Learning objectives: What does it mean to be addicted? How have psychologists explained addictive...
Transcript of Learning objectives: What does it mean to be addicted? How have psychologists explained addictive...
Learning objectives: What does it mean to be addicted?How have psychologists explained
addictive behaviour?Are certain people vulnerable to
addictions?How do we reduce/help those with
addictions?
A2 Psychology - Addictive Behaviour
The psychology of addictive behaviourModels of addictive behaviour • Biological,
cognitive and learning models of addiction, including
Explanations for initiation, maintenance and relapse
Explanations for specific addictions, including smoking and gambling
Factors affecting addictive behaviourVulnerability to addiction including self-esteem,
attributions for addiction and social context of addiction
The role of media in addictive behaviourReducing addictive behaviour • Models of
prevention, including theory of reasoned action and theory of
planned behaviourTypes of intervention, including biological,
psychological, public health interventions and legislation, and their effectiveness
What does it mean to be addicted?1.Write a basic definition
2.What kinds of things can people be addicted to?
3. What do you think causes a person to become addicted?
Defining addiction‘Addiction is a state of periodic or chronic
intoxication produced by repeated consumption of a drug’
(WHO, 1957)
Definitions now include other behaviours, not just drugs, e.g. sex, exercise, playing computer games, gambling, overeating
Defining addiction
‘a repetitive habit pattern that increases the risk of disease and/or associated personal and social problems. Addictive behaviours are often experienced subjectively as ‘loss of control’; behaviour still occurs despite efforts to stop it. Attempts to stop are often are marked with a high relapse rate’
Marlatt et al (88)
Shared attributes of addictions
All addictions seem to be characterised by self-indulgent behaviour with short term gratification at the cost of long term damage
Addictions lead to a powerful and rapid change of mood and sensation
Celebrity addictions –do you know what they suffer from?
Classifications of addictionsDSM-IV and ICD-10 include disabling
addictionsWHO- prefers the term ‘dependence’ to
addictionDependence = characterised by intermittent
craving for substance to avoid a dysphoric state (state of mind characterised by depression and guilt)
Dependence is differentiated- abuse and harmful abuse
Differences in classifications for addictions
Smoking- substance related disorder
Gambling- habit and impulse disorder
Explaining common addictions
In groups- explain your groups addictions using psychology theory/common sense
Chris and Farah – alcoholismEllie and Lucy- food addictionEmily, Naeemah and Andy- gambling addictions
http://www.youtube.com/watch?v=pHDYk15V6hE
Explaining addictions
Biological/medical/disease modelAddiction is a specific diagnosisAddiction is an illnessThe problem lies in the individualThe addiction is irreversibleThere is an emphasis on treatment
Genes and addictionsAddiction reflects an underlying
physiological abnormalityGenetics may play a roleIt is unlikely that a single gene is
responsible for addictive behaviourVery likely- multiple genes are involved
and different genes underlie different addictions
E.g. link between tobacco smoking and genes involved in dopamine regulation (Lerman et al, 99)
Genetic vulnerabilityMost research in this area focuses on alcohol
addictionFamily studies and twin studies are usedMerikangas et al (98) 36% of the relatives of
individuals with an alcohol disorder had also been diagnosed with an alcohol-use disorder
Difficult to separate genetics from the environment
Adoption studies do however show a linkTwin studies; 60-70% concordance for nicotine
dependence (Kendler et al, 99); 34-60% for alcohol abuse (Heath and Martin, 93)
Genetic predisposition for addictionsWhether this exists or not, you still need to
be exposed to a large amount of whatever to become addicted
Likely it is more complicated than genetics
BiochemistryHow the brain metabolises various addictive substances 2 key areas:-the dopamine reward system-the endogenous opioid system
Dopamine (neurotransmitter) has a vital role in the regulation of mood and emotion and in motivation and reward processes
Alcohol and nicotine affect the nervous system, increasing levels of dopamine (Altman et al, 96)
It is possible those that are susceptible to addictions might have inherited a more sensitive mesolimbic dopamine pathway (Liebman and Cooper, 89)
Controlling our behaviourPeople have the ability to exercise choice
over whether we engage in behaviours and we mostly maintain a balance so we don’t become addicted
Over indulgences are temporary for mostWe can do this because we have the ability to
balance 2 competing neurochemical systems- reward reinforcement system and control system
SerotoninSerotonin – plays an important role in controlSerotonin- lower levels found in impulsive
peopleOldham, Hallander and Skodal (90) –
patients who attempt compulsive suicides, impulsive homicidal behaviour, early onset alcoholism and bulimia –all have lower levels of serotonin
Obsessive –patients have high metabolic rates in the frontal areas of the brain and have high levels of serotonin
The brain’s Opioid systemBelieved to be linked to addictionOpioid neurotransmitters include
enkephalin and the endorphinsThe opioid systems are activated in
states of pleasure and can be directly stimulated by addictive drugs e.g. heroin, alcohol and nicotine
Naltrexone- used to treat alcohol addiction, blocks opioid receptors in the brain, preventing the rewarding effects of alcohol
Neuroadaptation
Drug dependence- based on the idea of neuroadaptation (Koob and LeMoal, 97)
Changes occur in the brain as result of the taking of psychoactive drugs
Tolerance quickly happens and so doses need to increase to have the same effect
Withdrawal symptoms- if drug taking stops
These symptoms will make people want to start taking the substance again
Summary- Biological modelsAlcohol, nicotine, opiate drugs- change brain
mechanisms (these act on the central nervous system)
Gambling and other addictions where no chemical substance is involved also change brain mechanisms
Evidence –correlational only
Sum up the biological model.
Provide 1 pro and 1 con
Learning (behavioural models)
1970s onwards Addictive behaviours – not seen as illnessesSeen as part of an individual’s repertoire of
behaviourAddictive behaviours- Acquired habits which are learned according
to the principles of SLTThings that can be unlearnedNot all or nothing categoriesNo different from any other behaviours
Classical conditioning Unconditional stimulus spontaneously produces an
unconditional response If the US is frequently associated with a conditional stimulus
this CS will come to produce the conditional response e.g. sitting with friends (US)= relaxed feeling (UR)Smoking with friends, leads to smoking alone becoming the
CS= relaxed feeling (CR)US-UR; CS-CR US- can be either internal/externalWikler (48) first applied this to people who were addicted to
opiate drugs. He noted withdrawal symptoms following the stopping of consumption of a drug. An addict deals with these feelings by hunting another dose, exposing them to a range of cues which become associated to the withdrawal.
Cue exposure theory (Heather and Greeley, 90) could explain why people suffer such intense cravings once they have been weaned off their addictive substance.
Operant conditioningDepends on the consequences of actions Behaviours are likely to be repeated if they
are rewarded in some wayPositive reinforcement – reward is a
desirable consequence, e.g. feeling relaxedNegative reinforcement- the reward is a
removal of an unpleasant consequence, e.g. the relief from withdrawal symptoms if smoking/drug taking continues
What is a reward varies- depending on the individual, their past/experiences/ their own needs etc
SLTThis is SLT developed, going beyond
simple observation to account for some of the more complex perceptual and reasoning skills of humans.
We learn through observing and hearing what others do/say
Significant people – make smoking etc attractive and rewarding
Also includes aspects of Cog Beh models – labelling and outcome expectancy model
Cog Beh modelsCognitive labelling models – an emotional
experience that is the result of an interaction between physiological arousal and its cognitive interpretation (the label). Cues to emotional arousal are very powerful, e.g. someone who is addicted to alcohol may smell it near a club and want alcohol more
Outcome expectancy model- cues set off expectations about an addictive substance, e.g. adverts of people drinking may trigger the thought ‘I really want/need a drink’
Sum up the behavioural model
Provide one pro and one con
Usefulness of Behavioural approachesLinks to cognitive make it more able to give
a solid explanationDoes stress the role of the media
(advertising for cigarettes/alcohol etc)However the theories of cognitive labelling
and outcome expectancy are simplistic (Tiffany, 99)
Avoids the idea that humans are creative thinkers
Cognitive models Emphasis on the processes that control mental functions
such as communication, learning, problem-solving, planning Self-regulation- weighing up the relative importance of
social and physical factors as well as one’s own personal goals when planning behaviour
Addictive behaviour- more common in people who place excessive reliance on external structures to maintain a balance between their physical and psychological needs
Impaired control over actions lead to addictive behaviour
Rational people can behave like this if they have faulty ways of thinking when exploring the consequences of their actions
Ainslie (92) all people can perfectly predict present and future consequences but they attach different weightings to them, mostly attaching greater weight to the present
Immediate reward over future benefit – called cognitive myopia (Hernstein and Prelec, 92)
Beck et al (93)Addictive beliefs play an important part in
the development of addictive behavioursAt first the individual thinks it would be
fun/exciting to drink/take drugs etc and then gradually they become reliant on the substance
These individuals often have very negative views of themselves and may suffer depression/anxiety
The cognitive processing model
Behaviours if repeated enough become automatic
Tiffany (90) argues that addictive behaviours are regulated by automatic processing
Drinking etc if repeated and repeated become automatic, thus it is difficult to stop automatic behaviour
We are continuously faced with situations that trigger automatic responses
This could be possible if everything else in an individual’s life is good, however if there are stresses etc it becomes more difficult
Sum up the cognitive model
Provide one pro and one con
Evaluations of cognitive theoriesUseful for explaining the thinking processes
of people who become addicted to certain behaviours
Provides helpful treatmentsAlso provides explanations for why relapses
occurDoes not explain why such addictions start
in the first place
Use one of the models to explain the following:
Russel Brand’s sex addictionPete Doherty’s drug addictionsMichael Jackson’s prescribed drugsDavid Hasselhoff’s alcohol addiction
Explaining specific addictionsSMOKING1.1 billion people are estimated to be
smokers across the world (WHO)4 million people are estimated to die from
smoke related illnesses (WHO)Evidence links smoking to:-high blood pressure; coronary heart
disease; lung disease; cancer and strokes-pregnant women who smoke are more
likely to have premature babies-smoke increases stress levels (Parrott, 00)
Why do people smoke cigarettes in the face of the side effects?.
SmokingThere are 3000 chemical components in
cigarette smoke- but nicotine is the active and addictive component
Hilts (94) compared nicotine to 5 other psychoactive drugs-heroin, cocaine, alcohol, caffeine and marijuana. He ranked nicotine lowest for intoxication but highest in terms of dependence
Relapse rates- 70% in the first 3 months of trying to give up. Individuals who give up experience quite nasty withdrawal effects
SmokingIt is classed as a psychoactive drug as it
directly affects the brain but it’s effects as more subtle than most drugs
Nicotine affects the central nervous system, its estimated that nicotine once smoked takes less than 25 secs to reach the brain
Nicotine has – stimulant and depressant effect on the brain- increases the amount of noradrenaline and adrenaline in the body
It activates the MESOLIMBIC PATHWAY- producing positive effects-smokers explain it has a relaxing yet arousing effect
Explaining smoking Biological factorsGenetic factors – Shields (42) looked at 42
twin pairs who had been reared apartOnly 9 pairs were discordant for smoking
behaviour
Explaining smokingSocial factorsMost people start smoking in childhoodTraditional learning theory is able to explain
smoking behaviour quite well- using the principles of operant conditioning
It is extremely common that the first experience is unpleasant, difficult to explain why children persist
SLTChildren continue to smoke to imitate role
modelsRole models are more influential if the are
the same sex, age or ethnic background as the observer
Those with a higher status have more influence (such as a celebrity) –Winnett et al, 89
The observation of others enjoying the experience leads to them persisting to expect future enjoyment
The role of parents in their children’s smoking behaviour
A key influence on smoking behaviour is parents’ attitudes to smoking
Children are twice as likely to smoke if their parents are smokers (Lader and Matheson, 91)
If parents’ attitudes are firmly against smoking, the child is 7 times less likely to smoke (Murray et al, 84)
Peer pressureBelieved to be very important, exerting
pressures on those that do not smoke to start .e.g. bullying
Michell and West (96) adolescents are considerably less susceptible to this kind of pressure. They explain that some here show a ‘readiness’ for smoking
Those not wanting to smoke, tend to adopt strategies to avoid situations where smoking is likely to be offered
What are the implications here are for health campaigns?
Individual differencesResearch in the US links smoking to certain
other traits such as poor performance at school, low self-esteem, evidence of risk taking behaviour (e.g drinking alcohol) –Mosbach and Lenethal, 88
Cognitive factorsTRA and TPBConner et al (06)- role of planned behaviour
in smoking initiation in 11-12 year olds.675 non-smoking adolescents were tested for
baseline measures including tpb9 months later they checked if any of these
adolescents had taken up smoking They used carbon monoxide poisoning instead of
subjective measuresResults- behavioural intentions were usually a good
predictor of smoking behaviourIn China childhood smoking is a big problem, Guo
et al (07) studied more than 14000 children with tra and tpb and found they were useful predictors of smoking behaviour
Problem gamblingExplain what is meant by the above
What causes such problems?
Problem gambling
Pathological gambling- term used to describe those at the most extreme end of the gambling behaviour spectrum
Problem gambling- gambling that is of a mild to moderate problem for the sufferer
Difficulties- no clear cut definition of what gambling is
General consensus- an activity where 2 / more people agree to take part – usually the operator and the person/persons who wish to gamble, the stake is paid by the winner
DSM-IV – to be a problem gambler you must have 5 or more:Preoccupation with gamblingNeed to gamble with increasing amountsRepeated unsuccessful efforts to control or cut
down gamblingRestlessness/irritability when trying to cut downReturn to gambling even after losing huge
amounts of moneyJeopardising or losing relationships due to the
gamblingCommitting illegal acts such as forgery to
conceal the gambling
Problem gambling Usually starts in adolescence for menLater in womenTypically gradual- starting with social to more
frequentGambling is common- millions report doing it
each year (National Centre for Social Research), however gambling does not always lead to addictions, e.g in Canada 0.6% of the population are addicted to gambling
Explanations of gambling behaviour
Biological accountsGenetic vulnerability (Eisen, Lin and Lyons, 99)Comings et al (01) argues the genetic vulnerability could be
explained in terms of genes controlling the activity of DOPAMINE, SEROTONIN AND NOREPINEPHRINE
Gamblers often report enjoying a high/buzz from the game/winning, problem gamblers have high levels of dopamine and norepinephrine in the anticipatory stage before non-problem gamblers
Meyers et al (04) compared 2 groups of problem gamblers- one playing cards not for money; the other gambling for money. Gamblers- raised heart rate and secreted more cortisol (both are linked to acute stress)
Rosenthal and Lesieur (92) problem gamblers who stop gambling, report withdrawal effects similar to drug addicts who stop taking drugs
There is evidence to link dysfunction of the prefrontal lobe to problem gambling (Cavendini et al, 02), high rates of EEG abnormalities have been found (Regard et al, 03)
Explanations of gambling behaviour
Meyers et al (04) compared 2 groups of problem gamblers- one playing cards not for money; the other gambling for money. Gamblers- raised heart rate and secreted more cortisol (both are linked to acute stress)
Rosenthal and Lesieur (92) problem gamblers who stop gambling, report withdrawal effects similar to drug addicts who stop taking drugs
There is evidence to link dysfunction of the prefrontal lobe to problem gambling (Cavendini et al, 02), high rates of EEG abnormalities have been found (Regard et al, 03)
Explanations of gambling behaviour
Sociocultural accountsGreater access to gambling opportunities are linked
to problem gamblingLadouceur et al (99) –found that problem
gambling rates increased with greater availabilityAn Australian study- found gambling rates
increased but not rates of problem gambling when access increased
National Lottery (UK, introduced in 94)-concern it would become addictive. GamCare survey in 98 found that 65% of people had played the national lottery compared to other countries where 90% in New Zealand and Sweden
Alcohol consumption- believed to increase gambling (evidence is inconsistent)
Explanations of gambling behaviour
Psychological factorsOne risk factor is impulsivity in
childhoodADHD is found in many problem-gamblers
(Carlson et al, 94)Operant conditioning- gambling is
reinforced when gambling is successful (money and the ‘buzz’)
Schedules of reinforcement show that variable successes are more powerful in making behaviour last and make them difficult to stop
Can’t explain the origin though
Explanations of gambling behaviour
Parental attitudes to gambling – are very influential particularly the father’s (Oei and Rayhi, 04)
Irrational self talk –common in gamblers, Winefield (99) found that 75% of game related thoughts were irrational, encouraging risk taking
Mood state- contributes to gambling, with people gambling to escape being depressed
Sharpe’s biopsychosocial model (02)
3 key contributing factors:1. Bioloigcal vulnerability (involving the
brain’s reward system)2. Family attitudes that support gambling3. High levels of impulsivity Nower et al (02) suggests a different
pathway-1. Behaviourally conditioned2. Emotionally vulnerable gamblers3. Anti-social, impulsive problem gamblers
(an underlying biological dysfunction, e.g. ADHD)
Vulnerability to addiction All addictive behaviours take place within a society- which has
norms, values etc E.g. France, considered odd not to drink alcoholSELF-ESTEEMLow self-esteem is linked to addictive behaviourATTRIBUTIONSCognitive biases –such as those found in young males who are
problem gamblers, unrealistic ideas about risk and their chances of influencing the outcome of their behaviour (Moore and Ohtsuka, 99)
PERSONALITYEysenck (97) ‘the addictive personality’ –addictive behaviour fulfils
a certain purpose related to the personality of the individual which are inherited: personality is divided up into 3 areas:
1. PSYCHOTICISM (P)2. NEUROTICISM (N)3. EXTRAVERSION (E)Evidence is mixed for high levels of P, but more convincing for N and
E for dependence to alcohol (Francis, 96)Correlational evidence onlyLink between alcohol addiction and personality disorder –
alcoholism is linked to anti-social personality/sociopathy
Vulnerability to addictionGender Smoking- increase in female smoking in the US
and UK, male smoking has remained stableWhy might this be the case?Ogden and Fox (94) Gambling- males are more regular gamblers
compared to females (Jacobs, 00)Social context of addictionDrinking, smoking and gambling to an extent-
are socially acceptableAlcohol –linked to transition from childhood to
adulthoodPeople with antisocial behaviour are more likely
to develop substance use problemsChildren with anxiety/depressive symptoms are
more likely to develop substance use problems and often it will be at an earlier age (Cicchetti and Rogosch, 99)
Vulnerability to addiction Family influenceSLT predicts children’s behaviour will reflect similarities in
their parents.Parents drugs use is linked to the onset of alcohol and
cannabis useParents with a permissive attitude to drug use are more likely
to have children who are more likely to start taking drugsRisk of substance abuse is higher where families have
problems
Sociocultural background is also significant- Hall et al found that people from lower social classes are more likely to develop substance use problems, same for those with a lack of educational experience
Problem gamblers show a wide range of school related difficulties- truancy etc (Fisher, 99)
Link between alcohol abuse and problem gambling in males (Vitaro et al, 01)
What role does the media have in causing addictions?Group 1- advertsGroup 2- tv showsGroup 3- role modelsGroup 4- filmGroup 5- computer games
Education How do schools address the potential
problem of addictions?
Does it work?
What else could they do?
The role of the media in addictive behaviour
TV shows such as Who Wants to be a Millionaire
Advertising e.g. the National Lottery ‘It could be you’
Other forms of addictive behaviour – Chapman and Fitzgerald (82) found that underage smokers preferred heavily advertised brands
Legislation has changed advertising Models are used widely within tv
shows/filmsSLT- we learn through observation and
vicarious reinforcement
How can addictive behaviour be reduced?.
Reducing addictive behaviour Models of prevention1. Education – to raise awareness of the
possible consequences of excessive smoking, drinking etc
2. Introduction to social change – raising prices of cigarettes etc, raising of age to buy products, controlling adverts
TRAInterested in how health beliefs lead to
health behaviourFishbein and Azjen (75, 80)Consists of 3 components:-attitude-behavioural intentions-subjective normsA person’s behaviour is influenced by an
interaction between their own views of their behaviour and how they think others will view it
TPBAzjen Later modelIncludes perceived behavioural control-subjective norm and attitude
Reducing gamblingThere is little research investigating the
effectiveness of reducing gamblingGadbury et al (93) conducted experiments
with high school students highlighting the difficulties with gambling, it did raise awareness but had little influence stopping such behaviours