Alcoholics Anonymous Groups Research Articles

From Wrestling with Monsters to Wrestling with God: Masculinities, "Spirituality," and the Group-ization of Religious Life in Northern Costa Rica

This piece explores support group movement's role in restructuring Latin American and contributing to trans-denominational and trans-secular spread of reformation of machismo—Elizabeth Brusco's (2010) name for Latin American evangelicalism's focus on transforming men and masculinity. Using ethnographic data from two years of fieldwork in an urbanizing area of northern Costa Rica and life history interviews with men from three churches and three men's groups there, this article argues that a region-wide popular discourse about a crisis of masculinity/machismo and a crisis of family has broadened appeal of efforts to transform men and masculinity—not only among most churches, but especially among a proliferating number of trans-denominational and non-religious men's groups that are modeled implicitly on all-male Alcoholics Anonymous groups, which are extraordinarily popular throughout Latin America. This essay's argument borrows from Wuthnow's analysis of the restructuring of [North] American religion under influence of support group movement (1988, 1994a, 1994b, 1998), but it also employs an historiographic approach, exploring origins of this restructuring of Latin American in same Methodist model of social organization that has driven evangelical growth throughout Americas (and men's conversions especially) during times of social change and male social dislocation (Martin 1990). The conversion histories of two Catholic men are used to illustrate how it is participation in these groups, rather than formal conversion, that transforms many men's lives, their gender identities, and their relationships with others. Finally, possible contributions of this research to anthropological studies of religion, ethics, and morality are explored, in particular role that models of social organization might play in spread of new ethical practices, discourses, or identity models.

Efficacy of Treating Sexual Trauma in a Substance Abuse Residential Program for Women

This is a program evaluation of treating sexual trauma in a residential substance abuse treatment program for women. Residents who were seeking treatment for their substance abuse disorder (SUD), also had a history of both childhood and adult sexual trauma. Given the literature supporting concurrent trauma-SUD treatment, the Warrior Renew (WR) protocol (Katz, Warrior Renew: Healing from military sexual trauma, Springer, New York, 2014) was added to the curriculum of Alcoholics Anonymous 12-step groups, relapse prevention, and substance abuse education classes. The WR manual consists of coping skills to address sleep and anxiety, and cognitive/experiential restructuring to address anger/resentments due to injustice, betrayal, and self-blame. It also addresses interpersonal factors such as relationship patterns and healthy interpersonal skills. This evaluation was conducted as part of routine clinical care in a naturalistic setting. Nineteen residents graduated the program and opted to complete pre-and post-treatment assessments. Findings revealed significant decreases in symptoms of anxiety, depression, posttraumatic negative thinking, and PTSD, and significant increases in positive factors of optimism and self-esteem-- all with large effect sizes. In addition, 95% of the sample had a reliable change at the 95% confidence interval. Resident’s feedback to staff reflected strong positive endorsement of the WR program. Results suggest WR is a promising effective treatment for women who have had sexual trauma in a substance abuse residential treatment program.

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.

Quality of life changes in an alcoholics anonymous self-help group

Straipsnyje analizuojama priklausomybės nuo alkoholio problema ir sveikimo galimybės anoniminių alkoholikų savipagalbos grupėje (AA). Į problemą žvelgiama sisteminiu požiūriu, aktualizuojamas biopsichosocialinis kontekstas. Teoriškai pagrindžiamos priklausomybės ir gyvenimo kokybės sampratos, pateikiami empirinio tyrimo rezultatai. Giluminio interviu duomenys atskleidžia, jog į priklausomybės ,,spąstus“ dažnai patenkama vaikystėje, kai perimamas psichosocialinis šeimos modelis. Savipagalbos grupėje, grindžiamoje 12 žingsnių ir tradicijų programa, vyksta nuolatinis dvasinio sveikimo procesas, pastebimi pozityvūs gyvenimo kokybės pokyčiai.

Wsparcie i zmagania religijne jako predyktory jakości życia Anonimowych Alkoholików – moderacja przez czas abstynencji

The aim of the study was to analyze the connection between religious comfort and struggle and quality of life in Alcoholics Anonymous. The interaction effect of the length of abstinence and religious variables on the quality of life was tested as well. The participants were 100 members of an Alcoholics Anonymous group. We used the Religious Comfort and Strain Scale by Yali, Exline, Wood, and Worthington and the Quality of Life Questionnaire for Adults by Schalock and Keith. The correlation analysis showed that Religious Comfort correlated positively while fear–guilt and negative emotions towards God correlated negatively with quality of life in the AA group. Duration of abstinence played a moderating role: participants in the long abstinence period group with high religious comfort showed the highest level of quality of life.

Wsparcie i zmagania religijne jako predyktory jakości życia Anonimowych Alkoholików – moderacja przez czas abstynencji

The aim of the study was to analyze the connection between religious comfort and struggle and quality of life in Alcoholics Anonymous. The interaction effect of the length of abstinence and religious variables on the quality of life was tested as well. The participants were 100 members of an Alcoholics Anonymous group. We used the Religious Comfort and Strain Scale by Yali, Exline, Wood, and Worthington and the Quality of Life Questionnaire for Adults by Schalock and Keith. The correlation analysis showed that Religious Comfort correlated positively while fear–guilt and negative emotions towards God correlated negatively with quality of life in the AA group. Duration of abstinence played a moderating role: participants in the long abstinence period group with high religious comfort showed the highest level of quality of life.

Are there gender differences in locus of control specific to alcohol dependence?

To investigate gender differences in locus of control in an alcohol-dependent population. Locus of control helps to explain behaviour in terms of internal (the individual is responsible) or external (outside forces, such as significant other people or chance, are responsible) elements. Past research on gender differences in locus of control in relation to alcohol dependence has shown mixed results. There is a need then to examine gender and locus of control in relation to alcohol dependence to ascertain the veracity of any locus of control differences as a function of gender. The Multidimensional Health Locus of Control form-C was administered to clients from alcohol dependence treatment centres in the West of Scotland. Independent t-tests were carried out to assess gender differences in alcohol dependence severity and internal/external aspects of locus of control. One hundred and eighty-eight (53% females) participants were recruited from a variety of alcohol dependence treatment centres. The majority of participants (72%) came from Alcoholics Anonymous groups. Women revealed a greater internal locus of control compared with men. Women also had a greater 'significant others' locus of control score than men. Men were more reliant on 'chance' and 'doctors' than women. All these trends were not, however, statistically significant. Gender differences in relation to locus of control and alcohol dependence from past studies are ambiguous. This study also found no clear statistically significant differences in locus of control orientation as a function of gender. This article helps nurses to contextualise health behaviours as a result of internal or external forces. It also helps nursing staff to better understand alcohol dependence treatment in relation to self-efficacy and control. Moreover, it highlights an important concept in health education theory.

Alcoólicos anônimos: potencialidades terapêuticas de um grupo de mútua ajuda

The present paper describes the mutual help group known as Alcoholics Anonymous (AA) and its therapeutic potentials. In order to do that, the relevant literature was widely reviewed, focusing on books that are considered to be the group’s rationale. In addition, a field study was conducted with AA members, using the participant observation technique, followed by voluntary interviews with members. As suggested to every newcomer to AA, our observation was made by attending 90 meetings over 90 days. Finally, an anonymous questionnaire was also applied, aiming to draw a more detailed profile of a small sample of the people attending the group. A total of 35 questionnaires were returned, and they revealedthe importance of the AA group in changing the lives of these people.

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.

Ask the Expert: Substance-Related and Addictive Disorders

Ask the Expert: Substance-Related and Addictive Disorders

Traducir la evidencia en salud: ¿Qué hacemos con el alcohol?

Los estudios epidemiológicos muestran que el consumo de alcohol va en aumento y que disminuye la edad de inicio (la mitad de los bebedores habrán de iniciar el consumo antes de la edad legal para beber y hay pocos casos que inician después de los 25 años), que la diferencia entre hombres y mujeres ha disminuido, que en ambos grupos el consumo excesivo, es decir la ingesta de grandes volúmenes de alcohol por ocasión de consumo, es muy frecuente (17.3% de los hombres adolescentes y 11.7% de las mujeres de entre 12 y 17 años y 53.6% y 20.8% respectivamente, entre quienes tienen entre 18 y 65 años),a que esta forma de beber se asocia con una proporción importante de problemas sociales como accidentes y violencia, incluida la autoinfligida, y de problemas de salud.

Análisis de la aproximación de Alcohólicos Anónimos a los pacientes hospitalizados

Resumen Antecedentes. El porcentaje de dependientes alcohólicos que acude a los grupos de autoayuda aumentó del 33.4% en 2008 al 43.7% en 2011 según las Encuestas Nacionales de Adicciones. Alcohólicos Anónimos (AA) y su programa de Doce Pasos representa el principal modelo de autoayuda en México. El 12º Paso o llevar el mensaje es una estrategia común para atraer nuevos miembros a los grupos de AA y se realiza frecuentemente en salas hospitalarias. Objetivo. Describir la actividad de llevar el mensaje en un contexto hospitalario para identificar los significados implicados y la manera de relacionarse con los pacientes. Se utilizó una aproximación etnográfica para observar la actividad de nueve miembros de AA en un hospital de tercer nivel de la Ciudad de México a lo largo de diez meses. Se aplicó el modelo del sistema de actividad para la organización e interpretación de los datos. Resultados. La actividad de llevar el mensaje tiene seis momentos principales: 1. Autopresentación del alcohólico en recuperación; 2. Definición del alcoholismo como una enfermedad sin cura; 3. Los Doce Pasos de AA como una alternativa; 4. Autodiagnóstico; 5. Preguntar sobre el consumo; 6. Invitación a las juntas del grupo de AA en el hospital. Los miembros de AA utilizan sus relatos personales para comunicar la visión de AA sobre el alcoholismo y la recuperación. Discusión y conclusión. Llevar el mensaje se orienta principalmente por el significado de la negación del alcoholismo. Las acciones de los AA están diseñadas para evitar la negación y promover la aceptación de la enfermedad. Además, el mismo contexto hospitalario legitima la presencia de AA y sus Doce Pasos. Llevar el mensaje nos presenta una estrategia para disminuir el estigma asociado con la dependencia alcohólica, el cual es uno de los principales obstáculos para solicitar ayuda.

Estilos de afrontamiento a la “obsesión mental por beber” (craving) en bebedores en proceso de recuperación

Resumen Antecedentes. En el alcoholismo, el tema del craving es un asunto controvertido. Sin embargo, se sabe que, si un alcohólico puede hablar del suceso en sus propios términos, aumenta la probabilidad de lograr un afrontamiento exitoso y evitar una recaída. No obstante, se conoce muy poco acerca de dicho afrontamiento y aún menos cuando se alude a él con términos propios del bebedor. Objetivo. Conocer el afrontamiento de la “obsesión mental por beber”, expresión que suelen utilizar los miembros de Alcohólicos Anónimos (AA) para hablar de las reacciones características del craving. Método. La muestra incluyó a 192 individuos que habían participado en AA durante 10 años en promedio (DE=7.5 años). Se aplicó un instrumento empírico para medir el afrontamiento (Kr=.86). Se utilizó un conglomerado de dos fases para establecer perfiles. Resultados. El análisis encontró cinco estilos de afrontamiento: 1. evadir situaciones inductoras al tiempo que se busca una solución (evasivo-activo); 2. evadir retrayéndose (evasivo-pasivo); 3. mostrar sentimientos de enojo y no hacer nada (emocional-pasivo); 4. recordar y comparar la vida pasada como alcohólicos activos (revalorativo) y 5. negar cualquier afrontamiento (negador). Discusión y conclusión. Los datos son preliminares, pero ofrecen la oportunidad de ampliar y especificar la forma en que ciertos alcohólicos de nuestro país solucionan un problema tan complejo como es el craving. El agrupamiento de respuestas supone esfuerzos o estilos de afrontar que pueden resultar o no efectivos para lograr una recuperación −por ejemplo, prevenir las recaídas en las personas que asisten a los grupos de AA−, por lo que plantea una importante perspectiva de investigación.

A proposed mechanism of action for the Twelve steps of Alcoholics Anonymous

Among peer-support groups for alcoholics, Alcoholics anonymous (AA) is by far the most widespread and successful with tens of thousands of groups all around the world. However, the mechanism of action of AA’s success is not immediately clear. Advances in understanding the neuroscience of addiction have allowed the identification of two brain areas that, among others, explain the irrational and self-destructive behavior of alcoholics. First, alcohol hijacks the reward systems of the midbrain in charge of detecting and experiencing pleasure (through the release of dopamine in the nucleus accumbens and the ventral tegmental area) with a pleasurable stimulation that far exceeds the normal pleasures of life (such as eating and sexual reproduction). These pleasurable experiences are essential for the survival and evolution of the species. Nature has cleverly linked pleasure with survival, and it is exactly this link that is usurped and hijacked by intoxicants like alcohol. Therefore, the reward system senses the effect of alcohol as essential for the survival of the alcoholic. In addition, the prefrontal cortex (perhaps the only area of the brain that could allow us to understand and prevent the dangers of the excessive and compulsive alcohol use) is also affected by this intoxicant. It becomes hypoactive and unable to counteract the urges and demands of the reward system to constantly repeat the “feel good” (associated over millions of years with survival of the individual and species) that comes from using alcohol. The Twelve Steps of AA help alcoholics reverse these effects. First, through steps 1 to 3, it encourages the use of a Surrogate Decision-Maker (often, it is the AA group itself that acts as such). Second, steps 4- 12 foster the practice of Compensatory Behaviors (a life of honesty and service) devoted to counteract the maladaptive behaviors that facilitate the alcoholic’s behavior of repeating what feels good (i.e. getting intoxicated). Lying, stealing, dishonesty and manipulation are not intrinsic personality defects of the alcoholic: they are the symptoms of a usurped reward system and hijacked prefrontal lobes.

Spiritual Beliefs and Quality of Life among Persons with Alcohol Dependence Syndrome

Spirituality as propagated through Alcoholics Anonymous (AA) has resulted in the attainment of sobriety for many persons with Alcohol Dependence Syndrome. The aim of the study was to see the association between Spiritual Beliefs and Quality of Life. We conducted a study using a cross sectional design where two groups (AA and hospital based program) from Bangalore consisting of 60 respondents were recruited for the study and standardized tools were used. The findings suggest that the AA group had a longer duration of abstinence and a positive association was observed between spiritual beliefs and quality of life. Support groups like the AA, are to be integrated as part of the holistic treatment for persons with addiction related disorders.

Computerised cognitive behavioural therapy for alcohol use disorder: a pilot randomised control trial

Cognitive behavioural therapy (CBT) has been used in the treatment of alcohol use disorder (AUD), generally in individual or group therapy, but not via computer. Aim This study examined the effectiveness of an interactive, personalised, computer-based CBT therapy in a randomised control trial. We studied a group of 55 patients with AUD, randomised to either 5-hour-long computerised CBT sessions or a placebo cognitive-stimulating session, together with a 4-week inpatient rehabilitation treatment, and followed them for 3 months. There was a high degree of patient adherence to the protocol. Both groups did well, with a significant fall in alcohol outcome measures including number of drinks per drinking day, and number of drinking days, and an increase in abstinence rates in both groups to an equivalent level. The CBT group attended alcoholics anonymous groups more frequently, and had significant alterations in their alcohol self-efficacy outcomes, which correlated with their drinking outcomes. We concluded that computerised CBT is a potentially useful clinical tool that warrants further investigation in different treatment settings for AUD.

Longitudinal trajectories of readiness to change: alcohol use and help-seeking behavior.

Pre-post changes in readiness for change (RC) are commonly assessed in treatment outcome studies, often with contradictory results. Little is known about 12-month RC trajectories among those initiating change or about the association between RC and either within- or between-person alcohol use or time-lagged help-seeking behavior. This observational longitudinal study measured RC as ambivalence, problem recognition, and taking steps. Participants (N = 253; 66.4% male) diagnosed with alcohol use disorders were recruited from treatment sites, Alcoholics Anonymous (AA) groups, and other community sources when first initiating change and assessed at baseline and 3, 6, 9, and 12 months. Support for significant participant heterogeneity as well as linear and quadratic change in RC trajectories was found, although results differed across the three aspects of RC. Independent associations of both within- and between-person percentage of days abstinent were found for ambivalence and taking steps. Lagged, time-specific fluctuations in prior help-seeking behaviors within an individual predicting subsequent RC showed that both AA (B = -1.650, p < .05) and treatment attendance (B = 2.914, p < .01) were associated with subsequent ambivalence. Prior increases in taking steps within individuals were predictive of subsequent AA but not treatment attendance. Results inform treatment providers about how RC trajectories vary depending on alcohol use, both within and between individuals, and how individuals may mobilize change attitudes and behaviors, especially in relation to AA attendance. Future research should investigate additional predictors of RC trajectories and the causal direction between RC and help seeking.

Readers of Joshua Loth Liebman's Peace of Mind

Readers of Joshua Loth Liebman's <i>Peace of Mind</i>

Alcoholism: A Social Deadly Disease of the Society

Alcoholism as a lightning has become a major deadly social disease of the society. Many lives and properties have been lost and many have been permanently deformed as a result of heavy consumption of alcoholic drinks. This paper therefore, examined the concept, patterns, types of and psycho-social reasons for alcoholism. The paper also investigated the dimensional problems or consequences associated with alcoholism as a deadly disease. It discussed the treatment of alcohol drinking problems and the role of health educators as regards alcoholism. Towards its reduction in the society, it is therefore, recommended that mass education on alcoholism should be encouraged, health education should be made a compulsory subject for all students in all educational institutions, and there should be a formation of Alcoholics Anonymous group for the peers or young in the society.

S24 * NEW DEVELOPMENTS IN THE TREATMENT OF ALCOHOL USE DISORDERS

S24 * NEW DEVELOPMENTS IN THE TREATMENT OF ALCOHOL USE DISORDERS