Bottoming out experiences: factor analyses and moderating effects of gender and race

Abstract

The Bottoming Out Experience (BOE) is thought to be the accumulation of negative experiences for those with Substance Use Disorders (SUDs). This study aimed to bridge research and the narrative utilized in 12-step programs by quantifying the construct of the BOE. To do this, we examined the factor structure of the BOE using negative experiences that have been associated with change for individuals at the intake level. We also tested for variances in factor loadings of the BOE between gender and ethnicity to understand moderating effects. Archival data from the Center from Substance Abuse Treatment (CSAT) was used, specifically data from the Global Appraisal of Individual Needs (GAIN). We hypothesized that identified negative experiences would load into a unidimensional model. Hypothesis one was rejected, due to exploratory factor analysis results. Thus, we created five subfactors (F1: mental distress and trauma; F2: stress; F3: substance use levels; F4: risky behaviors, and F5: financial problems) and confirmed the model with the second half of the dataset. Hypothesis two stated that differences would exist within the models based on both gender and ethnicity, and this hypothesis was supported. The overarching BOE model remained the same for all gender and ethnic groups, but factor loadings within the models differed based on both gender and ethnicity. Although previous theory supported the idea of the BOE, no research had been conducted on the multivariate relationships between these negative experiences. The BOE model and the gender and ethnic differences have significant implications for SUD treatment.

Keywords:

• Substance use
• bottoming out experience
• race
• gender
• treatment
• change

Disclosure statement

No potential conflict of interest was reported by the authors. The development of this study was supported by the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA) contracts [#277-00-6500; #270-2003-00006; #270-2007-00004C; # 283-2007-00003; # 283-2007-00003; # 283-2007-00003] using data provided by the following grantees: [20084; 20086; 655373; TI-13190; TI-13313; TI-13322; TI-13345; TI-13354; TI-13356; TI-14090; TI-14188; TI-14189; TI-14196; TI-14252; TI-14261; TI-14267; TI-14271; TI-14272; TI-14283; TI-14311; TI-14315; TI-14376; TI-15415; I-15421; TI-15433; TI-15438; TI-15446; TI-15447; TI-15458; TI-15461; TI-15466; TI-15467; TI-15469; TI-15478; TI-15479; TI-15485; TI-15486; TI-15489; TI-15511; TI-15514; TI-15524; TI-15527; TI-15562; TI-15577; TI-15584; TI-15586; TI-15670; TI-15671; TI-15674; TI-15677; TI-15678; TI-15682; TI-15686; TI-16400; TI-16414; TI-16904; TI-16928; TI-16939; TI-16961; TI-16992; TI-17046; TI-17071; TI-17334; TI-17446; TI-17475; TI-17476; TI-17534; TI-17535; TI-17538; TI-17547; TI-17646; TI-17648; TI-17673; TI-17702; TI-17719; TI-17728; TI-17742; TI-17744; TI-17751; TI-17755; TI-17761; TI-17763; TI-17765; TI-17775; TI-17779; TI-17786; TI-17788; TI-17812; TI-17821; TI-17825; TI-17830; TI-17831; TI-17847; TI-17864; TI-18587; TI-18723; TI-18849; TI-19313; TI-19942; TI-20117; TI-20759; TI-20781; TI-20806; TI-20827; TI-20847; TI-20848; TI-20849; TI-20852; TI-20865; TI-20870; TI-20910; TI-20921; TI-20925; TI-20938; TI-20941; TI-20946; TI-21551; TI-21580; TI-21585; TI-21595; TI-21597; TI-21624; TI-21632; TI-21639; TI-21682; TI-21688; TI-21705; TI-21714; TI-21748; TI-21774; TI-21788; TI-21815; TI-21874; TI-21883; TI-21890; TI-21892; TI-21948; TI-22424; TI-22425; TI-22513; TI-22544; TI-22622; TI-22695; TI-22856; TI-23037; TI-23056; TI-23064; TI-23096; TI-23101; TI-23186; TI-23188; TI-23197; TI-23224; TI-23247; TI-23270; TI-23279; TI-23310; TI-23311; TI-23312; TI-23345]. The author thanks these grantees and their participants for agreeing to share their data to support this secondary analysis. The opinions about this data are those of the author and do not reflect official positions of the government or individual grantees.