The role of attributions in abstinence, lapse, and relapse following substance abuse treatment

This study examined the role of attributions in the lapse and relapse process following substance abuse treatment. According to Marlatt and Gordon's theoretical framework, attributions made after a lapse (e.g., the Abstinence Violation Effect [AVE]) determine whether it progresses to a relapse. Also examined were the attributions of recovering drug users who were tempted but remained abstinent (never lapsed). Ninety-seven participants were recruited from an inpatient treatment center for substance abuse and completed an interview 6 months after leaving treatment. Findings partially confirmed predictions made by the AVE. Predictions made by the AVE were not supported in that lapsers and relapsers were similar regarding their internal/external attributions following a return to drug use; predictions were supported as relapsers made more stable and global attributions as compared to lapsers. Also as predicted, abstainers made more internal, stable, and global attributions regarding their abstinence (as compared to lapsers following their slip). Abstainers' attributions for their success in remaining abstinent tended to be similar to the attributions made by relapsers for their failure to remain abstinent (i.e., for their relapse). Combined, these findings highlight the complexity of the attributional process in early recovery from substance abuse. Clinical and research implications of the findings are discussed in relation to substance abuse relapse prevention.