12-Step Participation Is Linked to Lower Drinking and Specific Impulsive Personality Traits in Early Alcohol Use Disorder Recovery.

Abstract

Objective: Participation in 12-step groups, such as Alcoholics Anonymous, confers benefits among individuals with alcohol use disorder (AUD), and one candidate mechanism underlying these effects is reductions in impulsivity. Using a multidimensional assessment of impulsivity, the current study examined delay discounting and impulsive personality traits in a longitudinal cohort of adults with AUD initiating a significant recovery attempt.

Method: A prospective matched-sample cohort study design compared participants who reported a clinically meaningful increase in 12-step group attendance (i.e., increase of >1 meetings/week; n = 77) from enrollment to 6 weeks to a matched control group who did not increase attendance (n = 77). Drinking was assessed using the Timeline Followback (% drinking days [%DD], % heavy drinking days [%HDD]); impulsivity was assessed using the five-trial delay discounting task and five UPPS-P Impulsive Behavior Scale subscales. Mediation models evaluated whether impulsivity explained the relationship between increased 12-step attendance and alcohol outcomes.

Results: Compared with matched controls, participants who increased 12-step group attendance showed greater reductions over time in %DD and %HDD (ps < .001), as well as Negative Urgency (i.e., acting out due to negative emotions) and Lack of Perseverance (i.e., failure to persist in tasks) (ps = .03) after their recovery attempt. Reductions in impulsivity, however, did not mediate the association between increased 12-step group attendance and drinking.

Conclusions: Increased 12-step group attendance was associated with significant reductions in drinking and certain impulsivity traits in early AUD recovery. However, although the changes were contemporaneous, impulsivity did not explain the benefits associated with 12-step group attendance. Future research should evaluate this hypothesis in larger samples and over longer follow-up periods.