Alcoholics Anonymous Effectiveness: Faith Meets Science
Alcoholics Anonymous Effectiveness: Faith Meets Science
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DOI：
10.1080/10550880902772464
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发表时间：
2009-01-01
影响因子：
2.3
通讯作者：
Kaskutas, Lee Ann
中科院分区：
文献类型：
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作者：
Kaskutas, Lee Ann
关于匿名酗酒者协会（AA）有效性的研究存在争议，并且存在着广泛不同的解释。这篇文章的目的是提供一个重点审查的文献AA的有效性，将允许读者判断AA的证据有效性为自己。根据建立因果关系所需的6个标准，综述了AA有效性的研究：（1）效应幅度;（2）剂量反应效应;（3）一致性效应;（4）时间准确性效应;（5）特异性效应;（6）可解释性。标准1- 4和6的证据是强有力的：参加AA的人的禁欲率大约是参加AA的人的两倍（标准1，程度）;较高的出勤率与较高的禁欲率有关（标准2，剂量-反应）;这些关系在不同样本和随访期发现（标准3，一致性）;之前的AA出席是预测随后的禁欲（标准4，时间）;和行为改变理论预测的作用机制存在于AA（标准6，可接受性）。然而，建立AA或十二步易化/TSF效应特异性的严格实验证据（标准5）是混合的，2项试验发现AA的积极效应，1项试验发现AA的负面效应，1项试验发现无效效应。使用统计方法解决特异性的研究有两个相互矛盾的结果，其中两个报告了调整潜在混杂因素（如改变动机）后对AA的显著影响。
Research on the effectiveness of Alcoholics Anonymous (AA) is controversial and subject to widely divergent interpretations. The goal of this article is to provide a focused review of the literature on AA effectiveness that will allow readers to judge the evidence effectiveness of AA for themselves. The review organizes the research on AA effectiveness according to six criterion required for establishing causation: (1) magnitude of effect; (2) dose response effect; (3) consistent effect; (4) temporally accurate effects; (5) specific effects; (6) plausibility. The evidence for criteria 1- 4 and 6 is strong: rates of abstinence are about twice as high among those who attend AA (criteria 1, magnitude); higher levels of attendance are related to higher rates of abstinence (criteria 2, dose-response); these relationships are found for different samples and follow-up periods (criteria 3, consistency); prior AA attendance is predictive of subsequent abstinence (criteria 4, temporal); and mechanisms of action predicted by theories of behavior change are present in AA (criteria 6, plausibility). However, rigorous experimental evidence establishing the specificity of an effect for AA or Twelve Step Facilitation/TSF (criteria 5) is mixed, with 2 trials finding a positive effect for AA, 1 trial finding a negative effect for AA, and 1 trial finding a null effect. Studies addressing specificity using statistical approaches have had two contradictory findings, and two that reported significant effects for AA after adjusting for potential confounders such as motivation to change.