Alcoholics Anonymous attendance, decreases in impulsivity and drinking and psychosocial outcomes over 16 years: moderated-mediation from a developmental perspective.

Blonigen DM, Timko C, Finney JW, Moos BS, Moos RH. Alcoholics Anonymous attendance, decreases in impulsivity and drinking and psychosocial outcomes over 16 years: moderated-mediation from a developmental perspective. Addiction (Abingdon, England). 2011 Dec 1; 106(12):2167-77.

Related HSR&D Project(s)

• RCS 00-001 – Quality and Care of Substance Abuse and Psychiatric Treatment
• SUS 99-015 – System for Monitoring Substance Abuse Patients' Outcomes and Care

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Abstract:

AIMS: To examine whether decreases in impulsivity account for links between Alcoholics Anonymous (AA) attendance and better drinking and psychosocial outcomes, and whether these mediational 'effects' are conditional on age. DESIGN: A naturalistic study in which individuals were assessed at baseline, and 1, 8 and 16 years later. SETTING: Participants initiated help-seeking through the alcohol intervention system (detoxification programs, information and referral centers). PARTICIPANTS: Individuals with alcohol use disorders and no prior history of substance abuse treatment at baseline [n = 628; 47% women; mean age = 34.7 years (standard deviation = 9.4)]. MEASUREMENTS: Self-reports of impulsivity and drinking pattern at baseline and year 1, duration of AA (number of weeks) in year 1 and drinking (alcohol use problems, self-efficacy to resist drinking) and psychosocial outcomes (emotional discharge coping, social support) at baseline and follow-ups. FINDINGS: Controlling for changes in drinking pattern, decreases in impulsivity were associated with fewer alcohol use problems, better coping and greater social support and self-efficacy at year 1, and better coping and greater social support at year 8. Decreases in impulsivity statistically mediated associations between longer AA duration and improvements on all year 1 outcomes and indirect effects were moderated by participant age (significant only for individuals 25 years of age or younger). CONCLUSIONS: Decreased impulsivity appears to mediate reductions in alcohol-related problems over 8 years in people attending Alcoholics Anonymous.