Prevention Implications of a Test of Twelve-Step Theory

To what extent is the theory of alcohol and drug use underlying the 12 steps borne out by research? Few if any empirical models have tested the premises of the 12-step theory. We test the main underlying theory of the 12-step model using a sample of adolescent young men aged 16-19. Data from the Buffalo Longitudinal Survey of Young Men, a probability sample of 625 males in the Buffalo, New York metropolitan area, were used to develop the model because the measures available were suitable to assess 12-step theory. A longitudinal structural path model was developed using AMOS to test direct and mediated paths. The dependent variable was a sum of DSM-III-R alcohol dependence criteria. From a statistical standpoint, all twenty-four paths in the model had significant associations (all p <.05 one-tailed) as theorized from the 12-stop model, and the model has appropriate fit indices. Lack of support in the home contributes to low self-esteem. This in turn contributes to anxiety, low internal locus of control and unconventional attitudes towards the path to life success. Interpersonal conflict and irritability are, in turn, stimulated and then, in turn, so is alcohol dependence. Religiosity is protective, whereas positive alcohol expectancies increase risky drinking. These findings suggest that the theory of addiction underlying the 12-step model is supported by an empirical model. The measures in the model are ideal targets for youth alcohol prevention programs (e.g., parental support, early indicators of social and mental health problems, self-esteem).