Stressful Life Events and Relapse Among Formerly Alcohol Dependent Adults

Abstract

We examined associations between stressful life events and relapse among adults in the United States with at least 1 year of remission from DSM-IV alcohol dependence. The sample consisted of individuals in remission from alcohol dependence at the Wave 1 interview (2001–2002) for the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who also participated in a Wave 2 interview (2004–2005; N 1,707). Associations between stressful life events, demographic variables, = and the binary outcome of alcohol dependence relapse were examined with multiple logistic regression models. After adjustment for potential confounders, respondents who were divorced or separated in the year preceding the baseline assessment (Wave 1) were over two times more likely (OR = 2.32; CI = 1.01–5.34) to have relapsed 3 years later (Wave 2), compared to those not experiencing a divorce/separation in the 12 months prior to Wave 1. No other stressful life event was associated with relapse. Findings suggest that formerly alcohol dependent adults are at increased risk for relapse following divorce/separation. These results highlight the need for social work practitioners to consider the possibility of relapse following a divorce when one or both partners have a history of alcohol dependence.

Childhood Maltreatment, Stressful Life Events, and Alcohol Craving in Adult Drinkers

“…These included: (1) “Were you fired or laid off from a job?” (2) “Were you unemployed and looking for a job longer than a month?” (3) “Did you get separated, divorced, or break off a steady relationship?” (4) “Have you experienced major financial crisis, declared bankruptcy, or more than once been unable to pay bills on time?” (5) “Did you have serious trouble with the police or the law?” and (6) “Any family members or close friends died?” Recent NESARC studies of stressful life events and alcohol relapse used similar measures (Pilowsky et al, 2013). The six responses were combined into a categorical variable representing experience of none, one to two, or three or more stressful events, consistent with previous research in the NESARC (McLaughlin, 2010).…”

“…In recent years, alcohol craving has gained importance in alcohol research for several reasons, including the association between craving and poor course in both treated alcoholics (Breese et al, 2005, Fox et al, 2007, Sinha et al, 2009, Pilowsky et al, 2013, Higley et al, 2011) and in the general population (de Bruijn et al, 2005). Further, the inclusion of craving as a new criterion for Substance Use Disorders in the DSM-5 (American Psychiatric Association, 2013) has drawn interest to the need to gain a better understanding of craving (Agrawal et al, 2011).…”

“…Thus, understanding the factors underlying stress-induced craving outside of a clinical context may provide valuable insight for the development of public health prevention and treatment strategies. In the general population, stressful life events are associated with heavy alcohol consumption (San José et al, 2000, Dawson et al, 2005, Young-Wolff et al, 2012) and with relapse among formerly alcohol dependent adults (Pilowsky et al, 2013). However, whether stressful life events similarly increase the risk for alcohol craving in the general population remains unclear.…”

The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings

“…Relapse. Among those with Wave 1 remission from past alcohol dependence, factors predicting Wave 2 relapse were any Wave 1 drinking, (in older respondents), younger age, regardless of drinking [265], and recent divorce/marital separation [266]. Incidence.…”

Teoría de situación específica de autotrascendencia en personas dependientes del alcohol en proceso de recuperación

“…Diferentes estudios señalan que los eventos estresantes pueden convertir a una persona vulnerable en dependencia del alcohol (18,19). El experimentar eventos estresantes genera un grado de reacción que puede afectar el bienestar y salud de las personas (20,5); además, existe evidencia que señala que un número elevado de eventos estresantes podrían ser un factor relacionado a la dependencia del alcohol (5,21). Otro aspecto documentado es que los eventos estresantes se pueden relacionar con la espiritualidad ya que se ha identificado que situaciones como traumas y enfermedad psiquiátrica, o la pérdida de un ser querido, se pueden afrontar mediante la espiritualidad (22)(23)(24).…”