Relapse prevention for alcohol and drug problems: that was Zen, this is Tao

Relapse prevention, based on the cognitive-behavioral model of relapse, has become an adjunct to the treatment of numerous psychological problems, including (but not limited to) substance abuse, depression, sexual offending, and schizophrenia. This article provides an overview of the efficacy and effectiveness of relapse prevention in the treatment of addictive disorders, an update on recent empirical support for the elements of the cognitive-behavioral model of relapse, and a review of the criticisms of relapse prevention. In response to the criticisms, a reconceptualized cognitive-behavioral model of relapse that focuses on the dynamic interactions between multiple risk factors and situational determinants is proposed. Empirical support for this reconceptualization of relapse, the future of relapse prevention, and the limitations of the new model are discussed.     

Effects of alcohol intoxication on metamemory and on retrieval from long-term memory

In a balanced-placebo design, people expected either an alcohol drink or placebo drink and consumed either alcohol (1 ml/kg) or placebo. Shortly thereafter, each person attempted to recall the answers to general-information questions (e.g., "What is the capital of Chile?"), made confidence judgments about the accuracy of recall, made feeling-of-knowing judgments on all nonrecalled items, and received a recognition test. Unanticipated outcomes included: Alcohol intoxication significantly hindered recall from long-term memory, contrary to previous conclusions that alcohol does not affect retrieval; people's expectancy of alcohol had no significant effect on memory or metamemory performance, contrary to its established effects on other kinds of performance; and alcohol intoxication produced no significant overconfidence in judgments about recall or in feeling-of-knowing judgments, contrary to the overconfidence produced in other kinds of judgments such as an intoxicated person's assessment of his driving ability. This last outcome implies that alcohol intoxication does not produce a general lowering of the threshold for confidence but rather has effects that are situation specific.     

Preventing substance abuse in American Indian and Alaska native youth: promising strategies for healthier communities

Substance abuse has had profoundly devastating effects on the health and well-being of American Indians and Alaska Natives. A wide variety of intervention methods has been used to prevent or stem the development of alcohol and drug problems in Indian youth, but there is little empirical research evaluating these efforts. This article is an overview of the published literature on substance use prevention among Indian adolescents, providing background epidemiological information, a review of programs developed specifically for Indian adolescents, and recommendations for the most promising prevention strategies currently in practice.