Negative Affect, Relapse, and Alcoholics Anonymous (AA): Does AA Work by Reducing Anger?

Abstract

ABSTRACT. Objective: Anger and other indices of negative affect have been implicated in a stress-induced pathway to relapse. The Alcoholics Anonymous (AA) literature states that reduction of anger is critical to recovery, yet this proposed mechanism has rarely been investigated. Using lagged, controlled hierarchical linear modeling analyses, this study investigated whether AA attendance mobilized changes in anger and whether such changes explained AA-related benefit. Method: Alcoholdependent adults (N = 1,706) receiving treatment as part of a clinical trial were assessed at intake and at 3, 6, 9, 12, and 15 months. Results: Findings revealed substantially elevated levels of anger compared with the general population (98th percentile) that decreased over 15-month follow-up but remained high (89th percentile). AA attendance was associated with better drinking outcomes, and higher levels of anger were associated with heavier drinking. However, AA attendance was unrelated to changes in anger. Conclusions: Although support was not found for anger as a mediator, there was strong convergence between AA's explicit emphasis on anger and the present findings: Anger appears to be a serious, enduring problem related to relapse and heavy alcohol consumption. Methodological factors may have contributed to the lack of association between AA and anger, but results suggest that AA attendance alone may be insufficient to alleviate the suffering and alcohol-related risks specifically associated with anger. (J. Stud. Alcohol Drugs, 71, 434-444, 2010)

Alcoholics Anonymous attendance, decreases in impulsivity and drinking and psychosocial outcomes over 16 years: moderated‐mediation from a developmental perspective

“…Moreover, our findings suggest that efforts to identify mechanisms of change associated with AA may benefit from consideration of changes in personality traits that have been consistently linked to substance abuse (disinhibition, negative emotionality) 24,26 . In this regard, extant research has only examined links between AA and reductions on indicators of negative emotionality (i.e., anger, depression) 12,14 . Although preliminary, the current findings are novel and complement efforts to investigate whether formal and informal help for AUDs is linked to improvements on domains of emotional and behavioral functioning.…”

Anger, Hostility, and Aggression as Predictors of Persistent Smoking During Pregnancy

“…predictor of relapse for other substances of abuse such as alcohol (Kelly et al, 2010). Anger management interventions developed for substance-using populations may be particularly effective for low-income persistent pregnant smokers (González-Prendes, 2008;Reilly et al, 2000) and may be more likely to prevent relapse than treatments focused on depression alone.…”

Spirituality as a Change Mechanism in 12-Step Programs: A Replication, Extension, and Refinement

“…Among the change mechanisms specific to 12-step programs, (e.g., anger, Kelly, Stout, Tonigan, Magill, & Pagano, 2010), none is more central to 12-step philosophy or stressed as much in 12-step practice as is spiritual growth. In fact, an explicit goal of 12-step work and practice is to catalyze a spiritual awakening (Alcoholics Anonymous World Services, 2001).…”