Types of natural recovery from alcohol dependence: A cluster analytic approach

Background: Social capital and a low severity of alcohol-related problems have been focused upon to explain the processes of natural recovery from alcohol dependence. However, studies using control groups have not found significant differences in these variables. Subtypes of natural remission which might account for this inconsistency have only been described on grounds of qualitative data. Aims: To identify subtypes of natural remitters using cluster analysis. Participants: One hundred and seventy-eight media-recruited natural remitters were interviewed personally. Several triggering mechanisms and maintenance factors of remission were assessed using standardized questionnaires. Based on age of onset and severity of dependence, adverse consequences from drinking, social pressure and social support, cluster analyses were performed. Results: Cluster analyses yielded three groups of natural remitters: one cluster with a high severity of dependence, low alcohol-related problems and low social support ('low problems - low support': n = 65), one group characterized by high severity of dependence, high alcohol-related problems and medium social support ('high problems - medium support': n = 37), and a third group which consisted of subjects with high social support, late age of onset, low seventy of dependence, and low alcohol-related problems ('low problems - high support': n = 76). Cluster solutions were confirmed using discriminant analyses. Analyses of variance (ANOVAs) revealed further group differences on other triggering and maintaining factors of remission. Conclusions: Failure to identify specific pointers to natural recovery in previous research might be due to heterogeneous subgroups of natural remitters. In order to build a conceptual framework for understanding the processes of natural recovery, interactions of different independent variables should be considered.