Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Nov;77(6):849-858.
doi: 10.15288/jsad.2016.77.849.

Is the Construct of Relapse Heuristic, and Does It Advance Alcohol Use Disorder Clinical Practice?

Stephen A Maisto  1 , Katie Witkiewitz  2 , Dezarie Moskal  1 , Adam D Wilson  2
Affiliations

Is the Construct of Relapse Heuristic, and Does It Advance Alcohol Use Disorder Clinical Practice?

Stephen A Maisto et al. J Stud Alcohol Drugs. 2016 Nov.

Abstract

Objective: Alcohol use disorder (AUD) relapse is a construct that has been of major clinical and research interest but has been inconsistently defined. The purpose of this study was to review the definitions of AUD relapse that have been used in clinical research as a basis for drawing conclusions about its heuristic value.

Method: A systematic review of the literature was conducted on empirical studies that (a) were published in peer-reviewed journals, (b) were published between 2010 and 2015, (c) were written in English, and (d) provided a definition of alcohol relapse (or lapse) that was used in the study.

Results: The review yielded 139 individual studies that met inclusion criteria. The studies showed wide variability in how relapse was defined and interpreted in the literature, and there was little direct empirical or theoretical rationale provided for the definitions of relapse that were chosen. Furthermore, the concept of AUD relapse as a discrete state is not consistent with the empirical literature on the clinical course of alcohol consumption.

Conclusions: We conclude that the heuristic value of AUD relapse as currently studied is low. An alternative approach that embeds the construct in theory and data on the clinical course of alcohol consumption and aligns with current trends in healthcare would seem to have a better chance of improving AUD clinical decision-making and knowledge about AUD in general.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Flowchart of systematic search procedures for alcohol change points review. No alcohol change point includes articles in which an operationalization of any alcohol change point (i.e., response, remission, lapse/relapse, and recurrence) was absent from the article and/or was not used in the study.
See this image and copyright information in PMC

References

    1. Agosti V., Nunes E. V, O’Shea D. Do manualized psychosocial interventions help reduce relapse among alcohol-dependent adults treated with naltrexone or placebo? A meta-analysis. American Journal on Addictions. 2012;21:501–507. doi:10.1111/j.1521-0391.2012.00270.x. - PubMed
    1. American Medical Association. Hospitalization of patients with alcoholism. Journal of the American Medical Association. 1956;162:750–756.
    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: Author; 2013.
    1. Bach P., Vollstädt-Klein S., Kirsch M., Hoffmann S., Jorde A., Frank J., Kiefer F. Increased mesolimbic cue-reactivity in carriers of the mu-opioid-receptor gene OPRM1 A118G polymorphism predicts drinking outcome: A functional imaging study in alcohol dependent subjects. European Neuropsychopharmacology. 2015;25:1128–1135. doi:10.1016/j.euroneuro.2015.04.013. - PubMed
    1. Barkley R. A. The assessment of executive functioning using the Barkley Deficits in Executive Functioning Scales. In: Goldstein S., Naglieri J. A., editors. Handbook of executive functioning. New York, NY: Springer; 2014. pp. 245–263.

Publication types