In plain language
Research on addiction usually focuses on what goes wrong — symptoms, relapse, and mental illness. This study flipped the question: how much positive mental health do people in addiction treatment have, and does it grow during recovery? Using Corey Keyes’ framework, people can be classified as flourishing (high emotional, social, and psychological wellbeing), languishing (low wellbeing), or moderately mentally healthy. This was the first study to examine the prevalence of positive mental health, rather than mental illness, in a substance addiction context.
The researchers followed 794 people (79.5% male) attending residential drug and alcohol treatment run by The Australian Salvation Army, assessing them at treatment entry and at 3- and 12-month follow-ups. At entry, languishing was more common than in the general population — yet, strikingly, flourishing was also more common than community norms at every time point, and most participants had moderate mental health.
Mental health improved early in recovery and kept improving for people who stayed abstinent, while it declined slightly for those who returned to substance use. By 12 months, about two-thirds of abstinent participants were flourishing. Cross-lagged analyses showed that improvements in mental health followed reductions in substance use severity and cravings, not the other way around — suggesting better mental health is a consequence of recovery. The findings make the case that addiction treatment should track and promote wellbeing, not just symptom reduction.
Key findings
- At entry to residential treatment, 21.9% of participants were flourishing, 23.8% were languishing, and 54.3% had moderate mental health; languishing was more common than population estimates, but flourishing exceeded community norms at all time points.
- Categorical mental health improved significantly from baseline to 3-month and 12-month follow-ups (chi-square(2, N = 111) = 24.33, p < .001), with flourishing increasing and languishing decreasing over time.
- At every time point, abstinent participants were more likely to be flourishing (32.0%, 51.8%, and 65.9% at baseline, 3 and 12 months) than those still using substances (19.1%, 28.8%, 25.0%), and less likely to be languishing.
- A significant interaction between mental health and substance use status (F(2, 218) = 4.92, p < .01) showed both groups started at similar levels, but abstinent individuals gained substantially more mental health over time.
- Improvements in mental health occurred early in recovery: gains from baseline to 3 months were significant, with no further significant change between 3 and 12 months.
- Cross-lagged models supported the mental health as consequence model: reductions in alcohol and drug use severity and cravings predicted later increases in mental health, while mental health did not predict later substance use.
How to cite
APA
McGaffin, B. J., Deane, F. P., Kelly, P. J., & Ciarrochi, J. (2015). Flourishing, languishing and moderate mental health: Prevalence and change in mental health during recovery from drug and alcohol problems. Addiction Research & Theory, 23(5), 351-360. https://doi.org/10.3109/16066359.2015.1019346
BibTeX
@article{mcgaffin2015flourishing,
author = {McGaffin, Breanna J. and Deane, Frank P. and Kelly, Peter J. and Ciarrochi, Joseph},
title = {Flourishing, Languishing and Moderate Mental Health: Prevalence and Change in Mental Health During Recovery from Drug and Alcohol Problems},
journal = {Addiction Research \& Theory},
year = {2015},
volume = {23},
number = {5},
pages = {351--360},
doi = {10.3109/16066359.2015.1019346}
}
Related work
- All publications by Joseph Ciarrochi (searchable, with free PDFs)
- Process-Based Therapy & Idionomic Analysis
Author: Joseph Ciarrochi (ORCID 0000-0003-0471-8100). Free copy hosted with permission for scholarly use. Please cite the published version via the DOI above.