# Investigating impulsivity and social network changes as novel mechanisms of behavior change for Alcoholics Anonymous' (AA) positive effects

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2020 · $506,012

## Abstract

ABSTRACT
Alcoholics Anonymous (AA) is now well-established in its capacity to help individuals recover from alcohol use
disorder (AUD), but there are substantial gaps in understanding the mechanisms by which it does so. Recent
studies suggest two novel domains of mechanisms: 1) decreases in impulsivity; and 2) increases in salutary
social networks. However, these mechanisms have been investigated in only a small number of studies and
the extant studies employed low resolution measurement and suboptimal study designs. The proposed study
will address these limitations to systematically investigate impulsivity and social network composition as novel
mechanisms of behavior change (MOBCs) for AA’s positive effects on AUD recovery. The first primary aim is
to examine impulsivity, fractionating the concept into three distinct forms: 1) steep discounting of future
rewards (i.e., delay discounting); 2) poor behavioral inhibition (i.e., inability to inhibit a prepotent response); and
3) impulsive personality traits (i.e., self-attributions about regulatory capacity). The second primary aim is to
examine social network properties, quantifying participant social relationships via formal egocentric social
network composition analysis. The third primary aim is to examine whether these mechanistic relationships
systematically differ according to three important moderators: age, sex, and study site. An exploratory
secondary aim is to mine the findings from the primary aims to generate specific recommendations and
applications for clinical practice. These aims will be executed in a prospective cohort design that is optimized
for characterizing lagged dynamic changes in MOBCs. Specifically, the study design will examine these
processes in individuals with AUD who are newly engaging in community outpatient AUD treatment.
Participants will receive assessments at baseline, 6-weeks, and 3-, 6-, 9- and 12-months. AA involvement will
be measured using both the traditional measure of frequency of meeting attendance and a novel measure of
AA program engagement. Outcome variables will include percent days abstinent and percent heavy drinking
days. The findings will be disseminated using a comprehensive knowledge translation plan. Collectively, the
proposed study has the potential to make major contributions to understanding how AA helps people recover
from AUD. In turn, the insights from the study have the potential to substantially contribute to the use of AA and
other mutual recovery services in clinical practice.

## Key facts

- **NIH application ID:** 9985682
- **Project number:** 5R01AA025849-03
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** JOHN F. KELLY
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $506,012
- **Award type:** 5
- **Project period:** 2018-08-15 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9985682

## Citation

> US National Institutes of Health, RePORTER application 9985682, Investigating impulsivity and social network changes as novel mechanisms of behavior change for Alcoholics Anonymous' (AA) positive effects (5R01AA025849-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9985682. Licensed CC0.

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