title: The Twelve Promises of Alcoholics Anonymous: psychometric measure validation and mediational testing as a 12-step specific mechanism of behavior change.
abstract: BACKGROUND
  Empirical support for the recovery utility of 12-step mutual-help organizations (MHOs) has led to increased investigation of how such organizations confer benefit. The Twelve Promises of Alcoholics Anonymous (AA) feature prominently in 12-step philosophy and culture and are one of the few documented explications of the cognitive, affective, and behavioral benefits that members might accrue. This study investigated the psychometric properties of a measure of AA's Twelve Promises and examined whether it mediated the effect of 12-step participation on abstinence.
  
  
  METHODS
  Young adults (N=302, M age 20.4 [1.6], range 18-25; 27% female; 95% White) enrolled in an addiction treatment effectiveness study completed assessments at intake and 3-, 6-, and 12-months post treatment including a 26-item, Twelve Promises Scale (TPS). Factor analyses examined the TPS' psychometrics and lagged mediational analyses tested the TPS as a mechanism of behavior change.
  
  
  RESULTS
  Robust principal axis factoring extraction with Varimax rotation revealed a 2-factor solution explaining 45-58% of the variance across three administrations ("Psychological Wellbeing"=26-39%; "Freedom from Craving=17-21%); internal consistency was high (alpha=.83-.93). Both factors were found to increase in relation to greater 12-step participation, but significant mediation was found only for the Freedom from Craving factor explaining 21-34% of the effect of 12-step participation in increasing abstinence.
  
  
  CONCLUSIONS
  The TPS shows potential as a conceptually relevant, and psychometrically sound measure and may be useful in helping elucidate the extent to which the Twelve Promises emerge as an independent benefit of 12-step participation and/or explain SUD remission and recovery.
authors.affiliation: Center for Addiction Medicine, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 60 Staniford Street, Boston, MA 02114, United States. Electronic address: jkelly11@partners.org.
authors.forename: John F
authors.initials: JF
authors.lastname: Kelly
authors.forename: M Claire
authors.initials: MC
authors.lastname: Greene
mesh_terms: D000293:Adolescent; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000523:psychology* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D017008:Negotiating; D010349:Patient Compliance; D011594:Psychometrics; D015203:Reproducibility of Results; D012944:Social Support; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation; D016896:Treatment Outcome; D055815:Young Adult
keywords: 12-Step; Addiction; Alcoholics Anonymous; Recovery; Twelve Promises; Young adults