A2 - addiction Flashcards
what is the definition of addiction?
the compulsion to use a substance or carry out a behaviour despite the harmful consequences. It is the inability to stop to the extent that it interferes with the ability to engage in social activities/ meet deadlines
what is physical dependence?
occurs with the longterm use of many drugs, such as nicotine, heroin and prescription medicines such as painkillers and anti-anxiety drugs.
Physical dependence involves the need to take a substance in order to feel ‘normal’. It can
be demonstrated by the person displaying withdrawal symptoms if they stop taking the substance. They can also become ‘tolerant’,
which means the body gets accustom to having the substance and an increased intake is
needed to feel the same effect.
what is psychological dependence?
occurs when a drug or behaviour becomes the most important
thing to a person’s thoughts, emotions and activities. The person may experience cravings,
which are intense desires to take the drug or to engage in the behaviour.
Even though the addiction may be non physical (e.g. gambling), it can still lead to psychological dependence
How can the two informationprocessing systems explain psychological dependence?
Two I.P. systems: rational (thinking) and experiential (feeling).
Rational often related to cultural norms. Conscious, analytical and nonemotional.
Experiential preconscious, automatic and emotionallydriven. How we feel.
what was the procedure of Isabell et al’s research into tolerance?
Isbell et al (1955), carried out research with a group of prisoners who’d volunteered to take part. They were given a measured
amount of alcohol every day for 13 weeks. The quantity was enough to keep them in a constant state of intoxication.
what were the findings of Isabell et al’s research into tolerance?
In the first two weeks, all of the prisoners showed measurable changes in blood alcohol levels and showed behavioural signs
of intoxication.
Both of these changes dropped in the following weeks, despite continuing with the same intake of alcohol.
What is tolerance?
when using a drug for a long time, increasingly larger doses are needed to experience the same effect as the body no longer responds in the same way to the drug
what are the 3 types of tolerance?
- metabolic tolerance
- receptor density changes
- learned tolerance
what is metabolic tolerance?
occurs when enzymes become more effective at metabolising the drug resulting in reduced concentrations in the blood and at the sites of drug action. This means the effect experienced is weaker than before so the user takes higher doses
what is changes in receptor density?
prolonged drug use can lead to changes in receptor density which reduces the response to the normal dose of the drug
what is learned tolerance?
users will become accustomed to functioning normally when under the influence of the drug and so higher doses are needed to experience an effect
what is withdrawal syndrome?
occurs with the discontinued use of a drug. As it wears off, symptoms such as shakes or anxiety occur and often have a negative impact. It is a representation of a physical dependence on a drug
what is acute withdrawal?
begins within hours and gradually resolves after a few weeks (physical dependence)
what is post acute withdrawal?
emotional and psychological turmoil as the brain re-balances itself
how could the claim that addiction runs in the family be investigated?
twin, family, adoption studies looking at concordance rates
what was the aim of Slutske et al’s gambling study?
to identify genetic and environmental influences
what was the method of Slutske et al’s gambling study?
2889 pairs of australian twins were interviewed investigating the role of genetic and environmental factors in gambling development
what were the results of Slutske et al’s gambling study?
male identical twins had a concordance rate of 0.49
non-identical male - 0.21
female identical - 0.55
female non-identical - 0.21
outline Vink et al’s study on smoking
1572 dutch twin pairs found that the initiation of smoking is 44% genetic and 56% environmental
found that addiction as influenced 75% by genetic factors
what is the genetic vulnerability explanation?
individuals who are vulnerable to drug addiction have low levels of dopamine and have less responsive D2 receptors
what effect does it have when your D2 receptors are less responsive?
fewer dopamine molecules can bind to these receptors and initiate action potentials in the post-synaptic membrane.
therefore, anything that increases dopamine can produce and increased feeling of euphoria
what gene is related to the decreased D2 sensitivity?
A1
limitation of the genetic vulnerability explanation - gender differences
E - Mgue points out that only two of four adoption studies have reported a significant correlation between alcoholism in female adoptees and their biological parents.
Likewise, only 2/5 twin studies found greater concordance rates for alcoholism among female MZ twins than female DZ
strength of genetic explanation research
P - a strength of of research into the genetic explanation for addiction is that it can explain why some people with similar environmental influences develop addictions and others dont
E - some ppl are more likely to develop addiction. For example, the A1 variant of the dopamine receptor gene has been found to be linked with cocain and nicotine dependance
E - suggesting individuals who inherit this gene variant are more vulnerable to developing addiction
what is the definition of stress?
negative physiological and psychological responses where people perceive threats to their wellbeing are beyond their perceived ability to cope
what is the self-medication model?
individuals dealing with stressful events of lifestyles by engaging in behaviours that help reduce their symptoms and forget about stress
what is evidence for stress as a risk factor?
Dawes et al identified stress was the greatest predictor of relapse and drug craving
what is evidence of PTSD influencing drug use?
Robins et al interviewed US soldiers within a year of returning from the Vietnam war
- 50% had reported using opium or heroine
- 20% reported a dependance
support for using stress as a risk factor of obedience - stress management courses
E - Mathney and Weatherman followed up on 263 smokers who had completed a cesstation programme
F - they found that there was a strong correlation between use of stress coping resources and maintaining abstinance
E - suggests stress management techniques are effective
limitation of using stress as a factor of addiction
P - influences of stress varies by the type of addiction
E - Arevalo et al interviewed 393 women in substance abuse programmes and found an association between stress and drug use but not stress and alcohol addiction
H - however, this used self report measures which may face social desirability bias and under reporting drug use
what are the 3 character traits making someone more vulnerable to addiction related to personality
- personality traits
- addiction prone personality
- personality disorders
what did Cloninger propose behaviour was made up of?
novelty seeking
harm avoidance
reward dependence
what levels of
novelty seeking
harm avoidance
reward dependence
are seen in addictive ppl and what type of personality does this make?
novelty seeking - high
harm avoidance - low
reward dependence - high
neurotic personality
what did Barnes et al develop and find about addiction prone personality
They developed APP scale to assess the influence of personality on addictive behaviour
found personality to be a significant predictor of heavy marijuana use
therefore helps predict relapse
what is the prelevance of personality disorder in
alcoholics
cocain addicts
opiate addicts
polydrug addicts
% in alcoholics
70% in cocain addicts
% in opiate addicts
91% in polydrug addicts
longitudinal evidence to support the influence of impulsivity for addiction - AO3
higher impulsivity scores have been linked to a wide range of risky behaviours including alcohol and drugs.
Alcohol prone individuals with high impulsivity schore had higher mortality risk than others
H - however, the research is correlational not causational and there may be a third variable
AO3 - evidence for certain personality traits as a risk factor for obedience
Barnes found personality to be a significant predictor for the initiation, development and maintenance of abuse and dependence
This application could help identify vulnerable individuals and intervene before addiction, eventually reducing cost needed for treatment
How does social learning theory explain the influence of parents on addiction? (modelling)
when a child observes their parent and identifies with them (a role model) they may decide whether the behaviour is worth imitating via vicarious reinforcement, then either repeat or not repeat the actions depending on the consequence
Reith and Dobbie researched the influence of family on gambling behaviour and found:
when interviewing 50 gamblers, their knowledge and behaviour was passed on through routines of every day life. They reported watching and listening to family members talk about their gambling and eventually joined in
gender modelling and examples of men and women
men were more likely to place bets on sports whereas women on bingo
what did fletcher et al fins about parenting style in relation to addiction
parents rated as authoritative, show warmth, and exercise control resulted in children with resilience and emotional wellbeing
supporting evidence for the influence of parenting style in risk of addiction - AO3 chills parents
Bahr et al found that family characteristics of overly tolerant and relaxed attitudes to substance use were associated with an increased prevelance of binge drinking, smoking and drug use.
These adolescents also interacted more with peers who smoked
supporting evidence for the influence of parenting style in the risk of addiction - AO3 lack of parental control
A lack of parental involvement may increase the vulnerability to addiction.
Stattin and Kerr suggested a lack of control may result from adolescents disclosing too much information about their substance abuse to parents, and parents cant deal with it and feel it’s beyond their control
Resulting in continuous abuse and becoming more vulnerable.
what are the effects of nicotine?
calming, reduced irritability, increased alertness, improved cognitive functioning
how is nicotine absorbed and how long till it reaches its peak levels
absorbed through lining of mouth and nose
less than 10 seconds
explain the dopamine reward pathway
- nicotine enters brain
- stimulates nicotine receptors in ventral tegmental area
- dopamine releases in nucleus accumbent
- also stimulates release of the neurotransmitter glutamate which releases more dopamine
- pleasure likely to lead to addiction
how does nicotine effect GABA?
GABA is an inhibitory neurotransmitter which decreases dopamine activity
- nicotine reduces GABA activity
how does nicotine effect glutamate?
causes glutamate to speed up dopamine release
how does nicotine effect MAO?
it is an enzyme that breaks down dopamine
nicotine blocks its action
how does nicotine addiction develop?
nicotine stimulates release of dopamine which creates pleasure and relaxation
when dopamine is removed, loss of pleasure feeling, want of more nicotine
support for the connection between nic and dopamine AO3
P - Paterson and Markou found that a drug used to treat epilepsi (GVG)
E - reduces the surge of dopamine in the NAc that occurs after taking nicotine.
This reduces the addictive tendencies of nicotine and other drugs that boost levels of dopamine such as cocain and heroine
E - by counteracting any pleasurable experiences, this drug is an alternative treatment for nicotine addiction
support of neurochemistry explanation of nicotine - parkinsons
E - symptoms of parkinsons are due to gradual loss of dopamine producing neurons
Forgestron et al treated 2 elderly PD patients with nic gum and patches. They found significant changes in symptoms due to the increase of dopamine
E - suggesting that nicotine may have a neuroprotective function against the development of PD and may be beneficial in its treatment
support for the role of glutamate in nicotine addiction
P - the role of glutamate in nicotine addiction is shown through a study of dependant rats
E - the researcher blocked transmission of glutamate which resulted in a decrease of nicotine intake and seeking
This is because glutamate usually enhances dopamine effects
H - however, since this is on rats it is hard to apply to humans
how does the social learning theory explain initiation for nicotine addiction?
identification with role models such as friends or parents who smoke
vicarious reinforcement leads to the expectation of positive consequences from smoking
how does operant condition impact initiation?
addictive substances and behaviours are immediately rewarding. Due to this positive reinforcement, these behaviours will increase in frequency
how does conditioning explain maintenance of nicotine addiction?
when repeated, smoking becomes an established behaviour because of the positive reinforcement
negative reinforcement as well since it takes away feelings of irritability
what is relapse: cue reactivity?
specific ‘cues’ related with situations, moods, or environmental factors are associated with the reward response from nicotine (classical conditioning)
the presence of these cues produce similar physiological (decrease of dopamine) and psychological responses to nicotine
how is cue reactivity used to explain relapse in smoking?
if a person associates specific moods, situations or environmental factors with the rewarding effects of nicotine, these can cause relapse
what is the flow chart for classical conditioning in cue reactivity?
nicotine (UCS) = lower DA levels (UCR)
smoking related stimuli (NS) + nicotine (UCS) = lowering DA levels (UCR)
smoking related stimulus (CS) = lowered DA levels (CR)
support for the role of cue reactivity (AO3)
P - Wiers et al provided support for the importance of classically conditioned cues in nicotine cravings
E - they compared a group of heavy smokers, ex smokers, and non smokers
They responded to a picture of smoking-related and neural cues with either an ‘approach’ or ‘avoid’ response
Heavy smokers showed significant approach bias towards smoking related cues compared to others
E - not the case for ex smokers or non-smokers, confirming that smoking cues play a significant role in nicotine addiction
support for learning theory exp of nic addiction - Treatment RWA
AO3
P - Drumond et al proposed a treatment approach based on the idea that cues are important in maintenance
E - he proposed a treatment (cue exposure therapy) CET, involving presenting the cues without the opportunity to engage in smoking
This leads to stimulus discrimination, where the association between cue smoking and smoking is extinguished and therefore reduces cravings.
E - 76 moderately dependent smokers did this and within 6 sessions, resulted in less cue provoking cravings
Support for SLT to explain the initiation of smoking
Peer group influences have been found to be a key factor for adolescents and their experimenting smoking
The adolescents who smoked were more likely to hang out with peers who also smoked
Karcher and Finn found youths whose parents smoked were 1.88x more likely to smoke
if siblings did = 2.64x more and 8x more if close friends did
E - supports the idea that peers, parents, and siblings could be perceived as role models and imitate their behaviour
how can positive reinforcement be used to explain the learning theory of gambling addiction?
physiological - the buzz from winning
psychological - near misses
social - peer praise
financial - the big win
how can negative reinforcement be used to explain the learning theory of gambling addiction?
an escape/ distraction from the anxieties of everyday life
how can vicarious reinforcement be used to explain the learning theory of gambling addiction?
experiencing others being rewarded for their gambling as well as their pleasure, enjoyment and financial gain makes individuals more likely to gamble
- doesn’t have to be direct observation e.g. tv or newspaper
what is continuous reinforcement?
rewarded every time the response happens
what are the 2 types of partial reinforcement schedules?
fixed or variable
what is fixed schedule reinforcement?
reward every nth time the response happens
what is variable schedule reinforcement?
random reward with an unknown frequency
what role do continuous reinforcers have in gambling addictions?
they help establish addiction, quick learning but quick extinction
shown with skinner’s rats
what role does partial reinforcement have on gambling addictions?
most effective for maintaining and avoiding extinction
what role does variable reinforcement have on gambling addictions?
creates most persistent learning as unpredictability takes longer to learn so less chance of extinction
what role does cue reactivity have on gambling addictions?
the presence of shops can cue arousal that the gambler craves without placing a bet
presence of social / environmental / media can be hard to avoid, resulting in an increase in relapse
what is the ‘big win’ hypothesis?
an early ‘big win’ leads to a strong desire to repeat earlier peak experience (positive reinforcement)
what is the ‘near miss’ hypothesis?
near misses / close losses still elicit excitement and stimulation of reward pathways
what effect does the gambling environment have on addiction?
lights, bells, coin sounds etc are exciting and can become a conditioned stimulus with excitement and reward
support for the role of partial reinforcers in gambling addictions AO3
P - Horsley et al tested the assumption that partial reinforcement is fundamental to the persistence of gambling in the absence of winning, particularly among high frequency gamblers
E - they used high and low frequency gamblers to either partial or continuous reinforcement.
After partial reinforcement, high frequency gamblers continued to gamble for longer compared to low-frequency gamblers despite the lack of further enforcement
E - concluding the greater persistence pf high-frequency groups could be due to an increased dopamine function. Making them more likely to continue gambling even in absence of reinforcement
Limitation of using the learning theory to explain gambling addiction - only some people become addicted
P - fails to acknowledge why only some people become addicted
E - although many people gamble at some point during their lives and experience reinforcement, few become addicts
E - suggesting there are other factors in the transition from gambling behaviour to addiction
Limitation of using the learning theory to explain gambling addiction - fails to explain addiction for all forms of gambling
E - for example, some forms of gambling have a short time period between behaviour and consequence whereas others have a much longer time period
E - suggests the latter form has less to do with chance and more to do with the skill of the individual
support of using the learning theory to explain gambling addiction - classical conditioning
E - meyer found the heart rate and other signs of excitement increased when gamblers played betting games and when presented with cues
E - supporting the explanation of the association and conditioned response to gambling in addiction
what is the cognitive theory explanation for gambling?
assumes that distorted cognitive processes and irrational beliefs contribute to the development and maintenance of pathological gambling
what are the 4 common biases in gambling addictions?
gambler’s fallacy
illusion of control
near miss bias
recall bias
what is gambler’s fallacy?
belief that completely random events such as a coin toss are somehow influenced by recent events
what is illusion of control?
the belief that gambling is skill-based and that they have control over the outcome and/or superstitions that the gamblers believe will improve the chance of winning
- pathological gamblers also believe their knowledge of the system gives them an advantage
what is the near-miss bias?
perceived as almost winning rather than losing so doesn’t put them off
what is recall bias?
tend to remember their wins whilst forgetting their losses
believe that they will eventually be rewarded for their efforts
what was the aim of Griffiths 1994 study?
discover whether regular gamblers thought and behaved differently to non-regular gamblers when playing fruit machines
what was the procedure of Griffiths 1994 study?
he compared 30 regular gamblers (played more than once a week) with 30 non-regular (less than once a month)
- each were given £3 to spend
- he looked at the gamblers’ verbalisations as they played
what was the hypothesis of Griffiths 1994 study?
regular gamblers will produce more irrational verbalisations than non-regular
what were the findings of Griffiths 1994 study?
regular gamblers believed they were more skilful than they were and made irrational statements such as ‘putting only a quid in bluffs the machine’ (illusion of control)
- 26/30 regular gamblers believed success was due to skill
support for the cognitive explanation of gambling AO3 - griffiths
P - the findings of griffiths support the role of cognitive process differences between regular gamblers and occasional gamblers
E - e.g. support for illusion of control comes from findings that 26/30 gamblers though wins were due to skill or skill and chance but most non-gamblers believed it was just chance
also, near miss bias is shown where gamblers described losses as near wins
E - these results provide evidence for cognitive bias in gambling
strengths and limitations of grifiths study - validity etc
a strength of the study carried out is that is was carried out in a real arcade on a typical fruit machine, therefore was high in ecological validity
however, there could be examples of demand characteristics as the pps were aware they were being studies so may have verbally responded how they thought the experimenter wanted them to
- also, only 1/30 of the frequent gamblers were female so the findings may not be representative
real world application of cognitive explanation of gambling - AO3
Development of CBT and its usefulness as an intervention to reduce addiction to gambling
CBT may help correct cognitive biases and irrational beliefs , which is likely to decrease the motivation to gamble
E - research evidence of positive outcome from the use of CBT in preventing relapse in gamblers using slot machines is evident, however this may not be representative to all gamblers
what are the 2 main ways of reducing nicotine addiction?
nicotine replacement therapy
drug treatment
explain nicotine replacement therapy (NRT)
- gradually release a lower and steady level of nicotine and decrease strength over time
- use as a base but can pair with gum, sprays etc
- reduces relapse as it reduces withdrawal symptoms and cravings
explain drug treatment as a way of reducing nicotine addiction (var)
varenicline - blocks some nicotine receptors yet triggers dopamine release in some others
- steady dopamine release so there isn’t a spike if smoking takes place
- partial agonist partial antagonist
how does the drug buropion help nicotine addiction?
developed as an antidepressant
- inhibits the uptake of dopamine.
- complex mechanism that isn’t fully understood but seems to be effective
support for the effectiveness of nicotine replacement therapy AO3
P - stead et al investigated the effectiveness of NRT and placebo in treatment
E - 150 trials that compared NRT with placebo or ‘nothing’ control group. Concluded that they were all effective in helping reduce habits and were 70% more effective than placebo
E - there was no additional support e.g. therapy, so all results were from the NRT
what are endorphines?
chemicals produced by the body to relieve stress and pain
they work similar to opioids e.g. heroine, morphine, to release dopamine
give an example of an opioid antagonist
naltrexone
how do opioid antagonists work?
- they bind to the opioid receptors in the brain, which blocks these receptors
- this prevents the rewarding response associated with a particular substance
- reducing reinforcing properties of gambling behaviour reduces the urge to gamble
example of how opioid antagonists are effective - kim et al
a 12 week double bind placebo controlled trial
individuals were given placebo or naltrexone to 45 gamblers
- Ntx was found to be effective in decreasing frequency and intensity of gambling urges and behaviour
- was more effective in gamblers with ‘severe’ urges rather than ‘moderate’
limitation of using opioid antagonists to reduce gambling
P - opioid antagonists only offer a crude and general way of reducing the effects of the brain’s reward system
E - by stopping the release of endorphines, it could cause some people to lose pleasure in other areas of life e.g. sex or exercise, while on the drug
E - making fun activities uninspiring, leads to individuals discontinuing treatment
how do SSRIs work in helping reduce gambling behaviour?
- reduces symptoms of anxiety and depression, if gambling is a coping mechanism then reducing the symptoms may stop the gambling
- impulsivity is related to low levels of serotonin, and gambling. Raising serotonin levels would lower impuslivity
support for the effectiveness of drug treatments for gambling
P - SSRIs raise serotonin levels in the brain. These drugs have been seen to reduce gambling behaviours
E - Grant and Potenza gave 13 gambling addicts an SSRI for 3 months. After the 3, some of the individuals who had improved were randomly assigned more SSRIs or a placebo drug. All who continued, improved for the next 3 months, whereas those on the placebo drug, returned to anxious and gambling behaviours within 4 weeks
E - suggesting improvements were due to the SSRI drug
how does aversion therapy work?
- the behavioural approach states that addictions are learned through conditioning. Therefore, can be reduced or eliminated by changing the association or consequence
- replacing the good with bad
how does aversion therapy work with alcohol addiction? use an example of a drug
antebuse
- blocks the breakdown of alcohol in the body
- build up of a toxic alcohol related compound that causes a lot of vomiting
- for chronic alcoholism
is antebuse drug therapy?
no
explain how aversion therapy can be used to help gambling addiction
electric shock = pain
electric shock + gambling = pain
gambling = pain
gambling stimuli paired with shocks until a conditioned effect occurs = no more cravings
support for the efficacy of aversion therapy for addiction AO3
E - alcohol treatment for 600 patients using aversion therapy in 3 treatment hospitals, 75 of which also received cocaine treatment. 12 months after treatment, follow up found that 12 months after, there was a 65% rate of alcohol abstinence, and 83.7% cocaine.
E - this supports the use of aversion therapy
what is covert sensitisation?
involves eliminating unwanted behaviour by creating an association between the behaviour and an unwanted unpleasant stimulus.
Once the association is established, engaging in behaviour is no longer appealing
what was Kraft and Kraft’s study? can be AO1 or AO3
- used hypnotic suggestion to associate feelings of nausea to behaviours such as smoking, alcoholism, and chocolate addiction
- successfully treated the chocolate addiction, eliminating cravings in 4 sessions
- concluded it is a rapid and effective form of treatment
- claimed 90% effectiveness
strength of covert sensitisation and its effectiveness when compared to aversion therapy
McConaghy et al compared gambling addicts who either received electronic shock aversion therapy of covert sensitisation.
One year later, 90% in CS reported a reduction in behaviour whereas only 30% in the aversion group
strength of CS being less unethical than aversion therapy AO3
since there are no physical risks, such as induced sickness or electrical shock. Also individuals are not required to engage in the problem, but to imagine it, reducing the possibility of harm even further
outline the process of using CBT to help reduce addiction
typically use 10 x 1 hour sessions
focuses on changing thought processes and challenging irrational thinking and find better ways to cope
- helps individuals develop adaptive and helpful ways of thinking
- follow up sessions to prevent relapse
what are the 5 steps of CBT for gambling addictions?
- identification of triggers for behaviour
- identify irrational beliefs/ biases (e.g. recall bias)
- challenge and correct errors in thinking so reduce the urge to gamble e.g. ask how blowing on dice helps improve chance of winning
- find preferable behaviours/ solutions
- therapy can be online, in person, groups, emails etc
what is the aim of CBT (IA)
reduce pathological and excessive use of technology and internet
what are the 3 steps in CBT for internet addiction?
- modify behaviour by controlling internet usage
- reduce maladaptive cognitions - get rid of false assumptions
- identify and find strategies to address and deal with real problems that led to the addiction e.g. anxiety, drugs, depression
how do patients change their behaviour in CBT?
- encouraged to practice changes in every day life (homework) working from small to big things
- e.g. to go into a casino and not place any bets or go out for the day without a phone
- use behaviours and activities such as going to the gym to avoid addiction
- keep a diary and record triggers related to problem behaviour
how does relapse prevention work in CBT?
clients learn to recognise and avoid risky situations and triggers
e.g.
places - casinos or arcades
feelings - loneliness or boredom
situations - financial, work, family
support for the value of CBT as a treatment for addiction
Magil and Kay found CBT to be effective in reducing both alcohol and illicit drug, in a meta analysis of CBT trials. this was effective in both groups and individual settings
Kim et al also studied 65 adolescents who showed excessive online game play. After therapy, those who were in the CBT group scored higher on life satisfaction and lower on internet addiction than those without CBT, compared to their original scores.
advantage of CBT when compared to other therapies
some drug therapies used to treat gambling addictions can have strong negative side effects. For example, opioid antagonists such as naltrexone which binds to opioid receptors, blocks dopamine and therefore, regular activities which would normally stimulate dopamine no longer do, making individuals likely to stop taking the drug
By changing the underlying negative thought processes, an individual may be more resistant to every day pressures such as peer influence, and may feel less overwhelmed with life and therefore reducing triggers for coping
what is the theory of planned behaviour?
a model used to predict behaviour by looking at attitudes and beliefs which influence their intention and therefore behaviour
who proposed the theory of planned behaviour?
Icek Ajzen
what are the 3 things that influence intention on the theory of planned behaviour?
- attitudes towards the behaviour
- subjective norms
- perceived behavioural control
what us behaviour attitude?
positive or negative evaluation of a behaviour and a belief about the outcome
what are subjective norms?
an individual’s subjective awareness of whether an action is common
e.g. if all friends smoke, smoking will be perceived as more common and okay
what is perceived behavioural control?
the extent to which you believe you can do a behaviour
more control over self = stronger perseverance and intention
the key determinant for behavioural change
what are ways of changing behavioural attitudes in addiction?
show negative examples of the behaviour such as its cost or effect on health
what are ways of changing subjective norms?
show how the majority of people do not carry out that behaviour - stats
Limitation of the theory of planned behaviour - too rational AO3
The theory of planned behaviour is too rational. It makes the incorrect assumption that the formation of an intention to start an addiction is rational and involves logical decision making. When completing a questionnaire about attitudes and intentions, people might underestimate the strong desires and emotions to compel their behaviours in real life. This reduces the usefulness of applying theory of planned behaviour, since addiction is an irationnal way of dealing with external pressures.
methodological issues with the theory of planned behaviour? AO3
The subjective nature of several components of the TPB means that it is hard to assess objectively and measure the reliance on self report techniques limits reliability. Ogden argued that many addicts are in denial, meaning they’re unlikely to be able to give accurate responses. This is especially the case as addiction is generally treated as a taboo subject and an undesirable characteristic, meaning the result will be further influenced by social desirability bias
limitation of TPB - predicts intention rather than actual behaviour change
It is successful in predicting intention rather than actual behaviour change, and ignores other factors. Topa suggested that group variables such as peer identification, could play an important role in the relation with tabaco addiction. It also ignores motivation. Klog studied 350 substance abusers and found that recovery was consistently more successful in those who chose to get help, rather than those coerced. Therefore, self determination theory is prefereable as it acknowledges and emphasises individual motivation.
What are the 6 stages of Prochaska’s model?
- pre-contemplation
- contemplation
- preparation
- action
- maintenance
- termination
what is a description of the pre-contemplation stage and techniques to help?
denial, unaware of behaviour, resistance, may feel hopeless, avoid subject
help
- clarify that the decision is theirs
- encourage re-evaluation of current behaviour
- explain and personalise the risk
what is a description of the contemplation stage and techniques to help?
aware of the problem, may have an idea of how to change, not quite ready, realising other opportunities
help
- encourage the evaluation of pros and cons of change
- promote new outcome expectations
what is a description of the preparation stage and techniques to help?
detailed plan established, announced intention to change, set to take action
help
- identify support
- encourage small steps
- verify change skills
what is a description of the action stage and techniques to help?
visible action, overt behaviour change, shift in thinking and self image, up to about 6 months, vulnerable to relapse
help
- increase self efficacy for dealing with obstacles
- combat feelings of loss and reiterate long-term benefits
what is a description of the maintenance stage and techniques to help?
ongoing effort and commitment, consolidated change into habit, 6 months+, vulnerable to relapse
help
- reinforce rewards
- discuss coping with relapse
- plan for follow-up support
what is a description of the termination stage and techniques to help?
desired change to complete, new behaviour has become normal, 1/6 get to this stage
help
- reward
strength of prochaska’s 6 stage model - flexible
The model is flexible and reflects the everchanging emotions and attitudes towards the
behaviour. It has been recognised that addicts can switch between being in denial of their
problem and at other times realise they are an addict.
Therefore, the model offers a positive move away from an ‘all or nothing’ view of addiction
and suggests suitable interventions for people at different stages.
It also considers a realistic view of relapse which is built in to the model and is seen as a
normal part of the process rather than a failing of the addict.
strength of prochaska’s 6 stage model - practical application
It can suggest the most effective strategy by determining which stage an individual or target group is in, this can result in tailored and effective interventions.
For example women found to be further along the 6 stages were more convinced about the
dangers of smoking in pregnancy. In contrast, women in the first stage (precontemplation)
were more resistant to changing to healthy behaviours in pregnancy, Haslam and Draper
(2000).
This supports the usefulness of tailoring interventions depending on the stage of
change to increase the effectiveness of support and/or therapy.
Limitation of prochaska’s 6 stage model - limited evidence for behavioural outcomes
A limitation arises from reviews of research evidence as there are limited empirical studies
that have used behavioural outcomes as a measure for usefulness. A review conducted by
Whitelaw et al, concluded that stage progression as a measurement was a ‘softer’ method of
assessing the model’s success.
Stage progression is used as an indicator of success, however this doesn’t necessarily lead
to behaviour change. The intention to stop smoking may not result in stopping.
Due to limited scientific support, the supporting evidence may be overstated.
Limitation of prochaska’s 6 stage model - methodological issues
Research support for the stages of change theory has further issues.
There is a lack of evidence derived from robust experimental design. Some studies didn’t use
control groups, others only used selfselected samples. In addition, some studies have used a
variety of other treatments, such as nicotine replacement therapy and behavioural counseling.
Therefore, it is hard to distinguish effects from the stages of change approach from
other intervention effects.
