Enhancing alcohol use disorder recovery by capturing the dynamics of psychological well-being in daily life

Project Summary/Abstract In the alcohol field, the lack of consistent and robust assessment of psychological well-being (PWB) is problematic considering recent NIAAA recommendations that improvements in PWB should be recognized as important to the alcohol use disorder (AUD) recovery process, alongside drinking reductions.1–3 PWB, conceptualized as perceived enjoyment and fulfillment with life,4 is a critical element of health and functioning.5 Unfortunately, indices of PWB are seldom incorporated into primary clinical outcomes for AUD,2,6–8 despite clients having goals related to PWB such as returning to work, developing more meaningful relationships, and living more fulfilling lives.9,10 Research that does consider PWB-related outcomes varies considerably in how PWB is operationalized, ranging from a single positive marker (e.g., life satisfaction, self-esteem)11–13 to the absence of negative markers (e.g., mental health disorder symptoms).14 Yet, prominent positive psychological frameworks and measures contend that PWB (1) is multidimensional, consisting of Positive affect, Engagement, Relationships, Meaning, and Accomplishment (PERMA),15–17 and (2) changes dynamically over time in day-to-day life.18 To date, there has been no systematic effort to apply comprehensive and valid assessments of PWB in daily life, such as PERMA, among individuals in AUD recovery. Such an approach would help center the field on multidimensional assessment of PWB, thereby aligning PWB theory with daily- life measurement in addiction science. The proposed research will address the need to better understand and assess PWB in daily life during AUD recovery by combining baseline measures and ecological momentary assessments (EMA) of momentary PERMA (mPERMA), a comprehensive, validated, and theoretically-aligned measure of PWB in daily life from the positive psychology literature, among a community-based sample of adults in AUD recovery. First, this study will use multilevel modeling to test recovery duration, alcohol problem severity, and personal background characteristics (e.g., age, sex, race/ethnicity, sexual orientation, socioeconomic status) as baseline predictors of PWB level and variability in daily life as assessed by mPERMA (Aim 1). Second, group iterative multiple model estimation (GIMME) will be utilized to investigate group-, subgroup-, and individual-level temporal patterns of relationships among PWB dimensions and negative affect, craving, and alcohol use assessed via EMA in daily life (Aim 2). Study findings have the potential to provide a foundation for future research to assess PWB dynamics in daily life among individuals with AUD, and to inform novel personalized intervention efforts aimed at both improving PWB and curbing harmful alcohol use.