Systemic-relational factors associated with addiction severity and frequency of formal treatment of alcoholics

This is an exploratory study of the association of the interpersonal factors of (a) relationship quality and (b) relationship quantity, and (a) the severity of addiction and (b) the frequency of formal treatment of alcoholics. The study also explored differences among alcoholics, poly-drug users, and those with a dual diagnosis (alcoholism plus another mental disorder) in association with relationship quality and quantity, the frequency of formal treatment, and the severity of addiction. Eighty volunteer subjects were used for this study while they were receiving treatment for substance abuse at a Veterans' Administration Medical Center (VAMC) in St. Louis. The Addiction Severity Index (ASI), developed by McLellan, Luborsky, Woody, and O'Brien (1980), was used to determine the severity of the addiction. Relationship quality was determined by using the Bell Object Relations Inventory (BORI), developed by Bell (1985). Relationship quantity was determined by identifying the number of "heavy drinkers" in one's social network using the Modified Social Network Inventory (MSNI), based upon the Social Network Inventory (SNI) developed by Wesolowski (1985). Subjects were placed in an alcoholic subgroup based upon their treatment diagnoses at the VAMC. A multivariate multiple regression was performed to determine whether relationship quality and relationship quantity were statistically significantly related to the frequency of formal treatment and the severity of addiction. The hypothesis was supported, as the BORI subscale of egocentricity was significantly associated with the severity of addiction. All of the BORI subscale for this sample were elevated above the cutoff for impairment. A multiple analysis of variance (MANOVA) was conducted to determine whether there were statistically significant differences among alcoholics, poly-drug users, and those with a dual diagnosis in relation to the frequency of formal treatment, the severity of addiction, relationship quality, and relationship quantity. Significant differences among the subgroups were found with regard to the rate of formal treatment, the severity of drug addiction, and the BORI subscale of "alienation."...