Relapses in Alcohol and Cocaine Dependence in Spousal Relationships: A Behavioral Assessment with Couple
DOI:
https://doi.org/10.14738/assrj.118.17361Keywords:
Alcohol dependence, Cocaine dependence, Relapse, contingency analysis, Spousal RelationshipAbstract
Contingency analysis is a central concept and method in behavior analysis for understanding how the environment influences human behavior. In the treatment of chemical dependency, this analysis makes it possible to examine the functional relationships between antecedent stimuli, behaviors, and consequences (antecedent-behavior-consequence model) in order to understand and modify behavior. Through contingency analysis, professionals can personalize and adapt interventions according to the individual needs of substance-dependence patients, making it a fundamental tool in the multidisciplinary approach to relapse prevention. The purpose of this article is to conduct analyses of contingencies described in reports of relapse episodes of psychoactive substance use by individuals diagnosed with alcohol dependence and cocaine dependence, formally married, throughout their spousal behavioral histories. Based on detailed and systematic information about more than one case in comparison, contingency analyses of relapse episodes were conducted. The study sample consisted of four heterosexual couples (total N = 8), with one individual in the couple diagnosed with alcohol or cocaine dependence. The selection was made through the Rehabilitation Program of a Military Police Hospital located in Vitória/ES, Brazil. The analyses revealed common contingencies, including social pressure (from the friends' group with their invitations), negative emotional states (elicited by plans gone wrong, adverse conditions), and physiological dependence (craving, withdrawal syndrome, tolerance, and salience of use). The specificity of the spousal relationship provided the nuance for these contingencies, emphasizing the importance of therapeutic interventions with couples to assist in preventing relapses, including stress management skills, craving coping, conflict resolution, frustration tolerance, and communication.
References
DiClemente C, Crisafulli MA. Relapse on the Road to Recovery: Learning the Lessons of Failure on the Way to Successful Behavior Change. Journal of health service psychology. 2022; 48:59-68. DOI: 10.1007/s42843-022-00058-5
Catania A. Aprendizagem: comportamento, linguagem e cognição. 1nd ed. Porto Alegre: Artmed; 1999. 467 p.
Skinner B. Science and human behavior. 1nd ed. Macmillan Pub Co.; 1953. 462 p.
Kessler, O. Practice, Intersubjectivity and the Problem of Contingency. In Hellmann, G, Steffek J editors. TheoryPraxis as a Perspective on International Politics, 1nd ed. Bristol: Bristol University Press; 2022. p. 166-181. DOI: 10.51952/9781529220490.ch010
Todorov J. Sobre uma definição de comportamento. Perspectivas em Análise do Comportamento. 2012; 3:32-37. DOI: 10.18761/perspectivas. v3i1.79
Skinner B. The behaviour of organisms: an experimental analysis. New York: Copley Publishing Group; 1991. 457 p.
Zilio D, Carrara K, Leite L. Pragmatic reductionism: On the relation between contingency and metacontingency. Behavior and Social Issues, 2022;31:71-105. DOI: 10.1007/s42822-022-00097-z
Harte C, Barnes-Holmes, D, Barnes-Holmes, Kissi A. The study of rule-governed behavior and derived stimulus relations: Bridging the gap. Perspectives on Behavior Science, 2020;43:361-385. DOI: 10.1007/s40614-020-00256-w
Pietras CJ. (2022). Rule-governed behavior and climate change: Why climate warnings fail to motivate sufficient action. Behavior and Social Issues. 2022; 31:373-417. DOI: 10.1007/s42822-022-00109-y
Hill DA, Mantzoros T, Taylor JC. Understanding motivating operations and the impact on the function of behavior. Intervention in School and Clinic. 2020; 56:119-122. DOI: 10.1177/1053451220914901
Laraway S, Snycerski, S, Michael J, Poling A. Motivating operations and terms to describe them: Some further refinements. Journal of Applied Behavior Analysis. 2003; 36:407-414. DOI: 10.1901/jaba.2003.36-
White W. Recovery/Remission from Substance Use Disorders: an analysis of reported outcomes in 415 scientific reports. 1nd ed. Chicago: Philadelphia Department of Behavioral Health and Intellectual disability Services and the Great Lakes Addiction Technology Transfer Center; 2012. 163 p.
da Silva, M. L., Guimarães, C. F., & Salles, D. B. (2014). Fatores de risco e proteção à recaída na percepção de usuários de substâncias psicoativas. Revista da Rede de Enfermagem do Nordeste, 15(6), 1007-1015.
Mendoza-Vasconez AS, Arredondo EM, Larsen B, Crespo N, Hurst S, Marcus, BH. Lapse, relapse, and recovery in physical activity interventions for Latinas: A survival analysis. International Journal of Behavioral Medicine. 2020; 15:1-12. DOI: 10.1111/nuf.12458
Borloti E, César B. Estratégias de prevenção de recaída no uso de drogas. In: Borloti E, Balbi R, Machado A, Andrade A, editors. Crack, álcool e outras drogas: estratégias de intervenção para a formação permanente. 1nd ed. www.crresces.com.br; 2015. p. 141-180. ISBN: 978-85-8087-146-3 62
Marlatt G, Donovan D. Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. 2nd ed. Guilford Press; 2011. 416 p. ISBN: 1593856410
Bandura A, Walters, R. Social learning theory. 1nd ed. Prentice-hall: New Jersey; 1977. 256 p.
Marlatt A, Gordon J. Determinants of Relapse: Implications for the maintenance of behavior change. In: Davidson P, Davidson D, organizers. Behavioral medicine: Changing health lifestyles. 1nd ed. Brunner/Mazel: New York; 1980. p. 410-452.
Mendes Carvalho F, Brusamarello T, Noeremberg Guimarães A, Paes M, Alves M. Causas de recaída e de busca por tratamento referidas por dependentes químicos em uma unidade de reabilitação. Colombia Médica. 2011; 42:57-72.
Gorski T, Miller M. (1982). Counseling for relapse prevention. 1nd ed. Independence Press. 1982. 143 p.
Guliyev C, Ince-Guliyev, Ögel K. Predictors of relapse to alcohol and substance use: are there any differences between 3 and 12 months after inpatient treatment? Journal of psychoactive drugs. 2022; 54:358-367. DOI: 10.1080/02791072.2021.1976887
Kumar R, Maheshwari SK. Relapse precipitants, life events & coping behaviors among substance users. Indian Journal of Psychiatric Nursing, 2016:12:14-18. DOI: 10.4103/2231-1505.132848
Patton, M. Q. (2014). Qualitative research & evaluation methods: Integrating theory and practice. 4nd ed. Sage publications. 2014. 832 p. ISBN: 9781412972123
Yin R. Estudo de Caso: Planejamento e Métodos. 5nd ed. Bookman editor; 2015. 320 p.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5nd ed. Washington, DC: American psychiatric association. 2013. 992 p.
Schütze, F. Biographieforschung und narratives Interview. Neue praxis, 1983;13:283-293.
Silva M, Guimarães C, Salles D. Fatores de risco e proteção à recaída na percepção de usuários de substâncias psicoativas. Revista Rene. 2014; 15:1007-1015. DOI: 10.15253/2175-6783.2014000600014
Cavalcante L, Falcão R, Lima H, Marinho A, Macedo J, Braga V. Social support net for chemically dependents: ecomap as instrumental in health assistance. Northeast Network Nursing Journal. 2012; 13:231. DOI: 10.15253/2175-6783.2012000200009
Borloti E, Haydu V, Machado A. Crack: Análise comportamental e exemplos das funções da dependência. Acta Comportamentalia: Revista Latina de Análisis de Comportamiento. 2015; 23:323-338.
Organização Mundial da Saúde. CID-10: Classificação Estatística Internacional de Doenças. 8nd ed. Edusp; 2008. 212 p.
Kumar H. Critical Drinking Habit and Its Implications for Alcoholics in the Family Premises: A Case Study of Punjab (India). Advances in Research. 2020; 21:47-59. DOI: 10.9734/air/2020/v21i1130269
Lee H, Williams RA. Effects of parental alcoholism, sense of belonging, and resilience on depressive symptoms: A path model. Substance use & misuse. 2013:48: 265-273. DOI: 10.3109/10826084.2012.754899
França F, de Farias Gomes J. " Se não aguentar, corra!": um estudo sobre a pedagogia do sofrimento em um curso policial militar. Revista brasileira de segurança pública. 2015; 9:803-818. DOI: 10.31060/rbsp. 2015.v9. n2.506 URL: http://dx.doi.org/10.14738/assrj.118.17361 63
Zilberman M, Blume S. Domestic violence, alcohol and substance abuse. Brazilian Journal of Psychiatry. 2005; 27:51-55. DOI: 10.1590/S1516-44462005000600004
Sontate KV, Rahim KM, Naina MI, Mohamed RMP, Shaikh MF, Kamal H, Kumar J. Alcohol, aggression, and violence: From public health to neuroscience. Frontiers in psychology. 2021; 12:699-726. DOI: 10.3389/fpsyg.2021.699726
Filizola C, Perón C, Nascimento M, Pavarini S, Petrilli Filho J. Compreendendo o alcoolismo na família. Escola Anna Nery. 2006; 10:660-670. DOI: 10.1590/S1414-81452006000400007
Chinnusamy M, Eugin, PR, Janakiraman S. A study on the effect of alcoholism on the family members of alcoholic patients. Journal of Health and Allied Sciences NU, 2021;11:066-072. DOI: 10.1055/s-0040-1722426
Ólafsdóttir J, Orjasniemi T, Hrafnsdóttir S. Psychosocial distress, physical illness, and social behaviour of close relatives to people with substance use disorders. Journal of Social Work Practice in the Addictions, 2020,20:136-154. DOI: 10.1080/1533256X.2020.1749363
Maciel L, Zerbetto S, Filizola C, Dupas G, Ferreira N. Consequências e dificuldades da dependência química no âmbito familiar: uma revisão de literatura. Revista de APS. 2013; 16:187-196. DOI: 10.13140/RG.2.1.2880.2322
Pakula B, Macdonald S, Stockwell, T, Sharma R. Simultaneous use of alcohol and cocaine: A qualitative investigation. Journal of Substance Use, 2009;14:101-112. DOI: 10.1080/14659890802624279
Pennings EJ, Leccese AP, Wolff FAD. Effects of concurrent use of alcohol and cocaine. Addiction, 2002;97:773-783.
Maisto S, O'Farrell, T, McKay, J, Connors G, Pelcovits, M. Alcoholic and spouse concordance on attributions about relapse to drinking. Journal of substance abuse treatment. 1988; 5:179-181.
Raj H, Ray R, Prakash B. Relapse precipitants in opiate addiction: Assessment in community treatment setting. Indian journal of psychiatry; 2000; 42:253-257.
Agrawal D, Lal A, Chandra R. (2009). Relapse precipitants in alcohol addiction. Journal of social science research. 2009; 1:80-83
de Lima CBV, Assunção AÁ, Santos JE, da Silva LAF, Ramos SA, de Paula LE. Binge Drinking Among Public Sector Food Service Workers in Brazil: Physical and Psychosocial Demands on Focus. Journal of Occupational and Environmental Medicine, 2021;63:801-806. DOI: 10.1097/JOM.0000000000002382
Zahradnik M, Stewart S. Anxiety disorders and substance use disorder comorbidity. In: Martin M, Murray B editors. Oxford handbook of anxiety and related disorders. 1nd ed online. Oxford Library of Psychology: Oxford; 2008. DOI: 10.1093/oxfordhb/9780195307030.013.0043
Moeini B, Hazavehei SMM, Faradmal J, Ahmadpanah M, Dashti S, Hashemian M, Shahrabadi R. The relationship between readiness for treatment of substance use and self-efficacy based on life skills. Journal of ethnicity in substance abuse. 2022:21:364-376. DOI: 10.1080/15332640.2020.1772930
Bresin K, Verona E. Craving and substance use: Examining psychophysiological and behavioral moderators. International journal of psychophysiology. 2021; 163:92-103. DOI: 10.1016/j.ijpsycho.2019.03.006
Fenlon T, Davey J, Mann K. National guidelines for police workplace alcohol policy. Commonwealth Department of Health and Family Services: Australia. 1997. 64
Oxley, N. Police officer stress [thesis] Capella Tower: Capella University. 2006.
Violanti J, Marshall J, Howe B. Stress, coping, and alcohol use: The police connection. Journal of Police Science & Administration. 1985.
Irizar P, Puddephatt JA, Gage SH, Fallon V, Goodwin. The prevalence of hazardous and harmful alcohol use across trauma-exposed occupations: A meta-analysis and meta-regression. Drug and alcohol dependence, 2021; 226, 108858. DOI: 10.1016/j.drugalcdep.2021.108858
Silva C, Serra A. Cognitive and Cognitive-Behavioral Therapy for substance abuse disorders. Brazilian Journal of Psychiatry. 2004; 26:33-39.
Lima D, Bandeira M, Oliveira MSD, Tostes. Social skills of family caregivers of psychiatric patients. Estudos de Psicologia (Campinas). 2014; 31:549-558. DOI: 10.1590/0103-166X2014000400009
Bortolon CB, Signor L, Moreira TDC, Figueiró LR, Benchaya MC, Machado, C. A, Barros HMT. Family functioning and health issues associated with codependency in families of drug users. Ciência & Saúde Coletiva. 2016; 21:101-107. DOI: 10.1590/1413-81232015211.20662014
Servicio Extremeño de Salud (2011). Protocolo de atención a familiares de abusadores o dependientes de drogas u otras conductas adictivas. Badajoz: Consejería de Sanidad y Dependencia.
Spagnol, S. C. B. (2018). Familiares de dependentes químicos na rede de atenção psicossocial: panorama atual e perfil do grupo (Master's thesis, Universidade Federal do Espírito Santo).
World Health Organization. Management of Substance Abuse Unit. (2014). Global status report on alcohol and health, 2014. World Health Organization.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Adriana Madeira Alvares da Silva, Elizeu Borloti, Jaqueline Vago Ferrari
This work is licensed under a Creative Commons Attribution 4.0 International License.
