Beyond self-regulation: The role of psychosocial immunity and family dynamics in relapse prevention among men who use drugs in Thailand

Objective Despite various therapeutic approaches, relapse rates among men who have relapsed into drug use remain critically high. This study investigates the structural validity of the Relapse Prevention Behavior Model, hypothesizing that psychosocial factors are as critical as individual self-regulation in the Thai cultural context. Methods A Second-Order Confirmatory Factor Analysis (CFA) was conducted with 349 males who have relapsed into drug use in rehabilitation centers. The study examined four latent constructs: Psychosocial Immunity, Family Support and Awareness, Life Skills, and Self-Regulation. Results The measurement model demonstrated a robust fit with empirical data (Chi-square/df = 1.99, CFI = 0.952, RMSEA = 0.059). A key finding was the dominance of Psychosocial Immunity (β = 0.883) and Family Support (β = 0.865) over Self-Regulation (β = 0.670) in explaining relapse prevention patterns. We show that rehabilitating users believe that external support and internal “immunity” mechanisms are more strongly associated with effective relapse prevention than willpower alone. Conclusion In conclusion, rehabilitating users believe that effective relapse prevention cannot rely solely on individual behavioral modification (Self-Regulation). Rather, it necessitates the systemic integration of socio-cultural factors—specifically, the synergistic power of family dynamics, religious faith, and robust life skills. Further research is needed to determine whether these variables do indeed predict relapse.