Week Three - Lecture

Question 1

Define a theory:

Answer 1

a set of descriptors or principles put forward as an explanation of facts, findings, observations or experiences…allows us to organise and make sense of relationships among variables of interest

Question 2

Why are theories important:

Answer 2

Explains why a drug is more/less addictive:
in one society than another
for one individual and not another
for the same individual at one time and not another
Make sense of similar behaviour (e.g., compulsive)
Explains cycle of increasing dysfunctional involvement with drugs
Must be faithful to the lived human experience

Question 3

What are the theories of addiction:

Answer 3

1. Moral: sign of moral weakness, deviance
2. Disease: “sick role”, not reversible, genetic
3. Genetic/neuro-pharmacological: based on adoption and twin studies, limbic system, reward pathways/neurotransmitters
4. Psychological: classical/operant conditioning, positive reinforcement, associations
5. Socio-cultural: gender, age, SES, subculture
6. Bio-psycho-social: multiple contributing factors operate in combination

Question 4

Define the psychological theories

Answer 4

1. Disease theories
2. Behavioural theories (reinforcement)
3. Cognitive/Cognitive behavioural theories
4. Motivation and change theories
5. Family and systems theories

Question 5

Define disease theories

Answer 5

Dependence is a symptom of physical or mental illness or disease
Dependence is caused by the presence of a specific gene or biochemical abnormality that precedes substance use
Inability to discriminate blood alcohol level
Increased sensitivity to alcohol
Abnormal brainwaves
Evidence comes from family, twin and adoption studies

Question 6

Define psychoanalytic view:

Answer 6

Psychoanalytic View
Nature and nurture
Unconscious processes that govern the id, ego, & superego
Importance of childhood experiences

Variety of theories:

1. Fixated at the “oral” stage
2. Id –drive reduction theory.
3. Ego – “self medication”.

Question 7

Define personality theory:

Answer 7

[] Group of distinct personality characteristics that distinguish alcoholics from other individuals.

[] many ideas:

• predisposing factor (‘addictive personality’)
• Consequence of dependence
• Independent (personality trait and dependence)

[] Limited evidence of ‘addictive personality’

Question 8

Define genetic theory:

Answer 8

Presence of genetic predisposition for substance abuse. No specific gene has been identified, however issues re genetic predisposition is relevant.

Young et al, 2002 - People with alcoholic relatives they did not live with were twice as likely to become alcoholics as subjects who had no alcoholic relatives.

Question 9

Define the limbic system role:

Answer 9

[] Limbic system or lower brain - contains the brain’s reward circuit. it links a number of brain structures that control and regulate our ability to feel pleasure, to feel emotions, to have impulses as well as circuits involved in memory.

Question 10

Define brain stem role:

Answer 10

[] controls basic functions critical to life, such as heart rate, breathing, and sleeping.

Question 11

Define cerebral cortex role:

Answer 11

controls specific functions. Different areas process information enabling us to see, feel, hear, and taste.

Question 12

What is the impact of drugs on our brains in this gammon lid situation?

Answer 12

When under the influence, the higher brain is weakened and the lower brain is strengthened.

Question 13

Define behavioural theories

Answer 13

Only considers observable/measurable behaviour
Behaviour is a consequence of learning
Four main types of conditioning
Classical conditioning
Operant conditioning
Modelling 
Tension reduction

Question 14

Define classical conditioning in drug context:

Answer 14

Classical conditioning models
Sights, smells and sounds consistently associated with drug use elicit physiological and psychological responses that lead to drug seeking behaviour
Conditioned stimuli (CS) – cues and triggers
Conditioned response (CR) – physiological and psychological responses
CS more important than CR

Question 15

Define operant conditioning in drug context:

Answer 15

Operant conditioning models

[] Focuses on reinforcing properties of drugs, and the likelihood of people repeating immediately pleasurable experiences (and avoiding unpleasurable experiences)

[] Three main reinforcement types:

() Positive reinforcement (i.e.,
()drugs can cause ()pleasurable sensations)
()Negative reinforcement
Punishment

Question 16

Define modelling in drug context:

Answer 16

Modelling
People learn favourable attitudes and expectation about drinking based on how the behaviour is modelled.
Lowers the risk of harm if one does not have to experience negative consequences personally
Increases the likelihood of pleasant experiences learned from others
Maintenance associated with past associations with drug-taking environments/situations (see Rassool, 2011)

Question 17

Define expectancy theory:

Answer 17

Expectancy theory (Bandura, 1969; SCT)

Two specific cognitions:
[] Outcome expectancy – beliefs about effects and outcomes of using
[] Self efficacy – belief in ones own ability to effect change

Question 18

Define motivation and change theories:

Answer 18

Transtheoretical’
Increase the clients awareness of the potential problems caused, consequences experienced and the risks faced as a result of the behaviour in question (AOD Framework 2014)
Stages of change (Prochaska & DiClemente, 1986)
Clients do not necessarily enter treatment committed to action and making changes
Popular model – growing evidence base
Motivational interviewing - intrinsic motivation is a necessary and sufficient factor to initiate behaviour change

Question 19

Define family and systems theory

Answer 19

Determinants of behaviour are based on an individuals role within a system

Family and other systems (e.g., peers) have role in starting/maintaining substance use

Many differing theories

Shared common elements:
[] Boundaries
[] Reciprocal causality
[] Homeostasis

Importance of placing emphasis on interventions for the system.

Question 20

Define the common factor approach:

Answer 20

The quality and strength of the collaborative relationship between client and therapist is the strongest predictor of positive therapeutic outcomes (Fife et al 2014; Miller, Hubble, Duncan 2008)

The age, gender, and diagnosis of the client has no impact on the treatment success rate, nor does the experience, training, and theoretical orientation of the therapist. (Miller, Hubble, Duncan, 2008)

Treatment matching contributes to the development of the therapeutic alliance