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Scott J Tonigan - One of the best experts on this subject based on the ideXlab platform.

  • lifetime Alcoholics Anonymous attendance as a predictor of spiritual gains in the relapse replication and extension project rrep
    Psychology of Addictive Behaviors, 2017
    Co-Authors: Scott J Tonigan, Elizabeth Mccallion, Tessa Frohe, Matthew R Pearson
    Abstract:

    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

  • the general Alcoholics Anonymous tools of recovery the adoption of 12 step practices and beliefs
    Psychology of Addictive Behaviors, 2013
    Co-Authors: Brenna L Greenfield, Scott J Tonigan
    Abstract:

    Working the 12 steps is widely prescribed for Alcoholics Anonymous (AA) members although the relative merits of different methods for measuring step work have received minimal attention and even less is known about how step work predicts later substance use. The current study (1) compared endorsements of step work on an face-valid or direct measure, the Alcoholics Anonymous Inventory (AAI), with an indirect measure of step work, the General Alcoholics Anonymous Tools of Recovery (GAATOR); (2) evaluated the underlying factor structure of the GAATOR and changes in step work over time; (3) examined changes in the endorsement of step work over time; and (4) investigated how, if at all, 12-step work predicted later substance use. New AA affiliates (N = 130) completed assessments at intake, 3, 6, and 9 months. Significantly more participants endorsed step work on the GAATOR than on the AAI for nine of the 12 steps. An exploratory factor analysis revealed a two-factor structure for the GAATOR comprising behavioral step work and spiritual step work. Behavioral step work did not change over time, but was predicted by having a sponsor, while Spiritual step work decreased over time and increases were predicted by attending 12-step meetings or treatment. Behavioral step work did not prospectively predict substance use. In contrast, spiritual step work predicted percent days abstinent. Behavioral step work and spiritual step work appear to be conceptually distinct components of step work that have distinct predictors and unique impacts on outcomes.

  • evaluating Alcoholics Anonymous s effect on drinking in project match using cross lagged regression panel analysis
    Journal of Studies on Alcohol and Drugs, 2013
    Co-Authors: Stephen Magura, Charles M Cleland, Scott J Tonigan
    Abstract:

    Objective: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.Method: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.Results: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.Conc...

  • a novel application of propensity score matching to estimate Alcoholics Anonymous effect on drinking outcomes
    Drug and Alcohol Dependence, 2013
    Co-Authors: Stephen Magura, Joseph W Mckean, Scott Kosten, Scott J Tonigan
    Abstract:

    Background Randomized controlled trials (RCTs) of mutual aid, including Alcoholics Anonymous (AA), are notoriously difficult to conduct and correlational studies are problematic to interpret due to potential confounds.

  • impressions of Alcoholics Anonymous aa group cohesion a case for a nonspecific factor predicting later aa attendance
    Alcoholism Treatment Quarterly, 2012
    Co-Authors: Samara L Rice, Scott J Tonigan
    Abstract:

    Social support for abstinence in Alcoholics Anonymous (AA) has been reported to be a consistent factor accounting for AA benefit. However, the nonspecific or unintended effects of such support remain poorly understood and rarely investigated. This prospective study investigated how one nonspecific factor—perceived AA group cohesiveness—predicted increased practice of AA-related behaviors. Findings indicated that impressions of AA group cohesion predicted increased AA attendance, the practice of prescribed AA activities, and self-reported AA usefulness. It appears that a sense of belongingness predicts subsequent engagement in the AA social network that, in turn, is predictive of increased abstinence.

Lee Ann Kaskutas - One of the best experts on this subject based on the ideXlab platform.

  • does sponsorship improve outcomes above Alcoholics Anonymous attendance a latent class growth curve analysis
    Addiction, 2012
    Co-Authors: Jane Witbrodt, Jason Bond, Lee Ann Kaskutas, Kevin L Delucchi
    Abstract:

    Aims  To construct Alcoholics Anonymous (AA) attendance, sponsorship and abstinence latent class trajectories to test the added benefit of having a sponsor above the benefits of attendance in predicting abstinence over time. Design  Prospective with 1-, 3-, 5- and 7-year follow-ups. Setting and participants  Alcoholic-dependent individuals from two probability samples, one from representative public and private treatment programs and another from the general population (n = 495). Findings  Individuals in the low attendance class (four classes identified) were less likely than those in the high, descending and medium attendance classes to be in high (versus low) abstinence class (three classes identified). No differences were found between the other attendance classes as related to abstinence class membership. Overall, being in the high sponsor class (three classes identified) predicted better abstinence outcomes than being in either of two other classes (descending and low), independent of attendance class effects. Although declining sponsor involvement was associated with greater likelihood of high abstinence than low sponsor involvement, being in the descending sponsor class also increased the odds of being in the descending abstinence class. Conclusions  Any pattern of Alcoholics Anonymous attendance, even if it declines or is never high for a particular 12-month period, is better than little or no attendance in terms of abstinence. Greater initial attendance carries added value. There is a benefit for maintaining a sponsor over time above that found for attendance.

  • sponsorship and service as mediators of the effects of making Alcoholics Anonymous easier maaez a 12 step facilitation intervention
    Drug and Alcohol Dependence, 2011
    Co-Authors: Meenakshi S Subbaraman, Lee Ann Kaskutas, Sarah E Zemore
    Abstract:

    A recent trial (n=508) of “Making Alcoholics Anonymous Easier” (MAAEZ), a group-format 12-step facilitation program, showed that MAAEZ participants had increased odds of abstinence (OR = 1.58, p = 0.063). Effects were especially marked in several subgroups, including those with more prior AA/NA/CA exposure, and those with severe psychiatric problems. This paper examines whether the effects of MAAEZ were explained by higher engagement in particular Alcoholics Anonymous (AA) and other 12-step organization activities. Mediation analyses were performed, estimating MAAEZ effects attributable to AA/NA/CA meeting attendance, overall AA/NA/CA involvement, having a sponsor, and engaging in 12-step service. The only variable that appeared to mediate MAAEZ effects in the sample overall was doing service at either 6 months or at both 6 and 12 months. Among those with high prior AA/NA/CA attendance, both having a sponsor and doing service emerged as mediators, with having a sponsor explaining approximately 25% of the MAAEZ effect. Doing service also partially explained the MAAEZ effect among those with high psychiatric severity. Results highlight the value of studying specific AA/NA/CA activities as mediators of treatment effects, and demonstrate the importance of exploring subgroups when trying to understand treatment mechanisms. Findings also suggest that treatment programs should emphasize specific activities for particular clients. For example, individuals may have attended many AA/NA/CA meetings, but never known how to ask for a sponsor or get involved in service; doing service may represent a non-threatening way of connecting with 12-step members for clients with psychiatric problems such as social anxiety.

  • 7 year trajectories of Alcoholics Anonymous attendance and associations with treatment
    Addictive Behaviors, 2009
    Co-Authors: Lee Ann Kaskutas, Jason Bond, Lyndsay A Avalos
    Abstract:

    Although many members of Alcoholics Anonymous (AA) are introduced to AA during treatment, the relationship between treatment and AA attendance over time is unknown. This paper describes four latent classes of AA attendance among 586 dependent Alcoholics interviewed by telephone 1, 3, 5 and 7 years after baseline, and models the relationship between treatment exposure and AA attendance in each class. There was a low AA group (averaging fewer than 5 meetings at most follow-ups), a medium AA group (about 50 meetings a year at each follow-up), a descending AA group (about 150 meetings year 1, then decreasing steeply), and a high AA group (about 200 meetings at 1 year, then decreasing gradually by year 7). Declines in meeting attendance were not always accompanied by decreases in abstinence. After accounting for the effect of time on AA attendance (i.e., the "ups-and-downs" that occur over time), treatment exposure was minimally related to AA attendance in all but the descending AA group, where it was negatively associated (p<0.001). Considering AA patterns over time highlights a different role for treatment in AA attendance than what is gleaned from analyses at single timepoints.

  • effectiveness of making Alcoholics Anonymous easier a group format 12 step facilitation approach
    Journal of Substance Abuse Treatment, 2009
    Co-Authors: Lee Ann Kaskutas, Jane Witbrodt, Meenakshi S Subbaraman, Sarah E Zemore
    Abstract:

    Most treatment programs recommend clients attend 12-step groups, but many drop out posttreatment. The effectiveness of Making Alcoholics Anonymous [AA] Easier (MAAEZ ), a manual-guided intervention designed to help clients connect with individuals encountered in AA, was tested using an "OFF/ON" design (n = 508). MAAEZ effectiveness was determined by comparing abstinence rates of participants recruited during ON and OFF conditions and by studying the effect of the number of MAAEZ sessions attended. At 12 months, more clients in the ON condition (vs. OFF) reported past 30-day abstinence from alcohol (p = .012), drugs (p = .009), and both alcohol and drugs (p = .045). In multivariate analyses, ON condition participants had significantly increased odds of abstinence from alcohol (odds ratio [OR] = 1.85) and from drugs (OR = 2.21); abstinence odds also increased significantly for each additional MAAEZ session received. MAAEZ appeared especially effective for those with more prior AA exposure, severe psychiatric problems, and atheists/agnostics. MAAEZ represents an evidence-based intervention that is easily implemented in existing treatment programs.

  • Alcoholics Anonymous effectiveness faith meets science
    Journal of Addictive Diseases, 2009
    Co-Authors: Lee Ann Kaskutas
    Abstract:

    Research on the effectiveness of Alcoholics Anonymous (AA) is controversial and subject to widely divergent interpretations. The goal of this article is to provide a focused review of the literature on AA effectiveness that will allow readers to judge the evidence effectiveness of AA for themselves. The review organizes the research on AA effectiveness according to six criterion required for establishing causation: (1) magnitude of effect; (2) dose response effect; (3) consistent effect; (4) temporally accurate effects; (5) specific effects; (6) plausibility. The evidence for criteria 1- 4 and 6 is strong: rates of abstinence are about twice as high among those who attend AA (criteria 1, magnitude); higher levels of attendance are related to higher rates of abstinence (criteria 2, dose-response); these relationships are found for different samples and follow-up periods (criteria 3, consistency); prior AA attendance is predictive of subsequent abstinence (criteria 4, temporal); and mechanisms of action predicted by theories of behavior change are present in AA (criteria 6, plausibility). However, rigorous experimental evidence establishing the specificity of an effect for AA or Twelve Step Facilitation/TSF (criteria 5) is mixed, with 2 trials finding a positive effect for AA, 1 trial finding a negative effect for AA, and 1 trial finding a null effect. Studies addressing specificity using statistical approaches have had two contradictory findings, and two that reported significant effects for AA after adjusting for potential confounders such as motivation to change.

John F Kelly - One of the best experts on this subject based on the ideXlab platform.

  • overlapping mechanisms of recovery between professional psychotherapies and Alcoholics Anonymous
    Journal of Addiction Medicine, 2020
    Co-Authors: David Marcovitz, Kathryn R Mchugh, Corey R Roos, Jule J West, John F Kelly
    Abstract:

    BACKGROUND Much research over the past 25 years has focused on elucidating the mechanisms by which Alcoholics Anonymous (AA) affects behavioral change in its participants. In addition to research on the spiritual mechanisms for which AA is best known in the popular conception, research on mechanisms of recovery (MOR) has predominantly supported social, cognitive, and affective mechanisms that are also present in many professional psychotherapies. AIM This paper compares and contrasts the theorized MOR of AA with those found in several common professional psychotherapies to illustrate analogous elements. METHODS Literature review, summary, and synthesis of studies examining the MOR of both AA and common psychotherapies including analytic/dynamic therapies, cognitive-behavioral therapies, and acceptance and mindfulness-based therapies. RESULTS There exists a significant overlap in theorized MOR of AA and mainstream, professional psychotherapies. Mechanisms with the greatest overlap include those mobilizing stress and coping theory, behavioral choice theory, and social learning theory, while mechanisms more unique to AA compared to professional psychotherapies mobilize social control theory to a greater degree. CONCLUSIONS In caring for patients with addiction, practicing clinicians will find it useful to be aware of overlapping analogous elements found in the AA program and professional psychotherapies and how they can complement one another.

  • toward an enhanced understanding of the psychological mechanisms by which spirituality aids recovery in Alcoholics Anonymous
    Alcoholism Treatment Quarterly, 2014
    Co-Authors: John F Kelly, Claire M Greene
    Abstract:

    Alcoholics Anonymous (AA) is based on a spiritual program of action. In keeping with AA's spiritually based recovery theory, rigorous studies have revealed that spirituality may be one of the mechanisms through which AA aids recovery. A question that has lingered, however, is how exactly does an increase in spiritual beliefs and practices translate into more abstinence and remission? To help answer this question, this article reviews theory and research related to AA and spirituality as a mechanism of behavior change and offers five possible psychological pathways that may help explain how increases in spirituality may translate into enhanced abstinence and remission rates.

  • does Alcoholics Anonymous work differently for men and women a moderated multiple mediation analysis in a large clinical sample
    Drug and Alcohol Dependence, 2013
    Co-Authors: John F Kelly, Bettina B Hoeppner
    Abstract:

    Background Alcoholics Anonymous (AA) began as a male organization, but about one third is now female. Studies have found that women participate at least as much as men and benefit equally from AA, but it is unclear whether women benefit from AA in the same or different ways as men. This study tested whether gender moderated the mechanisms through which AA aids recovery.

  • how Alcoholics Anonymous aa and narcotics Anonymous na work cross disciplinary perspectives
    Alcoholism Treatment Quarterly, 2011
    Co-Authors: Amy R Krentzman, Elizabeth A R Robinson, William L White, Barbara C Moore, John F Kelly, Alexandre B Laudet, Sarah E Zemore, Ernest Kurtz, Stephen Strobbe
    Abstract:

    Evidence from multiple lines of research supports the effectiveness and practical importance of Alcoholics Anonymous and Narcotics Anonymous. Conference presenters discussed the relationship between 12-Step participation and abstinence among various populations, including adolescents, women, and urban drug users. Insight from the arts and humanities placed empirical findings in a holistic context.

  • negative affect relapse and Alcoholics Anonymous aa does aa work by reducing anger
    Journal of Studies on Alcohol and Drugs, 2010
    Co-Authors: John F Kelly, Scott J Tonigan, Molly Magill, Robert L Stout, Maria E Pagano
    Abstract:

    Objective:Anger and other indices of negative affect have been implicated in a stress-induced pathway to relapse. The Alcoholics Anonymous (AA) literature states that reduction of anger is critical to recovery, yet this proposed mechanism has rarely been investigated. Using lagged, controlled hierarchical linear modeling analyses, this study investigated whether AA attendance mobilized changes in anger and whether such changes explained AA-related benefit. Method:Alcohol-dependent adults (N = 1,706) receiving treatment as part of a clinical trial were assessed at intake and at 3, 6, 9, 12, and 15 months. Results:Findings revealed substantially elevated levels of anger compared with the general population (98th percentile) that decreased over 15-month follow-up but remained high (89th percentile). AA attendance was associated with better drinking outcomes, and higher levels of anger were associated with heavier drinking. However, AA attendance was unrelated to changes in anger. Conclusions:Although support...

Keith Humphreys - One of the best experts on this subject based on the ideXlab platform.

  • griffith edwards rigorous sympathy with Alcoholics Anonymous
    Addiction, 2015
    Co-Authors: Keith Humphreys
    Abstract:

    Griffith Edwards made empirical contributions early in his career to the literature on Alcoholics Anonymous (AA), but the attitude he adopted towards AA and other peer-led mutual help initiatives constitutes an even more important legacy. Unlike many treatment professionals who dismissed the value of AA or were threatened by its non-professional approach, Edwards was consistently respectful of the organization. However, he never became an uncritical booster of AA or overgeneralized what could be learnt from it. Future scholarly and clinical endeavors concerning addiction-related mutual help initiatives will benefit by continuing Edwards' tradition of 'rigorous sympathy'.

  • participation in Alcoholics Anonymous intended and unintended change mechanisms
    Alcoholism: Clinical and Experimental Research, 2003
    Co-Authors: Patricia L Owen, Valerie Slaymaker, Scott J Tonigan, Barbara S Mccrady, Elizabeth E Epstein, Lee Ann Kaskutas, Keith Humphreys, William R Miller
    Abstract:

    This article is a compilation of the information presented at a symposium at the 2001 RSA Meeting in Montreal, Canada. The presentations were: (1) Maintaining change after conjoint behavioral alcohol treatment for men: the role of involvement with Alcoholics Anonymous, by Barbara S. McCrady and Elizabeth E. Epstein; (2) Changing AA practices and outcomes: Project MATCH 3-year follow-up, by J. Scott Tonigan; (3) Life events and patterns of recovery of AA-exposed adults and adolescents, by Patricia L. Owen and Valerie Slaymaker; (4) Social networks and AA involvement as mediators of change, by Lee Ann Kaskutas and Keith Humphreys; and (5) What do we know about Alcoholics Anonymous? by William R. Miller, discussant.

  • Alcoholics Anonymous and 12 step alcoholism treatment programs
    Recent developments in alcoholism : an official publication of the American Medical Society on Alcoholism the Research Society on Alcoholism and the N, 2002
    Co-Authors: Keith Humphreys
    Abstract:

    Alcoholics Anonymous (AA) self-help groups are the most commonly accessed component of the de facto system of care for alcohol problems in the United States. Further, AA’s concepts and approach have strongly influenced a significant number of professional treatment programs. Nevertheless, only a modest number of longitudinal, comparative outcome studies on AA and on professional 12-step treatment programs have been conducted, which has limited both the certainty and scope of conclusions that can be drawn about these interventions. Research indicates that participation in Alcoholics Anonymous and in 12-step treatment are associated with significant reductions in substance abuse and psychiatric problems. Further, such interventions, it has been found, reduce health care costs over time in naturalistic, quasi-experimental, and experimental studies. Evaluation studies have also begun to illuminate the processes through which self-help groups and 12-step treatment programs exert their effects. To build on this knowledge base, future research should (1) be methodologically flexible and well-matched to its phenomenon of interest, (2) include evaluation of the unique features of self-help organizations, (3) increase representation of African-Americans and women in research samples, and (4) increase statistical power through larger sample sizes and more reliable measurement. Key content areas for future enquiry include further longitudinal evaluation of the outcomes of participation in AA and 12-step treatment (particularly in outpatient samples); better specification of the aspects of AA that influence outcome; and individual-, community-, and health organization-level controlled studies of the health care cost consequences of 12-step interventions.

  • community narratives and personal stories in Alcoholics Anonymous
    Journal of Community Psychology, 2000
    Co-Authors: Keith Humphreys
    Abstract:

    Storytelling is an extremely common activity in the spiritually-based mutual help organization Alcoholics Anonymous (A.A.). This paper describes the typical content, function(s), and structure of five types of A.A. stories, devoting particular attention to the interplay between the A.A. community narrative and the life stories of individual members. The information presented here suggests that a narrative point of view can fruitfully guide future investigations of mutual help organizations at multiple levels of analysis. © 2000 John Wiley & Sons, Inc.

  • the Alcoholics Anonymous affiliation scale development reliability and norms for diverse treated and untreated populations
    Alcoholism: Clinical and Experimental Research, 1998
    Co-Authors: Keith Humphreys, Lee Ann Kaskutas, Constance Weisner
    Abstract:

    Affiliation with Alcoholics Anonymous (AA) is an important variable to measure in many clinical and research activities. This paper reports on the development of an AA affiliation scale, and demonstrates its utility in a sample of 927 alcohol treatment seekers and 674 untreated problem drinkers. The scale is short (9 items), covers a range of AA experiences, and is internally consistent across diverse demographic groups, multiple health services settings, and treated and untreated populations. The validity of the scale is supported by the findings that treatment seekers report significantly higher AA affiliation than do untreated problem drinkers, and inpatients report higher affiliation than outpatients. Potential clinical and research applications of the scale are proposed.

Constance Weisner - One of the best experts on this subject based on the ideXlab platform.

  • the persistent influence of social networks and Alcoholics Anonymous on abstinence
    Journal of Studies on Alcohol and Drugs, 2003
    Co-Authors: Jason Bond, Lee Ann Kaskutas, Constance Weisner
    Abstract:

    Objective: The role of changes in Alcoholics Anonymous (AA) involvement and social networks in relation to abstinence following substance abuse treatment is studied. Specifically, the role of AA and network support for abstinence are examined in relation to their effect on changes in abstinence states between follow-ups. Method: Study sites were 10 representative public and private alcohol treatment programs in a northern California county. A recruitment of 367 men and 288 women seeking treatment were interviewed at intake and re-interviewed 1 and 3 years later to collect information about alcohol consumption, dependence symptoms, social support for reducing drinking, number of heavy drinkers in the social network and AA involvement. Results: Significant predictors of 90-day abstinence at both the 1- and 3-year follow-up interviews included AA involvement in the last year, percentage of heavy or problem drinkers in the social network, percentage encouraging alcohol reduction and AA-based support for reduc...

  • the Alcoholics Anonymous affiliation scale development reliability and norms for diverse treated and untreated populations
    Alcoholism: Clinical and Experimental Research, 1998
    Co-Authors: Keith Humphreys, Lee Ann Kaskutas, Constance Weisner
    Abstract:

    Affiliation with Alcoholics Anonymous (AA) is an important variable to measure in many clinical and research activities. This paper reports on the development of an AA affiliation scale, and demonstrates its utility in a sample of 927 alcohol treatment seekers and 674 untreated problem drinkers. The scale is short (9 items), covers a range of AA experiences, and is internally consistent across diverse demographic groups, multiple health services settings, and treated and untreated populations. The validity of the scale is supported by the findings that treatment seekers report significantly higher AA affiliation than do untreated problem drinkers, and inpatients report higher affiliation than outpatients. Potential clinical and research applications of the scale are proposed.

  • the relationship of pre treatment Alcoholics Anonymous affiliation with problem severity social resources and treatment history
    Drug and Alcohol Dependence, 1998
    Co-Authors: Keith Humphreys, Lee Ann Kaskutas, Constance Weisner
    Abstract:

    Little research has examined the relationship of substance abuse patients' prior Alcoholics Anonymous (AA) affiliation to important treatment-related variables. This study of 927 individuals seeking treatment in public, health maintenance organization (HMO) and private-for-profit medical programs, found that 82.8% of patients presented at treatment with a history of AA affiliation. Degree of prior AA affiliation was significantly associated with more extensive prior utilization of formal and informal helping resources, current seeking of treatment in the public sector, having low income, being divorced/separated and having more severe alcohol, employment/support and psychiatric problems. Implications for service delivery and future research are discussed.