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.

In this study, the role of positive and negative religious coping was evaluated for their interrelationship with demographic variables, religious variables, and the outcome of mental health distress. A sample of 253 United Methodist Church leaders from counties throughout the state of Mississippi completed a survey including measures for demographic characteristics, religious coping, general coping, and mental health distress. Through regression analysis and path analysis, the relationships among the variables were measured to determine the importance of religious coping strategies while controlling for demographic variables and general forms of coping. Through regression analysis, the subjective report of personal losses immediately after Hurricane Katrina, participation in religious activities, and involvement in recovery efforts significantly predicted the presence of mental health distress among United Methodist Church leaders in Mississippi. In particular, religious participation insulated against the presence of mental health distress while personal losses and recovery involvement promoted the likelihood of mental health distress. Positive forms of general coping as well as religious forms of coping provided no significant contribution to the presence or absence of mental health distress, but negative forms of general coping did predict higher levels of mental health distress. Among this religiously oriented sample, religious forms of coping was not significantly predictive of the presence of mental health distress after accounting for general forms of coping which suggested that religious coping may be indistinguishable from forms of coping that are more generalized in nature. Through path analysis, negative religious coping significantly influenced the increased presence of mental health distress but did not serve as a mediator between mental health distress and other religious and demographic variables. A surprising finding in this study was the important mediating role of recovery involvement between mental health distress and other factors including religious participation, religious salience, and status as an ordained minister. Additionally, at nearly three years after the storm, persons reporting to currently live in close proximity to the disaster and persons continuing to experience loss due to the disaster reported a higher prevalence of mental health distress. Implications for the current literature and the need for further research were discussed.