What Is The Abstinence Violation Effect AVE?

Theoretical constructs such as self-efficacy, appraisal, outcome expectancies related to addictions arising out these models have impacted treatment models considerably. 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, abstinence violation effect 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.

Does 12-Step Contribute to the AVE?

By providing comprehensive care, our treatment programs create a supportive environment in which our clients can build a solid foundation for lasting sobriety. Fortunately, professional treatment for addiction can improve outcomes for people experiencing the Abstinence Violation Effect. Some examples of proven coping skills include practicing mindfulness, engaging in exercise, or pursuing activities that bring you fulfillment. Counteracting the effects of the AVE is necessary to support long-term recovery from addiction. As a result, the AVE can trigger a cycle of further relapse and continued substance use, since people may turn to substances as a way to cope with the emotional distress.

• Therefore, many of the techniques discussed under relapse prevention that aim at modification of dysfunctional beliefs related to outcomes of substance use, coping or self-efficacy are relevant and overlapping.
• Implicit measures of alcohol-related cognitions can discriminate among light and heavy drinkers [58] and predict drinking above and beyond explicit measures [59].
• Although there may be practical reasons for your client to choose abstinence as a goal (e.g., being on probation), it is inaccurate to characterize abstinence-based recovery as the only path to wellness.
• As the foregoing review suggests, validation of the reformulated RP model will likely progress slowly at first because researchers are only beginning to evaluate dynamic relapse processes.
• Cognitive restructuring techniques are employed to modifying beliefs related to perceived self-efficacy and substance related outcome expectancies (“such as drinking makes me more assertive”, “there is no point in trying to be abstinent I can’t do it”).
• The dynamic model of relapse assumes that relapse can take the form of sudden and unexpected returns to the target behavior.

Understand The Relapse Process

Findings indicated nonlinear relationships between SE and urges, such that momentary SE decreased linearly as urges increased but dropped abruptly as urges peaked. Moreover, this finding appeared attributable to individual differences in baseline (tonic) levels of SE. When urge and negative affect were low, individuals with low, intermediate or high baseline SE were similar in their momentary SE ratings. However, these groups’ momentary ratings diverged significantly at high levels of urges and negative affect, such that those with low baseline SE had large drops in momentary SE in the face of increasingly challenging situations. These findings support that higher distal risk can result in bifurcations (divergent patterns) of behavior as the level of proximal risk factors increase, consistent with predictions from nonlinear dynamic systems theory [31].

Mindfulness-based relapse prevention

• Alan Marlatt is a professor of Psychology and Director of the Addictive Behaviors Research Center at the University of Washington.
• Altogether, these thoughts and attributions are frequently driven by strong feelings of personal failure, defeat, and shame.
• Rather than being viewed as a state or endpoint signaling treatment failure, relapse is considered a fluctuating process that begins prior to and extends beyond the return to the target behavior [8,24].
• Rajiv’s unsuccessful attempts at abstinence lead to a low sense of self-confidence and a belief that he would not be able help himself (low perceived self- efficacy) setting up a vicious cycle.
• Self-efficacy (SE), the perceived ability to enact a given behavior in a specified context [26], is a principal determinant of health behavior according to social-cognitive theories.

These patterns of thinking are extremely common, and they keep us working against ourselves. The need to be a perfect version of ourselves once we hit the “reset” button is a toxic and falsely hopeful outlook on life. We celebrate each other going on ridiculous and unsustainable diets at the beginning of the year, yet think nothing of it in February when any and all signs of healthy eating are gone. Instead of seeking the glamor that comes with full, abrupt transformations of ourselves, we should champion the achievement of smaller goals that it takes to actually sustain a healthy lifestyle. For instance, a person recovering from alcohol use disorder who has a drink may feel a sense of confusion or a lack of control and they may make unhealthy attributions or rationalizations to try to define and understand what they’re doing. Considering the numerous developments related to RP over the last decade, empirical and clinical extensions of the RP model will undoubtedly continue to evolve.

Genetic influences on treatment response and relapse

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What Can Clinicians Do To Counteract the AVE?

• Such findings have contributed to renewed interest in negative reinforcement models of drug use [63].
• By reframing lapses as learning opportunities and teachable moments, cultivating self-compassion, and seeking support, individuals can navigate these challenges more effectively, increasing their chances of leading a healthier lifestyle.