Reducing Addictive Behaviour

Question 1

The theory of planned behaviour

Answer 1

According to this theory am individuals decision to engage in addictive behaviour can be directly predicted by their intention to engage in the addictive behaviour. Intention is a function of 3 factors :
Attitude to that behaviour > arises from the individuals personal views and attitudes towards the behaviour
Subjective norms > they involve the individuals personal awareness of the social norms relating to that particular behaviour
Perceived behavioural control> the more control people believe themselves to have over the behaviour in question - they will have a stronger intention to actually preform that behaviour

Question 2

Planned behaviour as a way of targeting intervention

Answer 2

Individual attitudes > information given about the risks of addiction eg graphic images and educational programs
Social norms > changing norms about smoking eg government ban on smoking
Perceived behavioural control > educational programmes aimed at children showing them how to refuse a cigarette or drugs
Intentions not to carry out the behaviour : graphic images on cigarette packets and education programmes about addiction prevention

Question 3

Strengths of the theory of planned behaviour

Answer 3

Very influential and a much used model > currently the most popular cognition model used in health psychology. Meta analysis have shown that tpb can account for 60% of the variability in people’s behavioural intentions with self efficacy being the key component

Question 4

Strengths of the theory of planned behaviour > Godin et al

Answer 4

Tpb accurately predicts behaviour and can help with some addictions > In a study of smoking behaviour Godin et al collected data about smoking behaviour using interviews and self report questionnaires. They followed up the participants 6 months later and found that the most important predictor for whether people continued smoking was low perceived behavioural control over their smoking. Intervention programmes should therefore work with smokers to increase the extent to which they feel they have control over their smoking

Question 5

Limitations of the theory of planned behaviour

Answer 5

Too rational- the tpb fails to take into account emotions compulsions and other irrational determinations of behaviour. When people fill out questionnaires they may find it hard to predict the string impulse of real life.

Question 6

Tpb > Armitage and Connor

Answer 6

Armitage and Connor conducted a meta analysis of studies using tpb found that the model was successful in predicting intention to changer watcher that actual behavioural change. This was particularly the case in the prediction of health behaviours that involved adoption of difficult behavioural change

Question 7

Biological interventions > Agonist substitution (nicotine replacement therapy)

Answer 7

This provides the addict with a safer drug that is chemically similar to the addictive drug. NRT works by both reducing withdrawal symptoms by providing nicotine but may also desensitise nicotine receptors in the brain so that if a person smokes a cigarette it will seem less satisfying. NRT included patches gum and inhalers which deliver nicotine in controlled doses via the skin into the blood stream and then the brain.
Use: available in different strengths > 25mg for more that 10 cigarettes a day > 15mg for less than 10 > full strength patches used for 8 weeks and if the smoker has successfully abstained they can reduce the dose for 4 weeks until smoke free

Question 8

Agonist substitution (NRT) A02 effectiveness Silagy et al

Answer 8

Silagy et al found in a recent meta analysis that NRT is effective : people who use it are approximately twice as likely to quit smoking for at least 6 months compared to a control condition using a placebo patch.
HOWEVER
Studies of NRT show that although they are more effective than placebos initially more that 70% of users return to smoking when treatment stops and at a nine month follow up there is no different between the two groups

Question 9

General A02 for NRT

Answer 9

One advantage is that it’s readily available in uk pharmacies and on perception from the doctors. However it’s expensive.
Addicts do not find low nicotine dowse satisfying - can lead to them giving up the therapy.
Controversy over whether the nicotine in NRT is still harmful however a cost benefit analysis shows NRT is the better option

Question 10

Antagonist treatment - Bupropion

Answer 10

Bupropion is a drug that increased levels of dopamine in the brain which reduces cravings and withdrawal symptoms and blocks the nicotine receptors in the brain reducing the pleasurable aspect of smoking. The smoker starts taking twice daily doses of 150mg of bupropion for one to two weeks this builds up bupropion levels. They then quit smoking completely. They continue to take bupropion for about 8 weeks to help them get through withdrawal symptoms. It is only available on prescription and not if the person if pregnant or has some pre existing conditions such as a history of seizures

Question 11

Antagonist treatment - bupropion A02 > Jorenby

Answer 11

Jorenby found that sustained release bupropion , 150mg. Taken twice daily has been found to be either equivalent or slightly not effective than NRT that is just over twice as effective as a control condition.

Question 12

General A02 for bupropion

Answer 12

Generally well tolerated with few side effects. However bupropion has a slightly increased chance of seizures making it inappropriate for those vulnerable to seizures.
It is only available on prescription this lack of availability makes it less likely that people will continue with the treatment.

Question 13

A02 for biological treatments

Answer 13

When biological therapies are used in combination with psychological therapies smoking cessation rates at 6 and 12 months are enhanced.
Ethical issues > using medical interventions takes responsibility away from the addict for their recovery they may be less motivated to continue with treatment
Isolating the effectiveness of biological interventions can be difficult because there may be several influences on a persons ability to quit smoking such as tv adverts

Question 14

Psychological interventions - cognitive behavioural therapy CBT

Answer 14

Analysis of Irrational thoughts > the client and therapist identify the clients thoughts and feelings before and during carrying out the addictive behaviour. This allows the client and therapist to identify high risk situations that may lead to relapse. Also provides and insight into why the individual may be indulging in the addictive behaviour.
Skills training > unlearn habits associated with their addiction / initial focus is on skills related to control of their addiction / focus on identifying and reducing habits associated with a drug using lifestyle by enduring, positive activities and rewards / also focuses on techniques to recognise and cope with urges to do with their addiction / the client practices these skills and then reports back to how useful they were in real life settings / may be offered 12 weekly sessions

Question 15

CBT A02 > Ladouceur et al

Answer 15

Randomly allocated 66 gambles to either a CBT group where their irrational thoughts were questioned and they were given training in relapse prevention or they were placed in a control group who were placed on a waiting list. 86% of those who competed the CBT were no longer get seen as pathological gamblers. Patients who had CBT had higher self efficacy and were coping better at a one year follow up.

Question 16

CBT A02 General evaluation

Answer 16

Helps the client to deal with other issues in their life which may help with factors that make a person vulnerable to addictive behaviour.
Difficult to evaluate effectiveness as CBT is often used at the same time as other treatments
The definition of successful treatment varies between people

Question 17

Psychological interventions > aversion therapy

Answer 17

Aversion therapy involves the behavioural techniques of classical conditioning. The abused substance and its use is paired with an unpleasant stimulus/ response so that the behaviour is no longer enjoyed by the abuser.
Smith > studied a group of 327 participants in a stop smoking programme. They were given aversion therapy consisting of painful electric shocks self administered through a wrist band when they carried out any smoking related behaviour. In the later support phase the client was given an elastic band to snap on their smoking wrist to stimulate the electric shock if they felt the urge to smoke after the treatment was over.

Question 18

Aversion therapy A02

Answer 18

Results from the intervention show that 52% of the clients had abstained from smoking for 12 months. Relapse was much more common when the client returned to a smoking household (70%) than when they returned to a smoke free household (40%).
The use of unpleasant electric shocks raise ethical concern of physical and psychological harm to the client. However the clients are volunteers and many reported that they found the treatment less unpleasant than other kinds of talking therapy.
Behavioural therapy eliminates the behaviour but not the cause of the problem addicts need to learn how to cope in a more adaptive way otherwise Other addictions may develop

Question 19

A02 for psychological therapies

Answer 19

Requires high levels of motivation from the client.
Expensive and time consuming.
High replace rate if smoker returns to a smoking house hold highlights that there are other factors that may influence smoking behaviour.
The definition of successful treatment varies between people