Addiction AO1

• Addiction

  a repetitive activity in which short-term gratification is almost guaranteed but long-term harm is a high risk
• Characteristics of an addiction

  1. psychological and physical dependency
  2. tolerance
  3. withdrawal syndrome
• Physical dependency

  biological withdrawal symptoms (shaking)
• Psychological dependency

  cognitive cravings
• Tolerance

  need to take higher levels of a substance or engage in a behaviour more frequently to get the same effect
• Withdrawal syndrome


  unpleasant physical and psychological symptoms when they no longer have a substance in their system after a tolerance has been built
• Risk factors in the development of addiction

  1. genetics
  2. stress
  3. personality
  4. family influences
  5. peers
• family influence


  percieved parental approval

  if adolescents have substance-abusing parents they are more likely to engage in it themselves

  1. no interest in monitoring their behaviour
  2. exposure

  SLT
• Peers


  peer pressure makes people more vulnerable to addiction

  SLT - imitated in hope of receiving similar direct rewards

  • Social Identity Theory - associated with in-group to win social approval so adopt behaviours
• Genetics

  1. Twin studies - Vink et al - smoking in MZ twins 56% concordance rate and in DZ 15%
  2. low numbers of D2 receptors - Blum and Payne
  3. lack of CYP2A6 enzyme which is responsible for metabolising nicotine - Pianezza et al
• Stress

  1. Self-medication model (Gelkopf et al) - use pathological behaviour to treat the psychological symptoms because of everyday stressors (predictor of relapse and increased drug craving)
  2. Traumatic stress - Robins et al - US soldiers on return to vietnam war - almost half had used opium or heroin
• Personality

  1. The Addiction-Prone Personality Scale (Barnes et al) - discriminate non-addicts from drug addicts - traits such as hostility linked to addiction
  2. Anti-social Personality - act without thinking and fail to acknowledge risks
• Explanations for nicotine addiction

  1. Learning explanation (operant conditioning and cue reactivity)
  2. Neurochemical explanation
• Operant conditioning

  positive reinforcement and initiation

  1. if consequence of behaviour is rewarding (pleasure) then it is more likely to be repeated
  2. nicotine has physiological effects on the dopamine reward system in the mesolimbic pathway
  3. it stimulates the release of dopamine in the nucleus accumbens (producing mild euphoria) reinforcing the smoker to smoke again
• Operant conditioning

  negative reinforcement and maintenance

  1. withdrawal syndrome when sustaining from a cigarette
  2. causes withdrawal symptoms
  3. smoking another cigarette stops an unpleasant stimulus (negatively reinforcing)
• Cue reactivity - classical conditioning

  1. smoking = primary reinforcer
  2. any stimuli present whilst smoking = secondary reinforcer
  3. act as cues (lighters or pubs)
  4. cue reactivity = associations made between cues in the environment and smoking
  5. more vulnerable to relapse when in and environment or near an object they associated nicotine use with
• Neurochemical explanations

  1. Role of dopamine
  2. Nicotine regulation model
• The role of dopamine

  1. nicotine binds with nicotinic receptors in the ventral tegmental area
  2. triggers release of dopamine in the nucleus accumbens
  3. impacts the prefrontal cortex - short-term benefits over long-term costs
• Nicotine regulation model

  1. abstaining from nicotine = nicotinic receptors becoming sensitized
  2. leads to withdrawal symptoms - smoke again
  3. repeated activation and deactivation = chronic desensitisation
  4. need more nicotine to receive same rewards
• Learning explanation for gambling

  1. Vicarious reinforcement
  2. Operant conditioning
  3. Cue reactivity
• Vicarious reinforcement (SLT)


  seeing others rewarded = trigger desire for same reinforcement
• Operant conditioning

  1. Partial reinforcement - some behaviours reinforced but not all (partial reinforcement schedule)
  2. Variable reinforcement - reinforced after an unpredictable number of responses
• Cognitive biases


  irrational beliefs that are unhelpful and unrealistic with the social reality

  1. Gamblers fallacy
  2. Illusions of control
  3. near miss bias
  4. recall bias
  5. ritual bias
• The gamblers fallacy


  random results must even themselves out - run of losses followed by a win
• The recall bias


  remember and overestimate wins but forgetting and underestimating losses
• Ritual bias


  engage in superstitious behaviours
• Drug therapy

  1. Aversives - pair behaviour with unpleasant consequences
  2. Agonists - control withdrawal effects
  3. Antagonists - blocking receptor sites
• DT for nictotine


  Nicotine Replacement Therapy

  1. controlled dose of nicotine
  2. bind to nicotinic acethycholine receptor
  3. release dopamine in nucleus accumbens
• Behavioural interventions


  based on counterconditioning where the addict is taught a new association which runs counter to the original association
• Aversion therapy


  when two stimuli are presented together then they will become associated so the addictive behaviour becomes associated with an aversive outcome
• Aversion therapy for gambling


  shock delivered to the addicts upper arm whilst they read out gambling-related phrases
• Aversion therapy for alcohol

  giving the addict a tablet that makes them throw up and then giving them an alcoholic drink
• Behavioural interventions

  1. aversion therapy
  2. covert sensitisation
  3. CBT
• Covert sensitisation


  a type of aversion therapy based on classical conditioning that occurs invitro by the patient imagining the aversive situation (smoking cigarrettes covered in feces)
• CBT


  persuade the patient distorted thinking is causing the addiciton through disputing techniques
• Disputing techniques

  1. logical
  2. empirical
  3. pragmatic
• Assertiveness training


  addict is encouraged to confront situations that cause stress in a rational way (visiting a casino and refraining from betting)
• Social skills training


  help addicts deal with anxiety in social situations
• Theories of behavioural change

  1. Theory of planned behaviour
  2. Prochaskas six stage model
• Theory of planned behaviour - Ajzen


  a cognitive theory about the factors that lead to a persons decision to engage in a behaviour

  1. personal attitudes - favourable and unfavourable
  2. subjective norms - people close approve or disapprove
  3. perceived behavioural control - self-efficacy (control)