title: Spirituality/religiosity promotes acceptance-based responding and 12-step involvement.
abstract: BACKGROUND
  Previous investigations have observed that spirituality/religiosity (S/R) is associated with enhanced 12-step involvement. However, relatively few studies have attempted to examine the mechanisms for this effect. For the present investigation, we examined whether acceptance-based responding (ABR) - awareness or acknowledgement of internal experiences that allows one to consider and perform potentially adaptive responses - accounted for the effect of S/R on 12-step self-help group involvement 2 years after a treatment episode.
  
  
  METHODS
  Data were collected as part of a multi-site treatment outcome study with 3698 substance-dependent male veterans recruited at baseline. Assessments were conducted at baseline, discharge, 1-year follow-up, and 2-year follow-up. We utilized structural equation modeling to examine the relationships among latent variables of S/R, ABR, and 12-step involvement over time.
  
  
  RESULTS
  In the final model, S/R was not directly related to 12-step involvement at 2-year follow-up. However, S/R predicted enhanced ABR at 1-year follow-up after accounting for discharge levels of ABR. In turn, ABR at 1-year follow-up predicted increased 12-step involvement at 2-year follow-up after accounting for discharge levels of 12-step involvement.
  
  
  CONCLUSIONS
  S/R promotes the use of post-treatment self-regulation skills that, in turn, directly contribute to ongoing 12-step self-help group involvement.
authors.affiliation: University of California, San Francisco Department of Psychiatry, San Francisco, CA 94143, USA.
authors.forename: Adam W
authors.initials: AW
authors.lastname: Carrico
authors.forename: Elizabeth V
authors.initials: EV
authors.lastname: Gifford
authors.forename: Rudolf H
authors.initials: RH
authors.lastname: Moos
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000359:Aftercare; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D001364:Awareness; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012069:Religion and Psychology; D012657:Self-Help Groups; D029181:Spirituality; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D014728:Veterans / Q000523:psychology*