A Mixed Methods Approach to How Reasons for Quitting Might Predict Recovery Outcomes Among Those in Recovery from Alcohol Use Disorder

Abstract

Recent work has characterized specific reasons for quitting alcohol use that are important to those who have received treatment for alcohol use disorder (AUD). However, the measurement of reasons for quitting is heterogeneous, which affects which reasons are reported and hampers the ability to determine which reasons are most influential in predicting recovery outcomes. The aims of this study were to 1) compare how scale and open-ended measures impacted specific reasons for quitting reported and 2) evaluate if reasons reported via a scale vs. open-ended questions differentially predicted recovery outcomes. I examined this across a six-month longitudinal sample of 203 individuals in recovery (Mean age=42.89, 52.2% male, 77.8% White) who have had treatment for AUD. Thematic coding following a directed content analysis approach identified nine themes of one’s “Top Three” reasons for quitting: health reasons, people focused reasons, legal concerns, does not fit lifestyle, financial/work reasons, religious reasons, avoid disapproval from others, fear of consequences, and hit rock bottom. There were significant differences in endorsement of themes across the two measures. Latent class analysis identified three groups with similar Top Three reasons; path analysis found that neither the latent classes based on the open-ended measure nor the scale-based measure of reasons predicted alcohol use recovery outcomes. However, avoid disapproval from others reasons reported via the scale had a small positive association with alcohol problems. This study was the first to directly compare the types, and predictive nature, of reasons reported via different measures, which identified the need for standardization in the measurement of this construct as the type of measure affected the reasons being reported. Future research should focus on developing a standardized scale informed by the types of reasons identified via open-ended questioning to most accurately capture themes of reasons. This study is a key early step in a program of research aimed at developing and testing interventions targeting reasons for quitting in order to improve recovery outcomes. Should this line of work be successful, it would contribute to research efforts to identify active components of successful recovery, which can then be leveraged to improve recovery outcomes.