Theses and Dissertations

Date of Award


Document Type


Degree Name

Doctor of Psychology (PhD)


College of Psychology

First Advisor

Christian DeLucia

Second Advisor

Edward Simco

Third Advisor

Brandon G. Bergman


12-step recovery, coping, mutual help, Narcotics Anonymous, recovery involvement, stress


Substance use disorders (SUDs) affect a significant portion of the population and are noteworthy public health concerns. Mutual help organizations (MHOs) such as Alcoholics Anonymous and Narcotics Anonymous are considered evidence-based practices for SUDs. Despite a growing body of research examining mechanisms of change in MHOs, relatively few investigations of 12-step organizations have been theory-driven. Theory-based models of recovery provide a more comprehensive view of the range of individual factors affecting individuals in recovery and how and why they might engage in recovery-related behaviors. Stress and coping theory fills a gap in explaining how improvements occur as a result of MHO recovery engagement from a bio-psycho-social perspective. Although some recovery program-related mechanisms of change in MHOs have proven to be important factors in promoting long-term recovery from SUDs, fewer studies have examined what factors may influence participation in recovery practices. Using a sample of community-based Narcotics Anonymous members from 26 U.S. states, the relationships between stress and engagement in various recovery practices are examined from the perspective of a psychobiological, SUD-specific stress and coping framework. It is hypothesized that the relationship between stress and recovery practice engagement is moderated by abstinence duration, such that individuals at lower levels of abstinence duration would have fewer coping resources to mitigate stress and therefore would evidence a greater association between stress and engagement in higher levels of recovery practices. Results indicated the stress-recovery practice involvement relationship was not moderated by abstinence duration, and stress was not significantly associated with any recovery practices. However, helpfulness of social support received from individuals in recovery, abstinence duration, neuroticism, and substance use severity all significantly predicted recovery practice involvement. Gaining additional understanding of mechanisms that influence recovery involvement will allow clinicians and researchers to enhance interventions and facilitate involvement in beneficial aspects of recovery programs.

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