Aims: Examine whether decreases in impulsivity account for links between AA attendance and better drinking and psychosocial outcomes, and whether these mediational “effects” are conditional on age.
Design: A naturalistic study in which individuals were assessed at baseline, and 1, 8, and 16 years later.
Setting: Participants initiated help-seeking through the alcohol intervention system (detoxification programs, information and referral centers).
Participants: Individuals with alcohol use disorders and no prior history of substance abuse treatment at baseline [N= 628; 47% women; mean age = 34.7 years (SD = 9.4)].
Measurements: Self-reports of impulsivity and drinking pattern at baseline and Year 1, duration of AA (number of weeks) in Year 1, and drinking (alcohol use problems, self-efficacy to resist drinking) and psychosocial outcomes (emotional discharge coping, social support) at baseline and follow-ups.
Findings: Controlling for changes in drinking pattern, decreases in impulsivity were associated with fewer alcohol use problems, better coping, and greater social support and self-efficacy at Year 1, and better coping and greater social support at Year 8. Decreases in impulsivity statistically mediated associations between longer AA duration and improvements on all Year 1 outcomes, and indirect effects were moderated by participant age (significant only for individuals 25 years of age or younger).
Conclusions: Decreased impulsivity appears to mediate reductions in alcohol-related problems over 8 years in people attending Alcoholics Anonymous.