Addiction

Question 1

Physical dependence

Answer 1

− Physical dependence can occur with the long-term use of many drugs, for example, heroin and nicotine, but also prescription drugs, such as sedatives and anti-anxiety drugs e.g. BZ’s.
− Physical dependence on a drug often follows heavy daily use over several weeks or longer.
− People with a physical dependence need to take the drug in order to feel normal.
− Physical dependence does not necessarily mean the individual is ‘addicted’ to the drug, but such dependence often accompanies addiction.
− Physical dependence can be demonstrated by the presence of unpleasant physical symptoms known as withdrawal symptoms if the person suddenly abstains from the drug. The person depends on the drug to avoid these withdrawal symptoms and to function normally.
− Physical dependence is often accompanied by increased tolerance, in that the user requires more of the drug to experience the desired effect.

Question 2

Psychological dependence

Answer 2

− Psychological dependence occurs when a drug becomes a central part of an individual’s thoughts, emotions and activities. It can be demonstrated by a strong urge to use the drug, despite being aware of any possible harmful effects associated with its use.
− A characteristic of both types of dependence is the experience of cravings: a powerful desire for something that make it hard to stop + change their habits
− Psychological dependence may also arise for behaviour (non-physical) addictions. For example, gamblers who are motivated by the thrill of winning money may experience cravings to gamble that are every bit as strong as those experienced by drug addicts, making it hard for them to change their habits.

Question 3

Tolerance

Answer 3

− Tolerance occurs if drugs are used for a long period of time. Increased tolerance means that the person no longer responds to the drug in the same way. Therefore, increasingly larger doses are needed to feel the same effects.
− There are three ways in which tolerance can occur:
→ Metabolic tolerance – enzymes responsible for metabolising the drug do this more efficiently over time. This results in reduced concentrations in the blood and at the site of drug action, making the effect weaker.
→ Prolonged drug use leads to changes in receptor density, reducing the response to the normal dose of the drug.
→ Learned tolerance – the user has learned to function normally when under the influence of the drug.

Question 4

Withdrawal syndrome

Answer 4

− Withdrawal Syndrome occurs when a user abstains from the drug. They are an indication of the person’s physical dependence on the drug as the body attempts to deal with the absence of a drug’s effects. A user may take the drug again to relieve these symptoms.
− E.g. depression, anxiety, irritability, loss of/interrupted sleep
− The two phases of withdrawal:
→ Acute withdrawal begins within hours of cessation and gradually resolves after a few weeks. The physical cravings are intense and persistent.
→ Post-acute withdrawal can last for months or even years after the person has stopped taking the drug. It is characterised by emotional and psychological turmoil as addicts experience alternating periods of dysfunction and near-normality as the brain slowly re-organises and re-balances itself.

Question 5

Genetic vulnerability (risk factors)

Answer 5

− Some individuals may be born with a genetic vulnerability (or a predisposition) to develop an addiction.
− Genetic Vulnerability: the idea that someone may be more likely to become an addict because of their genetic make-up.
− This does not mean that they will definitely develop an addiction but they are more likely to, given the right circumstances e.g. environmental triggers

Question 6

Genetic vulnerability (risk factors) research

Answer 6

− Looking at the DNA of addicts and non-addicts, Neilsen et al. (2008) found that former heroin addicts have certain genes in common more frequently than non-addicts.
− Twin studies, such as Slutske et al. (2010) found that MZ twins had a much higher percentage of both twins being pathological gamblers* than DZ twins (Males: 49% vs. 21%; Females: 55% vs. 21%).
− Twin studies have also suggested an association between genes and addiction to alcohol, nicotine and cocaine.
− Kendler and Prescott (1998): compared concordance levels of drug abuse among MZ and DZ twins. The classification of drug abuse was the criteria set out by the DSM-IV and data from nearly 2000 twins was used.
→ The concordance rates for using, abusing and being dependent on drugs were higher for MZ than DZ twins. These figures indicate there is a genetic link to use of drugs. (Cocaine dependence: MZ twins – 35%, DZ twins – 0%)

Question 7

Genetic vulnerability (risk factors): The dopamine receptor gene – the A1 variant of the DRD2 gene (the ‘reward gene’)

Answer 7

− Research suggests that there is a specific gene involved in addiction, which goes some way to explain the genetic origins of addictive behaviour.
− Blum & Payne (1991): individuals who are vulnerable to drug addiction suffer from abnormally low levels of dopamine and a decreased ability to activate dopamine receptors in the reward centre of the brain (the nucleus accumbens). This means that anything that increases the amount of dopamine can produce strong feelings of euphoria.
− Blum et al. (1990) reported that a particular variant (the A1 variant) of the dopamine receptor (DRD2) gene associated with fewer dopamine receptor sites (resulting in lower levels of dopamine in the brain) occurred with a much higher frequency in the DNA of samples taken from alcoholics compared to non-alcoholics.
− Other research has implicated the A1 variant of the DRD2 gene in nicotine dependence, cocaine dependence and addiction to gambling.
− Individuals with this gene may not receive enough stimulation from everyday activities, such as eating and sex. Thus, individuals continue to engage in the addictive behaviour to compensate for the dopamine deficiency and increase levels of the neurotransmitter in the nucleus accumbens.
− Therefore, the way our genetics can increase our likelihood of becoming addicted is the way our body responds to a drug i.e. whether we experience more of its positive or negative effects.
− For example, about 50% of people from Asia possess a genetic code that causes them to metabolise alcohol in such a way that it makes them feel nauseous when they drink it, thus experiencing negative effects.

Question 8

Genetic vulnerability (risk factors): Genetics and the diathesis-stress model

Answer 8

− Research suggests that a gene-environment interaction is needed for an addictive behaviour to develop - an individual will not become addicted if they are not exposed to the substance in their environment.
− The Diathesis-Stress Model: we inherit a genetic vulnerability for developing an addiction. However, a disorder will only manifest itself if triggered by a life event

Question 9

Evaluation of Genetic vulnerability (risk factors): Strengths

Answer 9

ϑ An advantage of the genetic vulnerability explanation of addiction is that it can explain why some people develop addictive behaviour, yet others who have the same environmental experiences and life pressures do not.
ϑ Research support: research clearly indicates a genetic vulnerability to addiction.

Question 10

Evaluation of Genetic vulnerability (risk factors): Issues with twin studies

Answer 10

Λ No concordance rates in twin studies (among MZ twins) have ever shown 100% concordance, suggesting that genes only predispose an individual to addiction as opposed to being the sole determining factor.
Λ P: There may be a fundamental issue in drawing conclusions from twin studies as MZ twins are more likely to be treated similarly by parents than DZ twins.
E: This means that concordance rate differences may be accounted for by upbringing (i.e. the shared environment) rather than genetic similarity.
C: This weakens the argument for a genetic vulnerability to addiction.

Question 11

Evaluation of Genetic vulnerability (risk factors): Role of the environment

Answer 11

Λ The role of the environment must be considered. The diathesis-stress model offers an explanation as to how genes interact with the environment.Environmental factors which affect the predisposition to addiction include exposure to the drug, availability, stress, family influence and peers.

Question 12

Evaluation of Genetic vulnerability (risk factors): Variation across substances

Answer 12

Λ The genetic link to addiction varies across substances. This suggests that the vulnerability is not general, but specific to certain substances. Therefore, an individual may respond to different substances in different ways, depending on their genetic make-up.

Question 13

Stress (risk factors)

Answer 13

− High levels of stress, particularly in the long-term, can make individuals more vulnerable to addiction. Addiction is a coping mechanism: Turning to behaviours and drugs provide a temporary relief from stress i.e. it relieves the individual’s negative emotional state.
− There are higher levels of stress in cities or areas with a high population – lack of space, high living costs etc. However, cause and effect cannot be established. It could be that addicts live in urban areas because of the availability of drugs.

Question 14

Stress (risk factors): The self medication model

Answer 14

− Gelkopf et al. (2002) argued that individuals intentionally use drugs to treat and relieve certain psychological symptoms e.g. anxiety/stress
− The choice of drug/behaviour depends on the specific effect desired, as different drugs have different effects.
− The drug or activity may not actually alleviate the symptoms, it is simply perceived to do so.
− Once the addiction is established, there may be failures of ego-control, resulting in an inability to control the impulse to self-medicate.
− Research son drug abusers has shown that stress is one of the strongest predictors of relapse + increase drug cravings

Question 15

Stress (risk factors): Traumatic stress

Answer 15

− People exposed to severe stress are more vulnerable to addictions
− Robins et al. (1974) interviewed US soldiers within a year of their return from the Vietnam War. Of these, almost ½ had used either opium or heroin during their tour of duty, with about 20% reporting that they had developed physical or psychological dependence for heroin at some point during their time in Vietnam.

Question 16

Evaluation of Stress (risk factors): The paradox of smoking

Answer 16

P: The paradox of smoking:
E: Each cigarette has an acute (immediate) effect on stress because it relieves the withdrawal symptoms, thus temporarily relieving the stress and maintaining the behaviour, but the effects of nicotine soon wear off and stress levels rise again as cravings set in.
C: Therefore, in the long-term smoking will increase levels of stress, resulting in chronic stress (Parrott, 1998). Smokers actually report higher levels of stress than non-smokers.

Question 17

Evaluation of Stress (risk factors): Mediating factors

Answer 17

P: High levels of stress don’t always result in addictive behaviour there are mediating factors.
E: Mediating factors may include a lot of social support or utilising other ways of coping, for example, exercising when stressed.
C: Therefore, it is possible that it is not the level of stress, but the ability to cope with it that predisposes someone to addiction.

Question 18

Evaluation of Stress (risk factors): Cause + effect issue

Answer 18

P: Cause-effect issue
E: High stress levels may be linked to the likelihood of becoming addicted, but they could equally be a by-product of being addicted.
C: There is the possibility that addiction prompts high levels of stress due to the problems it causes e.g. the personal (relationships with friends and family) and financial costs.

Question 19

Evaluation of Stress (risk factors): Variation across addiction type

Answer 19

P: The relationship between stress and addiction appears to vary according to the type of addiction
E: The role of stress in drug addiction is fairly well established (Dawes et al., 2000).
C: However, there is less support for the role of stress in other forms of addiction. Arevalo et al. (2008) interviewed 393 women from substance abuse programmes and found no association between stress and alcohol addiction.

Question 20

Personality (risk factors)

Answer 20

− Research has shown that personality characteristics do appear to play an important role in predicting patterns of substance abuse and the development of addiction.
− Krueger et al. (1998) identified a number of personality traits e.g. sensation seeking and impulsivity, that are commonly associated with addiction.
− Impulsivity: behaving without thinking and without considering the risk involved in the behaviour
− Sensation seeking: the generalised tendency to seek varied, novel, complex, and intense sensations and experiences and the willingness to take risks for the sake of such experiences. Individuals are often easily bored.

Question 21

Personality (risk factors): Eysenck

Answer 21

− Eysenck (1997) proposed that addictions occur because of personality type and the needs of the personality. He argued that those with high levels of neuroticism and psychoticism were predisposed to addictions.
− Neuroticism: characterised by high levels of anxiety and irritability. These individuals seek relief from behaviours and drugs that they perceive as reducing their anxiety.
− Psychoticism: characterised by aggressiveness and emotional detachment. The high associated with drugs or certain behaviours helps to escape these negative emotional states.
− Eysenck also argued that there is a biological basis to personality and therefore the personality was inherited.

Question 22

Personality (risk factors): Cloninger’s tri dimensional theory of addictive behaviour

Answer 22

− The tri-dimensional theory of addictive behaviour suggests that there are 3 key traits that make an individual liable to substance abuse:
− Novelty seeking: the need for change and stimulation. Individuals will actively seek new environments and experience; they have a low boredom threshold. This element makes them more likely to seek out sensations from drugs.
− Harm avoidance: the amount that a person worries and sees the negative elements of a situation. This can affect their likelihood of taking a drug and therefore becoming addicted to it.
− Reward dependence: when someone reacts and learns from a rewarding situation quickly. This predisposes them to addiction as the rewarding effects are experienced quickly and easily.

Question 23

Personality (risk factors) research

Answer 23

− Zuckerman (1983):
→ Conducted research that demonstrated a link between the need for novelty and addictive behaviours.
→ Zuckerman claimed that high sensation seekers have a lower appreciation of risk, and anticipate arousal as more positive than lower sensation seekers.
→ He found a relationship between sensation-seeking and gambling as gamblers entertain the risk of monetary loss for the positive reinforcement produced by high arousal and winning.
− Howard et al. (1997): conducted a meta-analysis of the studies investigating Cloninger’s tri-dimensional theory and found that novelty seeking was the best predictor of alcohol abuse in teenagers and young adults.
− Wan-Sen Yan et al. (2013): demonstrated a relationship between personality characteristics and addiction. They found evidence to suggest that high levels of neuroticism and high levels of psychoticism were linked to Internet addiction, thus supporting Eysenck’s ideas.

Question 24

Evaluation of Personality (risk factors): research

Answer 24

P: Research support: There is evidence to suggest that certain personality traits are implicated in the development of addiction.
E: Research has shown that personality is a key predictor in the initiation of substance use, the development of substance abuse and the maintenance of substance dependence (Barnes et al., 2000).

Question 25

Evaluation of Personality (risk factors): Just a predisposition

Answer 25

However, having certain traits does not automatically mean that addiction will occur; it is merely a predisposition. There are many other factors involved in the development of addiction

Question 26

Evaluation of Personality (risk factors): Cause + effect issue

Answer 26

Cause and effect is difficult to establish: it is not always clear whether the addiction has altered the personality or vice versa.

Question 27

Family influence (risk factors): SLT

Answer 27

− Social Learning: the learning of behaviour by observation of role models in the environment. If the individual sees that model rewarded for their behaviour, then vicarious reinforcement is going to increase the likelihood of the observer imitating the behaviour.
− E.g. Older same-sex siblings and same-sex parents often act as role models, as a result of identification. If the child pays attention to a role model in their family displaying an addictive behaviour, such as smoking, and a positive outcome is observed e.g. praise or attention, then vicarious reinforcement will occur. The individual will then be more motivated to imitate the addictive behaviour and may start to engage in the behaviour as a result e.g. start smoking.

Question 28

Family influence (risk factors): Expectancies

Answer 28

− Expectancies: These are the associations (either positive or negative) we make from observing the environment around us, often our home environment.
− For example, we may learn from our environment that if we drink a lot of alcohol then we will get ill (negative association), because we witnessed our older brother consuming vast amounts of alcohol and vomiting as a result.
− If positive expectancies are formed, then this can increase the likelihood of trying a substance or behaviour and influence the chances of becoming addicted.
− Expectancies are a form of schema i.e. they develop through experience and govern our expectations in a given situation.

Question 29

Family influence (risk factors): research for expectancies

Answer 29

− There is evidence that children’s expectancies of alcohol develop within the family environment.
→ Dunn and Goldman (1998) found that 7-18 year old children’s expectancies of alcohol mirrored those of adults.
→ This suggests that the adults in a child’s environment can heavily influence attitudes towards substance abuse and potentially addiction.
− Furthermore, there is evidence that expectancies of adolescents can predict later drinking behaviour.
→ Christiansen et al. (1989) looked at the expectancies 11-14 year olds had about alcohol and found these predicted the amount and how often they drank a year later.

Question 30

Family influence (risk factors): research for family influence

Answer 30

− Reith and Dobie (2011): demonstrated the importance of the family in the transmission of gambling behaviour.
→ Drawing on interviews with 50 gamblers, they found that gambling knowledge and behaviour was passed on through the routines of everyday life. Individuals watched and heard family members doing and talking about their gambling and eventually joining in with it.

Question 31

Family influence (risk factors): parental influence

Answer 31

− 1) They provide social models for their offspring
− Reith and Dobie also found patterns of gambling were transmitted within families in gendered ways, with males’ first experience of gambling being through their fathers, and females’ through their mothers. The types of gambling activity that individuals were introduced to in this way were also gendered, with females introduced mainly to machines and bingo, and males to sports betting.
− According to SLT, this supports the concept of IDENTIFICATION: the extent to which an individual relates to a model and feels that he/she is similar or wishes to be like them (identification more likely to imitate behaviour).

− 2) Parenting style
− Certain parenting styles have been linked to likelihood of addiction, particularly the authoritative parent is linked to a decreased likelihood of addiction.
− Authoritative parents combine parental warmth with appropriate parental control.
− Authoritative parents emphasise setting high standards, being nurturing and responsive, and showing respect for children as independent, rational beings.
− The authoritative parent expects maturity and cooperation, and offers children lots of emotional support. This helps children to develop resilience to addictive behaviours (Fletcher et al., 1995).

Question 32

Family influence (risk factors): Sibling influence

Answer 32

− Studies have shown that the behaviour of older siblings is strongly associated with adolescent substance use. Moreover, sibling influence has generally been shown to be stronger than parental influence when it comes to substance use and deviant behaviour in general.
− In a sample of high school students in the US, sibling alcohol use had a stronger association with adolescent alcohol use than did parental alcohol use (Windle, 2000).
− The influence of siblings of the development of addictive behaviour can be explained as a product of modelling in the sibling relationship.
− The power imbalance between older and younger siblings suggests that older siblings serve as ‘role models’ for the younger sibling. Because modelling normalises substance use, it is likely that younger siblings would gravitate towards peers who resemble and validate their older siblings’ behaviour.

Question 33

Family influence (risk factors): Cohesiveness of the family

Answer 33

− There is evidence to suggest that other aspects of families can also influence the likelihood of addiction.
− Wan-Sen Yan et al. (2013) found a relationship between the cohesiveness of the family (i.e. strength of the emotional bond between family members and the level of connection between members) and the likelihood of Internet addiction when they studied 892 college students across five provinces in China.
− The group identified as having severe addiction had low family functioning levels.
− This therefore suggests that there may be many different ways in which families can influence addictive behaviours

Question 34

Evaluation of Family influence (risk factors): Research

Answer 34

P: Research support:
E: Akers and Lee (1996) found that the social learning process was important in explaining smoking behaviours in adolescents. They looked over 5 years at the smoking levels of 545 young adults aged 12-17 and found that social influences affected the smoking behaviours of these participants to try smoking, continue smoking or quit smoking.
C: One of the sources of social learning tested was family influences, therefore demonstrating their role in smoking behaviour.

Question 35

Evaluation of Family influence (risk factors): Variation with age + strength of relationship

Answer 35

P: However, the influence of the family will vary depending on the age and the strength of relationship for an individual.
E: It may be that at a younger age the influence of the family to try or abstain from a substance or behaviour could be much greater than in an older individual. Younger individuals are arguably more suggestible and lack the necessary cognitions to reflect on the behaviour before imitating it.
C: Therefore family influence is not constant throughout the lifespan. The stronger the relationship with the family member who engages in addictive behaviour, the greater the likelihood of imitation

Question 36

Evaluation of Family influence (risk factors): Mediating cognitive processes

Answer 36

P: Mediating cognitive processes: Not all behaviours observed are imitated e.g. a child may observe a parent smoking on a regular basis over a number of years, but this is no guarantee that they will smoke; there are important mediating cognitive processes that influence whether a behaviour is imitated or not.
E: Four mediating processes – attention, retention, reproduction, motivation
C: Motivations to behave a certain way are affected by other influences, which may counteract the family influence e.g. knowledge that the behaviour carries health risks.

Question 37

Evaluation of Family influence (risk factors): The relative influence of the family against all other potential influences is very difficult to gauge

Answer 37

P: The relative influence of the family against all other potential influences is very difficult to gauge as measurement is extremely difficult - it is not possible to isolate family influences to study their effect on the development of addictive behaviour.
E: Therefore, it is difficult to ascertain how family influences compare with peer influences – this is where age and strength of the relationship with family members needs to be considered, as arguably parents and siblings will have a greater influence when the child is younger.
E: Research suggests that family influences and peer influences are not independent of one another, in that tolerant parental attitudes make it more likely that adolescents will seek the company of peers that endorse substance abuse. Bahr et al. (2005) found that tolerant parental attitudes were strongly associated with an increased prevalence of binge drinking, smoking and drug use. They also found that parents who were tolerant of substance use were more likely to interact with peers who smoked, drank or used illicit drugs.
C: It is also possible that alcohol and drug use may result from a withdrawal of parental involvement, rather than any particular type of parent-adolescent interaction.

Question 38

Peer influence (risk factors): Peer pressure - social identify theory

Answer 38

− Peer influence can be the result of direct or indirect encouragement to engage in potentially risky and addictive behaviours.
− Peer pressure is often given as a reason why adolescents engage in behaviours such as smoking or substance abuse.
− Social Identity Theory (Tajfel and Turner, 1986) explains why individuals are likely to be influenced by peer pressure. It suggests that a significant part of an individual’s self-concept is formed as a result of the groups of which they are a part of (the ‘in-groups’) - self-esteem becomes bound up with group membership.
− As it is essential to be associated with the in-group in order to be socially accepted, this makes individuals more likely to adopt behaviours that have become the norm in the group, thus individuals adopt the identity of the group they have categorised themselves as belonging to.

Question 39

Peer influence (risk factors): Social influence

Answer 39

− Research on the emergence of risky behaviour and the subsequent development of addictive behaviour has focused on the importance of peer networks – the idea that social networks often consist of individuals with similar habits.
− For example, among adolescents, smokers tend to be friends with smokers, and non-smokers are often friends with other non-smokers (Eiser et al., 1991).
− Therefore, individual substance use may develop because of the prevalence of substance use within a particular social network.
− Research support: Latkin et al. (2004) found that the probability of drug abuse was related to the number of members within an individual’s social network who used drugs.
− By modelling behaviours such as alcohol use, members of social networks represent such behaviours as positive and socially acceptable (Kinard and Webster, 2011).

Question 40

Evaluation of Peer influence (risk factors): research

Answer 40

P: There is research evidence demonstrating the indirect influence of peers on addictive behaviour.
E: Litt and Stock (2011) found that teenagers who were exposed to Facebook profiles of their peers portraying alcohol use, reported a greater willingness to use alcohol and more positive feelings towards it, along with lower perceptions of negative consequences.
C: This therefore suggests that exposure to peer attitudes through social media alters adolescents perceptions of alcohol.

Question 41

Evaluation of Peer influence (risk factors): causality issue

Answer 41

P: However, it is difficult to establish causality in relation to the influence of peers. As the research is mainly correlational, it is possible that choice of peer group is influenced by addiction i.e. an addict chooses a peer group that allows them easy access to the focus of their addiction.
E: This is supported by Bullers et al. (2001) who found that selection of peer group followed addiction in many cases and that social influence had less of an effect.
C: This suggests that similarity in behaviours such as smoking may be a consequence of friendship selection, i.e. smokers befriend smokers, rather than smokers influence non-smokers to take up the habit (DeVries et al., 2006)

Question 42

Evaluation of Peer influence (risk factors): may be overstated / the importance of her factors

Answer 42

P: Peer influences may be overstated and are just one of many social factors influencing addiction; factors such as economic and social deprivation should be considered when assessing levels of vulnerability to dependency.
E: Kobus (2003) reviewed the literature on social influences and suggested that the effect of peer influence is more subtle and that media, family and neighbourhood were also involved.
C: This suggests that peers are not as strong an influence as some research would suggest. Further research is needed to determine the extent to which the link between peer behaviour and likelihood of addiction is causal or a result of peer selection.

Question 43

Evaluation of Peer influence (risk factors): likely to change with age

Answer 43

P: The influence of peers is likely to change with age.
E: Rich-Harris (1998) states that peer influence increases during adolescence and so substance use in young adults is more likely to be influenced by peers than parents.
C: However, because of the shifting nature of parental and peer influence over time, it is difficult to gauge the exact contribution of family and peers to the development of addiction.

Question 44

Explanations for nicotine addiction: Brain neurochemistry – the role of dopamine

Answer 44

− Nicotine is the main active ingredient of tobacco – it is absorbed through the lining of the mouth + nose + inhalation in the lungs
− Nicotine becomes addictive because it activates areas of the brain that regulate feeling of pleasure i.e. the ‘reward pathways’ of the brain
− Nicotine imitates the action of a natural neurotransmitter called acetylcholine + binds to a particular type of acetylcholine receptor known as the nicotine acetylcholine receptor in the brain
− Nicotine dependency arises because nicotine acetylcholine receptors are present on the neurons of the ventral tegmental area (VTA) which project their terminations into the nucleus accumbens
− When nicotine binds to receptor sites on the neurons of the VTA these neurons then trigger the release of the neurotransmitter dopamine in the nucleus accumbens – this subsequently boost activity of the prefrontal cortex
− In smokers repeated nicotine stimulation increases the amount of dopamine released in the nucleus accumbens – referred to the pleasure centre of the brain as the release of dopamine in this part of the brain produces feelings pleasure, the pleasure experienced encourages the individual to repeat smoking
− Bet. cigarettes however chronic smokers maintain a high enough concentration of nicotine to deactivate the receptors + slow down their recovery – this is why smokers develop a tolerance to nicotine + experience reduced pleasure over time
− Nicotine regulation model: Individuals continue to smoke to avoid withdrawal symptoms e.g. impairment of mood + concentration as nicotine levels in the blood drop
− Nicotine’s effects on glutamate + GABA in the brain are responsible for the longer-lasting pleasurable effects of nicotine – nicotine causes the release of the neurotransmitter glutamate which triggers an additional release of dopamine but nicotine also prevents GABA from slowing down after dopamine levels have been raised, this combination results in an increase in dopamine + an amplification of the rewarding properties of nicotine

Question 45

Explanations for nicotine addiction: Brain neurochemistry – the role of dopamine research

Answer 45

− Dani + Biasi found evidence to support the idea that activation of the nAch receptors leads to the release of dopamine in the nucleus accumbens – this supports the role of reward in nicotine dependency
− Watkins et al. found that dopamine release was reduced following chronic exposure to nicotine – this shows that tolerance develops due to the level of dopamine activity + reward decreasing

Question 46

Evaluation of Brain neurochemistry – the role of dopamine (Explanations for nicotine addiction): only one part of the explanation

Answer 46

Dopamine is only part of the neural action: The reason that nicotine is so addictive is due to several complex explanations

Question 47

Evaluation of Brain neurochemistry – the role of dopamine (Explanations for nicotine addiction): Genetic link

Answer 47

− Genetic link:
→ The role of dopamine could add support to the idea that there is a genetic link to addiction
→ Genetic explanations have focused on the action of the A1 variant of the DRD2 gene which is known to lead to lower levels of dopamine
→ Therefore the dopaminergic mechanism in some individuals could lead them to feel the rewarding effects of nicotine to a greater extent thus increasing the likelihood of them becoming addicted to smoking

Question 48

Evaluation of Brain neurochemistry – the role of dopamine (Explanations for nicotine addiction): Gender difference

Answer 48

− Gender differences in the effects of nicotine on the brain
→ Research conducted by Cosgrove et al. studied the brain of men + women using PET scans in order to measure the changing levels of dopamine when smoking – they observed the dopamine levels f 16 long-term cigarette smokers (8 men + 8 women) while smoking a cigarette
→ For women there was a rapid + strong dopamine effect in an area of the brain called the dorsal putamen whereas men only had a moderate to low activity in this area
→ Men had a rapid + strong activation affect in the ventral striatum whereas women were only mildly affected
→ Cosgrove at al. concluded that these findings support the claims that men + women smoke for different reasons – men for the nicotine effect itself + women to manage stress + mood

Question 49

Evaluation of Brain neurochemistry – the role of dopamine (Explanations for nicotine addiction): Reductionist

Answer 49

− Reductionist:
→ Much of the research purely focuses on the role of dopamine but there is evidence that there is a complex interaction bet. GABA, serotonin + other pathways in the brain
→ Behaviours is explained at a molecular level (dopamine) + more complex factors e.g. social + psychological influences are ignored (e.g. stress + the self-mediation model) which may not present a true picture of reasons for the development of addiction

Question 50

Explanations for nicotine addiction: Learning theory - operant conditioning

Answer 50

− Positive reinforcement (the provision of a desirable consequence that strengthens whatever behaviour came before it) can be used to explain the initiation + maintenance of addictive behaviour in that a behaviour will become more frequent if it has been reinforced in the past
− Addiction to nicotine could develop in terms of positive reinforcement coming from:
→ Physiological rewards: the activation of reward pathways in the brain + the release of dopamine in the pleasure centre of the brain
→ Psychological rewards: the perception that it makes you relaxed + reduces your stress
→ Social rewards: praise from peer + increased popularity
− Negative reinforcement (if behaviour results in an individual avoiding an unpleasant situation that behaviour is more likely to reoccur in similar situations in the future) can also be used to explain the maintenance + relapse of addictive behaviour
− Maintenance – as nicotine wears off bet. the hours of smoking this causes unpleasant physical symptoms (withdrawal syndrome) e.g. irritation + shakiness, reintroducing nicotine into the system provides relief from unpleasantness of withdrawal (a desirable consequence) which increases the likelihood of smoking reoccurring
− Relapse – long-term abstinence from smoking leads to unpleasant physical symptoms (withdrawal syndrome) e.g. irritation + shakiness, reintroducing nicotine into the system provides relief from unpleasantness of withdrawal (a desirable consequence) which increases the likelihood of smoking reoccurring

Question 51

Explanations for nicotine addiction: Learning theory − Cue reactivity (Classical conditioning)

Answer 51

− Classical conditioning – learning through association, the pairing of a neutral stimulus with an unconditioned stimulus
− Conditioned cue (secondary reinforce) – the object + or environment that had become associated with the primary reinforcer (in this case nicotine)
− Cue reactivity – objects + environments associated with a drug or behaviour becoming conditioned stimuli so people experience greater cravings + physiological arousal when exposed to the objects + environments associated with their addiction
− Cigarette-related stimuli could result in physiological responses e.g. increased heart rate + arousal which are synonymous with smoking + could therefore maintain the addictive behaviour as they trigger cravings in the individual
→ The ‘nicotine effect’ is where nicotine causes he activation of brain reward pathways thus increasing the release of dopamine (unconditioned stimulus)
→ This results in an unconditioned response to restore equilibrium within the brain i.e. lower dopamine levels back to normal
→ Any stimulus (i.e. environmental factors) that precedes or is present when the individual smokes initially acts as a neutral stimulus but over time after repeated associations becomes strongly associated with the ‘nicotine effect’ thus becoming a conditioned stimulus (conditioned cues)
→ When the individual comes into contact with these cues (conditioned stimulus) they signal to the brain that nicotine is on its way, the brain therefore anticipates the effects of nicotine
→ When a situation arises whereby there is the presence of the conditioned stimulus (an environmental cue) which triggers the anticipation of nicotine BUT in the absence of smoking then a state of disequilibrium occurs because dopamine levels are lowered below the optimum level (as nicotine has not entered the brain), the individual experiences this as withdrawal symptoms
→ The individual is then motivated to smoke in order to relieve these unpleasant withdrawal symptoms

Question 52

Explanations for nicotine addiction: Learning theory - SLT

Answer 52

− Key features – behaviour is learned from the environment, behaviour is learned from observing others + the reinforcement or punishment they receive, behaviour that is rewarded is imitated
− Using SLT to explain the initiation of smoking:
→ SLT proposes that young people begin smoking as a consequence of social models they have around them who smoke
→ From this perspective smoking is initially a function of parental + peer role modelling + the vicarious reinforcement that leads young people to expect positive consequences from smoking
− ‘Outcome expectancies’ – are the associations (either positive or negative) that an individual makes from observing their environment
→ a young person may form a positive association bet. smoking + receiving praise from peers, having observed this at school the individual may take up smoking with the expectancy that he/she will receive the same praise

Question 53

Explanations for nicotine addiction: Learning theory - research

Answer 53

− There is research support for operant conditioning as an explanation for nicotine addiction:
→ In research with monkeys Goldberg et al. used a system where the monkeys had to press a lever to receive nicotine
→ The research found that the monkeys presses the lever at the rate that was similar to the level that would be expected with cocaine
→ This suggests addictive behaviour + the idea that it is accessed for its reinforcing effects

− There is also research support for the role of cue reactivity in nicotine addiction:
→ Calvert reports that smokers shown cigarette packets experience strong activation in the ventral stristum + nucleus accumbens brain areas suggesting a biological explanation for craving behaviour
→ This also supports the idea of cue reactivity + the brain activation may show the neural basis for classical conditioning

− Many of the claims of social learning influences on the development of addictive behaviours have been supported by research evidence:
→ DiBlasio + Benda found peer group influences to be the primary influence for adolescents who experiment with smoking – adolescents who smoked were more likely to ‘hang out’ with other adolescents who smoked
→ Karcher + Finn found that youths whose parents smoked were 1.88x more likely to take up smoking, they were 2.6x more likely to smoke if their siblings smoked + 8x more like to smoke if close friends smoked

Question 54

Evaluation Learning theory (Explanations for nicotine addiction): animal research

Answer 54

− Difficultly in extrapolating research findings to humans:
→ There are issues with generalising results from animal research (e.g. Goldberg et al.) to human addiction especially the cognitive elements of SLT
→ Caution should be used in using animals research to explain why humans become addicted to a behaviour or substance as it might simplify the explanation

Question 55

Evaluation Learning theory (Explanations for nicotine addiction): Implication for treatment

Answer 55

− Implications for treatment:
→ Drummond et al. proposed a treatment approach Cue Exposure Therapy (CET) based on the idea that cue associated with smoking or other forms of drug-taking are an important factor in the maintenance of the habit
→ CET involves presenting the cues without the opportunity to engage in the smoking behaviour – this leads to the phenomenon known as stimulus discrimination as without the reinforcement provided by the actual nicotine the association bet. the cue + smoking is extinguished thereby reducing craving for cigarettes that arises when exposed to that particular cue

Question 56

Evaluation Learning theory (Explanations for nicotine addiction): Gender differences

Answer 56

− Gender differences in patterns of nicotine addiction:
→ Research suggests that nicotine addiction follows a different pattern in men compared to women which cannot be explained by using learning theory explanations
→ E.g. research found that women start smoking later than men (Lopez et al.) + the women are more likely to light up in stressful situations + their nicotine dependence grows more rapidly (Baewert et al.), women also experience withdrawal effects sooner + find it more difficult to give up smoking

Question 57

Evaluation Learning theory (Explanations for nicotine addiction): reductionist

Answer 57

− Reductionist: as there is very little consideration for cognitive + emotional influences, the theory also overlooks the role genetics might play e.g. genetic vulnerability

Question 58

Explanations for gambling addiction: Learning theory - Operant conditioning

Answer 58

Operant conditioning
− The principles of operant conditioning state that if behaviour is positively reinforced then it is more likely to reoccur
− Addiction to gambling can be explained using positive reinforcement
→ Physiological rewards: adrenaline rush causing a feelings of euphoria, increased dopamine in the nucleus accumbens resulting in pleasure
→ Psychological rewards: relieves perceived stress, ‘near misses’ – being close to winning raetes a brief period of excitement + thrill that encourages further gambling, raised self esteem
→ Social rewards: e.g. peer praise – congratulated by others, Slot machines reinforce reward by playing cheers and claps when someone wins
→ Financial rewards: experiencing a win
− Operant conditioning assumes that if a behaviour is punished then there is a decreased likelihood of it occurring again. However, gamblers do not always win and monetary losses are considered to be punishments, yet this does not extinguish the behaviour.

Question 59

Explanations for gambling addiction: Learning theory - Operant conditioning, Contiguity

Answer 59

− Contiguity is the co-occurrence of an action and a reinforcement or punishment
→ The reward or positive reinforcement for gambling is immediate, so is ‘time contiguous.’ This means the association is greater.
→ However, even though you can lose on a slot machine and receive immediate punishment, the overall negative feeling does not arise until there has been a series of losses, so the association is not as strong.
→ The individual wins are also much bigger in magnitude than each loss so the punishment does not evoke such a strength of feeling.

Question 60

Explanations for gambling addiction: Learning theory - Operant conditioning, Schedules of reinforcement

Answer 60

− The schedules of reinforcement studied by Skinner’s work on rats and pigeons help us to understand how gambling behaviour is maintained.
− Partial reinforcement: the behaviour is only sometimes reinforced (after a predictable – fixed - or unpredictable – variable - number of responses).
− Variable reinforcement: a type of partial reinforcement, where a proportion of responses are rewarded, after an unpredictable number of responses or time interval.
− The sequence of outcomes in some forms of gambling e.g. fruit machines is determined by a partial reinforcement schedule, with wins following some bets, but not all.
− Casinos specifically use the draw of a variable reinforcement schedule to attract gamblers because the uncertainty of when a payout is due keeps players playing for longer. The average ratio of wins to losses may be 1:4, but when they occur is unpredictable.
− It is the unpredictability of these rewards that keeps people gambling – they can’t be sure of when a win will occur, so they continue to gamble as the next play might result in a win.

Question 61

Explanations for gambling addiction: Learning theory - Operant conditioning, positive reinforcement

Answer 61

− The ‘big win’ hypothesis: Many pathological gamblers report having a ‘big win’ early in their gambling career or an early prolonged winning streak. They continue to gamble because of a desire to repeat that early ‘peak experience’ (Aasved, 2003)
− The ‘near miss’: Gambling can provide reinforcement even in the absence of a win. Near misses or losses that are ‘close’ to being wins create a brief period of excitement/thrill that encourage further gambling (Reid, 1986).

Question 62

Explanations for gambling addiction: Learning theory - classical conditioning

Answer 62

− Classical conditioning can also explain gambling addiction, particularly the maintenance and relapse aspects.
− Conditioned cues: Stimuli (objects or environments) that occur immediately before or at the same time as the gambling behaviour become heavily associated with the primary reinforcer (gambling) over time.
− These conditioned cues act as triggers for gambling because they have the ability to increase arousal, thus encouraging someone to revisit a casino or amusement arcade, to experience the positive emotions associated with it.
− It is possible that a positive association is made to the flashing lights, ringing bells and the sound of coins tumbling out of the fruit machines, due to the excitement experienced whilst gambling. Pubs, alcohol and betting slips could also act as conditioned cues.

Question 63

Explanations for gambling addiction: Learning theory - SLT

Answer 63

− Arguably, social learning theory can explain the initiation of gambling behaviour better than operant conditioning.
− A child or young adult could witness a parent receiving a big win in an amusement arcade, resulting in vicarious reinforcement. They will notice the happiness of the parent (attention), retain that memory (retention), forming positive outcome expectancies and, when they have the money and opportunity, try using slot machines themselves (reproduction). The motivation would be to win too i.e. receive the same positive outcome.

Question 64

Explanations for gambling addiction: Learning theory research

Answer 64

− Horsley et al. (2012) subjected high- and low- frequency gamblers to either partial or continuous reinforcement scheduling.
− After partial reinforcement, high-frequency gamblers continued to respond on gambling simulation for longer compared to low-frequency gamblers, despite the lack of reinforcement.
− The researchers concluded that the greater persistence of response among this group might be the result of increased dopamine function that is particular to high-frequency gamblers, making them more likely to continue gambling, even in the absence of reinforcement.
− This therefore suggests that there are individual differences that make some individuals more susceptible to gambling and receptive to the rewards, which challenges the learning theory.
− Support for the influence of operant conditioning:
− Parke and Griffiths (2004) supported the idea that gambling is reinforcing due to the money, thrill and excitement.
− They also said that the ‘near misses’ often experienced by gamblers are both physiologically and psychologically rewarding.
→ They give the gambler the impression that they are close to winning and confirm their strategy.
→ Gamblers get just as physiologically excited when they are nearly winning as when they are winning.
− This means that the behaviour is positively reinforced in both a win and an ‘almost win’, making it highly addictive.

Question 65

Evaluation Learning theory (Explanations for gambling addiction): cannot explain all forms of gambling

Answer 65

P: Learning theory cannot explain all forms of gambling
E: Some forms of gambling have a short-time period between the behaviour and the consequence (e.g. scratch cards), whereas others (e.g. sports betting) have a much longer period between bet and outcome, and so have less to do with chance and simple conditioning and more to do with the skill of the individual.

Question 66

Evaluation Learning theory (Explanations for gambling addiction): fails to explain why only some people get addicted

Answer 66

P: Learning theory fails to explain why only some people become addicted (i.e. it cannot explain individual differences)
E: Although many people gamble at some time in their lives and experience the reinforcements associated with this behaviour, relatively few become addicts.
C: This suggests that there are other factors involved in the transition from gambling behaviour to gambling addiction.

Question 67

Evaluation Learning theory (Explanations for gambling addiction): irrational beliefs

Answer 67

P: Reinforcement schedules may lead to irrational beliefs
E: Sharpe (2002): claimed that the placement of wins early on in the gambling experience (i.e. a big win when first gambling) and the patterns of wins and losses within gambling sessions may lead to irrational thoughts generated by beliefs about gambling machine reinforcement schedules. I.e. an early big win may give the gambler the illusion that they can control the outcomes and that they possess the skill necessary to win. The resulting overestimation of the chances to win and the underestimation of the possible losses encourage persistent gambling.
C: This would therefore suggest that that learning theory and cognitive theory should be combined to explain gambling addiction, as learning theory alone offers only a partial explanation.

Question 68

Evaluation Learning theory (Explanations for gambling addiction): different pathways to gambling

Answer 68

P: There are different pathways to gambling - learning theory is not the only explanation:
E: Blasczynski and Nower (2002) claim that there are different pathways for gambling addiction.
Gamblers who are ‘behaviourally conditioned’ may have begun gambling because of exposure to gambling through role models or peer groups. Their gambling addiction may therefore be largely explained through the process of social learning and reinforcement.
However, a second sub-group tends to have accompanying anxiety and/or depression, history of poor coping skills, as well as negative background experiences and life events. These factors produce an ‘emotionally vulnerable’ gambler, who uses gambling primarily to relieve their aversive emotional states.
C: This suggests that learning theory can only explain some types of gambling addiction, but does not explain all forms of gambling addiction.

Question 69

Evaluation Learning theory (Explanations for gambling addiction): reductionist

Answer 69

P: Learning theory is a reductionist explanation for gambling addiction
E: Traditional learning theories i.e. classical and operant conditioning, reduce the complex nature of gambling addiction down to simple stimulus-response units, and in doing so there is very little consideration for cognitive and emotional influences. The theory also overlooks the role that genetics might play i.e. genetic vulnerability.
E: Griffiths and Delfabbro (2001) reviewed the literature on gambling addiction and possible explanations for the behaviour. They found that any single explanation was insufficient and that an integrated theory of learning theory, biology and the role of the environment should be developed.
C: It seems that attributing gambling addiction to learning theory alone offers only a partial explanation.

Question 70

Explanations for gambling addiction: Cognitive theory

Answer 70

− According to this approach, gambling addiction is the result of faulty judgements, e.g. we will win or at least be able to control the odds, using our “lucky numbers” on the lottery

Question 71

Explanations for gambling addiction: Cognitive theory - cognitive biases

Answer 71

− The Gambler’s Fallacy – Assuming previous events will influence future events, which are in fact entirely random e.g. coin toss – assuming that three heads in a row will be balanced out by the opposite outcome (same number of tails).
− Illusions of Control – The individual believes that they can directly manipulate the outcome of the event through superstitious behaviours e.g. kissing dice before throwing. They might also show an exaggerated self-confidence in their ability to influence chance e.g. believing they can ‘beat the system’.
− The ‘Near Miss’ Bias – the gambler may think that they are constantly nearly winning, not constantly losing.
− Recall Bias (Availability Bias) – Remembering and overestimating wins; forgetting about/rationalising losses (losses won’t necessarily act as a disincentive for future gambling).
− Flexible Attributions – When the gambler explains wins as due to his/her skill and losses to other influences e.g. bad luck.
‘Just World’ Hypothesis – Gamblers believe they ‘deserve’ to win having lost so often on previous

Question 72

Explanations for gambling addiction: Cognitive theory - KEY STUDY Griffiths

Answer 72

− Procedure:
→ The study took place in an amusement arcade.
→ Griffiths compared 30 regular gamblers (who played fruit machines more than once a week) with 30 non-regular gamblers (who played less than once a month) – this was the main independent variable.
→ Each individual was given £3 to spend playing a fruit machine (‘Fruitskill’) in the arcade. Each gamble was 10 pence (30 gambles).
→ They were given the objective of staying on the machine for 60 gambles and making back the £3, which would enable them to continue gambling if they wished to do so.
→ Griffiths recorded the gamblers’ verbalisations (what they said they were thinking) whilst they were playing – ‘thinking aloud’ method. This was the main dependent variable, although he also made objective measurements of skill (how skilled they actually were on the machine), as well as subjective measures of skill perception (how skilled they ‘thought’ they were) by conducting post-experimental interviews.
− Findings:
→ Regular gamblers believed they were more skilled than they actually were.
→ Regular gamblers were more likely to make irrational statements during play. For example: ‘the machine hates me’, ‘this fruity is in a good mood’, ‘I had a feeling it was going to chew up those tokens fairly rapidly’
→ 26 of the 30 regular gamblers believed success was either due to skill or equally chance and skill, whereas the majority of the non-regular gamblers believed the game was ‘mostly chance’ and none believed it involved any ‘skill’.
→ Regular gamblers also explained losses by seeing ‘near misses’ as ‘near wins’ to justify their continuation.
→ One-third of the regular gamblers continued playing until they had lost all their money, whereas only two of the non-regular gamblers did so.

Question 73

Explanations for gambling addiction: Cognitive theory - Further research

Answer 73

− Joukhador et al. (2003)
→ Compared the cognitive styles of 52 social gamblers against 56 problem gamblers.
→ Problem gamblers demonstrated more cognitive biases and irrational thinking than social gamblers.
→ This therefore provides further evidence for the difference between those with and without an addiction to gambling in terms of their thought processes.
− Rogers (1998)
→ Examined cognitive biases amongst those who buy lottery tickets.
→ He found evidence of cognitive biases in the reasoning behind buying a lottery ticket.
→ For example, a belief in personal luck, the illusion of control, unrealistic optimism and gambler’s fallacy (assuming previous events will somehow influence future events).
→ This suggests that cognitive biases exist across other forms of gambling, not just those who play on fruit machines.

Question 74

Evaluation of Cognitive theory (Explanations for gambling addiction): treatment

Answer 74

P: Implications for treatment: An implication of the cognitive explanation of gambling addiction is that Cognitive Behavioural Therapy (CBT) might be helpful in reducing gambling behaviour.
E: Cognitive therapy can help to address faulty thinking and correct cognitive biases, replacing irrational thoughts with more rational ones.

Question 75

Evaluation of Cognitive theory (Explanations for gambling addiction): variation with gambling type

Answer 75

P: However, irrational thinking varies with types of gambling: Lund (2011) argues that some types of gambling are more likely than others to encourage cognitive biases and other irrational beliefs.
E: Lund studied the association between irrational beliefs and gambling preferences in nearly 5,000 adults. She found that increased frequency of gambling was related to increased cognitive biases, but this effect was stronger for some types of gambling than for others. She found that cognitive biases were more likely in gamblers who preferred gambling machines and Internet gambling than sports betting and horse racing. This findings could be because the use of gambling machines and Internet games is characterised by the mistaken beliefs that skill is involved. Lund concluded that the mistaken ideas of skill and illusions of control are important factors in the development of cognitive biases, which in turn can lead to gambling addiction.
C: This therefore adds support to the role of cognitive biases in gambling addiction, although suggests that they play a more significant role in certain types of gambling that are perceived as more skill-oriented.

Question 76

Evaluation of Cognitive theory (Explanations for gambling addiction): Challenging research

Answer 76

P: Challenging research evidence:
E: Delfabbro et al. (2006) found that pathological gamblers were more irrational in some forms of gambling-related cognition (e.g. thinking they were skilled when gambling on activities where no such skill was possible or thinking that certain numbers on a six-sided die were harder or easier to obtain), but were just as accurate as non-gamblers in estimating the actual odds of winning (when asked to indicate the probability of winning a major lottery, problem gamblers were no less accurate than others in the sample).
C: This therefore suggests that problem gamblers were not irrational across all forms of gambling-related thinking, as the cognitive theory assumes. Ladouceur (2004) referred to this as ‘cognitive switching’, where gamblers with objective views about the nature of gambling revert to irrational strategies when they become personally involved in the process of gambling

Question 77

Evaluation of Cognitive theory (Explanations for gambling addiction): Issue with cause + effect

Answer 77

P: Cause-effect issue:
E: It is difficult to establish cause and effect – it is possible that the faulty cognitive style exhibited by problem gamblers is a by-product of the problem and is a result of being an addict.

Question 78

Evaluation of Cognitive theory (Explanations for gambling addiction): social factors

Answer 78

P: The role of social factors needs to be considered and perhaps combined with cognitive factors:
E: Someone may be struggling with money and be motivated to gamble because of the prospect of a big win that could easily resolve their money worries.

Question 79

Evaluation of Cognitive theory (Explanations for gambling addiction): biological basis

Answer 79

P: Cognitive biases may have a biological basis: Research has shown that gambling addicts may have developed a different pattern of brain activity compared to non-gamblers. This particular pattern of brain activity gives them the misguided belief that they are able to beat the odds in games of chance.
E: Clark et al. (2014) identified a region of the brain that appears to play a critical role in the distorted thinking that makes people more likely to develop gambling addiction. The researchers discovered that if this region (the insula) is damaged as a result of brain injury, then people become immune to cognitive biases such as the gamblers’ fallacy.
C: These findings therefore suggest that cognitive biases found in gamblers have a neurological basis. This has far-reaching implications, as drugs could be developed in the future that target specific regions of the brain to reduce cognitive biases amongst problem gamblers.