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Alcoholics who stayed in Alcoholics Anonymous (AA) and worked through all 12 steps had lower levels of interpersonal insecurity than those who were just beginning the program, according to findings published recently in the American Journal on Addictions. Researchers Jared G. Suire and Robert K. Bothwell of the University of Louisiana at Lafayette reached this conclusion after evaluating the attitudes of alcoholics toward themselves and others after they had worked all 12 steps of an AA program relative to individuals who had not completed all of them. Specifically, the researchers implemented a quasi-experimental design in which measures of self-esteem, interpersonal trust, and related constructs were administered to a group of alcoholics who had been in a community-based AA program long enough to work all 12 steps, and another group of alcoholics who were just beginning to work the steps in a similar AA program. They predicted that significant differences would be found between these 2 groups in self-esteem and interpersonal security. Participants were alcoholics solicited outside of AA meeting rooms. Potential participants were asked if they would be willing to complete a series of personality questionnaires for a study on AA. Those who agreed to participate were later interviewed at a convenient location, such as a restaurant or coffee shop. Participants provided information on gender, race, and age, and answered questions about their AA experience, such as how long they had been in AA and how many steps they had worked. They were not exposed to questions regarding their past drinking. Measures were taken of global self-esteem, social self-esteem, social confidence, network trust, fear of negative evaluation, need for approval, preoccupation with relationships, discomfort with closeness, relationships as secondary, and optimism. Analyses were conducted on 50 "completers" who had completed all 12 steps, 7 "continuers" working on steps between Step 4 and Step 9, 24 "newcomers," and 18 "relapsers" who were starting over because they had slipped. Principal components analysis on the measures revealed two factors: "interpersonal insecurity" which reflected low interpersonal trust and high ambivalence and anxiety about close relationships; and "social potency" which reflected high social self-esteem and confidence and low fear of negative evaluation. Results indicated that there was a significant difference in interpersonal insecurity between alcoholics who had completed all 12 steps in a community-based AA program and those who had started to work the steps but had not yet completed all of them, with completers showing lower interpersonal insecurity. There were no differences in this finding on gender, age, and ethnicity. No significant differences were found in social potency between alcoholics who completed the steps and those who had not completed the steps. Study limits The design of this study does not allow for causal inference about the difference found between groups in interpersonal insecurity. It is possible that alcoholics who stayed in the program and worked through all the steps had higher levels of interpersonal security to begin with. Authors' conclusions It is possible that participation in AA brings about fundamental change in members who are able to stay in the program and work the steps. The authors note that it is likely that such change will occur in this context so gradually that it will be less obvious to the alcoholic in his or her daily reflections than to others who may see him or her at the weekly AA meeting. They posit that future research will show that as the alcoholic works the steps with the supportive backing of a community-based AA homegroup and sponsor, there will be great potential for change in the alcoholic's ability to relate to others in ways that can meaningfully enhance the quality of his or her life. Future investigations should also attempt to clarify the specific nature of changes that occur in personality as alcoholics work through the 12 steps within community-based AA programs. No funding information provided. Suire JG, Bothwell RK: The psychosocial benefits of alcoholics anonymous. Am J Addictions 2006; 15:252-255. E-mail: bothwell@louisiana.edu. Suggested readings: Moos RH, Moos BS: Long-term influence of duration and frequency of participation in Alcoholics Anonymous on individuals with alcohol use disorders. J Consult Clin Psychology 2004; 72:81-90. Study sample N=100 56 males, 44 females 76 were white, 18 were black; 6 other ethnicities
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