Predicting drinking lapses in alcohol use disorder: The toxic combination of agonistic striving and poor anger regulation

Interpersonal stressors and reactions to them have long been considered important determinants of lapse/relapse following treatment for alcohol use disorder (AUD). We tested predictions from the Social Action Theory (SAT) of chronic stress that persons who often suffer stress related to Agonistic striving (i.e., seeking to control others) would experience a shorter time to alcohol lapse and have generally poorer alcohol use outcomes following admission to outpatient AUD treatment than persons who often suffer stress related to Transcendence striving (i.e., seeking to control the self) or Dissipated striving (i.e., lack of goal focus). This effect was hypothesized to be especially strong if anger regulation is relatively poor. The participants were 119 men and women admitted to AUD outpatient treatment. They completed assessment protocols at baseline and several times over the following 12 weeks. The results replicated the 3-group striving taxonomy found in previous research with nonclinical samples of adolescents and young adults. Analyses comparing the profile groups and their interaction with anger regulation did not detect a link with alcohol use outcomes. However, Agonistic Striving represented as a continuous variable interacted with anger regulation as hypothesized to predict time to first alcohol lapse and drinks per drinking day over the 12-week follow-up period. Results encourage further applications of SAT to understanding the determinants of AUD clinical course.