Network Support treatment for alcohol dependence: Gender differences in treatment mechanisms and outcomes

Abstract

Objective Network Support treatment was intended to help alcohol dependent patients alter their close social support networks to be more supportive of sobriety and less supportive of drinking. The purpose of the present study was to examine the differential influences of Network Support treatment on men and women. Methods Alcohol dependent men (n=122) and women (n=88) recruited from the community were randomly assigned to 1 of 3 12-week outpatient treatment conditions: Network Support (NS), Network Support + Contingency Management (NS+CM), or case management (CaseM; a control condition). Patients were then followed for a period of 27 months. Multilevel modeling was used to evaluate Sex X Treatment interaction effects on outcome variables over time. Tests of mediation were used to determine what factors might account for differential effectiveness for men or women in the NS conditions. Results Analyses of drinking-related outcome measures over the 27 months indicated that women fared less well overall, and particularly poorly in the Network Support conditions, relative to men. Tests of mediation indicated that self-efficacy change and change in the number of non-drinking close associates partially mediated the effect of NS treatments on outcome. Conclusions It was concluded that the NS conditions failed to alter women’s social networks, and may have had the effect of undermining women’s self-efficacy. Network Support treatment might be applicable for women and more effective generally if particular attention is paid to understanding preexisting social support networks.

Social Identities as Pathways into and out of Addiction

“…This echoes the notion of “disposable ties” found in the urban poor who rely on strangers rather than family or established social network to meet their immediate needs ( Desmond, 2012 ). Existing literature (e.g., Kelly et al, 2011 ; Litt et al, 2015 ) highlights the significantly lower relapse risk for those who have a strong recovery support network in place. The maintenance of recovery-oriented identities forged in TCs may foster engagements in such networks beyond treatment.…”

“…For example, the onset of problematic substance use may be associated with social isolation ( Chou et al, 2011 ) or with peer pressure and normative influences on behavior ( Bauman and Ennett, 1996 ; Ary et al, 1999 ). For individuals in addiction treatment, social network support for abstinence influences treatment outcomes ( Zywiak et al, 2009 ; Kelly et al, 2011 ; Litt et al, 2015 ). Furthermore, two of the three most common reasons for relapse into substance misuse after treatment are social: namely, interpersonal conflict and social pressure to use ( Hodgins et al, 1995 ; Zywiak et al, 2006 ).…”

Gender differences in cannabis use disorder treatment: Change readiness and taking steps predict worse cannabis outcomes for women

“…Evidence suggests differential substance use treatment outcomes by gender, with women often faring worse than men (DeVito, Babuscio, Nich, Ball, & Carroll, 2014; Litt, Kadden, & Tennen, 2015; McRae-Clark AL, 2015). Although men are more likely to be diagnosed with CUD, women may be more treatment resistant given their greater sensitivity, more rapid progression to disorder, and greater abuse potential.…”

Are there gender differences in locus of control specific to alcohol dependence?

“…In a recent study, men achieved improved outcomes for network support treatment for alcohol dependence compared with women (Litt et al . ). This may indicate that men generally have a higher external locus of control in relation to alcohol dependence than women.…”