Theses and Dissertations

Date of Award


Document Type


Degree Name

Doctor of Psychology (PhD)


Center for Psychological Studies

First Advisor

Christian DeLucia

Second Advisor

Ryan Black

Third Advisor

Edward Simco


12-Step Recovery, Instrument Refinement, IRT, Measurement, Narcotics Anonymous, Positive Psychology


Twelve step organizations such as Alcoholics Anonymous and Narcotics Anonymous are free, community-based fellowships. Such organizations are the most widely sought recovery management options, surpassing professional treatment. The emerging evidence base suggests that involvement in such organizations is associated with positive substance-related outcomes (e.g., abstinence). Relatively speaking, however, far less is known about whether or not involvement is associated with other meaningful psychosocial constructs. The current study examined gratitude, meaning in life, life satisfaction, personal growth, and various other recovery and psychosocial constructs in a sample of self-identified NA members (N = 128) from 26 U.S. states, ranging in age from 22 to 64 years. The primary aim of the present study was to psychometrically evaluate and refine four distinct positive psychology instruments (i.e., Gratitude Questionnaire (GQ – 6), Meaning in Life Scale (MLQ), Satisfaction With Life Scale (SWLS), Personal Growth Initiative Scale (PGIS)). The current study contained three phases. First, the psychometric properties of each instrument were examined within an Item Response Theory measurement framework. The Rating Scale Model was used to evaluate the each instrument using WINSTEPS 3.74.01. With the exception of the Meaning in Life Questionnaire (which did not conform to an IRT measurement model), each instrument was iteratively refined based on statistical and clinical considerations, resulting in the collapse of response options and the removal of poorly fitting items. These refinements improved the psychometric properties of each instrument, resulting in a more reliable, accurate, and efficient way to measure gratitude, life satisfaction, and personal growth in clinical samples. Second, items from the GQ – 6, SWLS, and PGIS were examined concurrently using the PROC IRT procedure in SAS to explore whether the constructs were distinct from one another. Results provide support that gratitude, life satisfaction, and personal growth are unique and distinct constructs. Last, the study examined several recovery-related correlates of gratitude, life satisfaction, and personal growth. Hierarchical regression models assessed whether abstinence duration and other recovery-related variables accounted for significant incremental variance in gratitude, life satisfaction, and personal growth, over and above several covariates. As a block, abstinence duration and recovery predictors accounted for significant incremental variance in all of the constructs. These data suggest ongoing recovery involvement in 12-step organizations may be associated with positive outcomes beyond abstinence. Limitations and directions for future research are discussed.

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