Dissertation
THE RELATIONSHIP BETWEEN ALCOHOL USE AND PSYCHOLOGICAL WELL-BEING OVER TIME AMONG INDIVIDUALS WITH SERIOUS MENTAL ILLNESS RECEIVING CONTINGENCY MANAGEMENT
Doctor of Philosophy (PhD), Washington State University
2026
Abstract
Alcohol use disorder (AUD) presents a pervasive and costly global public health challenge, particularly among populations with serious mental illness (SMI), yet treatment engagement remains low, and abstinence-centered recovery models often fail to reflect diverse recovery trajectories. The present study assessed whether contingency management (CM), an incentive-based behavioral intervention, was associated with longitudinal improvements in psychological well-being (positive affect, life satisfaction, meaning and purpose) among individuals with co-occurring AUD and SMI, and whether abstinence and reductions in alcohol use, measured longitudinally via urine ethyl glucuronide (uEtG), predicted such outcomes. A secondary aim explored whether relationships between psychological well-being and key social determinants of health (SDOH)—marital status, employment, neighborhood satisfaction, and instrumental social support—moderated the relationships between key clinical and demographic predictors—CM condition, sex at birth, SMI diagnosis, and recent heavy drinking during the last week of induction—and psychological well-being. Linear mixed models were used to assess these longitudinal associations during a 16-week CM intervention and a one-year follow-up period. Results suggested that abstinence and uEtG-defined alcohol use were not significantly associated with longitudinal psychological well-being during the intervention or follow-up phases. Instrumental social support was positively associated with all well-being outcomes during at least one phase (all p ≤ .045), and significant time-by-instrumental social support interactions were found for meaning and purpose during the intervention period and for positive affect during follow-up (all p ≤ .031). Marital status and neighborhood satisfaction were significantly associated with life satisfaction during follow-up (all p ≤ .032). Across models, p-values for fixed effects ranged from <.001 to .992. Limitations and implications for future research are discussed.
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Details
- Title
- THE RELATIONSHIP BETWEEN ALCOHOL USE AND PSYCHOLOGICAL WELL-BEING OVER TIME AMONG INDIVIDUALS WITH SERIOUS MENTAL ILLNESS RECEIVING CONTINGENCY MANAGEMENT
- Creators
- Michael Williams
- Contributors
- Michael G McDonell (Advisor)Yoshie Sano (Committee Member)Jennifer Duckworth (Committee Member)Douglas Weeks (Committee Member)
- Awarding Institution
- Washington State University
- Academic Unit
- Department of Human Development
- Theses and Dissertations
- Doctor of Philosophy (PhD), Washington State University
- Number of pages
- 111
- Identifiers
- 99901394104401842
- Language
- English
- Resource Type
- Dissertation