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. 2011 Sep;25(3):462-73.
doi: 10.1037/a0022502.

Mental health, not social support, mediates the forgiveness-alcohol outcome relationship

Jon R Webb  1 , Elizabeth A R Robinson, Kirk J Brower
Affiliations

Mental health, not social support, mediates the forgiveness-alcohol outcome relationship

Jon R Webb et al. Psychol Addict Behav. 2011 Sep.

Abstract

Religiousness and spirituality are important to most Americans, and evidence suggests that they may contribute to both addiction and recovery. Forgiveness is a specific dimension of religiousness and spirituality that may enhance recovery, but the mechanism(s) through which it operates is unknown. We hypothesized that higher levels of forgiveness would be associated with higher levels of mental health and social support, which, in turn, would be associated with improved alcohol-related outcomes. Baseline and 6-month longitudinal data from a sample of 149 individuals with alcohol use disorders seeking outpatient substance abuse treatment were analyzed through multiple-mediation statistical techniques. While previous research has shown direct associations among forgiveness, alcohol-related outcomes, mental health, and social support, this study found that the direct associations between forgiveness and alcohol-related outcomes were no longer significant when mental health and social support were analyzed as mediator variables. At baseline, for each alcohol-related outcome measured (alcohol-related problems, percent heavy drinking days, percent days abstinent, and drinks per drinking day), mental health individually played a role in the relationship with both forgiveness of self and forgiveness of others, fully mediating or operating through an indirect-only pathway. For alcohol-related problems only, mental health fully mediated the relationship with forgiveness of self at follow-up and operated through an indirect-only pathway with forgiveness of others longitudinally. Social support and feeling forgiven by God were nonsignificant variables at baseline, follow-up, and longitudinally.

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Figures

Figure 1
Figure 1. Illustration of an Indirect Effects Model
c = Total Effect (Forgiveness affects Alcohol-Related Outcomes) ab = Total Indirect Effect (Forgiveness affects Alcohol-Related Outcomes through Psychiatric Distress and Social Support) a1b1 = Specific Indirect Effect: Forgiveness affects Alcohol-Related Outcomes through Psychiatric Distress a2b2 = Specific Indirect Effect: Forgiveness affects Alcohol-Related Outcomes through Social Support c′ = Direct Effect (Forgiveness affects Alcohol-Related Outcomes after accounting for a Total Indirect Effect and/or a Specific Indirect Effect) Adapted from Preacher and Hayes (2008a)
Figure 2
Figure 2. Baseline Indirect Effects Model: Forgiveness and Alcohol Problems
* p ≤ .05; ** p ≤ .01; *** p ≤ .001; **** p ≤ .0001
Figure 3
Figure 3. Follow-Up Indirect Effects Model: Forgiveness and Alcohol Problems
* p ≤ .05; ** p ≤ .01; *** p ≤ .001; **** p ≤ .0001
Figure 4
Figure 4. Baseline to Follow-Up Indirect Effects Model: Forgiveness and Alcohol Problems
* p ≤ .05; ** p ≤ .01; *** p ≤ .001; **** p ≤ .0001
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