High-Risk Situations

Linear Model

The linear model of relapse posits that following exposure to a high-risk situation, outcomes will progress in one of two linear frames. In the first instance, an effective coping response is elicited following a high-risk situation. As the response is effective, the individual will experience increased self-efficacy and therefore, a decreased probability of relapse. In the second occurrence, the high-risk situation fails to elicit an effective coping response, leading to decreased self-efficacy combined with positive outcome expectancies (or the belief that using will be reinforcing). This combination may lead to a lapse, or initial use of the substance, resulting in experiencing the effects of the substance. Depending on the individual's cognitions related to the lapse, two additional outcomes are possible. If the individual views the lapse as an unfortunate occurrence or as a learning opportunity, he or she [Page 463]may resume the prelapse goal of abstinence or moderation. Conversely, relapse or increased usage may follow if the individual experiences an abstinence violation effect (AVE). Common components of AVE include a feeling of loss of control over the ability to abstain from use and internal, stable, global attributions of the lapse.

A taxonomy of high-risk situations was developed to identify the precipitating events in relapse and is subdivided into eight categories: coping with negative emotional states, coping with negative physical-psychological states, enhancement of positive emotional states, testing personal control, giving in to temptations and urges, coping with interpersonal conflict, social pressure, and enhancement of positive emotional states. Each of the categories is briefly discussed.