Mediational relations between 12-Step attendance, depression and substance use in patients with comorbid substance dependence and major depression.

Addiction
Matthew J WorleySandra A Brown

Abstract

Among patients with substance dependence and comorbid major depressive disorder (MDD) receiving treatment in a controlled trial, we examined if group differences in depression were mediated by 12-Step involvement, and if the effects of 12-Step involvement on future alcohol and drug use were mediated by reductions in depression. Controlled trial of Twelve-Step facilitation (TSF) and integrated cognitive-behavioral therapy (ICBT), delivered in out-patient groups for 6 months with adjunct pharmacotherapy. Out-patient dual diagnosis clinic in Veteran's Affairs Healthcare Center. Veterans (n = 209) diagnosed with alcohol, stimulant or marijuana dependence and substance-independent MDD. Twelve-Step attendance and affiliation, depression severity, percentage of days drinking and percentage of days using drugs assessed at baseline and months 3, 6 and 9. In multi-level analyses greater 12-Step meeting attendance predicted lower depression and mediated the superior depression outcomes of the TSF group, explaining 24.3% of the group difference in depression. Independent of treatment group, lower depression severity predicted lower future alcohol use and mediated the effects of 12-Step meetings, explaining 15.7% of their effects on future ...Continue Reading

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Citations

Jan 1, 2013·International Journal of High Risk Behaviors & Addiction·Jafar AnisiMarziyeh Jahanbakhsh
Jan 19, 2013·Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse·Matthew J WorleySandra A Brown
Sep 17, 2013·Alcoholism, Clinical and Experimental Research·Brandon G BergmanJohn F Kelly
Nov 29, 2016·The American Journal of Drug and Alcohol Abuse·Claire E Wilcox, J Scott Tonigan
Jul 28, 2021·The International Journal on Drug Policy·Michael VoronkovStephen E Lankenau

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