Is Alcoholics Anonymous religious, spiritual, neither? Findings from 25 years of mechanisms of behavior change research

Addiction

Volumn 112, Issue 6, 2017, Pages 929-936

  Kelly, John F ^a  

^a HARVARD MEDICAL SCHOOL   (United States)

Author keywords

Addiction recovery; Alcoholics Anonymous; groups; mechanisms of behavior change; mutual help; religion; self help; spirituality

Indexed keywords

ADDICTION SEVERITY INDEX; ALCOHOLICS ANONYMOUS; AROUSAL; BEHAVIOR CHANGE; HUMAN; PUBLIC HEALTH; PUBLICATION; RELIGION; SELF HELP; SYNTHESIS; THEORETICAL MODEL; ALCOHOLISM; RESEARCH; UNITED STATES;

ALCOHOLICS ANONYMOUS; ALCOHOLISM; HUMANS; RELIGION; RESEARCH; SPIRITUALITY; UNITED STATES;

EID: 84991106696     PISSN: 09652140     EISSN: 13600443     Source Type: Journal    
DOI: 10.1111/add.13590     Document Type: Article

References (60)

1. Alcoholics Anonymous. Twelve Steps and Twelve Traditions. New York: Alcoholics Anonymous World Services; 1952.
2. st printing. New York, NY: Alcoholics Anonymous World Services; 1939.
3. Volkow N. D., Koob G. Brain disease model of addiction: why is it so controversial? Lancet Psychiatry 2014; 2: 677–9.
4. Kelly J. F. The new science on AA and 12-step facilitation. In: Frenz D., editor. The Carlat Report, Vol. 2; 2014, pp. 1–5.
5. Kelly J. F., Yeterian J. D. Mutual-help groups for alcohol and other substance use disorders. In: McCrady B. S., Epstein E. E., editors. Addictions: A Comprehensive Guidebook, 2nd edn. New York: Oxford University Press; 2013, pp. 500–25.
6. Inouye v. Kemna. United States Court of Appeals, Ninth Circuit; 2007. Available at: http://caselaw.findlaw.com/us-9th-circuit/1008140.html (accessed 24 September 2016) (Archived at http://www.webcitation.org/6klgiL8w7).
7. Alcoholics Anonymous. Living Sober. New York, NY: Alcoholics Anonymous World Services; 1975.
8. MacKinnon D. P., Fairchild A. J. Current directions in mediation analysis. Curr Dir Psychol Sci 2009; 18: 16–20.
9. Emrick C. D., Tonigan J. S., Montgomery H., Little L. Alcoholics Anonymous: what is currently known? In: McCrady B. S., Miller W. R., editors. Research on Alcoholics Anonymous: Opportunities and Alternatives. Piscataway, NJ: Rutgers Center of Alcohol Studies; 1993, pp. 41–76.
10. Tonigan J. S., Toscova R., Miller W. R. Meta-analysis of the literature on Alcoholics Anonymous: sample and study characteristics moderate findings. J Stud Alcohol Drugs 1996; 57: 65–72.
11. Institute of Medicine. Broadening the Base of Treatment for Alcohol Problems. Washington, DC: The National Academies Press; 1990.
12. Kelly J. F., Yeterian J. D. Empirical awakening: the new science on mutual help and implications for cost containment under health care reform. Subst Abuse 2012; 33: 85–91.
13. Walitzer K. S., Dermen K. H., Barrick C. Facilitating involvement in Alcoholics Anonymous during out-patient treatment: a randomized clinical trial. Addiction 2009; 104: 391–401.
14. Litt M. D., Kadden R. M., Kabela-Cormier E., Petry N. M. Changing network support for drinking: network support project 2-year follow-up. J Consult Clin Psychol 2009; 77: 229–42.
15. Project MATCH Research Group. Matching alcoholism treatments to client heterogeneity: Project MATCH three-year drinking outcomes. Alcohol Clin Exp Res 1998; 22: 1300–11.
16. Humphreys K., Moos R. H. Can encouraging substance abuse patients to participate in self-help groups reduce demand for health care? A quasi-experimental study. Alcohol Clin Exp Res 2001; 25: 711–16.
17. Humphreys K., Moos R. H. Encouraging posttreatment self-help group involvement to reduce demand for continuing care services: two-year clinical and utilization outcomes. Alcohol Clin Exp Res 2007; 31: 64–8.
18. Project MATCH Research Group. Matching alcoholism treatments to client heterogeneity: Project MATCH posttreatment drinking outcomes. J Stud Alcohol 1997; 58: 7–29.
19. Longabaugh R., Wirtz P. W., Zweben A., Stout R. L. Network support for drinking, Alcoholics Anonymous and long-term matching effects. Addiction 1998; 93: 1313–33.
20. Subbaraman M. S., Kaskutas L. A. Social support and comfort in AA as mediators of ‘Making AA easier’ (MAAEZ), a 12-step facilitation intervention. Psychol Addict Behav 2012; 26: 759–65.
21. Humphreys K., Blodgett J. C., Wagner T. H. Estimating the efficacy of Alcoholics Anonymous without self-selection bias: an instrumental variables re-analysis of randomized clinical trials. Alcohol Clin Exp Res 2014; 38: 2688–94.
22. Ye Y., Kaskutas L. A. Using propensity scores to adjust for selection bias when assessing the effectiveness of Alcoholics Anonymous in observational studies. Drug Alcohol Depend 2009; 104: 56–64.
23. Magura S., McKean J., Kosten S., Tonigan J. S. A novel application of propensity score matching to estimate Alcoholics Anonymous' effect on drinking outcomes. Drug Alcohol Depend 2013; 129: 54–9.
24. Mundt M. P., Parthasarathy S., Chi F. W., Sterling S., Campbell C. I. 12-Step participation reduces medical use costs among adolescents with a history of alcohol and other drug treatment. Drug Alcohol Depend 2012; 126: 124–30.
25. Gossop M., Stewart D., Marsden J. Attendance at Narcotics Anonymous and Alcoholics Anonymous meetings, frequency of attendance and substance use outcomes after residential treatment for drug dependence: a 5-year follow-up study. Addiction 2008; 103: 119–25.
26. McKellar J., Stewart E., Humphreys K. Alcoholics Anonymous involvement and positive alcohol-related outcomes: cause, consequence, or just a correlate? A prospective 2-year study of 2,319 alcohol-dependent men. J Consult Clin Psychol 2003; 71: 302–8.
27. Moos R. H., Moos B. S. Long-term influence of duration and frequency of participation in alcoholics anonymous on individuals with alcohol use disorders. J Consult Clin Psychol 2004; 72: 81–90.
28. Timko C., Moos R. H., Finney J. W., Lesar M. D. Long-term outcomes of alcohol use disorders: comparing untreated individuals with those in alcoholics anonymous and formal treatment. J Stud Alcohol Drugs 2000; 61: 529–40.
29. Witbrodt J., Mertens J., Kaskutas L. A., Bond J., Chi F., Weisner C. Do 12-step meeting attendance trajectories over 9 years predict abstinence? J Subst Abuse Treat 2012; 43: 30–43.
30. Kelly J. F., Stout R. L., Slaymaker V. Emerging adults’ treatment outcomes in relation to 12-step mutual-help attendance and active involvement. Drug Alcohol Depend 2013; 129: 151–7.
31. Room R., Babor T., Rehm J. Alcohol and public health. Lancet 2005; 365: 519–30.
32. Sacks J. J., Gonzales K. R., Bouchery E. E., Tomedi L. E., Brewer R. D. 2010 National and State Costs of Excessive Alcohol Consumption. Am J Prev Med 2015; 49: e73–9.
33. Kelly J. F., Magill M., Stout R. L. How do people recover from alcohol dependence? A systematic review of the research on mechanisms of behavior change in Alcoholics Anonymous. Addict Res Theory 2009; 17: 236–59.
34. Kelly J. F., Stout R. L., Magill M., Tonigan J. S., Pagano M. E. Spirituality in recovery: a lagged mediational analysis of Alcoholics Anonymous’ principal theoretical mechanism of behavior change. Alcohol Clin Exp Res 2011; 35: 454–63.
35. Tonigan J. S., Rynes K. N., McCrady B. S. Spirituality as a change mechanism in 12-step programs: a replication, extension, and refinement. Subst Use Misuse 2013; 48: 1161–73.
36. Krentzman A. R., Cranford J. A., Robinson E. A. Multiple dimensions of spirituality in recovery: a lagged mediational analysis of Alcoholics Anonymous’ principal theoretical mechanism of behavior change. Subst Abus 2013; 34: 20–32.
37. Wilcox C. E., Pearson M. R., Tonigan J. S. Effects of long-term AA attendance and spirituality on the course of depressive symptoms in individuals with alcohol use disorder. Psychol Addict Behav 2015; 29: 382–91.
38. Tonigan J. S., Rynes K., Toscova R., Hagler K. Do changes in selfishness explain 12-step benefit? A prospective lagged analysis. Subst Abuse 2013; 34: 13–9.
39. Kelly J. F., Stout R. L., Magill M., Tonigan J. S. The role of Alcoholics Anonymous in mobilizing adaptive social network changes: a prospective lagged mediational analysis. Drug Alcohol Depend 2011; 114: 119–26.
40. Kelly J. F., Hoeppner B., Stout R. L., Pagano M. Determining the relative importance of the mechanisms of behavior change within Alcoholics Anonymous: a multiple mediator analysis. Addiction 2012; 107: 289–99.
41. Kelly J. F., Greene M. C. The twelve promises of Alcoholics Anonymous: psychometric validation and mediational testing as a 12-step specific mechanism of behavior change. Drug Alcohol Depend 2013; 133: 633–40.
42. Blonigen D. M., Timko C., Moos R. H. Alcoholics Anonymous and reduced impulsivity: a novel mechanism of change. Subst Abus 2013; 34: 4–12.
43. Morgenstern J., Labouvie E., McCrady B. S., Kahler C. W., Frey R. M. Affiliation with Alcoholics Anonymous after treatment: a study of its therapeutic effects and mechanisms of action. J Consult Clin Psychol 1997; 65: 768–79.
44. Kelly J. F., Myers M. G., Brown S. A. A multivariate process model of adolescent 12-step attendance and substance use outcome following inpatient treatment. Psychol Addict Behav 2000; 14: 376–89.
45. Kelly J. F., Myers M. G., Brown S. A. Do adolescents affiliate with 12-step groups? A multivariate process model of effects. J Stud Alcohol 2002; 63: 293–304.
46. Kelly J. F., Hoeppner B. B. Does Alcoholics Anonymous work differently for men and women? A moderated multiple-mediation analysis in a large clinical sample. Drug Alcohol Depend 2013; 130: 186–93.
47. Hoeppner B. B., Hoeppner S. S., Kelly J. F. Do young people benefit from AA as much, and in the same ways, as adult aged 30+? A moderated multiple mediation analysis. Drug Alcohol Depend 2014; 143: 181–8.
48. Alcoholics Anonymous. Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered From Alcoholism, 4th edn. New York, NY: Alcoholics Anonymous World Services; 2001.
49. Alcoholics Anonymous. Twelve Steps and Twelve Traditions. New York: Alcoholics Anonymous World Services; 1953.
50. Yalom I. D., Leszcz M. The theory and practice of group psychotherapy, 5th edn. New York: Basic Books; 2005.
51. Buckingham S. A., Frings D., Albery I. Group membership and social identity in addiction recovery. Psychol Addict Behav 2013; 27: 1132–40.
52. Alcoholics Anonymous Grapevine. The Bill W. - Carl Jung Letters. New York: Alcoholics Anonymous World Services, Inc.; 1963.
53. Alcoholics Anonymous. Alcoholics Anonymous, 2nd edn. New York: Alcoholics Anonymous World Services; 1955.
54. Leamy M., Bird V., Le Boutillier C., Williams J., Slade M. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry 2011; 199: 445–52.
55. Kurtz E., White W. Recovery Spirituality. Religions 2015; 6: 58–81.
56. Kelly J. F., Greene M. C. Toward an enhanced understanding of the psychological mechanisms by which spirituality aids recovery in Alcoholics Anonymous. Alcohol Treat Q 2014; 32: 299–318.
57. Winzelberg A., Humphreys K. Should patients’ religiosity influence clinicians' referral to 12-step self-help groups? Evidence from a study of 3,018 male substance abuse patients. J Consult Clin Psychol 1999; 67: 790–4.
58. Kelly J. F., Stout R., Zywiak W., Schneider R. A 3-year study of addiction mutual-help group participation following intensive outpatient treatment. Alcohol Clin Exp Res 2006; 30: 1381–92.
59. Mercadante L. A. Belief Without Borders: Inside the Minds of the Spiritual but not Religious. New York, NY: Oxford University Press; 2014.
60. Vaillant G. E. Spiritual Evolution: A Scientific Defense of Faith Harmony. New York, NY: Broadway Books; 2008.