Meta-analysis of the literature on Alcoholics Anonymous: sample and study characteristics moderate findings.
Abstract
OBJECTIVE: Reviews of research on Alcoholics Anonymous (AA) have speculated how findings may differ when grouped by client and study characteristics. A meta-analytic review by Emrick et al. in 1993 provided empirical support for this concern but did not explore its implications. This review divided results of AA affiliation and outcome research by sample origin and global rating of study quality. The review also examined the statistical power of studies on AA. METHOD: Meta-analytic procedures were used to summarize the findings of 74 studies that examined AA affiliation and outcome. Results were divided by whether samples were drawn from outpatient or inpatient settings and a global rating of study quality that jointly considered use of subject selection and assignment, reliability of measurement and corroboration of self-report. Efficacy of dividing study results was examined by changes in magnitude of correlations and unexplained variance. RESULTS: AA participation and drinking outcomes were more strongly related in outpatient samples, and better designed studies were more likely to report positive psychosocial outcomes related to AA attendance. In general, AA studies lacked sufficient statistical power to detect relationships of interest. CONCLUSIONS: AA experiences and outcomes are heterogeneous, and it makes little sense to seek omnibus profiles of AA affiliates or outcomes. Well-designed studies with large outpatient samples may afford the best opportunity to detect predictors and effects of AA involvement.
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Taking part in 12-step programs is linked to higher rates of abstinence.
“Participation in 12-step programs is associated with greater abstinence (5)”
From Mindfulness-Based Relapse Prevention for Substance Use Disorders: A Pilot Efficacy Trial (2009) · cites this paper as [5]
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Drebing, C. E., Reilly, E. D., Henze, K. T., Kelly, M. M., Russo, A. J., Smolinsky, J., Gorman, J. A., & Penk, W. E. (2018) · Psychological Services · doi:10.1037/ser0000178 · Cited by 104 · see citing works
Gossop, M., Harris, J., Best, D. W., Man, L. H., Manning, V., Marshall, J., & Strang, J. (2003) · Alcohol and Alcoholism · doi:10.1093/alcalc/agg104 · Cited by 99 · see citing works
Cleveland, H., Harris, K., Baker, A. K., Herbert, R., & Dean, L. R. (2007) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2006.11.005 · Cited by 105 · see citing works
Walitzer, K. S., Dermen, K. H., & Barrick, C. (2009) · Addiction · doi:10.1111/j.1360-0443.2008.02467.x · Cited by 98 · see citing works
Kelly, J. F., & Myers, M. G. (2007) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2007.10400612 · Cited by 95 · see citing works
McKay, J., Mclellan, A., Alterman, A., Cacciola, J., Rutherford, M., & O'Brien, C. (1998) · Journal of Studies on Alcohol · doi:10.15288/jsa.1998.59.152 · Cited by 96 · see citing works
Kelly, J., Brown, S. A., Abrantes, A., Kahler, C., & Myers, M. (2008) · Alcoholism: Clinical and Experimental Research · doi:10.1111/j.1530-0277.2008.00712.x · Cited by 88 · see citing works
Is it beneficial to have an Alcoholics Anonymous sponsor?
Tonigan, J. S., & Rice, S. L. (2010) · Psychology of Addictive Behaviors · doi:10.1037/a0019013 · Cited by 91 · see citing works
Self-citationSmit, F., Lokkerbol, J., Riper, H., Majo, M. C., Boon, B., & Blankers, M. (2011) · Journal of Medical Internet Research · doi:10.2196/jmir.1694 · Cited by 78 · see citing works
“h Tonigan et al's [28] meta-analysis of 2097 harmful and dependent users where effect size r converted into d.”
MethodThe Role of Twelve-Step-Related Spirituality in Addiction Recovery
Dermatis, H., & Galanter, M. S. (2015) · Journal of Religion and Health · doi:10.1007/s10943-015-0019-4 · Cited by 85 · see citing works
Kelly, J. F., Mckellar, J. D., & Moos, R. H. (2003) · Addiction · doi:10.1046/j.1360-0443.2003.t01-1-00294.x · Cited by 81 · see citing works
Zemore, S. E., Karriker‐Jaffe, K. J., Mulia, N., Kerr, W. C., Ehlers, C. L., Cook, W. K., Martínez, P., Lui, C. K., & Greenfield, T. K. (2017) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2018.79.7 · Cited by 81 · see citing works
Kelly, J. F., Stout, R. L., & Slaymaker, V. J. (2012) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2012.10.005 · Cited by 80 · see citing works
Pagano, M. E., White, W. L., Kelly, J. F., Stout, R. L., & Tonigan, J. S. (2013) · Substance Abuse · doi:10.1080/08897077.2012.691450 · Cited by 80 · see citing works
Self-citationPredictors of Initial AA-Related Helping: Findings From Project MATCH
Pagano, M. E., Zemore, S. E., Onder, C. C., & Stout, R. L. (2009) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2009.70.117 · Cited by 77 · see citing works
The effects of sponsorship in 12-step treatment of injection drug users
Crape, B. L., Latkin, C. A., Laris, A., & Knowlton, A. R. (2002) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(01)00175-2 · Cited by 77 · see citing works
Kelly, J. F., & Yeterian, J. D. (2008) · Elsevier eBooks · doi:10.1016/b978-012088520-6.50005-6 · Cited by 76 · see citing works
Zemore, S. E., Murphy, R., Mulia, N., Gilbert, P. A., Martínez, P., Bond, J. C., & Polcin, D. L. (2014) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.12500 · Cited by 76 · see citing works
Gender, treatment and self-help in remission from alcohol use disorders.
Moos, R., Moos, B., & Timko, C. (2006) · Clinical Medicine Research · doi:10.3121/cmr.4.3.163 · Cited by 77 · see citing works
Witbrodt, J., & Kaskutas, L. A. (2005) · The American Journal of Drug and Alcohol Abuse · doi:10.1081/ada-68486 · Cited by 73 · see citing works
12-step facilitation for the dually diagnosed: A randomized clinical trial
Bogenschutz, M. P., Rice, S. L., Tonigan, J. S., Vogel, H. S., Nowinski, J., Hume, D., & Arenella, P. B. (2013) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2013.12.009 · Cited by 70 · see citing works
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Zemore, S. E., Kaskutas, L. A., Mericle, A. A., & Hemberg, J. (2016) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2016.10.004 · Cited by 69 · see citing works
Participation in Alcoholics Anonymous: Intended and Unintended Change Mechanisms
Owen, P. L., Slaymaker, V. J., Tonigan, J. S., McCrady, B. S., Epstein, E. E., Kaskutas, L. A., Humphreys, K. N., & Miller, W. R. (2003) · Alcoholism Clinical and Experimental Research · doi:10.1097/01.alc.0000057941.57330.39 · Cited by 66 · see citing works
Self-citationMatching substance abuse aftercare treatments to client characteristics
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Project MATCH Client Impressions About Alcoholics Anonymous
Tonigan, J. S., Miller, W. R., & Connors, G. J. (2000) · Alcoholism Treatment Quarterly · doi:10.1300/j020v18n01_02 · Cited by 65 · see citing works
Self-citationOutpatient Management of Patients with Alcohol Problems
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Predictors of alcohol and crack cocaine use outcomes over a 3-year follow-up in treatment seekers.
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The role of mutual-help groups in extending the framework of treatment.
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One Small Step for Manuals: Computer-Assisted Training in Twelve-Step Facilitation
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FACTORS ASSOCIATED WITH FREQUENCY OF 12-STEP ATTENDANCE BY DRUG ABUSE CLIENTS
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Spiritual Awakening Predicts Improved Drinking Outcomes in a Polish Treatment Sample
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Benefits of Alcoholics Anonymous Attendance
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Self-citationWhat is Alcoholics Anonymous Affiliation?
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Here comes the self-help revolution in mental heath.
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Self-Efficacy as a Factor in Abstinence from Alcohol/Other Drug Abuse: A Meta-Analysis
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Self-citationChi, F. W., Satre, D. D., & Weisner, C. M. (2006) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2006.00100.x · Cited by 52 · see citing works
The Treatment of Addiction: What Can Research Offer Practice?
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The Role of AA Sponsors: A Pilot Study
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Blonigen, D. M., Timko, C., Finney, J. W., Moos, B. S., & Moos, R. H. (2011) · Addiction · doi:10.1111/j.1360-0443.2011.03522.x · Cited by 51 · see citing works
- Authors
- Tonigan, J. S., Toscova, R., & Miller, W. R.
- Affiliations
- University of New Mexico (US)
- Venue
- Journal of Studies on Alcohol
- Publisher
- Alcohol Research Documentation, Inc.
- Published
- 1996-01
- Volume
- 57
- Issue
- 1
- Pages
- 65-72
- ISSN
- 0096-882X (ISSN-L)
- 1934-2683
- OpenAlex
- W2102714420
- Cited by
- 350
- References
- 55
- Citations by year
- 2026: 5 · 2025: 1 · 2024: 1 · 2022: 5 · 2021: 7 · 2020: 27 · 2019: 8 · 2018: 11 · 2017: 10 · 2016: 11 · 2015: 11 · 2014: 11 · 2013: 14 · 2012: 19
- FWCI
- 1.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Studies on Alcohol (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Keywords
- Alcoholics Anonymous, self-help groups, alcohol use outcomes, study quality, statistical power, treatment effect heterogeneity, alcohol recovery
- MeSH terms
- Alcoholics Anonymous, Alcoholism, Ambulatory Care, Humans, Temperance, Treatment Outcome
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