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Managerial women : substance use, stress, support systems and instrumentality Cormier, Rachel Marguerite 1989

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MANAGERIAL WOMEN: SUBSTANCE USE, STRESS, SUPPORT SYSTEMS, AND INSTRUMENTALITY by RACHEL MARGUERITE CORMIER B.A., Simon Fraser University, 1986 LI.B., University of British Columbia, 1973 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE FACULTY OF GRADUATE STUDIES Department of Counselling Psychology We accept this thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA October 1989 © RACHEL MARGUERITE CORMIER, 1989 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of C o u n s e l l i n g P s y c h o l o g y The University of British Columbia Vancouver, Canada Date O c t o b e r , 1989 DE-6 (2/88) ABSTRACT This study is concerned wi th variables that might influence substance use by women in non-traditional manager ia l occupations; a group at r isk as a consequence of stressful and isolated work circumstances. The study examined the relationship between substance use and stress (daily hassles), perceived social support and work support, family history of alcohol abuse, friends' dr inking behaviour and sex-role style. The Substance Use and Significant Others Scale was developed to measure use of alcohol, prescription drugs, il legal drugs, nicotine, and food, as wel l as the alcohol-using history of the family of origin and the dr inking behaviour of current friends. The val idi ty of this instrument was supported through a pilot study involving 113 male clients and 61 female clients from a drug and alcohol out-patient counselling centre and from the A u r o r a Treatment Centre, and 59 female managers from non-traditional occupations. A one-way mult ivariate analysis of variance wi th the five substances, family history of alcohol use and friends' dr inking behaviour as dependent measures indicated a significant mult ivariate group effect. Post hoc analysis , using Scheffie's tests, comparing managers and female drug and alcohol clients, indicated significant group differences for the measures of alcohol, smoking, prescription drugs, il legal drugs, and family background of alcohol abuse. Comparison of the managers group wi th male drug and alcohol clients indicated group differences for the five substances, the family history, and for current friends' dr inking behaviour. Internal consistency analysis in the pilot study led to the removal of the i tem on eating i n the calculations of substance use. Part icipants for the study were volunteers involved in a longitudinal study i i on stress and coping. Eighty women from managerial non-traditionnal occupations in the Greater Vancouver area completed two questionnaire packets containing several instruments. Those of interest to this study were the Hassles Scale, the Social Support Scale, the Work Relationship Index, the Bern Sex Role Inventory and the new Substance Use and Significant Others Scale. Data on sex-role style and social support were collected one month prior to data on daily hassles, work support, substance use and significant others. A stepwise multiple regression analysis was conducted with substance use as the criterion variable. The regression equation reached signifance, _F(3,76) = 6.84, _p_<.01, and accounted for 21% of the variance in substance use. Family history of alcohol abuse, hassles, and friends' drinking behaviour were positively related to substance use. Implications for further research and for counselling are discussed. The findings contribute to the knowledge about the relationship between daily stress, social and work support, family and friends' drinking behaviour, sex-role style, and substance use in managerial women. iii TABLE OF CONTENTS A B S T R A C T i i T A B L E O F C O N T E N T S iv L I S T O F T A B L E S v i A C K N O W L E D G M E N T S v i i I N T R O D U C T I O N 1 L I T E R A T U R E R E V I E W 5 Theoretical Framework for Addict ion 7 Theoretical Framework for Stress and Coping 12 Substance Use and Stress 14 Social Support and Stress 20 Sex-role Style and Stress 26 S u m m a r y 28 Statement of the Problem 29 Hypotheses 29 M E T H O D 31 Subjects 31 Sample Characteristics , 32 Procedure 34 Independent Measures 37 Dependent Measure 40 Da ta Ana lys i s 40 R E S U L T S 42 D I S C U S S I O N 46 Conclusions 49 Suggestions for Fur ther Research 51 R E F E R E N C E S 53 Appendix A Informed Consent 60 Appendix B Hassles Scale 61 Appendix C Social Support Scale 68 Appendix D Work Environment Scale 73 Appendix E Bern Sex Role Inventory 77 Appendix F Substance Use and Significant Others Scale 79 iv Development of the Substance Use and Significant Others Scale (SUSO) . 82 Appendix G Letter to D r u g and Alcohol Centre 89 Appendix H Letter to A u r o r a Treatment Centre 90 v List of Tables Table 1: Job Classifications According to 1981 Statistics Canada Census for Manager ia l Women 33 Table 2: Demographic Var iables of Manager ia l Women 35 Table 3: Means , Standard Deviations, and Intercorrelations of Measures for Women Managers 44 Table 4: Mul t ip le Regression Ana lys i s on Substance Use in Women Managers 45 Table 5: Means and Standard Deviations, The Substance Use and Significant Others Scale (SUSO) for Managers , Alcohol and D r u g Females and Alcohol and D r u g Males 87 Table 6: Post hoc Ana lys i s Scheffe Tests on S U S O 88 v i ACKNOWLEDGMENTS I thank m y academic advisor, D r . Bonnie Long , without whom this research would not have proceeded. H e r continued encouragement, support, re-focussing and generous avai labi l i ty kept me going many times when, without her, I would have floundered. I also greatly appreciated the opportunity and experience to have been a part of her longitudinal research on stress and coping. In addition, I thank m y committee members, D r . Donald F i n l a y and D r . Richard Young , for their assistance and support. I acknowledge and thank the Robson Street Alcohol and D r u g Outpatient Clinic and the A u r o r a Treatment Centre for Women for their assistance in validation of the Substance Use and Significant Others Scale. I thank m y cousin, Marlene McPhee, for her helpful suggestions in the development of the Substance Use and Significant Others scale. I thank m y friend, L a y n e Powel l , for her many hours of editing assistance and for her valued support and encouragement. I thank Dean Nicholson, L y n n Par is ien , War ren Wei r , and Colleen Haney for their help at cri t ical stages. I also thank m y sister, Yvet te Buchanan, and dear friends, Sandra A lmond , Joyce Donahue, Elizabeth Fawcet t , Bernice Urban iak , and Madge V a n Hat ten , whose consistent friendship eased me through the rough spots. F i n a l l y I acknowledge m y appreciation for the fellowship of Overeaters Anonymous which is a lways there for me, for the 12 steps of Alcoholics Anonymous which show me how to live, and for the guidance of m y Higher Power, the Source of a l l m y good. v i i DEDICATION To all women who are breaking new ground in their personal and professional lives, and particularly to those dealing with the challenges of addiction. viii INTRODUCTION The presence of women at the manageria l level is a relat ively recent employment phenomenon. This emerging role for women creates new challenges and complications for them and for their male peers (Henning & J a r d i m , 1977; Johnson, 1982). O n a daily basis, women at this level face circumstances for which they have few role models and fewer guidelines. In areas of non-traditional female employment, they are in essence pioneers. Several authors have made reference to the special problems and pressures faced by manager ia l women which are unique to their circumstances (Davidson & Cooper, 1986; Henning & J a r d i m , 1979; Rayburn , 1986). These include the stress associated wi th the role of the "token woman" , the lack of role models, and the sense of isolation. Davidson and Cooper (1986) found that women in management, in comparison to male managers, experienced higher levels of pressure and manifested more reaction because of the combination of stressors in the work, home/social, and individual arenas. Manager ia l women often do not have a peer network to facilitate understanding of the role norms at this level of employment and thus tend to be isolated (Nieva & Gutek, 1981). The personal isolation, combined wi th pressures ar is ing from the position itself and from a combination of roles, may be associated wi th a reliance on substances as a w a y of dealing wi th , or escaping from, levels of stress for which female managers m a y lack adequate coping resources. In her study of male and female alcoholics, women experiencing psychiatric and emotional problems, and a female control group, Beckman (1978) concluded that the special stress and conflicts faced by women in manageria l positions m a y place them at r isk for alcoholism. Johnson (1982) found that employment for women seemed to 1 I N T R O D U C T I O N / 2 be related to heavier dr inking and dr inking problems and that the relationship between being employed and excessive alcohol use is even stronger for women at middle and higher socio-economic status levels than i t is for those at lower levels. Johnson also found that non-traditionally employed women who drink tend to be heavier drinkers and are considerably more l ikely to be problem drinkers. These higher rates could also be due to attempted conformity to a new and different set of peer dr inking norms. Through entering male-dominated areas, women w i l l be pressured to conform to the behavioural codes of male co-workers, resulting in an increase in alcohol consumption (Fraser, 1981; Johnson, 1982). Studies of the use and abuse of substances have frequently examined alcohol use, drug addiction, or the abuse of nicotine or food separately wi th much of the research to date focusing on alcohol and illegal drugs. In recent years there has been an increased interest in examining the dynamics that are common to a var ie ty of compulsive behaviours (Filstead, Par re l la , & Ebbit t , 1988; Levison, Gerstein, & Maloff, 1983; M a r l a t t & Gordon, 1985; Sinnett, Judd , & Olson, 1983; Zweben, 1987). F o r example, binge eating or eating disorders have been linked to alcoholism and substance abuse (Eckert, Solomon, Goldberg, & H a l m i , 1979; Ha t sukami , Owen, Py le , & Mi tche l l , 1982; Pyle , Mi tche l l , & Ecker t , 1981). Car ro l l , M a l l o y , Roscioli, Pindjak, and Clifford (1982) found drug dependents, alcoholics, and dual abusers to display s imilar psychological profiles on the Tennessee Self Concept Scale (Fitts, 1965). The social learning model of addiction (Peele, 1985) postulates that the individual choice of a part icular substance is an art if icial distinction created largely by its social acceptability or unacceptability. Differing patterns of substance use m a y reflect socially acceptable or common gender behaviours. INTRODUCTION / 3 Alcohol, for example, plays a larger part in common male activities, while prescription use results from the more frequent reliance on doctors by women (Biener, 1987). There is also considerable evidence that women, more than men, are affected by the substance-using behaviour of friends and of the family of origin (Beckman, 1976; Binion, 1982; Chetwynd & Pearson, 1983; Fraser, 1973). As addicted women have been found to be multi-substance dependent (Beckman, 1976; Celentano & McQueen, 1984; Chetwynd & Pearson, 1983; Sandmaier, 1980), this study will examine the relationship of several substances (i.e., alcohol, prescription drugs, illegal drugs, nicotine, and food) treated as a single concept of substance use, with several relevant personality traits and environmental circumstances of managerial women. Research has validated the role that social support plays in buffering the individual from the effects of stress (Billings & Moos, 1982; Holahan & Moos, 1981; Holubowycz, 1983; Husaini, Neff, Newbrough, & Moore, 1982). Theorists from a wide variety of fields have suggested the importance of social support for individual well being (Caplan, 1979; DeLongis, 1984; Ericksbn, 1975; Schilit, 1984). There is also considerable evidence of the special importance of social networks and social support in the lives of women (DeLongis, 1984; Schilit, 1984). Sex-role style, as it may affect the appraisal of what is stressful and what coping choices are made, is another relevant factor in an examination of the stressors and coping strategies. Research on addiction and women has frequently been conducted on groups in treatment centres (Beckman, 1976; Hornik, 1977). This study examined whether high stress and the lack of social and work support is associated with greater substance use, prior to the substance use reaching levels where treatment I N T R O D U C T I O N / 4 is required. In addition, the relationship between substance use and family history of alcohol abuse, friends' dr inking behaviour, and sex-role style were examined. Should a relationship be found among substance use, social isolation and stress, future direction for addiction prevention and treatment for women might more profitably be directed at social networking, interpersonal skills and stress management. LITERATURE REVIEW This study is concerned wi th variables which might influence substance use by women i n non-traditional managerial occupations; a group at r isk as a consequence of stressful and isolated work circumstances. M a n y of the social and economic characteristics of women employed in non-traditional areas differ from their male peers and from women employed in other, more traditional, occupations. Compared to other employed women, they tend to have achieved higher levels of education, to have higher employment rates and greater income (Marsha l l , 1987). Y e t their income is considerably below that of men i n their same fields. Average earnings of women, in 1980, were approximately 77% of men wi th s imi lar experience and employed at s imilar levels (Marsha l l , 1987). Ye t , manageria l level women face work-related stresses to which they are no more immune than men have been (Hornik, 1977). Al though there is a new level of freedom to pursue personal choices, there continues to be confusion and turbulence as women make a variety of tentative role commitments i n order to arrive at a satisfying role blend (Henning & J a r d i m , 1977). Women choosing a time consuming and demanding career path m a y experience stress result ing from the traditional view of women. Tradi t ional ly, women were viewed p r imar i ly as homemakers, or involved in occupations that emphasize expression of nur tur ing and supportive tendencies (Long, 1989). Whi le women, more than men, m a y rely on the presence and support of significant others (DeLongis, 1984; Schil i t , 1984), for many the decision to pursue a career has meant l imited mar i ta l and parental options (Marsha l l , 1987). Women i n non-traditional occupations are more l ikely than other women to have never marr ied or, i f marr ied, to have had fewer or no children (Marshal l , 1987). 5 L I T E R A T U R E R E V I E W / 6 Women committed to family life or to parenthood must balance family demands and responsibilities wi th those of employment in a w a y that has rarely been expected of men (Henning & J a r d i m , 1977). There is also more role discontinuity for women than for men as they adjust their role structure to their changing needs (Frieze, Parsons, Johnson, Ruble, & Zel lman, 1978; Morr issey , 1986). G r a y (1983) found that marr ied professional women today are more committed to their careers than they have been in the past and this requires a balancing of family needs and career demands. "Mos t often stress in women does not involve the job per se but the interface of their job and family or personal responsibilities, their sense of rejection, isolation, and the need for social networks to affirm them in their non-traditional or non-accepting job situations" (Rayburn, 1986, p. 239). Funct ioning and advancing in this male-dominated environment appears to be associated wi th a part icular sex-role style and coping strategies which relate to efficiency and success (Jagacinski, 1987; Long , 1989). The following sections contain the theoretical framework wi th in which this study is conceptualized, wi th a review of the constructs of interest to this study. Substance use and stress are discussed first w i th reference to the special kinds of stressors manageria l women might experience. Work and social support are explored as resources which m a y moderate the level of stress experienced. Significant others, i n the form of family history of alcohol use and current friends' dr inking behaviour, are considered as further dimensions of the background and social environment of these women. Sex-role style is examined for the effect it might have on the appraisal of what is stressful and on choices for coping. L I T E R A T U R E R E V I E W / 7 THEORETICAL FRAMEWORK FOR ADDICTION M a n y of the studies on addiction have focused on one substance, frequently alcohol or heroin. The circumstances and conditions surrounding that part icular drug use were examined wi th a view, p r imar i ly , to understanding how it could be treated (Peele, 1985). A s research in addiction grew, increasing discrepancies were observed i n the nar rowly defined cause-and-effect explanations. There was growing evidence of great var iabi l i ty in levels of addictive behaviour and in the kinds of drugs relied upon by individuals in different situations and life experiences. Queries developed as to why a given personality developed a need for a specific k ind of drug, and w h y others w i th comparable personalities did not become wedded to the same substances. The case for the association of addiction wi th certain social groups and part icular lifestyles became obvious (Peele, 1985). The social learning theory of addiction changes the focus of investigation from the individual to the social mi l ieu and i n essence says that as society changes its ideas about what constitutes addiction and what is potentially dangerous, the k ind of drugs which are "abused" changes. A t various times in history, opinions about and the legal status of different addictive substances have varied. Restrictions on certain substances are usual ly justified on scientific grounds, that is, the inherent harmfulness of the targeted substance. A s an example, Peele (1985) makes reference to the extensive and common use of an opiate derivative (laudanum) by women prior to opium being legislated illegal in the ear ly 1900's (Harr ison A c t , 1914). A s the social opinion changed about opium, i t became a rar i ty . It is not the i l legali ty as such that generates a decline in use so much as the general belief about the potential ha rm. A recent v i v i d example of a change in social acceptability can be seen i n the use of L I T E R A T U R E R E V I E W / 8 nicotine. E v e n five years ago, the current "no smoking" restrictions i n many public buildings and airplanes would have been inconceivable. Y e t nicotine, wi th its accompaniment of thousands of chemicals i n an ordinary cigarette, remains legal, (in spite of recent restrictions on its use in public places). S imi l a r l y extensive alcohol use, also st i l l legal, is more toxic than the heavy (antiseptic) administrat ion of a narcotic, which is i l legal (Peele, 1985). F r o m the social learning theory has emerged a model that regards substance use as an adaptive coping response when an individual fails to achieve levels of self-reliance, competence, social acceptance and self-confidence. These form the basic social expectations of the individual i n a particular circumstance (Alexander, 1986). The substance is "adaptive", even where i t m a y exacerbate underlying problems, in the sense that it provides some cushion or protection from what might be overwhelming or unbearable circumstances. People develop a dependence on some substance wi th the ensuing likelihood of addiction when circumstances i n their lives become excessively stressful and they lack alternative resources for dealing wi th them (Abrams & N i a u r a , 1987). In this model, addiction has been defined as a situation i n which a person disregards health, personal well-being and social propriety in order to continue a behaviour (Alexander, Peele, Hadaway , Morse , Brodsky, & Beyerstein, 1985). In recent years the social learning theory of addiction has broadened to include substances other than narcotics and has become more accepting of a range of psychological functions (Alexander, 1986; Peele, 1985). Peele, the main proponent of the social learning theory, maintains that unless we measure the range of addictive possibilities (i.e., to different substances as wel l as to certain behaviours or even to people), we cannot evaluate the extent to which the L I T E R A T U R E R E V I E W / 9 person is in fact addicted. Peale states that in this broader approach to addiction and its treatment, it is crucial to consider relationships to other people, to work and to the environment as essential elements in mainta ining balance in healthy behaviours. The social learning theory leads to several possible explanations for the development of addiction in some persons and not in others. H a t s u k a m i et a l . (1982) found evidence of a s imi lar i ty of personality type between groups addicted to different substances. A comparison of 52 bulimic women and 120 women i n treatment for drug and alcohol addiction found s imilar mean M M P I profiles and pre-dominant code-types. The profile revealed individuals who demonstrated social wi thdrawal and who experienced, among other characteristics, repeated problems wi th interpersonal relationships. In another study, part of a larger project which examined the presence and severity of psychiatric disorders i n bulimics, 35 bulimic women (mean age 30 years) were compared wi th 35 age-matched healthy controls. Findings showed that alcoholism and drug dependency occurred significantly more frequently in bulimics and i n their close relatives than i n controls (Bulik, 1987). These findings suggest that addictive propencity is an underlying tendency which can manifest in different forms in the same individual and in families. Another direction for this theory has been the exploration of the connection between personality traits and the development of different levels of addiction. In a longitudinal case study (over 37 years), 100 individuals were followed from adolescence to adulthood and personality characteristics were charted at each stage of the study. Fo r one report (Jones, 1971), individuals were classified into five amount-frequency categories: problem drinkers, heavy drinkers, moderate L I T E R A T U R E R E V I E W / 10 drinkers, light drinkers, and non-drinkers or abstainers. Fo r each category of drinkers, some distinctive personality syndromes were observed to be present in ear ly adolescence and to continue into adulthood. A s an example, heavy drinkers were self-assured i n an upper middle-class social setting. A s adolescents this group had the highest ratings on social ski l ls , poise, expressiveness and interest in the opposite sex. Another theoretical focus is the exploration of certain high-risk experiences or situations which might precipitate addictive behaviour. This si tuational approach was the focus of a study of 54 hospitalized individuals who demonstrated alcohol and other drug abuse and binge eating (Filstead et a l . , 1988). Patients completed a standard battery of psychosocial questionnaires. A 100-question alcohol and drug abuse questionnaire was modified to create an instrument that applied to eating as wel l . Correlations among the 8 subscale scores were performed for each version of the two addiction tests separately. These indicated acceptable interscale correlations (ranging from .50 to .93 for the drinking/drug use version and from .40 to .88 for the binge eating version) but between-test correlations were significant for only four out of eight subscales on emotional states: negative emotional states, positive emotional states, testing personal control and interpersonal conflict. While these four subscales indicated some s imi la r i ty in the triggering emotions, a hierarchical analysis revealed different r ank ing of the four for the different forms of addiction. The same emotional states were involved but their rank of importance as precipitating agents differed for each different form of addiction. F i l s tead et a l . conclude that although the potential r i sk for engaging i n either dr inking or drug use or overeating m a y be similar , the interaction of the substance type and the r isk context m a y determine the salience of the L I T E R A T U R E R E V I E W / 11 part icular problem behaviour as a situational response. A long s imi lar lines of exploring high r isk circumstances, a study of 32 universi ty students who were registered in a weight control class examined periods of the day when there appears to be a part icular difficulty restraining from a destructive habit (Sinnett et a l . , 1983). They found that most deviations from diet occurred between 7 and 10 p .m. which matched a temporal curve of occasional heroin use by addicts i n treatment, their most common time being between 6 and 10 p .m. This later time of the day seemed to be a period when resolve weakened or the need for relief sharpened, indicating a high r isk time of day. This temporal frame coincides wi th the end of the usual workday, a time when employed women might be inclined to relax or reward themselves after a hard day's work. In summary , while a convincing argument can be • entertained for the broad approach of the social learning theory of addiction, there remains considerable ambiguity as to which factors, or which combinations of factors, are relevant. Substances other than narcotics are seen as potential expressions of addiction and social factors create the environmental background in the development of addiction. Some studies have examined part icular combinations of personality traits, emotional states, and high r isk situational or temporal frames (Hatsukami et a l . , 1982; B u l i k , 1987; Fi ls tead et a l . , 1988; Sinnett et a l . , 1983). A difficulty i n comparing these studies and drawing conclusions from them is that many of them were conducted on addicted populations in treatment. Whi le research on populations in treatment provides some indication of the presence of part icular circumstances in conjunction wi th addiction, there is no evidence regarding whether the characteristics or circumstances under study preceeded the L I T E R A T U R E R E V I E W / 12 addictive behaviour or resulted from it. No studies have addressed the part icular characteristics and circumstances of women in non-traditional managerial positions in relation to substance use. Associated wi th non-traditional managerial women are part icular work and personal stresses, accompanied by isolation, and affected by sex-role style. These women face new combinations of challenges which are potentially stressful. Isolated from female peers, they m a y be part icular ly reliant on supportive others, both from the social and work environments. Sex-role style m a y affect both how much stress they experience and how they choose to deal wi th it. In accordance wi th the social learning theory, these are factors included in this study. Substances l ikely to be salient to women in management are the relatively socially acceptable substances of alcohol, prescription drugs, some illegal drugs, nicotine, and food. THEORETICAL FRAMEWORK FOR STRESS AND COPING The conceptualization of stress and coping in this study follows Lazarus and F o l k m a n (1984) who views stress as a complex interaction between the environment and the person. They define stress as a person-environment interaction that involves a situation appraised by the person as taxing or exceeding resources and endangering well-being. Stress does not exist as a separate, independent entity but is essentially related to the individual 's perception and personality. The appraisal of a potential stressor is a two-stage process of assessing the nature of the threat and of .determining the coping strategy of choice. It is an interaction of personal and situational factors. Atti tudes about the stressor w i l l affect not only whether it is viewed as a threat but also the L I T E R A T U R E R E V I E W / 13 degree to which i t is experienced as taxing. Beliefs about coping resources influence how the individual w i l l cope wi th what is perceived as stressful. Laza rus and F o l k m a n (1984) describe coping as the effort required to manage the stressful situation, as wel l as the emotions i t engenders, regardless of how effective or ineffective the effort might be. They conceptualize coping as dynamic, bi-directional and reciprocal; a constantly changing process happening as the interface of the person-environment relationship varies. Laza rus and F o l k m a n (1984) postulate two general forms of coping: problem-focused and emotion-focused. When conditions appear amenable to change, problem-focused coping is more l ikely adopted. It includes direct action aimed at el iminating or altering the harmful situation or its consequences. W h e n there has been an appraisal that nothing can be done to modify perceived threats, emotion-focused coping is l ikely to be adopted. It involves several types of behaviours and/or thought processes aimed at regulating the emotional response. The ways people actually cope depend on the resources available to them and the constraints that inhibit use of these resources in the context of the specific stressor. Laza rus and F o l k m a n (1984) found that both forms of coping are used in different combinations in v i r tua l ly every stressful encounter. We can thus assume that when faced wi th a stressful situation, manageria l women w i l l use both problem-focused coping and emotion-focused coping to alter the intensity of the threat. Emotion-focused coping includes strategies such as avoidance, cognitive reappraisal , distancing, minimizat ion, positive comparisons, selective attention, seeing positive value from negative events, or just wishful thinking. Emotion-coping such as avoidance or wishful th inking m a y be manifested in the use of whatever substance is available and preferred, be it alcohol, prescription L I T E R A T U R E R E V I E W / 14 drugs, illegal drugs, nicotine, or food as a form of distraction or emotional regulation. SUBSTANCE USE AND STRESS Repeated studies have associated the use of alcohol w i th stress reduction and have identified alcohol use as a coping strategy (Hull & Young , 1983; Mar l a t t , 1976; Pear l in & Radabaugh, 1976; Polich & Orv i s , 1979). In a review of the literature examining alcohol and its connection wi th stress, M a r l a t t (1976) indicates that the findings, wi th both social drinkers and wi th alcoholics, are wide-ranging and contradictory. He theorizes however that the probability of dr inking increases as a function of stress, lack of personal control, inadequacy of coping responses, plus personal expectations about the effectiveness of alcohol . (Marla t t , 1976). This was the finding in the Pear l in and Radabaugh (1976) report which was part of a larger investigation into the social origins of personal stress in an urbanized area of Chicago. Both male and female subjects were included in the sampl ing of 2,300 persons, wi th a preponderance of women because women typical ly head more households. (Actual numbers of women were not reported). Stress was measured by economic strain and, for the purpose of this analysis, the dr inking measurement was l imited to only two statements: " A drink helps me to forget m y worries" and " A drink helps cheer me up when I a m i n a bad mood." These are clearly examples of avoidance or wishful th inking emotion-focused forms of coping. In C h i square tests, three levels of anxiety (low, moderate, and intense) were significantly related to three levels of disposition to use alcohol to relieve distress (strong, weak, and minimal) , ^"{4, N = 1671) = 24.4, _p_ <.001. Y e t there was not a greater disposition to use alcohol when anxiety L I T E R A T U R E R E V I E W / 15 was intense, as opposed to low. Fur ther analysis revealed that the disposition to use alcohol to relieve distress was significant only for individuals who possessed a very low sense of mastery over their environment, i.e., a sense of an inabil i ty to control events or to change outcomes. The substance-using response therefore appears to have two components: the belief about the benefits of alcohol plus a feeling of helplessness or powerlessness w i th regard to whatever is the exterior stressor. Beliefs and attitudes toward alcohol were the focus of two other extensive studies. In a study involving 120 female alcoholics, 120 male alcoholics, 119 non-alcoholic women ("normal" controls) and 118 non-alcoholic women i n treatment for psychiatric and emotinal problems (treatment controls), between the ages of 20 and 59, Beckman (1980) tested the hypotheses that i n comparison wi th non-alcoholic women, female (and male) alcoholics perceive more positive psychological consequences of dr inking. The instrument administered covered antecedents and effects of dr inking (selected p r imar i ly from past literature); subjects' feelings before, during and after dr inking; and the perceived effects of dr inking "a l i t t le", or "a lot". Two scales of social desirabili ty, the Eysenck L i e Scale (Eysenck & Eysenck, 1968) and the Bern Sex Role Inventory Social Desirabi l i ty Scale (Bern, 1974), indicated an unlikelihood of response bias by alcoholics. In general the findings indicate that female alcoholics, compared wi th both normal controls and treatment controls, seemed especially l ikely to believe that dr inking more frequently made them feel more adequate, buil t self-confidence, relieved anxiety, reduced worries and loneliness, and increased feelings of power and control. Beckman concludes that female alcoholics are most l ikely of a l l four LITERATURE REVIEW / 16 groups to use drinking for escapist reasons, i.e., emotion-focused coping. Beckman's study, provides compelling conclusions of the susceptibility of women to avoidance coping, at least once a substance abuse level has been reached. Moreover, Beckman found not only that the negative feelings were antecedents to drinking behaviour, but also that alcoholics, both men and women, experience more negative affect than do non-alcoholics generally. Interestingly, this finding of the entrenchment of emotion-focused coping among an addicted group appears comparable with the findings of the stability of emotion-focused coping found by Folkman, Lazarus, Gruen, and DeLongis (1986) working with a middle class group of married couples living in the community. In examining 85 married couples in the Contra Costa County, Calif., Folkman et al. found that emotion-focused coping are the most stable strategies, indicating that this coping form is independent of situations and perhaps related to the influence of a generally stable personality style. This suggests that persons who use emotion-focused coping may do so regardless of situations. Should substance use be the chosen form of such coping, there would then be an on-going propensity to substance use. Addressing more directly this issue of drinking to cope, and using a causal model, Cooper, Russell, and George (1988) studied 119 male and female alcoholics and a comparison group of 948 social drinkers (57% female). The hypothesis tested was that expectancies and general coping skills will make significant independent contributions to the prediction of drinking to cope and, further, that expectancies will moderate the relationship between general coping skills and drinking to cope. These authors administered a battery of measures regarding drinking status according to the DSM-III criteria, (17 symptoms were tapped, L I T E R A T U R E R E V I E W / 17 e.g., needing a drink before breakfast, having trouble on the job or at school because of dr inking, having the shakes), dr inking quantities and frequencies, expectations regarding alcohol, the Dr ink ing to Cope Scale (Polich & Orv i s , 1979), and three general coping skills measures. Coping responses were related directly to a recently experienced stressful event or situation. Correlational analyses indicated that alcohol-related variables (alcohol consumption, problem dr inking status, dr inking to cope, and positive alcohol expectations) were significantly positively inter-correlated. The range (.20 < _r_ < .45) indicated that conceptually distinct but related constructs were tapped. In a factor analysis , two distinct domains of coping behaviours were represented. "Anger i n " , "anger out", "avoidance", and "anger reflect" loaded on Factor 1; and "active cognitive coping", "active behaviour coping", and "active coping style" loaded on Factor 2. The two factors appear to reflect the major domains of coping identified by Laza rus and F o l k m a n (1984) as emotion-focused and problem-focused coping, respectively. The hierarchial multiple regression analyses were estimated twice: once using the emotion-focused coping index and then using the problem-focused coping index. Three equations were calculated: first, regressing dr inking to cope; second, alcohol consumption; and finally, dr inking status. This analytic strategy is s imi lar to path analysis wi th variables postulated as effects being regressed simultaneously on a l l variables postulated as causes. In this conservative analysis, only non-overlapping variance is attributed to each factor. In the analysis , the greater number of younger male problem drinkers was compensated for by controlling for sex and for age. In predicting dr inking to cope, Cooper et a l . (1988) found that individuals who use avoidant styles of emotion-focused coping and who suppress their anger L I T E R A T U R E R E V I E W / 18 are more l ikely to drink to cope only i f they also have high expectations about the effectiveness of alcohol. Fur thermore, for individuals low in positive expectations about alcohol, neither anger suppression, nor avoidance coping were significantly predictive of dr inking to cope. S imi l a r ly problem-focused coping strategies did not predict dr inking to cope. Since i t is the expectations about the effects of alcohol which significantly predict dr inking (accounting for nearly 25% of the variance in the self-reported use of alcohol to cope), Cooper et a l . (1988) speculate that as individuals rely on alcohol to suppress feelings, psychological dependence on alcohol develops. This wel l documented and carefully analysed study provides compelling evidence of the importance of beliefs i n the development of alcohol reliance. In addition, individuals who hold strong positive expectations and who dr ink to cope not only drink more but are also more l ikely to experience problems as a result of their dr inking. A s dependence increases it may promote continued dr inking despite the experience of negative consequences indicative of abuse levels. Incongruence between expectations and results w i l l increase both the level of stress experienced and the inadequacy of the chosen coping strategies. A part icular situational characteristic of managerial women is role overload or role conflict; characteristics which have been identified as factors in female addiction (Beckman & A m a r o , 1984; Johnson, 1982). Role stresses include inter-role conflict, which occurs when a person is in two roles wi th conflicting expectations at the same time (i.e., the employed mother); and conflict where there is discrepancy in the behaviour called for by cul tural or interpersonal expectations and those required by a person's work position (i.e., as in the tradit ionally yielding woman who finds herself in a position i n which she L I T E R A T U R E R E V I E W / 19 exercises authority over others; Johnson, 1982). In a secondary analysis of data from a national survey involving 1016 men and 1141 women aged over 18 years , Johnson (1982) found employment for women to be associated wi th both heavier dr inking and wi th dr inking problems. Fur ther , the proportion of out-of-role (non-traditionally employed) women who drank tended to be heavier drinkers and to be considerably more l ikely to be problem drinkers than the proportion in-role women (Z_ = 2.29, _p_ < .01; two-tailed _Z_ test for independent proportions). Potential ly then, the manageria l woman i n a non-traditional occupation m a y be at r isk to substance abuse (Cohen, 1981). In summary , there is evidence that i n a stressful situation beliefs about the positive effects of alcohol (a basic form of wishful th inking or avoidance emotion-focused coping) are pre-requisites to the development of substance reliance (Cooper et a l . , 1988). This propensity to alcohol use appears to be most prevalent when combined wi th a low sense of mastery over the environment (Pearlin & Radabaugh, 1976), and generally a negative affect (Beckman, 1980). A s reliance increases, so does the likelihood of additional problems result ing from the substance use (i.e., missed responsiblities due to forgetfulness or illness, poor concentration, low performance). Such additional problems would add to the level of stress being experienced (Cooper et a l . , 1988). Johnson's (1982) findings indicate that women in non-traditional occupations are part icular ly susceptible to resorting to substance use when stressed. Fur thermore , F o l k m a n et a l . (1986) suggested that emotion-focused coping, when i t is an established form of coping, is independent of situations and is l ikely to be the more common pattern of behaviour on an on-going basis. Hence, it is expected that as the level of stress increases, some manageria l women w i l l be more l ike ly to resort to substance use, L I T E R A T U R E R E V I E W / 20 an emotion-focused coping strategy; and as substance use increases, stress levels w i l l increase in a self-perpetuating manner. While the above-noted studies clearly establish the connection between stress, emotional coping and substance reliance, none of these included an examination of social support or sex-role style. The question which emerges is whether the likelihood of substance reliance is modified by the presence and use of social and work supports or by a particular sex-role style. SOCIAL SUPPORT AND STRESS A considerable body of literature addresses the concept of social support and its association wi th stress (for review see Turner , 1983). M u c h of the research attention has addressed the concept of social support as a buffer or a mediator of the effects of life stress. Social support is part icularly significant when the subjective sense of being supported is assessed rather than a quantitative assessment of the number of the potential sources of support which might be available to the individual (Turner, 1983). Strong social support has been recognized to have a contributing effect on the maintenance of wel l being (DeLongis, 1984), to have a significant buffering effect on the occurrence of depression (Husaini et a l . , 1982), and to be a mit igating factor in the development of illness (Schilit, 1984). However social support is not a lways necessarily a positive influence. M a n y researchers have noted that support m a y actually be negative in terms of an individual 's overall best interests (Caplan, 1979; K a h n & Antonnuci , 1980). Laza rus and F o l k m a n (1984) cite a series of both positive and negative effects of social support in the areas of prevention, coping, and recovery from illness. Act iva t ion of the support includes expectations LITERATURE REVIEW / 21 of reciprocity, or may encourage dependency which may be welcomed as short term relief but undesirable in the long run (Tucker, 1982). A distinction must also be made between general social support and work related support. Different types of relationships provide different types of social provisions which are not entirely inter-changeable (LaRocco, House, & French, 1980; Schilit, 1984). Studies that applied social support hypothesis directly to the work place found that, for men, non-work related social support did not protect against the effect of job stress or job-related strain (Bromet, Dew, Parkinson, & Schulberg, 1988; LaRocco et al., 1980). Job stress and job strain were primarily affected by co-worker sources of support. Fennel, Rodin, and Kantor (1981), in a study involving both men and women, observed that supervisor and peer support buffered job-related stress. Other studies have found that the effects of social support are more pronounced among women than among men (Turner, 1983). Using the Hassles Scale (Kanner, Coyne, Schaefer, & Lazarus, 1981), DeLongis (1984) in her study of 75 well-educated, high income couples, found that wives reported significantly more hassles with family and friends than their husbands did. She concluded that this may reflect their greater involvement with such relationships. Substance use and social support. Social isolation is a prominent feature of substance dependency in women (Fraser, 1981; Holubowycz, 1983; Reed, 1985) and it has been identified as an antecedent to alcoholism (Beckmari, 1980; Scida & Vannicelli, 1979). Argerion and Paulino (1976) identify female impaired drivers as "isolated individuals" and Gomberg (1974) found alcoholics generally to be distrustful and unable to form healthy relationships. Schilit (1984) found female alcoholics to have had less childhood support and to have less current support L I T E R A T U R E R E V I E W / 22 than the non-alcoholic comparison group. In a study of 90 successfully treated alcoholic women and 90 unsuccessfully treated ones, Thomas (1971) found that successful treatment was characterized, among other things, by changes in social groups and improved social relationships wi th family , friends and people i n general. S imi l a r results were found i n a follow-up of 93 18- to 63-year-old alcoholic women after treatment (Macdonald, 1987). P r i m a r y supportive relationships were significant predictors of successful treatment outcomes. Research involving both men and women participating i n a heroin addiction treatment program, examined the extent to which the subjective sense of the unavai labi l i ty of social relations is related to the use of potentially dysfunctional coping strategies such as substance use. Results of three sets of measures of social support, coping style and depression were analyzed (Tucker, 1982). A series of _t_ tests and C h i square tests of association indicated that persons under stress and without the perception of being socially supported tend to engage in activities that either do not contribute to problem resolution or that create other stressors, even i f social support is in fact available. Tucker indicates that activation of the available system is probably controlled by a number of factors. For example a sense that support w i l l be of assistance or helpful would probably affect whether or not social support is activated. The data also demonstrated that the use of alcohol and other drugs as coping mechanisms is situation-specific, i.e., used only under specific social conditions. This research indicated that the pattern of relations between variables was quite distinct for women and men and support the proposition that women are dr iven by social considerations more than men are. However as both the measures of social support and of coping were quite l imited i t m a y be that men also use negative L I T E R A T U R E R E V I E W / 23 strategies in the absence of support but these were not tapped. Fur ther , i t is important to consider that this research was conducted on an addicted population i n treatment and there is no foundation for assuming that the behaviour of persons in treatment is necessarily comparable to that of normal ly functioning and employed persons. Evidence does indicate that social support is part icularly relevant to female employment as women are more strongly affected by work conditions than men are and cannot buffer their dissatisfactions as wel l (Verbrugge, 1982a). A 6-week study focused on health and employment satisfaction, and based on daily health records of 243 men and 346 women sampled from the general population, . revealed that women, more than men, tended to use drugs for chronic problems on a daily basis regardless of whether or not they were satisfied wi th their work; moreover, when dissatisfied, women experienced greater stress and increased their use of nicotine and alcohol (Verbrugge, 1982b). However it is worth noting that results from multiple regression indicated that gender differences could be accounted for by other stronger variables related to health and socio-demographics (Verbrugge, 1982b). Thus, i t is not the fact of being a woman which leads to substance reliance so much as the factors i n a working woman's life. The woman, more than her male counterpart, faces stressors and circumstances which are associated wi th avoidance coping in the form of substance abuse. Thus any factors, such as social support, which might mitigate her stress are part icular ly v i t a l to her (Holubowycz, 1983). Evidence that women m a y value social relations on the job more than men do (Nieva & Gutek, 1981) is par t icular ly cri t ical to women in non-traditional work settings. E v e n more than her male counterparts, she m a y be sensitive to L I T E R A T U R E R E V I E W / 24 the presence of supportive others to deal wi th work demands (Rayburn, 1986). To date there is no evidence regarding the support requirements of women i n manager ia l positions. The female manager in non-traditional settings continues to be an anomaly in her work context and her special circumstances m a y give rise to different results from those found among employees engaged in what has been tradit ional work for the respective genders. However , in view of the research indicating women's greater reliance on social support and greater susceptibility to work stressors, it is expected that managerial women who feel unsupported w i l l experience greater stress and w i l l be more l ikely to resort to substance use. Substance use and significant others. F o r purposes of this study, "significant others" is used to designate the family of origin and close current friendships. F a m i l y history of alcohol use or abuse and friends' dr inking behaviour provide further insights into the background and social environment of the participants in this study. A n environmental factor .of influence in female addiction, for example, is the occurrence of alcohol abuse in the family of origin (Estep, 1987). Female alcoholics, more than male alcoholics, tend to come from homes where there has already been a history of alcoholism (Beckman, 1976; Chetwynd & Pearson, 1983; Fraser , 1973; Horn ik , 1977). However an unexpected marked s imi lar i ty between women problem drinkers and women abstainers was observed by Jones (1971). Both these groups of women were described as self-defeating, vulnerable, pessimistic, wi thdrawn, guil ty, somatized, and projected feelings. They were less productive, more dependent; and emotional inadequacies were suggested in their fluctuating moods, anxiety, i r r i tabi l i ty and in their inabil i ty to relax. The female abstainers, more than male abstainers, appeared marked by ear ly unfavorable family situations where one parent drank L I T E R A T U R E R E V I E W / 25 excessively. The suggestion was made that their abstinence was a reaction to childhood circumstances rather than an integrated pattern of negation and overcontrol. Based on the above studies, it appears that there w i l l be greater likelihood of substance use i f managerial women come from an alcohol abusing family of origin. However the Jones (1971) report indicates that there m a y be confounding factors in the relationship between family history and current behaviour which might express itself as abstinence from the substance. The evidence as to the effect of the behaviour of close friends is more consistent. Pa rke r (1972) found female heavier drinkers, and part icular ly spree drinkers, to have heavy dr inking friends. Bin ion (1982) found in i t ia l drug use for female heroin users to be closely related to inter-personal affiliative issues and noted that on-going use led to seeking an addict peer group. However , in working wi th a treatment group of dually addicted women (alcohol and prescriptions) and a control group of a community sample, Estep (1987) found that about ha l f of each of the two groups had companions who used prescription depressants. Interview data indicated that women often obtained and/or shared their drugs wi th their companions. There was no indication as to whether the level of use by the companions of the control group was at abuse levels. Nevertheless, i n the current study it is expected that an indication the friends are heavy drinkers w i l l be associated wi th higher substance use by our respondents. L I T E R A T U R E R E V I E W / 26 SEX-ROLE STYLE AND STRESS "Sex-role style" refers to an individual 's general approach to life. A n assertive, pro-active style has been named "masculine"; i t m a y also be referred to as "instrumental" . A more yielding, inter-dependent style has been associated wi th "femininity"; some researchers refer to i t as "expressive" (Broverman, Vogel , Broverman, Clarkson, & Rosenkrantz, 1972). Bern (1981a) found that perceptions of, and responses to, stressful situations are affected by sex-role orientation. A n instrumental sex-role style, which is more task oriented and suggests rat ionali ty and competence (Broverman et a l . , 1972), m a y lend itself more easily to an occupation which has not tradit ionally been performed by women (Long, 1989), and thereby mediate the stress expressed in that position. In the Lazarus and F o l k m a n (1984) framework, sex-role style affects not only the manner of coping, i.e., the combination of problem-focused and emotion-focused coping undertaken, but i t affects wha t is appraised as stressful and the manner in which resources are evaluated and utilized. Fo r example, an assertive pro-active person m a y enjoy the challenge of a situation which might be viewed as threatening by a more yielding inter-dependent person. Bern (1975) concluded that sex-typed individuals are uncomfortable performing cross-sex tasks as these are incongruent wi th their basic sex-role style. A s women moved into the workplace and adopted new non-traditional lifestyles, ear ly studies on alcoholism indicated that an increased likelihood of addiction development (Beckman, 1978; Morr i ssey , 1986). This is so part icular ly for the non-traditionally employed woman (Johnson, 1982). However examining stress and coping among employed women from both traditional and non-traditional occupations, using the Bern Sex Role Inventory (BSRI ; Bern, L I T E R A T U R E R E V I E W / 27 1981b), L o n g (1989) found that greater problem-focused coping was associated w i t h greater instrumental i ty for both kinds of occupations. S imi l a r ly , Jagacinski (1987), using the Personal Attr ibutes Questionnaire ( F A Q ; Spence & Helmreich , 1978) wi th both male and female engineers, found that those who scored high on instrumental i ty indicated higher levels of performance and greater satisfaction wi th their work. Terborg (1977) also found women in non-traditional occupations to possess more effective coping strategies. Accordingly, there is evidence to indicate that instrumental i ty is associated wi th more problem-focused coping, high levels of performance and greater satisfaction wi th work. It m a y therefore mediate the effect of the stress experienced. Address ing the effect of sex-role style in the util ization of social support, Bu rda , V a u x , and Schi l l (1984) sampled 133 college students and examined several measures of social support. Subjects were classified into feminine, masculine, androgynous, and undifferentiated. Feminine and androgynous individuals (both high on feminine characteristics) reported more global support than the other two orientations. They also scored higher on emotional support and perceptions of support from family. This indicates that those wi th high feminine sex-role style either experience more social support or are more l ikely to utilize what is available to them. Accordingly, the greater problem-focused coping of the high instrumental i ty might be off-set by a decreased use of available social support. The L o n g (1989) and Jagacinski (1987) studies indicate that women who are more highly instrumental i n sex-role style m a y experience less tendency for avoidance coping (substance use) yet they m a y also be more self-reliant and hence less inclined to use available support systems. Evidence available to date does not permit prediction of the direction of effect of an instrumental sex-role L I T E R A T U R E R E V I E W / 28 style, but i t is expected that instrumental i ty is related to substance use. SUMMARY In summary , the social learning model of addiction indicates that environmental circumstances are relevant to the examination of addictive behaviour and that addiction encompasses more than what has tradit ionally been regarded as narcotics. Y e t addiction research to date has frequently been conducted on treatment centre populations, thus l imi t ing the generalizability of the findings for normal ly functioning groups. Women i n managerial , non-traditional occupations experience the usual stress that such positions entail as wel l as the additional daily stress of balancing many demands on their time and attention. The stress and coping model of Lazarus and Fo lkman , indicates that one form of coping, par t icular ly emotion-focused coping in the form of avoidance or wishful thinking, can manifest as substance use. Manager ia l stress levels m a y be factors leading to substance use wi th the resulting r isk of reliance leading to abuse. Studies have linked various personality traits (i.e., low sense of mastery, negative affect, and positive beliefs about alcohol) wi th substance use but none have examined how these might be modified by work or social support or by a sex-role style of instrumentali ty. Social support and work support are resources which might mitigate the effect of the stress experienced. It remains unclear exactly what effect an instrumental sex-role style may have on substance use and the uti l ization of available social and work support resources. L I T E R A T U R E R E V I E W / 29 STATEMENT OF THE PROBLEM The question emerges as to whether manageria l women in non-traditional occupations are at r isk of developing addictive reliance on a substance as a w a y of dealing wi th stress i f they feel unsupported by their social or work-related environment. Fur thermore, it is expected that subjects who come from a home where alcohol was abused or who currently have friends who are substance abusers w i l l be more l ikely to be at r isk of substance abuse. The sex-role style, instrumentali ty, because of its relation to efficacy in manager ia l employment, may lower the overal l stress level and thereby moderate substance use (i.e., it is expected that higher instrumental i ty w i l l be associated wi th lower stress and thus lower substance use) or" high instrumental i ty m a y be associated wi th less activation of the available social support and thereby inhibi t use of this potential coping resource. Alcohol , prescription drugs, il legal drugs, nicotine, and food are considered relevant substances and are assessed as to degree of use, from non-use to abuse. HYPOTHESES It is hypothesized that (either singly or in combination) there w i l l be a significant l inear relationship between the criterion, substance use, and the predictors, stress, social support, work support, family history of alcohol abuse, friends' dr inking behaviour, and instrumental i ty. F r o m previous research, i t would be expected that greater substance use would be associated wi th greater stress, lack of social support and work support, greater family history of alcohol abuse, greater level of friends' dr inking. The direction of the effect of the variable, instrumental i ty , is unclear. D a i l y stress w i l l be measured by the Hassles Scale L I T E R A T U R E R E V I E W / 30 (DeLongis, 1984); social support w i l l be measured by the Social Support Scale (Kaplan , 1977); work support w i l l be measured by the Work Relationship Index (Moos, 1981); and instrumental i ty w i l l be measured by the Bern Sex Role Inventory (Bern, 1981b). F a m i l y history of alcohol abuse, friends' dr inking patterns and substance use w i l l be measured by the Substance Use and Significant Others Scale (SUSO) developed for this study. METHOD SUBJECTS This study is part of a larger longitudinal research project (n = 300) testing a model of stress and coping strategies of managerial women i n non-traditional occupations, under the principal investigator, B . Long . Volunteers were found through approaches to various women's organizations, through newspaper advertisements, and by word of mouth. Substantial demographic characteristics and many constructs were assessed in the larger study. Manager ia l women have been defined as women who supervise or oversee two or more other persons. Non-tradit ional occupations have been established in accordance w i t h the 1981 census of Statistics Canada and include occupations i n which women make up less than 35% of the workforce, w i th one exception, managers in the social science field. Excluded were the fields of education, nursing and social work as wel l as a number of other positions such as postal managers, personnel officers, medical supervisors, and some social service positions. (See Table 1 for occupational classifications). A l l but nine participants indicated that their colleagues are predominately male. The nature of these responses did not indicate whether the participants were referring to their immediate work ing environment or to the overall organization, which m a y have been national in scope wi th operations in several locations. The participants for this study consist of 80 women who were interviewed for their 6-month follow-up interviews during the months of June , J u l y , and August , 1989. Nine ty participants began the study but in the course of the interviews 10 dropped out due to various causes, e.g., pregnancy, t ravel outside M E T H O D / 32 the country, and vacations. A comparison of the demographics of the women who dropped out and those who remained, indicated no substantial differences in age distribution, income levels, caretaking responsibilities or other relevant demographics. (See Table 2). SAMPLE CHARACTERISTICS Respondents ranged in age from 25 years to 63 years, ( M = 39 years, S D = 7.4). Fif ty-seven percent were marr ied, 18% were single, and 25% were divorced or widowed. Forty-three percent have children and of these, 89% have at least one child st i l l l iv ing at home. Job levels ranged from lower or entry level (approximately 23%) management to executive positions (approximately 22%), w i th approximately 45% classifying themselves as middle management. Approximate ly 41% had high school or less education; about 59% had college or more formal education. Approximate ly 45% indicated they had received additional t raining. Approx imate ly 24% earn $40,000 C D N per annum or less; 25% earn between $41,000 and $60,000; wi th the balance of 51% earning above that. (See Table 2 for demographics). METHOD / 33 Tab le 1 Job C l a s s i f i c a t i o n s Accord ing to 1981 S t a t i s t i c s Canada Census f o r Manager ia l Women % Women i n Workforce % Managers Code C l a s s i f i c a t i o n Canada B. C. (n=90) (JL=80) 1113 Managers: A d m i n i s t r a t i o n 20.0 21.5 2 2 1119 Government O f f i c i a l s 29.3 30.5 1 4 1130 Managers /Sen ior O f f i c i a l s 9.4 12.1 2 10 1131 Managers: N a t u r a l Sc ience 6.4 8.7 1 2 1132 Managers: S o c i a l Sc ience 48.2 41.9 3 3 1133 A d m i n i s t r a t o r s : Teaching -24.3 21.8 10 8 1134 Program Coord ina to r .0 .0 0 3 1135 A d m i n i s t r a t o r s : F inances 23.4 26.9 18 11 1136 Managers: Personne l & I n d u s t r i a l R e l a t i o n s 27.7 28.7 6 10 1137 Managers: Sa les & Adv. 21.1 21.4 10 9 1141 Managers: Purchas ing 14.2 12.5 1 3 1142 Managers: S e r v i c e s 30.5 34.5 5 17 1147 Managers: Transpor t & Communications 12.6 10.3 14 10 1149 E d i t o r 38.9 39.3 5 0 1171 Accoun tan ts , A u d i t o r s 31.1 28.7 4 5 M E T H O D / 34 1173 Organization & Methods Analysts 22.4 16.9 4 0 1179 Consultant; Advertising 38.1 33.9 3 3 3115 Veterinarian 17.2 1 0 PROCEDURE Potential respondents were screened by telephone as to their non-traditional occupation and were first contacted through their ini t ia l interview where informed consents were signed (See Appendix A for Consent). H a v i n g indicated a willingness to participate i n the study, the women were met by an assigned interviewer at a time and location convenient to the respondents. They were interviewed monthly, by the same interviewer, for a 6-month period and one year hence. Ini t ial ly the interviewer remained wi th the respondent while she completed the battery of questionnaires involved in the longitudinal study. This was to ensure that the respondent was famil iar wi th and understood the scoring instructions involved in the different questionaires. In subsequent months, frequently the set of questionnaires were left w i th the respondent and picked up the next month when the next set was dropped off. D a t a were collected in 2 sessions of approximately one hour's duration, about 3-6 weeks apart. Instrumentali ty and social support were assessed at the first session; stress, work support, substance use and significant others were assessed at the second interview. Instrumentali ty and social support are seen as more stable and enduring characteristics and the latter as more variable and related to a specific work stressor which was the focus of the second interview. Tab le 2 Demographic V a r i a b l e s of Manager ia l Women M E T H O D / 35 V a r i a b l e (n = 90) % (n = 80) Age 2 4 - 2 9 7.8 30 - 39 46.6 40 - 49 37.8 over 50 7.8 M a r i t a l S ta tus S i n g l e 18.9 Mar r i ed 58.9 D ivo rced or Widowed 22.2 Have C h i l d r e n No 59.6 Yes 40.4 S t i l l a t home (of yes) 88.9 Educa t ion High School or l e s s 40.0 Some C o l l e g e 17.8 Some U n i v e r s i t y 42.2 E x t r a T r a i n i n g Yes 43.3 7.5 42.5 40.0 10.0 17.5 57.5 25.0 57.5 42.5 88.8 41.4 21.2 37.4 45.0 METHOD No 56.7 55.0 Job Leve l En t ry Management 20.0 22.5 M idd le Management 45.6 45.0 Sen ior Management 22.2 21.2 Other 12.2 11.3 Time i n P o s i t i o n Less than a year 18.2 19.0 1 - 2 years 25.0 26.6 3 - 5 yea rs 30.5 29.1 over 5 yea rs 26.1 25.3 Income L e v e l $25,000 or l e s s 3.5 5.1 $26,000 - 40,000 20.2 19.0 $41,000 - 60,000 25.8 25.3 $61,000 - 80,000 13.5 12.6 $81,000 - 100,000 15.7 15.2 $100,000 or over 21.3 22.8 M E T H O D / 37 INDEPENDENT MEASURES The Hassles Scale ( H A S ; see Appendix B) developed by K a n n e r et a l . , (1981) and revised by DeLongis (1984) is a 117-item checklist in which respondents are instructed to indicate any occurrences which have "hassled" them in the past month and its severity. The list covers chronic concerns such as financial problems or unsatisfactory personal relationships and minor i r r i tants such as traffic tie-ups or meal preparation. DeLongis reported a test-retest rel iabil i ty correlation of .79 between adjacent months for frequency and .48 for severity. DeLongis conducted factor analysis w i th oblique rotation which yielded a conceptually meaningful set of 8 factors: future security, time pressures, work, household, health, inner concerns, financial responsibilities and environmental stress. I tem loadings on each factor ranged from 4 to 11 items. Scale reliabilities were high, wi th alphas ranging from .79 to .91. Three items which might confound the substance use measure (dealing wi th smoking, alcohol and drug use) were eliminated for scoring purposes for this study. In DeLongis ' factor analysis these 3 items had low loadings and did not emerge as part of any of the 8 identified subscales. A n i tem referring to concerns over weight was left in as it does not necessarily imply food abuse (initially targetted in this study) and it loaded in the subscale dealing wi th health in the DeLongis analysis . E a c h reported occurrence is rated on a 3-point scale as to severity: "somewhat", "moderately" or "extremely". A cumulative severity score ranging from 0 to 342 was used; the higher the score, the greater the severity of stress. Internal consistency in this study was acceptable (Cronbach's standardized a lpha = .94) The Social Support Scale consists of nine descriptions of various levels of social support and was developed by K a p l a n (1977) and revised and shortened by M E T H O D / 38 Turner , F r anke l , and L e v i n (1983) (see Appendix C) . The instrument measures the subjective experience of social support, regardless of the nature and size of the network potentially available to the subject (Turner, 1983). Turner reported Cronbach's a lpha coefficients ranging from .81 to .83 for internal consistency. Va l id i t y data are l imited but Turner et a l . tested the content domain against two other measures of social support. Al though half of the alpha coefficients were below .70, they were clear and consistent (Turner et a l . , 1983). Correlations of the Revised K a p l a n Scale wi th various single indices of social support range from .19 to .49. The instrument is designed wi th 5-point scale vignettes (ranging from no support, to moderate support, to a lways supported) that are distributed such that the high level (always supported) of the scale appears randomly on the r ight or on the left. Tota l scale scores were used ranging from 9 to 45; the higher the score, the stronger the element of feeling supported. Cronbach's alpha for this instrument in this study was _r_ = .88. Work support was measured using the W o r k Environment Scale (Moos, 1981; see Appendix D) . This scale consists of 63 items which assess the nature of the work environment. The Work Relationship Index (WRI) was used as it depicts the relationship between co-workers and supervisors. W R I is based on the three subscales assessing involvement, cohesion, and supervisor support. The scale is scored by summing the three subscale scores (9 items each). Part icipants were instructed to indicate whether or not the statements, some positive and some negative, are true or false (scored 1 or 0) for their work environment. H i g h internal consistency has been reported for the relationship dimension (alpha — .88; Bi l l ings & Moos, 1982) and is correlated wi th traditional measures of social support (Holahan & Moos, 1981). The construct val idi ty of the W E S has been supported by M E T H O D / 39 a number of studies (Moos, 1981; Moos, Clayton , & M a x , 1979). A composite score, the sum of the three scales, ranging from 0 to 27, was used; the higher the score, the greater the availabil i ty of work support. Internal consistency i n this study was acceptable (Cronbach's standardized a lpha = .91). The Bern Sex Role Inventory (BSRI; Bern, 1981b; see Appendix E) measures the extent to which individuals identify themselves along tradit ional sex-typed roles. It has been argued that this scale measures socially desirable instrumental and expressive traits and is related to sex role preferences that call on instrumental or expressive capacities (Spence & Helmreich, 1981). Est imates of test-retest rel iabi l i ty have been found to range between .76 and .94 for these scales, whereas coefficient alpha estimates of internal consistency range from .75 to .90 (Bern, 1981b). Instrumental i ty and expressiveness scores from the B S R I have been shown to be uncorrec ted (Bern, 1974). The B S R I consists of two 20-item scales, designated as instrumental and expressive respectively, and 20 neutral items. The 60 items are personality characteristics previously scaled as being desirable for men, women or for both (neutral). Part icipants were instructed to indicate on a 7-point scale the degree to which each characteristic was "true of you" . Fo r purposes of this study, the 20 items on instrumental i ty were summed for a total instrumental score ranging from 20 to 140; the higher the score, the greater the level of instrumental i ty . Internal consistency in this study was acceptable (Cronbach's standardized alpha = .82). M E T H O D / 40 DEPENDENT MEASURE The Substance Use and Significant Other Scale ( S U S O ; see Appendix F) was developed for this study using the K a p l a n (1977) scale as a model. S U S O contains 7 vignettes w i th regard to which the participants are asked to identify which is most s imilar to their situation. The 5 substance measures include alcohol, prescription drugs, il legal drugs, nicotine, and food. One i tem is on family of origin and one is on friends' dr inking behaviours. The substance scale was scored on a 5-point scale (ranging from no use, little use, at r isk use, greater use, to abuse). Based on the data analysis of the pilot study, the i tem on eating was deleted from the scale and a total substance use score ranging between 1 to 20 (4 sets of vignettes) was used; the higher the score, the greater the substance use. The items on family of origin and significant friends were scored separately wi th a range of 1 to 5 for each. Cronbach's standardized alpha for 4 substances wi th 80 respondents was .37. DATA ANALYSIS Stepwise multiple regression (MR) was conducted to examine the linear relationship between substance use and dai ly hassles, perceived social support, perceived work support, history of family of origin alcohol abuse, and current friends' dr inking behaviour. "Mul t ip le regression analysis is a method for s tudying the effects and magnitude of more than one independent variable on one dependent variable using principles of correlation and regression" (Kerlinger, 1973, p. 605). Stepwise multiple regression analysis determines the correlations between each independent variable and the dependent variable after the effects of other variables i n the model have been partialled out. Thus the independent variables are entered METHOD / 41 into the regression equation according to their relative strength of association with the dependent variable. Such analysis provide measures of the variation in the dependent variable accounted for by the different independent variables, singly and in combination with each other (Kerlinger & Pedhazur, 1973). Significance was acceptable at_p_<.05 level. RESULTS Means , standard deviations, and pairwise correlations are given for a l l variables in Table 3. F a m i l y history, hassles, and friends' behaviour are significantly positively correlated wi th substance use (r_ = .30, _r_ = .24, and _r_ = .29, respectively) but not wi th each other. Social support and instrumental i ty showed a significant positive correlation, _r_ = .32, wi th each other and are negatively associated wi th substance use. Social support, work support, hassles, family history and friends' behaviour each showed little or low relationships (all _r_ = .30) wi th each other. The Substance Use and Significant Others Scale scores are s imilar to the results of women managers in the pilot study ( M = 9.4; wi th 5 substances and M = 7.1; w i th 4 substances), and are lower than scores found among both the male and the female groups from the alcohol and drug counselling centre. The social support measure results are comparable to those found among H I V positive men ( M = 34.1; S D = 6.1) (Nicholson, 1989). The "work support mean score was higher than that found among marr ied female clerical workers ( M = 16.5; S D = 5.8) and single female clericals ( M = 14.8; S D = 6.9) (Kahn & Long , 1988). The measure on instrumental i ty found results s imi lar to those of a sample of female junior and senior college undergraduates ( M = 100.8; S D = 15.18) (Fassinger, 1985). Comparisons of the results in the Hassles Scale must be done wi th consideration for the different alternatives for scoring this instrument and for the deletion of the three items for purposes of this study. The original longitudinal study of 294 managers, assessed one year earlier (Long & K a h n , 1989), reported a mean of 32.8 (SD = 24) us ing summed severity scores; s imi lar to this study. However using summed severity scores, Z i k a and Chamber la in (1987) in their work wi th 161 42 R E S U L T S / 43 ex t ramura l students and a replication study w i t h 120 community members reported means of 63.2 (SD = 32.4) and 66.7 (SD = 42.6), respectively, considerably higher than this study. The stepwise multiple regression used to test the hypotheses was significant, (3,76) = 6.84, _p_<.01, for three predictor variables, family history of alcohol abuse, hassles, and friends' d r inking behaviour. A n E-to-enter level of 3.0 was required for inclusion in the equation. These predictor variables together accounted for 21% of the variance in substance use (adjusted R = .40). Table 4 summarizes the findings. F a m i l y history of alcohol abuse entered the equation first and accounted for 9% of the variance. Hassles entered next, followed by friends' dr inking behaviour. Results indicate that female managers who had a higher family history of alcohol abuse, who experienced greater hassles, and who had friends who drank heavily were more l ikely to substance use. No relationship was found wi th social support, work support, and instrumental i ty. RESULTS / 44 Tab le 3 Means, Standard D e v i a t i o n s , and I n t e r c o r r e l a t i o n s  of Measures f o r Women Managers (N = 80) Measure Measure _M s a 1 2 3 4 5 1. Substance Use 7.4 2.6 — 2 . Fami l y H i s t o r y 3.3 1.2 .30 — 3 . Hass les 31.4 25.1 .24 - . 0 9 — 4. F r i e n d s ' Behav. 3.3 0.8 .29 .07 .15 — 5. S o c i a l Support • 35.0 5.9 - . 1 9 - . 1 2 - . 1 1 - . 0 6 — 6. Work Support 20.0 6.2 .05 - . 0 2 - . 0 7 .06 .10 7 . I n s t r u m e n t a l i t y 105.5 11.0 - . 0 8 - . 0 5 - . 0 1 .15 .32 r .05,80 = .22 r .01,80 = .29 RESULTS / 45 Table 4 M u l t i p l e Reg ress ion A n a l y s i s on Substance Use i n Women Managers (N = 80) S tandard ized R, R_ R. f t o Regress ion V a r i a b l e cumula t i ve ad jus ted i n c r e a s e enter C o e f f i c i e n t Fami l y H i s t o r y .09 .08 .09 7.64 .30 Hass les .16 .14 .07 6.60 .23 F r i e n d s Behaviour .21 .18 .05 4.96 .23 F(3 ,76) = 6 .84 , p<.01 D I S C U S S I O N This study was concerned wi th the relationship between substance use and dai ly hassles, perceived social and work support, family history of alcohol abuse, friends' dr inking behaviour, and an instrumental sex-role style of managerial women. Substance use was assessed wi th an instrument measuring alcohol, prescription drugs, i l legal drugs, and nicotine consumption. Findings from the regression analysis suggest that the largest proportion of the variance in the likelihood of substance use was having a family of origin where alcohol was abused. This is i n agreement wi th the preponderance of addiction literature that indicates alcoholics, par t icular ly female alcoholics, tend to come from homes where there has been a history of alcohol abuse (Beckman, 1976; Che twynd & Pearson, 1983). This finding is in accordance wi th the social learning theory of addiction and indicates that the most powerful and influential social learning is that experienced in the family of origin. The significance of friends' behaviour, the third variable entered into the regression, is also in accordance wi th prior research that indicates women's substance using is strongly influenced by the behaviour of friends (Binion, 1982; Parker , 1972). It is noteworthy that the mean level of substance use assessed among these managers by S U S O does not reach "at r i sk" levels and of the 80 participants only about 10% scored "at r i sk" or above levels. A further examination of these 8 women did not reveal anything different about them. They range in age between 28 and 38; 4 were single, 2 were marr ied and the other 2 were divorced. F ive of them had high school or less education and their job levels ranged from administrat ive assistant to middle management. A comparison of their social support scores w i th those for a l l the managers ( M = 33.6; S D = 8.6 vs. M = 35.0; S D 46 D I S C U S S I O N / 47 5.9) and of their instrumental i ty scores w i th those for a l l the managers ( M = 104.9; S D = 8.6 vs. M = 105.5; S D = 11.0) indicates no differences. In spite of the smal l proportion of managers scoring at the higher levels on the S U S O scale, fami ly history and friends' behaviour were both significant predictors of substance use. A s a preventative measure i t would be worthwhile to make this connection known, to expand awareness of the addictive potential for women coming from an alcohol-abusing background. This connection also argues for the involvement of significant friends and family in a treatment p lan for substance abuse for women, i n accordance wi th conclusions reached by Muchowski-Conley (1982). Should the friends and family members continue to be in the substance-abusing lifestyle, i t m a y be necessary to suggest to women wish ing to abstain to make a change in companions and/or to lessen contact wi th fami ly members. In contrast, should the friends and family be i n recovery themselves, they provide powerful role models for the woman wishing to make s imilar changes. Women who might be abstaining as a reaction against a substance-abusing family of origin, such as those found by Jones (1971), might be present among these female managers. A n examination of the data found that 28% of the managers (n_ = 22) were assessed as abstainers from alcohol. O f these, 27% (n_ = 5) came from alcohol abusing families. However these are very smal l numbers and would require further research to support any statements. Hassles explained the second largest proportion of variance i n substance use. This is i n accordance wi th the many studies which have associated substance use and stress (Hul l & Young , 1983; Mar la t t , 1976). The association between stress and substance use bears further examination. Increased stress might result from substance use increases (i.e., lower level of functioning and less effective coping) or D I S C U S S I O N / 48 the increased stress might lead to emotion-focused coping such as avoidance. The social support finding lends weight to several possible notions. It is negatively associated wi th substance use (r_ = -.19) as expected, indicating that as social support increased, substance use decreased. The lack of relationship between social support and work support endorses the need of measuring these two kinds of support separately as indicated by previous studies (LaRocco et a l . , 1980; Turner et a l . , 1983). The lack of significance of social support argues against what is known i n the addiction treatment field about the importance of the support of significant others. The long te rm success of Alcoholics Anonymous is strongly rooted in the power of the support of the fellowship. It m a y be that the constructs of support measured by the K a p l a n scale (based on 3 sub-scales of love, esteem and network) (Turner et a l . , 1983) are not the same constructs in social support more relevant to substance abuse treatment. Fo r example, relevant constructs for substance abuse treatment might be more along the lines of understanding, mutual i ty , and unconditional acceptance. The lack of a correlation between this social support construct (measured by the K a p l a n scale) and the coping strategies of H I V + men (Nicholson, 1989) supports the argument for the need for an examination of the relevant construct of social support i n life-threatening situations. Recovering alcoholics frequently speak of their situations as a life-and-death matter. Alcoholics Anonymous li terature encourages and endorses this line of th inking. The format of the K a p l a n scale, w i th its vignettes, would lend itself nicely to the development of a scale measur ing different constructs. The moderate to low positive correlation (r_ = .32) between social support and instrumental i ty also merits attention. It argues against the suggestion that DISCUSSION / 49 instrumentality is associated with less experienced social support and it indicates that, at least for these non-traditional women, the instrumental sex-role style is not a factor which causes them to feel isolated or ostracized. In fact, this group of managers scores at the higher level on the social support scale (M = 35 ; potential range = 9-45). It is possible that a subjective sense of being supported is a factor in the instrumental sex-role style. Perhaps instrumentality, measured by the ability to be self-reliant, defending own beliefs, etc., on the Bern Sex-Role Scale, is founded on an underlying sense of being loved, esteemed and well supported. CONCLUSIONS To summarize, this study found that for women in managerial, non-traditional occupations a family history of alcohol abuse, daily hassles, and friends' drinking behaviour accounted for approximately 2 1 % of the variance of substance use. After the three entries, the variables of social and work support and instrumentality were not significantly associated with substance use. In considering the study's results, a number of issues were raised and speculation was made regarding the relationships of the variables to each other and to substance use. The results of this study are limited by the use of the new instrument, the SUSO Scale created for these purposes. While the pilot project provided some support for the discriminating powers of the SUSO scale, and internal consistency was increased by elimination of the item on eating, reliability is still quite low (Cronbach's alpha = .37). Greater reliability might be achieved by increasing the number of items for each of the remaining substances. The validity of assessing substance use on a continuum should also be further explored. The intervals between the vignettes should be examined closely to verify their equidistance. D I S C U S S I O N / 50 Perhaps the lower end of the scale (which relates to abstinence or relat ively light use) is not a meaningful predictor of potential abuse and should be disregarded as a measure of substance abuse. Ye t , i n spite of the relatively low scores among these managers, there was an association between the substances and the variables of family history and friends' dr inking. Whi le this study proposed to study individuals "at r i sk" of developing substance abuse or addiction, the study is cross-sectional. Thus no indication is available regarding who might develop addiction problems at some time i n the future, when they might do so and under which conditions. This study is not intended to be a source of information about the actual quantities which might be used by women managers. No objective quantitative cri ter ia is established; in essence i t is the participants ' perception of the degree and the k ind of substance use which is being measured. Fur ther , no implication as to causali ty can be made as this study is correlational; substance use m a y cause lack of hassles or the converse m a y be true. The study is l imited in generalizability to manageria l women in non-traditional occupations. The moderate degree of variance accounted for in this study m a y be related to the l imitat ion of using the Hassles scale to assess stress while disregarding possible changes in stress levels. Al though hassles severity was found to be associated wi th substance use, i t is a change, par t icular ly an increase, in levels of daily hassles which is part icularly relevant i n measuring stress (DeLongis, Fo lkman , & L a z a r u s , 1988). Different individuals can cope wi th different quantities of hassles and i f these are a norm, they are not necessarily experienced as stressful (DeLongis, 1984). A stronger correlation between substance use and stress might be found in a longitudinal study which examined whether substance use and stress D I S C U S S I O N / .51 covary. It is possible that the moderate proportion of variance accounted for i n this study is related to the lack of measuring underlying beliefs about the effects of substance use or about the controllability of environmental factors. Three studies (Beckman, 1980; Cooper et a l . , 1988; Pear l in & Radabough, 1976) indicated that beliefs about the positive effects of alcohol, a low sense of mastery over the environment and generally a negative affect were underlying variables which predict substance use. It is l ikely that this highly achieving non-traditional group of managers m a y have a very strong sense of self and of mastery over the environment together w i th a lack of illusions about the effect of substance use. According to the stress and coping theory of Laza rus and F o l k m a n (1984), underlying beliefs also affect choice of coping strategies. SUGGESTIONS FOR FURTHER RESEARCH This study only begins to address the combined effect of the variables measured. It is an exploratory study dealing wi th areas largely overlooked in the past. O n the basis of these data and knowledge of the study's l imitations, several research directions are suggested: 1. It would be useful to verify the findings of the S U S O scale wi th more detailed objective quantitative measures of substance use, family history of alcohol (or other substance) use, and friends' substance using behaviour, and to increase the reliabili ty of S U S O wi th a more extended version of the vignettes. 2. Longi tudinal studies of changes in stress levels and substance use would provide further evidence of the connection between these two variables. D I S C U S S I O N / 52 3. 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APPENDIX B HASSLES SCALE 61 / 62 D i r e c t i o n ? : H a s s l e s a r e I r r i t a n t s t h a t can range from minor annoyances to f a i r l y major p r e s s u r e s , p r oblems, or d i f f i c u l t i e s . They can o c c u r f e u or many t i m e s . L i s t e d below a r e a number o f ways In which a person can f e e l h a s s l e d . F i r s t , c i r c l e the h a s s l e s t h a t have happened t o you In the p a s t month. Then look a t the numbers on the r i g h t o f the items you c i r c l e d . I n d i c a t e by c i r c l i n g a 1, 2, o r 3 bow SEVERE each o f the c i r c l e d h a s s l e s has been f o r you In the p a s t month. I f a h a s s l e d i d not o c c u r l a s t month do NOT c i r c l e I t . HASSLES 1. M i s p l a c i n g or l o s i n g t h i n g s 2. Troublesome n e i g h b o r s 3> S o c i a l o b l i g a t i o n s *4. I n c o n s i d e r a t e smokers 5 . T r o u b l i n g t h o u g h t s about your f u t u r e Thoughts about d e a t h H e a l t h o f a f a m i l y member Not enough money f o r c l o t h i n g Not enough money f o r h o u s i n g 10. Concerns about owing money 1 1 . Concerns abut g e t t i n g c r e d i t 1 2 . Concerns about money f o r emergencies 13- Someone owes you money l * . F i n a n c i a l r e s p o n s i b i l i t y f o r someone who doesn't l i v e w i t h you 1 5 . C u t t i n g down on e l e c t r i c i t y , w a t e r , e t c . 1 6 . Smoking t o o mi^ch 17. Use o f a l c o h o l Ul ec Ul Ul Ul oc > Ul VE SE Ei Ul 1/) to >• _> >-H ui • J < Ul < X U l c Ul r 0 P 0 0 X 10 X. U l 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 / 63 1 8 . Persona] use of drugs 19. Too many responsibilities 2 0 . Decisions about having children 2 1 . Mon-family members living In your house 2 2 . Care for pet 2 3 . Planning meals 2 * . Concerned about the meaning of l i f e 2 5 . Trouble relaxing 26. Trouble making decisions 27. Problems getting along with fellow workers 28. Customers or clients give you a hard time 29. Home maintenance (inside) 30 . Concerns about Job security 31 . Concerns about retirement 32. Laid-off or out of work 33- Don't like current work duties 3^ . Don't like fellow workers 35. Not enough money for basic necessities 36. Not enough money for food 37. Too many interruptions 38. Unexpected company UJ ec UJ UJ « > UJ UJ > to U l < 2: o 1/5 >< _] UJ H < DC Ul Q O x: UJ cf, UJ > UJ UJ U l oc X UJ 1 3 1 2 3 1 2 3 ' 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 ' 2 3 1 2 3 1 2 3 / 64 39. Too much time on hands *»0. Having to wait 41 . Concerns about accidents 42. Being lonely '13- Not enough money for health care 44. Fear of confrontation 45. Financial security 46. Silly practical mistakes ^7. Inability to express yourself 18. Physical Illness 49. Side erfects of medication 50. Concerns about medical treatment 5'. Physical appearance 52. Fear of rejection 53- Difficulties with getting pregnant 54. Sexual problems that result from physical problems 55. Sexual problems other than those resulting from physical problems 56. Concerns about health In general 57. Not seeing enough people 58. Friends or relatives too far away 59. Preparing meals 60. Writing time 61 . Auto maintenance Ul cc U) U) ce OS > Ul U) Ul > > i n Ul U l </> </) >-_ i >* Ul _> < H Ul X < r 3 Ul Ul U) ce r Q o o X to X u 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 2 3 62. Filling out form? 63- Neighborhood deterioration 6". Financing children's education 65. Problems with employee? 66. Problems on Job due to being a woman or man S7. Declining physical abilities 68. Being exploited 69. Concerns about bodily functions 70. Rising prices of common goods 71. Not getting enough rest 72. Not getting enough sleep 73. Problems with aging parents 71 . Problems with your children 75. Problems with persons younger than yourself 76. Problems with your lover 77. Difficulties seeing or hearing 78. Overloaded with family responsibilities 79. Too many things to do 80. Uncha11englng work 81. Concerns about meeting high standards 82. Financial dealings with friends or acquaintances 83. Job dissatisfactions 81. Worries about decisions to change Jobs 85. Trouble with reading, w r i t i n g or spelling abilities 86. Too many meetings 87. Problems with divorce or separation 88. Trouble with arithmetic skills 69. Gossip 90. Legal problems 9 ' . Concerns about weight 92. Mot enough time to do the things you need to do 93- Television 91. Not enough personal energy 95 . Concerns about Inner conflicts 96. Feel conflicted over what to do 97. Regrets over past decisions 98. Menstrual (period) problems 99. The weather 100. Nightmares 101. Concerns about getting ahead 102. Hassles from boss or supervisor 103- Difficulties with mends 101. Not enough time for family 105. Transportation problems 106. Not enough money for transportation 107. Not enough money for entertainment and recreation \» £ £ 6 6 Ul Ul > > </» U > ul in —' >-U J _ J < » - U J X -t £ S ac ui I O t-O O X to a: U J 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 ' 2 3 > 2 3 ' 2 3 1 2 3 1 2 3 » 2 3 1 2 3 ' 2 3 1 2 3 ' 2 3 1 2 3 1 2 3 i 2 3 i 2 3 i 2 3 1 2 3 ' 2 3 1 2 3 / 67 Ul DC U) UJ Ul CC PC > UJ Ul Ul > UJ to Ul to to v~ - J >> Ul < U) X < Zu Ul Ul Ul os T. Q H O o X to y. Ul 1 0 8 . Shopping 1 0 9 . P r e j u d i c e and d i s c r i m i n a t i o n from o t h e r s 1 1 0 . P r o p e r t y , i n v e s t m e n t s or t a x e s 1 1 1 . Not enough time f o r e n t e r t a i n m e n t and r e c r e a t i o n 1 1 2 . Yardwork or o u t s i d e home maintenance 1 1 3 - Concerns about new events l i t . Noise 1 1 5 . Crime 1 1 6 . T r a f r i c 1 1 7 . P o l l u t i o n 1 1 8 . HAVE WE MISSED ANY OF YOUR HASSLES? IF SO WRITE THEM IN BELOW : APPENDIX C SOCIAL SUPPORT SCALE 68 / 69 We would l i k e to know your thoughts and feelings about yourself and the people who matter to you. After reading each set of descriptions please t e l l me which description best applies to you. DEBBIE LESLIE ROBIN People are devoted to Debbie and love her. They always support her, l i s t e n to her and sympathize with her. They care about her a l o t . People are usually fond of L e s l i e . They can be sympathetic, but do not always l i s t e n to her or support her. People are not devoted to Robin. They do n©fc support her, l i s t e n her or sympathize witf her. They do not care about her or love her. .1 Check one. • I'm halfway I'm l i k e I'm halfway Deoole. between Debbie L e s l i e . between Leslie Robin and Leslie. and Robin. JANE People rarely l e t Jane know that she i s wanted. She does not r e a l l y make a difference to them and they are rarely concerned about her. She does not matter to there. SONIA People sometimes let Sonla know that she matters. Sometimes they think that she makes a difference to them. VIKI People constantly l e t Vlkl know that she i s wanted. She rea l l y makes a difference to them. They are concerned about her and she matters. .2 Check one. • • I'm l i k e Jane. I'm halfway between Jane and Sonla. I'm l i k e Sonla . I'm halfway I'm l i k e between Sonla V l k l . and V l k l . MlCHbLLt J I L L / 70 PAULA People always think that Michelle is a r r i e n d . They l i k e t a l k i n g with her and spending a lot of time with her. She always has l o t s of people around. She Is seldom alone. J i l l has friends and Is a good person to be with, but she Isn't always surrounded by people. Paula Is mostly alone. She rarely sees people or spends time with them. She Is most often by herself. ,3 Check one n I'm l i k e Michelle. I'm halfway between Michelle and J i l l . I'm l i k e J i l l . I'm halfway between J i l l and Paula. I'm l i k e Paula. JENNY DELORES SHELLEY Jenny r a r e l y has a close f r i e n d that she can count on. She does not know that they w i l l always be there for her to lean on and she does not support them. .4 Check one. Delores sometimes has a close f r i e n d who Is there for her and who she can count on. Shelley always has a close friend that she can count on. She does not have to worry about whether they w i l l be there for her to lean on. She give them the same support • • I'm like 'Jenny. I'm halfway between Jenny and Delores. I'm like Delores. I'm halfway between Delores and Shelley. I'm l i k e Shelley / 71 CARRIE RHODA SHARON People believe that Carrie w i l l make the right decisions and do the right things. They have confidence and faith In her. .5 Check one. Some people have confidence and faith In Rhoda. Sometimes they think that she will make the right decisions and do the right things. People rarely believe that Sharon will make the right decisions or do the right things. They hardly ever have confidence in her. I'm like Carrie. I'm halfway between Carrie and Rhoda. I'm like Rhoda. I'm halfway between Rhoda and Sharon. I'm like Sharon. ANNE JULIE MARY Anne rarely spends time with other people.. When she wants to do things, she hardly ever has anyone to do things with her. Julie sometimes spends time with other people. When she wants to do things, sometimes there are other people around to do things with her. Mary Is almost always with other people. Whenever she wants to do things, she knows that one or another of her friends will be there to do things with her. .6 Check one • • I'm lik e Anne. I'm halfway between Anne and Julie. I'm like Julie. I'm halfway between Julie and Mary. I'm like Mary. RUTH GILLIAN JEAN .Ruth knows t h a t p e o p l e c a r e a l o t about h e r . She has t h e i r a t t e n t i o n and s u p p o r t . G i l l i a n sometimes h a 3 p e o p l e ' s a t t e n t i o n and s u p p o r t . She sometimes f e e l s t h a t they c a r e about h e r . / 72 J e a n Is u n c e r t a i n t h a t p e o p l e c a r e about h e r . She g e t s l i t t l e a t t e n t i o n o r s u p p o r t . Check one. • • • I'm l i k e R u t h . I'm h a l f w a y between Ruth and G i l l i a n . I'm l i k e G i l l i a n . I'm h a l f w a y between G i l l i a n and J e a n . I'm l i k e J e a n . P H YLLIS MARTHA TINA P h y l l i s i s r a r e l y a d m i r e d and p r a i s e d . T h e r e a r e v e r y few I p e o p l e who t h i n k P h y l l i s l a I m p o r t a n t and w o r t h y . .8 Check one. D Martha i s sometimes admired and p r a i s e d by some p e o p l e . She i s not a l w a y s b e i n g reminded o f h e r w o r t h . T i n a i s c o n s t a n t l y b e i n g a d m i r e d by p e o p l e . They al w a y s p r a i s e h e r and t h i n k t h a t she i s i m p o r t a n t and w o r t h y . • I'm l i k e P h y l l i s . I'm h a l f w a y between P h y l l i s and M a r t h a . I'm l i k e M a r t h a . I'm h a l f w a y between M a r t h a and T i n a . I'm l i k e T i n a . BETH FA YE KAREN Beth does not have a l o t o f d i f f e r e n t p e o p l e she can l e a n on. She does n o t b e l o n g t o a g r o u p of p e o p l e who know each o t h e r and who would h e l p one a n o t h e r when needed. Faye sometimes has people she can l e a n on. She b e l o n g s t o a group of p e o p l e who sometimes h e l p one a n o t h e r when needed. K a r e n knows t h a t t h e r e a r e a l o t of d i f f e r e n t p e o p l e she can l e a n on. She b e l o n g s to a g r o u p o f many people who know each o t h e r and who a l w a y s h e l p one a n o t h e r out when needed. Check one • I'm l i k e B e t h . I'm h a l f w a y between B e t h and Fa V0. I'm l i k e F aye. I'm h a l f w a y between Faye and Karen. I'm l i k e K a r e n . APPENDIX D WORK ENVIRONMENT SCALE 73 YOUR WORK ENVIRONMENT / 74 The f o l l o w i n g s t a t e m e n t s are about the p l a c e In which you work. The s tatements a re in tended to a p p l y to a l l work e n v i r o n m e n t s . However, some words may not be q u i t e s u i t a b l e fo r your work env i ronment . For e x a m p l e , the term s u p e r v i s o r Is meant to r e f e r to the b o s s , manager, depar tment h e a d , o r the person or persons to whom an employee r e p o r t s . You a r e to d e c i d e which s ta tements a r e t rue o f your work env i ronment and which a r e f a l s e ( d u r i n g the  pas t month) . If you t h i n k a s ta tement i s t r u e or m o s t l y t r u e o f your work env i ronment , c i r c l e the l e t t e r T ( t r u e ) . If you t h i n k the s t a t e m e n t Is r a i s e , o r most l y f a l s e , c i r c l e the l e t t e r F ( f a l s e ) . TRUE FALSE 1. The work i s r e a l l y c h a l l e n g i n g . T F 2. People go out o f t h e i r way to h e l p a new employee f e e l c o m f o r t a b l e . T F 3. S u p e r v i s o r s tend to t a l k down to employees . T F I. Few employees have any Important r e s p o n s i b i l i t i e s . T F 5. There Is c o n s t a n t p r e s s u r e to keep w o r k i n g . ' T F 6 . Th ings a re sometimes p r e t t y d i s o r g a n i z e d . T F 7. T h e r e ' s a s t r i c t emphasis on f o l l o w i n g p o l i c i e s and r e g u l a t i o n s . T F 8. T h e r e ' s not much group s p i r i t . T F 9. The atmosphere Is somewhat i m p e r s o n a l . T F 10. S j p e r v i s o r s u s u a l l y compliment an employee who does something wM 1 . T F I I . Employees have a g reat d e a l of f reedom to do as they l i k e . T F 12. There always seems to be an urgency about e v e r y t h i n g . T F 13- A c t i v i t i e s are w e l l p l a n n e d . T F l " . People can wear w i l d l o o k i n g c l o t h i n g on the Job i f they want . T F 15. A l o t of peop le s e e m to be Just p u t t i n g i n t i m e . T F 16. P e o p l e t a k e a p e r s o n a l i n t e r e s t I n e a c h o t h e r . T F 1 7 . S u p e r v i s o r s t e n d t o d i s c o u r a g e c r l M c l r m T f r o m e m p l o y e e s . T F 18. F . m p l o y e e - * a r e " n e o n r . i g e d t o m.iVe t h e | r o u n d e c i s i o n ? . T F 1 9 . Peop le cannot a f f o r d to r e l a x . T 20. Ru les and r e g u l a t i o n s are somewhat vague and ambiguous. T 21 . Peop le are expec ted to f o l l o w s e t r u l e s In d o i n g t h e i r work. T 22. Peop le seem to take p r i d e In the o r g a n i z a t i o n . T 23. Employees r a r e l y do t h i n g s t o g e t h e r a f t e r work. T 24. S u p e r v i s o r s u s u a l l y g i v e f u l l c r e d i t to Ideas c o n t r i b u t e d by employees . T 25. Peop le can use t h e i r own I n i t i a t i v e to do t h i n g s . T 26. Nobody works too h a r d . T 27. The r e s p o n s i b i l i t i e s o f s u p e r v i s o r s a re c l e a r l y d e f i n e d . T 28. S u p e r v i s o r s keep a r a t h e r c l o s e watch on e m p l o y e e s . T 29. Peop le put q u i t e a l o t o f e f f o r t Into what they d o . T 30. Peop le a r e g e n e r a l l y f rank about how they f e e l . T 31. S u p e r v i s o r s o f t e n c r i t i c i z e employees over minor t h i n g s . T 32. S u p e r v i s o r s encourage employees t o r e l y on t h e m s e l v e s when a prob lem a r i s e s . T 33- There i s no time p r e s s u r e . T 34. T h e . d e t a i l s o f a s s i g n e d Jobs a re g e n e r a l l y e x p l a i n e d to e m p l o y e e s . T 35. Ru les and r e g u l a t i o n s are p r e t t y w e l l e n f o r c e d . T 36. Few peop le ever v o l u n t e e r . T 37. Employees o f t e n eat lunch t o g e t h e r . T 38. Employees g e n e r a l l y f e e l f r e e to ask f o r a r a i s e . T 39. Employees g e n e r a l l y do not t r y t o be un ique and d i f f e r e n t . T 40. It Is very hard to keep up wi th your work load. T 41. Employee? are often confused about exactly what they are supposed to do. T ^2. Supervisor? are always checking on employee? and supervise them very closely. T 43. It Is qutte a l i v e l y place. T / 76 44. Employees who d i f f e r g r e a t l y from the o t h e r s i n t h e o r g a n i z a t i o n don't get on w e l l . T F 4 5 . S u p e r v i s o r s e x p e c t f a r too much from employees. T F 46. Employees are encouraged t o l e a r n t h i n g s even I f they a r e not d i r e c t l y r e l a t e d t o the J o b . T F 47. you can t a k e i t easy and s t i l l get your work done. T F 4 8 . F r i n g e b e n e f i t s a r e f u l l y e x p l a i n e d t o employees. T F 49. S u p e r v i s o r s do not o f t e n g i v e i n t o employee p r e s s u r e . T F 50. I t ' s h a r d t o get people t o do any e x t r a work. T F 5 1 . Employees o f t e n t a l k t o each o t h e r about t h e i r p e r s o n a l p r o b l e m s . T F 52. Employees d i s c u s s t h e i r p e r s o n a l problems w i t h s u p e r v i s o r s . T F 5 3 - Employees f u n c t i o n f a i r l y i n d e p e n d e n t l y o f s u p e r v i s o r s . T F 5 4 . There a r e always d e a d l i n e s t o be s e t . T F 5 5 . Rules and p o l i c i e s are c o n s t a n t l y c h a n g i n g . T F 5 6 . Employees are e x p e c t e d t o conform r a t h e r s t r i c t l y t o the r u l e s and customs. T F 5 7 . The work i s u s u a l l y very I n t e r e s t i n g . T F 5 8 . O f t e n p e o p l e make t r o u b l e by t a l k i n g b e h i nd o t h e r s ' backs. T F 5 9 . S u p e r v i s o r s r e a l l y s t a n d up f o r t h e i r p e o p l e . T F 6 0 . S u p e r v i s o r s meet w i t h employees r e g u l a r l y t o d i s c u s s t h e i r f u t u r e work g o a l s . T F 6 1 . People o f t e n have t o work o v e r t i m e t o get t h e i r work done T F 62. S u p e r v i s o r s encourage employees to be neat and t i d y . T F 6 3 . I f an employee comes i n l a t e , s/he can make i t up by s t a y i n g l a t e . T F APPENDIX E BEM SEX ROLE INVENTORY 77 We would l i k e you to use the folJowing c h a r a c t e r i s t i c s in order to describe yourself. That Is, Indicate, on a scale fro« 1 to 7 , how true of you these various c h a r a c t e r i s t i c s are. Please do not leave any c h a r a c t e r i s t i c s unmarked- Place appropriate number in box beside word- / 78 J L Never or almost never Usually not t rue Sometimes but infrequently true Occasionally Often true true Usually Always or true almost always true S e l f - r e l i a n t ' Reliable Warn Yielding Analytical Solemn Helpful Sympathet ic W i l l i n g to take a stand Defends own b e l i e f s Jealous Tender Cheerful Has leadership a b i l i t i e s Friendly Moody Sensitive to the needs of others Aggressive Independent Truthful G u l l i b l e Shy Wil l i n g to take ri s k s I n e f f i c i e n t Consc ien t icus Understand ing Acts as a leader Ath l e t i c Secre c ive C h i l d l i k e Affectionate Hakes decisions e a s i l y Adaptable Theatrical Compassionate I n d i v i d u a l i s t i c Assert ive Sincere Does not use harsh language Flatterable S e l f - s u f f i c i e n t Unsystematic Happy Eager to soothe hurt feelings Coapet i t ive Strong personality Conce 11 ed Loves children Loyal Doralnant Tactf u l Unpredictable So f t-spoken A.-3 b i t ious Force fu1 Likeable Cen c1e Femlnine Ma sc u1ine Covenr ional X X X APPENDIX F SUBSTANCE USE AND SIGNIFICANT OTHERS SCALE 79 / 80 We w o u l d l i k e some i n d i c a t i o n o f t h e ways you m i g h t c h o o s e t o c o p e o r h e l p y o u r s e l f t o d e a l w i t h a d i f f i c u l t s i t u a t i o n . Which o f t h e f o l l o w i n g BEST d e s c r i b e s you TODAY? 1. SALLY S a l l y r a r e l y o r n e v e r d r i n k s any a l c o h o l i c b e v e r a g e s . MARIE M a r i e o c c a s i o n a l l y d r i n k s , s o m e t i m e s a l o t , b u t may go f o r l o n g p e r i o d s w i t h o u t d r i n k i n g . FAYE Faye d r i n k s r e g u l a r l y and s o m e t i m e s t o o m u c h . She may d r i n k a l o n e . 1. CHECK ONE: o I 'm T i k e S a l l y 2. BETTY C I 'm h a l f w a y b e t w e e n S a l l y and M a r i e B e t t y i s a has smoked heavy smoker and f o r y e a r s . She has f a i l e d i n h e r a t t e m p t s t o q u i t . o I 'm l i k e M a r i e o o I 'm h a l f w a y b e t w e e n M a r i e and F a y e RUTH I 'm l i k e Faye WANDA R u t h p r e v i o u s l y smoked and s t i l l somet imes w i s h e s s h e c o u l d have a c i g a r e t t e . Wanda has n e v e r s m o k e d . She c a n ' t i d e n t i f y w i t h t h e d i f f i c u l t y o f q u i t t i n g . 2. CHECK ONE: o ' m n k e B e t t y o I 'm h a l f w a y b e t w e e n B e t t y and R u t h o I 'm l i k e R u t h O O I 'm h a l f w a y b e t w e e n I 'm l i k e R u t h and Wanda Wanda 3. MARTHA M a r t h a e a t s a t m e a l t i m e o r when h u n g r y and does n o t t h i n k a b o u t f o o d o t h e r w i s e . JEANNIE J e a n n i e f i n d s f o o d r e l a x i n g and somet imes r e s o r t s t o e a t i n g when s t r e s s e d , o r b o r e d , o r ? CAROL C a r o l f r e q u e n t l y o v e r e a t s t o t h e p o i n t where she g e t s mad a t h e r s e l f . o I 'm h a l f w a y b e t w e e n M a r t h a and J e a n n i e 3. CHECK ONE o I 'm l i k e M a r t h a 4. E I L E E N E i l e e n r e l i e s on m e d i c a t i o n , e i t h e r p r e s c r i p t i o n o r o v e r -t h e - c o u n t e r . She s o m e t i m e s t a k e s more t h a n one k i n d a t a t i m e . o I 'm l i k e J e a n n i e DANIELLE o I 'm h a l f w a y b e t w e e n J e a n n i e and C a r o l o I 'm l i k e C a r o l D a n i e l l e o c c a s i o n a l l y r e s o r t s t o o v e r - t h e - c o u n t e r r e m e d i e s o r p r e s c r i p t i o n d r u g s . ELLA E l l a r a r e l y u s e s any m e d i c a t i o n and t h e n o n l y as recommended o r D r e s c r i b e d . 4. CHECK ONE: c I 'm l i k e E i1e e n o I 'm h a l f w a y b e t w e e n E i l e e n and D a n i e l l e o I 'm l i k e D a n i e l l e o o I 'm h a l f w a y be tween I 'm l i k e D a n i e l l e and E l l a E l l a / 81 5. ANNA A n n a ' s c l o s e s t f r i e n d i s a r e g u l a r and heavy d r i n k e r . 5. CHECK ONE: CLAIRE NORMA C l a i r e ' s c l o s e s t f r i e n d s o m e - N o r m a ' s c l o s e s t f r i e n d t i m e s has a d r i n k a t an o u t i n g , n e v e r d r i n k s , even a t a p a r t y . o I 'm l i k e Anna I 'm h a l f w a y b e t w e e n Anna and C l a i r e 6. BARBARA B a r b a r a does not use any i l l e g a l d r u g s . 6. CHECK ONE: o I 'm l i k e C l a i r e KELLY o I 'm h a l f w a y b e t w e e n C l a i r e and Norma I 'm l i k e Norma VICKY K e l l y u s e s some i l l e g a l d r u g s on o c c a s i o n . V i c k y u s e s many and d i v e r s e d r u g s . Q I 'm n ke B a r b a r a o o I 'm h a l f w a y b e t w e e n B a r b a r a and K e l l y 7. PATRICIA P a t r i c i a comes f r o m a home where h e a v y d r i n k i n g o c c u r r e d . T h e r e were f i g h t s and p r o b l e m s o v e r t h e d r i n k i n g . 7. CHECK ONE: I 'm l i k e K e l l y DONNA I 'm h a l f w a y b e t w e e n K e l l y and V i c k y I 'm l i k e V i c k y FRIEDA D o n n a ' s p a r e n t s had l i q u o r i n t h e h o u s e . M o s t l y i t was u s e d i n m o d e r a t i o n o r f o r e n t e r t a i n i n g . F r e i ' d a comes f r o m a home w h e r e t h e r e was no a l c o h o l , even a t p a r t i I ' m i i k e P a t r i c i a o o I 'm h a l f w a y b e t w e e n I 'm l i k e P a t r i c i a and Donna Donna o I 'm h a l f w a y b e t w e e n Donna and F r i e d a I 'm l i k e F r i e d a YOUR COMMENTS ABOUT F I L L I N G OUT THIS QUESTIONNAIRE ARE MUCH A P P R E C I A T E D : Thank y o u f o r y o u r t i m e and a t t e n t i o n . DEVELOPMENT OF THE SUBSTANCE USE AND SIGNIFICANT OTHERS SCALE (SUSO) The S U S O scale was modelled after Kap l an ' s (1977) social support scale which assesses the two distinct dimensions of love/esteem and social support. Because addiction studies generally focus on only one or two substances, i t was necessary to develop a measure which would provide a substance use score for multiple substances that could be summed for a total substance use measure. Studies which have included many substances have been large national surveys wi th inappropriate scales. Those scales were overly detailed and unique to substances (i.e., number of ounces of alcohol, pounds overweight, cigarettes smoked) and did not reflect a comparable degree of substance use/abuse on one continuum. Init ial ly 10 sets of vignettes were developed which dealt wi th the following: 1. Alcohol 2. Wine and beer 3. Prescription drugs 4.0ver-the-counter drugs 5.Illegal drugs 6. Nicotine 7. Food 8. Weight control/concerns 9. F a m i l y of origin habits 10. Significant friends behaviour This original form of the S U S O scale was presented to 10 associates/friends for feedback about intention and clar i ty of the vignettes. A s "a-, result of this feedback, the alcohol and wine and beer vignettes were collapsed to one vignette 82 / 83 dealing wi th alcohol generally; the prescription and the over-the-counter drug vignettes were collapsed to one dealing wi th legal drugs; and the vignette around weight control was dropped as it appeared to deal wi th consequences rather than the food abuse itself. In consultation wi th experts, each of the vignettes was re-written for greater simplici ty and clar i ty . The format for each i tem includes three vignettes representing each of the five substances: the first represents a "no use" or "normal use", the second represents an "at r i sk" level of use and the third represents "excessive use" or "abuse". A set of vignettes deal wi th family of origin ranging from no alcohol use to one where there was heavy dr inking, and another set deals w i th a closest friend, ranging from not dr inking to regular and heavy drinking. Fo r the purpose of this study the vignettes were wri t ten wi th women's names. A masculine instrument was also prepared for validation testing. Respondents were instructed to indicate which of the three vignettes most resembled their circumstances. A n in-between choice was possible for subjects who did not fit exactly in any of the three examples. Scoring is on a range of 1 to 5 for each vignette; wi th 1 representing "no use", 2 representing "little use", 3 representing an "at r i sk" level, 4 representing "high use", and 5 representing "abuse" of the substance. A score on one substance is comparable to a s imilar score on another substance. This revised 7-item scale was presented to 19 male and female graduate students, ranging from 25 to 45 years, i n the Counselling Department, Un ive r s i ty of B r i t i s h Columbia , for assessment of the face val idi ty and c lar i ty of the statements. Comments and feedback space were provided. None of the students found the vignettes unclear. Concern regarding the instrument was expressed when the respondent was unable to fit clearly wi th in one vignette and had to choose / 84 between two. The possible range of scores was 1 to 25; the students scored between 3 and 10, with a mean of 5.42. This is what would be expected of a group not identified as having an addiction/substance use problem. The inclusion of the family of origin and the significant friend vignettes were questioned as to face validity for substance use. This revised 7-item scale was then administered to male and female clients at a Alcohol and Drug Counselling Centre (A&D) in Vancouver during the months of January through to March, 1989. (See Appendix G for letter to Drug and Alcohol Centre). In April and May, 1989, the scale was also completed by residents at the Aurora Treatment Centre for Women in Vancouver. (See Appendix H for letter to Aurora Treatment Centre). During this period, a total of 113 men (A&D males) and 61 women (A&D females) from both sources completed the form. Respondents from these sources were expected to score above 10 on substance use as they represent a group already identified as having an addiction problem. The mean score on the five substances for the 61 A&D females was 13.8 and the mean score on the substances for the 113 A&D males was 14.6. Concurrently with the above testing, the revised SUSO scale was administered to 59 female managers during the months of December, 1988 and January, 1989, as part of a follow-up stage of the larger longitudinal research project. The mean score on use of the five substances by these managers was 9.4. A one-way multivariate analysis of variance (MANOVA) with the 5 substance use items, family history of alcohol use, and friends drinking behaviour as dependent measures, was conducted to examine differences between the A&D males and A&D females and the managers groups. The multivariate group effect was significant, 1X14, 448) = 11.93, _p_ <.0001. An examination of the univariate F_ tests revealed significant group effects for alcohol, / 85 jF(2, 230) = 20.85, j3_ <.001; smoking, F(2, 230) = 42.13, £ <.001; eating , F(2, 230) = 7.48, _p_ <.001; prescription drugs, F(2, 230) = 5.99, _p_ <.002; illegal drugs, JF(2, 230) = 30.27, _p_ <.001; friends, _F(2, 230) = 7.20, jp_ <.001; family of origin, F(2, 230) = 13.89, _p_ <.001. Post hoc analysis, using Scheffe' tests, comparing the 59 managers with the 61 A&D females indicated significant differences (p_<.05) for the alcohol, smoking, prescription drugs, illegal drugs and family background items; with the A&D females scoring higher on each substance. There was no difference on the eating item and no significant difference on the friends' drinking behaviour. Comparison of the managers group with the A&D males group found significant differences (p_<.05) for every item; with the A&D males scoring higher on every item, except the eating item on which the managers scored higher. Comparison of the A&D males and the A&D females found significant differences (p_<.05) only on the smoking and eating items. (See Table 5). The difference on the eating item between the two A&D groups may reflect a gender difference. The difference on the smoking item may be a reflection of the eating-difference, i.e., overeaters very frequently do not smoke and smokers frequently show less interest in food. Actually smoking is more closely associated with drinking (Beckwith, 1986; Mello, Mendelson, & Palmieri, 1987). The lower overall mean score for the managers group, compared with the A&D groups, indicates that the SUSO scale discriminates between groups and provides some evidence of construct validity. The profiles for the A&D males and the A&D females show marked similarities and are quite different from the managers' profile. A surprising result was the high scores for the managers on the friends' behaviour, which was not significantly different from A&D females. / 86 No significant difference was found between the managers and the A & D females on the eating measure. Clients at the drug and alcohol facility would not be solicited on the basis of problems wi th food and would be responding to a commonly and officially held view of addiction as related to narcotics. Accordingly it is expected that their level of food use/abuse would not necessarily be different than that of the "normal/average" women. A l so , food being a very socially acceptable and non-stigmatized form of compulsion (particularly for women) i t is not surprising to find the highest managers ' scores to be on the eating i tem, along wi th alcohol (another "acceptable" legal form of indulgence). Based on the Cronbach's alpha (.40) found for the S U S O using 5 substances and that found when the i tem on food was removed (.56), a decision was made to eliminate the i tem on food in the S U S O calculations in the study. Tab le 5 Means and Standard Dev ia t i ons of Items from the Substance Use  and S i g n i f i c a n t Others S c a l e (SUSO) f o r Managers, A l c o h o l and  Drug (A&D) Females and A l c o h o l and Drug (A&D) Males ITEMS MANAGERS A&D FEMALES A&D MALES (11=59) (U=61) (Jl=113) & SJD i l SD M_ SB. A l c o h o l 2.26 1.16 3.15 1. 50 3 .61 1.30 Smoking 2.04 1.32 3.38 1. 56 4 .07 1.35 E a t i n g 2.26 1.12 2.26 1. 35 1 .69 0.94 P r e s c r i p . Drugs 1.60 0.93 2.38 1. 58 2 .32 1.56 I l l e g a l Drugs 1.24 0.76 2.66 1. 47 2 .90 1.54 T o t a l Substances 9.40 5.29 13.83 7. 46 14 .59 6.69 Fr iends Behav. 2.93 0.72 3.34 1. 38 3 .64 1.22 Fami ly H i s t o r y 2.88 1.07 3.93 1. 15 3 .72 1.24 Note ; Grea te r the s c o r e , the g rea te r the substance u s e . / 88 Tab le 6 Post hoc A n a l y s i s Sche f fe / Tes ts on Substance Use and S i g n i f i c a n t  Others S c a l e (SUSO) i n Three Groups; Managers, A l c o h o l and  Drug (A&D) Females, and A l c o h o l and Drug (A&D) Males Managers/A&D Females Managers/A&D Males A&D Females/A&D Males (IL=59) (H=61) Cn=59) (B,=H3) (n=61) Q]=113) A l c o h o l 14.17*** 41.50*** 4.78 Smoking 28.95*** 84.18*** 9.56** E a t i n g .01 9.63** 10.55** P r e s . Drugs 9.10* 10.04** 2.22 I l l e g a l Drugs 32.62*** 57.65*** 1.23 Fr i ends 3.75 14.52*** 2.65 Fami l y 23.85*** 19.73*** 1.14 p_<.05, **p_<.01, ***£<.001 


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