title: Do young people benefit from AA as much, and in the same ways, as adult aged 30+? A moderated multiple mediation analysis.
abstract: BACKGROUND
  Research has shown that participation in Alcoholics Anonymous (AA) confers significant recovery benefit to adults suffering from alcohol use disorder (AUD). Concerns persist, however, that AA may not work as well for younger adults, who tend to have shorter addiction histories, different social circumstances, and less spiritual/religious interest than adults.
  
  
  METHODS
  Secondary data analysis of Project MATCH, using a prospective, moderated multiple mediation analysis to test and compare six previously identified mechanisms of change in younger adults (n=266) vs. adults aged 30+ (n=1460). Nine clinical sites within the United States. Treatment-seeking adults (n=1726) suffering from AUD who participated in 12 weeks of outpatient treatment and completed follow-ups at 3-, 9- and 15-months. AA attendance during treatment; mediators at 9 months; and outcomes [percentage of days abstinent (PDA) and drinks per drinking day (DDD)] at 15 months.
  
  
  RESULTS
  AA attendance was associated with improved drinking outcomes in both younger adults (PDA: F(1, 247)=8.55, p<0.01; DDD: F(1, 247)=15.93, p<0.01) and adults aged 30+ (PDA: F(1, 1311)=86.58, p<0.01; DDD: F(1, 1311)=11.96, p<0.01). Only two of the six hypothesized pathways (i.e., decreases in pro-drinking social networks, self-efficacy in social situations) appeared to work in younger adults.
  
  
  CONCLUSIONS
  Unidentified mechanisms of behavior change that are mobilized by AA participation appear to be at work in young people. Once identified, these mechanisms may shed new light on how exactly AA confers similar benefits for young people and, more broadly, may enhance our understanding of recovery-related change for young adults that could yield novel intervention targets.
authors.affiliation: Center for Addiction Medicine, Massachusetts General Hospital, Harvard Medical School, 60 Staniford Street, Boston, MA 02114, United States. Electronic address: bhoeppner@mgh.harvard.edu.
authors.forename: Bettina B
authors.initials: BB
authors.lastname: Hoeppner
authors.affiliation: Center for Addiction Medicine, Massachusetts General Hospital, Harvard Medical School, 60 Staniford Street, Boston, MA 02114, United States.
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Hoeppner
authors.affiliation: Center for Addiction Medicine, Massachusetts General Hospital, Harvard Medical School, 60 Staniford Street, Boston, MA 02114, United States.
authors.forename: John F
authors.initials: JF
authors.lastname: Kelly
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D000553:Ambulatory Care; D015928:Cognitive Behavioral Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D062405:Motivational Interviewing; D017008:Negotiating; D011446:Prospective Studies; D020377:Self Efficacy; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
keywords: Alcohol; Alcohol use disorder (AUD); Alcoholics Anonymous; Mechanism of change; Mediation; Young adults