 79.4 (19.6)
Most support for substance use (Index 9)f 2.8 (1.2) 2.8 (1.1)
Least support for substance use (Index 10)f 2.2 (1.0) 2.2 (1.0)
Average support for substance use (index 11)g 0.1 (0.3) 0.2 (0.3)
Most support for abstinencef 4.8 (0.6) 4.9 (0.4)
Least support for abstinencef 4.4 (1.1) 4.7 (0.6)
Percentage of networkmale 39.4 (24.3) 62.9 (22.4)
Percentage of networkfamily 28.8 (24.9) 23.2 (21.7)

Note. 1 = Index Scores are reported prior to z-transformations. N = 87 (38 females,

49 males).
a Range = 0 (not at all in past 6 months)7 (daily).
bRange = 1 (not at all important)6 (extremely important).
c Range = 1, 2 (recovering, abstainer)5 (heavy user).
d Range = 0 (not at all in past 6 months)7 (daily).
e Range = 0 (does not drink or use drugs)4 (10 or more in single day).
f Indicates networks reaction to participants use/abstinence; Range = 1 (left/made me

leave)5 (encouraged).
g Index 11 is distinct from 9 and 10 and computed as the product of three values for each

person listed as important.

p < .001 for the difference between women and men.

users in an individuals network, the percentage of
abstainers and recovering people in an individuals
network, ratings of each the most and the least sup-
port for drinking/drug use assigned to the people in-
cluded in an individuals list of most important peo-
ple, and the average support for drinking/drug use
(which is an index computed from three other vari-
ables, and is conceptually distinct from the indices
on most and least support for drinking/drug use)
(Longabaugh et al., 1998).
The CSI is a summary score that is created by
summing the standardized scores for each of the
11 indices (i.e., the 3 indices and the 8 indices that
compose the two composite scores), and then do-
ing a z-transformation. Several of the indices are re-
versed scored so that all indices have the same di-
rection, with larger scores representing more support
for drinking/drug use. Longabaugh et al. (1993, 1995)
have demonstrated strong construct validity across
IPA subscale indices (.80), as well as a testretest re-
liability over a 23-day period of .95 (Longabaugh
et al., 1998; Del Boca, McRee, & Babor, 1995).
Beattie et al. (1993) have also reported acceptable
overall item and subscale alphas for this instrument
(i.e., for both subscales and total items, Cronbachs
alpha was .66.67). In the present study, while the
IPA subscale indices were acceptable and the CSI
yielded a Cronbachs alpha of .68, the index of
Social Support and Self-Efficacy for Recovery
investment in support network (i.e., the social in-
vestment score) yielded an alpha of .31, suggesting
low reliability of this composite score. It is impor-
tant to note that because the magnitude of a corre-
lation tends to decline as the measurement of either
variable is less reliable, the poor reliability of the so-
cial investment score is likely to attenuate the abso-
lute value of the observed correlation between it and
other variables (Kline, 1998).4
Additional information from the IPA was used
to provide a detailed description of female and male
participants social networks and activities including
the composition of networks, the subjective value at-
tached to respondents relationships with most im-
portant others (computed as the average of the im-
portance and liking ratings of the most important
others that are listed), and abstinent activities (calcu-
lated by dividing the number of activities an individ-
ual participates in where others present drink alcohol
and/or use drugs by the total number of activities).
RESULTS
Statistical analyses were performed in two
stages. The first stage was to provide descriptive and
exploratory information on the sample and differ-
ences between females and males who composed the
sample. The second stage used structural equation
modeling (SEM) to conduct a path analysis investi-
gating the relationships among the variables of the
proposed mediational model and also to test for dif-
ferences in these relationships between males and
females.
Stage 1: Descriptive and Comparative Analyses
Characteristics of the sample are presented in
Table II. Because exploration of differences be-
tween females and males was a major focus of the
4 RexKline (1998) maintains that unreliability in either the indica-
tor (X) variable or the criterion (Y) variable serves to attenuate
the absolute value of any observed correlation (i.e., rXY). This is
based on classical measurement theory (Nunnally and Bernstein,
1994), which shows that the theoretical maximum absolute value
of correlation rXY is equal to the square root of the product of
the reliabilities of X and Y (i.e., rXX and rYY). Thus, rXY will
equal 1.00 only if both variables X and Y are perfectly reliable.
The implication of this for the present study is that given the
poor reliability of the social investment score (i.e., .31), even if
the other variables were perfectly reliable, the theoretical max-
imum value of a correlation between Investment and another
variable equals .56.
265
study, data depicting characteristics are reported sep-
arately for the two groups. As noted in Table II, the
women and men in this sample were fairly similar
to each other in age, ethnicity, marital status, edu-
cation, employment, and legal status. Additionally,
the substances that women and men were most de-
pendent upon were similar (e.g., cocaine was most
common, followed by alcohol, heroin/opiates, and
cannabis dependence, respectively). Both women
and men reported histories of arrests, charges, con-
victions, and having spent time incarcerated. Consis-
tent with previous reports, most men and women re-
ported multiple alcohol and drug dependencies, as
well as prior participation in numerous substance
abuse treatment programs. Thus, it is evident by
their substance use and treatment histories that
this sample represents a chronic substance abusing
population.
The main differences between women and men
in this sample involved family composition and in-
come. With respect to family composition, women
reported only having a slightly higher number of chil-
dren than men (t(64) = 1.89, p = .06). However,
of the women who had children, 23% reported hav-
ing their children living with them, while none of
the men did, 2 (1, 43) = 4.56, p = .03. Significantly
more men than women reported paying child sup-
port, 2 (1, 42) = 10.57, p = .001. With regard to in-
come, womens weekly income was significantly less
than mens, t(75) = 3.52, p < .001. Because these
analyses involved making numerous comparisons, an
alternative significance level was calculated using the
Bonferroni correction in which the family-wise Type
I error rate (.05) was divided by the number of con-
trasts made. Using the Bonferroni correction for the
foregoing series of comparisons, a level of .001 would
be considered a more conservative estimate of sig-
nificance. Given this criterion, the only gender dif-
ferences that remain significant include payment of
child support and weekly income.
Residency and Social Support for Alcohol/Drug Use
Although not statistically significant, the men
generally reported greater lengths of time of cur-
rent continuous abstinence and residence in OH.
Whereas women in this sample had an average of
335 days (SD = 396.5) of current continuous absti-
nence, men had an average of 453 days (SD = 628.3).
Similarly, women reported an average of 284 days
(SD = 314.4) of current continuous residence in OH,
266 Davis and Jason

Table II. Mean Scores and Percentages for Characteristics of the Sample and
Comparisons by Gender
Descriptor variable Women Men Significance
Age in years (M) 38.1 (8.6) 37.5 (8.2)
Ethnicity (%)
African American 26.3 35.4
Caucasian 68.4 58.3
Other 5.2 6.3
Marital status (%)
Single 52.6 59.6
Married 0.0 4.3
Separated 10.5 6.4
Divorced 36.8 29.8
Family composition (%)
Number of children (M) 1.9 (1.2) 1.2 (1.7) p = .06
Have lost custody 8.0 17.6
Children live with 23.1 0 2 p = .03
Pay child support 8.0 52.9 2 p = .001
Education in years (M) 12.6 (1.8) 12.5 (2.9)
Employment status (%)
Full time 76.3 79.2
Part time 7.9 4.2
Unemployed 5.3 0.0
Disabled 5.3 6.3
Weekly income (dollars) (M) 282.9 (140.6) 426.6 (195.3) p < .001
On probation/parole (%) 24.3 20.0
Number of times arrested
and charged (M) .8 (6.1) 5.2 (6.4)
Number of times convicted (M) 2.1 (4.3) 2.4 (3.2)
Total days incarcerated (M) 147.3 (316.4) 263.4 (671.2)
1st Substance of dependence (%)
Alcohol 37.8 22.2
Cannabis 8.1 6.7
Cocaine 43.2 53.3
Heroin/opiates 10.8 17.8
2nd Substance of dependence (%)
Alcohol 18.9 44.4
Cannabis 16.2 15.6
Cocaine 32.4 20.0
Heroin/opiates 5.4 4.4
Sedatives/hypnotics 5.4 0.0
Number of drug/alcohol
treatments (M) 5.1 (3.1) 6.8 (5.6)
Number of 12-step meetings (M) 3.9 (2.1) 4.2 (2.3)

Note. Values in parentheses reflect SDs. N = 87 (38 females, 49 males).

while men had been residing for an average of 395
days (SD = 487.3). As hypothesized, for the total
sample longer lengths of time as residents in OH
were significantly related to decreased social support
for alcohol/drug use (r = .33, p < .01). This rela-
tionship was strong, but nonsignificant, for men (r =
.28, ns) and even stronger for women (r = .53,
p < .01). In neither case was length of residency in
OH significantly correlated with investment, though
there was a trend toward increased investment with
women (r = .24, p = .07), but not for men (r = .05,
p > .073).4
Characteristics of Social Support Networks
Information and statistical comparisons be-
tween females and males with respect to character-
istics related to their social support networks and
support for alcohol/drug involvement are presented
in Table I. Again, because of the numerous com-
parisons involved, an alternative significance level
of .002 was calculated using the Bonferroni correc-
tion in order to maintain a Type I error rate of
.05 for this family of 24 contrasts. Results of anal-
yses indicated that women and men in this sample
Social Support and Self-Efficacy for Recovery
were fairly similar to each other in terms of ab-
stinent activities and characteristics of their social
support networks, as well as their networks sup-
port for alcohol/drug use. The only significant dif-
ference between women and men on social support
variables was the gender composition of their net-
works. On average, males compose 63% of mens
networks, but only 39% of womens network, t(84) =
4.65, p < .001. Thus, women reported that the ma-
jority of their networks are female, whereas men re-
ported that the majority of their networks are male.
The hypothesis that females important social net-
works would be more largely composed of friends
and males networks would be primarily composed of
family members was not supported. Overall, friends
composed 74% of important social networks, while
family members accounted for 26%. Women actu-
ally reported a slightly higher percentage of fam-
ily members in their networks than men (29% vs.
23%, respectively), t(84) = 1.10, ns. Including sig-
nificant others (not titled spouse) as family mem-
bers, rather than as friends, did not strongly impact
these findings. In this case, the average percent of
family members (including significant others) in both
womens and mens networks increased (M = 37%,
SD = 25 for women; M = 32%, SD = 24 for men;
t(84) = 1.03, ns).
Abstinence Self-Efficacy
Statistical comparisons between females and
males were made on the total score of the SCQ-39, as
well as the eight subscales. No significant differences
were found using t-tests comparing males and fe-
males. Both women and men reported high amounts
of confidence that they could remain abstinent in
the face of intra- and interpersonal high-risk relapse
precipitants. The average SCQ-39 total scores for
women and men were 79.8 and 77.5 (SDs = 24.7
and 23.4) respectively. Both female and male par-
ticipants also demonstrated the highest abstinence
self-efficacy in situations involving negative physical
states, positive emotional states, interpersonal con-
flict, and social pressure. In each of these cases, they
were over 80% confident they could resist the urge
to drink and use drugs. Both women and men also
demonstrated the least situational confidence with
respect to resisting the urge to drink or use drugs
to test personal control. This was the only subscale
in which participants averaged less than 65% confi-
dence. It was also the only subscale in which the dis-
267
crepancy between womens and mens average self-
efficacy exceeded a 3% difference.
Stage 2: Testing the Proposed Model
Following the initial analyses, analyses were
conducted to test the proposed model derived from
that described by Longabaugh et al. (1993, 1995,
1998) in which substance use outcomes are a function
of social support for alcohol/drug use, moderated by
social investment. In this study, Longabaughs model
was modified to include length of residency in OH as
a predictor of support for alcohol/drug use and absti-
nence self-efficacy such that time spent as a resident
in an OH would be associated with decreased sup-
port for substance use and increased network invest-
ment and self-efficacy. Moreover, it was proposed
that the social support variables would mediate the
relationship between length of residency in OH and
abstinence self-efficacy. Lastly, it was predicted that
the direct effect of social support for substance use on
self-efficacy would vary as a function of (i.e., be mod-
erated by) the level of investment individuals have in
their support networks.
To test the model and these hypotheses, struc-
tural equation modeling (SEM) was used to conduct
a path analysis to investigate the direct and indirect
effects of length of residency in OH on abstinence
self-efficacy. Utilizing this approach permitted esti-
mation of the individual path coefficients and their
levels of statistical significance, as well as the pro-
portion of variance explained and the models over-
all fit to the data (Kline, 1998). The path model
was estimated using LISREL 8 (Joreskog & Sorbom,
1996). Because the chi-square statistics is sensitive
to sample size and model size, additional indices
were also used to assess model fit (Bollen, 1989).
A goodness-of-fit index (GFI) of .90 or higher was
set as evidence of acceptable model fit (Bentler &
Bonett, 1980). One-tailed tests to interpret signifi-
cant effects were used where specific directional ef-
fects were proposed, but two-tailed tests were used
otherwise.
Following an established procedure (see Aiken
& West, 1991; Cohen & Cohen, 1983), in order to
test whether level of investment moderates the im-
pact of social support on self-efficacy, an interac-
tion term was created between the two continuous
IPA variables: the CSI score and the social invest-
ment score. The interaction term is a product vari-
able that embodies the shared variance of two vari-
ables. Creating and including the interaction term in
268
the model is an established way to test whether the
effect of one variable (i.e., CSI score) on the criterion
(i.e., self-efficacy) is conditional on the other vari-
able (i.e., social investment score) (Kline, 1998). In
specifying the proposed model to be analyzed, the
observed variables included one exogenous predic-
tor variable: self-reported length of residency in OH;
and four endogenous outcomes: the IPA CSI score,
the IPA social investment score, the interaction term
between the two IPA scores, and the total score on
the SCQ-39. Because there was a high correlation
between length of abstinence and residency in OH
(r = .81, p < .001), the use of only the one proposed
predictor variable in the model was justified. The
theoretical model predicted that paths from length
of residency to the social support variables, and
from the support variables to abstinence self-efficacy
were unidirectional. Additionally, it predicted that
the effect of length of residency on abstinence self-
efficacy would be accounted for at least in part by
investment in social networks that do not support
substance use.
Model testing proceeded in three phases. First,
the direct effect of length of residency on absti-
nence self-efficacy (excluding mediating variables)
was evaluated. Second, the direct and indirect ef-
fects of length of residency on abstinence self-efficacy
were examined including the proposed mediating
variables. Third, differences between women and
Fig. 1. Results of testing mediational model.
Davis and Jason
men in the magnitude of the path coefficients in the
proposed model were tested.
Direct Effects of Residency in Oxford House
on Abstinence Self-Efficacy
As hypothesized, length of residency was posi-
tively associated with abstinence self-efficacy in the
expected direction. Analyses revealed that longer
time residing in OH was significantly related to
greater abstinence self-efficacy ( = .27, z = 2.11,
p < .02), but the variance explained was relatively
low (R2 = .07).
Effects of Residency on Abstinence Self-Efficacy
Mediated by Social Support for Substance Use
Baron and Kennys (1986) guidelines were fol-
lowed to test the social support variables as potential
mediators of the direct effect of length of residency
on abstinence self-efficacy.
As depicted in Fig. 1, the test of the proposed
model revealed that length of residency was highly
and negatively related to social support for sub-
stance use ( = .33, p < .005), but was not signif-
icantly associated with investment in that support
( = .11, p = .20) nor the interaction of social sup-
port and investment ( = .17, p = .09). In turn,
social support for substance use was significantly
Social Support and Self-Efficacy for Recovery
and inversely related to abstinence self-efficacy ( =
.29, p < .02), while neither investment nor the
interaction of support and investment were asso-
ciated with self-efficacy ( = .01, p = .43 and =
.16, p = .13, respectively). Furthermore, in the me-
diated model, the direct effect of length of resi-
dency on abstinence self-efficacy was nonsignificant
( = .20, p = .06). The overall model fit was accept-
able, 2 (1) = 4.02, p = .05. The goodness-of-fit in-
dex (GFI) indicated that the proposed path model
reproduced the observed covariance matrix quite
well, with GFI = .97. Additionally, the model yields
a respectable .90 on both the normed-fit index (NFI)
and the comparative-fit index (CFI). The predictor
explained little of the variance in investment in so-
cial support for substance use (R2 = .01) and the
interaction between social support and investment
(R2 = .03); while the proportion of the variance ex-
plained in social support for alcohol/drug use (R2 =
.11) and abstinence self-efficacy (R2 = .15) was
higher but still modest. These findings offer evidence
that social support fully mediated the link be-
tween length of time residing in OH and abstinence
self-efficacy.
Sex Differences in the Mediational Model
To test for differences between women and men
in the proposed model, multiple-group path analysis
via SEM was used. The same baseline model (Fig. 1)
was postulated for both females and males. Analy-
ses examined the fit of the postulated model to each
groups data separately before testing for equality
across groups (Byrne, 1994). In comparing the di-
rect effect of residency in OH on abstinence self-
efficacy for women and men independently, it was
found that length of residency was more strongly as-
sociated with abstinence self-efficacy for men, than
it was for women. For men, analyses revealed that
longer time residing in OH was significantly related
to greater abstinence self-efficacy ( = .36, z = 2.06,
p < .02); whereas for women this effect was not sig-
nificant ( = .15, z = .79, p = .21). The variance of
self-efficacy explained was modest for men (R2 =
.13), but low for women (R2 = .02).
Examination of the fit of the mediated model
to each gender independently demonstrated differ-
ences between women and men, which are depicted
in Fig. 2. For the females, the model fit very well;
whereas for the males it was a poor fit. For women,
length of residency was strongly related to decreased
social support for substance use ( = .53, p < .001)
269
and increased investment in social support ( = .56,
p < .001), as well as significantly and negatively re-
lated to the interaction of social support and invest-
ment ( = .63, p < .001). For men, length of res-
idency was not significantly associated with any of
these social support-related variables. Although res-
idency was modestly related to decreased social sup-
port for substance use ( = .28, p = .06), there was
no apparent impact on investment in social support
( = .10, p = .29) nor the interaction between so-
cial support and investment ( = .18, p = .16). Ad-
ditionally, whereas social support for substance use
was significantly and inversely related to womens
abstinence self-efficacy ( = .39, p < .05), it did
not appear to influence mens. Neither investment
nor the interaction term was associated with self-
efficacy for either gender. Furthermore, in the medi-
ated model the effect of length of residency on ab-
stinence self-efficacy was nonsignificant for women
( = .18, p = .23) but remained significant for men
( = .36, p = .02).
The overall model fit was quite good for women,
2 (1) = .12, p = .73; but poor for men, 2 (1) = 6.72,
p < .01. Goodness-of-fit statistics indicated that the
model fit better for women (GFI, NFI, and CFI
each = 1) than men (GFI = .93, NFI = .68, CFI =
.47). For women, the predictor explained a moder-
ate amount of variance in social support for alco-
hol/drug use (R2 = .28), investment in that support
network (R2 = .32), and the interaction between so-
cial support and investment (R2 = .39); while the
proportion of the variance explained in abstinence
self-efficacy (R2 = .16) was modest. For men, the
predictor accounted for little variance in social sup-
port for alcohol/drug use (R2 = .08), investment in
that support network (R2 = .01), and the interaction
between support and investment (R2 = .03); but ex-
plained greater variance in abstinence self-efficacy
(R2 = .18).
Consequently, testing the mediated model for
equality across gender groups yielded significant re-
sults. The omnibus test of the equality of all of the
model path coefficients for males and females re-
sulted in 2 (9) = 31.71. Compared to the baseline
2 (2) = 6.84, the 2 (7) = 27.87 is significant (p <
.001, two-tailed), demonstrating that gender signifi-
cantly influenced the magnitude of the path coeffi-
cients in the model. Further analysis involved impos-
ing equality constraints on two path coefficients: the
path between length of residency and social support
for substance use, and the path between social sup-
port for substance use and abstinence self-efficacy.
270
Fig. 2. Result of testing mediational model for women and men independently.
Testing with these two constraints yielded 2 (4) =
13.62, 2 (3) = 6.78, p = .03 (two-tailed); suggest-
ing that at least one of the paths was different for
women and men. Testing equivalence of the first path
coefficient resulted in 2 (3) = 13.33, 2 (3) = 6.49,
p = .01 (two-tailed); while testing equivalence of
the second path coefficient resulted in 2 (3) = 7.12,
2 (3) = .28, p = .60 (two-tailed). Thus, results indi-
cated that the coefficient for the path between length
of residency and social support for substance use
was significantly different for males and females. The
coefficient for the path between social support for
Davis and Jason
substance use and abstinence self-efficacy was not
significantly different.
DISCUSSION
Beyond exploring differences in individual char-
acteristics, results indicated several significant differ-
ences between females and males over the course
of recovery with respect to social process variables.
Analyses revealed that for both women and men,
longer lengths of residency in OH were significantly
related to decreased social support for alcohol/drug
Social Support and Self-Efficacy for Recovery
use. This finding is an important one given the impact
that such support has been found to have on drink-
ing behaviors (Longabaugh et al., 1993, 1995, 1998).
That this relationship was stronger for women than
men suggests the possibility that the process of recov-
ery and the impact of variables such as social support
may differ for women and men.
With respect to the development of abstinence
self-efficacy, analyses of the entire sample revealed
a significant and positive direct effect of residency
in OH on abstinence self-efficacy. However, in com-
paring the impact of residency in OH on abstinence
self-efficacy for women and men independently, the
relation remained significant and positive for men,
but for women this direct effect was not significant.
Despite the fact that residency had a stronger direct
impact on mens abstinence self-efficacy than it did
on womens, there were no sex differences with re-
spect to amounts of abstinence self-efficacy in gen-
eral. Notably, both women and men reported high
levels of confidence that they could remain absti-
nent in the face of intra- and interpersonal high-
risk relapse precipitants. Because prior research has
demonstrated that abstinence self-efficacy is predic-
tive of posttreatment drinking outcomes (Greenfield
et al., 2000) and relates to more successful abstin-
ence and coping activities during recovery main-
tenance (DiClemente, 1986; Marlatt & Gordon,
1985), the high levels of abstinence self-efficacy re-
ported by the present sample represent an impor-
tant finding. Additionally, considering that research
by Greenfield and her colleagues (2000) has shown
that individuals having overall SCQ-39 scores greater
than 45 had better drinking outcomes than those
scoring less than or equal to 45, it is reasonable to
conjecture that the high average score of 78 for this
sample represents an index of superior projected suc-
cess in maintaining longer-term abstinence. It also
supports the premise that one of the potential ben-
efits of residency in OH is the provision of an en-
vironment to gain the skills and confidence needed
to cope more effectively with stressors that often
prompt relapse.
Because women and men had similar levels of
self-efficacy, the differing impact of length of resi-
dency suggests that something other than mere du-
ration of residing in an OH must influence womens
sense of confidence in remaining abstinent. Analyses
of the mediational model suggest one possible expla-
nation for this difference. Studies of social support
have consistently shown that the strengths of social
contacts shared with individuals can have a protec-
271
tive and health-enhancing influence (Cassel, 1974;
Levine & Perkins, 1987; Orford, 1992) and that social
support that promotes healthy behaviors is related
to more positive psychological functioning (Sarason,
1974). It has also been demonstrated that social
resources, including social support, work in conjunc-
tion with personal resources to buffer the negative
impact of adverse life events and stress (Hobfoll,
1998; Holahan & Moos, 1991). Research conducted
by Longabaugh and his colleagues (1993, 1995, 1998)
in the area of substance use and recovery, supports
both the direct positive effects of investment in
networks that are supportive of abstinence versus
substance involvement, as well as the buffering ef-
fect of involving individuals with others who are sup-
portive of abstinence when their networks are gener-
ally supportive of substance use (Longabaugh et al.,
1998).
The mediational model proposed in the present
study emphasized the direct effects of social sup-
port, although this does not preclude the possibil-
ity that individuals support networks serve buffering
functions as well. Path analyses results for the total
sample revealed that length of residency was highly
and negatively related to social support for substance
use, and social support for substance use was in turn
significantly and inversely related to abstinence self-
efficacy. In the mediational model, social support
fully mediated the link between length of time re-
siding in OH and abstinence self-efficacy. However,
although the overall model fit was acceptable, the
predictor explained only a modest proportion of the
variance in social support for alcohol/drug use (R2 =
.11) and abstinence self-efficacy (R2 = .15).
In general, these results suggest that the pro-
cess of gaining self-efficacy to remain abstinent is dis-
tinct for women and men, and that social support
may play a different role in womens recovery than
it does in mens. Specifically, the results indicate that
the transformation of social networks to being less
supportive of drinking/drug use has a significant and
positive impact on womens abstinence self-efficacy
during the course of recovery, whereas social support
may play a more minor role in shaping mens ab-
stinence self-efficacy. This finding is consistent with
previous research that has demonstrated that in com-
parison with men, womens drinking and psycholog-
ical functioning are more responsive to social envi-
ronmental influences (e.g., Cronkite & Moos, 1984;
Kessler & McLeod, 1984; Moos, Finney, & Cronkite,
1990; Skaff et al., 1999). However, whereas previ-
ous research has often tended to report findings that
272
emphasize the vulnerability of women to the negative
influences of support networks and the deleterious
association between social-network-related stressors
and psychological distress for women (Kessler &
McLeod), this studys results highlight the benefits
women may reap from these relations and the im-
portance of examining the positive aspects as well
(Skaff et al., 1999).
As the results of Skaff et al.s (1999) year-long
study of womens and mens vulnerabilities to prob-
lem drinking and depression indicate, the differen-
tial impact of support resources and stressors upon
women and men is complex. The present results
support the need to devote greater attention to ex-
ploring the complex social aspects and dynamic pro-
cesses of substance use and recovery for women and
men, as well as individual characteristics and out-
comes. As noted, substance abuse and addiction are
the result of an interaction of a variety of individ-
ual, social, and environmental factors. Thus, it is es-
sential to expand our inquiries to examine multiple
interacting intra-, inter-, and extra-personal factors,
and how these impact the success of treatment and
longer-term recovery.
Limitations, Lingering Questions,
and Directions for Future Research
Analyses concerning characteristics of the so-
cial support networks of the women and men in the
present sample revealed that they were fairly sim-
ilar to each other, with the exception that women
reported that the majority of their networks are fe-
male, while men reported that the majority of their
networks are male. Thus, it appears that the men
and women in this sample are more comparable in
their engagement in support networks than is typ-
ically reported (e.g., see Leavy, 1983; Wills, 1985).
Although, the small N may account for some of
the non-significant findings in these and the descrip-
tive comparisons, as well as in the modeling, it may be
that the experience of living in an OH promotes these
values independent of gender, or it is possible that
these men and women are more similar (e.g., the men
more social-network-support oriented) when seek-
ing residency in an OH. Though this study did not
provide an opportunity to explore these alternatives
directly, it would be important to distinguish as it
speaks to the ability to generalize these results and
to whether OH is better suited for some individu-
als (e.g., those who are more support-oriented) or
Davis and Jason
is equally effective in promoting such values in all
persons.
Additionally, it is possible that the women and
men in this study may somehow differ from the gen-
eral population of individuals attempting to recover
from substance abuse problems in terms of other
qualities (e.g., motivation) that may impact their
recovery processes. Although the sample reported
chronic histories of abusing multiple substances and
generally shares many characteristics typically re-
ported in the treatment research literature, until fur-
ther studies are conducted with diverse recovery
populations one need exercise caution in general-
izing these results to all substance abusers seeking
treatment.
Given the results of this study, it would be
worthwhile to further examine whether and by what
processes residency in OH actively shapes women
and mens social support networks. For example, is
the high proportion of friends and abstinent individ-
uals composing this samples networks a reflection of
merely residing in a recovery home or is it individu-
als active attempts to restructure their networks so
as to be more supportive of their recovery? Given
that a common advisement to new members enter-
ing recovery programs is to break associations that
may promote relapse, even if that entails a separation
from family and former friends (Nowinski, Baker, &
Carroll, 1995), it is conceivable that individuals play
a pro-active role in transforming their support net-
works during the recovery processparticularly if
prior network members use alcohol or drugs.
Additionally, whereas previous studies (Ohanne-
ssian & Hesselbrock, 1993; Rice & Longabaugh,
1996; Robles et al., 1998; Rubin et al., 1996) have
tended to report on perceived social support (PSS),
this study measured the composition of individuals
with whom participants reported spending the great-
est time over the past 6 months (i.e., those persons
who are available as possible providers of perceived
support). This distinctionbetween availability of
social support and its adequacy as perceived by the
recipientis an important one (Cohen & Wills,
1985) and research needs to examine both objective
and subjective factors, perceived and actual social
resources, in order to distinguish between them
and discern the potentially differing impact of these
factors upon individuals (Hobfoll, 1998). Unfor-
tunately, neither this study nor the studies cited
previously provide an opportunity to investigate
the relationship between these various indices of
support. It would be beneficial for studies in the
Social Support and Self-Efficacy for Recovery
future to elaborate upon this notion and explore
the conceivably divergent impact of perceived and
actual support on recovery. Lastly, despite the poor
ability of the IPAs index to measure it, the concept
of investment in support networks is worthy of
continued investigation. The creation of a reliable
assessment instrument would allow for further
examination of this potentially important theoretical
construct and be of benefit to the field.
REFERENCES
Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and
interpreting interactions. Newbury Park, CA: Sage.
Annis, H. M., & Davis, C. S. (1991). Relapse prevention. Alcohol
Health and Research World, 15, 191215.
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator
variable distinction in social psychological research: Concep-
tual, strategic, and statistical considerations. Journal of Per-
sonality and Social Psychology, 51, 11731182.
Beattie, M., & Longabaugh, R. (1997). Interpersonal factors and
posttreatment drinking and subjective well-being. Addiction,
92(11), 15071521.
Beattie, M., Longabaugh, R., Elliott, G., Stout, R. L., Fava, J.,
& Noel, N. E. (1993). Effects of the social environment on
alcohol involvement and subjective well-being prior to al-
coholism treatment. Journal of Studies on Alcohol, 54, 283
296.
Beattie, M., Longabaugh, R., & Fava, J. (1992). Assessment of
alcohol-related workplace activities: Development and test-
ing of Your Workplace. Journal of Studies on Alcohol, 53,
469475.
Bentler, P. M., & Bonett, D. A. (1980). Significance tests and good-
ness of fit in the analysis of covariance structures. Psycholog-
ical Bulletin, 88, 588606.
Blumenthal, S. J. (1998). Women and substance abuse: A New
national focus. Drug addiction research and the health of
women (pp. 1332). National Institute on Drug Abuse: NIH
Publication.
Bollen, K. A. (1989). Structural equations with latent variables.
New York: Wiley.
Byrne, B. M. (1994). Structural equation modeling with EQS and
EQS/Windows: Basic concepts, applications, and program-
ming. Thousand Oaks, CA: Sage.
Cassel, J. (1974). An epidemiological perspective on psychoso-
cial factors on disease etiology. American Journal of Public
Health, 64, 10401043.
Clifford, P. R., & Longabaugh, R. (1991). Manual for the admin-
istration of the Important People and Activities instrument:
Adapted for use by Project MATCH. Unpublished document.
Center for Alcohol and Addiction Studies, Brown University:
Providence, RI.
Cohen, J., & Cohen, P. (1983). Applied multiple regres-
sion/correlation for the behavioral sciences (2nd ed.).
Hillsdale, NJ: Erlbaum.
Cohen, S., & Wills, T. (1985). Stress, social support and the buffer-
ing hypothesis. Psychological Bulletin, 98, 310357.
Cronkite, R. C., & Moos, R. H. (1984). Sex and marital status in
relation to the treatment and outcome of alcoholic patients.
Sex, Roles, 11, 93112.
Del Boca, F. K., McRee, B., & Babor, T. F. (1995). Reliability in
Project MATCH: A preliminary report on the cross-site relia-
bility study. Unpublished manuscript. University of Connecti-
cut Health Center: Connecticut.
273
DiClemente, C. C. (1986). Self-efficacy and the addictive behav-
iors. Journal of Social and Clinical Psychology, 4(3), 302315.
DiClemente, C. C., Carbonari, J. P., Montgomery, R. P. G., &
Hughes, S. O. (1994). The alcohol abstinence self-efficacy
scale. Journal of Studies on Alcohol, 55, 141148.
DiClemente, C. C., Fairhurst, S. K., & Piotrowski, N. A. (1995).
Self-efficacy and addictive behaviors. In J. E. Maddux (Ed.),
Self-efficacy, adaptation, and adjustment: Theory, research,
and application (pp. 109141). New York: Plenum.
Dvorchak, P. A., Grams, G., Tate, L., & Jason, L. A. (1995). Preg-
nant and postpartum women in recovery: Barriers to treat-
ment and the role of Oxford House in the continuation of
care. Alcoholism Treatment Quarterly, 13, 97107.
Fields, R. (1998). Drugs in perspective (3rd ed.). Boston, MA:
McGraw Hill.
Gomberg, E. S. L. (1999). Women. In B. S. McCrady
& E. E. Epstein (Eds.), Addictions: A sourcebook for
professionals (pp. 527541). New York: Oxford University
Press.
Greenfield, S. F., Hufford, M. R., Vagge, L. M., Muenz, L. R.
Costello, M. E., & Weiss, R. D. (2000). The relationship of
self-efficacy expectancies to relapse among alcohol dependent
men and women: A prospective study. Journal of Studies on
Alcohol, 61, 345351.
Hobfoll, S. E. (1998). Stress, culture, and community: The psychol-
ogy and philosophy of stress. New York: Plenum.
Holahan, C. J., & Moos, R. H. (1991). Life stressors, personal and
social resources and depression: A four-year structural model.
Journal of Abnormal Psychology, 100, 3138.
Humphreys, K., Mankowski, E. S., Moos, R. H., & Finney, J. W.
(1999). Do enhanced friendship networks and active coping
mediate the effect of self-help groups on substance abuse?
Annals of Behavioral Medicine, 21, 5460.
Jason, L. A., Davis, M. I., Ferrari, J. R., and Bishop, P. D. (2001).
Oxford House: A review of research and implications for sub-
stance abuse recovery and community research. Journal of
Drug Education, 31, 127.
Jason, L. A., & Kobayashi, R. B. (1995). Community building: Our
next frontier. Journal of Primary Prevention, 15, 195208.
Joreskog, K. G., & Sorbom, D. (1996). LISREL 8: Users reference
guide. Chicago, IL: Scientific Software International.
Julien, R. M. (1985). A primer of drug action. New York: W. H.
Freeman.
Kaniasty, K., & Norris, F. H. (2001). Social support dynamics in
adjustment to disasters. In B. R. Sarason & S. Duck (Eds.),
Personal relationships: Implications for clinical and commu-
nity psychology (pp. 201224). New York: Wiley.
Kessler, R. C., & McLeod, G. W. (1984). Sex differences in vul-
nerability to undersirable life events. American Sociological
Review, 49, 620631.
Kline, R. B. (1998). Principles and practice of structural equation
modeling. New York: Guilford.
Leavy, R. (1983). Social support and psychological disorder: A re-
view. Journal of Community Psychology, 11, 321.
Leshner, A. I. (1998a). Foreword pp. iiiiv, and pp. 34, Drug Ad-
diction Research and the Health of Women, Executive Sum-
mary. National Institute on Drug Abuse; NIH Publication No.
984289.
Leshner, A. I. (1998b). Directors Column: Gender matters in drug
abuse research. NIDA Notes, 13(4), 34. National Institute on
Drug Abuse; NIH Publication No. 983478.
Levine, M., & Perkins, D. V. (1987). Principles of community
psychology: Perspectives and applications. New York: Oxford
University Press.
Longabaugh, R., Beattie, M., Noel, N., Stout, R., & Malloy, P.
(1993). The effect of social investment on treatment outcome.
Journal of Studies on Alcohol, 54, 465478.
Longabaugh, R., Wirtz, P., Beattie, M., Noel, N., & Stout, R.
(1995). Matching treatment focus to patient social investment
274
and support: 18-month follow-up results. Journal of Consult-
ing and Clinical Psychology, 63, 296307.
Longabaugh, R., Wirtz, P. W., Zweben, A., & Stout, R. (1998).
Network support for drinking, Alcoholics Anonymous, and
long-term matching effects. Addiction, 93, 13131333.
Mactas, D. J. (1998). Treatment of women with substance use
problems. Drug Addiction Research and the Health of Women
(pp. 565571). National Institute on Drug Abuse: NIH
Publication.
Marlatt, G. A., & Gordon, J. R. (Eds.). (1985). Relapse prevention:
Maintenance strategies in the treatment of addictive behaviors.
New York: Guilford.
McCrady, B. S., & Raytek, H. (1993). Women and substance
abuse: Treatment modalities and outcomes. In E. S. L.
Gomberg & T. D. Nirenberg (Eds.), Women and substance
abuse (pp. 314338). Norwood, NJ: Ablex.
Miller, P. J., Ross, R., Emmerson, R., & Todt, E. H. (1989). Self-
efficacy in alcoholism: Clinical validation of the Situational
Confidence Questionnaire. Addictive Behaviors, 14, 217224.
Mohr, C. D., Averna, S., Kenny, D. A., & Del Boca, F. K. (2001).
Getting by (or Getting High) with a little help from my
friends: An examination of adult alcoholics friendships. Jour-
nal of Studies on Alcohol, 62, 637646
Moos, R. H., Finney, J., & Cronkite, R. C. (1990). Alcoholism
treatment: Context, process, and outcome. New York: Oxford
University Press.
Morganstern, J., Labouvie, E., McCrady, B. S., Kahler, C. W., &
Frey, R. M. (1997). Affiliation with Alcoholics Anonymous
after treatment: A study of its therapeutic effects and mech-
anisms of action. Journal of Clinical and Consulting Psychol-
ogy, 65, 768777.
National Institute on Drug Abuse. (1997). Gender affects rela-
tionship between drug abuse and psychiatric disorders. NIDA
Notes, 12(4).
National Institute on Drug Abuse. (1999). Advances in re-
search on womens health and gender differences. In
Womens health and gender differences [On-line]. Available:
http://165.112.78.61/WHGD/WHGDHome.html
National Institute on Drug Abuse & National Institute on
Alcohol Abuse and Alcoholism. (1998). Chapter 1: Ex-
ecutive summary. In The economic cost of alcohol and
drug abuse in the United States1992 [On-line]. Available:
http://www.nida.nih.gov/EconomicCosts/Index.html
Davis and Jason
Nowinski, J., Baker, S., & Carroll, K. (1995). Twelve step facili-
tation therapy manual. Project MATCH Monograph Series,
Vol. 1. National Institute on Alcohol Abuse and Alcoholism;
NIH Publication No. 94-3722.
Ohannessian, C. M., & Hesselbrock, V. M. (1993). The influence
of perceived social support on the relationship between family
history of alcoholism and drinking behaviors. Addiction, 88,
16511658.
Orford, J. (1992). Community psychology theory and practice.
Chichester, England: Wiley.
Rice, C., & Longabaugh, R. (1996). Measuring general social
support in alcoholic patients: Short forms for perceived so-
cial support. Psychology of Addictive Behaviors, 10(2), 104
114.
Rice, C., Longabaugh, R., & Stout, R. (1997). A comparison
sample validation of Your workplace: An instrument to
measure perceived alcohol support and consequences from
the work environment. Addictive Behaviors, 22(5), 711
722.
Robles, R. R., Marrero, C. A., Matos, T. D., Colon, H. M., Cancel,
L. I., & Reyes, J. C. (1998). Social and behavioral conse-
quences of chemical dependence (pp. 355364). Drug Addic-
tion Research and the Health of Women. National Institute on
Drug Abuse; NIH Publication.
Rubin, A., Stout, R. L., & Longabaugh, R. (1996). Gender differ-
ences in relapse situations. Addiction, 91 (Suppl.), S111S120.
Sarason, S. B. (1974). The psychological sense of community:
Prospects for a community psychology. San Francisco: Jossey
Bass.
Skaff, M. M., Finney, J. W., & Moos, R. H. (1999). Gender dif-
ferences in problem drinking and depression: Different vul-
nerabilities? American Journal of Community Psychology,
27(1), 2554.
Substance Abuse and Mental Health Services Administra-
tion. (2000). National Household Survey on Drug Abuse.
SAMHSA Office of Applied Studies: NHSDA Publications.
Wallen, J. (1998). Need for services research on treatment for drug
abuse in women (pp. 229236). Drug Addiction Research and
the Health of Women. National Institute on Drug Abuse; NIH
Publication.
Wills, T. (1985). Supportive functions of interpersonal relation-
ships. In S. Cohen & S. Syme (Eds.), Social support and health
(pp. 6182). New York: Academic Press.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.