Little is known about how behavior change is mobilized and sustained in AA, and even less is known about how co-occurring psychiatric severity may mediate such changes. This is remarkable given that Twelve-step (TS) therapy is the prevailing alcohol treatment model in the United States and a majority of persons receiving alcohol treatment (TS and non-TS) will attend AA, if only for a limited time. Significant gains have been made in identifying the: (1) characteristics of people most likely to attend AA, and (2) understanding the nature and magnitude of benefits associated with AA exposure. What actually occurs in AA, and how these specific behaviors may predict improved functioning, however, remains poorly understood and rarely investigated. The overall aim of this study is to test a transtheoretical model of behavior change in AA, and to identify the specific AA-related behaviors that mobilize such change. This application proposes a 2-year longitudinal study (N = 300) of AA-exposed individuals, with participants recruited from AA and out-patient treatment. The study has five aims that prospectively test how prescribed AA-related behaviors mobilize AA-specific and non-specific change mechanisms, and how such mechanisms once mobilized predict reductions in drinking and other drug use. A theme in this application is to argue for ecologically sound AA studies, but not at the expense of sacrificing rigorously designed and executed science. To this end, AA-related behaviors, behavior change mechanisms, and substance use are each defined multi-dimensionally, using assessments with strong psychometric properties. New knowledge of the general and mediational processes of behavior change in AA is critical for improvement of TS-based therapy. Study findings will provide TS oriented therapies with evidenced-based feedback that is instrumental for improving intervention strategies.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA014197-04
Application #
7218142
Study Section
Health Services Research Review Subcommittee (AA)
Program Officer
Chiapella, Page
Project Start
2004-04-15
Project End
2009-03-31
Budget Start
2007-04-01
Budget End
2008-03-31
Support Year
4
Fiscal Year
2007
Total Cost
$349,117
Indirect Cost
Name
University of New Mexico
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
868853094
City
Albuquerque
State
NM
Country
United States
Zip Code
87131
Kuerbis, Alexis; Tonigan, J Scott (2018) More than Taking a Chair: The Perceived Group Social Dynamics of Alcoholics Anonymous Related to Changes in Spiritual Practices. Alcohol Treat Q 36:314-329
Wilcox, Claire E; Tonigan, J Scott (2018) Changes in depression mediate the effects of AA attendance on alcohol use outcomes. Am J Drug Alcohol Abuse 44:103-112
Montes, K S; Tonigan, J S (2017) Does Age Moderate the Effect of Spirituality/Religiousness in Accounting for Alcoholics Anonymous Benefit? Alcohol Treat Q 35:96-112
Wilcox, Claire E; Pearson, Matthew R; Tonigan, J Scott (2015) Effects of long-term AA attendance and spirituality on the course of depressive symptoms in individuals with alcohol use disorder. Psychol Addict Behav 29:382-91
Rice, Samara L; Hagler, Kylee J; Tonigan, J Scott (2014) Longitudinal trajectories of readiness to change: alcohol use and help-seeking behavior. J Stud Alcohol Drugs 75:486-95
Tonigan, J Scott; Martinez-Papponi, Brenda; Hagler, Kylee J et al. (2013) Longitudinal study of urban American Indian 12-step attendance, attrition, and outcome. J Stud Alcohol Drugs 74:514-20
Rice, Samara Lloyd; Tonigan, J Scott (2012) Impressions of Alcoholics Anonymous (AA) Group Cohesion: A Case for a Nonspecific Factor Predicting Later AA Attendance. Alcohol Treat Q 30:40-51
Jenkins, Christopher O E; Tonigan, J Scott (2011) Attachment avoidance and anxiety as predictors of 12-step group engagement. J Stud Alcohol Drugs 72:854-63
Tonigan, J Scott; Beatty, Gregory K (2011) Twelve-step program attendance and polysubstance use: interplay of alcohol and illicit drug use. J Stud Alcohol Drugs 72:864-71
Tonigan, J Scott; Rice, Samara L (2010) Is it beneficial to have an alcoholics anonymous sponsor? Psychol Addict Behav 24:397-403