Graduation Year

2026

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Psychology

Major Professor

Robert Schlauch, Ph.D.

Committee Member

Jack Darkes, Ph.D.

Committee Member

Juliana French, Ph.D.

Committee Member

Eunsook Kim, Ph.D.

Committee Member

Jamie Spiegel, Ph.D.

Keywords

dynamic structural equation modeling, interpersonal drinking consequences, loneliness, mechanisms of change, recovery, therapeutic alliance

Abstract

Drinking is intertwined with social processes, including social support and group belongingness. Although drinking can transiently enhance social functioning, escalating to heavy use can be detrimental to it. It is well-known that excessive drinking and social dysfunction exacerbate each other over time, and it follows that social support and belonging are key mechanisms of addiction recovery. Yet, less is known about how changes in belongingness throughout treatment dynamically affect drinking outcomes, and even less is known about how drinking outcomes and other social processes (e.g., therapeutic alliance, interpersonal drinking consequences) dynamically influence belongingness. The current project (N = 210) studied belongingness and drinking outcomes over a 12-session outpatient AUD intervention. Residual dynamic structural equation models examined 1) how de-trended session-to-session fluctuations in belongingness and drinking outcomes were bidirectionally related and 2) how similar fluctuations in client-reported therapeutic alliance and interpersonal drinking consequences were bidirectionally related with belongingness. Results indicated that more days abstinent and less high intensity drinking predicted belongingness at the following session (within-person). Further, reduced interpersonal drinking consequences were concurrently associated with belongingness (within-person). Exploratory analyses highlighted a within-person indirect effects pathway, whereby the effects of all drinking outcomes on thwarted belongingness were fully explained by interpersonal drinking consequences. Finally, individuals with steeper improvements in the therapeutic alliance during treatment also exhibited steeper improvements in belongingness (between-person). Improved belonging largely manifested as an outcome of treatment, rather than a potential mechanism of change. Significance of the findings are discussed in the context of treatment and relational processes. Implications for AUD recovery are explored.

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