The Psychology of Addictive Behaviour...khyxtdrzwxetrcytvubyiunoimiknoubyiutvcrytxecrfyvubyiunoim

8/13/2019 The Psychology of Addictive Behaviour...khyxtdrzwxetrcytvubyiunoimiknoubyiutvcrytxecrfyvubyiunoim

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The psychology of

Addictive BehaviourCWs


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The Biological Approach to Gambling

Initiation: Role of genetics

SHAH ET AL

Twin study

Evidence of genetic transmission of gambling in

men

BLACK ET AL1STdegree relatives of pathological gamblers

more likely to also be pathological gamblers than

more distant relatives


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Maintenance: Underactive pituitary-adrenal

response to gambling stimuli

PARIS ET AL

Measured gamblers cortisol levels (cortisol

associated with pituitary-adrenal response)before and after watching video of preferred

mode of gambling

Recreational gamblers high levels whereas

pathological gamblers no cortisol increase in

response to videos


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ZUCKERMAN

Individual differences in stimulation

High sensation seekers have lowerappreciation of risk and anticipate arousal as

more positive than low sensation seekers

Therefore more likely to gamble


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Relapse:

BLASZCYNSKI ET ALPoor tolerance to boredom may contribute to

repetitive gambling behaviour

Pathological gamblers significantly highboredom prone scores than control groups of

non gamblers


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Evaluation of Biological Approach to Gambling

Explains individual differences

- Why some people develop pathological gambling and yet others

who experience same environment do not

- Diathesis-stress model also states how some may be more

vulnerable to addiction due to a genetic predisposition

Reductionist

- Ignores importance of external factors in development of

behaviour eg. Incentives (nature side of nature/nurture debate)

- Reduces complex phenomenon down to simple explanation

Deterministic

- Suggests individuals bound by their biology/genetics and have no

choice or free will in their actions


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BONNAIRE ET AL

Pathological gamblers who bet at race racks had higher

sensation seeking scores than those playing games available

in cafesConcluded 2 subgroups:

- racetrack gamblers (arousal)

- cafe gamblers (to avoid boredom)

Most popular current view is that gambling is a

product of biological factors plus external

factors


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The Biological Approach to Smoking

Initiation: Role of genetics

VINK ET AL

Dutch twin study

Individual differences in smoking initiation due to

44% genetic and 56% environmental influences

BOARDMAN ET AL

Identical twins and same sex fraternal twins

estimate heritability for regular smoking to be

42%


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Maintenance:

Nicotine causes release of dopamine, whichcreates short-lived feelings of pleasure which must

be repeated to avoid withdrawal symptoms

VINK ET AL

Nicotine dependence influences by genetic

factors


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Relapse

XIAN ET ALTwin study to test whether genetic risk factors

contributed to failed attempts to quit smoking

Found 54% of risk for quit failure attributed to

heritability

UHL ET AL

Attempted to identify specific gene clustersassociated with quit success and nicotine

dependence with aim of matching treatments to

benefit smokers trying to quit


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Evaluation of Biological Approach to Smoking

THORGEIRSSON ET AL

Identified gene variant that influences nicotinedependence/no. of cigarettes smoked a day

Suggests genetics may not determine initiation but make it

more likely that some smokers will become addicted should

they start

Reductionist

- Neglects other possible determining factors eg. Social context

of behaviour

- however regarding smoking as biological problem creates

possibility it may be treated by pharmacological methods


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Deterministic

- Suggests individuals bound by their biology/genetics and have

no choice or free will in their actions

LERMAN ET AL

Genetic testing of individuals allows therapists to choose most

effective therapy to maximise likelihood of quitting successfully


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The Cognitive Approach to Gambling

Initiation: Self medication

GELKOPF ET AL

Individuals use pathological behaviours to treatpsychological symptoms

Activity chosen is perceived as helping particular

problem

Gambling might not actually make things better

but is judged as doing so by the individual to

become an addiction


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Maintenance:

OEI + GORDONProblem gamblers have irrational perceptions

about abilities in influencing the outcomes of

their gambling eg. Illusions of control and

superstitious behaviours

They also show a self confidence in ability to

beat the system with success being attributed

to skill


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Relapse: Just World Hypothesis

BLANCO ET ALGamblers overestimate wins and underestimate

losses

Individuals believe they will eventually be

rewarded for their efforts and are motivated to

return based on belief they deserve to win

having lost on previous occasions


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Evaluation of the Cognitive Approach to Gambling

LI ET AL

Pathological gamblers who gambled to escape realityas opposed to those gambling for pleasure,

significantly more likely to have other substance

dependencies

Supports self medication explanation

BECONA ET AL

Depressive disorder evident in majority of

pathological gamblers

- Correlation

- Does not mean depression cause of gambling

- May be consequence due to personal/financial costs of

gambling


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BENHSAIN + LADOUCER

Possessing relevant knowledge does not make people less

susceptible to cognitive distortions

No difference found in trained statistics students and non statstrained students in susceptibility to irrational gambling related

cognitions

Implications for treatment;

- More than one motivation for becoming pathological gambler

implies there should be differing treatments

- In case of self-medicating gamblers, might be more beneficial to

treat underlying problems firstly


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The Cognitive Approach to Smoking

Initiation: Expectancy Theory

BRANDON ET AL

Behaviours escalate into addiction because ofexpectations individual has about costs and

benefits of the activity

MERMELSTEINExpectancy of positive mood states have been shown

to be reasons for adolescents beginning to smoke


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Maintenance:

BRANDON ET AL

As an addiction develops, activity influenced less by

conscious expectancies, more by unconscious

expectancies involving automatic processing

Explains loss of control smokes experience anddifficulties in abstaining


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Relapse:

Expectations of costs and benefits of smokingaffect an individuals readiness to quit and

likelihood of them relapsing

Individuals who perceive smoking to have many

benefits and quitting to have only few are most

likely to relapse


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Evaluation of Cognitive Approach to Smoking

Much research relating to expectancy theory is concerned more

with excesses of a particular behaviour rather than addiction to it

- Research might focus on problematic behaviour eg. Heavy

smoking but does not consider loss of control

JULIANO + BRANDONSmokers reported greater expectancies that cigarettes alleviate

negative mood states and had a positive effect on weight

control compared with different forms of NRT

- Therefore positive expectancies do not generalise to NRT whichexplains modest success rates for smoking cessation

(implication for treatment)


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Focus of research into expectancy theory and addiction largely

been on positive findings with negative results receiving far less

attention

- Constitutes a publication bias- Selective publication of positive results gives unrepresentative

view of research


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The Learning Approach to Gambling

Initiation: Operant Conditioning

GRIFFITHS

Gamblers playing slot machines become addicted

because of physiological rewards (buzz fromwinning), psychological rewards (near miss) and

social rewards (praise from peers)also financial

awards if they win

Although they generally lose, greater weight isgiven to the experience of winning and so person

continues


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Maintenance: Positive reinforcers

Intermittent reinforcement

People become used to long periods without reward

and their gambling is reinforced by the occasional

payout

Social approval

LAMBOS ET AL

Peers/family members of problem gamblers more

likely to approve of gamblingRespondents of such reinforcement gambled more

than others and intended to continue doing so


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Relapse: Classical Conditioning

Addicts associate other stimuli with gambling

behaviour (eg. any form of flashing lights/slot machine

type sounds) and therefore if they come into contact

with these conditioned cues they are at higher risk of

relapse


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The Learning Approach to Smoking

Initiation:

KANDEL + WU

SLT explanations of smoking propose young people

begin smoking as consequence of observing social

models around them who smoke

MAYEUX ET AL

Positive correlation between smoking at 16 and boys

popularity 2 years laterSuggests popularity among peers serves as positive

reinforcer in initiation of smoking

- Cannot establish cause and effect from correlations


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Maintenance:

Repetition leads to conditioned association between

sensory aspects of smoking (sight of cigarettes/smell of

smoke etc.) and reinforcing effects of nicotine

Over time, sensory cues become conditioned stimuliand activate same brain areas as nicotine, making

cessation difficult


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Relapse:

Cues associated with receiving nicotine (smell of

smoke etc.) increase likelihood smoker will respond to

these by smoking

LAWRENCE + RUBINSONThose who frequently smoke have less confidence in

their ability to abstain and are more likely to relapse


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Evaluation of The Learning Approach to Smoking

KARCHER + FINN

Youth whose parents smoked, almost twice as likely totake up smoking

8 times more likely if close friends smoked

Supports parents/peers as models important for

initiation

THEWISSEN ET AL

Repeatedly presented smokers with cues predicting

smoking

in 2ndroom presented smoking unavailability cuesCues predicting smoking led to greater urge to smoke

therefore highlighting importance of conditioned cues


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LOPEZ ET AL

Gender bias in smoking addiction research

Women start smoking later than men and contexts of

smoking differs between gendersExplanations often fail to address these differences,

reducing validity of data


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Risk Factors in the Development of

Addiction


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Stress

Everyday stress:

People report that they drink, smoke, take drugs, gamble etc. as ameans of coping with daily hassles (relationship

problems/workplace stress)

Traumatic stress:People exposed to severe stress (parental loss/child abuse) more

vulnerable to addictions

DRIESSEN ET AL

30% drug addicts, 15% alcoholics also suffered from PTSD


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Many smokers smoke to reduce stress yet smoking may actually

increase stress levels

- Stress may be risk factor for smoking addiction but smoking

doesnt have desired effect in reducing stress

CLONIGER

Type 1 alcoholics drink to reduce tension

Type 2 drink to relieve boredom

Therefore stress may explain vulnerability for some alcoholics

(type 1) but not all

Cannot establish cause and effect:- Stress may be the result not cause of addiction


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SUSSMAN + AMES

Friend and peer use of drugs was a strong predictor of drug

use among teenagers

WAGNER + ANTHONY

Cannabis smokers more likely to progress to cocaine usage

due to being in peer groups where there are opportunities

for new drug experiences

SIT:

Little known about extent to which groups influence their

members to smoke

- Unknown whether adolescents will conform to behaviours iftheir conflict with own concerns


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AgeInfluence of peers on smoking/drug use habits decreases in

later adolescence.

BROWN ET AL

Close friends/romantic partners become increasingly

important as an influence on attitudes and behaviours as weget older

Peers have a greater impact on young adolescents


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Implications for Treatment:

Suggests public health interventions should be targeted at

specific age groups (teenagers) at most risk of addiction

Potentially skewed data:

Addiction in young people most publicised, therefore youth

appear more vulnerable

- Older people may become addicted but do not engage in it

publically/less media attention- This implies artificial link between age and addiction


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PersonalityConcept of addictive personality can explain why some people

become addicted when others dont, despite both trying the

same experience.

EYSENCK

Personality based on 3 dimensions:

- extroversion (seek external stimulation to increase arousal)- neuroticism (experience negativity, depression, anxiety)

- psychoticism (related to hostility/impulsivity)

FRANCIS

Link between addiction and high scores on both neuroticism

and psychotism

These individuals more prone to develop addiction as a

means of relieving everyday stressors


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CLONIGER

3 personality traits predispose individuals towards substance

dependence:

- Novelty seeking- Harm avoidance

- Reward dependence


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ROUNSAVILLE ET AL

Link between alcohol addiction and personality disorders

SLUTSKY

Link between alcohol and conduct disorder

Research is only correlational:

- Some traits may be common among addicts however this

does not mean they cause addictive behaviour

Practical Application:

- Findings could be used to identify individuals who may be most

prone to addiction and levels of neuroticism/psychotism/stress

can then be reduced

di fl ddi i h i


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Media Influences on Addictive Behaviour

Film representations of Addiction:

SULKUNEN

Analysed 61 scenes from films that represented addictions

to alcohol, drugs, tobacco, gambling and sex

Competent use of drugs represented in a way of alleviatinga particular problem

WAYLEN ET AL

Found a significant relationship between adolescentsmoking and no. of films they had seen depicting smoking

Suggests media representations of smoking influence

teenagers to take up the habit


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SARGENT + HANEWINKEL

Surveyed adolescents and re-surveyed a year later

Of individuals who had not smoked when first surveyed,

exposure to movies with smoking over the year betweensurveys was a strong predictor of whether they had begun to

smokeexposure effect

BYRNE

Films important as they can educate public about addiction bycreating stereotypes eg. Trainspotting

REAL WORLD APP:Guidelines for film/tv writers recommend illegal drug use should be

communicated as unhealthy/harmful and no references should be

made to recreational drug use.


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Antidrug Campaigns:

2008 TV/internet campaign launched to warn

teenagers of cocaine dangers

HORNIK ET AL

Campaign had negative effects as gave implicit

message that drug use is commonplace

JOHNSTON ET AL

Youths took message that peers were using drugsand so were more likely to start taking drugs

themselves

General E al ation of Media Infl ences on Addicti e


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General Evaluation of Media Influences on Addictive

Behaviour

People may look to media to help their addiction however there

is also the addiction to the media itself

Danger of alienating and demonising addicts through negatively

portraying them in the media- May prevent them from seeking support with their addiction

The media affects people differently, many people are exposed

regularly but not everyone becomes an addict

- Shows media is not the only influence in developing addictions


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TPB as a Model for Addiction Prevention

Intention to engage in a particular behaviour is a function

of 3 factors:

1) Behavioural Attitude

2) Subjective Norms

3) Perceived Behavioural Control

Ch i h i l i d


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Changing Behavioural Attitude

- individuals attitude towards the behaviour

- beliefs of consequences of performing behaviour

SLATER ET AL

Targeting attitudes is key to success of anti-drug

campaigns US Office of National Drug Control Policy (ONDCP)

launched campaign to lower teenage marijuana use

Campaign created different attitude towards effects of

drug (inconsistent with achieving aspirations) and this isthought to be why it was successful

Ch i S bj i N


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Changing Subjective Norms

- individuals subjective awareness of norm relating to

behaviour eg. Injunctive norm (perceived right thing to do)and descriptive norm (what others actually do)

WILSON + KOLANDER

Anti-drug campaigns seek to give adolescents actual dataabout % of people engaging in drug taking behaviour

Accurate statistical information corrects subjective

norms and contributes to an effective campaign

Ch i P i d B h i C l


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Changing Perceived Behaviour Control

- More control people believe they have over a behaviour,

stronger their intentions to perform it will be

GODIN

3 elements of TPB explain intentions of smoking behaviour

whereas perceived behavioural control most important

predictor of actual behaviour

Therefore prevention programmes should help smokers to

focus on the willpower required to give up

MAJER ET ELEncouraging addicts belief in ability to abstain related to a

positive outcome

Enhancing self-efficacy should form primary goal of treatment

plans

E l ti f TPB


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Evaluation of TPB

WALKER ET AL

TPB most popular and widely used social cognition model in

health psychology

ARMITAGE + CONNER

Meta-analysis of studies using TPB

Model successful in predicting intention tochange rather than actual behavioural change

Suggests TPB primarily an account of intention

formation rather than specifying processes

involved in translating intention into action

Research on TPB almost entirely correlational

- Not clear whether any one component of model (behavioural

attitude, perceived behavioural control etc.) caused the

behavioural change


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ARMITAGE ET AL

TPB fails to take into account emotions/compulsions of other

irrational determinants of human behaviour

Attitudes/intentions tend to be measured when sober whereas

actual risky behaviours are often performed when under

influence of alcohol/drugs

MACDONALD ET ALWhen pshad taken alcohol they showed increased

intentions to engage in risky behaviours

Therefore sober measurements may be invalid of actual

behaviour

Types of Intervention and their


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Types of Intervention and their

Effectiveness

Biological Interventions

Agonist Substitution eg. Methadone for heroin addiction

- Methadone mimics effects of heroin but it less addictive

- Drug user given increasing amounts of methadone toincrease tolerance to drug

- Does then decreased until addict no longer needs

methadone or heroin

Antagonist Substitution eg. Naltrexone for alcohol addiction

- Blocks the action of neurochemicals that provide rewarding

feelings as result of drinking alcohol

- Also found to be effective in reducing gambling behaviour

Immunotherapy


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Immunotherapy

- Antibodies created according to addictive substance

- When substance consumed, antibodies bind to it

- Prevent it from reaching brain

CARRERA ET AL

Developed antibodies for cocaine in rats

Rats no longer experienced effects of cocaine afterconsumption

E l ti f Bi l i l I t ti


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Evaluation of Biological Interventions

Some addicts can become just as reliant on methadone as they

were on heroin and therefore one addiction is merely beingsubstituted for another

Use of methadone is controversial:

- Stats show more than 300 methadone-related deaths in2007 in UK

- Consumption is unsupervised, created a black market in

methadone

KIM + GRANT

Naltrexone led to proven to be successful after 6 weeks of

treatment


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REAL WORLD APP + IMPLICATIONS FOR FURTHER RESEARCH

CARRERA ET ALs research suggests soon vaccinations for heroin,

cocaine and nicotine will be available for addicts in attempts to reduce

or halt their addictions.

- However, although data looks promising, extensive human trialsfirstly need to be conducted as the original study was carried out on

rats and due to their different physiological and genetic makeup to

humans, results from rats cannot directly be applied to us

Biological interventions may ignore the underlying reason for

the addiction in the first place

Addicts may relapse one the treatments (drugs) are halted

Psychological Interventions


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Psychological Interventions

Reinforcement

- Reward people for not engaging in the behaviour- Rewards act as positive reinforcers and so people continue to

not engage in the behaviour

SINDELAR ET ALTested people on methadone treatment

One group rewarded each time urine samples tested

negative

End of programme and reward group had 60% morenegative urine samples than control group


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CBT

- Goal is to help people change the way they think about their

addiction and learn ways of coping efficiently- Eg. in gambling, cognitive errors play part in maintenance,

CBT aims to correct these errors

SYLVAIN ET ALPathological gamblers given CBT and social skills training

Resulted in improvements maintained at 1 year follow up

Evaluation of Psychological Interventions


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Evaluation of Psychological Interventions

Psychological interventions focus on principles of operant

and classical conditioning (aversion therapy) rather than

why smoking, gambling or alcoholism started in the first

place

- If triggers still present in the persons environment

then psychological interventions may only be

successful for a short period of time as they do not

address underlying causes of addiction

As much evidence proves addictions to be source of faulty

cognitions, CBT makes sense as an effect form ofintervention

- However, so many different areas to CBT difficult to know

which are most effective eg. Teaching patients to correct

erroneous thinking or motivational interview

Public Health Interventions


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Public Health Interventions

Telephone smoking Quitlines

STEAD ET ALSmokers who received repeated quitline calls, increased

their odds of stopping smoking by 50% compared to smokers

who only received self-help materials

Doctors Advice

OGDEN

5.1% of smokers advised by their doctors were able to

refrain from smoking for 12 months afterwards

N f l i l i h l f d i


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No. of government legislation changes also enforced in attempts

to prevent addiction eg:

Smoking ban in public places

- However, followed by a rebound effect

- Increased outdoor smoking

Increasing cost of cigarettes

Controlling sales of cigarettes and alcohol

Evaluation of Public Health Interventions


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Evaluation of Public Health Interventions

BECKHAM ET AL

Combination of Quitline counselling and NRT highly

effective in treating US military veterans

Government sponsored NIDA intervention reduced cocaine

use and unprotected sex

Public interventions are proactive approaches to addressing

potentially devastating social issues

- Problem gambling during adolescents can lead to adverseoutcomes and interventions are preventing these

The Psychology of Addictive Behaviour...khyxtdrzwxetrcytvubyiunoimiknoubyiutvcrytxecrfyvubyiunoim

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