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PYB159 > 3. Theories of Substance Use > Flashcards

3. Theories of Substance Use Flashcards

1
Q

What is a theory?

A

“…a set of descriptors or principles put forward as an explanation of facts, findings, observations or experiences…allows us to organise and make sense of relationships among variables of interest”

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2
Q

why are theories important in the context of drugs?

A

it explains why a drug is more or less addictive, makes sense of similar behaviour and explains cycle of increasing dysfunctional involvement with drugs

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3
Q

In what contexts do theories explain why drugs are more or less addictive?

A

in one society than another, for one individual and not another, for the same individual at one time and nother another

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4
Q

with regards to making sense of similar behaviour, what are theories supposed to look at?

A

theories are not supposed to look at alcohol and drugs, but rather other compulsive behaviours and how we can transfer the understanding across

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5
Q

what questions do theories tough on when explaining the cycle of increasing dysfunctional involvement with drugs?

A

why do people continue in engaging in something that is often dysfunctional?

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6
Q

what must a theory that explains the cycle of increasing dysfunctional involvement with drugs involve?

A

it must be faithful to the lived human experience, hence it must be based on reality

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7
Q

what are theories a matter of?

A

perspective. for example. is there a difference between someone having to take daily prescribed drugs and someone taking elicit drugs daily?

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8
Q

why do people use substances?

A
  • To enjoy the experience and short term effects
  • To feel confident
  • To “break the rules”
  • To be part of the subculture
  • To relieve boredom
  • Peer influence
  • Family factors
  • Community factors
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9
Q

why do people first start engaging in drugs?

A

o peer pressure
o fun
o curiosity
o cultural expectations (e.g. at weddings, you drink)

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10
Q

why do people continue to use addictive substances?

A
  • To counter the unpleasant effects of prescribed medications
  • To continue the habit
  • To avoid unpleasant feelings
  • To satisfy cravings
  • To avoid withdrawal symptoms
  • To counter the effects of other drugs (e.g., benzos after speed)
  • Gateway theory
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11
Q

what is the gateway theory?

A

Using one drug to lead to another

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12
Q

what are the theories of drug addiction?

A

Moral, disease, genetic/neuro-phamacological, psychological, socio-culural, bio-psycho-social

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13
Q

what is the general concept of the moral theory of addiction?

A

sign of moral weakness, deviance

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14
Q

what is the general concept of the disease theory of addiction?

A

“sick role”, not reversible, genetic

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15
Q

what is the general concept of the genetic/neuro-pharmacological theory of addiction?

A

based on adoption and twin studies, limbic system, reward pathways/neurotransmitters

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16
Q

what is the general concept of the psychological theory of addiction?

A

classical/operant conditioning, positive reinforcement, associations

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17
Q

what is the general concept of the socio-cultural theory of addiction?

A

gender, age, SES, subculture

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18
Q

what is the general concept of the bio-psycho-social theory of addiction?

A

multiple contributing factors operate in combunation

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19
Q

what are the psychological theories of drug addiction?

A

disease theories, behavioural theories, cognitive/cognitive behavioural theories, motivation and change theories and family and systems theories

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20
Q

according to the disease theory, what is dependence a symptom of?

A

dependence is a symptom of physical or mental illness or disease

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21
Q

according to the disease theory, what is dependence caused by?

A

the presence of a specific gene or biochemical abnormality that precedes substance use

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22
Q

according to the disease theory, what do the genes or biochemical abnormalities that precede substance use do to precede substance use?

A

causes an inability to discriminate blood alcohol level, increased sensitivity to alcohol, brainwaves

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23
Q

where does most of the evidence of disease theories come from

A

there is an extensive history of studies on the disease theory where most of the evidence comes from family, two and adoption studies

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24
Q

what are the common approaches to disease theories in the community

A

12 step models, psychoanalytic view, personality theories, genes/genetics, endorphin deficiency theory

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25
Q

what does the 12 step model believe dependence is?

A

it is a spiritual disease and a lack of control

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26
Q

what are types of 12 step models?

A

AA, NA, Alcoholics-Anon

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27
Q

what are the main premises of the 12 step model

A

o Alcoholism is “all or nothing”. Problem or no problem.
o Alcoholics are powerless over alcohol and experiences.
o Alcoholism cannot be “cured”, only managed.
o Disease is progressive and deterioration in condition is inevitable if drinking continues.
o Support through attending groups, peer support, submitting to a higher power.
o support groups

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28
Q

how are the mechanisms of this theory explained?

A

not very well, as there is limited evidence based research

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29
Q

what does the 12 step model fail to evidence?

A

that the disease is progressive. Heavy drinkers can control their use, and many dependent users do return to controlled use. This is an example of abstinence vs harm reduction approaches

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30
Q

what are 12 step programs associated with?

A

greater friends, spiritual connection, finding meaning in life

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31
Q

what is one of the most common treatments to drug addiction in the world?

A

12 step model

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32
Q

how does the 12 step program compare to cognitive behavioural therapy?

A

does very well

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33
Q

what is the main premise of the psychoanalytic view?

A

nature and nurture

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34
Q

what does the psychoanalytic view comprise of?

A

unconscious processes that govern the id, ego and superego.

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35
Q

what is the id?

A

it is the needs - food, sex, desires

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36
Q

what is the ego>

A

manages a balance between the id and superego?

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37
Q

what is the superego?

A

moral

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38
Q

what is important in the psychoanalytic view of drug addiction?

A

childhood experiences

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39
Q

what is the theory encompassed in the psychoanalytic view if drug addiction?

A

Drug addiction is fixated at the ‘oral’ stage of development. i.e. a person that engages in drug use had a disruption to their secure attachment and uses drugs to solve it. e.g. smokers struggled to breast feed, thus smoke to relace that loss

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40
Q

in regards to the psychoanalytic view of drug addiction, what is the theory behind the id?

A

drive reduction theory

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41
Q

in regards to the psychoanalytic view of drug addiction, what is the theory behind the ego?

A

self medication

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42
Q

what does the psychoanalytic view of drug addiction believe will cure drug addiction?

A

managing early childhood distresses

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43
Q

what are the shared assumptions of the psychoanalytic view of drug addiction?

A

o Drug use is a symptom of an underlying psychological disorder - drug use is not seen as a normative behaviour
o Indicates severe psychopathology - mentally unwell
o Psychological problems are assumed to cause substance abuse, but not usually recognised as a consequence of use
o Addiction is considered a uniform disorder

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44
Q

what is the treatment of drug addiction according to the psychoanalytic view of drug addiction?

A

treatment via therapeutic relationship and specific psychoanalytic technices

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45
Q

what is the process of treatment according to psychoanalytic view of drug addiction?

A

about building a trusting warm relationship with somebody to resolve those childhood issues thus doesn’t rely on drugs to attempt to solve those psychological problems

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46
Q

what does consumption of drugs provide according to psychoanalytic view of drug addiction?

A

relief from conflict generated by oral fixation; or repressed psychological conflict

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47
Q

according to the personality theories, what is the 5 types of alcohol provided by Jellinek (1960)?

A

alpha, beta, gamma, delta and epsilon

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48
Q

according to the personality theories, what is the alpha alcoholic?

A

pure psychological addiction

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49
Q

according to the personality theories, what is the beta alcoholic?

A

continuous heavy drinking leading to medical complications, but psychological or physical dependence is not evident

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50
Q

according to the personality theories, what is the gamma alcoholic?

A

increased tolerance, withdrawals, cravings and loss of control

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51
Q

according to the personality theories, what is the delta alcoholic?

A

increased tolerance, withdrawals, cravings and loss of control (similar to beta) however adds the inability to abstain

52
Q

according to the personality theories, what is the epsilon alcoholic?

A

intermittent binge drinking interspersed with abstinence/controlled use

53
Q

what are the contemporary types of alcoholics according to Cloninger (1987; 1991) ; Wennberg et al., 2014?

A

type 1 (late onset) and type 2 (early onset)

54
Q

what are the characteristics of a type 1 alcoholic?

A

high reward dependency, high harm avoidance, and low novelty seeking

55
Q

what do type 1 alcoholics tend to do?

A

o ‘I need you to say good things about me’ – if you say im okay im okay
o avoid conflict
o not risk takers – nervous and anxious people

56
Q

what are the characteristics of a type 2 alcoholic?

A

lower reward dependence, low harm avoidance*, high novelty seekers

57
Q

what do type 2 alcoholics tend to do?

A

o the risk takers
o sensation seeking
o I don’t care what you think about me
o I don’t care about what society has to say

58
Q

what is there inconsistent research about with regard to type 2 alcoholics?

A

that they have low harm avoidane

59
Q

where are most people characterised in the contemporary categories of alcoholics?

A

between type 1 and type 2

60
Q

How do personality theories determine why you are addicted?

A

look at how you grew up and your personality

61
Q

what does the personality theory suggest that makes an alcoholic different from other individuals?

A

a group of distinct personality characteristics

62
Q

what are the main ideas of the personality theory?

A

o Predisposing factor (‘addictive personality’)
o Consequence of dependence
o Independent (personality trait and dependence)

63
Q

what is there limited evidence for in the personality theory?

A

addictive personalities

64
Q

what are addictive personalities related to?

A

specific personality characteristics (e.g. sensation seeking)

65
Q

what puts people at higher risk of drug addiction according to the personality theory?

A

different traits. • e.g. athletes: highly driven, high perfectionist - seen as a greater risk of substance use

66
Q

what are the personality predictors of drug use according to psychologists like McGue 1995; Rassool, 2011?

A

o Behavioural disinhibition (impulsivity)
o Emotional negativity (negative mood, depressive PD)
o Other personality features (e.g., narcissism)
o Used to enhance sensation and avoid pain

67
Q

what are personality characteristics also related to according to the personality theory?

A

related to the drug of choice

68
Q

what to heroine patients show according to the personality theory?

A

greater novelty seeking than alcohol patients (Le Bon et al., 2004)

69
Q

what do some researches consider when determining the drug of choice according to the personality theory?

A

internal vs. external stressors and uses MMPI personality profiles to categorise drug of choice

70
Q

where can the genes that cause alcohol use disorders be found according to the genetic theory?

A

dopaminergic, glutamatergic, GABAergic, opioidergic, sertotoninergic, annabinoid, noredrenaline, circadine rhythem systems

71
Q

what are environmental factors contribute to alcohol use disorders according to the genetic theory?

A

culture/peer influences, age of first use, alcohol availability, childhood behaviour disorders, childhood maltreatment, parental attitudes, stress

72
Q

what parts of the brain are involved in addicition according to the genetic theory?

A

cortex, limbic system, brain stem

73
Q

what is the reward pathway according to the genetic theory?

A

starts at the Ventral Tegmental Area in the brain, then to the nucleus accumbens then to the prefrontal cortex

74
Q

where does the activation of the reward pathway begin when using heroin according to the genetic theory?

A

at the VTA (ventral tegmental area)

75
Q

where does the activation of the reward pathway begin when using cocaine, heroin and nicotine?

A

at the nucleus accumbens

76
Q

what are the brain circuits, (from VTa, Nucleus accumbens and Frontal Cortex) important for?

A

natural rewards such as food, music and sex

77
Q

what is dopamine increase a response to?

A

natural rewards such as good

78
Q

what happens to dopamine increase when cocaine is taken?

A

dopamine increases are exaggerated and communication is altered

79
Q

What does the behavioral theories consider?

A

it considers only observable/measurable beahaviour

80
Q

what is behaviour a consequence of according to the behavioural theories?

A

learning

81
Q

what are the 4 main types of conditioning according to the behavioural theories?

A

classical, operant, modelling, tension reduction

82
Q

what is classical condition in relation to drugs?

A

Sights, smells and sounds consistently associated with drug use elicit physiological and psychological responses that lead to drug seeking behaviour. Conditioned stimuli (CS) – cues and triggers. Conditioned response (CR) – physiological and psychological responses

83
Q

what does operant conditioning focus on?

A

Focuses on reinforcing properties of drugs, and the likelihood of people repeating immediately pleasurable experiences (and avoiding unpleasurable experiences)

84
Q

what are the three main reinforcement types?

A

positive reinforcement, negative reinforcement, punishment

85
Q

According to the modelling model of behavioural theories, what do people learn?

A

favourable attitudes and expectation about drinking based on how the behaviour is modelled?

86
Q

According to the modelling model of behavioural theories, what lowers the risk of harm of drugs?

A

if one does not have to experience negative consequences personally

87
Q

According to the modelling model of behavioural theories, what does modelling increase the likelihood of?

A

pleasant experiences learned from others

88
Q

According to the modelling model of behavioural theories, what is maintenance of drug use assocated with?

A

past associations with drug-taking environments/situations

89
Q

what is the tension reduction theory?

A

Tension in society -> demands relief -? Problem of elimination of reduction of conditions that create tension OR problem of finding a mode for relief of tension

90
Q

what are the three elements of the tension reduction theory

A

A - Antecedents
B - Behaviour
C - consequences (reinforcing)

91
Q

what are possible antecedents in the tension reduction theory?

A

TRIGGERs - a situation, thought or feeling

92
Q

what are the consequences in the tension reduction theory?

A

PAYS OFF - immediate outcome that maintain the behavour

93
Q

what are the models and theories that underpin the cognitive and cognitive behavioural theory?

A
  • Cognitive model
  • Expectancy theory
  • Social learning theory
  • Relapse prevention
  • Core beliefs (schemas)
94
Q

what does the cognitive model focus on?

A

focuses on the thoughts/beliefs, and impact on behaviours and feelings. the way people interpret specific situations, that influences feelings, motivations and actions

95
Q

what does “layers of belief” mean in the cognitive model?

A

core beliefs and reactions - we are not conscious of these

96
Q

what does the cognitive model look into?

A

your thoughts and how you make sense of thigns and how they make you feel the way you feel

97
Q

what is there a lot of in the processes of the cognitive model?

A

interpretation

98
Q

what does the cognitive model believe causes drug addiction?

A

conflicting beliefs - cognitive dissonance

99
Q

what are hte conflicting beliefs that cause drug addiction according to the cognitive model theory?

A

conflict between the desire to use drug and the desire to be free of the drug

100
Q

what do conflicting beliefs in the cognitive model lead to?

A

a cycle of behavioural, emotional an thinking patters

101
Q

what does the cognitive behavioural theory suggest?

A

thoughts and behaviours are learnt and therefore can be unlearnt

102
Q

what factors does the social learning theory encompass?

A

personal factors, environmental and behaviour

103
Q

personal factors/views + environment =

A

behaviour

104
Q

what is a popular term used in the social learning theory?

A

belinging

105
Q

according to the expectancy theory (Bandura, 1969) what are the two specific cognitions?

A

outcome expectancy, and self efficacy

106
Q

what is outcome expectancy with regards to drugs?

A

beliefs abut effects and outcomes of using

107
Q

what is self efficacy?

A

belie in ones own ability to effect change

108
Q

what would someone with high outcome expectancy be likely to say?

A

nothing else will fix now i feel

109
Q

what does relapse prevention, in regards to the expectancy theory. aim to do?

A

reduce high risk situations and increase alternative coping strategies and self-efficiacy

110
Q

what causes relapses according to the expectancy theory?

A

Interaction of high risk situations (cues/triggers) with coping response and expectancy (outcome and self-efficacy)

111
Q

what is a word to describe the motivational and change theories

A

transtheoretical

112
Q

What is motivational interviewing

A

intrinsic motivation is a necessary and sufficient factor to initiate behaviour change

113
Q

what are the elements or factors in the motivational and change theories?

A

precontemplation, contemplation, preparation, action, maintenance, relapse

114
Q

what is involved in precontemplation in the motivational and change theories?

A

No intention of changing behaviour

115
Q

what is involved in contemplation in the motivational and change theories?

A

aware a problem exists. No commitment to action

116
Q

what is involved in preparation in the motivational and change theories?

A

intent upon taking action

117
Q

what is involved in the action phase in the motivational and change theories?

A

active modification of behaviour

118
Q

what is involved in the maintenance phase in the motivational and change theories?

A

Sustained change - new behaviour replaces old

119
Q

what is involved in the relapse phase in the motivational and change theories?

A

fall back into old patterns of behaviour

120
Q

what is involved in the precontemplation phase in the motivational and change theories?

A

No intention of changing behaviour

121
Q

according to the family systems theory, what are determinants of behaviour based on?

A

based on an individual’s rle within a system

122
Q

what do family and other systems (e.g. peers) have a role in according to the family systems theory?

A

have a role in starting/maintaining substance use

123
Q

what are the common elements of a family systems theory?

A

boundaries, reciprocal causality, homeostasis

124
Q

what are boundaries in the family systems theory?

A
  • appropriate way to act and inappropriate way to act

* and the blur of the boundaries

125
Q

what is homeostasis in the family systems theory?

A

try to fit within the system

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