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AQA A2 Psychology Addiction
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Terms in this set (19)
Biological explanations of gambling
Pathological gambling is a major psychiatric disorder. The DSM-IV-TR focuses on three areas:
1. The individual demonstrates a loss of control of gambling behaviour.
2. They exhibit a progressive increase in gambling frequency and time spent thinking about gambling.
3. They continue to gamble despite negative repercussions on their life.
The biological model perceives addiction as a physiologically controlled pattern of behaviour, with initiation of addiction occurring by genetic vulnerability, triggered by environmental stressors, while maintenance is regulated through the activation of dopamine, which some drugs, like cocaine, have a direct effect on. Relapse is explained as due to physiological cravings.
The PFC (prefrontal cortex) controls behaviour, decision making and inhibiting the drive to respond to urges for immediate reinforcement, if the long-term consequences result in negative outcomes. Chronic drug use can cause desensitisation of dopamine receptors in the brain so that individuals require higher or more frequent doses to achieve the behavioural effect. This also reduces PFC's activity, reducing addicts' ability to resist cravings.
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Black et al found that first degree relatives of pathological gamblers were more likely to suffer from pathological gambling than were more distant relatives. This explains why some people are more vulnerable to addiction because of their genetic predisposition and so are more likely to gamble after environmental experiences and life pressures, unlike those who are not genetically predisposed (diathesis-stress model). But then, this ^^^ is a combination of biological and environmental factors.
This could also mean they are resistant to treatment and are more prone to relapsing.
The ideas are essentially bio reductionist as they reduce a complex phenomena to a simple explanation ie. an imbalance of brain chemicals or the influence of specific genes.
Biological explanations of smoking
Addiction to smoking occurs when an individual has developed an uncontrollable dependence on cigarettes such that they find it almost impossible to stop smoking.
Nicotine affects brain chemistry by activating nicotine acetylcholine receptors which lead to the release of dopamine. Creating short-lived feelings of pleasure until nicotine levels in the blood drop. Vink et al reported that nicotine dependence was influenced primarily (75%) by genetic factors.
Thorgeirsson et al identified a specific gene on chromosome 15 that influenced the number of cigarettes smoked per day, nicotine dependence and the risk of developing smoking-related diseases.
This is good, if genes are the case, then biological treatments can be made specific to the patient and thus be more effective.
IGNORES ENVIRONMENTAL FACTORS as they may smoke because their parents did, or because their peers do so to act 'cool'. Although biological factors may be important in determining who has the potential for addiction, environmental factors might be the reason that people actually take up smoking or gambling. (nature vs nurture). (diathesis stress model).
As only genetic causes are being controlled and not any external factors, this could lead to the initiation of relapse.
Cognitive explanations of gambling
A cognitive view of addiction, by contrast, emphasises habitual ways of thinking and interpreting events that might lead up to the development of addictive behaviour. A person may rely on smoking or gambling as a way of coping with life's problems, but may up creating more problems than they solve.
Initiation: Gelfopf et al, self-medication model, proposes that individuals intentionally use different form of pathological behaviour to treat their psychological symptoms. The activity is chosen at random e.g. gambling, and someday may be chosen again to overcome anxiety for example. It is judged as 'making things better' by the individual as it suppresses their symptoms.
Maintenance: 'irrational beliefs', Griffiths compared 30 regular and non-regular gamblers verbalisations as they played a fruit machine. Regular gamblers believed they were more skilful than they actually were and appeared to have self-confidence to 'beat the system', explaining their losses as 'nearly winning' seemed to justify their continuation.
Relapse: Pathological gamblers suffer from a 'recall bias' they overestimate their wins and underestimate their losses. So that a string of losses is not seen as a disincentive as individuals believe they will win because they 'deserve' to be rewarded for their efforts = just world hypothesis.
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Li et al found though who are 'self medicating' gamblers to escapes the painful reality of life rather than for pure pleasure are more likely to have other substance dependencies also. This model argues that psychological distress precedes, Becona et al offered support for this, MDD is evident in most pathological gamblers but correlation doesnt mean depression is the cause of gambling. It is equally possible for it to be the consequence of the personal and financial costs of pathological gambling. Treat these gamblers by treating underlying mood problems before getting them to quit.
CBT as well.
cognitive explanations of smoking
The cognitive model sees addiction as due to distorted thinking relating to dysfunctional beliefs, like social functioning being dependent upon drug use. These maladaptive processes relate to mood causing addicts to believe that happiness is impossible without drugs.
Initiation: expectancy theory, whether they expect positive or negative effects of their behaviour. Brandon et al proposes that behaviour escalates into addiction depending on the individual costs and benefits of that activity. Adolescent smokers report smoking when they are experiencing negative moods (Kassel et al) and that smoking will decrease the intensity of that mood (Brandon and Baker).
Maintenance: Brandon et al suggests that as an addiction develops, the activity is influenced less by conscious experiences and more by unconscious expectancies involving automatic processing. This would explain the loss of control most addicts experience in their behaviour and the difficulties they are experiencing in abstaining.
Tate et al. told 2 groups of smokers, one, that they would experience somatic effects during a period of abstinence, and the other, that they would experience no effects. Those told to expect somatic problems experienced severe complaints than a control group who hadn't been told to expect this.
Relapse: assessing costs and benefits, affect an individuals' readiness to quit and make it more likely that they will relapse. Those who see smoking as having high benefits and quitting having few, are far more likely to relapse than making an attempt to quit.
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Juiliane and Brandon reported greater expectancies, that cigarettes alleviate mood states, cravings and have a positive effect on weight control.
Moolchan et al showed that the use of nicotine patches could improve cessation rates among adolescents and reduce relapse rates only when accompanied by CBT to change the positive expectancies of smoking behaviour
Evidence largely supports expectancies and addictive behaviour but the selective publication of research into this area, particularly when the number is small and contradictory findings are frequent.
Learning explanations of gambling
OC proposes that any behaviour that produces a positive outcome (reinforcement) is likely to be frequently repeated. Griffiths argues that gamblers play slot machines because they become addicted to the physiological rewards (getting a buzz from winning) and the 'near miss'. As well as social rewards like peer praise and financial rewards.
People continue to gamble because of the intermittent reinforcement (the occasional payout). As well as social approval . Those that received social approval gambled more than those with other forms of reinforcement.
Addicts have formed conditioned cues through CC, like the presence of other gamblers and casinos increase arousal, they are at an especially high risk of relapse is they are undergoing a period of abstinence. Motivation fluctuates between wanting to gamble and wanting to stop (avoidance conflict).
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It is more likely that long-time gamblers are conditioned, rather than now and again scratch cards users when there is less time for conditioning to take place.
There are different pathways for gambling that predict the likelihood of treatment being successful, people that are behaviourally conditioned by the people around them will find it difficult to quit as they will be around these triggers on a day to day basis. But those that use gambling as a form of coping mechanism are more resistant to change by altering this mechanism and developing coping skills and having support from friends and family.
Many people gamble during their life and experience short term reinforcements e.g. winning a fiver on the lottery, but few people actually become addicts and so there must be other psychological factors involved in the transition from gambling behaviour to gambling addiction.
learning explanations of smoking
Initiation: Young people smoke as a consequence of social models around them, like their parents (SLT). e.g. peer and parental modelling (Bandura) and vicarious reinforcement that leads young people to expect positive physical and social consequences from smoking e.g. popularity.
Maintenance: Continuous repetition leads to a strong conditioned associated between the sensory aspects of smoking e.g. smell or sight, and the reinforcing affects of nicotine e.g. these cells become conditioned to immediately activate the same brain areas.
Relapse: A conditioned stimulus such as the smell or people, urges people to have a smoke. Hogarth et al found craving increased when a conditioned stimulus related to smoking was presented to a smoker.
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Di Blasio and Benda found peer group influences to be the primary cause for I, M and R of smoking. Karcher and Finn, people are 8x more likely to smoke if their friends do, 1.88 for parents and 2.64 for siblings.
Theiwissen et al presented 33 smokers with a cue e.g. smell and were more likely to feel a greater urge than those presented without a cue.
Drummond et al, involved presenting a cue without the opportunity to smoke to stimulate but not provide the reinforcement of nicotine (cue exposure). This reduces cravings for a cigarette that arises when exposed to that particular cue.
Botvin, drug prevention programmes should be put in place, particularly for adolescents as they are at a stage of critical development and more vulnerable to the influence of peers therefore they will learn resistance skills much more quickly than older people who have been smoking for a much longer period of time.
Risk factors in the development of addiction
Stress: everyday stress, addiction to something is seen as a coping mechanism which can spiral out of control, particularly if the stress intensifies, such as loss of a family member. Driessen et al found 30% of drug addicts and 15% of alcoholics suffered from PTSD.
Peers: Adolescents who are smokers tend to befriend those who also smoke (Eiser et al). and as a way to gain popularity. SLT, more likely to imitate via vicarious and it is seen as a novel behaviour. Social identity theory, Abrams and Hogg adapt norms that are central to the identity of the group.
Age: influence of peers is great during adolescence but romantic relationships become more important during adulthood and have a much better understanding of health implications and there is no gain of popularity.
Personality: Someone may have an 'addictive personality' possibly due to genes or early childhood and upbringing. It can explain why some people become addicted and others don't despite trying the same experience.
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Bio theory of personality dimensions, inc, extraverts seek external stimuli to arouse them, people high in neuroticism such as anxiety and high in psychoticism such as impulsivity, reacting with little forethought.
The tridimensional theory, Cloniger proposed 3 personality traits that predispose individuals towards substance dependence they inc, novelty seeking, harm avoidance e.g. worrying, and reward dependence.
Smoking increases stress levels, even though it is supposed to reduce them, people become stressed when they cannot smoke, whereas before they were stressed about other life events, so instead of eliminating stress, it is just causing it in another format. correlation and causation. heightened levels of stress among poorer people, easy access to drugs as a way of earning money.
Little is known as to why adolescents stick to the demands of their social group when it clearly conflicts with their own concerns to maintain a healthy lifestyle (but fast metabolism so not bothered). Older people are reluctant to admit to or talk about their addictions and dependency problems my be discrete, e.g. taking medication for old ladies and public drinking for youths
Personality, +ve correlation between personality traits and addiction but which causes the other? Belin found personality to come first as the 'sensation seekers' immediately take up large doses and didn't become addicted, those who took smaller doses over a long period of time became addicted. Those who become addicted could have high levels of dopamine from a hypersensitive dopamine response system (Buckholtz et al). When people with Parkinson's disease were treated with drugs that increased dopamine levels, there found to be a 3.5 fold increase in impulse disorders.
Media influences on addictive behaviour
Sulkunen believes that the media are a rich source of lay beliefs about substance abuse and misuse e.g. in the 1990's the use of recreational drugs inspired a number of drug-related films such as Trainspotting which revealed the world of a heroin addict, some found quite satisfying.
He collects 140 scenes from 47 films inc gambling, smoking, drugs and alcohol, they were seen as a form of excitement to the ordinary day, enjoyment, a way of alleviating a particular problems and in the case of the film 'Human Traffic' a way of resolving relationship problems.
In adolescents, Waylen et al found teenagers were more likely to smoke if they had seen a large number of films depicted smoking, even if their friends do not.
Now, television is promoting more healthy life styles, tobacco publication has been banned on TV, and people are only to smoke outside, over 21's only allowed in casinos but efforts of treatment are hampered by the motivation of the addict. Just providing more knowledge on the subject doesn't necessarily mean they will quit because of this because this is only controlling one part of the complex problem, treatment relies on high levels of self efficacy.
Boyd argued that not all films depict drug use as positive but some show the negative consequences such as rape and physical degradation in an attempt to put people off the idea. Some US filmmakers are also offered financial incentives to depict use in a negative way.
Why don't drug campaigns always work? Well, since they are on so frequently, messages in the campaigns are not particularly novel. Johnston et al found that youths who watched the campaign took the message that their friends were using marijuana and so were more likely to imitate. As well as showing them all the different types available.
National lottery adverts are often a great stimulus for gamblers, especially double rollovers, bingo websites like gala, are very difficult to avoid.
Theory of planned behaviour
TPB (Ajzen) is an adaptation of the earlier theory of reasoned action which perceived addictive behaviours and attempts to manage or refrain from, as due to decision making and factors supporting decision making, rather than predisposing factors. A new component of self-confidence and skills will help them to overcome difficulties and achieve abstention. If an individual thinks they are unable to quit smoking, they will not even try. Perceive behavioural control has a direct effect on behaviour, bypassing behavioural intentions.
- Behavioural beliefs, linking behaviour to expected outcomes, will the behaviour be positively or negatively valued.
- Normative beliefs, 'perceived' beliefs such as being accepted into a popularity social group and the pressures they will face if not done the deed.
- Control beliefs, involves the perceived factors that will hinder performance and are seen as determining perceived behavioural control. With the control, accurate measurement of perceived factors and the intention, all can be used to predict behaviour by the individuals willingness.
TPB allows that assessment of motives and personal beliefs in their resolve to quit, resist withdrawal effect and cravings. A persons perceived behavioural control must be high enough to convince them that they can conquer all difficulties that they come into contact with.
Oh and Hsu used a Q to assess gamblers previous behaviour, social norms, attitudes and perceived behavioural control and intentions. A positive correlation was found between attitudes and intentions and actual behaviour, supporting the model.
Goodie found that chronic gamblers were overconfident in their wages compared to social gamblers, indicating that perceived behavioural control differ between addicts and non-addicts.
Self report evidence ^^^ addicts may play down their degree of dependency. Additional factors also need to be considered, especially anticipated regret and the strength of emotional disappointment if the intended behaviour is not achieved.
Doesn't account for individual differences, it states that those that possess the desired characteristics are only the ones that can quit!
Biological interventions
Include drugs, benzodiazepines gradually reduce alcohol intake and thus less side effects cos gradual. Gelder et al found that a smooth course of withdrawal meant that they are not likely to be abused and are therefore an effective treatment. Antagonistic drugs eliminate the effects of neurotransmitters by blocking cellular activity to reduce cravings, they are most effective when combined with CBT. Trauer, methadone is associated with psychiatric disorders, although it is used to treat heroin. People on it are 10x more likely to have a disorder than the general population, suggesting that drugs cause one problem but create another.
Naltrexone is another dopamine antagonist that reduces the urge to gamble, and Kim and Grant found that after 6 weeks of treatment, gambling thoughts and behaviours had decreased.
Yet these interventions do not alleviate any environmental problems or other medical problems that might prevent the drugs from having their full effect.
Psychological interventions
CC aversion therapy, alcohol is paired with an emetic drug that induces vomiting so that vomiting can then become the conditioned response and so they are unlikely to want to drink, ps were also given soft drinks so that this idea was not generalised to all forms of drinking, only alcohol.
OC contingency management, 'unexpected surprises' of reinforcement play a role in encouraging and discouraging drinking. If ps don't drink, they will be rewarded. But if they are not rewarded from friends and family per say, they may drink again in order for friends to feel guilty. They will become dependent upon the reward and not the alcohol, and once the reward is removed, drinking will be the coping mechanism once again.
Behavioural self-control training focuses on three components:
-Stimulus, narrow down drinking situations
-Modification, mixed drinks, not shots
-Rewarding, a non-alcoholic treat for resisting the urge
This is a practical application that is easy and a realistic and gradual approach, not making big leaps but only small steps in the right direction makes it easier to have long-term benefits. Unlike, cutting all alcohol out of your life, will intensify your cravings and you will end up relapsing and drinking/smoking/gambling even more often or even more money than you did before.
Cognitive intervantions
Therapists forming a relationship with patients to reduce cravings and establish control by introducing strategies that will increase willpower and develop rational explanation to address false beliefs and to prevent perceiving lapses as catastrophic. CBT and behavioural self-control training help addicts identify when they are at risk, coping skills, relaxation methods and positive self-talk. CBT is brief so that more people can be available to it and it can be tailored to individual circumstances as well as having long-lasting effects. This can be even better when combined alongside drug treatments.
Petry et al found cognitive management to be effective in treating alcoholism as after a programme, only 26% of those given the treatment relapsed unlike whereas 61% of the control group not given the treatment relapsed. This doesn't show whether it was over a long period of time and how large was the sample? was it both men and women?
Public health interventions
Aim to promote behaviour change in whole populations by using the government, internet and community.
-Social inoculation tries to strengthen attempts to resist temptation to addictive activities by using defence statements.
-Fear arousal, is used in health campaigns to show the negative consequences of addictive practices and the effects it will have on friends, family etc.
-Targeting risk groups, such as younger children who are at a critical stage in development, could be more successful than providing the same information and treatments to all age groups.
In the workplace, smokers now must go outside which potentially decreases the risk of passive smoking and diseases related to this such as CHD. Implementation of work-based health programmes, make them compulsory, not get paid for the time you smoke etc.
However, bans on gambling led to an increase in criminal activity as activities were then taken underground.
Community programmes focus on group support and motivation rather than going through difficulties on your own, ultimately aimed at those unwilling to attend clinics.
Governments have banned tobacco advertising as well as increased tax, and alcohol cannot be portrayed as improving sexual or social success. Making drugs illegal in fact increased criminality and overdosing from other alternatives, such as common drugs. The reduction in advertising and increasing of tax could have the desired outcome of reducing tobacco abuse yet this can lead to a reduced tax revenue to be spent on other things such as health care. The lottery is seen as a 'positive promoter' and an acceptable pastime, so people that have stopped gambling in one area, may turn to this as they are 'allowed'.
Conrod et al devised a school based intervention to assess its success amongst adolescents with a high risk of substance abuse. By evaluating 2,506 using a Q inc, impulsivity, happiness, personality, 624 were identified as high risk and so underwent 2 90minute group sessions. Another group of 384 high risk students underwent no intervention. After 6 months, binge drinking was 55% lower in the intervention group, showing it is effective! but self report could produce flawed findings, and this was only focused on adolescents. not people who were already addicts.
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