Matthew J Worley1, Susan R Tate, Sandra A Brown. 1. San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA 92093-0043, USA.
Abstract
AIMS: Among patients with substance dependence and comorbid major depressive disorder (MDD) receiving treatment in a controlled trial, we examined if group differences in depression were mediated by 12-Step involvement, and if the effects of 12-Step involvement on future alcohol and drug use were mediated by reductions in depression. DESIGN: Controlled trial of Twelve-Step facilitation (TSF) and integrated cognitive-behavioral therapy (ICBT), delivered in out-patient groups for 6 months with adjunct pharmacotherapy. SETTING: Out-patient dual diagnosis clinic in Veteran's Affairs Healthcare Center. PARTICIPANTS: Veterans (n = 209) diagnosed with alcohol, stimulant or marijuana dependence and substance-independent MDD. MEASUREMENTS: Twelve-Step attendance and affiliation, depression severity, percentage of days drinking and percentage of days using drugs assessed at baseline and months 3, 6 and 9. FINDINGS: In multi-level analyses greater 12-Step meeting attendance predicted lower depression and mediated the superior depression outcomes of the TSF group, explaining 24.3% of the group difference in depression. Independent of treatment group, lower depression severity predicted lower future alcohol use and mediated the effects of 12-Step meetings, explaining 15.7% of their effects on future drinking. Controlled, lagged models indicated these effects were not confounded by current substance use, suggesting that depression had unique associations with 12-Step meeting attendance and future drinking. CONCLUSIONS: For patients with substance dependence and major depressive disorder, attendance at 12-Step meetings is associated with mental health benefits that extend beyond substance use, and reduced depression could be a key mechanism whereby 12-Step meetings reduce future drinking in this population.
AIMS: Among patients with substance dependence and comorbid major depressive disorder (MDD) receiving treatment in a controlled trial, we examined if group differences in depression were mediated by 12-Step involvement, and if the effects of 12-Step involvement on future alcohol and drug use were mediated by reductions in depression. DESIGN: Controlled trial of Twelve-Step facilitation (TSF) and integrated cognitive-behavioral therapy (ICBT), delivered in out-patient groups for 6 months with adjunct pharmacotherapy. SETTING: Out-patient dual diagnosis clinic in Veteran's Affairs Healthcare Center. PARTICIPANTS: Veterans (n = 209) diagnosed with alcohol, stimulant or marijuana dependence and substance-independent MDD. MEASUREMENTS: Twelve-Step attendance and affiliation, depression severity, percentage of days drinking and percentage of days using drugs assessed at baseline and months 3, 6 and 9. FINDINGS: In multi-level analyses greater 12-Step meeting attendance predicted lower depression and mediated the superior depression outcomes of the TSF group, explaining 24.3% of the group difference in depression. Independent of treatment group, lower depression severity predicted lower future alcohol use and mediated the effects of 12-Step meetings, explaining 15.7% of their effects on future drinking. Controlled, lagged models indicated these effects were not confounded by current substance use, suggesting that depression had unique associations with 12-Step meeting attendance and future drinking. CONCLUSIONS: For patients with substance dependence and major depressive disorder, attendance at 12-Step meetings is associated with mental health benefits that extend beyond substance use, and reduced depression could be a key mechanism whereby 12-Step meetings reduce future drinking in this population.
Authors: Roger D Weiss; Margaret L Griffin; Robert J Gallop; Lisa M Najavits; Arlene Frank; Paul Crits-Christoph; Michael E Thase; Jack Blaine; David R Gastfriend; Dennis Daley; Lester Luborsky Journal: Drug Alcohol Depend Date: 2005-02-14 Impact factor: 4.492
Authors: Kristin L Tomlinson; Susan R Tate; Kristen G Anderson; Denis M McCarthy; Sandra A Brown Journal: Addict Behav Date: 2005-06-21 Impact factor: 3.913
Authors: Suzette Glasner-Edwards; Susan R Tate; John R McQuaid; Kevin Cummins; Eric Granholm; Sandra A Brown Journal: J Stud Alcohol Drugs Date: 2007-09 Impact factor: 2.582
Authors: Brandon G Bergman; M Claire Greene; Bettina B Hoeppner; Valerie Slaymaker; John F Kelly Journal: Alcohol Clin Exp Res Date: 2013-09-13 Impact factor: 3.455