Alcoholics Anonymous Attendance Research Articles

Disparities in Alcoholics Anonymous Participation from 2000 to 2020 Among U.S. Residents With an Alcohol Use Disorder in the National Alcohol Survey.

Mutual-help groups (MHGs) like Alcoholics Anonymous (AA) are effective for resolving alcohol use disorders (AUDs), but few studies have examined disparities in MHG participation, particularly recently. We used five waves of National Alcohol Survey data to investigate whether prevalence of AA attendance among those with a lifetime AUD differed by race/ethnicity, age, and sex, directly testing whether these associations varied with time. Analyses pooled weighted data from 2000 to 2020, including only participants with a lifetime AUD and identifying as non-Hispanic White, Latinx/Hispanic, or non-Hispanic Black/African American (N = 8,876). Logistic regression models examined associations between lifetime AA attendance and survey year, race/ethnicity, age, and sex; models also tested for differences in demographic effects across survey year using interaction terms. In bivariate models, AA attendance was significantly less prevalent among participants identifying as Latinx/Hispanic (vs. White); ages 18-29 (vs. 30-64); and female (vs. male). Survey year was unrelated to AA attendance, and all interactions involving survey year were nonsignificant. In the final multivariate model (which controlled for severity and other help-seeking), disparities persisted for those identifying as Latinx/Hispanic (vs. White; adjusted odds ratio [aOR] = 0.63) and ages 18-29 (vs. 30-64; aOR = 0.35); AA attendance was also less prevalent among Black/African American (vs. White) participants (aOR = 0.59), but sex became nonsignificant. Results replicate and extend sparse findings regarding disparities in MHG attendance and suggest a stagnation in AA's growth and reach to underserved populations. Findings highlight the need to more effectively facilitate MHG attendance (and perhaps broader social network change) among racial/ethnic minorities and emerging adults.

Cooperation vs. affiliation: an exploratory qualitative study of alcoholics anonymous’ position within the recovery ecosystem

Background Addressing substance use disorder (SUD) requires intricate solutions, usually involving several organizations within a complex institutional environment. Alcoholics Anonymous (AA) shares the recovery ecosystem with other organizations, is ubiquitous across communities, and is notably inexpensive as an intervention; yet the exact nature of the connections between AA and other organizations in the recovery ecosystem is underexplored. Objective Explore relationships AA has with other recovery ecosystem organizations and guide future research. Methods Data were gathered via ethnographic participant observations, which were triangulated and contextualized via semi-structured interviews with key informants and archival documents. Results Though AA does not formally link itself with other organizations, findings point toward strong relationships at the individual level and of an informal nature. Individual members who also have affiliation with other organizations (e.g., legal institutions, treatment services) create bridges, enabling efficient solving of complex issues. Conclusions Services wishing to leverage AA (or other mutual-aid) attendance will likely benefit from fostering informal relationships with individual AA members, including lowering barriers to disclosure of recovery status, and contacting local AA service elements capable of making these connections. Similarly, research to advance community-level SUD services and the knowledge-base would benefit from incorporating and partnering with people in recovery.

Predictors of alcohol use disorder treatment outcomes over 12 months: Role of concerned others’ functioning and Al-Anon participation

BackgroundThis study included dyads comprised of adults entering treatment for alcohol use disorder and their Concerned Others (COs) to examine indicators of COs functioning (Al-Anon attendance and involvement, relationship stressors, use of approach coping and stigma) as predictors of patient outcomes (Alcoholics Anonymous (AA) attendance and involvement, abstinence and risk of substance use) over 12 months following adults’ entry into AUD treatment. MethodsDyads (n = 279) were assessed when patients entered treatment and at 3-, 6- and 12-month follow-ups. Data were collected through participants’ self-report. Lagged generalized linear mixed models were used to examine associations between indicators of COs’ functioning at baseline, 3- and 6-month follow-ups and patients’ outcomes at 3-, 6- and 12-month follow-ups. ResultsPatients reported less AA attendance and involvement and likelihood of maintaining abstinence from alcohol use over time. Findings from our multivariate analysis showed that any CO involvement in Al-Anon, relative to none, was associated with more patient AA attendance. In contrast, more stigma (e.g., need to hide patient’s drinking) reported by COs was associated with lower patient AA participation and involvement, while more CO use of approach coping was associated with less patient risk for alcohol and drug use. ConclusionsFindings suggest that COs’ functioning can affect longer-term outcomes of adults entering AUD treatment. Treatment programs should increase the availability of help to COs to improve their functioning and patient outcomes.

Dose of psychotherapy and long-term recovery outcomes: An examination of attendance patterns in alcohol use disorder treatment.

The purpose of this study was to examine associations between psychotherapy session attendance, alcohol treatment outcomes, and Alcoholics Anonymous (AA) attendance. Using data from Project MATCH, repeated measures latent class analyses of psychotherapy session attendance were conducted among participants in the outpatient arm who were randomly assigned to complete 12-session cognitive-behavioral therapy (CBT; n = 301), 12-session twelve-step facilitation (TSF; n = 335), or 4-session motivational enhancement therapy (MET; n = 316). Associations between psychotherapy attendance classes, heavy drinking, alcohol-related consequences, psychosocial functioning, and AA attendance were examined at posttreatment (97% retention), 1-year posttreatment (92% retention), and 3-years posttreatment (85% retention). In general, participants who attended all 12 CBT/TSF sessions had significantly fewer heavy drinking days and alcohol-related consequences at all posttreatment time points than participants who attended 0-2 CBT/TSF sessions. Participants who attended all four MET sessions generally had significantly fewer heavy drinking days and alcohol-related consequences at posttreatment and 1-year posttreatment than participants who attended 0-1 MET sessions. Participants who attended more TSF and MET sessions generally attended more AA meetings, and participants who attended less CBT sessions generally attended fewer AA meetings. With some exceptions, attending all sessions in CBT, TSF, and MET was related to the most favorable heavy drinking and alcohol-related consequences outcomes. Alcoholics' Anonymous and other mutual help groups may be attended differently based on the form and dose of psychotherapy (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Factors Having an Impact on Relapse and Survival in Transplant Recipients With Alcohol-Induced Liver Disease.

ObjectiveTo assess the impact of standardized pretransplant alcohol abstinence and treatment guidelines on liver transplant outcomes.MethodsThis study assessed the posttransplant relapse and survival associated with a pretransplant guideline mandating alcohol abstinence, addiction treatment, and Alcoholics Anonymous (AA) attendance. This retrospective cohort study included liver recipients with alcohol-induced liver disease transplanted between January 1, 2000, and December 31, 2012, at a Midwest transplant center. Cox regression models tested for associations between pretransplant treatment, demographic and clinical characteristics, and outcome measures.ResultsOf 236 liver recipients (188 [79.7%] male; 210 [89%] white; mean follow-up, 88.6±55.0 months), 212 (90.2%) completed pretransplant treatment and 135 (57.2%) attended AA weekly. At 5 years, 16.3% and 8.2% had relapsed to any alcohol use and to high-dose drinking, respectively. Smoking during the 6 months before transplant was associated with any relapse (P=.0002) and high-dose relapse (P<.0001), and smoking at transplant was associated with death (P=.001). High-dose relapse was associated with death (hazard ratio, 3.5; P<.0001).ConclusionA transplant center with a guideline requiring abstinence, treatment, and AA participation experienced lower posttransplant relapse rates from those previously reported in comparable large US transplant programs. Smoking cessation may further improve posttransplant outcomes.

New converts and seasoned campaigners: the role of social identity at different stages in the addiction recovery journey

Social identities associated with recovery are protective of relapse from addiction. How such identities develop and differentially link to outcomes at different points of the recovery journey and across multiple recovery attempts is relatively unknown. The current study utilised a pre-existing cross-sectional dataset (n = 237 Alcoholics Anonymous (AA) members, 50% male, 49.4% female and 0.6% female-to-male, aged between 19 and 71 years) to explore these issues. Relationships between AA identity, quit efficacy (a proxy for recovery maintenance) and AA meeting attendance (over the last month) were tested. The moderating effects of length of AA attendance during the current recovery episode and first vs. subsequent quit attempts on the identity-efficacy link were also tested. Levels of social identity were stable amongst those in the early in their current recovery through to those who have more experience, but the relationships between identity and efficacy differed. While those early on in their current AA attendance showed a positive relationship between identities and frequency of attending meetings, those with more long-standing attendance reported social identification unrelated to involvement. Our results suggest that social identities may be particularly protective for those who are on their first quit, suggesting recovery formation and transition may be a priority.

Rates and predictors of Alcoholics Anonymous attendance across sexual orientations

Sexual minority (e.g., gay, lesbian, bisexual) individuals experience alcohol dependence at 2–6 times the rates of heterosexual individuals. Among the general population, Alcoholics Anonymous (AA) serves as the most common source of support for alcohol-related problems in the United States. Yet, relatively little is known about sexual minority involvement in AA, including rates and predictors of AA attendance among sexual minorities. This paper aims to: 1) Compare rates of AA attendance across sexual orientations; 2) Compare relationships between AA attendance and common predictors of AA attendance across sexual orientations. Using five waves of the National Alcohol Survey (N = 7862 respondents with at least one lifetime AUD symptom), this study found lesbian and bisexual women, but not gay and bisexual men, had greater odds of attending AA, even while controlling for lifetime AUD severity, gender, race/ethnicity, age, religiosity, and current income. Interaction models for women showed there was a stronger association between older age and AA attendance, a stronger association between greater religiosity and AA attendance, and a weaker association between lifetime AUD severity and AA attendance for sexual minority women relative to heterosexual women. This study did not find significant interactions between sexual orientation and these covariates for men. These results suggest AA may serve as a promising resource for sexual minority individuals experiencing alcohol-related problems, particularly for sexual minority women who are older, more religious, and have less severe AUD.

Urban American Indian Adult Participation and Outcomes in Culturally Adapted and Mainstream Alcoholics Anonymous Meetings

ABSTRACTVery little is known about American Indian (AI) adults’ participation in Alcoholics Anonymous (AA) despite their elevated rates of negative sequelae due to heavy alcohol consumption and alcohol use disorders. This study sought to fill that gap and examined the engagement in AA by urban Southwest AI (S-AI) adult problem drinkers and whether enculturation and acculturation accounted for type of AA attended (mainstream vs. culturally adapted AA; CA-AA). Additionally, we compared 3- and 6-month drinking outcomes of urban S-AI adults by type of meeting attended. Sixty-one urban S-AI adults consented and were assessed at baseline, 3, and 6 months. We examined the association between frequency of AA attendance and differences between types of meetings attended regressed on the outcomes of proportion abstinent days and drinks per drinking day. Results indicate that AA attendance is the model approach and assists urban S-AI adults in reducing their drinking. Despite higher engagement among those attending AA and CA-AA, this did not translate into differential AA-related benefit which speaks to the need for additional research to assist AI adults in effectively reducing their alcohol use.

AA attendance and abstinence for dually diagnosed patients: a meta-analytic review.

There is consensus that best clinical practice for dual diagnosis (DD) is integrated mental health and substance use treatment augmented with Alcoholics Anonymous (AA) attendance. This is the first quantitative review of the direction and magnitude of the association between AA attendance and alcohol abstinence for DD patients. A systematic literature search (1993-2017) identified 22 studies yielding 24 effect sizes that met our inclusion criteria (8075 patients). Inverse-variance weighting of correlation coefficients (r) was used to aggregate sample-level findings and study aims were addressed using random- and mixed-effect models. Sensitivity and publication bias analyses were conducted to assess the likelihood of bias in the overall estimate of AA-related benefit. AA exposure and abstinence for DD patients were associated significantly and positively [rw =0.249; 95% confidence interval (CI)=0.203-0.293; tau=0.097). There was also significant heterogeneity in the distribution of effect sizes and high between-sample variance (I2 =74.6, P < 0.001). Subgroup analyses indicated that the magnitude of AA-related benefit did not differ between 6- (k=7) and 12- (k=12) month follow-up (Q=0.068, P=0.794), type of treatment received (in-patient k=9; intensive out-patient, out-patient, community k=15; Q=2.057, P=0.152), and whether a majority of patients in a sample had (k=11) or did not have (k=13) major depression (Q=0.563, P=0.453). Sensitivity analyses indicated that the overall meta-analytical estimate of AA benefit was not impacted adversely or substantively by pooling randomized controlled trial (RCT) and observational samples (Q=0.763, P=0.382), pooling count, binary and ordinal-based AA (Q=0.023, P=0.879) and outcome data (Q=1.906, P=0.167) and reversing direction of correlations extracted from studies (Q=0.006, P=0.937). No support was found for publication bias. Clinical referral of dual diagnosis patients to Alcoholics Anonymous is common and, in many cases, dual diagnosis patients who attend Alcoholics Anonymous will report higher rates of alcohol abstinence relative to dual diagnosis patients who do not attend Alcoholics Anonymous.

Forgiveness and gratitude trajectories among persons undergoing alcohol addiction therapy

Background: The first studies concerning changes in moral virtues during alcohol addiction therapy were published during the last decade. However, as all of these studies applied a variable-oriented approach, it is impossible to capture differences between starting points and changes in variables of interest. Method: In this study, we employed a person-oriented approach to identify trajectories of change in two moral virtues—forgiveness and gratitude—during alcohol addiction treatment. The sample consisted of 358 alcohol-dependent individuals who were receiving outpatient therapy. Measurements were taken (1) at the beginning of the basic treatment, (2) after its completion (5–7 weeks from baseline), and (3) about six months later. Three forgiveness scales and the Gratitude Questionnaire (GQ-6) were used to assess the patients’ moral virtues. Results: Latent class growth analysis (LCGA) revealed four trajectories for self-forgiveness and gratitude, and three trajectories for forgiveness of others and feeling forgiven by God. For patients with a low baseline level of moral virtues, the changes varied depending on the kind of moral virtue. Patients with a relatively high initial level of moral virtues maintained that level in subsequent measurements. Significant correlates of trajectory class membership were gender, education, age, religiosity, diagnosis of coexisting psychiatric disorders, and frequency of attending Alcoholics Anonymous (AA) meetings. Conclusions: This study highlights the clinical importance of considering differences at the baseline level and in changes of forgiveness and gratitude, as well as personal and alcohol-related correlates of trajectory group membership among people who participate in alcohol addiction therapy.

Drug and alcohol treatment providers' views about the disease model of addiction and its impact on clinical practice: A systematic review.

Addiction treatment providers' views about the disease model of addiction (DMA), and their contemporary views about the brain disease model of addiction (BDMA), remain an understudied area. We systematically reviewed treatment providers' attitudes about the DMA/BDMA, examined factors associated with positive or negative attitudes and assessed their views on the potential clinical impact of both models. Pubmed, EMBASE, PsycINFO, CINAHL Plus and Sociological Abstracts were systematically searched. Original papers on treatment providers' views about the DMA/BDMA and its clinical impact were included. Studies focussing on tobacco, behavioural addictions or non-Western populations were excluded. The 34 included studies were predominantly quantitative and conducted in the USA. Among mixed findings of treatment providers' support for the DMA, strong validity studies indicated treatment providers supported the disease concept and moral, free-will or social models simultaneously. Support for the DMA was positively associated with treatment providers' age, year of qualification, certification status, religious beliefs, being in recovery and Alcoholics Anonymous attendance. Greater education was negatively associated with DMA support. Treatment providers identified potential positive (e.g. reduced stigma) and negative (e.g. increased sense of helplessness) impacts of the DMA on client behaviour. The review suggests treatment providers may endorse disease and other models while strategically deploying the DMA for presumed therapeutic benefits. Varying DMA support across workforces indicated service users may experience multiple and potentially contradictory explanations of addiction. Future policy development will benefit by considering how treatment providers adopt disease concepts in practice.

Alcoholics Anonymous and other 12-step programs for alcohol use disorder

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The primary objective of this review is to evaluate the efficacy of Alcoholics Anonymous mutual help groups, operated by peers, and TSF interventions, operated by professionals. Both will be evaluated relative to other interventions for AUD by examining their effects on abstinence, drinking intensity, and drinking‐related consequences. The secondary objective is to examine the healthcare utilization cost impact of Alcoholics Anonymous attendance and of TSF. In this review, Alcoholics Anonymous attendance and TSFs will be compared with the following interventions. 1) Other clinical interventions (e.g. motivational enhancement therapy (MET), cognitive‐behavioral therapies (CBT), etc.). 2) Other 12‐step program variants (e.g. studies comparing different types of 12‐step interventions). 3) No treatment (e.g. wait list control).

Effects of Treatment Type on Alcohol Consumption Partially Mediated by Alcoholics Anonymous Attendance

ABSTRACTBackground: As insurance coverage, funding sources and venues for drug and alcohol treatment evolve in the United States, it is important to assess how the type of treatment received may impact long-term outcomes. The current study aims were to examine effects of treatment type on alcohol consumption in the year after treatment intake and to test mediators of effects of treatment type on later alcohol use. Methods: Longitudinal data from clients in inpatient and outpatient alcohol treatment programs in California (n = 560) were used in ordinary least squares path analysis adjusting for respondent characteristics typically associated with both treatment completion and alcohol use. The primary outcome was amount of alcohol consumed in the 12 months after treatment entry; hypothesized mediators were treatment duration and participation in Alcoholics Anonymous (AA). Results: Despite higher baseline problem severity and a shorter treatment duration, inpatient clients consumed less alcohol after treatment than outpatient clients (B [95% CI] = −0.95 [−1.67, −0.23]). AA involvement was a significant mediator of the relationship between treatment type and alcohol consumption, with inpatient clients being more involved in AA and also drinking less after treatment than outpatient clients; the bias-corrected bootstrap 95% confidence interval for the indirect effect (B = −0.20) was entirely below zero (−0.43 to −0.05). Conclusions: Outpatient clients may benefit from customized posttreatment recommendations to identify additional resources to assist in the recovery process during the first year after treatment.

Lifetime Alcoholics Anonymous attendance as a predictor of spiritual gains in the Relapse Replication and Extension Project (RREP).

This study investigated the association between extent of lifetime attendance in Alcoholics Anonymous (AA) and spiritual gains among treatment seeking adults for alcohol use disorder. Participants included 246 individuals from 2 of the 3 sites in the Relapse Replication and Extension Project (Lowman, Allen, Stout, & The Relapse Research Group, 1996). Baseline characteristics included 63% male, 39.9% single, and the average age was 34 years (SD = 8.2). The Alcoholics Anonymous Involvement questionnaire (Tonigan, Connors, & Miller, 1996) was used to assess lifetime AA attendance. The Religious Beliefs & Behaviors Questionnaire (Connors, Tonigan, & Miller, 1996) was used to assess spirituality. Percent days abstinent (PDA) and drinks per drinking day (DPDD) were measured using the Form 90. At baseline, adults with more extensive AA histories were more severely alcohol impaired although they were no older relative to adults with less past AA exposure. Clear patterns of AA engagement were found between the high-low AA history groups over follow-up, with adults with less AA experience reporting less AA participation across a swath of AA-specific measures. Gains in spiritual practices significantly mediated AA-related benefit as measured by PDA and DPDD. Tests for moderated-mediation indicated that the magnitude of the mediational effect of spiritual gains did not differ between high-low AA history groups. Having an extensive AA history did not advantage (or disadvantage) adults in mobilizing future spiritual practices that are prescribed in AA. Clinical assessment of client AA history is important, however, because it predicts both the nature and extent that clients may participate in AA. (PsycINFO Database Record

Asmenų, priklausomų nuo alkoholio, psichoemocinė sveikata

Priklausymas nuo alkoholio – sunki lėtinė liga, kuri sutrikdo ne tik priklausomų asmenų socialinę aplinką, bet ir psichoemocinę sveikatą. Kiekvienais metais vis didėja ir besigydančiųjų skaičius. Lietuvoje besigydančių nuo psichikos ir elgesio sutrikimų dėl alkoholio vartojimo 2013 m. buvo 47,9 tūkst, o 2014 metais šis skaičius išaugo iki 49,8 tūkst. Šiame darbe buvo nagrinėjama priklausomų nuo alkoholio asmenų, lankančių ir nelankančių (besigydančių stacionare) anoniminių alkoholikų grupes, psichoemocinė sveikata. Tyrimo tikslas – išanalizuoti asmenų, priklausomų nuo alkoholio, psichoemocinę sveikatą. Tyrimo metodika. Atliktas kiekybinis tyrimas. Naudoti instrumentai: Hospitalinė nerimo ir depresijos (HAD) skalė ir A. Antonovsky sutrumpintas gyvenimo orientacijos klausimynas (SOC – 13), skirtas vidinės darnos lygiui įvertinti. Imtį sudarė – 322 respondentai, iš kurių 170 lankantys anoniminių alkoholikų grupes ir 152 – besigydantys stacionare. Aprašomoji duomenų analizė atlikta statistiniu programų paketu „SPSS 17.0.1 for Windows”. Tyrimas atliktas laikantis etikos principų. Tyrimo rezultatai. Nustatyta, kad tarp tiriamųjų, lankančių anoniminių alkoholikų grupes, buvo žymiai daugiau asmenų, nejaučiančių nerimo, išsiskyrė reikšmingai daugiau asmenų be depresijos simptomų nei tarp nelankančių anoniminių alkoholikų grupių. Stipresnės vidinės darnos tiriamieji turėjo mažesnį nerimo ir depresijos išreikštumą nei silpnesnės vidinės darnos tiriamieji. Tyrimo metu nustatyta, kad tiriamųjų, lankančių anoniminių alkoholikų grupes, nerimo ir depresijos išreikštumą didino jaunesnis amžius, trumpesnis alkoholio vartojimo laikotarpis, problemų dėl alkoholio vartojimo turėjimas, žemesnis išsilavinimas ir darbo neturėjimas. Tiriamųjų, nelankančių anoniminių alkoholikų grupių, nerimo išreikštumą didino vienišumas, dažnesnis alkoholio vartojimas ir problemų dėl alkoholio vartojimo turėjimas, o depresijos išreikštumą – vienišumas. Tyrimo rezultatai parodė, kad aukštesnius vidinės darnos, būtent, prasmingumo ir kontrolės vertinimus turėjo tiriamieji, kurie rečiau vartodavo alkoholį ir asmenys su aukštesniu išsilavinimu. Abiejose tiriamųjų grupėse priklausomai nuo anoniminių alkoholikų grupių lankymo vidinė darna nelankantiems buvo susijusi su šeimine padėtimi, o lankantiems – su amžiumi. Išvada. Nustatyta, kad asmenų, priklausomų nuo alkoholio, lankančių anoniminių alkoholikų grupes, psichoemocinė sveikata yra geresnė už nelankančių.

Changes in depression mediate the effects of AA attendance on alcohol use outcomes

ABSTRACTBackground: Depression may contribute to increased drinking in individuals with alcohol use disorder. Although Alcoholics Anonymous (AA) attendance predicts drinking reductions, there is conflicting information regarding the intermediary role played by reductions in depression. Objectives: We explored whether AA attendance reduces depressive symptoms, the degree to which improvement in depression results in reductions in drinking, and in which subgroups these effects occur. Methods: 253 early AA affiliates (63% male) were recruited and assessed at baseline 3, 6, 9, 12, 18, and 24 months. Depression was measured using the Beck Depression Inventory (BDI) and was administered at baseline 3, 6, 12, 18, and 24 months. AA attendance and alcohol use outcomes were obtained with the Form 90. Mediation analyses were performed at early (3, 6, and 9 months) and late (12, 18, and 24 months) follow-up to investigate the degree to which reductions in depression mediated the effect of AA attendance on drinking, controlling for concurrent drinking. In addition, a series of moderated mediation analyses were performed using baseline depression severity as a moderator. Results: At early follow-up, reductions in depression (6 months) mediated the effects of AA attendance (3 months) on later drinking (drinks per drinking day) (9 months) (b = −0.02, boot CI [−0.055, −0.0004]), controlling for drinking at 6 months. Baseline depression severity did not moderate the degree to which BDI mediated the effects of AA attendance on alcohol use (ps > .05). Conclusion: These findings provide further evidence that depression reduction is a mechanism by which AA attendance leads to reductions in alcohol use. Improving depression may help reduce alcohol use in individuals with AUD, and AA attendance may be an effective way to achieve that goal.

Engaging with 12-Step and Other Mutual Aid Groups During and After Treatment: Addressing Workers’ Negative Beliefs and Attitudes through Training

ABSTRACTAlthough attending Alcoholics Anonymous (AA) meetings is associated with improvements in alcohol consumption and related problems, barriers to engagement persist, including negative perceptions by addiction professionals. The current project examined clinician (N = 64) attitudes to AA and other mutual aid (MA) groups before and after training. Following training, there were increases in knowledge and willingness to refer clients. A follow-up of 38 clinicians identified moderate increases in referrals to MA groups over the following month. Referral to mutual aid groups was predicted by how important clinicians perceived 12-Step groups to be, their satisfaction with the training and support from their agency.

Spirituality mediates state anxiety but not trait anxiety and depression in alcohol recovery

Background and objectives: Twelve-step based interventions promote the recovery from alcohol dependence, support relapse prevention and are associated with improved mental status indices (e.g. depression). This treatment model largely relies on spiritual experience. We tested three different alcohol treatment settings, which differently involve elements of spirituality in order to reveal its possible mediator effect on the level of depressive and anxiety symptoms. Methods: Patients were involved from (1) detoxification (n = 34), (2) long-term – 12-step based – therapeutic community treatment (n = 89), (3) and from Alcoholics Anonymous (AA) groups after at least 3 years of attendance (n = 46). Anxiodepressive symptoms and spirituality/transcendence were compared and the potential mediator role of spirituality was assessed in the levels of depressive and anxiety symptoms. Results: Long-term 12-step based rehabilitation and sustained AA attendance was connected to lower levels of anxiodepressive symptoms and to more pronounced spirituality. The spiritual component of the different treatments played a mediator role in the decrease of state anxiety but this mediation was not detected in the case of depressive symptoms and trait anxiety. Conclusions/Importance: The role of spirituality in the decrease of state anxiety indicates acute beneficial effect. Therefore, long term, regular attendance in AA groups is essential.

Assessing the Quality of Life of Clients with Alcohol Dependence Syndrome (ADS) attending Alcoholics Anonymous (AA) meetings in a selected area of Delhi

Assessing the Quality of Life of Clients with Alcohol Dependence Syndrome (ADS) attending Alcoholics Anonymous (AA) meetings in a selected area of Delhi

Do young people benefit from AA as much, and in the same ways, as adult aged 30+? A moderated multiple mediation analysis

BackgroundResearch has shown that participation in Alcoholics Anonymous (AA) confers significant recovery benefit to adults suffering from alcohol use disorder (AUD). Concerns persist, however, that AA may not work as well for younger adults, who tend to have shorter addiction histories, different social circumstances, and less spiritual/religious interest than adults. MethodsSecondary data analysis of Project MATCH, using a prospective, moderated multiple mediation analysis to test and compare six previously identified mechanisms of change in younger adults (n=266) vs. adults aged 30+ (n=1460). Nine clinical sites within the United States. Treatment-seeking adults (n=1726) suffering from AUD who participated in 12 weeks of outpatient treatment and completed follow-ups at 3-, 9- and 15-months. AA attendance during treatment; mediators at 9 months; and outcomes [percentage of days abstinent (PDA) and drinks per drinking day (DDD)] at 15 months. ResultsAA attendance was associated with improved drinking outcomes in both younger adults (PDA: F(1, 247)=8.55, p<0.01; DDD: F(1, 247)=15.93, p<0.01) and adults aged 30+ (PDA: F(1, 1311)=86.58, p<0.01; DDD: F(1, 1311)=11.96, p<0.01). Only two of the six hypothesized pathways (i.e., decreases in pro-drinking social networks, self-efficacy in social situations) appeared to work in younger adults. ConclusionUnidentified mechanisms of behavior change that are mobilized by AA participation appear to be at work in young people. Once identified, these mechanisms may shed new light on how exactly AA confers similar benefits for young people and, more broadly, may enhance our understanding of recovery-related change for young adults that could yield novel intervention targets.