Labbe Allison K, Greene Claire, Bergman Brandon G, Hoeppner Bettina, Kelly John F
MGH Center for Addiction Medicine, 60 Staniford Street, Boston, MA 02114, United States.
Drug Alcohol Depend. 2013 Dec 1;133(2):541-7. doi: 10.1016/j.drugalcdep.2013.07.021. Epub 2013 Aug 12.
Participation in 12-step mutual help organizations (MHO) is a common continuing care recommendation for adults; however, little is known about the effects of MHO participation among young adults (i.e., ages 18-25 years) for whom the typically older age composition at meetings may serve as a barrier to engagement and benefits. This study examined whether the age composition of 12-step meetings moderated the recovery benefits derived from attending MHOs.
Young adults (n=302; 18-24 years; 26% female; 94% White) enrolled in a naturalistic study of residential treatment effectiveness were assessed at intake, and 3, 6, and 12 months later on 12-step attendance, age composition of attended 12-step groups, and treatment outcome (Percent Days Abstinent [PDA]). Hierarchical linear models (HLM) tested the moderating effect of age composition on PDA concurrently and in lagged models controlling for confounds.
A significant three-way interaction between attendance, age composition, and time was detected in the concurrent (p=0.002), but not lagged, model (b=0.38, p=0.46). Specifically, a similar age composition was helpful early post-treatment among low 12-step attendees, but became detrimental over time.
Treatment and other referral agencies might enhance the likelihood of successful remission and recovery among young adults by locating and initially linking such individuals to age appropriate groups. Once engaged, however, it may be prudent to encourage gradual integration into the broader mixed-age range of 12-step meetings, wherein it is possible that older members may provide the depth and length of sober experience needed to carry young adults forward into long-term recovery.
参与12步互助组织（MHO）是针对成年人的常见持续护理建议；然而，对于年轻人（即18至25岁）参与MHO的效果知之甚少，因为会议中通常年龄较大的成员构成可能会成为他们参与并从中受益的障碍。本研究考察了12步会议的年龄构成是否会调节参与MHO所带来的康复益处。
纳入一项关于住院治疗效果的自然主义研究的年轻人（n = 302；18 - 24岁；26%为女性；94%为白人）在入组时接受评估，并在3个月、6个月和12个月后评估12步会议的参与情况、所参加12步小组的年龄构成以及治疗结果（戒酒天数百分比[PDA]）。分层线性模型（HLM）在同时性模型以及控制混杂因素的滞后模型中检验年龄构成对PDA的调节作用。
在同时性模型（p = 0.002）而非滞后模型中检测到参与情况、年龄构成和时间之间存在显著的三向交互作用（b = 0.38，p = 0.46）。具体而言，相似的年龄构成在治疗后早期对12步会议低参与度的年轻人有帮助，但随着时间推移变得有害。
治疗机构和其他转诊机构可能通过找到并最初将这些年轻人与年龄合适的小组联系起来，提高他们成功缓解和康复的可能性。然而，一旦他们参与进来，谨慎的做法可能是鼓励他们逐渐融入更广泛的混合年龄的12步会议中，在这种会议中，年长成员可能会提供推动年轻人实现长期康复所需的清醒经历的深度和时长。
