Social support and cognitive impairment in clients receiving treatment for alcohol- and drug-use disorders: A replication study

Objective: The influence that social network members exert on the drinking behaviors of alcohol-dependent individuals may represent a behavioral change process that is sensitive to co-occurring cognitive impairment and operates outside treatment to promote or impede outcomes. This study was aimed at extending earlier research support for this hypothesis by assessing impairment in memory as well as executive functions in a more heterogeneous population with alcohol- and/or drug-use disorders. Method: Latent class analysis was used as a person-centered approach to characterize the nature and extent of social support for abstinence from alcohol and drug use in 122 men and women entering treatment for substance-use disorders. Substance use, executive dysfunction, and memory impairments were compared across latent classes at four points during the first year after treatment entry. The interrelationship of impairment and social support on treatment outcomes was also examined. Results: Three independent social support classes - (1) Frequent Positive Support, (2) Limited Positive Support, and (3) Negative Support - were identified. The Frequent Positive Support class demonstrated the most frequent substance use and greatest executive impairment at treatment entry but - by the end of treatment - showed pronounced improvements in both. In addition, less recovery of executive function by the end of treatment predicted better 12-month substance-use outcomes in the Frequent Positive Support class, whereas it predicted poorer outcomes in the Negative Support class. Conclusions: The results offer further evidence for the heightened importance of informal social network processes in the treatment outcomes of persons with severe and ongoing deficits in executive functioning.