Tonigan J S, Toscova R, Miller W R
Center on Alcoholism, Substance Abuse and Addictions (CASAA), University of New Mexico, Albuquerque, 87106, USA.
J Stud Alcohol. 1996 Jan;57(1):65-72. doi: 10.15288/jsa.1996.57.65.
Reviews of research on Alcoholics Anonymous (AA) have speculated how findings may differ when grouped by client and study characteristics. A meta-analytic review by Emrick et al. in 1993 provided empirical support for this concern but did not explore its implications. This review divided results of AA affiliation and outcome research by sample origin and global rating of study quality. The review also examined the statistical power of studies on AA.
Meta-analytic procedures were used to summarize the findings of 74 studies that examined AA affiliation and outcome. Results were divided by whether samples were drawn from outpatient or inpatient settings and a global rating of study quality that jointly considered use of subject selection and assignment, reliability of measurement and corroboration of self-report. Efficacy of dividing study results was examined by changes in magnitude of correlations and unexplained variance.
AA participation and drinking outcomes were more strongly related in outpatient samples, and better designed studies were more likely to report positive psychosocial outcomes related to AA attendance. In general, AA studies lacked sufficient statistical power to detect relationships of interest.
AA experiences and outcomes are heterogeneous, and it makes little sense to seek omnibus profiles of AA affiliates or outcomes. Well-designed studies with large outpatient samples may afford the best opportunity to detect predictors and effects of AA involvement.
对戒酒互助会(AA)相关研究的综述推测,根据客户和研究特征进行分组时,研究结果可能会有所不同。埃姆里克等人在1993年进行的一项元分析综述为这一担忧提供了实证支持,但并未探讨其影响。本综述按样本来源和研究质量的总体评分对AA入会情况及结果研究的结果进行了划分。该综述还考察了关于AA研究的统计效力。
采用元分析程序总结了74项考察AA入会情况及结果的研究结果。结果按样本是来自门诊还是住院环境,以及综合考虑受试者选择与分配的使用、测量的可靠性和自我报告的确证情况的研究质量总体评分进行划分。通过相关性大小的变化和无法解释的方差来检验划分研究结果的有效性。
在门诊样本中,参与AA与饮酒结果的相关性更强,设计更好的研究更有可能报告与参加AA相关的积极心理社会结果。总体而言,AA研究缺乏足够的统计效力来检测感兴趣的关系。
AA的经历和结果是异质性的,寻求AA成员或结果的综合概况没有多大意义。对大量门诊样本进行精心设计的研究可能提供检测AA参与的预测因素和效果的最佳机会。