Abstract
Participation in Alcoholics Anonymous (AA) appears to have numerous benefits beyond sobriety. Previous research has highlighted the role of gratitude and helping others in the AA philosophy, as well as their importance in creating social ties. Helping others, social relationships, and gratitude may contribute not only to sobriety but also physical health and psychological well-being; however, little is known about the relationship between these variables and how they contribute to well-being for people in recovery. In this study, we examined how gratitude (state and trait level), social contact, and helping predicted self-rated physical health and psychological distress in adult AA members maintaining sobriety. Participants (N = 113) completed baseline measures (trait gratitude, physical health) as well as daily reports of their participation in AA, helping behaviors, social contact, and psychological distress for 7 days. Analyses revealed different predictors for physical health and psychological distress. The implications for theory and practice are discussed.
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References
Alcoholics Anonymous World Services Inc. (2001). Alcoholics anonymous: The story of how many thousands of men and women recovered from alcoholism (4 ed.). New York, NY. Author.
A. A. (Alcoholics Anonymous) World Services. (2021). Estimates Worldwide A.A. Individual and Group Membership. https://www.aa.org/assets/en_US/smf-132_en.pdf
Algoe, S. B. (2012). Find, remind, and bind: The functions of gratitude in everyday relationships. Social and Personality Psychology Compass, 6, 455–469. https://doi.org/10.1111/j.1751-9004.2012.00439.x
Amato, P. R. (1990). Personality and social network involvement as predictors of helping behavior in everyday life. Social Psychology Quarterly, 53, 31–43. https://doi.org/10.2307/2786867
Berger, M., & Sarnyai, Z. (2015). “More than skin deep”: Stress neurobiology and mental health consequences of racial discrimination. Stress, 18, 1–10. https://doi.org/10.3109/10253890.2014.989204
Bond, J., Kaskutas, L. A., & Weisner, C. (2003). The persistent influence of social networks and Alcoholics Anonymous on abstinence. Journal of Studies on Alcohol, 64(4), 579–588. https://doi.org/10.15288/jsa.2003.64.579
Cacioppo, J. T., & Hawkley, L. C. (2003). Social isolation and health, with an emphasis on underlying mechanisms. Perspectives in Biology and Medicine, 46(3), S39–S52. https://doi.org/10.1353/pbm.2003.0063
Caputo, A. (2015). The relationship between gratitude and loneliness: The potential benefits of gratitude for promoting social bonds. Europe’s Journal of Psychology, 11(2), 323–334. https://doi.org/10.5964/ejop.v11i2.826
Chen, G. (2006). Social support, spiritual program, and addiction recovery. International Journal of Offender Therapy and Comparative Criminology, 50(3), 306–323. https://doi.org/10.1177/0306624X05279038
Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310–357. https://doi.org/10.1037/0033-2909.98.2.310
Cook, E. P. (1990). Gender and psychological distress. Journal of Counseling & Development, 68(4), 371–375. https://doi.org/10.1002/j.1556-6676.1990.tb02513.x
Conversano, C., Di Giuseppe, M., Miccoli, M., Ciacchini, R., Gemignani, A., & Orrù, G. (2020). Mindfulness, age and gender as protective factors against psychological distress during COVID-19 pandemic. Frontiers in Psychology, 11, 1–9. https://doi.org/10.3389/fpsyg.2020.01900
Cornwell, E. Y., & Waite, L. J. (2009). Social disconnectedness, perceived isolation, and health among older adults. Journal of Health and Social Behavior, 50, 31–48. https://doi.org/10.1177/002214650905000103
Cousin, L., Redwine, L., Bricker, C., Kip, K., & Buck, H. (2020). Effect of gratitude on cardiovascular health outcomes: A state-of-the-science review. The Journal of Positive Psychology, Advance online publication. https://doi.org/10.1080/17439760.2020.1716054
Deichert, N. T., Fekete, E. M., & Craven, M. (2019). Gratitude enhances the beneficial effects of social support on psychological well-being. The Journal of Positive Psychology. Advance online publication. https://doi.org/10.1080/17439760.2019.1689425
DeLongis, A., Folkman, S., & Lazarus, R. S. (1988). The impact of daily stress on health and mood: Psychological and social resources as mediators. Personality and Social Psychology, 54(3), 486–495.
Diessner, R., & Lewis, G. (2007). Further validation of the gratitude, resentment, and appreciation test (GRAT). The Journal of Social Psychology, 147(4), 445–447. https://doi.org/10.3200/SOCP.147.4.445-448
Elosúa, M. R. (2015). The influence of gratitude in physical, psychological, and spiritual well-being. Journal of Spirituality in Mental Health, 17(2), 110–118. https://doi.org/10.1080/19349637.2015.957610
Emmons, R. A., & McCullough, M. E. (2003). Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, 84(2), 377–389. https://doi.org/10.1037/00223514.84.2.377
Eriksson, I., Undén, A. L., & Elofsson, S. (2001). Self-rated health. Comparisons between three different measures. Results from a population study. International Journal of Epidemiology, 30(2), 326–333. https://doi.org/10.1093/ije/30.2.326
Gallagher, S., Solano, A. C., & Liporace, M. F. (2020). State, but not trait gratitude is associated with cardiovascular responses to acute psychological stress. Physiology & Behavior, 221, 12896. https://doi.org/10.1016/j.physbeh.2020.112896
Gee, G. C., Delva, J., & Takeuchi, D. (2007). Relationships between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence among Filipino Americans. American Journal of Public Health, 97(5), 933–940. https://doi.org/10.2105/AJPH.2005.075739
Golden, J., Conroy, R. M., & Lawlor, B. A. (2009). Social support network structure in older people: Underlying dimensions and association with psychological and physical health. Psychology, Health & Medicine, 14(3), 280–290. https://doi.org/10.1080/13548500902730135
Gordon, C. L., Arnette, R. A., & Smith, R. E. (2011). Have you thanked your spouse today?: Felt and expressed gratitude among married couples. Personality and Individual Differences, 50(3), 339–343.
Ha, J. H., & Ingersoll-Dayton, B. (2011). Moderators in the relationship between social contact and psychological distress among widowed adults. Aging & Mental Health, 15(3), 354363. https://doi.org/10.1080/13607863.2010.519325
Hall-Lande, J. A., Eisenberg, M. E., Christenson, S. L., & Neumark-Sztainer, D. (2007). Social isolation, psychological health, and protective factors in adolescence. Adolescence, 42(166), 265–286.
Hawton, A., Green, C., Dickens, A. P., Richards, S. H., Taylor, R. S., Edwards, R., Greaves, C. J., & Campbell, J. L. (2011). The impact of social isolation on the health status and health-related quality of life of older people. Quality of Life Research, 20(1), 57–67. https://doi.org/10.1007/s11136-010-9717-2
Horsfall, J. (2001). Gender and mental illness: An Australian overview. Issues in Mental Health Nursing, 22(4), 421–438. https://doi.org/10.1080/01612840490249028-24
Hser, Y. I. (2007). Predicting long-term stable recovery from heroin addiction: Findings from a 33-year follow-up study. Journal of Addictive Diseases, 26(1), 51–60. https://doi.org/10.1300/J069v26n01_07
Jans-Beken, L., Jacobs, N., Janssens, M., Peeters, S., Reijnders, J., Lechner, L., & Lataster, J. (2020). Gratitude and health: An updated review. The Journal of Positive Psychology, 15(6), 743–782. https://doi.org/10.1080/17439760.2019.1651888
Kaskutas, L. A. (2009). Alcoholics Anonymous effectiveness: Faith meets science. Journal of Addictive Diseases, 28(2), 145–157. https://doi.org/10.1080/10550880902772464
Kaskutas, L. A., Bond, J., & Humphreys, K. (2002). Social networks as mediators of the effect of Alcoholics Anonymous. Addiction, 97(7), 891–900. https://doi.org/10.1046/j.1360-0443.2002.00118.x
Kelly, J. F., Magill, M., & Stout, R. L. (2009). How do people recover from alcohol dependence? A systematic review of the research on mechanisms of behavior change in Alcoholics Anonymous. Addiction Research and Theory, 17(3), 236–259. https://doi.org/10.1080/16066350902770458
Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S. L. T., Walters, E. E., & Zaslavsky, A. M. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), 959–976. https://doi.org/10.1017/S0033291702006074
Klein, N. (2017). Prosocial behavior increases perceptions of meaning in life. The Journal of Positive Psychology, 12(4), 354–361. https://doi.org/10.1080/17439760.2016.1209541
LaBelle, O. (2020). Daily associations between helping behavior, gratitude, and selfishness in members of Alcoholics Anonymous. Alcoholism Treatment Quarterly, 1–14. https://doi.org/10.1080/07347324.2020.1768992
LaBelle, O. P., & Edelstein, R. S. (2018). Gratitude, insecure attachment, and positive outcomes among 12-step recovery program participants. Addiction Research & Theory, 26(2), 123–132. https://doi.org/10.1080/16066359.2017.1333111
LaBelle, O. & Hastings, M. (2020). Assessing recovery-related behaviors, emotions, and cognitions among members of Alcoholics Anonymous over 7 days: A quantitative daily diary study. Mendeley Data, 4. https://doi.org/10.17632/4wd9scvdvk.4
Larzelere, M. M., & Jones, G. N. (2008). Stress and health. Primary Care: Clinics in Office Practice, 35(4), 839–856. https://doi.org/10.1016/j.pop.2008.07.011
Lee, H. W., Bradburn, J., Johnson, R. E., Lin, S.-H., & Chang, C.-H. (2019). The benefits of receiving gratitude for helpers: A daily investigation of proactive and reactive helping at work. Journal of Applied Psychology, 104(2), 197–213. https://doi.org/10.1037/apl0000346
Lehavot, K., & Simoni, J. M. (2011). The impact of minority stress on mental health and substance use among sexual minority women. Journal of Consulting and Clinical Psychology, 79(2), 159–170. https://doi.org/10.1037/a0022839
Lemke, S., & Moos, R. H. (2003). Outcomes at 1 and 5 years for older patients with alcohol use disorders. Journal of Substance Abuse Treatment, 24(1), 43–50. https://doi.org/10.1016/S0740-5472(02)00321-5
Ma, L. K., Tunney, R. J., & Ferguson, E. (2017). Does gratitude enhance prosociality?: A meta-analytic review. Psychological Bulletin, 143(6), 601–635. https://doi.org/10.1037/bul0000103
Măirean, C., Turliuc, M. N., & Arghire, D. (2019). The relationship between trait gratitude and psychological wellbeing in university students: The mediating role of affective state and the moderating role of state gratitude. Journal of Happiness Studies, 20, 1359–1377. https://doi.org/10.1007/s10902-018-9998-7
Meyer, I. H. (2015). Resilience in the study of minority stress and health of sexual and gender minorities. Psychology of Sexual Orientation and Gender Diversity, 2(3), 29–213. https://doi.org/10.1037/sgd0000132
McCullough, M. E., Emmons, R. A., & Tsang, J. A. (2002). The grateful disposition: A conceptual and empirical topography. Journal of Personality and Social Psychology, 82(1), 112–127. https://doi.org/10.1037/0022-3514.82.1.112
Neto, F. (2007). Forgiveness, personality and gratitude. Personality and Individual Differences, 43(8), 2313–2323. https://doi.org/10.1016/j.paid.2007.07.010
Ng, D. M., & Jeffery, R. W. (2003). Relationships between perceived stress and health behaviors in a sample of working adults. Health Psychology, 22(6), 638–642. https://doi.org/10.1037/0278-6133.22.6.638
O’Connell, B. H., & Killeen-Byrt, M. (2018). Psychosocial health mediates the gratitude-physical health link. Psychology, Health & Medicine, 23(9), 1145–1150. https://doi.org/10.1080/13548506.2018.1469782
Ouweneel, E., Le Blanc, P. M., & Schaufeli, W. B. (2014). On being grateful and kind: Results of two randomized controlled trials on study-related emotions and academic engagement. The Journal of Psychology, 148(1), 37–60. https://doi.org/10.1080/00223980.2012.742854
Pagano, M. E., Friend, K. B., Tonigan, J. S., & Stout, R. L. (2004). Helping other alcoholics in alcoholics anonymous and drinking outcomes: findings from project MATCH. Journal of Studies on Alcohol, 65(6), 766–773. https://doi.org/10.15288/jsa.2004.65.766
Pagano, M., Krentzman, A., Onder, C., Baryak, J., Murphy, J., Zywiak, W., & Stout, R. (2010). Service to others in sobriety (SOS). Alcoholism Treatment Quarterly, 28(2), 111–127. https://doi.org/10.1080/07347321003656425
Pagano, M. E., Post, S. G., & Johnson, S. M. (2011). Alcoholics Anonymous-related helping and the helper therapy principle. Alcoholism Treatment Quarterly, 29, 23–34. https://doi.org/10.1080/07347324.2011.538320
Post, S. G. (2005). Altruism, happiness, and health: It’s good to be good. International Journal of Behavioral Medicine, 12(2), 66–77. https://doi.org/10.1207/s15327558ijbm1202_4
Raposa, E. B., Laws, H. B., & Ansell, E. B. (2016). Prosocial behavior mitigates the negative effects of stress in everyday life. Clinical Psychological Science, 4(4), 691–698. https://doi.org/10.1177/2167702615611073
Recovery.org. (2020, June). Who’s going to AA? Inquiring minds want to know. Retrieved from https://www.recovery.org/whos-going-to-aa-inquiring-minds-want-to-know/
Rehm, J., Room, R., Graham, K., Monteiro, M., Gmel, G., & Sempos, C. T. (2003). The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease: An overview. Addiction, 98(9), 1209–1228. https://doi.org/10.1046/j.1360-0443.2003.00467.x
Robustelli, B. L., & Whisman, M. A. (2018). Gratitude and life satisfaction in the United States and Japan. Journal of Happiness Studies, 19(1), 41–55. https://doi.org/10.1007/s10902-016-9802-5
Rubin, M., Evans, O., & Wilkinson, R. B. (2016). A longitudinal study of the relations among university students’ subjective social status, social contact with university friends, and mental health and well-being. Journal of Social and Clinical Psychology, 35(9), 722–737. https://doi.org/10.1521/jscp.2016.35.9.722
Schiff, M., & Bargal, D. (2000). Helping characteristics of self-help and support groups: Their contribution to participants’ subjective well-being. Small Group Research, 31(3), 275–304. https://doi.org/10.1177/104649640003100302
Sheldon, K. M., & Lyubomirsky, S. (2006). How to increase and sustain positive emotion: The effects of expressing gratitude and visualizing best possible selves. The Journal of Positive Psychology, 1(2), 73–82.
Starkey, A. R., Mohr, C. D., Cadiz, D. M., & Sinclair, R. R. (2019). Gratitude reception and physical health: Examining the mediating role of satisfaction with patient care in a sample of acute care nurses. The Journal of Positive Psychology, 14(6), 779–788. https://doi.org/10.1080/17439760.2019.1579353
Thoits, P. A. (2010). Stress and health: Major findings and policy implications. Journal of Health and Social Behavior, 51(S), S41–S53. https://doi.org/10.1177/0022146510383499
Tsang, J. A. (2006). Gratitude and prosocial behavior: An experimental test of gratitude. Cognition & Emotion, 20, 138–148. https://doi.org/10.1080/02699930500172341
Watkins, P. C., Woodward, K., Stone, T., & Kolts, R. L. (2003). Gratitude and happiness: Development of a measure of gratitude, and relationships with subjective well-being. Social Behavior and Personality: An International Journal, 31, 431–451. https://doi.org/10.2224/sbp.2003.31.5.431
Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: Evidence and needed research. Journal of Behavioral Medicine, 32, 20–47. https://doi.org/10.1007/s10865-008-9185-0
Wood, A. M., Froh, J. J., & Geraghty, A. W. (2010). Gratitude and well-being: A review and theoretical integration. Clinical Psychology Review, 30(7), 890–905. https://doi.org/10.1016/j.cpr.2010.03.005
Zemore, S. E., Kaskutas, L. A., & Ammon, L. N. (2004). In 12-step groups, helping helps the helper. Addiction, 99(8), 1015–1023. https://doi.org/10.1111/j.1360-0443.2004.00782.x
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Krieger, M.A., Balint, S. & LaBelle, O. Predictors of Physical and Mental Health in Recovery: the Role of State and Trait Gratitude, Social Contact, and Helping Others. Int J Ment Health Addiction 21, 1092–1105 (2023). https://doi.org/10.1007/s11469-021-00644-6
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DOI: https://doi.org/10.1007/s11469-021-00644-6