Satisfaction and frustration of basic psychological needs and the risk of relapse in alcohol dependence

Introduction
According to Self-Determination Theory (SDT), low satisfaction, especially frustration of basic psychological needs like autonomy, competence and relatedness lead to poor well-being, the risk of harmful behaviour and psychopathology. The aim of the study was to identify the meaning of needs satisfaction and frustration for alcohol-dependence relapse risk. The predictors of relapse-risk were belief in the possibility of permanent abstinence, abstinence self-efficacy in risky situations and alcohol craving intensity.

Material and methods
Data was collected from 115 stationary addiction therapy patients (93% men) of 18-65 years of age. Variables were measured using the Basic Psychological Needs Satisfaction and Frustration Scale (BPNS&FS), the Penn Alcohol Craving Scale (PACS), the Alcohol Abstinence Self-Efficacy Scale (AASES) and an estimation scale assessing the possibility of maintaining permanent abstinence.

Results
A significant difference was found in perceived alcohol craving, self-efficacy in abstinence coping and belief in the possibility of maintaining it for those with high and low needs satisfaction. Relapse risk was the most differentiated by competence satisfaction.

Discussion
Patients with highly satisfied needs experienced a significantly higher self-efficacy in coping with risky situations, trust in their ability to maintain abstinence and experienced a weaker alcohol craving than patients with low need satisfaction. Additionally, patients with highly frustrated needs experienced lower self-efficacy in maintaining abstinence and higher alcohol craving than patients with low frustration. Competence frustration had the greatest impact on the risk of relapse.

Conclusions
Satisfying psychological needs, especially competence, is an important condition for building sobriety and effectively coping with its threats. Therapists should pay special attention to satisfying patients’ psychological needs.