The Campuswide Alcohol and Drug Abuse Prevention Program (CADAPP) was implemented and evaluated over a 1.5-year span at the University of New Mexico (UNM). Drawing on self-regulation theory as a basis for understanding motivation for change, the program was designed to increase risk perceptions and thereby reduce the use of alcohol and other drugs among university students. The program was evaluated from 1988 to 1989 through repeated anonymous random sample surveys of all enrolled students on the UNM campus and on a similar control campus not implementing new prevention efforts during the same period. As predicted, relative to the control campus, students on the CADAPP campus after the program showed significantly higher perceived risks from substance use and significantly reduced levels of alcohol and marijuana use. These findings provide encouraging evidence for this theory-based approach to primary and secondary prevention.
Twelve-step programs are the most popular mutual-help organizations for individuals seeking relief from a common problem. It is estimated that 3.5 million individuals attend 12-step programs annually (Room, 1993) and that 1 in 10 Americans will attend an Alcoholics Anonymous (AA) meeting, the largest of the 12-step programs, in their lifetime (McCrady & Miller, 1993). Among individuals seeking professional treatment, prior 12step involvement is relatively common (especially in substance abuse; Burton & Williamson, 1995), at rates that are certainly higher than for the general population. For example, in a national study of alcohol treatment-client matching (Project MATCH Research Group, 1997), a majority of clients seeking professional treatment for alcohol problems had already attended AA
TABLE 12.2 Defining Characteristics of Serenity~1. The ability to detach from desires and/or emotion and feelings. 2. The ability to be in touch with an inner haven of peace and security. 3. A sense of connectedess with the universe. 4. A trust in the wisdom of the universe. 5. The habit of actively pursuing all reasonable avenues for solving problems. 6. An ability to accept situations that cannot be changed. 7. A way to give unconditionally of one's self. 8. Forgiveness of self and others. 9. The ability to let go of the past and the future and to live in the present. 10. A sense of perspective as to the importance of one's self and life events.
Objective 12-step attendance is associated with increased abstinence. A strong claim made in 12-step literature is that alcoholics are pathologically selfish and that working the 12 steps reduces this selfishness which, in turn, leads to sustained alcohol abstinence. This study tested this assumption by investigating the linkages between 12-step attendance, pathological narcissism, and drinking. Method 130 early AA affiliates with limited AA and treatment histories were recruited from treatment and community-based AA. A majority of the sample was alcohol dependent and reported illicit drug use before recruitment. Participants were interviewed at intake and at 3, 6, and 9 months. Results A majority of participants attended AA meetings throughout follow-up and such attendance predicted increased abstinence and reduced drinking intensity. 12-step affiliates were significantly higher on pathological narcissism (PN) relative to general population samples and their PN remained elevated. Contrary to predictions, PN was unrelated to 12-step meeting attendance and did not predict later abstinence or drinking intensity. Conclusion Findings did not support the hypothesis that reductions in PN explain 12-step benefit. An alternative function for the emphasis placed on pathological selfishness in 12-step programs is discussed and a recommendation is made to use unobtrusive measures of selfishness in future research.
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