addiction- 3 Flashcards
what is addiction
disorder characterized by repetitive behaviours despite substantial adverse consequences (e.g., damage to health or negative social consequences)
what is psychological dependance
form of dependence that involves emotional–motivational withdrawal symptoms upon ceasing to use a drug or discontinuing habit-forming behaviours
what is tolerance
reduction in the response to the drug, so that more is required for the same effect -occurs in response to sustained use of a tolerance-forming drug- Not all drugs are tolerance forming
- Behavioural tolerance- an individual learns through repeated exposure to the drug to adjust their behaviour to compensate for the effects of the drug
what is physical dependance
when the body undergoes a physiological change in response to the repeated use of substance/drug.
-evidenced by withdrawal syndrome
-most common with tolerance-forming drugs, but can occur in non-tolerance forming drugs too
what is withdrawal syndrome
when a person who has developed physical dependence to a drug stops or reduces intake of the drug.
-physical symptoms- increased heart rate, higher blood pressure
-psychological symptoms- anxiety, anhedonia (loss of pleasure) and cravings
what is genetic vulnerability
any inherited predisposition that makes a person vulnerable to addiction, e.g. 40% to 60% of the risk for alcoholism is genetic
why are peers a risk factor for addiction
people of a similar age and social status become a significant risk factor as young people are highly motivated to seek social acceptance
- model attitudes that encourage addictive behaviour- creation of a group norm that favours risk-taking
-Because addictive behaviours draw attention, adolescents often over-estimate the extent to which their peers engage in such behaviours- creates a misconception that addictive behaviours are normal and therefore acceptable
how is personality a risk factor for addiction
Personality refers to patterns of thinking, feeling and behaving that differ between individuals
-traits that contribute to development of addiction;
-impulsive personality, likely to act on desires without thinking of consequences- focus on instant gratification.
-Sensation seeking - involves need for high levels of external stimulation with the urge to seek such stimulation
how is stress a risk factor for addiction
self-medication theory- use drugs to cope with tension associated with life
stressors- drug use functions as a means to regulate emotions and soothe psychological distress
- biological explanation- Chronic stress reduces functioning of prefrontal cortex, leads to more impulsive decision making
how is family influence a risk factor for addiction
parenting style that are risk factors;
-permissive style (involved with the child but do not place any controls on their behaviour)
-authoritarian style (demanding and quickly resort to the use of punishment)
-authoritative style of parenting (high levels of emotional warmth and an appropriate level of parental control) is a protective factor
limitation- research into risk factors- free will
theorises that if a person is exposed to enough risk factors they will develop an addiction- overlooks the role of free will
-no conscious decision making in the development of an addiction- addicts never had a choice
however- challenges the idea that addicts have “chosen” to be such
-could lead some to believe they lack the internal locus of control to take control of their behaviour and give up their addiction
strength - research into risk factors- economic impacts
drug addictions lead to £10.7 billion in policing, healthcare, welfare and crime -leads to economic inactivity and poor productivity
-can inform public policies that can reduce the likelihood of developing an addiction- can save society money.
explain the pathway of nicotine in the brain
-binds with and activates nicotine receptors in the VTA in the reward pathway
-leads to release of dopamine in the nucleus accumbens- creating the rewarding feeling of pleasure
why does tolerance occur-nicotine addiction
the nicotine receptors become less responsive to nicotine through repeated exposure- desensitisation
-binding of nicotine causes less excitation over time- means less dopamine is released into the nucleus accumbens
-upregulation of receptors due to increased exposure to nicotine
why does withdrawal syndrome occour
combination of no nicotine and desensitized nicotine receptors means the body will struggle to activate these receptors with only acetylcholine
-less dopamine is released because of this- low mood, anxiety, cravings for nicotine
-upregulation-more receptors made for desensitisation- positive feedback
what happens if a smoker quits for a sustained time
nicotine receptors in the VTA return to normal sensitivity- less receptors are needed, downregulation
-reward pathway returns to a normal state of activity
-tolerance to nicotine is reduced
limitation-neurochemical exp for nic addiction- limited exp
study found- social factors increased the probability of adolescent smoking
-demonstrates the importance of social factors in exp of nic addiction- partial explanation for nicotine addiction
-neurochemical exp still needed- e.g. biopsychosocial
- must include all relevant levels of explanation
strength- neurochemical exp for nic addiction- real-life applications
-drug treatments for addiction- varenicline is x3 more effective in helping people quit than placebos
-effectiveness of drug treatments, show the neurochemical exp is of practical use in society
-economic implications of the neurochemical exp- less smokers means less health treatment for smoking related diseases
-effectiveness of varenicline provides indirect support for the neurochemical exp- generates effective treatments
outline SLTs exp for why people start smoking
(role) model models smoking behaviour,
attention, retention, motor reproduction, motivation, imitation
-vicarious reinforcment makes this more likely
learning theorys exp for why smokers continue to smoke
positive reinforcement- rewarding feeling from dopamine in reward pathway
negative reinforcement- removal of withdrawal syndrome
what is cue relativity
learned response seen in addicts, involving physical reactions and psychological reactions in response to stimuli associated with their addiction
-primary (cigarette) and secondary (friends who smoke/lighters) reinforcers
strength- learning theorys exp for nic addiction- research support
meta-analysis- when smokers were presented with items associated with nicotine, their heart rates increased and they reported a strong desire to smoke.
-support the exp- cue relativity and classical conditioning
-meta-analysis-data from several published studies- reliable
limitation- learning theorys exp for nic addiction- limited exp
only around half the people who smoke in adolescence develop an addiction
-according to learning theory everyone who starts smoking should continue due to the positive reinforcement from smoking- other factors are needed to explain this
- holistic exp shown in biopsychosocial
-complete exp cannot operate at a single level of explanation
outline learning theorys exp for gambling addiction
gambling is directly reinforced through operant conditioning
- positive reinforcement- act of gambling is rewarded and reinforced by a pay-out, especially the ‘big wins’
-negative reinforcement- offers a way of escaping from negative aspects of a person’s life- leads to a spiral in which the negative aspects become worse as the gambling continues, meaning the gratification of escaping the negatives become greater
what is a near miss and how does it reinforce the behaviour of gambling
gambling can even be positively reinforced by losing, as nearly winning (a ‘near miss’) can still create a feeling of excitement which is rewarding enough to reinforce the behaviour
what is a reinforcement schedule
the pattern through which a behaviour is reinforced
what is a partial reinforcement schedule
when the behaviour is not reinforced` every time it is completed
what is a variable reinforcement schedule
there is an uncertainty about if and when a behaviour will be reinforced
what is a fixed reinforcement schedule
there is a clear pattern to when the behaviour will be reinforced
what is a variable ratio schedule
a reward being given a certain amount of the time, but at unpredictable times
-e.g. slot machine
explain gambling addiction through classical conditioning
gambling addicts will have learned to associate a range of stimuli with gambling- being exposed to these stimuli may result in a gambling addict experiencing the psychological desire to gamble
limitation- learning theory’s exp for gambling- limited exp
research shows- many people gamble at some point but do not become addicted even in the same situations gamblers were in
-individual differences can’t be explained
-stimulus-response exp is too simplistic
-e.g. biopsychosocial exp needed-holistic exp
strength- learning theorys exp for gambling addiction- real life applications
-covert sensitization- a year after receiving covert sensitisation, 90% of patients had reduced their gambling.
-useful applications and success provides indirect support for validity of exp
- study doesnt have a control group-limited support for learning theory’s exp
what are cognitive biases
systematic errors in thought processes that lead gambling addicts to expect that continuing to gamble will be profitable
what is the illusion of control
incorrectly judging the extent to which an outcome can be controlled
overestimating their ability to influence the outcome of an event
so overestimating their chances of winning
what are faulty perceptions
distorted perception about the odds of winning-e.g. gambler’s fallacy- the belief that a losing streak increases the chance of a subsequent bet winning
what are recall biases
tendency to remember wins and forget losses
-series of losses wont stop them from gambling
-has a memory of typically winning so form an expectation that the benefits outweigh the costs
strength- cog exp for gambling addiction- research support
Griffiths - regular gamblers were more likely to make irrational utterances (e.g., saying they had tricked a fruit machine) than non-regulars
-evidence of an increased vulnerability to the illusion of control in regular gamblers compared to irregular gamblers
- use of a naturalistic setting strengthens its conclusions- high ecological validity so generalisable
limitation- cog exp for gambling addiction- limited exp
large amount of variation- some types of gambling seem to be affected more by cognitive biases than other types
-not easily explained by the cognitive explanation- should be a clear relationship between the gambling addiction and the experience of cognitive biases- too simplistic
-biopsychosocial exp- holistic exp explains multiple pathways to addiction
what are agonist drug therapies/ what is their function
bind with and activate receptors in the brain that are involved in the original addiction
- reduce withdrawal symptoms making it easier for addicts to abstain.
-e.g. varenicline to treat nicotine addiction
what are antagonist drug therapies/ what is their function
bind with but do not activate receptors- used to prevent addictive behaviours from producing pleasurable effects
-e.g. naltrexone used to treat addiction to opioids
-also used to treat gambling addiction-reduces the release of dopamine into the reward pathway so gamblers may experience less reward from gambling
strength- drug therapies for addiction- research support
meta-analysis by the Cochrane charity- varenicline is the most effective medication for tobacco cessation- three times more likely to quit on varenicline than with placebos
-provide clear support for the effectiveness of varenicline
-use of control group shows real – rather than just psychological - effects
-meta-analysis- large samples so representative
-not all drug therapies are equally effective in treating addiction
limitation- drug therapies for addiction- side effects
most medications can cause side effects-mild nausea while taking varenicline, or diarrhoea and abdominal cramping with naltrexone
-undermines the effectiveness of a drug therapy as a treatment- patient may refuse to begin treatment or decide to abandon the treatment before they overcome their addiction
-ethical issues- potential for harm caused by the side effects
outline aversion therapy (overt sensitization)
therapist will explain the treatment rationale and protocol- understanding and consent are important
- patient keeps a behavioural diary of their addiction-can be checked after sessions to see if therapy is effective
- patient is exposed to their addiction and pre-selected negative stimulus
Outline covert sensitisation
therapist explains treatment rationale and protocol- understanding and consent are important
- patient keeps behavioural diary of their gambling- can be checked after sessions to see if therapy is effective
- therapist instructs the client to imagine themselves engaged in their addictive behaviour and then imagine an extremely unpleasant consequence- worse imagined situation is more effective therapy
-then instructed to imagine a situation in which they refuse the addictive behaviour and experience feeling relieved
limitation- behaviour interventions- changing addictive behaviour
only work by seeking to replace positive associations with negative ones
-changing associations is incredibly difficult, associations formed over years- interventions only last weeks
-ignores other levels of explanations- cog explanations etc.
comparison point-behavioural interventions- comparative research
compared effectiveness of behavioural interventions
-McConaghy -one-year follow up 90% of patients receiving covert sensitisation had reduced their gambling compared to only 30% of patients receiving aversion therapy
-findings suggest that both interventions may be effective- covert sensitisation is considerably more effective than aversion therapy at helping gambling addicts
-lack of control group- not possible to compare the effect of these interventions with the effect of not doing anything
ideas behind CBT for addiction
addiction is a learnt response- stems from irrational thought processes and maladaptive behaviours
-new patterns new patterns of thinking and behaving are taught to avoid addictive behaviour
what is functional analysis
identify high-risk situations (triggers) leading them to engage in their addictive behaviour
why is functional analysis effective
Addictions involve habitual behaviours and patterns of thinking that occur in response to cues
-therapist can help the client find ways to change their thinking and behaviour by understanding the cues
what is cognitive restructuring
therapist helps client examine thought processes which precede their addictive behaviour and challenge them
why is cognitive restructuring effective
CBT views irrational patterns of thinking as a root cause for addiction
-Changing the patterns can produce changes in negative behaviours and emotions that support an addiction
what is behavioural skills training
The therapist teaches the client skills that can help them avoid engaging in their addiction
why is behavioural skills training effective
Addictions are often linked with a wide range of maladaptive behaviours
-changing these means the client can be supported to avoid situations which may lead them to engaging in their addiction
strength- CBT for addiction - research support
Petry- participants receiving 8 sessions of CBT and attending Gamblers Anonymous (GA) gambled significantly less after 12 months than controls who only attended GA
- suggests that CBT may have long-term benefits
-use of a control group strengthens its internal validity and therefore adds weight to its conclusions
-findings cannot be generalised to other addictionsl
limitation- CBT for addiction- reductionist approach
CBT focuses only on irrational thinking and maladaptive behaviours
-only focuses on addressing issues arising from only one level of explanation: the cognitive
-biopsychosocial- no single pathway to addiction
-CBT doesn’t address other levels of explanation
what does the theory of planned behaviour explain
how humans can change a behaviour, such as quitting an addiction
what are intentions influenced by (TPB)
attitudes, subjective norms and perceived behavioural controls
what are intentions (TPB)
person’s motivation to engage in a behaviour- strength of an intention can be influenced
how is attitude formed (TPB)
by what a person believes to be the outcome of the behaviour, and the importance they attach to this outcome
what are subjective norms (TPB)
individual’s beliefs of if others believe the individual should engage in the behaviour ;descriptive and injunctive norms
-descriptive norms-what a person believes about how often others engage in the behaviour
-injunctive norms refer to the person’s beliefs regarding- what other people think about the behaviour
what is perceived behavioral control (TPB)
how easy a person believes carrying out a behaviour will be- higher PBC if they think it will be easy
strength- TPB- ability to predict behaviour
Kelly- surveyed 168 alcoholics, intention to seek further treatment after initial detox was significantly correlated with how they responded to the attitude and perceived behavioural control questions
-intention to change the addictive behaviour is the result of contributing factors
-especially strong - large sample, high population validity
limitation- TPB- methodological issues
research relies on self-report measures and correlational analysis of factors
-social desirability bias may lead addicts to give answers that do not reflect their actual behaviour/ thinking
-supporting research may lack validity -Evidence of correlation is not evidence of causation- could be explained by a third variable
outline Prochaska’s six-stage model of behaviour change
quitting an addiction is a process that happens in stages
-progression through stages need not be linear
-effectiveness of an intervention for addiction depends partially on what stage the addict is in
order of Prochaska’s six-stage model
pre-contemplation, contemplation, preparation, action, maintenance
-termination
outline pre-preparation (six-stage model)
not thinking of changing their behaviour in the near-future (6 months time).
-may be aware what they are doing is unhealthy or may be in denial
-Intervention should focus on providing information and advice
outline contemplation (six-stage model)
thinking about changing their behaviour in the near future (within 6 months) but not definitively
-weighing up the costs and benefits of taking action
-Information and advice should be the basis for any intervention.
outline preparation (six-stage model)
decided the benefits outweigh the costs and decides to act, sometime in the next month
haven’t worked out what they should do to change their behaviour- Relapse is still a concern
-interventions should focus on constructing a plan
outline action (six-stage model)
has done something within the last 6 months to change their behaviour
-action taken must be meaningful enough to actually reduce risk- Relapse is still a concern
-specific treatments will be useful at this stage- coping skills
outline maintenance (six-stage model)
maintained some change of their behaviour for more than 6 months
-growing confidence that they can maintain this change
-relapse still a concern
-Effective intervention will focus on developing coping skills
outline termination (six-stage model)
newly learnt behaviours become automatic
-person no longer feels tempted by their addiction and have complete confidence in their ability to maintain the change
-Relapse may still be possible, but it is no longer a concern
-intervention no longer required
strength- six- stage model- applications
meta-analysis-Velicer- found that smoking cessation programs based on Prochaska’s model were more successful than programs not based on it
-provides indirect support for the validity of the model- interventions were more successful if they were tailored to the stage an addict is in as the model suggests
- if the model was incorrect, then interventions that used its ideas wouldn’t be effective
- meta-analysis -large sample so representative
-only shows Prochaska’s model has been useful for helping smokers
limitation- six-stage model- focus on conscious decision making
evident in preparation stage- consciously decided the benefits of quitting outweigh the negatives, and consciously plan how to give up
- neglects that patterns of addictive behaviour become entrenched and semi-automated through repeated reward
-assumption that addicts can choose socially sensitive -suggests they choose to be addicts
-hard determinist approach to explaining addiction-avoids the attribution of responsibility and the potential for blame to the addict
