An alternative framework to investigating and understanding intraindividual processes in substance abuse recovery: an idiographic approach and demonstration.

Abstract

Sustained recovery from substance abuse is a dynamic intraindividual-level process. We argue that research on recovery process will benefit from a theoretical approach that captures both the dynamic and the idiographic nature of substance abuse recovery. In addition to setting out why we believe that research on recovery can benefit from such an approach, we provide a demonstration of idiographic within-individual analyses of between- and within-day associations among negative affect, substance use craving, and positive social experiences. The data used were drawn from 39 abstinent young adults in 12-step recovery from substance abuse (mean age = 22.9, females = 12). Participants provided an average of 26.7 days of daily diary data by end-of-day collections. Unified first-order structural equation models were fit individually to predict daily levels of craving and negative affect from the previous day's same two variables as well as from both the previous day's and the same day's positive social experiences. Model estimates demonstrated substantial interindividual heterogeneity in their day-to-day associations in both direction and magnitude, highlighting the importance of applying idiographic approach to understanding recovery. Cluster analyses were subsequently applied to individual model estimates to identify homogeneous subgroups that demonstrated similar day-to-day association patterns, revealing two distinct subgroups that appeared to manage daily abstinence through different mechanisms. The idiographic approach presented provides the potential value of framing recovery as an idiosyncratic dynamic process and provides targets for tailored and adaptive treatment and recovery supporting intervention in future design and evaluation.