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Randomized Controlled Trial
. 2011 Apr 1;114(2-3):119-26.
doi: 10.1016/j.drugalcdep.2010.09.009. Epub 2010 Oct 28.

The role of Alcoholics Anonymous in mobilizing adaptive social network changes: a prospective lagged mediational analysis

John F Kelly  1 , Robert L Stout, Molly Magill, J Scott Tonigan
Affiliations
Randomized Controlled Trial

The role of Alcoholics Anonymous in mobilizing adaptive social network changes: a prospective lagged mediational analysis

John F Kelly et al. Drug Alcohol Depend. .

Abstract

Objective: Many individuals entering treatment are involved in social networks and activities that heighten relapse risk. Consequently, treatment programs facilitate engagement in social recovery resources, such as Alcoholics Anonymous (AA), to provide a low risk network. While it is assumed that AA works partially through this social mechanism, research has been limited in rigor and scope. This study used lagged mediational methods to examine changes in pro-abstinent and pro-drinking network ties and activities.

Method: Adults (N=1726) participating in a randomized controlled trial of alcohol use disorder treatment were assessed at intake, and 3, 9, and 15 months. Generalized linear modeling (Generalized linear modeling) tested whether changes in pro-abstinent and pro-drinking network ties and drinking and abstinent activities helped to explain AA's effects.

Results: Greater AA attendance facilitated substantial decreases in pro-drinking social ties and significant, but less substantial increases in pro-abstinent ties. Also, AA attendance reduced engagement in drinking-related activities and increased engagement in abstinent activities. Lagged mediational analyses revealed that it was through reductions in pro-drinking network ties and, to a lesser degree, increases in pro-abstinent ties that AA exerted its salutary effect on abstinence, and to a lesser extent, on drinking intensity.

Conclusions: AA appears to facilitate recovery by mobilizing adaptive changes in the social networks of individuals exhibiting a broad range of impairment. Specifically by reducing involvement with pro-drinking ties and increasing involvement with pro-abstinent ties. These changes may aid recovery by decreasing exposure to alcohol-related cues thereby reducing craving, while simultaneously increasing rewarding social relationships.

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Figures

Figure 1
Figure 1
Lagged Mediational Model.
Figure 2
Figure 2
Relationship between frequencies of AA attendance and changes in pro-abstinent and pro-drinking network ties.
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