Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Drug Alcohol Depend. 2011 Apr 1;114(2-3):119-26. doi: 10.1016/j.drugalcdep.2010.09.009. Epub 2010 Oct 28.
Many individuals entering treatment are involved in social networks and activities that heighten relapse risk. Consequently, treatment programs facilitate engagement in social recovery resources, such as Alcoholics Anonymous (AA), to provide a low risk network. While it is assumed that AA works partially through this social mechanism, research has been limited in rigor and scope. This study used lagged mediational methods to examine changes in pro-abstinent and pro-drinking network ties and activities.
Adults (N=1726) participating in a randomized controlled trial of alcohol use disorder treatment were assessed at intake, and 3, 9, and 15 months. Generalized linear modeling (Generalized linear modeling) tested whether changes in pro-abstinent and pro-drinking network ties and drinking and abstinent activities helped to explain AA's effects.
Greater AA attendance facilitated substantial decreases in pro-drinking social ties and significant, but less substantial increases in pro-abstinent ties. Also, AA attendance reduced engagement in drinking-related activities and increased engagement in abstinent activities. Lagged mediational analyses revealed that it was through reductions in pro-drinking network ties and, to a lesser degree, increases in pro-abstinent ties that AA exerted its salutary effect on abstinence, and to a lesser extent, on drinking intensity.
AA appears to facilitate recovery by mobilizing adaptive changes in the social networks of individuals exhibiting a broad range of impairment. Specifically by reducing involvement with pro-drinking ties and increasing involvement with pro-abstinent ties. These changes may aid recovery by decreasing exposure to alcohol-related cues thereby reducing craving, while simultaneously increasing rewarding social relationships.
许多接受治疗的人都参与到会增加复发风险的社交网络和活动中。因此，治疗项目会促进他们利用社交康复资源，如戒酒匿名会（AA），以提供一个低风险的网络。虽然人们认为 AA 部分通过这种社交机制起作用，但研究的严谨性和范围有限。本研究使用滞后中介方法来检验戒酒和饮酒网络联系和活动的变化。
参加酒精使用障碍治疗随机对照试验的成年人（N=1726）在入组时、3 个月、9 个月和 15 个月进行评估。广义线性模型（Generalized linear modeling）测试了戒酒和饮酒网络联系以及饮酒和戒酒活动的变化是否有助于解释 AA 的效果。
更多的 AA 出席有助于大幅减少饮酒社交联系，并显著但程度较小地增加戒酒联系。此外，AA 出席减少了与饮酒相关的活动参与，增加了戒酒活动的参与。滞后中介分析显示，正是通过减少饮酒网络联系，以及在较小程度上增加戒酒联系，AA 对戒酒产生了有益的影响，对饮酒强度的影响较小。
AA 似乎通过动员个体社交网络中的适应性变化来促进康复，这些个体表现出广泛的损伤。具体来说，通过减少与饮酒相关的联系的参与，并增加与戒酒相关的联系的参与。这些变化可能通过减少与酒精相关的线索的暴露来帮助康复，从而减少渴望，同时增加有益的社交关系。
