Résumés
Résumé
Contexte : Le mouvement des Alcooliques Anonymes (AA) demeure la source d’aide la plus utilisée au monde en alcoolisme. Il propose un modèle de rémission basé sur les principes des 12 étapes et soutenu par une communauté d’entraide qui, au-delà de l’abstinence, vise la reconstruction de sa vie sans alcool et l’atteinte d’un bien-être. Peu d’études ont exploré la qualité de vie des membres abstinents au profit d’une littérature plus abondante concernant l’atteinte et le maintien de l’abstinence.
Objectif : Cette étude vise à évaluer un modèle de médiation mettant en relation l’engagement dans le mouvement des AA, tant dans le programme qu’au sein de la fraternité, et le niveau de bien-être psychologique des membres, tout en tenant compte de la qualité de l’expérience positive de l’abstinence.
Sélection des études et extraction des données : L’échantillon était composé de 168 membres AA de longue date, appelés « old-timers », avec un taux de réponse de 49 %. Un questionnaire autoadministré a permis d’évaluer l’engagement dans le mouvement, le niveau de bien-être psychologique ainsi que l’évaluation subjective de l’expérience d’abstinence.
Résultats : Les membres AA rapportent généralement un niveau élevé de bien-être psychologique, un engagement dans la fraternité et une adhésion aux principes des 12 étapes. La socialisation avec les membres a un effet significatif et important sur le sentiment de bonheur et de satisfaction dans la vie, alors que l’application des étapes de maintien tend à influencer positivement le degré de satisfaction dans la vie et le sens donné à la vie grâce à l’expérience positive de l’abstinence.
Conclusion : Les membres « old-timers » abstinents rapportent être heureux, satisfaits dans la vie et donner un sens à leur vie. La relation d’entraide qui se développe dans la fraternité et l’expérience de donner et de recevoir de l’aide contribuent de façon significative à ce bien-être psychologique.
Mots-clés :
- Alcooliques Anonymes,
- old-timers,
- engagement,
- bien-être psychologique,
- 12 étapes
Abstract
Context : Alcoholics Anonymous remains one of the most commonly used sources of support for alcoholics worldwide. It offers rehabilitation process based on the twelve-step program and sustained by an anonymous fellowship for mutual support, and besides remission aims to rebuild the individual’s life without alcohol and help him or her achieve a state of well-being. Few studies have explored the quality of life of abstinent members. Instead most literature has focused on analyzing the success in achieving and maintaining abstinence among the members.
Objectives : This study aims to assess a mediation model exploring the relationship between involvement in the AA movement, both in the program and the fellowship, and psychological well-being of old-timers, while taking into account the quality of their experience with abstinence.
Study selection and data extraction : The sample consisted of 168 AA members, who have been abstinent and members of AA for an extended period of time, called ‘old-timers’, for a response rate of 49 %. A self-administered questionnaire assessed involvement in the fellowship, involvement in the 12-step program, level of psychological well-being, including happiness, life satisfaction and meaning in life, and the subjective evaluation of the experience of abstinence.
Results : AA members reported a high level of psychological well-being, strong involvement in the fellowship, and an adherence to the 12 steps. Socialization with members seems to have a greater effect on happiness and life satisfaction, while the application of the maintenance steps allowed a positive experience of abstinence, and mediated positively the effect on life satisfaction and meaning in life.
Conclusion : Old-timers members reported to be happy, satisfied in life and finding meaning in living. The mutual support in the fellowship through experiences of giving and receiving help appear to contribute significantly to the psychological well-being of old-timers.
Keywords:
- Alcoholics Anonymous,
- Old-timers,
- Commitment,
- Well-Being,
- Twelve-steps
Resumen
Contexto : el movimiento de Alcohólicos Anónimos(AA) continúa siendo la fuente de ayuda más utilizada enel mundo en materia de alcoholismo. El mismo propone un modelo deremisión basado en los principios de las 12 etapas y sostenidopor una comunidad de ayuda mutua que, más allá de laabstinencia, tiene como objetivo la reconstrucción de una vidasin alcohol y el logro del bienestar. La literatura sobre el logro y elmantenimiento de la abstinencia es muy abundante pero pocos estudioshan explorado la calidad de vida de los miembros abstinentes.
Objetivo : Este estudio se dirige a evaluar un modelo de mediación que relacione el compromiso con el movimiento de los AA, tanto en el programa como dentro de la fraternidad, con el nivel de bienestar psicológico de sus miembros, teniendo en cuenta la calidad de la experiencia positiva de la abstinencia.
Selección de estudios y extracción de datos : La muestra estuvo compuesta por 168 miembros de larga data de AA, llamados “old-timers” (los antiguos), con un porcentaje de respuesta del 49 %. Un cuestionario autoadministrado permitió evaluar el compromiso con el movimiento, el nivel de bienestar psicológico y la evaluación subjetiva de la experiencia de abstinencia.
Resultados : Los miembros de AA declaran generalmente gozar de un nivel elevado de bienestar psicológico, estar comprometidos con la fraternidad y adherir al principio de las 12 etapas. La socialización con los miembros tiene un efecto significativo e importante en el sentimiento de bienestar y satisfacción en la vida, mientras que las etapas de mantenimiento tienden a influir positivamente en el grado de satisfacción en la vida y en el sentido que se le da a la vida gracias a la experiencia positiva de la abstinencia.
Conclusión : Los miembros “old-timers” abstinentes declaran ser felices, estar satisfechos con su vida y afirman haberle dado un sentido a la misma. La relación de ayuda mutua que se desarrolla en la fraternidad y la experiencia de brindar ayuda y de recibirla contribuyen de manera importante con el bienestar psicológico.
Palabras clave:
- Alcohólicos Anónimos,
- “old timers”,
- compromiso,
- bienestar psicológico,
- 12 etapas
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Parties annexes
Remerciements
Nous remercions l’organisation des Alcooliques Anonymes, son comité de coopération avec les professionnels, tous les membres et spécialement Francine G., André C. et Jacques L. pour leur support et leur généreuse contribution à cette recherche. Nous tenons aussi à remercier Dre Louise Nadeau pour ses suggestions constructives et pour son aide précieuse dans la réalisation de cette étude.
Bibliographie
- Alcooliques Anonymes. (1952). Twelve Steps and Twelve Traditions. New York: Alcoholic Anonymous World Services Inc.
- Alcooliques anonymes. (1976). Alcoholics Anonymous. New York: Alcoholic Anonymous World Services Inc.: 3d Édition.
- Alcooliques Anonymes. (2003[1963]). Alcoholics Anonymous. New York: Alcoholics Anonymous World Services, Inc.
- Alibrandi, L. A. (1985). The Fold Psychotherapy of Alcoholics Anonymous. In S. B. Blume, J. Wallace & S. Zimberg (Eds.), Practical Approaches to Alcoholism Psychotherapy (pp. 239-256). New York, NY: Phenum Press.
- Andrews, F.M. et Withey, S.B. (1976). Social indicators of well-being: America’s perception of Life quality. New York: Plenum Press.
- Antonovsky, A. (1987). Untraveling the mystery of health: How people manage stress and stay well. San Francisco: Jossey-Bass.
- Baron, R. M., & Kenny, D. A. (1986). The Moderator-Mediator Variable Distinction in Social Psychological Research: Conceptual, Strategic, and Statistical Considerations. Journal of Personality and Social Psychology, 51(6), 1173-1182.
- Bean, M. (1975). Alcoholics Anonymous II. Psychiatric Annals 5, 7-57.
- Bean-Bayog, M. (1993). AA processes and change: How does it work. Dans McCrady, B.S. & Miller, W.R. (Eds.), Research on Alcoholics Anonymous: Opportunities and Alternatives (p. 99-112). New York: Rutgers Center of Alcohol Studies.
- Bollen, K. A. & Long, J. S. (Eds) (1993). Testing Structural Equation Models. Newbury Park, CA: Sage Publications, Inc..
- Borkman, T. (2008). The Twelve-Step recovery model of AA: A voluntary mutual help association. Dans Galanter, M. & Kaskutas, L.A. (Eds.), Recent developments in alcoholism: Vol. 18. Research on Alcoholics Anonymous and spirituality in addiction recovery (p. 209-227). New York: Springer.
- Boscarino, J. (1980). Factors related to stable and unstable affiliation with Alcoholics Anonymous. The International Journal of the Addictions, 15, 839-848.
- Bradburn, N.M. (1969). The structure of psychological well-being. Chicago: Aldine.
- Brault-Labbé, A. & Dubé, L. (2010). Engagement scolaire, bien-être personnel et autodétermination chez des étudiants à l’université. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 42(2), 80-92.
- Brickman, P. (1987). Commitment, conflict and caring. Englewood Cliffs, NJ: Prentice Hall.
- Brickman, P. & Coates, D. (1987). Commitment and mental health. Dans Brickman, P. Commitment, conflict and caring. (p. 222-276). Englewood Cliffs, NJ: Prentice Hall.
- Brown, S.D. (1993). Therapeutic processes in Alcoholics Anonymous. Dans: McCdray, B.S. & Miller, W.R. (Eds), Research on Alcoholics Anonymous: Opportunities and Alternatives (pp. 137-152). New York: Rutgers Center of Alcohol Studies.
- Brown, S. (1985). Treating the alcoholic: A developmental model of recovery. New York: Wiley.
- Brown, S.A. & Schuckit, M.A. (1988). Changes in depression among abstinent alcoholics. Journal of Studies on Alcohol, 49, 412-417.
- Caetano, R. (1987). Alcohol use and depression among U.S. Hispanics. British Journal of Addiction, 82, 1245-1251.
- Caldwell, P. E., & Cutter, H. S. G. (1998). Alcoholics Anonymous Affiliation During Early Recovery. Journal of Substance Abuse Treatment, 15(3), 221-228.
- Carroll, S. (1993). Spirituality and purpose in life and alcoholism recovery. Journal of Studies on Alcohol, 54, 297-301.
- Cloud, R.N., Ziegler, C.H., & Blondell, R.D. (2004). What is Alcoholics Anonymous affiliation ? Substance Use and Misuse, 39(7),1117-1136.
- Connors, G.J., Walitzer K.S., & Tonigan, J.S. (2008). Spiritual change in recovery. Dans Galanter, M. & Kaskutas, L.A. (Eds.), Recent developments in alcoholism: Vol. 18. Research on Alcoholics Anonymous and spirituality in addiction recovery (p. 209-227). New York: Springer.
- Crumbaugh, J.C. (1968). Cross-validation of purpose in life test based on Frankl’s concept. Journal of Individual Psychology, 24, 74-81.
- Ciskszentmihalyi, M. (1990). Flow: The psychology of optimal experience. New York: Harper & Row.
- Denzin, N.K. (1987). The recovering alcoholic. Beverly Hills, CA: Sage Publications Inc.
- Diener, D. (1984). Subjective well-being. Psychological Bulletin, 85, 542-575.
- Diener, E. & Emmons, R.A. (1984). The independence of positive and negative affect. Journal of Personality and Social Psychology, 47, 1105-1117.
- Donovan, D.N., & Floyd, A.S. (2008). Facilitating Involvement in Twelve-Step programs. Dans Galanter, M. & Kaskutas, L.A. (Eds.), Recent developments in alcoholism: Vol. 18. Research on Alcoholics Anonymous and spirituality in addiction recovery (p. 209-227). New York: Springer.
- Dubé L., Kairouz, S. & Jodoin, M. (1997). L’engagement: Un gage de bonheur ? Revue Québécoise de Psychologie, 18(2), 211-237.
- Emmons, R.A. (1986). Personal strivings: An approach to personality and subjective well-being. Journal of Personality and Social Psychology, 51, 1058-1068.
- Emrick, C.D. (1987). Alcoholics Anonymous: Affiliation processes and effectiveness as treatment. Alcoholism: Clinical and Experimental Research, 11, 416-423.
- Ferri, M., Amato, L., & Davoli, M. (2006). Alcoholics Anonymous and others 12-step programs for alcohol dependence. Cochrane Database Systematic Review, 19(3).
- Forceimes, A.A. (2004). DeProfundis: Spiritual transformations in Alcoholics Anonymous. JCLP, 60(5), 503-514.
- Galanter, M. (2007). Spirituality and recovery in 12-step program: an empirical model. Journal of Substance Abuse, 33(3), 265-272.
- Groh, D.R., Jason, L.A. & Keys, C.B. (2008). Social network variables in alcoholics anonymous: A literature review. Clinical Psychology Review, 28, 430-450.
- Harding, S. D. (1982). Psychological well-being in great Britain: An evaluation of the Bradburn Affect Balance Scale. Personality and Individual Differences, 3(2), 167-175.
- Hesslbrock, M.N., Meyer, R.E. & Keener, J.J. (1985). Psychopathology in hospitalized alcoholics. Archives of General Psychiatry, 42, 1050-1055.
- Jacobson, G.R., Ritter, D.P. & Mueller, L. (1977). Purpose in life and personal values among adults alcoholics. Journal of Clinical Psychology, 33, 314-316.
- Kaskutas. L.A. (2008). Introduction. Dans Galanter, M. & Kaskutas, L.A. (Eds.), Recent developments in alcoholism: Vol. 18. Research on Alcoholics Anonymous and spirituality in addiction recovery (p. 209-227). New York: Springer.
- Kammeier, M.L. & Anderson, P.O. (1976). Two years later: Posttreatment participation in AA by 1970 Hazelden patients. Paper presented at the Annual Meeting of Alcohol and Drug Problems Association of North America, New Orleans.
- Klinger, E. (1977). Meaning and Void: Inner Experience and Disengagement from Incentives. Minneapolus. MN: University of Minesota Press.
- Klinger, E. (1987). Current concerns and disengagement from incentives. Dans Halischf, F. & Kuhl, J. (Eds), Motivation, Intention and Volition (p. 337-348). New York: Springler-Berlag.
- Knoester, C., Petts R.J. & Eggebeen, D.J. (2007). Commitments to fathering and the well-being and social participation of new, disadvantaged fathers. Journal of Marriage and Family, 69(4), 991-1004.
- Krampen, G. (1989). Motivation in the treatment of alcoholism. Addictive Behaviors, 14, 197-200.
- Kranzler, H.R. & Liebowitz, N.R. (1988). Anxiety and depression in substance abuse: Clinical implications. Medical Clinics of North America, 72, 867-885.
- Krippenstappel, P. (1987). A fresh look at relapse. Alcoholism Treatment Quarterly, 4, 1-17.
- Kurtz, W. (1982). Why A.A. works. The intellectual significance of Alcoholics Anonymous. Journal of Studies on Alcohol, 43, 38-80.
- LeBron McBride, J. (1991). Abstinence among members of Alcoholics Anonymous. Alcoholism Treatment Quarterly, 8, 113-121.
- Lehmiller, J.J. (2009). Secret romantic relationships: Consequences for personal and relational well-being. Personality and Social Psychology Bulletin, 35(11), Nov, 1452-1466.
- Lippman, S., Manshadi, M., Chirstie, S. & Gultekin, A. (1987). Depression in alcoholics by the NIMH diagnostic interview schedule and Zung self-rating depression scale. International Journal of the Addiction, 22, 273-281.
- Martin, J.E. & Carlson, C.R. (1988). Spiritual dimensions of health psychology. Dans Miller, W.R. & Martin, J.E. (Eds), Behavior Therapy and Religion. Integrating Spiritual and Behavioral Approaches to Change. Newsbury, CA: Sage Publications.
- McGrath, R.M. (1996). Within the Science of Unitary Human Beings. Unpublished Doctoral Dissertation.
- McMahon, R.C. & Davidson, R.S. (1986). An examination of depressed versus non-depressed alcoholics in inpatient treatment. Journal of Clinical Psychology, 42, 177-184.
- Meyer, J.P. & Maltin, E.R. (2010). Employee commitment and well-being: A critical review, theoretical framework and research agenda. Journal of Vocational Behavior, 77(2), 323-337.
- Miller, W.R. & Martin, J.W. (1988). Behavior Therapy and Religion. Newsbury Park, CA: Sage Publications.
- Montgomery, H.A., Miller. W.R. & Tonigan, J.S. (1995). Does Alcoholics Anonymous involvement predict treatment outcome ? Journal of Substance Abuse Treatment, 12, 241-246.
- Morgenstern, J. & McCrady, B.S. (1993). Cognitive processes and change in disease-model treatment. Dans McCrady, B.S. & Miller, W.R. (Eds), Research on Alcoholics Anonymous: Opportunities and Alternatives (p. 153-166). New York: Rutgers Center of Alcohol Studies.
- Mulford, H. (1977). Stages in the alcoholic process. Journal of Studies on Alcohol, 38, 563-583.
- Mullaney, J.A. & Trippett, C.J. (1979). Alcohol dependence and phobias: Clinical description and relevance. British Journal of Psychiatry, 135, 565-573.
- Nowinski, J. (1993). Questioning the answers: Research and the AA traditions. Dans McCrady, B.S. & Miller, W.R. (Eds.), Research on Alcoholics Anonymous: Opportunities and Alternatives (p. 27-40). New York: Rutgers Center of Alcohol Studies.
- Olafsdottir, H. (1992). Comparison of AA groups in seven countries. Papier présenté au 18th Annual Alcohol Epidemiology Symposium, Toronto, June 1-5.
- Piderman, K.M., Schneekloth, T.D., Pankratz, V.S., Maloney, S.D. & Altchuler, S.I. (2007). Spirituality in alcoholis during treatment. American Journal Addiction, 16(3), 232-237.
- Patton, M.Q. (1979). The Outcomes of Treatments: A Study of Patients Admitted to Hazelden in 1976. Center City, MN: Hazelden Foundation.
- Robinson, D. (1979). Talking out of Alcoholism: The Self-Help Process of Alcoholics Anonymous. London: Croom Helm.
- Room, R. (1993). Alcoholics Anonymous as a social movement. Dans McCrady, B.S. & Miller, W.R. (Eds.), Research on Alcoholics Anonymous: Opportunities and Alternatives (p. 167-188). New York: Rutgers Center of Alcohol Studies.
- Rubington, E. (1980). The first year of abstinence: Notes on an exploratory study. Journal of Studies on Alcohol, 41, 577-582.
- Russell, J.A. (1979). Affective space is bipolar. Journal of Personality and Social Psychology, 37, 345- 356.
- Russell, J.A. (1980). A circumplex model of affect. Journal of Personality and Social Psychology, 39, 1161-1178.
- Russell, J.A. & Mahrabian, A. (1977). Evidence for a three-factor theory of emotions. Journal of Research in Personality, 11, 273-294.
- Ryff, C.D. (1989). Happiness is everything or is it ? Explorations on the meaning of psychological well being. Journal of Personality and Social Psychology, 57, 1069-1081.
- Ryff, C.D. (1995). The structure of psychological well-being revisited. Journal of Personality and Social Psychology, 69, 719-727.
- Santé Canada. (2002). Meilleures pratiques: troubles concomitants de santé mentale de l’alcoolisme et de toxicomanie (Préparé par le Centre for Addiction and Mental Health). Ottawa: ministre des Travaux publics et services gouvernementaux Canada.
- Schwartz, A. & Strack, F. (1991). Evaluating one’s life: A judgmental model of subjective well-being. Dans Strack, F., Argyle, M. & Schwartz, N. (Eds.), Subjective Well-Being: An Interdisciplinary Perspective (p. 27-47). New York: Pergamon Press.
- Sheeren, M. (1988). The relationship between relapse and involvement in Alcoholics Anonymous. Journal of Studies on Alcohol, 49, 104-106.
- Shin, D.C. & Johnson, D.M. (1978). Avowed happiness as an overall assessment of the quality of life. Social Indicators Research, 5, 475-492.
- Spalding, A.D. & Metz, G.J. (1997). Spirituality and quality of life in Alcoholics Anonymous. Alcoholism Treatment Quarterly, 15, 1-14.
- Tonigan, J. S., Ashcroft, F., & Miller, W. R. (1995). AA group dynamics and 12-step activity. Journal of Studies on Alcohol and Drugs, 56(6), 616-621.
- Tonigan, J. Scott, Connors, Gerard J. ; Miller, William R. (1996). Alcoholics Anonymous Involvement (AAI) scale: Reliability and norms. Psychology of Addictive Behaviors, Vol 10(2), 75-80.
- Tonigan, J. Scott, Connors, Gerard J., Miller, William R. (2003). Participation and involvement in Alcoholics Anonymous. Dans Dans Babor, Thomas F. & Del Boca, Frances K. (Eds), (2003). Treatment matching in alcoholism. International research monographs in the addictions., (pp. 184-204). New York, NY, US: Cambridge University Press.
- Vaillant, G. E. (2005). Alcoholics Anonymous: Cult or cure ? Australian and New Zealand Journal of Psychiatry, 39, 431–436
- Veenhoven, R. (1991). Questions on happiness: Classical topics, modern answers, blind spots. Dans Strack, R., Argyle, M. & Schwartz, N. (Eds.), Subjective Well-Being: Interdisciplinary Perspective (p. 7-26). Oxford: Pergamon Press.
- Waisberg, J.L. & Porter, J.E. (1994). Purpose in life and outcome of treatment for alcohol dependence. British Journal of Clinical Psychology, 33, 49-63.
- Wiseman, J.P. (1981). Sober comportment. Journal of Studies on Alcohol, 42, 106-126.
- White, W.L. (2010). Commentary on Kelly et al. (2010) Alcoholics Anonymous, alcoholism recovery, global health and quality of life. Addiction, 105, 637-638.
- Witbrodt, J., Kaskutas, L., Bond, J., & Delucchi, K. (2011). Does sponsoring improve outcomes above Alcoholics Anonymous attendance ? A latent class growth curves analysis. Addiction, Manuscrit en cours de correction.
- Yalom, I.D. (1980). Existential Psychotherapy. New York: Basic Books.
- Zemore, S.E. (2008). An Overview of Spirituality in AA (and Recovery). Dans Galanter, M. & Kaskutas, L.A. (Eds.), Recent developments in alcoholism: Vol. 18. Research on Alcoholics Anonymous and spirituality in addiction recovery (p. 209-227). New York: Springer.