Author ORCID Identifier

https://orcid.org/0000-0002-0874-4616

Defense Date

2022

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Danielle Dick

Second Advisor

Wendy Kliewer

Third Advisor

Fazil Aliev

Fourth Advisor

Vivia McCutcheon

Fifth Advisor

Thomas Bannard

Sixth Advisor

Mary Loos & Dace Svikis

Abstract

Alcohol and drug use disorders are associated with significant cost to individuals, families, and society.Approximately 40-75% of affected individuals remit from alcohol use disorders (AUD). Although the development of AUD is well studied, recovery from AUD and factors that contribute to recovery are not as well characterized. With the definition of recovery evolving towards a process rather than an outcome, there is a need to better understand psychosocial functioning and quality of life among individuals at different points in their recovery journeys. Concurrently, additional research is needed to understand the interplay between sources of recovery capital, individual differences in risk factors for substance use, genetic influences, and psychosocial functioning and quality of life. To address that gap, we used a subsample of young adults who met criteria for AUD in their lifetime but later remitted (N = 323), derived from the Collaborative Study on the Genetics of Alcoholism (COGA) Prospective Study, to investigate profiles of functioning related to quality of life at first remitted assessment. We also examined recovery capital, epidemiological risk factors for substance use, and genome-wide polygenic risk scores as predictors of these profiles. Results suggested that a two-profile solution fit the data best, with 40% of participants categorized into the “infrequent alcohol use, good health” profile and 60% into the “frequent alcohol use, good to very good health” profile. These findings indicate heterogeneity in functioning related to quality of life among those in AUD remission. Importantly, however, individuals in the “frequent alcohol use, good to very good” profile relative to individuals in the “infrequent alcohol use, good health” profile may represent those individuals who matured out of AUD. Social support for recovery, lifetime maximum depressive and post-traumatic stress disorder symptoms, and lifetime exposure to sexual assaultive trauma were higher in the “infrequent alcohol use, good health” profile than in the “frequent alcohol use, good to very good health” profile, while affiliation with deviant peers during adolescence and sensation seeking was higher in the latter profile. When examining the joint influence of all predictors on assigned profile membership, none had a unique effect. None of our polygenic risk scores were associated with assigned profile membership. Our findings add to the body of literature suggesting thatheterogeneity in patterns of quality of life exists among those in AUD remission. Although none of our predictors had a unique effect on assigned profile membership when modeled simultaneously, findings suggest that mechanisms that underlie the development of AUD, such as comorbid internalizing symptoms and externalizing behaviors, may be important to consider with respect to quality of life in AUD remission. Moreover, findings from the present study can inform our understanding of recovery processes. The present findings underscore the importance of measuring individuals’ self-reported recovery status and/or recovery identity so as not to conflate recovery processes with maturing out of AUD.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

8-3-2022

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