Alcoholics Anonymous attendance, decreases in impulsivity and drinking and psychosocial outcomes over 16 years: Moderated‐mediation from a developmental …

DM Blonigen, C Timko, JW Finney, BS Moos… - …, 2011 - Wiley Online Library
Addiction, 2011Wiley Online Library
Aims To examine whether decreases in impulsivity account for links between Alcoholics
Anonymous (AA) attendance and better drinking and psychosocial outcomes, and whether
these mediational 'effects' are conditional on age. Design A naturalistic study in which
individuals were assessed at baseline, and 1, 8 and 16 years later. Setting Participants
initiated help‐seeking through the alcohol intervention system (detoxification programs,
information and referral centers). Participants Individuals with alcohol use disorders and no …
Abstract
Aims  To examine whether decreases in impulsivity account for links between Alcoholics Anonymous (AA) attendance and better drinking and psychosocial outcomes, and whether these mediational ‘effects’ are conditional on age.
Design  A naturalistic study in which individuals were assessed at baseline, and 1, 8 and 16 years later.
Setting  Participants initiated help‐seeking through the alcohol intervention system (detoxification programs, information and referral centers).
Participants  Individuals with alcohol use disorders and no prior history of substance abuse treatment at baseline [n = 628; 47% women; mean age = 34.7 years (standard deviation = 9.4)].
Measurements   Self‐reports of impulsivity and drinking pattern at baseline and year 1, duration of AA (number of weeks) in year 1 and drinking (alcohol use problems, self‐efficacy to resist drinking) and psychosocial outcomes (emotional discharge coping, social support) at baseline and follow‐ups.
Findings  Controlling for changes in drinking pattern, decreases in impulsivity were associated with fewer alcohol use problems, better coping and greater social support and self‐efficacy at year 1, and better coping and greater social support at year 8. Decreases in impulsivity statistically mediated associations between longer AA duration and improvements on all year 1 outcomes and indirect effects were moderated by participant age (significant only for individuals 25 years of age or younger).
Conclusions  Decreased impulsivity appears to mediate reductions in alcohol‐related problems over 8 years in people attending Alcoholics Anonymous.
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