Emphasizing interpersonal factors: an extension of the Witkiewitz and Marlatt relapse model.

Aim Recently, Witkiewitz & Marlatt reformulated the Marlatt & Gordon relapse model to account for current research findings. The present paper aims to extend this model further to incorporate social variables more fully. Methods The social-factors and alcohol-relapse literatures were reviewed within the framework of the reformulated relapse model. Results The literature review found that the number of social network members, investment of the individual in the social network, levels of general and alcohol-specific support available within the social network and specific behaviors of network members all predict drinking outcomes. However, little is known about the mechanisms by which these social variables influence outcomes. The authors postulate that social variables influence outcomes by affecting intra-individual factors central to the reformulated relapse prevention model, including processes (e.g. self-efficacy, outcome expectancies, craving, motivation, negative affective states) and behaviors (e.g. coping and substance use). The authors suggest specific hypotheses and discuss methods that can be used to study the impact of social factors on the intra-individual phenomena that contribute to relapse. Conclusion The proposed extension of the relapse model provides testable hypotheses that may guide future alcohol-relapse research.