Abstinence Violation Effect: what it is and how it is expressed.

This psychological phenomenon is related to alcohol addiction and the end of abstinence.

Marlatt and Gordon's relapse prevention program is aimed at treating alcohol addiction. It discusses the Abstinence Violation Effect.which involves relapse into addictive behavior within a detoxification or detoxification treatment.

Relapses have an important influence on the evolution of a person who is in the process of recovery. In this article we will see what the Abstinence Violation Effect consists of; we will know how it appears and the repercussions it entails for the person with an addictive disorder.

Relapse Prevention Program

The Relapse Prevention Program by Marlatt and Gordon (1985) is aimed at people with a substance-related addictive disorder. Specifically, it is usually used in patients with alcohol addiction.

The program, as its name suggests, is aimed at preventing relapses inherent to each addictive disorder. Marlatt and Gordon argue that three cognitive factors interact in the relapse process:

• Self-efficacy: perceived ability to cope with situations.
• Expectations of the results of the consuming behavior.
• Attributions of causality.

The Relapse Prevention Program speaks of the Abstinence Violation Effect (AVE) as the appearance of a new addictive behavior on the part of the patient (i.e., that the patient returns to drinking, relapses); it is therefore an emotional and cognitive consequence of the relapse. emotional and cognitive consequence that arises in the addicted patient after a period of abstinence and commitment to treatment. and commitment to treatment.

Abstinence Violation Effect: characteristics

Now that we have seen a little bit of what the Abstinence Violation Effect consists of, let's get to know its characteristics in more detail.

The Abstinence Violation Effect involves a loss of control in the drinker, which leads the subject to a new relapse.. This effect produces in the person a negative emotional state of guilt and internal conflict between the incompatibility of the addictive behavior performed and his/her desire for abstinence.

The Abstinence Violation Effect is a thought pattern that appears after the a pattern of thought that appears after drug use.. It is often used in cases of alcoholism.

There are authors who argue that this effect appears as a result of the intense desire to drink, which appears after taking the first drink; this desire leads to a series of physiological manifestations in the organism.

For their part, Marlatt and Gordon believe that it is due more to a belief or the existence of expectations of the "self-fulfilling prophecy" type, rather than to underlying physiological mechanisms.

Components of the VAS

The Abstinence Violation Effect is made up of two cognitive-affective elementsand appears as a function of both of them. Moreover, these components are what will trigger the aforementioned unpleasant emotional state associated with the VAS. These components are:

1. A cognitive dissonance effect 2.

Cognitive dissonance occurs because the addictive behavior of "drinking again" does not fit with the self-image of the addicted person. does not fit with the person's desired self-image of abstinence..

There is then this dissonance or "incompatibility" for the patient between what he/she wants (drinking) and what he/she knows is "right" or what he/she wants in the long term (not to drink and remain abstinent).

2. A personal attribution effect

On the other hand, once the drinking behavior has been carried out, the patient makes an internal attribution, the patient makes an internal, stable and global attribution of the addictive behavior (e.g., thinking that one has (for example: thinking that one has consumed because one is a disaster and that one will not be able to recover from one's addiction).

In other words, the subject attributes the occurrence of his relapse behavior to stable, global and internal factors, and this decreases his resistance to future temptations (and therefore makes it more likely that he will relapse in the future, thus creating a kind of "vicious circle").

What factors influence relapse?

But what factors influence a person's return to drug use and therefore relapse?

On the one hand, the fact that the person is exposed to a situation considered high-risk without having previously detected it, in addition to the fact that he/she does not have sufficient without having previously detected it, added to the fact that he/she does not have sufficient coping skills to know how to expose him/herself to such a risk situation and/or high levels of emotionality (pleasant or unpleasant).

All these factors will hinder the person's reasoning and will lead to a loss of control (or self-control) in the person; finally, the person would develop the Abstinence Violation Effect, returning to drinking and therefore relapsing.

In other words, it could be said that relapsing makes relapse more likely in the future. In other words, the Abstinence Violation Effect translates into a situation of high risk for relapse (non-drinking or occasional drinking).

The role of relapse

The fact that a consumption occurs again, punctual and concrete, would imply relapse. Throughout detoxification treatment, it is preferable that relapses do not occur. However, the fact that they do occur does not necessarily prevent the continuation of treatment and the eventual abstinence and that abstinence and recovery are eventually achieved.

As we have seen in the Abstinence Violation Effect, when relapses appear during treatment, a series of emotional and cognitive changes also occur in the person, which will affect his or her state and evolution within treatment.

Treatment of VAS

Within a broader psychological and behavioral treatment, one of the possible techniques to be used to reduce the probability of occurrence of the Abstinence Violation Effect, consists in training in different cognitive strategies.

Such strategies include cognitive restructuring, focused on modifying errors associated with the abstinence-violation effect or seemingly irrelevant decisions.

Bibliographical references:

• Echeburúa, E. (1999). Addictions without drugs: the new addictions: gambling, sex, food, shopping, work, Internet. Desclée de Brouwer.
• Pereiro, C. (2007). Relapse prevention and other psychotherapeutic or psychosocial approaches in the management of alcoholism. Guía Clínica Alcohol basada en la Evidencia.
• Pérez, M.; Fernández, J.R.; Fernández, C. and Amigo, I. (2010). Guide to effective psychological treatments I: Adults. Madrid: Pirámide.