title: Emerging adults' treatment outcomes in relation to 12-step mutual-help attendance and active involvement.
abstract: BACKGROUND
  Participation in Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) during and following treatment has been found to confer recovery-related benefit among adults and adolescents, but little is known about emerging adults (18-24 years). This transitional life-stage is distinctive for greater distress, higher density of psychopathology, and poorer treatment and continuing care compliance. Greater knowledge would inform the utility of treatment referrals to 12-step organizations for this age-group.
  
  
  METHODS
  Emerging adults (N=303; 18-24 years; 26% female; 95% White; 51% comorbid [SCID-derived] axis I disorders) enrolled in a naturalistic study of residential treatment effectiveness assessed at intake, 3, 6, and 12 months on 12-step attendance and involvement and treatment outcomes (percent days abstinent [PDA]; percent days heavy drinking [PDHD]). Lagged hierarchical linear models (HLMs) tested whether attendance and involvement conferred recovery benefits, controlling for a variety of confounds.
  
  
  RESULTS
  The percentage attending 12-step meetings prior to treatment (36%) rose sharply at 3 months (89%), was maintained at 6 months (82%), but declined at 12 months (76%). Average attendance peaked at about 3 times per week at 3 months dropping to just over once per week at 12 months. Initially high, but similarly diminishing, levels of active 12-step involvement were also observed. Lagged HLMs found beneficial effects for attendance, but stronger effects, which increased over time, for active involvement. Several active 12-step involvement indices were associated individually with outcome benefits.
  
  
  CONCLUSIONS
  Ubiquitous 12-step organizations may provide a supportive recovery context for this high-risk population at a developmental stage where non-using/sober peers are at a premium.
authors.affiliation: Center for Addiction Medicine, Departments of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States. jkelly11@partners.org
authors.forename: John F
authors.initials: JF
authors.lastname: Kelly
authors.forename: Robert L
authors.initials: RL
authors.lastname: Stout
authors.forename: Valerie
authors.initials: V
authors.lastname: Slaymaker
mesh_terms: D000293:Adolescent; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D009042:Motivation; D009483:Neuropsychological Tests; D010349:Patient Compliance; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012114:Residential Treatment; D012657:Self-Help Groups / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D013695:Temperance; D016896:Treatment Outcome; D055815:Young Adult