Substance use: abstinence violation effect: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Substance use: abstinence violation effect

Sample item

A man abstinent from alcohol for five months has one drink at a wedding. He thinks, 'I have ruined it, I am a failure,' and drinks heavily for the next three weeks. Which concept in relapse prevention explains this?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Abstinence violation effect

Marlatt's relapse prevention model describes the abstinence violation effect, in which guilt and a sense of failure after a lapse convert it into a full relapse. Treatment trains the patient to see a lapse as a learning event rather than a disaster.

Option by option

  • A. Reaction formation

    Reaction formation is a defence in which an unacceptable impulse is expressed as its opposite.

  • B. Cognitive dissonance

    Cognitive dissonance is discomfort from conflicting beliefs, and does not explain the escalation after a lapse.

  • C. Kindling

    Kindling describes increasing severity of withdrawal with repeated detoxifications.

  • D. Abstinence violation effect (correct)

    Correct. Self-blame after a lapse drives continued use.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is D, Abstinence violation effect. Marlatt's relapse prevention model describes the abstinence violation effect, in which guilt and a sense of failure after a lapse convert it into a full relapse.

Why is "Reaction formation" not the answer?

Reaction formation is a defence in which an unacceptable impulse is expressed as its opposite.

Why is "Cognitive dissonance" not the answer?

Cognitive dissonance is discomfort from conflicting beliefs, and does not explain the escalation after a lapse.

Why is "Kindling" not the answer?

Kindling describes increasing severity of withdrawal with repeated detoxifications.

What concept does this question test?

It tests Substance use: abstinence violation effect in Psychiatry. Treatment trains the patient to see a lapse as a learning event rather than a disaster.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Substance use: abstinence violation effect?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.