Addiction

Question 1

What is addiction

Answer 1

A mental health problem where somebody develops a compulsive, repetitive use of a substance/behaviour because it is pleasurable. They become entirely focused on the substance / behaviour with harmful consequences. They become dependent on it, in order to avoid withdrawal symptoms.

Question 2

What is dependence

Answer 2

Is a characteristic of addiction but is not the same.

Dependence is doing something because of the psychological reliance and to prevent withdrawal symptoms

Addiction is were a person is dependent on the substance activity but also does it because of the sense of escape.

Question 3

Substance misuse versus abuse

Answer 3

The difference between substance misuse and abuse lies in the person’s intentions.
Misuse is not following the ‘rules’ for usage like taking a substance more often than recommended or using it for something else.
Abuse is using the substance to ‘get high’ or to escape because a person’s intentions are about the outcome of taking the drug.

Question 4

What are the clinical characteristics for ICD - 10

Answer 4

1. A strong desire to use the substance.
2. Persisting despite known harm.
3. Difficulty in controlling use.
4. A higher priority given to the substance.

Withdrawal symptoms if substance/activity is stopped.
Evidence of tolerance, i.e. needing more to achieve the same effect.

Question 5

What is the ICD

Answer 5

International Classification of Diseases (ICD-10) has a category called ‘Mental and behavioural disorders due to psychoactive substance abuse disorders’.
A diagnosis of addiction should usually be made only if three or more characteristics have been present together at some time during the previous year.

Question 6

What is peer influence

Answer 6

Nurture’ refers to the influence of experience from the physical and/or social environment.
Peers are people who are equal in terms of, for example, age or education.

Question 7

What is the social learning theory

Answer 7

Learning through the imitation of role models especially especially if they are rewarded.
If a peer smokes we see them as a role model and imitate them to be like them

Question 8

What are social norms

Answer 8

Unwritten rules we look to our peers for norms/guidence on how to behave.
Peers influence our social norms and tell us what is acceptable for our social group

Question 9

What is social identity theory

Answer 9

Being defined by a particular social group. We take part in group behaviours to avoid being an outsider and maintain our group memberships

Question 10

Creating opportunities for addictive behaviour

Answer 10

Peers provide opportunities for an individual to smoke or use alcohol by someone else purchasing items or providing a safe place to do drugs. They may also instruct a person on what to do

Question 11

Evaluate the psychological explanation for addiction

Answer 11

One strength of peer influence as an explanation of addiction is that there is research support.
Simons-Morton and Farhat reviewed 40 studies into the relationship between peers and smoking and found that all but one showed a positive correlation between the two factors.
This shows a strong relationship between peers and addiction.

One weakness is that peers may not be doing any influencing.
Individuals may just be actively selecting others who are like them rather than conforming to the social norm of the group.
This means addictive behaviour is a consequence of addiction rather than the group causing the addiction.

One strength of the peer influence explanation is its real-world application.
Programmes using normative education have had more success than just resistance skills (Hansen and Graham).
This shows the positive value in peer influence explanations.

Question 12

What is aversion therapy

Answer 12

Based on classical conditioning.
Addict learns to associate their addiction with something unpleasant, and therefore avoids the addictive substance

Question 13

How can you treat alcoholism

Answer 13

A drug like Antabuse is taken which causes nausea.
Just before vomiting, the addict has an alcoholic drink several times.

Antabuse (UCS unconditioned stimulus) leads to vomiting (UCR unconditioned response)

Alcohol (NS neutral stimulus) is associated with Antabuse (UCS).

Alcohol becomes a learned/conditioned stimulus (CS) producing nausea (CR). Conditioned response
Alcohol is no longer associated with pleasure but vomiting.

Question 14

How can you treat gambling

Answer 14

An addicted gambler writes phrases related or unrelated to gambling on cards.
The gambler reads out each card and gets an electric shock for gambling-related phrases.

Electric shock (UCS) leads to pain (UCR)

Gambling-related phrase (NS) is associated with electric shock (UCS).

Gambling-related phrase becomes a learned/conditioned stimulus (CS) associated with pain (CR).
Gambling-related behaviours now associated with pain.

Question 15

How can you treat smoking

Answer 15

Addicted smoker rapidly smokes in closed room.
Disgust/nausea from smoking is associated with smoking.

Question 16

Evaluate aversion theory

Answer 16

Addicts may abandon the therapy as it uses stimuli that are unpleasant.
Many addicts drop out before the treatment is completed. It wouldn’t work unless the aversive stimulus was negative.
This means it is difficult to assess the effectiveness of the treatment.

A weakness is that benefits of aversion therapy seem to be short-term rather than long-term.
In a long-term follow-up of up to nine years McConaghy et al. found that aversion therapy was no more effective than a placebo, and covert sensitisation was more effective.
This suggests that aversion therapy lacks overall effectiveness.

EXTRA: A holistic approach
One strength is that aversion therapy can be combined with CBT in a holistic way.
Aversion therapy gets rid of the immediate urge to use the addictive substance and CBT provides longer lasting support where a person’s thoughts and feelings are worked on.
This provides a longer-term solution to the addiction.

Question 17

What is a self management program

Answer 17

A theory method which requires no specialist leader. The individuals organise their own treatment

Question 18

Describe the step of the higher power in the Alcoholics Anonymous 12 step program

Answer 18

One key element to the 12-step recovery programme is giving control to a higher power and letting go of your own will.
Could be a religious power or power of the group

Question 19

Describe the step of admitting and sharing guilt in the Alcoholics Anonymous

Answer 19

Person comes to terms with the things they have done.
Members of the group and the higher power listen to the confession to accept the ‘sinner’.

Question 20

Describe the step of lifelong processes in the Alcoholics Anonymous recovery program

Answer 20

Recovery is a lifelong process where the group supports each other.
They can call other members if they need help in the case of relapse.

Question 21

Evaluate self management as a treatment for addiction

Answer 21

One weakness is the lack of research showing effectiveness.
The AA reported in 2007 that 33% of its 8000 North American members have remained sober for ten years or more but this doesn’t include how many left without success.
This suggests that it is difficult to get clear evidence on effectiveness.

A weakness is that the 12-step programme may only be effective for certain types of people.
The dropout rates are high which suggests that the self-help approach is demanding and requires high levels of motivation.
This means that the treatment is a limited approach.

One strength is that the 12-step recovery programme focuses on the whole person.
Many steps are concerned with emotions, particularly guilt, together with providing social support to help a person cope with their emotions.
This can be contrasted with more reductionist programmes, such as aversion therapy which targets just stimulus-response links

Question 22

Definition of holistic

Answer 22

Taking the whole person into account

Where as a reductionist takes the more in depth