Changes in alcohol-related social network composition mediate the effects of AA meeting attendance on drinking following a recovery attempt in adults with alcohol use disorder.
Emily E Levitt, Liah Rahman, Desmond Singh, Kyla Belisario, Amanda Doggett, Allan Clifton, Robert Stout, John F Kelly, James MacKillop
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Abstract
Aims: To assess whether changes in social network drinking is a mechanism of behaviour change responsible for the benefits of attending Alcoholics Anonymous (AA) during a recovery attempt.
Design: An observational longitudinal cohort study investigating mechanisms of behaviour change among adults with alcohol use disorder (AUD) reporting initiation of a substantial recovery attempt.
Setting: Boston, Massachusetts, United States, and Hamilton, Ontario, Canada.
Participants: From a larger observational cohort, participants were individuals who reported a substantive increase in AA attendance (increase of ≥1 + meetings/week) from baseline to 6 weeks (n = 71) and a propensity score-matched control group of participants who did not increase AA attendance (n = 71). Propensity score matching used demographics and baseline drinking.
Measurements: Baseline assessment and a 6-week follow-up assessment, including outcome variables: diagnostic assessment of AUD, timeline followback interview [percent drinking days (%DD) and percent heavy drinking days (%HDD)]; and exposure variables: formal egocentric social network assessment collecting egocentric social network metrics and using up to 20 network alters.
Findings: Compared with the control group, participants who increased AA participation statistically significantly reduced %DD [mean (M) = 5.67% (standard error of the mean, SEM = 1.81) vs 30.91% (3.59); F = 46.22, P < 0.001] and %HDD [5.21% (1.79) vs 23.32% (3.14); F = 28.34, P < 0.001] and exhibited statistically significantly improved social network indicators including reduced network drinking frequency [1.99 (0.08) vs 2.96 (0.09); F = 42.26, P < 0.001] and severity [1.68 (0.06) vs 2.34 (0.08); F = 40.51, P < 0.001]. Changes in social network drinking statistically significantly mediated the relationship between changes in AA attendance and reductions in %DD [b = -0.06 (0.02), P = 0.01] and %HDD [b = -0.05 (0.02), P = 0.04] at follow-up.
Conclusions: Reduced social network drinking appears to be one mechanism of behaviour change associated with the positive effects of Alcoholics Anonymous on drinking behavior during recovery.
期刊介绍：
Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines.
Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries.
Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.
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