Was können wir aus Langzeitstudien über Rückfall und Rückfallprophylaxe bei Drogen- und Alkoholabhängigen lernen?

  • G. E. Vaillant
Part of the Suchtproblematik book series (SUCHT)


Suchtkrankheiten und ihre Behandlung stellen eine beunruhigende Herausforderung an die moderne Gesellschaft dar. Trotz jahrzehntelanger Forschung scheint die Wirksamkeit von Maßnahmen zur Rückfallprävention umstritten. Ein Beispiel: Zur gleichen Zeit, als in einer großangelegten amerikanischen Studie versichert wurde, daß die öffentlich finanzierten Behandlungszentren für Alkoholabhängige immerhin bei 67% ihrer Patienten eine Besserung erzielen (Armor et al. 1978), resümierte ein anderer bekannter amerikanischer Experte in einem Editorial, es habe in der Rückfallprophylaxe in den letzten 25 Jahren keinerlei Fortschritte gegeben (Gordis 1976).


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Armor DJ, Polich JM, Stambul HB (1978) Alcoholism and treatment. John Wiley, New YorkGoogle Scholar
  2. Baekeland F, Lundwall L, Kissin B (1975) Methods for the treatment of chronic alcoholism: A critical appraisal. In: Gibbins RJ, Israel Y, Kalant H, Popham RE, Schmidt W, Smart RG (eds). Research advances in alcohol and drug problems, vol 2. John Wiley, New YorkGoogle Scholar
  3. Bandura A (1977) Self-efficacy: Toward a unifying theory of behavior change. Psychol Rev 84: 191–215PubMedCrossRefGoogle Scholar
  4. Brownell KD, Marlatt GA, Lichtenstein E, Wilson GT (1986) Understanding and preventing relapse. Am Psychol 41: 765–782PubMedCrossRefGoogle Scholar
  5. Chein I, Gerard DL, Lee RS, Resenfeld E (1964) The road to H. Basic Books, New YorkGoogle Scholar
  6. Costello RM (1975) Alcoholism treatment and evaluation. II. Collation of two year follow-up studies. Int J Addict 10: 857–867PubMedGoogle Scholar
  7. Dole VP, Nyswander M (1965) A medical treatment for diacetylmorphine (heroin) addiction. JAMA 193: 646–650PubMedCrossRefGoogle Scholar
  8. Duvall HJ, Locke BZ, Brill L (1963) Follow-up study of narcotic drug addicts five years after hospitalization. Public Health Rep 78: 185–193PubMedCrossRefGoogle Scholar
  9. Edwards G, Guthrie S (1966) A Comparison of in-patient and out-patient treatment of alcohol dependence. Lancet 1: 467–468PubMedCrossRefGoogle Scholar
  10. Frank JD (1961) Persuasion and healing: A comparative study of psychotherapy. John Hopkins, Baltimore (Dt. Ausgabe 1981: Klett Cotta, Stuttgart )Google Scholar
  11. Glueck S, Glueck E (1950) Unraveling juvenile delinquency. Commonwealth Fund, New YorkGoogle Scholar
  12. Goldberg S, Schuster CR (1966) Classic conditioning of the morphine withdrawal syndrome. Federation Proceedings 25: 261Google Scholar
  13. Gordis E (1976) Editorial: What is alcoholism research? Ann Intern Med 85: 821–823PubMedGoogle Scholar
  14. Gottheil E, Thornton CC, Skoloda TE, Alterman A (1982) Follow-up of abstinent and non-abstinent alcoholics. Am J Psychiatry 139: 560–565PubMedGoogle Scholar
  15. Heinberg H (ed) (1969) Scientific basis of drug dependence. Churchill, London, 344fGoogle Scholar
  16. Hodgson RT, Stockwell T, Rankin H, Edwards G (1978) Alcohol dependence: The concept, its utility and measurement. Br J Addict 73: 339–342CrossRefGoogle Scholar
  17. James W (1902) The varieties of religious experience. Longmans Green, LondonCrossRefGoogle Scholar
  18. 18.
    Jones KR, Vischi TR (1979) Impact of alcohol, drug abuse, and mental health on treatment of medical care utilization. Med Care [suppl] 17: 1–81Google Scholar
  19. Knupfer G (1972) Ex-problem drinkers. In: Roff M, Tobins L, Pollack M (eds) Life history research and psychopathology, vol 2. Univ of Minnesota Press, MinneapolisGoogle Scholar
  20. Lief A (ed) (1948) The commonsense psychiatry of Dr. Adolf Meyer. McGraw-Hill, New YorkGoogle Scholar
  21. Marlatt GA, Rohsenow DJ (1980) Cognitive processes in alcohol use: Expectancy and the balanced placebo design. In: Marlow NK (ed) Advances in substance abuse: Behavioral and biological research. JAI Press, GreenwichGoogle Scholar
  22. McLellan AT, Luborsky L, O’Brian CP, Woody GE, Druley KA (1982) Is treatment for substance abuse effective? JAMA 247: 1423–1428PubMedCrossRefGoogle Scholar
  23. McNamee HB, Mendelson JH, Mello NK (1968) Experimental analysis of drinking patterns of alcoholics: Concurrent psychiatric observations. Am J Psychiatry 124: 1063–1069Google Scholar
  24. Merry J (1966) The loss of control myth. Lancet 1: 1257–1258PubMedCrossRefGoogle Scholar
  25. Morse WH, Kelleher RT (1970) Schedules as fundamental determinants of behavior. In: Schoenfeld WN (ed) The theory of reinforcement schedules. Appleton Century Crofts, New YorkGoogle Scholar
  26. Mottin JL (1973) Drug induced attenuation of alcohol consumption. Q J Stud Alcohol 34: 444–472PubMedGoogle Scholar
  27. Orford J, Edwards G (1977) Alcoholism. Oxford Univ Press, OxfordGoogle Scholar
  28. Reiff S, Griffith B, Forsythe AB, Sherman RM (1981) Utilization of medical services by alcoholics participating in a health maintenance organization outpatient treatment program: Three year follow-up. Alcoholism Clin Exp Res 5: 559–562CrossRefGoogle Scholar
  29. Robins LN (1974) The Vietnam drug-user returns. Government Printing Office, Washington/DC (Special action office monograph series A No 2)Google Scholar
  30. Skinner BF (1953) Science and human behavior. Macmillan, New YorkGoogle Scholar
  31. Sobell MB, Sobell L (1978) The behavioral treatment of alcohol problems. Plenum, New YorkGoogle Scholar
  32. Stall R, Biernacki P (1986) Spontaneous remission from the problematic use of substances: An inductive model derived from a comparative analysis of alcohol, opiate, tobacco, and food/obesity literatures. Int J Addict 21: 1–23PubMedGoogle Scholar
  33. Stinson DJ, Smith WG, Amidjaya I, Kaplan JM (1979) Systems of care and treatment outcomes for alcoholic patients. Arch Gen Psychiatry 36: 535–539PubMedCrossRefGoogle Scholar
  34. Straus R, Bacon SD (1951) Alcoholism and social stability: A study of occupational integration in 2023 male clinic patients. Q J Stud Alcohol 12: 231–260PubMedGoogle Scholar
  35. Thompson T, Schuster CR (1964) Morphine self-administration, food reinforcement, and avoidance behaviors in rhesus monkeys. Psychopharmacologia 5: 87–94PubMedCrossRefGoogle Scholar
  36. Vaillant GE (1966 a) A 12 year follow-up of New York narcotic addicts: I. The relation of treatment and outcome. Am J Psychiatry 122: 727–737Google Scholar
  37. Vaillant GE (1966 b) A 12 year follow-up of New York narcotic addicts: II. The natural history of a chronic disease. N Engl J Med 275: 1282–1288CrossRefGoogle Scholar
  38. Vaillant GE (1966e) A 12 year follow-up of New York narcotic addicts: III. Some social and psychiatric characteristics. Arch Gen Psychiatry 15: 599–609PubMedCrossRefGoogle Scholar
  39. Vaillant GE (1966d) A 12 year follow-up of New York narcotic addicts: IV. Some characteristics and determinants of abstinence. Am J Psychiatry 123: 573–584PubMedGoogle Scholar
  40. Vaillant GE (1966e) Parent-child cultural disparity and drug addiction. J Nery Ment Dis 142: 534–539CrossRefGoogle Scholar
  41. Vaillant GE (1968) The natural history of urban narcotic drug addiction: Some determinants. In: Steinberg H (ed) Scientific basis of drug dependence. Churchill, LondonGoogle Scholar
  42. Vaillant GE (1973) A 20 year follow-up of New York narcotic addicts. Arch Gen Psychiatry 29: 237–241PubMedCrossRefGoogle Scholar
  43. Vaillant GE (1980) The doctor’s dilemma. In: Edwards G, Grant M (ed) Alcoholism treatment in transition. Helm, LondonGoogle Scholar
  44. Vaillant GE (1983) Natural history of alcoholism. Harvard Univ Press, Cambridge/MAGoogle Scholar
  45. Vaillant GE, Clark W, Cyrus C, Milofsky ES, Kopp J, Wulsin V, Mogielnicki NP (1983) The natural history of alcoholism: An eight year follow-up. Am J Med 75: 455–466PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • G. E. Vaillant

There are no affiliations available

Personalised recommendations