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Original

What is Alcoholics Anonymous Affiliation?

, Ph.D., , M.S. & , M.D.
Pages 1117-1136 | Published online: 07 Dec 2004
 

Abstract

An increasing body of research evidence supports the use of 12-step program affiliation as an effective adjunct and aftercare for formal treatment. Recently, three brief (9- or 10-item) measures of affiliation have been developed. However, the brief scales are difficult to interpret, and the question of exactly what is affiliation (or disaffiliation) remains unclear. This analysis examines the question of what is the essence of affiliation vs. disaffiliation. Data from the Project MATCH 1-year posttreatment Alcoholics Anonymous Involvement (AAI) scale (N = 1506) are used to identify the most salient items of Alcoholics Anonymous (AA) affiliation predicting 1-year posttreatment drinking outcomes. Analysis using stepwise regression suggests that a three-item solution can explain a similar amount of variance in the proportion of days abstinent in months 9 through 12 posttreatment, as does using the nine items. These three “core items predicting recovery” include AA attendance, sum of steps completed, and identifying self as an AA member. As an affiliation composite scale, these three items are easier to interpret and administer than the full AAI scale, and when combined, possess adequate reliability (α = 0.72).

Resumen

La creciente evidencia que aporta la investigación apoya el uso de la afiliación a un programa de doce pasos como un componente efectivo durante el tratamiento formal y posteriormente a éste. Recientemente se han puesto en práctica tres medidas breves de afiliación (de nueve o diez puntos). Sin embargo, las escalas breves son difíciles de interpretar, y por tanto la respuesta a qué se entiende exactamente por afiliación (o falta de afiliación) no está clara todavía. El presente análisis examina el asunto de cuál es la esencia de la afiliación versus la ausencia de la misma. Se usa la información que provee la escala del Involucramiento de Alcohólicos Anónimos (AAI) obtenida un año después del tratamiento, a través del Proyecto MATCH, (N = 1506), para identificar los puntos sobresalientes de la afiliación a Alcohólicos Anónimos, los cuales predicen los resultados del tratamiento –en cuanto a la condición alcohólica–, un año después del mismo. Los análisis que utilizan una regresión de pasos sugieren que tres puntos pueden explicar la mayoría de la variedad en cuanto a la proporción media de días de abstinencia desde el noveno hasta el duodécimo mes posteriores at tratamiento. Estos tres puntos claves en la predicción de la recuperación son la asistencia a reuniones de Alcohólicos Anónimos, la suma de todos los pasos que se han llevado a cabo, y la autoidentificación como miembro de Alcohólicos Anónimos. Considerados como una escala de afiliación compuesta, estos tres puntos son m0s fáciles de interpretar y administrar que la escala completa de AAI, y cuando son combinados, poseen una adecuada exactitud (Alpha = 0.72).

Résumé

Un nombre croissant d’études indiquent que l’affiliation à un programme en douze paliers s’avère être un complément efficace à un traitement médical en bonne et due forme. Récemment, trois échelles de mesure (9 ou 10 questions) permettant de mesurer le degré d’affiliation ont été établies. Toutefois, les résultats que ces échelles permettent d’obtenir sont difficiles à interpréter, et la définition du concept d’affiliation (ou de désaffiliation) reste problématique. La présente étude cherche à établir ce qui constitue l’essence du concept d’affiliation en opposition au concept de désaffiliation. Les données de l’échelle de mesure de l’Alcoholics Anonymous Involvement (AAI) (N = 1506), recueillies dans le cadre du projet MATCH, un programme de traitement complémentaire d’un an, ont été utilisées afin d’identifier les facteurs principaux permettant de déterminer les résultats du traitement en termes de succès ou d’échec. Une analyse utilisant une *stepwide regression* montre que trois facteurs expliquent en grande partie l’écart du nombre moyen de jours d’abstinence entre patients au cours de la période allant du neuvième au douzième mois de traitement complémentaire. Ces trois ≪ facteurs-clé permettant de prédire la guérison ≫ sont la présence aux réunions des Alcoholics Anonymous, le nombre de paliers atteints et la reconnaissance de la part du patient de sa qualité de membre des Alcoholics Anonymous. En tant que mesure d’affiliation, ces trois facteurs sont plus faciles à déterminer et à interpréter que l’ensemble de l’échelle de mesure de l’AAI. En outre, lorsqu’on les combine, ils produisent un taux de fiabilité adéquat (Alpha = 0.72).

Notes

aSee the methods section for a description of the scale items.

Additional information

Notes on contributors

Richard N. Cloud

Richard N. Cloud, Ph.D., is an assistant professor in the Kent School of Social Work at the University Louisville. He was previously a substance abuse counselor before earning his Ph.D. from the University of Tennessee at Knoxville. His current research interests include use of the recovery community and mutual-aid groups in the prevention and treatment of addictions.

Craig H. Ziegler

Craig H. Ziegler, M.S., is an Academic Consultant Senior in the School of Public Health and Informatics at the University of Louisville. He has a M.S. degree in Sociology from the University of Louisville with an emphasis on research methodology and statistics. For the past ten years Craig has provided statistical consulting, data analysis, and database management to faculty, residents and graduate students at the University of Louisville. Due to the nature of his job, he has been able to acquire co-authorships of articles in various academic disciplines and has recently worked in disciplines such as Social Work, Nursing, Emergency Medicine, and Audiology.

Richard D. Blondell

Richard D. Blondell, M.D., is an Associate Professor in the Depart-ment of Family Medicine at the University of Buffalo. He received his medical degree at the University of Rochester School of Medicine and Dentistry and completed a residency in family practice at the University of Louisville. He has successfully completed the certification requirements of the American Society of Addiction Medicine. His current interests include the detoxification of alcoholics who are hospitalized for an acute medical or surgical problem. He also is studying the use of people in recovery as a way to motivate these hospitalized patients to initiate treatment for substance use disorders.

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