Predicting proximal factors in cocaine relapse and near miss episodes: clinical and theoretical implications

FRANÇAIS :
Cette étude évalue les facteurs de vulnérabilité et les facteurs proximaux de rechute après un traitement de l'abus de cocaïne pendant une année, ainsi que les cas où "il s'en faut de peu". Il y a peu de coïncidence avec les évènements qui se sont déroulés la semaine avant la rechute. Les facteurs de vulnérabilité sont associés à la gravité des problèmes familiaux et à l'humeur au cours des périodes d'abstinence. Il manque à cette étude une évaluation précise du suivi thérapeutique des patients et une comparaison entre un suivi classique et une stratégie préventive de la rechute.
ENGLISH :
This study examined the degree of correspondence between relapse vulnerability factors assessed at intake to aftercare in 100 cocaine dependent patients and proximal factors in their first cocaine relapse and near miss episodes during a 1-year follow-up. Proximal factors in relapse and near miss episodes were also compared. Correspondence between experiences associated with prior use and experiences in the week prior to relapse and near miss episodes was generally poor. Psychiatric and family/social problem severity and coping factors at intake to aftercare predicted experiences in the week prior to near misses, and to a lesser degree, experiences in the week prior to relapse episodes. However, relapse vulnerability factors were also associated with psychiatric and family/social problem severity and mood during abstinent periods. Therefore, there was little evidence of specificity in relationships between relapse vulnerability factors and experiences prior to relapse. Proximal measures of coping, sensation seeking, positive experiences, and unpleasant affect differentiated relapses from near misses in a within-subjects analysis. (Author' s abstract)