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application of coping strategies, whether the reduction in dependence is tautological with the application of coping or whether the reduction in dependence is affected by some other variable which is associated with the application of coping strategies.
As to the question of the hypothesis regarding pre-treatment variables, the substance emerged as a significant predictor of clinically significant change in dependence at three months. This finding lends support to the potential importance of distinguishing clinically significant change: no significant difference was found in the amount of change in dependence between the two drug groups in preliminary analysis. No other pre-treatment variables, nor social or psychological functioning were found to predict the outcomes of change in dependence in either of the groups of regression analyses.
10.1.4 Predictors of change in substance use
Although it was the central concern of the thesis to elucidate the nature of change in dependence, the predictors of changes in use were also examined as part of the attempt to investigate the nature of the relationship between dependence and use. On the question of whether dependence determines use or use determines dependence, I have suggested that there may be a difference in the direction of the relationship during the period of developing dependence compared with that which occurs once dependence has been established. The level of dependence at intake was shown significantly to predict the change in the number of days using at three months and the level of dependence at three months was shown significantly to predict the change in the number of days using at twelve months. It is, however, difficult to interpret these findings: the correlation in both cases is a positive one and may again be a measurement artefact. This once more highlights the difficulty in using change scores: the people with the highest dependence had the most scope for change both in dependence and in use.
10.2 On the validity of the findings
The validity of the findings are a function of the method of sampling, the reliability of the instruments used and the design of the data analysis; there follows a critical examination of the methodology and analysis, drawing conclusions about the limitations of the findings and some recommendations for the future direction of enquiry in elucidating the nature of change.
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