The abstinence violation effect: investigating lapse and relapse phenomena using the relapse prevention model with domestically violent men Document Gale Academic OneFile

The closest example of an offence process model in the extant literature is the often-cited study by Lenore Walker (1979). Walker described the “cycle of violence” theory, outlining three phases in a process of offending by men who battered their partners. These phases were (a) tension the abstinence violation effect refers to building, (b) the battering episode and (c) contrition and affectionate behaviour. However, Walker derived this model from interviews with victims, so that significant processes internal to offenders, such as the psychological events that initiate an assault, are absent from the model.

  • Serotonin plays an important role in postingestive satiety, and appears to be important in regulation of mood and anxiety-related symptoms.
  • (b) Restrained eaters whose diets were broken by a milkshake preload showed increased activity in the nucleus accumbens (NAcc) compared to restrained eaters who did not consume the preload and satiated non-dieters [64].
  • The desire for immediate gratification can take many forms, and some people may experience it as a craving or urge to use alcohol.
  • Be that as it may, a perennial threat to recovering, especially if abstinence is perceived as the prerequisite of changing one’s substance using behavior, is to use, even once.

People with effective coping responses have confidence that they can cope with the situation (i.e., increased self-efficacy), thereby reducing the probability of a relapse. Conversely, people with ineffective coping responses will experience decreased self-efficacy, which, together with the expectation that alcohol use will have a positive effect (i.e., positive outcome expectancies), can result in an initial lapse. This lapse, in turn, can result in feelings of guilt and failure (i.e., an abstinence violation effect). The abstinence violation effect, along with positive outcome expectancies, can increase the probability of a relapse. Marlatt and Gordon (1980, 1985) have described a type of reaction by the drinker to a lapse called the abstinence violation effect, which may influence whether a lapse leads to relapse.

11.4.2 Cognitive Behavioral Models

Those measures do not necessarily indicate, however, whether a client is actually able or willing to use his or her coping skills in a high-risk situation. To increase the likelihood that a client can and will utilize his or her skills when the need arises, the therapist can use approaches such as role plays and the development and modeling of specific coping plans for managing potential high-risk situations. There are many relapse prevention models used in substance abuse treatment to counter AVE and give those in recovery important tools and coping skills. The abstinence violation effect (AVE) refers to the negative cognitive and affective responses that an individual experiences after the return to substance abuse after a period of abstinence. These responses, both physical and psychological, can be very difficult to deal with.

This taxonomy includes both immediate relapse determinants and covert antecedents, which indirectly increase a person’s vulnerability to relapse. Based on the classification of relapse determinants and high-risk situations proposed in the RP model, numerous treatment components have been developed that are aimed at helping the recovering alcoholic cope with high-risk situations. The results of recent research, particularly the RREP study, likely will lead to modifications of the original RP model, particularly with regard to the assessment of high-risk situations as well as the conceptualization of covert and immediate antecedents of relapse.

The Big Book, the Twelve Steps, and the Twelve Traditions

This collaborative research project evaluated the reliability of raters’ categorizations of high-risk situations using Marlatt’s taxonomy and assessed whether a prior situation could predict future lapse episodes. Twelve-step can certainly contribute to extreme and negative reactions to drug or alcohol use. This does not mean that 12-step is an ineffective or counterproductive source of recovery support, but that clinicians should be aware that 12-step participation may make a client’s AVE more pronounced. His issue with drinking led to a number of personal problems, including the loss of his job, tension in his relationship with his wife (and they have separated), and legal problems stemming from a number of drinking and driving violations. He lost his license due to drinking and driving, and as a condition of his probation, he was required to attend Alcoholics Anonymous meetings. In order to cope or avoid these damaging thoughts, these individuals turn back to drugs or alcohol to numb the pain.

What are the two principles of the relapse prevention model?

Each principle is complemented with a procedure or clinical technique that can be used to operationalize that principle with patients: the first principle of self-regulation is operationalized with a procedure for physical, psychological, and social stabilization; the second principle of integration is operationalized …

This perceived violation results in the person making an internal explanation to explain why they drank (or used drugs) and then becoming more likely to continue drinking (or using drugs) in order to cope with their own guilt. While some assert that relapse occurs after the first sip of alcohol or use of another drug, certain scientists believe it is a process which more closely resembles a domino effect. Social-cognitive and behavioral theories believe relapse begins before the person actually returns to substance abuse. The onset of bulimia nervosa is often preceded by extended periods of recurrent dieting occurring in the context of other psychosocial stressors. Other behavioral characteristics that have been identified in patients with bulimia nervosa include impulsivity and mood lability, and it is possible that these traits may contribute to the onset or perpetuation of symptoms in this disorder. In one model, for example, an individual attempting to follow a reduced calorie diet may experience an abstinence violation effect following ingestion of modest amounts of snack foods, leading to a transient inclination to abandon dietary restraint altogether.

Office of Justice Programs

This relapse prevention (RP) model, which was developed by Marlatt and Gordon (1985) and which has been widely used in recent years, has been the focus of considerable research. This article reviews various immediate and covert triggers of relapse proposed by the RP model, as well as numerous specific and general intervention strategies that may help patients avoid and cope with relapse-inducing situations. The article also presents studies that have provided support for the validity of the RP model. While a person may physically abstain from using drugs or alcohol, their thoughts and emotions may have already returned to substance abuse. This model asserts that full-blown relapse is a transitional process based on a combination of factors. Questionnaires such as the situational confidence test (Annis 1982b) can assess the amount of self-efficacy a person has in coping with drinking-risk situations.

  • Abstinence violators realize that their actions (e.g. “I drank”) do not line up with their personal goal (e.g. “I want to abstain”) and feel compelled to resolve the discrepancy.
  • Relapse occurs when this behavior accelerates back into prolonged and compulsive patterns of drug abuse.
  • This preparation can empower a client to avoid relapse altogether or to lessen the impact of relapse if it occurs.
  • There are two major types of high-risk situations, those with intrapersonal determinants, in which the person’s response is physical or psychological in nature, and interpersonal determinants, those that are influenced by other individuals or social networks.

It includes thoughts and feelings like shame, guilt, anger, failure, depression, and recklessness as well as a return to addictive behaviors and drug use. AVE describes the negative, indulgent, or self-destructive feelings and behavior people often experience after lapsing during a period of abstinence. Thus, despite various definitional issues in the research, the above definitions will guide this article and discussing the issue of relapse. How one defines relapse may be an important influence on determining what happens when one suffers a lapse or slip. For instance, one interesting manifestation of a lapse is something termed the abstinence violation effect. Someone experiencing the abstinence violation effect will relapse, then struggle to get sober again because of how they perceive they are perceiving their relapse, and themselves.