Spirituality in Recovery: A Lagged Mediational Analysis of Alcoholics Anonymous' Principal Theoretical Mechanism of Behavior Change
Spirituality in Recovery: A Lagged Mediational Analysis of Alcoholics Anonymous' Principal Theoretical Mechanism of Behavior Change
复制标题
DOI：
10.1111/j.1530-0277.2010.01362.x
复制
发表时间：
2011-03-01
影响因子：
3.2
通讯作者：
Pagano, Maria E.
中科院分区：
文献类型：
--
作者：
Kelly, John F.;Stout, Robert L.;Pagano, Maria E.
背景：有证据表明，匿名酗酒者协会（AA）在酒精使用障碍的康复方面可以发挥宝贵的作用。虽然AA本身声称它通过“精神”实践和信仰来帮助康复，但这种说法仍然存在争议，很少受到正式调查。本研究采用滞后、中介分析法，以大量的酒精使用障碍成年患者为临床样本，研究了AA、灵性/宗教和酒精使用之间的关系，并测试了AA和更好的酒精结果之间的关系是否可以用精神变化来解释。方法：成年人（N = 1，726）参与一项关于酒精使用障碍的社会心理治疗的随机对照试验（项目匹配）进行了评估，在治疗摄入量，3，6，9，12和15个月的AA出席，精神/宗教习俗，和酒精使用的结果，使用验证的措施。一般线性模型（GLM）和控制滞后中介分析被用来测试mediational effects.Results：控制各种混杂变量，参加AA与增加精神的做法，特别是对于那些最初低，这一措施在治疗摄入量。结果显示，AA也始终与更好的后续酒精结果相关，这部分是由灵性的增加介导的。这种中介作用表现在门诊和善后样本和酒精的结果（比例禁欲天，饮料每饮酒日）。结论：研究结果表明，AA导致更好的酒精使用的结果，在一定程度上，通过提高个人的精神做法，并提供支持AA的自己的重点增加精神的做法，以促进酒精使用障碍的恢复。
Background: Evidence indicates Alcoholics Anonymous (AA) can play a valuable role in recovery from alcohol use disorder. While AA itself purports it aids recovery through "spiritual" practices and beliefs, this claim remains contentious and has been only rarely formally investigated. Using a lagged, mediational analysis, with a large, clinical sample of adults with alcohol use disorder, this study examined the relationships among AA, spirituality/religiousness, and alcohol use, and tested whether the observed relation between AA and better alcohol outcomes can be explained by spiritual changes.Method: Adults (N = 1,726) participating in a randomized controlled trial of psychosocial treatments for alcohol use disorder (Project MATCH) were assessed at treatment intake, and 3, 6, 9, 12, and 15 months on their AA attendance, spiritual/religious practices, and alcohol use outcomes using validated measures. General linear modeling (GLM) and controlled lagged mediational analyses were utilized to test for mediational effects.Results: Controlling for a variety of confounding variables, attending AA was associated with increases in spiritual practices, especially for those initially low on this measure at treatment intake. Results revealed AA was also consistently associated with better subsequent alcohol outcomes, which was partially mediated by increases in spirituality. This mediational effect was demonstrated across both outpatient and aftercare samples and both alcohol outcomes (proportion of abstinent days; drinks per drinking day).Conclusions: Findings suggest that AA leads to better alcohol use outcomes, in part, by enhancing individuals' spiritual practices and provides support for AA's own emphasis on increasing spiritual practices to facilitate recovery from alcohol use disorder.