Etiology of Substance Abuse/Addiction

Question 1

What are some models for explaining etiology of addiction?

Answer 1

Moral, Psychological, Family, Disease, Biological, Sociocultural.

Question 2

What is the Moral Model?

Answer 2

Personal choice; no biological basis. Religious beliefs of sinfulness, punishment in legal system, social stigma.

Question 3

What are three sub-components of psychological models?

Answer 3

Learning models, cognitive behavioral models, psycho-dynamic model.

Question 4

What is the learning model of psychological models?

Answer 4

Operant conditioning. Positive/negative reinforcement, positive/negative punishment.

Question 5

What is the cognitive-behavioral model of psychological model?

Answer 5

Thoughts lead to feelings. Irrational/distorted thoughts lead to problematic feelings Problematic behaviors lead to more negative thoughts. Thinking, feelings and behaviors can become vicious cycle. May form the dysfunctional belief that substance use be used to deal with negative feelings.

Question 6

What is the psycho-dynamic model of psychological model?

Answer 6

Underlying psychopathology like ego deficiencies.

Question 7

What are the sub-components of family models?

Answer 7

Behavioral and family systems.

Question 8

What is the behavioral component of the family model?

Answer 8

Behavior is reinforced by family members. Family members enabling behaviors are also rewarded. This is similar to the learning model but applied to the family in its entirety.

Question 9

What is the family systems component of the family model?

Answer 9

Roles in families - all energy flows to the person with the addiction. Changes are threatening. Codependency.

Question 10

What is codependency?

Answer 10

When an individual assumes responsibility for another person’s behaviors and feelings. This allows an addicted person to use with less “personal consequences.”

Question 11

What is the Disease model?

Answer 11

Addiction is seen as a primary disease. No moral stigma. According to this model, addiction should be viewed as incurable. Abstinence is required. Also includes E.M. Jellinek’s progressive stages.

Question 12

What is E.M. Jellinek’s progressive stages in relation to the disease model?

Answer 12

Prodromal: use to cope with feelings.
Crucial: use is leading to harsh consequences. Once they start, it is often hard to stop. They still feel the ability to choose whether to use.
Chronic: Using no longer feels like a “choice” in spite of major consequences.

Question 13

What is the sociocultural model?

Answer 13

Context influences drug definitions, use, and effects. Includes the supra-cultural and sub-cultural sub-components.

Question 14

What is the supra-cultural sub-model?

Answer 14

Culture’s collective attitudes impact addictions. Views of alcohol, other societal expectations.

Question 15

What is the sub-cultural sub-model?

Answer 15

Sociological and environmental causes. Patterns within specific groups (age, gender, ethnicity, forced into a stereotype).

Question 16

What is the genetic sub-model of the biological models?

Answer 16

Strong statistical associations from genetics.

Question 17

What is the neurobiological sub-model of the biological model?

Answer 17

Limbic system, brain chemistry change with use. Dopamine hypothesis (reward system).

Question 18

What are some things that can lead to the increased release of dopamine?

Answer 18

Alcohol, opiates, overeating, sex, gambling, rage/violence, steroids, nicotine, caffeine.

Question 19

How is dopamine related to our reward systems?

Answer 19

1. Liking: the experience or memory of pleasure in the presence of the reward.
2. Wanting/anticipation: willingness to work for the reinforcer.

Question 20

It seems that dopamine plays more of a role in “wanting”. What could this explain?

Answer 20

This could explain why addicts will continue to crave even after the behavior is no longer pleasurable and physiological withdrawal is completed.

Question 21

How are the mesolimbic DA system and the Frontal cortex connected?

Answer 21

Recent research suggests that the DA system can almost shut down the decision making part of the frontal lobe.

Question 22

What are some dopamine hypothesis implications?

Answer 22

May be a link to research suggesting genetic predisposition to addiction. This hypothesis may also explain why only certain individuals become addicted. Underscores difference between abusers and addicts.

Question 23

What are some treatment implications of the dopamine hypothesis?

Answer 23

Suggests that the benefits of a medical component to treatment. Education regarding the DA system can be helpful motivation and relapse prevention. Emphasize therapy and group work.