The abstinence violation effect in child molesters

Abstract

The Relapse Prevention (RP) approach to the treatment of addictive disorders (Marlatt & Gordon, 1985) and the model of the relapse process underlying it, is described and critically analysed. Its application to the treatment of sex offenders is described and a key RP construct, the abstinence violation effect, is critically examined. A reformulation of the abstinence violation effect is presented together with a discussion of the empirical support for this construct. Classification issues are also reviewed. Twenty-six incarcerated male child molesters were assessed, using the Differential Emotions Scale (Izard, Doughty, Bloxom, & Kotsch, 1974) and the Four Attributional Dimension Scale (Benson, 1989), at three points (background, lapse, and relapse) while they listened to an audiotaped recording of a description of their most typical offence chain. Subjects were also classified as either fixated or regressed according to age of onset of their offending, quality of the relationship with the victim, lifestyle issues, stress, and drug use. Eighteen subjects experienced an AVE at the point of relapse and seven as the result of a lapse. There were significant increases in most negative emotions and decreases in interest over the relapse chain. There were significantly higher disgust, contempt, hostility, fear, shame, shyness and anger scores reported by those showing an AVE. Conversely the AVE group showed significantly lower scores for joy and surprise. There were no significant differences on any of the four attributional dimensions across the relapse process but those showing an AVE reported significantly more uncontrollability and higher stability scores. The results also indicated that there appear to be different types of AVE that, in conjunction with the generally high levels of positive emotion at the lapse point, reflects the important role of emotion in the relapse process. Concerning classification, there were no differences in the frequency with which fixated or regressed offenders experienced an AVE, although five out of the seven experiencing this reaction at the point of lapsing were regressed subjects, as were twelve out of eighteen at relapse. Fixated subjects reported more positive emotions and less negative emotions than regressed offenders. In addition fixated subjects perceived the cause of their offending as more stable than regressed offenders. For subjects experiencing the AVE at relapse, those classified as fixated saw the cause of the relapse as more stable than did regressed subjects. The significance of these results for Pithers (1990) RP model, clinical practice and research, is discussed, along with limitations of the study.