A person's likelihood of relapsing will change depending on their expected outcome of engaging in the addictive behavior. A person who only focuses on the positive effects of a behavior and discounts the negative effects is more likely to relapse, especially in high risk situations where the behavior may be perceived to help the individual cope with negative emotions. 

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The four immediate determinants of relapse are:

- High risk situations
- Coping skills
- Outcome expectancy
- Abstinence Violation Effect

Immediate Determinants of Relapse

Although an individual will start to experience greater self-efficacy as they abstain from using a substance, certain high-risk situations will pose a threat to the person's sense of control, which may lead them to relapse. Some characteristics of high-risk situations are:

- Negative emotional states
- Interpersonal conflict, which can lead to negative emotions
- Social pressure, both direct and indirect (for example, being around other people who are consuming alcohol)
- Positive emotional states
- Exposure to alcohol-related stimuli (for example, seeing an ad for alcohol)
- Attempts to test one's personal control/willpower

High Risk Situations and Relapse

Larimer, M.E., Palmer, R.S., & Marlatt, G.A. (1999). Relapse prevention: An overview of Marlatt's cognitive behavioral model. Alcohol Research & Health, 23(2), 151-160. 

Relapse Prevention:  An Overview of Marlatt's Cognitive Behavioral Model

Ultimately, it is the individual's response to the high risk situation that affects whether or not they will relapse. For example, a person who uses effective coping skills, such as leaving the situation or positive self talk, is less likely to relapse than someone who does not use effective coping skills. A person who has coped successfully with a high-risk situation will experience a greater sense of self-efficacy, thereby decreasing their chance of relapse in the future.

Coping Skills and Relapse

Outcome Expectancies and Relapse

The abstinence violation effect states that it is a person's emotional response to a single lapse in substance use which will determine whether or not they ultimately relapse. For example, someone who considers the lapse to be a personal failure is more likely to continue to engage in the addictive behavior to attempt to escape the feeling of failure, thereby leading to a full relapse. On the other hand, someone who considers the lapse to be an instance where they did not cope effectively is more likely to see the lapse as a single mistake they can learn from. 

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