Understanding and Preventing Relapse

American Psychologist (Impact Factor: 6.87). 08/1986; 41(7):765-82. DOI: 10.1037/0003-066X.41.7.765
Source: PubMed


Examines relapse by integrating knowledge from the addictive disorders of alcoholism, smoking, and obesity. Commonalities across these areas suggest at least 3 basic stages of behavior change: motivation and commitment, initial change, and maintenance. A distinction is made between lapse and relapse, with lapse referring to the process (slips or mistakes) that may or may not lead to an outcome (relapse). The natural history of relapse is discussed, as are the consequences of relapse for patients and the professionals who treat them. Information on determinants and predictors of relapse is evaluated, with the emphasis on the interaction of individual, environmental, and physiological factors. Methods of preventing relapse are proposed and are targeted to the 3 stages of change. (156 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)

46 Reads
  • Source
    • "Finally, the effectiveness of AA depends upon cognitive, not just limbic/ spiritual techniques. In their reviews of the literature on remission from addiction to alcohol, tobacco, food, and opiates, Stall and Biernacki (1986) and Brownell, Marlatt, Lichtenstein, and Wilson (1986) identified four behavioral techniques that are conscious and can also lead to stable remission without recourse to AA's limbic language of the heart and the drinking bad coffee and sitting on hard rented church basement chairs that go with AA attendance. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Alcoholics Anonymous (AA) works because it discovered the use of positive emotions as a therapeutic tool 50 years before academic psychology discovered positive psychology. First, AA's emphasis on admitting dependence on and attachment to others, leads to the positive emotion of love and second, the recognition that to keep it you have to give it away, leading to the positive emotion of joy. The first three Steps of AA involve turning oneself over to a trusted other as long as it is not “me” (AA has always been clear that the definition of “God” was the alcoholic's choice) is to allow oneself to feel loved. The second component of AA is guiding new members toward joy via the last two Steps of AA. The 12th step, of course, is “As the result of these Steps: we tried to carry this message to alcoholics, and to practice these principles (positive emotions) in all our affairs.” Secure attachment (a.k.a. love), as extrapolated from brain-imaging studies of mother–child attachment, is like addiction associated with reduction in amygdala firing and increases in nucleus accumbens activity. Imaging researchers have found that the joy of giving to your favorite charity, like taking cocaine, stimulates the nucleus accumbens. In short, like methadone in opiate addiction, the positive emotions induced by AA provide a safe, nonpharmacological substitute for alcohol.
    Alcoholism Treatment Quarterly 06/2014; 32(2-3):214-224. DOI:10.1080/07347324.2014.907032
  • Source
    • "The frequency of past weightloss attempts, the magnitude of the largest past loss and age at that time, and the number of methods used across past attempts were assessed prior to treatment and were examined as potential predictors of treatment outcome and treatment duration, controlling for pretreatment BMI. This exploratory study examined whether (a) more frequent and/or larger past weight losses predict poorer weight-loss outcome in self-help treatment, consistent with previous findings from university-based treatments (Teixeira et al., 2005), or (b) more frequent and/or larger past weight losses predict superior weight-loss outcome in self-help treatment , consistent with relapse prevention theory (Brownell et al., 1986) and research on smoking cessation (Schroeder, 2005). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Weight-loss history was examined as a predictor of outcome in group self-help obesity treatment. Participants (n = 128; 83% women; mean body mass index = 34.2 kg/m(2); mean age = 47.2 years) in self-help, group behavioral weight-loss treatment reported a mean of 5.1 prior weight-loss attempts and lost 13.8 percent of initial weight in current treatment. A greater number of past attempts independently predicted greater 6-month, 18-month, and intent-to-treat weight losses. Greater magnitude of largest past loss predicted greater 18-month weight loss. In contrast to studies on professional treatment, group self-help participants might benefit from repeated weight-loss efforts despite previous failures.
    Journal of Health Psychology 01/2013; 19(2). DOI:10.1177/1359105312468191 · 1.88 Impact Factor
  • Source
    • "Preventing relapse is essential to the successful maintenance of recovery from addiction (Brownell et al., 1986). Relapse prevention strategies could benefit from a better understanding of the underlying processes and mechanisms of relapse, which animal models may facilitate (Conklin and Tiffany, 2002). "
    [Show abstract] [Hide abstract]
    ABSTRACT: A preclinical model that includes measures of alternative behavior and drug-seeking could improve our understanding of the processes involved in successful recovery; however current preclinical models of relapse do not measure alternative behavior. We assessed the persistence of food-maintained responding and the resumption of ethanol-maintained responding after ethanol-maintained responding was reduced by changing the response requirement for concurrently available food. Ethanol (10% w/v) was always available following 5 responses (FR5). A 16kHz tone indicating food delivery followed 150 responses (FR150) resulted in ethanol-predominate responding and substantial amounts of ethanol were earned (0.47g/kg per 30-min session) and consumed. An 8kHz tone indicating food delivery followed 5 responses (FR5) for 1, 2, 4, or 16 consecutive sessions reduced ethanol-maintained responding despite unchanged ethanol availability. Ethanol-maintained responding resumed upon subsequent presentation of the 16kHz tone. However, more responses occurred on the food lever before 5 responses occurred on the ethanol lever as the number of preceding FR5 food sessions increased. These results suggest that alternative reinforcement may reduce control by discriminative stimuli that occasion ethanol-seeking and is consistent with the risk of relapse declining with longer periods of recovery because of the strength of alternative behavior.
    Behavioural processes 12/2012; 94. DOI:10.1016/j.beproc.2012.12.004 · 1.57 Impact Factor
Show more


46 Reads
Available from