The results from this study supported a bi-directional theory of addiction for a sample of Black, inner-city, working-class, male substance abusers. Using structural equations modeling, at 6 months posttreatment we found that (a) the reciprocal effect emotional and psychological distress and substance relapse had on one another existed within the context of their bi-directional relationship with social instability, and (b) effective coping skills and resources moderated the negative effects that emotional and psychological distress, social structure, and substance relapse had on one another. These findings led us to three suggestions treatment professionals can use to counteract recidivism.
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