Alcoholics Anonymous Participation Research Articles

Factors associated with integration of people recovering from alcohol dependence syndrome with their family: An exploratory study

ABSTRACT Background: Alcohol is the most commonly consumed psycho-active substance in India. People who use substances and are in recovery often face societal discrimination and rejection, such as difficulty in obtaining employment, poor support for treatment, and inter-personal rejection. Aim: To find out the factors affecting the integration of people recovering from alcohol dependence syndrome with their families. Materials and Methods: A cross-sectional observational study was conducted using a purposive sampling technique among 50 pairs of alcohol-dependent people and their family members. Data were collected using self-administered Family Adaptability and Cohesion Evaluation Scale (FACES IV package), Substance Abuse Self-Stigma Scale, Affiliate Stigma scale, and A Social Support Inventory for Successful Transition. Appropriate statistical tests were used to identify correlations. Results: A negative correlation (r = -0.313, P < 0.05) was found between affiliate stigma and integration, and a positive correlation (P < 0.05) was found between social support and integration. Alcohol-dependent people from Alcoholics Anonymous reported higher levels of perceived social support than those from a tertiary hospital (mean = 47.68 vs. 39.84, P < 0.05). Conclusion: Affiliate stigma negatively impacts people with alcohol dependence and contributes to increased opportunities for interventions to address stigma. Social support has a positive impact on family integration of alcohol-dependent people with Alcoholics Anonymous participants reporting higher levels of social support compared to tertiary hospital participants. Therefore, the findings of this study highlight the need to involve families more intensively to reduce affiliate stigma.

Meeting-makers make meaning: alcoholics anonymous participation and personal meaningfulness.

The central aim of this study was to determine whether intentional, voluntary alcoholics anonymous (AA) participation showed any independent association with affect, over and above that which has been observed in association with other recovery-related behaviors, such as abstinence, among individuals with a history of alcohol use disorder. Additionally, we sought to determine the nature of the affective changes associated with specific dimensions of AA participation (i.e. meeting attendance, fellowship involvement, 12-step work). Thirty abstinent alcohol use disorder individuals were recruited and evaluated. Multivariate linear regressions were used to examine associations between dimensions of AA participation, measured using the Multidimensional Mutual-Help Assessment Scale and standardized measures of affective experiences, including the Profile of Mood States, Subjective Happiness Scale, and the Twelve Promises Scale. Increase in AA participation was associated with higher positive affective experiences. These associations were observed independently with AA meeting attendance and fellowship involvement, but not 12-step work. This study's findings suggest that greater AA meeting attendance and fellowship involvement are correlated with enhancements in the meta-emotional experience of personal meaningfulness. This study extends evidence on AA-related changes by considering affective improvements as a primary clinical outcome, thereby laying the foundation for subsequent, more comprehensive research into the relationship between dimensions of AA participation and recovery-related affective changes.

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.

Association of racism and substance use treatment with belief in the myth of an American Indian/Alaska Native biological vulnerability to alcohol problems.

Belief in an American Indian/Alaska Native (AIAN) specific biological vulnerability (BV) to alcohol problems is associated with worse alcohol outcomes among AIANs. Despite a notable lack of evidence that biogenetic factors play a greater role in the development of alcohol problems among AIANs than other groups, many people still believe this myth. Consistent with theory and evidence that greater experiences with discrimination leads to the internalization of stereotypes and oppression, we hypothesized that greater perceived racial discrimination (racism) would be associated with greater BV belief, but that having a stronger ethnic identity would weaken this association. We also examined whether previous substance use treatment as well as participation in Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) was associated with BV belief. Participants were 198 reservation-dwelling AI adults with a substance use problem who completed a survey as part of a larger community-based participatory study. A multiple regression analysis revealed that greater systemic racism was associated with greater belief in a BV; this association was not moderated by ethnic identity. Greater interpersonal racism was also associated with greater BV belief-but only among those low in ethnic identity. A regression analysis revealed that previous treatment, AA, and NA participation were not associated with BV belief. Greater systemic and interpersonal racism were associated with belief in a BV, and greater ethnic identity buffered the association between interpersonal racism and BV belief. This suggests that both combatting racism and fostering positive ethnic identity may help to lessen BV belief. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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.

The Beneficial Role of Involvement in Alcoholics Anonymous for Existential and Subjective Well-Being of Alcohol-Dependent Individuals? The Model Verification

Involvement in Alcoholics Anonymous (AA) is an important psychosocial factor for the recovery of alcohol-dependent individuals. Recent studies have confirmed the beneficial role of involvement in AA for abstinence and reduction in drinking alcohol. Little is known about the mechanism underlying the relationship between involvement in AA and subjective well-being. This study aims to verify whether in a sample of Polish AA participants involvement in AA is indirectly related to subjective well-being through existential well-being consisting of hope and meaning in life. The achieved results have confirmed that involvement in AA is positively related to existential well-being, which in turn positively predicts subjective well-being including life satisfaction as well as positive and negative affect. It was confirmed that AA involvement in self-help groups indirectly via existential well-being is related to subjective well-being. Theoretical and practical implications were discussed.

Spiritual Predictors of Improved Resilience in People Recovering from Alcohol Use Disorder: An Exploratory Study

ABSTRACT Alcoholics Anonymous (AA) provides its members with a spiritual recovery program for Alcohol Use Disorder (AUD) that could be seen as a resilience program. This article aimed to study the possible relationships between participation in AA, spirituality and resilience and identify the best spiritual predictors of resilience. Spirituality, participation in AA, and resilience were assessed in a population of AA members recruited throughout France (N = 263, age: M = 58.08, SD = 9.92), using the Religious Background and Behavior Scale the Spiritual Well-Being Scale, the Recovery Interview and g the Connor-Davidson Resilience Scale. Correlations, means comparisons, principal components analyses, and multiple regressions were performed. The 263 participants had resilience characteristics, a quality relationship with a God/Higher Power (God/HP), and an existential well-being greater than the general population. Increased participation in AA predicted increased spirituality. The best spiritual predictors of increased resilience were believing in a life purpose, sense of well-being about one’s future and being able to appreciate life. Results encourage clinicians to implement positive psychological interventions in the care of patients with AUD and to assign empowering tasks to them.

Ethical Considerations for Psychotherapists Participating in Alcoholics Anonymous.

As the demands of professional psychology can be taxing, psychotherapists are not immune to the development of mental health and substance use disorders. One estimate indicates that roughly 30-40% of psychologists know of a colleague with a current substance abuse problem (Good et al., 1995). 12-step mutual self-help groups, particularly Alcoholics Anonymous (AA), are the most widely used form of treatment for addiction in the United States. AA has empirically demonstrated effectiveness at fostering long-term treatment success, and is widely accessible throughout the world. However, psychotherapist participation in AA raises a number of ethical concerns, particularly regarding the potential for extra-therapy contact with clients and the development of multiple relationships. This article attempts to review the precarious ethical and practical situations that psychotherapists, either in long-term recovery or newly sober, may find themselves in during AA involvement. Moreover, this article provides suggestions for psychotherapists in AA regarding how to best adhere to both the principles of AA (i.e., the 12-steps and 12-traditions) and the American Psychological Association's Ethical Principles of Psychologists and Code of Conduct.

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.

Indirect Relationship between Alcoholics Anonymous Spirituality and Their Hopelessness: The Role of Meaning in Life, Hope, and Abstinence Duration

Spiritual growth is a significant factor in Alcoholics Anonymous treatment process. In the literature, there is an observable lack of research regarding spiritual mechanisms of recovery in alcohol addicted individuals who are participants of self-help groups. The study purpose was to examine the potential mechanisms indirectly influencing participants of Alcoholics Anonymous (AA) and to determine the effects of spiritual experiences on their feelings of hopelessness through finding meaning in life, improving hope, and longer abstinence duration. The study was conducted using a cross-sectional design. Participants were AA meeting attenders from Poland. According to the obtained results, the relationship between spiritual experiences and feelings of hopelessness was indirect through meaning in life, hope, and abstinence duration. Additionally, the moderated mediation effect was positively verified. Meaning in life moderated the relationship between hope and feelings of hopelessness. In a group of AA participants with less-than-average and average levels of meaning in life, hope protected against feelings of hopelessness. Among AA participants with higher-than-average meaning in life, hope was not related to their depression symptoms. The spiritual mechanisms, which led to reduced feelings of hopelessness among AA participants, and the role of meaning in life, hope, and duration of abstinence were confirmed.

Do Involvement in Alcoholics Anonymous and Religiousness Both Directly and Indirectly through Meaning in Life Lead to Spiritual Experiences?

Spirituality is a key element of Alcoholics Anonymous (AA) recovery. However, little is known about the potential religious and secular sources of spiritual experiences in AA fellowship. The aim of the study was to verify if in a sample of AA participants, meaning in life mediates the relationship between their religiousness and spiritual experiences, as well as between their involvement in AA and spiritual experiences. The study sample consisted of 70 Polish AA participants, and the following tools were used: the Alcoholics Anonymous Involvement Scale (AAIS); Santa Clara Strength of Religious Faith Questionnaire (SCSORFQ); Purpose in Life Test (PIL); two one-item measures regarding frequency of prayer and Mass attendance; and the Daily Spiritual Experiences Scale (DSES) duration of AA participation, which was positively related to involvement in addiction self-help groups and religiousness. Involvement in AA and religiousness were positively related to meaning in life, which in turn positively correlated with spiritual experiences. This research indicated that in a sample of AA participants, finding meaning in life partially mediates the relationship between religiousness and spiritual experiences, as well as fully mediating the relationship between involvement in AA and spiritual experiences. The theoretical and practical implications are discussed.

Recovering Theism

Recent studies in the sociology of religion have shown that religion and spirituality are related yet distinct concepts which impact social life in a variety of ways. Since its founding in 1935, the popular program known as Alcoholics Anonymous (AA) has offered an approach to addiction recovery that manifestly adopts spirituality as a means to sobriety while at the same time eschewing certain organized religious beliefs. This paper seeks to understand how participants perceive spirituality to be integral to addiction recovery as featured through three biographical case studies of unrelated AA members living in different cities in the United States. While the particularities of these three case studies should not be taken as representative of the AA population since they are tied to specific contexts, the similarities of their stories and the emphasis each respondent places on spirituality should prompt researchers to consider the evident connection between spirituality and recovery through AA participation. Suggestions for future research studies and the implications of these results will be discussed.

Affiliation to alcoholics anonymous or narcotics anonymous among patients attending an English specialist addiction service

Purpose Attendance at alcoholics anonymous (AA) or narcotics anonymous (NA) meetings and affiliation with the fellowship has potential benefits for people with alcohol or drug use disorders. This effect is present whether or not the individual attends professional treatment services, but the two process can have a synergistic effect. Limited information exists about the extent to which people attending UK specialist treatment services also attend AA/NA and their views about such attendance. The paper aims to discuss these issues. Design/methodology/approach A cross-sectional survey of 200 consecutive attendees at the specialist treatment service in an English region was conducted between January and April 2018. A measure of past attendance and affiliation with AA/NA (AAAS) and a scale designed to quantify future readiness to attend (Survey of Readiness for Alcoholics Anonymous Participation) were administered and anonymously linked to data supplied to the National Drug Treatment Monitoring Service (NDTMS). Findings A minority of the sample had ever attended an AA meeting (31 per cent, n=59) or an NA meeting (41 per cent, n=79), and only 14 per cent (n=27) and 24 per cent (n=45) had attended an AA or NA meeting, respectively, in the past year. Only two variables significantly predicted level of readiness to attend AA or NA in a regression model: attended more AA/NA meetings in the past (ß=0.149, p=0.036) and previous level of participation (AAAS score) (ß=0.409, p &lt; 0.001). Practical implications A significant proportion of attendees of a specialist drug and alcohol treatment service had never attended AA/NA, despite many positive views about their potential benefits. Given the established benefits of attending AA/NA meetings and participating in the AA or NA fellowship, these results suggest that professional treatment services should do more to explain the process and challenge preconceived ideas about how they operate. Originality/value The authors are not aware of any published research that captures the rates of attendance of and participation in both AA and NA groups in a UK-based community treatment sample. These results may therefore provide a baseline for evaluating the impact of interventions to increase attendance/participation, and also provide some insight into the potential barriers to attendance in this population.

The Growth of Spiritual Awareness through AA Participation: A Phenomenological Study

ABSTRACTThis phenomenological study focused on the question: What is the lived-experience of the Alcoholics Anonymous (AA) Fellowship in relation to spiritual awakening for members of AA with long-term sobriety? Nine participants who had long-term sobriety, experienced a spiritual awakening, and were active in AA were interviewed, and the data gathered was analyzed through transcendental phenomenology to discover the experience of the AA Fellowship. The analysis showed multiple themes and structures that led to the creation of a synthesis of themes, explaining participants’ experience of breaking down the self-view, changing life perceptions, and identifying as full Fellowship member. Limitations were considered leading to suggestions for further studies.

Women’s spiritually mediated stories about recovery from Alcohol Use Disorder: A brief report

This study explored women’s lived recovery experiences from alcohol use disorder (AUD) facilitated by Alcoholics Anonymous (AA). The women (n = 10; age range 30–62 years; married = 6) completed life story interviews regarding their recovery from AUD with AA participation. Discourse analysis of the interview data yielded themes to suggest the women characterise their recovery as spiritual growth, a healing process with reliance of a higher authority, renewed purpose of life, and actively engaging rehabilitation. Spirituality appears a key resource in women’s AUD recovery.

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

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.

Evaluating Alcoholics Anonymous's Effect on Drinking in Project MATCH Using Cross-Lagged Regression Panel Analysis

The objective of the study is to determine whether Alcoholics Anonymous (AA) participation leads to reduced drinking and problems related to drinking within Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity), an existing national alcoholism treatment data set. The method used is structural equation modeling of panel data with cross-lagged partial regression coefficients. The main advantage of this technique for the analysis of AA outcomes is that potential reciprocal causation between AA participation and drinking behavior can be explicitly modeled through the specification of finite causal lags. For the outpatient subsample (n = 952), the results strongly support the hypothesis that AA attendance leads to increases in alcohol abstinence and reduces drinking/ problems, whereas a causal effect in the reverse direction is unsupported. For the aftercare subsample (n = 774), the results are not as clear but also suggest that AA attendance leads to better outcomes. Although randomized controlled trials are the surest means of establishing causal relations between interventions and outcomes, such trials are rare in AA research for practical reasons. The current study successfully exploited the multiple data waves in Project MATCH to examine evidence of causality between AA participation and drinking outcomes. The study obtained unique statistical results supporting the effectiveness of AA primarily in the context of primary outpatient treatment for alcoholism.

The 10-Year Course of Alcoholics Anonymous Participation and Long-Term Outcomes: A Follow-Up Study of Outpatient Subjects in Project MATCH

ABSTRACT This study investigates the 10-year course and impact of Alcoholics Anonymous (AA)-related helping (AAH), step-work, and meeting attendance on long-term outcomes. Data were derived from 226 treatment-seeking alcoholics recruited from an outpatient site in Project MATCH and followed for 10 years post treatment. Alcohol consumption, AA participation, and other-oriented behavior were assessed at baseline, end of the 3-month treatment period, and 1, 3, and 10 years post treatment. Controlling for explanatory baseline and time-varying variables, results showed significant direct effects of AAH and meeting attendance on reduced alcohol outcomes and a direct effect of AAH on improved other-oriented interest.

Multiple Dimensions of Spirituality in Recovery: A Lagged Mediational Analysis of Alcoholics Anonymous’ Principal Theoretical Mechanism of Behavior Change

ABSTRACT Alcoholics Anonymous (AA) states that recovery is possible through spiritual experiences and spiritual awakenings. Research examining spirituality as a mediator of AA's effect on drinking has been mixed. It is unknown whether such findings are due to variations in the operationalization of key constructs, such as AA and spirituality. To answer these questions, the authors used a longitudinal model to test 2 dimensions of AA as focal predictors and 6 dimensions of spirituality as possible mediators of AA's association with drinking. Data from the first 18 months of a 3-year longitudinal study of 364 alcohol-dependent individuals were analyzed. Structural equation modeling was used to replicate the analyses of Kelly et al. (Alcohol Clin Exp Res. 2011;35:454–463) and to compare AA attendance and AA involvement as focal predictors. Multiple regression analyses were used to determine which spirituality dimensions changed as the result of AA participation. A trimmed, data-driven model was employed to test multiple mediation paths simultaneously. The findings of the Kelly et al. study were replicated. AA involvement was a stronger predictor of drinking outcomes than AA attendance. AA involvement predicted increases in private religious practices, daily spiritual experiences, and forgiveness of others. However, only private religious practices mediated the relationship between AA and drinking.