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PDF The Abstinence Violation Effect Following Smoking Lapses and Temptations Mary Hickcox

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. This reaction focuses on the drinker’s emotional response to an initial lapse and on the causes to which he or she attributes the lapse. People who attribute the lapse to their own personal failure are likely to experience guilt and negative emotions that can, in turn, lead to increased drinking as a further attempt to avoid or escape the feelings of guilt or failure. In contrast to the former group of people, the latter group realizes that one needs to “learn from one’s mistakes” and, thus, they may develop more effective ways to cope with similar trigger situations in the future.

In addition, many individuals in recovery consider a single slip as a full-blown relapse. Reframing use as something other than failure requires a change in perspective. Referring to use following a period of abstinence as a “lapse” rather than having “F-ed up” presents individuals with the opportunity to “act on” their use rather than “react to” it. In addition to reframing, it is also helpful to invite individuals to appreciate the temporal nature of such experiences. The severity of dependence seems a strong predictor of future relapse.

Global Lifestyle Self-Control Strategies

Proximal risks actualize, or complete, the distal predispositions and include transient lapse precipitants (e.g. stressful situations) and dynamic individual characteristics (e.g. negative affect, self-efficacy). Combinations of precipitating and predisposing risk factors are innumerable for any particular individual and may create a complex system in which the probability of relapse is greatly increased. Counteracting the drinker’s misperceptions about alcohol’s effects is an important part of relapse prevention. To accomplish this goal, the therapist first elicits the client’s positive expectations about alcohol’s effects using either standardized questionnaires or clinical interviews. Positive expectancies regarding alcohol’s effects often are based on myths or placebo effects of alcohol (i.e., effects that occur because the drinker expects them to, not because alcohol causes the appropriate physiological changes).

• Recontact contracts can also be useful where it is agreed in advance what the criterion will be for a time where a gambler should recontact the therapist.
• After the two stimuli have been paired repeatedly, the neutral stimulus becomes a conditioned stimulus that elicits the same physiological response.
• Therefore, one global self-management strategy involves encouraging clients to pursue again those previously satisfying, non-drinking recreational activities.
• Instead, if the individual had considered their behavior a simple lapse as opposed to a full-blown violation of abstinence, they may have been able to use the situation to learn from their mistakes and move on.

In contrast, several models of relapse that are based on social-cognitive or behavioral theories emphasize relapse as a transitional process, a series of events that unfold over time (Annis 1986; Litman et al. 1979; Marlatt and Gordon 1985). According to these models, the relapse process begins prior to the first posttreatment alcohol use and continues after the initial use. This conceptualization provides abstinence violation effect a broader conceptual framework for intervening in the relapse process to prevent or reduce relapse episodes and thereby improve treatment outcome. Teasdale and colleagues (1995) have proposed a model of depressive relapse which attempts to explain the process of relapse in depression and also the mechanisms by which cognitive therapy achieves its prophylactic effects in the treatment of depression.

Etiological Influences in Eating Disorders

These properties of the abstinence violation effect also apply to individuals who do not have a goal to abstain, but instead have a goal to restrict their use within certain self-determined limits. The limit violation effect describes what happens when these individuals fail to restrict their use within their predetermined limits and the subsequent effects of this failure. These individuals also experience negative emotions similar to those experienced by the abstinence violators and may also drink more to cope with these negative emotions. Cognitive dissonance also arises, and attributions are then made for the violation. In a similar fashion, the nature of these attributions determines whether the violation will lead to full-blown relapse.

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. This article presents one influential model of the antecedents of relapse and the treatment measures that can be taken to prevent or limit relapse after treatment completion. 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.

What is the Abstinence Violation Effect?

A specific process has been described regarding attributions that follow relapse after an extended period of abstinence or moderation. The abstinence violation effect can be defined as a tendency to continue to engage in a prohibited behavior following the violation of a personal goal to abstain. For example, an individual who has successfully abstained from alcohol, after having one beer, may drink an entire case of beer, thinking that since he or she has “fallen off the wagon,” he or she might as well go the whole way. When an abstinence violation occurs, the attributions an individual makes play an important part in determining the trajectory of subsequent use. When abstinence violation occurs, individuals typically enter a state of cognitive dissonance, defined as an aversive experience resulting from the discrepancy created by having two or more simultaneous and inconsistent cognitions.

Being able to understand how your thoughts, emotions, and behaviors play off of each other can help you to better control and respond to them in a positive way. Acknowledging your triggers and developing the appropriate coping skills should be a part of a solid relapse prevention program. Lastly, treatment staff should help you to learn how to recognize the signs of an impending lapse or relapse so that you can ask for help before it happens. The abstinence violation effect, described by the famous substance abuse researcher Alan Marlatt, occurs when someone who was made a commitment to abstinence suffers an initial lapse that they define as a violation of their abstinence. 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. More and more, behavioral health organizations are moving away from “kicking people out of treatment” if they return to substance use.

Marlatt and Gordon (1985) contend that individuals’ reactions to the initial slip and their attributions regarding the cause of the slip are the determining factors in the escalation of a lapse or setback into a full-blown relapse. The transition from slip or lapse to relapse involves the “abstinence violation https://ecosoberhouse.com/article/wet-mush-brain-from-alcoholism-symptoms-and-dangers/ effect,” which results from a state of cognitive dissonance regarding the nonabstinent behavior and the individual’s image of being abstinent. This dissonance can be reduced by either changing the behavior or changing the image, and characteristically in this population is resolved by the latter.

This response often creates a feeling of self-blame and loss of perceived control due to breaking a self-imposed rule regarding substance use. According to AVE research, those who do chose to respond to their behavior with blame and a sense of lost perceived control are more likely to relapse than those who respond by attributing lapse to preventable events and not feeling as though they failed completely. So long as an individual maintains a perceived sense of self-control, he/she has a better chance at evading further lapses. AVE has been studied and supported for the cessation of sex offenses, heroin, marijuana, and other illicit drug use. In order to understand AVE, it is important to realize the difference between a lapse and relapse. Again, many experts agree that a one-time lapse into using drugs or alcohol does not equally relapse.