Alcoholics Anonymous attendance, decreases in impulsivity and drinking and psychosocial outcomes over 16 years: moderated-mediation from a developmental perspective.

AIMS: To examine whether decreases in impulsivity account for links between Alcoholics Anonymous (AA) attendance and better drinking and psychosocial outcomes, and whether these mediational 'effects' are conditional on age.
DESIGN: A naturalistic study in which individuals were assessed at baseline, and 1, 8 and 16 years later.
SETTING: Participants initiated help-seeking through the alcohol intervention system (detoxification programs, information and referral centers). PARTICIPANTS: Individuals with alcohol use disorders and no prior history of substance abuse treatment at baseline [n=628; 47% women; mean age=34.7 years (standard deviation=9.4)]. MEASUREMENTS: Self-reports of impulsivity and drinking pattern at baseline and year 1, duration of AA (number of weeks) in year 1 and drinking (alcohol use problems, self-efficacy to resist drinking) and psychosocial outcomes (emotional discharge coping, social support) at baseline and follow-ups.
FINDINGS: Controlling for changes in drinking pattern, decreases in impulsivity were associated with fewer alcohol use problems, better coping and greater social support and self-efficacy at year 1, and better coping and greater social support at year 8. Decreases in impulsivity statistically mediated associations between longer AA duration and improvements on all year 1 outcomes and indirect effects were moderated by participant age (significant only for individuals 25 years of age or younger).
CONCLUSIONS: Decreased impulsivity appears to mediate reductions in alcohol-related problems over 8 years in people attending Alcoholics Anonymous. Published 2011 This article is a U.S. Government work and is in the public domain in the USA.