addiction

• Nicotine


  Social learning theory - role models, observation, imitation, vicarious reinforcement, mediational processes
• Operant conditioning


  Positive/negative reinforcement, reward, mesolimbic pathway, withdrawal symptoms encourage people to smoke more often
• Classical conditioning


  Association between primary and secondary reinforcer = cue reactivity, pleasurable effects of smoking + stimuli (lighter) = craving (cue reactivity)
• Gambling

  Risk of winning/losing = rewarding, secretive, out of control, withdrawal symptoms
• Social learning theory

  Vicarious reinforcement, observing others win (role models)
• Operant conditioning

  Withdrawal symptoms, financial debt (partial reinforcement) ensures excitement remains high
• Classical conditioning


  Secondary reinforcers (alcohol, bookies, friends betting shops/apps)
• Cognitive bias


  Premise that gambling addicts think differently to non-gambling addicts, distortion of memory, attention and thinking
• Recall bias


  Only remembering wins to confirm views
• Illusions of control


  'Beat the system' controlling wins
• Gambler's fallacy


  Distorted views about chance
• Pathological gamblers have poor planning skills and cognitive flexibility, Cavedine (2002)
• Pathological gamblers showed similar decision making impairments to frontal lobe damaged patients, Cavedine (2002)
• CBT


  Helps change the way addicts think about their addiction and learn ways to cope with tempting circumstances
• Research has shown that CBT reduces the frequency of gambling
• CBT for gambling addiction

  1. 10 sessions over 12 weeks

  2. Functional analysis: identify high risk situations, focus on client's thoughts before, during and after, identify/try to prevent triggers

  3. Relapse prevention: provides coping strategies for triggers, relaxation skills to learn from their relapse

  4. Skills training: cognitive restructuring - skills become tailored to the individual and their addiction, tackles cognitive biases with an education of reality, encourages negative thinking about gambling, take these skills into real life
• Aversives


  Emetic (sickness-inducing) drugs, Antabuse, used with alcoholics which creates a hypersensitivity to alcohol and causes sickness, rapid effect 5-10 minutes after drinking
• Agonists


  Works as a drug substitute, bind to the receptors in the same way to cause the same activation as the addictive substance, carefully monitored to prevent withdrawal
• Agonists


  • Methadone & heroin
• Antagonists


  Block receptors so the drug of dependence can't have usual effects of euphoria
• Antagonists


  • Naltrexone used for heroin dependency
• Antagonists


  • Side effects: nausea, headaches, fatigue, dizziness, muscle pain
• Side effects


  • nausea
  • headaches
  • tadigive
  • dizziness
  • musue pain
• Nicotine Replacement Therapy


  • Agonists that work in the same way as nicotine bind to the nicotinic acetylchoune receptons in the mesolimbic pathway = release of dopamine in the ducious accumbens = rewarding effect on the pre-frontal contex
  • Amount of nicotine is managed to prevent craving and subsequently reduced
  • Transdermal patches, gum and nasal spray
• Nicotine Fiore


  1994+
• Meta-analysis showed nicotine patches meant people were twice as key to quit than a placebo group
• Kim + Grant et al

  2001
• 17 complusive gamblers on Naurexone for 6 weeks, only 2 relapsed when they stopped taking the medication
• Gambling


  • Gamblers fill the same rush as drug addicts within the reward system
  • Agonists that block dopamine receptons
  • No officially approved drug treatment, but Naltrexone is used to BLOCK the rewarding effects of dopamine which reduces the compulsion to gamble
• Azjen (1991)


  Theoretical model that attempts to describe the components involved in making a behavioural decision
• Components of the model

  • Personal attitudes
  • Subjective norms
  • Perceived behavioural control
• Perceived Behavioural Control


  Directly influences our intentions to change our behaviours
• Perceived Behavioural Control


  • Willpower, determination and self-efficacy
  • Generally the most important to determine success
• Personal Attitudes


  Collection of the addict's beliefs, weighs up the positives and negatives of changing their behaviour
• Can only change when positives outweigh the negatives
• Subjective Norms


  Addict's belief of social norms/consequences, those who matter to the addict (friends, family) who will approve or disapprove their behaviour
• Only change when they disapprove of their behaviour
• Theory of Planned Behaviour - Azjen (1991)


  1. Personal Attitudes

  2. Subjective Norms

  3. Intention

  4. Behaviour

  5. Perceived Behavioural Control
• The model doesn't explicitly state how to change behaviour
• The model can be used to devise treatment schemes to address each component for an individual