Year Of Sobriety Research Articles

Community Identity in an Alcoholics Anonymous Group

This study is based on long-term observation and a series of in-depth interviews with members of an ongoing meeting of Alcoholics Anonymous. Analysis of this meeting, composed primarily of upper-middle class people with several years of sobriety, allows exploration of several key issues in understanding A.A. as an intentional community which promotes sobriety by, in part, inculcating new members with serviceable moral identities. In particular, examining the process of this meeting illustrates an underlying contention in the moral discourse of contemporary A.A. between traditionally-based 12-Step thinking and more recent, therapeutically-based concepts and rhetoric imported into A.A. via professional treatment programs and psychotherapy.

Hypoperfusion of inferior frontal brain regions in abstinent alcoholics: a pilot SPECT study.

This pilot study evaluated hypotheses concerning the relationship between cerebral hypoperfusion and residual deficits in the functioning of frontal brain systems in abstinent long-term alcoholics. The participants (N = 22) were 10 healthy, abstinent alcoholics (9 men) and 12 age-equivalent nonalcoholic controls (10 men). Cerebral blood flow was observed through the use of regionally specific computer-derived quantitative analysis of single photon emission computed tomography (SPECT) perfusion images. Measures of alcohol use, abstinence and neuropsychological functioning were also obtained to relate to SPECT findings. A positive relationship was observed between perfusion levels in the left inferior frontal brain region and years of sobriety. Alcoholics with less than 4 years of sobriety had significantly reduced left inferior frontal perfusion compared with both nonalcoholic controls and alcoholics having longer periods of sobriety. The findings support the hypothesis that frontal brain abnormalities in alcoholics may subside with extended abstinence.

Alcoholics anonymous as seen from the perspective of self psychology

This study utilizes Heinz Kohut's self psychology concepts of mirroring, idealization and twinship to explain the ways in which Alcoholics Anonymous is helpful to its long‐term members. Fourteen AA members with an average of 10 years of sobriety were interviewed. Analysis of their responses suggests that mirroring is taking place when the members feel they are seen for who they truly are and when they are a positive influence in the lives of others. Idealization, whether of a sponsor, the group, or of one's Higher Power, is in evidence when members tell of feeling bolstered by identification with some greater source of strength and wisdom and when they describe the re‐parenting they receive from AA. Twinship is operating when members speak of the healing effect of belonging to the group and finding peers with similar experiences. The author encourages clinicians to attend AA meetings in order to enhance their own understanding of Alcoholics Anonymous and to better support their clients’ participation in AA.

The Experience of Long-Term Recovering Alcoholics in Alcoholics Anonymous

ABSTRACT Twelve members of Alcoholics Anonymous with four, five, six and seven years of continuous sobriety were interviewed about their experiences in recovery and in therapy. An essential theme which emerged was a change over years of sobriety, in their perception of themselves and the world. Participants' experiences in therapy are discussed and recommendations for treatment are made.

Predictors of Self Esteem Among Members of Women for Sobriety

One goal of alcohol treatment for women is enhancement of their feelings about themselves, and a treatment approach that explicitly addresses this challenge is Women For Sobriety (WFS). This paper reports on the results of the first WFS membership survey, conducted in 1991 (n = 600; response rate = 73%). Results were similar to those from longitudinal research which found about a 20% improvement in self esteem in the first year of sobriety. Significant predictors of self esteem included endorsement of the WFS programmatic beliefs and practices, use of those beliefs and practices in every day life, disbelief in AA's first step (powerless over alcohol), and length of time in WFS and length of time sober.

Rates of attrition among the membership of Alcoholics Anonymous in Finland.

Anniversary announcements published in the national AA newsletter are used to analyze membership turnover in Finnish AA. Of the total membership with at least 1 year of sobriety, close to 90% continue as sober members for another year. Of those having 1 year of sobriety, about two-thirds survive to the next year. The survival rate of members with between 2 and 5 years of sobriety is about 85%. Among members with more than 5 years of sobriety, the survival rate is above 90%. There are no gender differences in survival rates. The sober membership of AA represents between one-third and one-fifth of general population survey estimates of the number of abstaining former frequent drinkers with concerns about losing control over their drinking behavior.

Long-Term Recovery from Alcoholism

AA has demonstrated success in steadily increasing membership, with no loss of the proportion of those with over 5 years of sobriety. It has been recognized as effective long-term treatment for alcoholism by psychiatrists and psychoanalysts experienced in treatment of the addictions. The triennial membership surveys of AA have shown stability in 1. A 50% dropout rate within the first 3 months of starting AA. Only 41% of those in the first year will remain in the Fellowship for another year. 2. Roughly equal numbers of those with less than 1 year, 1 to 5 years, and over 5 years of sobriety, with an average length of sobriety of about 4 years. 3. Members having a sponsor (85%) and belonging to a home group (88%). 4. Attendance by members of about three meetings a week, regardless of duration of sobriety. 5. Members telling their doctor that they are in AA, but not helping him or her learn about the program. The survey data also indicate that AA is changing in the following ways: 1. The number of women members has increased to more than one third the total membership. 2. An increasing number of young people, under 30 years of age, to more than one fifth the total. 3. A decreasing number of older people, over 50 years of age, to just under one fourth the total. 4. An increasing number of members who were also addicted to other drugs (46%). Psychiatrists can use these data and knowledge of AA to 1. Increase the effectiveness of referrals of alcoholic patients to AA regardless of age, sex, race, or other characteristics. All are welcome and can benefit. 2. Deal with resistance, which occurs when patients begin to make contact with AA. 3. Help alcoholic patients through the difficult first year of sobriety. 4. Encourage their alcoholic patients to use AA as a program for personal growth and development. 5. Helping dually addicted patients use AA's singleness of purpose to facilitate their recovery. 6. Cooperate with alcohol and drug treatment programs in helping patients transfer to AA and work on an effective program of recovery. 7. Work with members of the local AA Treatment Facilities and Cooperation with the Professional Community Committees in helping alcoholic patients enter and use AA. 8. Provide psychiatric treatment for AA members in ways that support and sustain their program of recovery, especially by avoiding dependence-producing medications.

The Reading of Bethany: A Case Study of an Adolescent Reader

Bethany can read. It was not always so. Bethany is seventeen, blond, blue-eyed, a senior at a local high school, bright, and articulate. She takes three classes during the day, three classes in night school, and works a part-time job. She says, plan on graduating, so I can go to college. You need college to get ahead. Bethany is a recovering alcoholic and drug addict. She has just celebrated her first year of sobriety; she has been alcoholand drug-free for one year. Now Bethany's favorite book is the Big Book of Alcoholics Anonymous (1976, New York: AA World Services). She likes to read How It Works, (5860) because tells me how to live, and page 449 because need to learn to accept, she said. When I sit down to read the Big Book, I want to know how to get out of the situation that I'm in. Occasionally I will read just for fun or to escape, but I really don't have much time. Bethany was drunk for the first time when she was ten. She tried drugs at eleven. She says, started young. Drinking really didn't catch up with her in middle school, but it did by high school. In middle school Bethany was a straight A student, but she feels that her addiction kicked in by the time she entered high school. Her addiction interfered with her learning process. Bethany believes that her emotional and intellectual growth just stopped.

Sobriety, friends, and gay men

The purpose of this study was to learn how sobriety affected friendship circles of gay men recovering from alcoholism. Twenty gay recovering alcoholic men, each with at least 1 year of sobriety, were interviewed in depth. Before sobriety, the typical picture portrayed by the men was that of losing friends, having many heavily drinking acquaintances, and having difficulty meeting the responsibilities in friendships. In sobriety, the typical gay man realized that most of the gay men that he had thought were his friends were actually only drinking buddies. As sobriety time lengthened, the men reported expanding their friendship circles to include primarily gay men of Alcoholics Anonymous and others who were either normal drinkers or abstainers. Finally, nursing implications of this study are discussed.

Preliminary Validation of the Assessment of Occupational Functioning with an Alcoholic Population

This paper describes preliminary validation of the Assessment of Occupational Function (AOF) (Brollier & Watts, 1985; Watts, Brollier, Bauer, & Schmidt, 1988; Watts, Kielhofner, Bauer, Gregory, & Valentine, 1986), a screening tool based on the model of human occupation (Kielhofner, 1985a), with an alcoholic population. A study of 48 adult alcoholics from two groups, inpatients at an alcoholism rehabilitation center and Alcoholics Anonymous (AA) members having at least one year of sobriety, was conducted to examine the AOF's ability to discriminate between the groups. Results indicated that the instrument could distinguish between the occupational functioning of the AA and inpatient groups. Additionally, significant differences between the two groups were found in total AOF scores and in habits, roles, personal causation, and values component scores. The AOF appears to have potential as a valid instrument for use with an alcoholic population. Additional findings of the study suggested that occupational fun...

Alcoholism and non-acceptance of gay self: the critical link.

As part of a larger research project designed to generate grounded theory on the nature of gay sobriety, this study was designed to explore the etiology of alcoholism among gay American men and how etiology is related to gay bars or non-acceptance of gay self or both. In-depth interviews were conducted in Seattle, Iowa City, Chicago, and Oklahoma City with 20 gay recovering alcoholic men, each of whom had at least one year of sobriety. It was found that: (a) Gay bars were totally unrelated to the etiology in any of the informants, yet most thought that this gay bar ethnotheory could explain why there was a high incidence of alcoholism in the gay community; (b) none of the men saw being gay as a positive thing before sobriety, yet many didn't realize their non-acceptance until after sobriety was chosen; (c) accepting being gay as a positive aspect of self occurred only after sobriety was chosen and lived; and (d) not accepting being gay as a positive thing may therefore explain the etiology and thus the high incidence of alcoholism among gay American men.

Attributional styles of alcoholics.

This study found that alcoholics in treatment differed significantly from nonalcoholics and recovering alcoholics who had completed at least 1 year of sobriety on 2 subscales of the Attributional Style Questionnaire: on the good outcomes-global and good outcomes-stable. Implications for further research and treatment are discussed.

Medical-behavioral treatment of the older alcoholic patient.

The purpose of the present research was to assess the treatment effectiveness of a multimodality alcoholism treatment program with older alcoholic patients. Treatment success was defined as 1 year of sobriety following inpatient treatment in a multicomponent program oriented around aversion conditioning to alcohol. A total of 87 patients, 65 years or older, were admitted, and a total of 78 patients were treated in the Raleigh Hills Hospital-Portland over a 2-year period. Descriptive psychological test data, demographic characteristics, and symptom history data were obtained for these patients and related to treatment outcome. This population of elderly alcoholic patients treated as successfully as younger patients. Their abstinence percentage combined for the two treatment years was 65.4% continuous sobriety over a 12-month follow-up period.

Loneliness and Alcoholism: A Study of Three Groups of Male Alcoholics

Three groups of alcoholics at different stages of recovery were tested for loneliness with the Sisenwein Loneliness Scale. The groups consisted of alcoholics going through detoxification (acute), alcoholics in outpatient treatment who had had at least two drinking episodes in the previous 6 months (chronic), and alcoholics having at least 1 year of sobriety (recovering). It was hypothesized that the acute group would exhibit more loneliness than the chronic group, who would in turn demonstrate more loneliness than the recovering group. Results showed that acute group to demonstrate significantly (p less than .01) more loneliness on the Sisenwein (mean = 134.4) than the recovering group (mean = 54.6). The chronic group (mean = 91.0) was not significantly different than the others at the p less than .01 level, but the mean score did fall in the expected direction.

Sexual dysfunctions of the alcoholic

After reviewing the theories proposed as models for alcoholism, a picture seems to emerge that may serve to incorporate the sexual dysfunctions occuring in chronic alcoholism. So far, neither the clinical anecdotal data, nor the recent research on non-alcoholics conducted in controlled laboratory conditions could explain the persistence of sexual ysfunctions after years of sobriety. The seemingly paradoxical appearance, during periods of alcohol abstinence, of a more severe symptom of sexual malfunction—the total lack of sexual desire—may be conceived as an attempt to compensate a psychodynamic imbalance: as alcoholism is aleviated, the sexual dysfunction is aggravated. Therefore, in order to be effective, sex therapy for the alcoholic, has to address itself at the same time to the intrapersonal dynamics, to the inter-personal system as well as to the actual presenting sexual complaints.

The relationship between abstinence and Recovery of function in male alcoholics

Abstract Recovery of information-processing skills following prolonged abstinence was studied in middle-aged (mean = 50 years) chronic alcoholics. A battery of neuropsychological tests was administered to 25 long-term abstinent (21.2 months) alcoholics, 25 short-term abstinent (1.6 months) alcoholics, and 25 non-alcoholic control subjects. While there was a tendency for LTA alcoholics to perform better than STA alcoholics on digit-symbol substitution tests, there was no evidence of recovery on short-term memory or paired-associate learning: both groups of alcoholics were equally impaired, compared to control subjects. This suggests that the typical alcoholic manifests subtle neuropsychological deficits despite 1–2 years of sobriety.

Alcohol-induced sexual impotence.

Sexual impotence resulting from prolonged alcohol abuse may persist even after years of sobriety. The authors believe this problem is neither a psychological nor a hormonal defect but is due to the destructive effect of alcohol on the neurogenic reflex arc that serves the process of erection. The damage may be irreversible, accounting for the inability of some men to reattain potency.

Antabuse in a Clinic Program

The patients who go into the Antabuse program at the County Hospital in Racine have not responded to other kinds of treatment for problem drinking. Many are not alcoholics, but have character disorders with problem drinking. They do not seem to want help, and they have been in and out of hospitals and jails. All patients admitted to the inebriate program in the county hospital are court committed, voluntarily or involuntarily. After psychiatric and physical examination, about one third of these patients go into the Antabuse program. Antabuse is a crutch, not complete therapy. However, during a year of sobriety, even though it is enforced, most of our patients develop resources of their own and can make it without the drug. If they wish to continue taking Antabuse on a voluntary basis they may, and quite a few do for a while. We strongly urge Alcoholics Anonymous programs for those persons who seem at all receptive. Our program is not designed or intended for lifetime support. After detoxification, patients who do go on the program are saturated with disulfiram (Antabuse) re-

The psychodynamics of the dry drunk.

Our study of the responses of the 52 respondents to the questionnaire on the dry drunk leads us to the following conclusions: 1. The dry drunk is experienced by the majority of alcoholics who have maintained sobriety over a long period. 2. The occupation of an alcoholic has no statistical significance in maintaining sobriety. 3. A number of alcoholics will drink from 10 to 20 years before they begin to maintain sobriety. 4. Dry drunks generally occur within the first year of sobriety ( occasionally during the early months). 5. This symptom occurs irregularly and with diminishing intensity as the period of sobriety lengthens. 6. The dry drunk is characterized by a feeling of deep depression and frustration and by indecision regarding taking a drink. 7. "Inner life" is largely responsible for precipitating a dry drunk. 8. The dry drunk often is preceded by the same feelings. 9. The principal feelings after a dry drunk are relief and thankfulness at not drinking during this period of craving. 10. Drugs are not used to combat the moods and feelings of a dry drunk nor to produce similar feelings. 11. Alcoholics are irritable, restless, and impatient during a dry drunk. 12. After a dry drunk one's thoughts, feelings, and behavior return to normal. 13. A. A. members are the persons most helpful during a dry drunk while spouses, other members of the family, and former drinking companions are the least helpful. 14. Dry drunks may be prevented by contacts with A. A. and efforts to keep the mind off the drinking problem. 15. Dry drunks are generally related to one's mood swings 16. The financial status generally improves when sobriety is maintained over an extended period. 17. The dry drunks described by our respondents have a number of the same characteristics as the " late withdrawal symptoms" described by Wellman. We feel that this study has been useful in clarifying our thinking on the dry drunk, in indicating sources of help for persons who are experiencing or may suffer dry drunks, and in pointing out areas for further study. We are impressed with the thoughtful, painstaking way in which the questionnaires were answered and with the willingness of the respondents to elaborate in detail on their experiences.