The Protective Influence of Interpersonal Social Support and Peer-Led Recovery Support Groups Among Trauma-Exposed Parents with Substance Use

Background and Purpose: The co-occurrence of parental substance use and PTSD can negatively impact the overall functioning and well-being of an entire family unit in multiple psychosocial domains. Different forms of interpersonal social support, including involvement with peer-led recovery support groups, have been linked to attenuated substance use and greater psychosocial well-being among adults with unresolved trauma. Our study examines how different forms of interpersonal social support and engagement with peer-led recovery support groups influence multiple domains of psychosocial well-being and recent substance use patterns among parents with PTSD.

Method: We analyze a sample of parents (N=841; 51% women) from a midwestern state who have PTSD and engage in substance use. All parents indicated they had a child under 18 years of age and completed intake surveys required by the Government Performance and Results Act (GPRA; 2022-2024). Multiple linear regression was used to explore how different forms of interpersonal social support (partner status, recognition of an unsupportive social environment, supportive interpersonal interactions, and relationship satisfaction ratings), and engagement with peer-led recovery support groups influence parents’ psychosocial outcomes in a variety of domains. Psychosocial outcomes included mental health (via symptoms of depression, anxiety, general distress) quality of life, violent behaviors, criminal legal system involvement, housing status, and recent substance use. Demographics were analyzed as covariates (age, annual income, health insurance status).

Results: Relationship satisfaction (RS) and engagement with peer-led recovery support groups (P-L RSG) had a significant influence on almost all outcome measures. Parents with higher ratings of relationship satisfaction were less depressed (b=3.29, p≤.001), anxious (b=1.72, p≤.001), distressed (b=.37, p≤.001), violent (b=.56, p≤.001), less likely to engage in recent substance use (b=.56, p≤.001), reported a higher quality of life (b=-.31, p≤.001), and were housed (b=-.05, p=.03). Parents who attended peer-led recovery support groups reported similar outcomes regarding depression (b=-2.98, p≤.001), anxiety (b=-2.51, p≤.001), general distress (b=-.30, p≤.001), violent behaviors (b=-.74, p=.03), recent substance use (b=-.74, p=.03) and quality of life (b=.33, p= p≤.001). An unsupportive social environment was related to criminal legal system involvement (b=.15, p=.003). Socioeconomic characteristics (lack of health insurance, less income) were related to being unhoused, criminal legal system involvement, and recent substance use.

Implications and Conclusions: Results provide an in-depth analysis about the beneficial aspects of general and recovery-oriented forms of social support for multiple domains of psychosocial wellbeing among parents with PTSD and substance use Implications extend beyond the recovery of parents’, as these domains impact the health, safety, and overall well-being of the family, such as housing and reduced risk of child maltreatment. Social support, especially satisfying relationships and engagement with peer-led recovery support groups can help buffer against the consequences of substance use that overlaps with PTSD. Helping parents connect with different forms of concrete and interpersonal social supports and encouraging attendance at peer-led recovery support groups may be benefits of trauma-informed, family-oriented treatment approaches for co-occurring PTSD and substance use. We encourage further studies evaluating these approaches.