Addiction

• Describing addiction:

  • dependence - physical or psychological dependence
  • tolerance - a reduction in response to substances so need more for the same effect
  • withdrawal symptoms - symptoms that develop when someone reduces the substance
• Risk factors in the development of addiction: Genetic vulnerability

  • genetic vulnerability - inherit a predisposition to dependence
  • Kendler: found children with addicted parents who were adopted 9% more likely to become addicted
• Risk factors in the development of addiction: stress

  • stress - stressful or traumatic life experiences are risk factors of addiction
  • Epstein: found women with a history of childhood rape are twice as likely to become alcoholics
• Risk factors in the development of addiction: personality

  • personality - various traits can increases risk of addiction
  • Bahlmann: interviewed 55 alcoholics of which 18 were also diagnosed with APD developed 4 years prior to their alcohol dependency
• Risk factors in the development of addiction: family influences

  • family influences - positive attitudes reinforces the addiction
  • Madras: found a positive correlation between parent addiction and an adolescents addiction
• Risk factor in the development of addiction: peers

  • peers - attitudes of peers can influence the risk of addiction
  • O'Connell: suggests there are 3 major elements:
  • drinking to conform to attitudes and norms of peers
  • drinking because peers provide more opportunities to drink
  • drinking to keep up with the perceived norm
  • real world application: research found a poster in a University Student Union reading "students overestimate what others drink by 44%"
• Explanations for nicotine addiction: Brain neurochemistry 


  Heinemann's desensitisation theory:

  • nicotine binds to nAchR's, releasing dopamine, neuron is desensitised
  • excessive dopamine convinces brain to have another cigarette
  • the better you feel, the more you smoke, the more nAchR's
  • no nicotine in nAchR's means unstimulated reward pathway and decrease dopamine
  • decrease in dopamine causes withdrawal symptoms
  • real world application: neurochemistry has lead to treatment such as NRT
  • Watkins: argues only focuses on dopamine and ignores neurotransmitters like serotonin and GABA
• Explanations for nicotine addiction: Learning Theory; operant conditioning

  operant conditioning - how the addiction is initiated

  • positive reinforcement - reward increases the likelihood of repeated behaviour
  • negative reinforcement - explains dependence and withdrawal;
  • behavioural - disturbed sleep
  • cognitive - poor concentration } keep smoking to avoid these
  • emotional - anxiety or depression
• Evaluating Learning Theory: operant conditioning

  Strength: Levin: trained rats the self-administer nicotine from a waterspout, found that number of licks increased over 24 sessions, this suggests that the effects of nicotine positively reinforce self-administration in rats, implying its similar in humans

  Limitation: animal studies are unethical and can't be generalised to humans
• Explanations for nicotine addiction: Learning Theory; cue reactivity

  • primary reinforcer - the pleasurable effect of smoking
  • secondary reinforcer - stimuli such as friends, music, pubs, having a favourite lighter, that is associated with the primary reinforcer, known as cue reactivity
• Evaluating Learning Theory: cue reactivity

  Strength: Tiffany and Carter: conducted a meta-analysis, presented images of smoking related cues to dependent and non-dependent smokers, self-reported desire was measure with indicators of physiological arousal (increased heart rate), found dependent reacted strongest to cues suggesting they learn secondary associations between smoking related stimuli and pleasurable effects of smoking
• Explanations for gambling addiction: Learning theory

  • vicarious reinforcement - seeing others be rewarded through pleasure or monetary value
  • direct positive or negative reinforcement - the excitement of gambling or escapism from everyday anxieties
  • partial reinforcement - reinforced only some of the time it occurs (you won't win every time, the one time you do win reinforces behaviour)
  • variable reinforcement - unpredictability of winning
  • cue reactivity - secondary reinforces such as music, lights or a betting shop reinforce behaviour
• Evaluating explanations for gambling addiction: learning theory 


  Strength: Dickerson: compared gamblers who placed the most and least bets on horse racing, found high-frequency gamblers more likely to place bets in the last 2 mins due to the excitement, real world application

  Limitation: Dickerson's research lacks inter-rater reliability as there was a single observer

  Limitation: research was only used on one type of gambling addiction, therefore learning theory is limited as it doesn't provide a general explanation of all gambling addiction
• Explanations for gambling addiction: Cognitive Theory 


  Rickwood identified 4 categories for cognitive biases which reinforce addictive behaviour:

  • skill and judgement - illusion of control
  • personal traits/ritual behaviours - belief in greater probability
  • selective recall - choosing to remember wins and not loses
  • faulty perceptions - a losing streak cannot last and must always be followed by a win

  Self-efficacy - the expectations we have about our ability to achieve a desire outcome, and is a key element in relapse (a person's biased belief they cannot quit)
• Reducing Addiction: Drug Therapy:

  • aversives - create unpleasant consequences (vomiting), creates a negative association to addiction
  • antagonists - block neural receptor sites so the drugs can't have its usual effect
  • agonists - drug substitutes as a less harmful replacement with fewer side effects +
  • NRT - gum, inhalers, patches to deliver the psychoactive substance less harmfully
• Evaluating Drug Therapy:


  Strength: Boyce: conducted a meta-analysis on NRT's, placebo's and no treatment, found that NRT increased quitting rates by 60%

  Limitation: negative side effects of drugs, such as; sleep disturbance, dizziness, headaches and blurred vision

  Limitation: may be high attrition rates if clients have to administer the drugs themselves
• Reducing Addiction: Behavioural Interventions: aversion therapy

  aversion therapy = counter conditioning

  • by taking aversive drugs, a new negative association is made through classical conditioning
  • Limitation: Stead: impossible to judge effectiveness, researchers knew who had the placebo
  • Limitation: Fuller: no significant difference between aversive or placebo, both had counselling
• Reducing Addiction: Behavioural Interventions: covert sensitisation

  covert sensitisation = in vitro conditioning

  • think about the negative consequence of an aversive drug, then think about addiction, this creates another negative association
  • Strength: McConaghy: compared covert sensitisation and shock therapy for a year, found 90% improved covert sensitisation
  • Limitation: only a method of suppressing the addiction, not curing it
• Reducing Addiction: Cognitive Behavioural Therapy (CBT)

  Cognitive - functional analysis

  • client and therapist identify situations where addictive behaviour may occur
  • therapist challenges distorted beliefs, known as cognitive restructuring

  Behavioural - skills training

  • specific skills = client may lack a skill that copes with situations that trigger addiction
  • social skills = role play with therapist helps client build courage to refuse addiction

  Strengths: useful in the prevention of relapse

  Limitations: CBT treatment groups can be up 5 times greater than for other forms of therapy
• Applying theories of behaviour change to addiction: Theory of Planned Behaviour:

  • Ajzen identified 3 variables that effect behaviour:

  (1) personal attitudes - our personal beliefs towards the behaviour

  (2) subjective norms - considers how we view the ideas of other people about the behaviour

  (3) perceived behavioural control - extent to which we believe behaviour can be controlled, known as self-efficacy

  Strength: completed questionnaires and found a correlation between 3 variables

  Limitation: reductionist, ignores emotions that influence behaviour
• Applying theories of behaviour change to addiction: Prochaska's Model

  • Precontemplation - not considering to change behaviour
  • Contemplation - thinking about benefits of changing behaviour
  • Preparation - decided to change behaviour but doesn't know how
  • Action - change of behaviour, still a risk of relapse
  • Maintenance - staying on track and preventing relapse
  • Termination - change of behaviour is permanent, no risk of relapse

  Strength:dynamic process as well as realistic

  Limitation: Taylor: meta-analysis showed no more effective than the theory of planned behaviour