Principal Investigator: William R. Miller, Ph.D.
Co: Investigators: J. Scott Tonigan, Ph.D., Verner S. Westerberg, Ph.D.
Funding Agency: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Why do clients relapse? Is it possible to see it coming? That was a central question in this study in which we followed a sample of 122 people entering treatment for alcohol problems, with interviews every two months for one year. This study was part of a multisite replication and extension of Marlatt?s model of relapse (Lowman, Allen & Miller 1996). We found that the level of stressful/risk situations to which clients were exposed did not predict whether or not they would relapse. However, their style of coping with such situations did predict outcomes. As others have found, avoidant coping patterns were associated with relapse. Once coping skills had been taken into account, cognitive factors (self-efficacy, alcohol expectancies), craving, and mood states did not add unique variance in predicting an upcoming relapse. The client?s degree of endorsement of a traditional disease model of alcoholism did add unique variance: The more the clients reported believing in the traditional disease model, the more likely they were to relapse at each follow-up point (Miller, Westerberg, Harris & Tonigan, 1996).
One byproduct of this study was the development of a scale to model Gorski?s progressive steps toward relapse. This novel scale performed surprisingly well in predicting impending relapse (Miller & Harris, 2000). We also developed a structured interview for reconstructing the events of a relapse (Miller & Marlatt, 1996). We further explored the complexity of defining and modeling ?relapse? when multiple drugs are taken into account (Westerberg, Miller, Harris & Tonigan, 1998). The experience of this study also raised serious questions as to whether use of the concept of ?relapse? is really a service to our clients, or accurately captures the normal course of recovery (Miller, 1996).
References:
Co: Investigators: J. Scott Tonigan, Ph.D., Verner S. Westerberg, Ph.D.
Funding Agency: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Why do clients relapse? Is it possible to see it coming? That was a central question in this study in which we followed a sample of 122 people entering treatment for alcohol problems, with interviews every two months for one year. This study was part of a multisite replication and extension of Marlatt?s model of relapse (Lowman, Allen & Miller 1996). We found that the level of stressful/risk situations to which clients were exposed did not predict whether or not they would relapse. However, their style of coping with such situations did predict outcomes. As others have found, avoidant coping patterns were associated with relapse. Once coping skills had been taken into account, cognitive factors (self-efficacy, alcohol expectancies), craving, and mood states did not add unique variance in predicting an upcoming relapse. The client?s degree of endorsement of a traditional disease model of alcoholism did add unique variance: The more the clients reported believing in the traditional disease model, the more likely they were to relapse at each follow-up point (Miller, Westerberg, Harris & Tonigan, 1996).
One byproduct of this study was the development of a scale to model Gorski?s progressive steps toward relapse. This novel scale performed surprisingly well in predicting impending relapse (Miller & Harris, 2000). We also developed a structured interview for reconstructing the events of a relapse (Miller & Marlatt, 1996). We further explored the complexity of defining and modeling ?relapse? when multiple drugs are taken into account (Westerberg, Miller, Harris & Tonigan, 1998). The experience of this study also raised serious questions as to whether use of the concept of ?relapse? is really a service to our clients, or accurately captures the normal course of recovery (Miller, 1996).
References:
- Lowman, C., Allen, J., & Miller, W. R. (Eds.) (1996). Perspectives on precipitants of relapse. Monograph supplement to Addiction, Volume 91.
- Lowman, C., Allen, J., Stout, R. L., & the Relapse Research Group (1996). Replication and extension of Marlatt?s taxonomy of relapse precipitants: Overview of procedures and results. Addiction, 91 (Supplement), S51-S71.
- Marlatt, G. A., Stout, R. L., Zywiak, W. H., & the Relapse Research Group (1996). Marlatt?s taxonomy and scoring rules as recommended for use in the relapse replication and extension project. Addiction, 91, (Supplement), S241
- Miller, W. R. (1996). What is a relapse? Fifty ways to leave the wagon. Addiction, 91 (Supplement), S15-S27.
- Miller, W. R., & Harris, R. J. (2000). A simple scale of Gorski?s warning signs for relapse. Journal of Studies on Alcohol, 61, 759-765.
- Miller, W. R., & Marlatt, G. A. (1996). Relapse Interview. Addiction, 91 (Supplement), S231
- Miller, W. R., Westerberg, V. S., Harris, R. J., & Tonigan, J. S. (1996). What predicts relapse? Prospective testing of antecedent models. Addiction, 91 (Supplement), S155.
- Westerberg, V. S., Miller, W. R., Harris, R. J., & Tonigan, J. S. (1998). The topography of relapse in clinical samples. Addictive Behaviors, 23, 325-337.
