Addiction

Question 1

Define addiction

(and what is is marked by?)

Answer 1

It is a disorder in which an individual takes a substance/engages in a behaviour that is pleasurable but eventually becomes compulsive with harmful consequences.
- It is marked by physiological and/or psychological dependance, tolerance and withdrawal

Question 2

Define physical dependence

Answer 2

A state of the body that is said to have occurred when a withdrawal symptom is produced by stopping the drug

Question 3

Define psychological dependence.

Answer 3

Psychological dependence is the compulsion to continue taking a drug because it’s use is rewarding e.g. lead to reduction of discomfort, or an increase in pleasure

Question 4

Define tolerance and state what it is caused by?

Answer 4

A reduction in response to a drug,so that the addicted individual needs more to get the same effect
- It is caused by repeated exposure to a drug

Question 5

Outline 2 types of tolerance

Answer 5

1. Behavioural tolerance: where person learns to adjust their behaviour to compensate for the effects of a drug.
2. Cross-tolerance: Where developing tolerance to 1 type of drug (e.g. alcohol) can reduce sensitivity to another type (e.g. benzodiazepines)

Question 6

What are withdrawal symptoms?

Answer 6

They are a collection of symptoms associated with abstaining from a drug or reducing it’s use
- They are usually the opposite of one’s created by the drug e.g. withdrawal of nicotine leads to irritability, anxiety, instead of pleasure.

Question 7

What is an addicts motivation to continue taking a drug?

Answer 7

To avoid withdrawal symptoms

When a physical dependence develops, an addict experiences withdrawal symptoms whenever they cant get the drug. This happens relatively often so they are familiar with these symptoms and want to avoid them (a secondary form of psychological dependence).

Question 8

What is a ‘risk factor’ (in the context of addiction)

Answer 8

Any internal or external influence that increases the likelihood that a person will develop an addiction

Question 9

Name the risk factors of addiction?

Answer 9

1. Genetic vulnerability
2. Stress
3. Personality
4. Family Influences
5. Peers

Question 10

How can a genetic vulnerability act as a risk factor for addiction?

Answer 10

Whilst genes are not inevitable causes of addiction on their own, they may explain why some people become dependent and others do not

Genetic mechanisms may be involved:
1- Dopamine receptors: low numbers of D2 receptors inherited, people compensate by engaging in addictive behaviour.
2. Nicotine metabolised by CYP2A6 enzyme: People are more likely to smoke is this enzyme is fully functioning.

Question 11

How can stress act as a risk factor for addiction?

Define stress and include research in your answer

Answer 11

1. Childhood trauma: Epstein et al. found a strong correlation between incidence of childhood rape and adult alcohol addiction, but only for women with PTSD (supports diathesis-stress model)
2. Sensitive period: Andersen and Teicher suggest early experiences of distress damage the brain during a ‘sensitive period’ - this creates a vulnerability to addiction in adolescence .

Question 12

How can personality act as a risk factor for addiction?

Answer 12

There’s no addictive personality but some traits (e.g. hostility and impulsivity) are linked with addiction.
- Traits associated with an antisocial personality disorder e.g. Risk-taking, a lack of planning, and a preference for immediate gratification (impulsivity) strongly correlates with addiction-related behaviour and begins in early adolescence.

Ivanon et al suggests that impulsivity and addiction may share a genetic and neurological basis.

Question 13

How can family influences act as a risk factor for addiction?

Answer 13

1. Approval from parents: Children more likely to engage in addiction-related behaviours if their parents show positive attitudes towards it and/or seem to take little interest in the behaviour of their child
2. Exposure: Children more likely to start engaging in addiction-related behaviour, e.g. drinking alcohol, if it is an everyday feature of family life.

Question 14

How can peers act as a risk factor for addiction?

use the example of alcohol in your answer

Answer 14

A group norm that favours rule-breaking can be influential (conformity)

O’connell et al suggests 3 major elements to peer influence for alcohol addiction.

1. Attitudes about drinking are influenced by associating with peers who use alcohol.
2. Peers provide more opportunities to use alcohol.
3. Individuals overestimate how much their pees are drinking and attempt to keep up with the perceived norm.

Question 15

Evaluate risk factors in the development of addiction

Answer 15

Strengths

1. Support for family influence: Livingston et al. Found that final-year high school students who were allowed by their parents to drink alcohol at home were significantly more likely to drink excessively the following year at college
2. Real-life application: Focusing on risk factors allows us to prevent and treat addictions early for those who are most at risk e.g. Those experiencing stressful events

Limitations

3. Correlation ≠ cause: raises issues over research such as Jeffrey epsteins and Livingston et al.
4. May be that addictions cause higher levels of stress because of their general negative effects on lifestyle, relationships,l and financial affairs.
5. Methodological issues: identifying risk factors often required participants to recall incidents of stress, trauma and family behaviours, and this may be difficult to recall (low validity).

Question 16

Name 2 explanation for nicotine addiction

Answer 16

1. Brain neurochemistry

2. Learning theory

Question 17

What 2 ideas make up the brain neurochemistry explanation for nicotine addiction?

Answer 17

1. The desensitisation hypothesis

2. The nicotine regulation model

Question 18

Outline the desensitisation hypothesis.

Answer 18

1. The role of naChRs: Some neurons that produce dopamine are in the ventral tegmental area (VTA) of brain. These neurons have acetylcholine (ACh) receptors that respond to nicotine (these are called nAChRs)
2. Desensitisation caused by nicotine: When nicotine binds to nAChR, the neuron is stimulated and produces dopamine and the receptors shut down within milliseconds and can’t respond to neurotransmitters. desensitisation of neuron (no longer responds) leading to downregulation (fewer active neurons available).
3. Effect of dopamine: When dopamine is released from VTA , it is transmitted along:
   - Mesolimbic pathway to the nucleus accumbens to be released in the frontal cortex.
   - Mesocortical pathway to be released in the frontal cortex.
   The dopamine system creates a sense of reward and pleasure. (e.g reduced anxiety, mild euphoria). This is now associated with intake of nicotin.

Question 19

Describe the nicotine regulation model.

Answer 19

1. Resensitisation of neurons lead to upregulation: When smokers go without nicotine for a prolonged period, nicotine disappears from the body. nAChRs become functional again, so neurons resensitise and more become available.
2. Upregulation leads to withdrawal symptoms: As more nAChRs available but not stimulated, the smoker experience acute withdrawal symptoms e.g. anxiety. Meanwhile, nAChRs is at most sensitive stage, which is why smokers describe 1st cigarette as most pleasurable (as nicotine reactivates dopamine reward system). Smoker is motivated to avoid unpleasant withdrwal symptoms by smoking.
3. Chronic desensitisation: Persistent desensitisation of nAChRs through repeated smoking leads to a permanent decrease in the number of active receptors. - requiring more nicotine for same effects. (tolerance develops).

Question 20

Evaluate the brain neurochemistry explanation for nicotine addiction.

Answer 20

Strengths

1. Research support: Joseph McEvoy studied smoking behaviour in schizophrenics. Patients took Haloperidol treatment, which is a dopamine antagonist that blocks dopamine receptors in the brain. The treatment increased smoking.
2. Real-life application: led to developments such as nicotine replacement therapy (NRT) in the form of patches and inhalers.

Weaknesses

1. Over-emphasis on dopamine: other neuro-mechanisms involved e.g. GABA and serotonin pathways, and endogenous opioids
2. Ignores psychological and social influences: e.g. Family influences (Livingston et al)
3. Individual differences: shiffman studied individuals who smoke regularly for long periods but who do not become dependent. Even those who smokes an average of 5 a day did not show withdrawal symptoms.

Question 21

What 2 main mechanisms make up the learning theory for nicotine addiction?

Answer 21

1. Operant conditioning

2. Classical conditioning

Question 22

Describe how operant conditioning explain nicotine addiction?

Answer 22

Positive reinforcement: behaviour is repeated to experience pleasant consequences.
- Nicotine is a powerful reinforcer as its physiological effects on dopamine reward system in the mesolimbic pathway, increases feelings of mild euphoria .

Negative reinforcement: Behaviour is repeated to avoid unpleasant consequences.
- Cessation of nicotine can lead to acute withdrawal syndrome such as disturbed sleep, agitation, poor concentration. Addiction to nicotine prevents unpleasant consequences.

Question 23

Outline the 3 main ideas that make up the classical conditioning explanation

Answer 23

1. Primary reinforcers
2. Secondary reinforcers
3. Cue reactivity

Question 24

How do primary reinforcers link to nicotine addiction?

Answer 24

Smoking is a primary reinforcer as it’s intrinsically rewarding
- Feeling of pleasure from smoking is not learnt as it is biologically determined.

Question 25

How do secondary reinforcers link to nicotine addiction?

Answer 25

Stimuli present at the same time as the primary reinforcer, become rewarding in their own right because of their association with pleasurable effects. These are secondary reinforcers
- These include environments such as pubs, certain people, objects etc

Question 26

how does cue reactivity link to nicotine addiction?

Answer 26

Cravings are triggered by cues related to smoking.

Secondary reinforcers act as cues, as their presence produces a similar response to nicotine itself.. This is cue reactivity and it is indicated by 3 main elements:

1. Self-reported desire to smoke
2. Physiological signs of reactivity to cue (e.g. heart rate)
3. Objective behavioural indicators when a cue is present (e.g. how many draws taken on the cigarette)

Question 27

Evaluate the learning approach to explaining nicotine addiction.

Answer 27

Strengths

1. Support from Levin et al: In experiment where rats were given a choice to lick 2 water spots (one which contained nicotine), rats licked nicotine water spot more often. This suggests positive reinforcement .
2. Support for cue reactivity: Carter and Tiffany found that dependent smokers reacted strongly to smoking-related cues e.g. ashtrays, and reported high levels of cravings and increased physiological arousal.
3. Real-life application and economic implications: Can use aversion therapy which counterconditions nicotine addiction by associating pleasurable effects of smoking with negative stimulus e.g electric shock. This may reduced NHS spending.

Weaknesses

1. Unethical nature of Levin et al’s study: Nicotine provided to rats and nicotine can have harmful effects e.g. increase in blood pressure.
2. Levin et al’s study conducted on rats not humans: Therefore, can’t generalise results to humans.
3. Ignores role of dopamine

Question 28

What 5 ideas make up the learning theory for gambling addiction.

Answer 28

1. Vicarious reinforcement
2. Direct reinforcement
3. Partial/variable reinforcement
4. Cue reactivity
5. Classical conditioning

Question 29

How is vicarious reinforcement linked to a gambling addiction?

Answer 29

It may lead to a gambling addiction forming as a person may see someone being rewarded for gambling (e.g. Seeing someone on TV/newspaper articles winning money by gambling)

Question 30

How is direct reinforcement linked to gambling addiction?

Answer 30

Positive and negative reinforcement

Positive reinforcement comes from a direct gain (e.g. Winning money)

Negative reinforcement comes from wanting a distraction from aversive stimuli (e.g. The anxieties of everyday life)

Question 31

Define

• Partial reinforcement

- Variable reinforcement (give an example)

Answer 31

Partial reinforcement = when a behaviour is reinforced only some of the time it occurs.

Variable reinforcement = Type of partial reinforcement in which a behaviour is reinforced after an unpredictable period of time or number of responses e.g. variable ratio schedules

Question 32

What is the main difference between learning through positive reinforcement and partial reinforcements

Answer 32

1- In + reinforcement, behaviour is reinforced every time it is carried out, but in variable reinforcement, behaviour is only reinforced only some of the time it occurs

2. It takes longer for learning to be established if the reinforcement schedule is variable but once it is established it is more resistant to extinction.

Question 33

Give an example of research that shows variable reinforcement

Answer 33

Skinners research

- As rats became full, behaviours became ‘extinct’ but were reinforced again once variable ratio schedules were used.

Question 34

How is partial/variable reinforcement linked to a gambling addiction?

Answer 34

• This means gambler learns that they will not win with every gamble, but eventually win if they persist. Hence, the gambling is reinforced.

Question 35

How is cue reactivity linked to gambling addiction?

Answer 35

An individual will experience many secondary reinforcers - things they associate with the exciting arousal experienced through gambling e.g. the colour of lottery scratch cards, t.v. horse-racing channel.
- These cues trigger the gamblers cravings causes its reinstatement after a period of abstinence so that the gambling addiction is maintained.

Question 36

Evaluate the learning theory as an explanation for gambling addiction?

Answer 36

Strengths

1. Research evidence for + reinforcement: Dickerson found that high-frequency gamblers in natural settings were more likely than low-frequency gamblers to place bets in last 2 minutes of a race. This may be due to prolong rewarding excitement e.g. tension from radio commentary.
2. Real-life setting: Investigation carried out in real life setting so higher external validity.
3. Lab experiments: Research tends to be carried out in labs e.g. Skinners, making research more scientific and replicable.

Limitations

1. Individual differences: Griffiths and Delfabbro argue that there may be individual differences. Some are more vulnerable to cues than others, some feel relaxation from gambling but dont get addicted, some never relapse.
2. Alternative explanation: Cognitive and biological explanation.

Question 37

What is the 2nd explanation for gambling addiction?

Answer 37

The cognitive theory

Question 38

What ideas make up the cognitive theory?

Answer 38

1. The expectancy theory
2. Cognitive biases
3. Research into cognitive biases
4. Self-efficacy

Question 39

What does the ‘expectancy theory’ say?

Answer 39

Gamblers have expectations about the future benefit and cost of our behaviour, just like us. If people expect the benefits of gambling to outweigh the costs, then addiction becomes more likely.
- this is an unconscious decision as memory and attention processes do not operate in a rational and logical manner.

Question 40

How do cognitive biases relate to gambling?

Answer 40

Gamblers will hold irrational beliefs about gambling.
- Beliefs may involve attention and/or mental processes and addiction occurs and is maintained due to selective attention to and memory of gambling-related info.

Question 41

Outline the 4 different categories of cognitive biases

Answer 41

SPRAFS

1. Skill & judgement: gambling addicts have an illusion of control and overestimate their skill against chance.
2. Personal traits/ritual behaviours: Addicts believe they are especially lucky or engage in superstitious behaviour.
3. Selective recall: Gamblers remember their wins but forget their losses.
4. Faulty perceptions: Gamblers have distorted views of chance (e.g. belief that a losing streak can’t last)
5. Automatic cognitive bias: Gamblers have an automatic bias to pay attention to gambling-related info.

Question 42

What is self-efficacy?

Answer 42

Self-efficacy: Belief we have in our own competence to achieve a desired outcome.

Question 43

How can self-efficacy lead to a relapse in gambling addictions?

Answer 43

An individual resumes gambling as they don’t believe they are capable of giving it up.The relapse then reinforces their lack of self-efficacy, ‘I told you I couldn’t give it up’

Question 44

Describe the PROCEDURE of a key study into cognitive biases?

Answer 44

Mark Griffiths (1994)

Procedure:

1. ‘Thinking aloud’ method, a form of introspection, was used to investigate differences between regular slot machines gamblers and occasional users.
2. Content analysis used to classify utterances into rational or irrational.
3. Interviews used to explore participants perceptions of the skill required to win.

Question 45

Describe the FINDINGS of a key study into cognitive biases?

Answer 45

Mark Griffiths (1994)

Findings:

1. Regular gamblers made almost 6 times as many irrational verbalisations (e.g. the machine likes me) compared to occasional gamblers.
2. Regular gamblers also prone to illusion of control (e.g. ‘I’m going to bluff this machine’) and overestimated the skill required to win.

Question 46

Evaluate the cognitive theory for gambling addictions

Answer 46

Strengths

1. Research evidence: michalczuk et al compared addicted gamblers to non-gambling control group. Addicted gamblers had significantly higher levels or gambling-related cognitive distortions (illusion of control).
   - Mccusker and Gettings made pps (gamblers and non gamblers identify ink colours of words, whilst ignoring the words meanings. Gamblers took longer to do this than control group of non gamblers when gambling-related words were shown due to their automatic bias to pay attention to gambling-related info.
2. Practical application: CBT can be used to challenge patients irrational beliefs/cognitive biases

Limitations

1. Individual differences: People differ in motivation to achieve control over their lives: Those with a high level of control motivation are more likely to believe they can influence chance-determined situations. Therefore, they might be more attracted to certain types of gambling e.g choosing lottery numbers. Therefore, personality may also influence gambling addiction.
2. Alternative theory: Learning theory.
3. Demand characteristics: ‘Thinking aloud method’ in Griffiths study involves self-report. Ppts may not have expressed what they really feel.
4. Artificial task: Reading ink colours of words doesn’t reflect real-life scenarios so low in external validity.

Question 47

Outline the 3 types of drug therapy

Answer 47

1. Aversive drugs
2. Agonists
3. Antagonists

Question 48

What do aversive drugs do (and give an example of a type of aversive drug?)

Answer 48

They pair the behaviour with unpleasant consequences such as vomiting (classical conditioning

Example: disulfiram is a drug therapy that creates the effects of a severe hangover just mins after the alcohol is drunk.
- The idea is that the alcohol with these unpleasant with these unpleasant effects rather than the ones they enjoy

Question 49

What do agonists do? (and give an example of an agonists)

Answer 49

Agonists bind to the neuron receptors and activate them. This produced a similar effect to the addictive drug and controls the withdrawal effects.

E.g. Methadone is used to treat heroin addiction but has fewer harmful side effects than heroin itself

Question 50

What do antagonists do? (and give an example of one)

Answer 50

Antagonists treat addiction by binding to the receptor sites and blocking them. Therefore, the drug of dependance cannot produce its usual addictive effects.

E. G. Naltrexone is used to treat heroin addiction.

Question 51

Give one drug therapy for nicotine addictions and state how it operates.

Answer 51

NRT (in the form of gum, inhalers and patches to deliver nicotine in a less harmful way)
- Dosage can be reduced over time to decrease withdrawal symptoms

• it operates neurochemically by:
  1. Binding to nicotinic acetylcholine receptors in the mesolimbic pathway of the brain.
  2. Stimulating the release of dopamine in the nucleus accumbens, just as it does in cigarette smoking

Question 52

Give one drug therapy for gambling addiction and state how it operates.

Answer 52

As gambling addiction uses the same dopamine reward system as heroine, nicotine.
- therefore, the same drugs used to treat heroin are used with gamblers

Opioid antagonists (e.g. Naltrexone) reduce cravings to gamble by enhancing the release of neurotransmitter GABA in the mesolimbic pathway which reduces the release of dopamine in nucleus accumbens, which reduces the craving to gamble.

Question 53

Are drugs officially approved for gambling in addiction?

Answer 53

No

Question 54

Evaluate drug therapies as a treatment for addiction.

Answer 54

Strengths:

1. Research support: Stead et al concluded that NRT is more effective in helping smokers quit than eiyther placebo or no treatment group. NRT users were more likely to have still abstained from smoking after 6 months.
2. Removes addiction stigma: Encourages the idea that addiction is a medical problem, and not a form of psychological or moral failure. This, in turn, encourages addicts to seek treatment.
3. drug therapies like NRT is less unpleasant than behavioural treatments such as aversion therapy.
4. Drugs more convenient as doesnt take too much time out of a person’s day and can be collected over-the-counter (unlike therapies) but people need to be motivated enough to take them regularly for it to work.

Limitations

4. Side effect: Side effects of naltrexone include sleep disturbances, dizziness and headaches.
5. Individual differences: Drugs don’t work in the same way for everyone. e.g. Alcoholics with 1 gene variant respond more readily to naltrexone treatment than those with a different version of the gene.

Question 55

Name some behavioural treatments for addiction

Answer 55

1. Aversion therapy

2. Covert sensitisation

Question 56

What is the main idea behind aversion therapy?

Answer 56

Aversion therapy is a behavioural intervention based on classical conditioning (learning via consequences).
- addiction is reduced by associating the drug with an unpleasant state (counterconditioning)

Question 57

Describe how aversion therapy is used to treat alcohol addiction.

Answer 57

Disulfiram: client is given a drug such as disulfiram (UCS), which causes a person drinking alcohol to experience an instant hangover with severe nausea and vomiting (UCR)
- The client learns to associate the alcohol (NS and then CS) with the unpleasant symptoms (CR) and the fear of symptoms can prevent the client from drinking.

Question 58

Describe how aversion therapy is used to treat gambling addiction.

Answer 58

Electric shocks

The gambler selects phrases that relate to their gambling behaviour and others do not (e.g. Went straight home)
- They read out each phrase and whenever a gambling-related phrase is read (NS and then CS), they receive a 2-second electric shock (UCR and then CR) which is painful but not too bad.

Question 59

Name a form of covert sensitisation.

Answer 59

A form of aversion therapy also based on classical conditioning. Instead of experiencing an unpleasant stimulus, the patient imagines (in vitro) how it would feel.

Question 60

Describe how covert sensitisation is used to treat nicotine addiction.

Answer 60

Patients with nicotine addictions first encourages to relax, then conjure up a vivid image of themselves smoking a cigarette (CS), followed by the most unpleasant consequences (CR) such as vomiting, faeces on a cigarette, (including graphic details of smells, sights).
- this association should make the client feel relief at being away from cigarette, reducing smoking behaviour

Question 61

Evaluate behavioural interventions as a treatment for addiction

Answer 61

Strengths

1. Research support for covert sensitisation: McConaghy et al compared effectiveness of aversion therapy with covert sensitisation in treating gambling addiction. He found that those that underwent covert sensitisation were significantly more likely to have reduced their gambling addiction long-term and reported experiencing fewer and less intense gambling addictions (as it is less traumatic).
2. Aversion therapy did show some effectiveness: McConaghy et al also found aversion therapy to be effective, but only in the short term.

Limitations

1. Methodological problems: After reviewing 25 studies of aversion therapies used to treat nicotine, researchers found that procedures weren’t blind so ppts knew who received treatment/placebo. Therefore, demand characteristics may have been present.
2. High drop-out rate for aversion therapy: As it is unpleasant, many choose to avoid/discontinue sessions. This makes it hard to see effectiveness of aversion therapy.
3. Ethical issues: Participants placed under distress, nausea, psychological harm.

Question 62

What are the 2 aspects that make up CBT, as a method of reducing addiction.

Answer 62

1. Functional analysis

2. Skills training

Question 63

What does functional analysis involve?

Answer 63

The client and therapist identify high-risk situations that lead to gambling/drug addiction.

• A collaborative and responsive relationship is built between the therapist and the client.
• The therapist reflects on what the client is thinking before, during and after such a situation and then challenge’s their cognitive distortions (this method continues throughout treatment)

Question 64

What is the main idea behind skills training?

Answer 64

People seeking treatment may have a huge range of problems but only 1 way of dealing with them - their addiction.

CBT helps replace this strategy with more constructive ones by developing new skills.

Question 65

What are the 3 main techniques that make up skills training? (in order of more basic techniques to more individually tailored techniques)

Answer 65

1. Cognitive restructuring
2. Specific skills training
3. Social skills training

Question 66

How does cognitive restructuring teach a patient key skills?

Answer 66

An addict e.g. a gambling addict may have faulty beliefs about probability, randomness and control.
- in the initial educational stage, the therapist may give the client info about how to challenge these faulty beliefs.

Question 67

How does SPECIFIC skills training teach a patient key skills? (and give a few examples of some skills that are taught at this stage of CBT)

Answer 67

This technique teaches the client skills that deal with the WIDER aspects of the client’s life related to the addiction.

e. g. In the case of a lack of skills to cope with situations that trigger alcohol use:
- Anger may trigger addictive behaviour, so anger management training may be appropriate
- Interpersonal conflicts may trigger addictive behaviour, and may be dealt with through assertiveness training.

Question 68

How does SOCIAL skills training teach a patient key skills?

Answer 68

Most client can benefit from developing a few skills that allow them to cope with anxiety in social situations. (e.g. trying not to drink alcohol every other night)

• SST helps the client to refuse alcohol in order to avaoid embarrassment (e.g. making eye contact and being firm)
• The therapist and client may model coping strategies using role play.

Question 69

Evaluate CBT as a treatment for reducing addiction.

Answer 69

Strengths

1. Research support: Petry et al found that, after 12 months, Gamblers assigned to a treatment (Gamblers anonymous meeting + CBT) were gambling significantly less than those assigned to only the meetings.
2. High validity: Gamblers were randomly assigned to a condition and there were no significant differences in the extent of their addiction at the start.
3. Lower risk of side effects, unlike drugs.

Limitations

1. High drop out rate: Many patients may not feel ablt to take on high level of cognition involved in CBT and drop out. Pim Cuijpers et al indicate that drop out rates in CBT can be 5 times greater than other forms of therapy
2. Lack of standard treatments: The variety of techniques used in CBT (e.g. online, in person. via telephone, with different focuses on different aspects of CBT) makes it difficult to know which part of CBT is most effective.
3. Economical implications: May take significant amount of time out of someone’s day, so they may have to take time of work.
4. Ignores biological approach

Question 70

Briefly outline the main idea behind the theory of planned behaviour?

Answer 70

TPB suggests that changes in addictive behaviour depend on exercising self-control and deliberate behaviours.
- Central to the model is a person’s intention to change. Subsequent behaviour can be predicted from a person’s intentions.

Question 71

What 3 key influences do intentions arise from?

Answer 71

1. Personal attitudes towards the attitude.
2. Subjective norms: Perception of what others think.
3. Perceived behavioural control: beliefs about ability to quit.

Question 72

Define ‘personal attitudes’ in the context of TPB and how are they formed?

Answer 72

These refer to the entire collection of the addicts attitudes towards their addiction, and this is formed from weighing up the balance of favourable and unfavourable attitudes.
- e.g. ‘it gives me a thrill…but I lose more money than i win’

Question 73

According to TPB, how do ‘subjective norms’ influence our intention to change?

(1- Use gambling as an example)
(2- Outline role of perception)

Answer 73

Ideas of ‘normality’ are based on what key people in the addict’s life believe to be ‘normal behaviour’
- e.g. they may think ‘Do others gamble? and how often’
If the addict concludes that others believe their gambling is atypical, they are less likely to intend gambling, so less like to gamble.

Perception: The most influential aspect of subjective norms is the person’s PERCEPTION of whether the person closest to them approve or disapprove of THEIR gambling

Question 74

Define ‘perceived behavioural control’, in the context of TPB

(1- Use gambling as the example)

2-Outline role of perception

Answer 74

Perceived behavioural control is about how much control we think we have over our behaviour (SELF-EFFICACY)
e.g. Does the addicted gambler believe they are capable of giving up gambling.
This may be related to their perception of resources available to them (e.g. time, support, skill)

Question 75

According to TPB, how do ‘perceived behavioural control’ influence our intention to change?

Answer 75

Perceived behavioural control can have 2 possible effects

1. It can influence behaviour directly: The greater the perceived control/self-efficacy, the longer and harder the addict will try to stop.
2. It can influence behaviour indirectly by influencing intentions: The greater the perceived control/self-efficacy, the stronger the intention to stop the gambling.

Question 76

Evaluate the theory of planned behaviour

Answer 76

Strengths

1. Hagger et al research support: Found that the 3 factors all predicted an intention to limit drinking to the guideline number of units. Intentions were also found to influence the number of units actually consumed after 1 and 3 months. Perceived behavioural control also predicted actual unit consumption DIRECTLY.
   - Haggers research was a lab experiment: Scientific credibility.

Limitations

1. Can’t predict long-term changes: McCeachan conducted a meta-analysis and found that intention to stop drinking may be a good predictor of giving up, but only if the time between intention and behaviour is short. If longer, intention is not a good indicator. Therefore, we can’t accept theory as entirely valid.
2. Methodological issues: Self-report assessment of 3 factors may be subject to social desirability bias.
3. Correlation between intention and behaviour does not mean causation.
4. Doesnt take into account how emotions, cognitive biases and pas experiences may affect personal attitudes towards behaviour.

Question 77

What assumptions did Prochaska make about addiction?

Answer 77

That overcoming addiction is a cyclic process, in which individual may return to earlier stages (of the 6 stages proposed in his 6-stage model)

Question 78

What 2 insights is Prochaska’s model based on?

Answer 78

1. It is based on how ready people are to change their behaviour.
2. The usefuness of a treatment intervention depends on the stage a person has reached.

Question 79

Name Prochaska’s 6 stages

Answer 79

1. Pre-contemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance
6. Terminance

Question 80

Describe the pre-contemplation stage and what intervention is assigned at this stage?

Answer 80

At this stage, people are not thinking about overcoming addiction within the next 6 months. May be due to:

1. Denial “I dont have a problem”
2. Demotivation: “I’ve tried before but had no success”

Intervention: helping addict consider need for change.

Question 81

Describe the contemplation stage and what intervention is assigned at this stage?

Answer 81

At this stage, people are thinking about making a change to their behaviour in the next 6 months. They are aware of both the benefits and the costs.

Intervention: Helping addict see that the pros outweigh the cons and helping them reach a decision to change.

Question 82

Describe the preparation stage and what intervention is assigned at this stage?

Answer 82

At this stage, addicts believe that pros outweigh costs and has decided to make a change within the next month. However, they have not decided how to do this.

Intervention: Helping addict construct a plan (e.g. see a drugs counsellor/GP)

Question 83

Describe the action stage and what intervention is assigned at this stage?

Answer 83

At this stage, people have done something to change addictive behaviour in last 6 months. (e.g. removed alcohol from house)

Intervention: Teach addict coping skills needed to quit.

Question 84

Describe the maintenance stage and what intervention is assigned at this stage?

Answer 84

At this stage, person has maintained changed behaviour for more than 6 months.

Intervention: relapse prevention by encouraging application of coping skills and offering support.

Question 85

Describe the termination stage and what intervention is assigned at this stage?

Answer 85

At this stage, abstinence is automatic and the person no longer returns to addictive behaviour.

Intervention: Not required at this stage but it may not be possible or realistic for everyone to reach this point.

Question 86

Evaluate Prochasky’s 6-stage model.

Answer 86

Strengths

1. Recognises nature of addictive behaviour: Traditional theories see recovery from addiction as an ‘all or nothing’ event but model recognises importance of time and that it is a dynamic and continuing process.
2. Realistic attitude on relapse: Recognises that relapse is an inevitable part of the dynamic process and that changes to behaviour require several attempts to reach maintenance/termination stages.

Limitations

1. Contradictory research: Taylor et al reviewed available evidence and concluded that stage-based approaches are no more effective than alternatives in treating nicotine addiction. A later review by Kate Cahill et al came to the same conclusion.
2. Arbitrary nature of the stages: Some researchers suggest that stages should be grouped together due to few differences (Kraft et al suggests 2-5 should be grouped together). Bandura claims that first 2 stages aren’t even qualitatively different as the only difference is quantitative (how much a person wants to change’. Sutton (2001) argues that the only difference between contemplation & preparation stage is 1 day (30-31 days).