Week 2: Models of Misuse 2

Question 1

Personality and Substance Abuse (3 sections)

Answer 1

Idea of Psychological Vulnerability is less simplistic and more valid than Addictive Personality

• ​Prior psychological factors make patterns of substance dependence more likely — rather than particular personalities leading to addictive/compulsive behaviour
• Difficult to identify relationship of addiction to ‘addictive’ personality traits because many traits overlap.

​_________

Cloninger (1987): identified 3-dimensional model of personality for addiction:

• Harm avoidant
• Reward dependent
• Novelty seeking
• Maladaptive motivational structure also important; can’t maintain motivation to achieve goals

Question 2

Tension Reduction Theory

(5 sections)

Answer 2

People have biological variations in levels of tolerance to stress & stim:

• Early research: drugs used to reduce tension, relieve stress.
• Now that’s just one aspect of use.

​_________

2 major assumptions of TRT

• Drugs reduce tension
• People take drugs for their tension-reducing properties

_________

Gitlow (1972) described addiction as a biochemical defect in how people respond to stress. They use drugs for sedating effects and once dependent, use drugs to relieve agitation caused by withdrawal

​_________

​The Opponent Process Theory of Motivation: Solomon & Corbit (1974)

Built on a homeostatic theory of tolerance: body a homeostat, with a set point. Tries to maintain homeostasis/balance. Drug used to counteract aversive emotional state (stress, anxiety…)

_________

3 classifications dealing with stimuli:

• Stimulus reducers perceive/react as if stimulus less than it is
• Stimulus moderators perceive/react to stimulus as it is
• Stimulus augmenters perceive/react as if stimulus more than it is

Question 3

​Opponent Process Theory of Motivation

(Tension Reduction Theory)

Answer 3

​Opponent Process Theory of Motivation: Solomon & Corbit (1974)

Built on a homeostatic theory of tolerance: body a homeostat, with a set point. Tries to maintain homeostasis/balance. Drug used to counteract aversive emotional state (stress, anxiety…)

Question 4

3 classifications re: stimuli

(RMA)

(Tension Reduction Theory)

Answer 4

Stimulus Reducers perceive/react as if stimulus less than it is

Stimulus Moderators perceive/react to stimulus as it is

Stimulus Augmenters perceive/react as if stimulus more than it is

Question 5

Self-Medication Motive

Answer 5

Drug use is not a random phenomenon: It’s a purposeful attempt to:

• Assuage painful affective (feeling) states
• Manage psychological problems
• Manage personality traits and disorders
• Manage depression or anxiety/lots of stress/loss in their life…

Self medicating aversive state.

• Depressed = stimulants
• Angry/anxious = pot, opiate, etc.

Treatment

For therapists, important to explore motive to help user identify why they take drugs. Find other ways to cope with particular problems ‘ work through’ issues.

Question 6

Social Learning Theory (SLT)

Answer 6

Most important factor is social learning aspect of drug use. Also incorporates other theories (ex Tension Reduction)

Drug use is a socially acquired, learned behaviour pattern, maintained by:

• antecedent cues
• consequent reinforcers
• cognitive factors
• modelling influences
• interaction of behavioural & genetic influences

Important social learning and cognitive behavioural points:

• Addictive behaviours learned maladaptive behaviours
• Addictive behaviours occur on a continuum
• Social factors important to consider
• Strong influence of the individual’s expectation of desired effects
• Addictive behaviour can be changed to new, more adaptive behaviours

Question 7

Sociocultural Model

Bales (1946)

Answer 7

Bales (1946): identified influence of culture on rates of alcoholism, based on:

• Degree to which culture causes acute need to adjust inner tension (shame)
• Attitudes toward drinking culture produces in its members (e.g. Irish)
• Degree to which culture provides substitute means of satisfaction
• People who feel alienated = more likely to be addicts

Question 8

Psychoanalytic Model

Answer 8

Historically: Fixation at oral stage resulting in narcissistic personality.

Drug use:

• alleviates stress about mother’s denial of milk/security
• relieve anxiety about masculine inadequacy
• suppress latent homosexuality

More recently: Drug use caused by a structural deficit in object relations

• addicts have difficulty establishing interpersonal relationships because they cannot manage their feelings and control their impulses

Psychoanalytic Meaning: Choice of a drug is related to the meaning that the drug has (both consciously & subconsciously) for that person

• Drugs as Power (‘getting high’)
• Drugs as Self-Destruction (failure of the Ego)
• Drugs in Seduction and Sexuality
  
  • shared altered state of consciousness

Question 9

Trauma Model

Answer 9

Trauma experience/witness event “involving actual death, death threat, serious injury…. intense response: fear, helplessness, horror. ex. war, abuse.

Two major hypotheses:

• Individual self-medicates. Attempt to ‘numb out’ feelings associated with traumatic experience(s); research tends to support this theory
• Individual using alcohol/drugs is more susceptible to trauma and then developing PTSD

Question 10

Other Theories

Answer 10

Personality-deficiency theory - addicts have developmental personality traits of motivational immaturity

The cognitive-affective-pharmacogenic (CAP) theory - addict’s cognitive style while interpreting anxiety determines whether they will abuse drugs

Existential theory - drugs relieve the pain of having a dysphoric lifestyle

Achievement, Anxiety, and Addiction - drug use as a time-saving device to cope with the stress of achieving

Pharmacological Approach - receptors and neurotransmitters involved in feelings of well-being.