Much work is now being carried out in the field of relapse prevention from a cognitive and behavioral approach. Smoking cessation studies have shown that self-efficacy ratings made near the time of cessation predicted outcome. These ratings predicted both the occurrence of relapse and the situations associated with it. In the field of alcoholism, Litman and coworkers have provided valuable insight into the role of high-risk situations as a discriminator between alcoholics who relapse and alcoholics who do not. In a similar context Annis and her colleagues have been able to correlate posttreatment self-efficacy with both relapse occurrence and relapse situations. Thus, studies indicate that patients who have low levels of self-confidence in dealing with relapse situations are more likely to relapse. This relapse is also more likely to occur in the situations in which confidence is the lowest. Thus, posttreatment self-efficacy ratings would appear to be extremely useful in treatment planning. However, before specific therapeutic interventions can be instituted, more information should be obtained about the process of relapse. The goal of this study is to learn more about relapse, and the specific aims are to investigate whether: 1) drug abuse and antisocial personality increase the risk of relapse, 2) past behavior in risk situations and low posttreatment self-efficacy predict the risk of relapse, and 3) relapse categorization is sable. We plan to intensively study 150, treated, male alcoholics over a 6 month period of time. We shall use survival analysis to study the relationship between drug abuse and antisocial personality and the risk of relapse, and to study the relationship between both prior behavior in risk situations and posttreatment self-efficacy and the risk of relapse. We shall use Marlatt's relapse categorization to classify each relapse according to the situations associated with it. Information from this study will add to the knowledge of the relapse process, and give therapists more information about who is most vulnerable to early relapse and about what their vulnerabilities are.
