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Models of Addictive Behaviour

Biological, Cognitive and Behavioural
by

Danielle Weston

on 11 June 2013

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Transcript of Models of Addictive Behaviour

Models of Addictive Behaviour Biological Model Behavioural Model Genetic Explanation Addictive behaviour is inherited
if you're related to someone suffering, you're at higher risk

Suggests you are predicted to that addictive behaviour due to inheriting the A1 variant of the DRD2 gene which means you have fewer dopamine receptors in the pleasure centres of the brain - more vulnerable to addictive behaviours in order to increase their dopamine

People with the gene - have to seek out more dangerous activities to get the 'high' dopamine Biochemical Explanation Neurotransmitter levels
Strongly linked to levels of dopamine
Addictive Behaviour increases release of dopamine
(resulting in 'high') in reward pathways activating the dopamine receptors in the mesolimbic pathway and nucleus accumbens.
Linked to hippocampus (memory) remembering the sense of pleasure - as a result - repeat behvaiour chronic addiction reduces normal dopamine activity known as down regulation
receptor site sensitivity is reduced and larger anount of the addiction is needed to reach same level of stimulation
leads to symptoms of withdrawal/craving and the addictive behaviour is maintained to avoid withdrawal symptoms (physiological) initiation Maintenance need more dopamine avoid withdrawal Neuroadaptation Chronic exposure to addiction results in neuroadaptation in the frontal cortex.
down regulation of dopamine receptor sites available, therefore, they get a more normal response.

Brain physically changes, consequently needs to seek out more dangerous activity to recreate the 'high'; = brain becomes tolerant to the addictive behaviour.

ability to override drives and instincts.
negative impact on the prefrontal cortex, effects planning/irrational thinking - more likely to result in addictive behaviour. Comings 1996
focusing on smoking - found significantly increased incidence of the A1 variant in smokers and ex-smokers



48.7% of the smokers carried the A1 variant of the DRD2 gene compared to 25.9% of the general population (non-smokers)
Men with the A1 gene - smoking earlier and shorter periods of abstinence. A1 + Thorgeirsson 2008
particular genetic variants make people more addicted to nicotine once they start
50,000 icelanders - questionnaire - smoke or every smoked and how many a day?
Studied the DNA of 10,000 who replied and found a particular pattern of gene variant more common among people who had lung cancer
Had an effect of how many was smoked per day and highly significant association with nicotine dependence. gene more common in those with lung cancer Shachter 1977
physical dependence theory is relevant to smokers nicotine regulation model - smokers continue to smoke to maintain nicotine in the body at a level high enough to avoid any negative withdrawal symptoms
Compared how many cigarettes different smokers needed to consume each week.
Some participants were given cigarettes with low nicotine content and high nicotine content.
Low nicotine cigarettes smoked more than those with high - as predicted by nicotine regulation model
Higher nicotine content allowed smokers to reach the level of nicotine required with fewer cigarettes.
Heavy smokers - smoked on average 25% more low nicotine cigarettes then high Wray & Dickinson
Being prevented from gambling often report changes that resemble withdrawal symptoms - not as intense as those smoking - highly influential in determining whether a gambler maintains his/her behaviours.
Avoiding withdrawal symptoms is simple - keep gambling - they will not appear. Lerman et al 2007
Shown smokers who are deprived of nicotine during withdrawal show increased activity in certain parts of their brain.
Tested regular smokers just after a cigarette then after a single night of abstinence - showed after the night without smoking was an increase of blood flow to parts of the brain concealed with attention, memory and reward.
Active when craving - research is useful, helps to understand relapsing and why some are more likely to than others. Potenza et al 2003
Used MRI with gamblers viewing gambling tapes.
They showed different blood flow to non-gamblers.
These differences were not found with other types of happy/sad situations.
Findings are consistent with studied of people who lack control in other behavioural areas (aggression and decision making) Evaluations Determinism
It is deterministic because it suggests if you have the A1 variant you are ineviatbly going to have an addiction, becuase your genes are inherited and cannot be changed.

Freewill
However, Comings research suggests that even if you have the gene you may not develop an addiction. 25.9% of the population in his study had the gene but did not develop an addiction. Therefore, there is an element of freewill involved in an addiction (giving up) Individual Differences
Does account for individual differences as it explains why some people develop an addiction and why others don't, it is due to the gene.

Doesn't account for individual differences as it doesn't explain why the 25.9% of the general population with the addictive gene in Comings research didn't develop an addiction suggesting there is another cause (something overriding biological approach). Implications of Treatment
Can develop drugs to effect dopamine which would help to regulate the behaviour.
However, it only treats the symptoms and not the actual addiction. Scientific Evidence
Scientific evidence - measuring dopamine levels, brain blood flow, neuroimaging techinques.
Self-report data obtained, despite technical methods used which show biological functioning - lack of understanding of exact mechanisms. Social Learning Theory Operant Conditioning Classical Conditioning Initiation of addiction through the observation of a significant role model and vicarious reinforcement (being thought of as cool because of smoking)

Observer may imitate this behaviour as they want the same reward - to be 'cool'

The observer has to relate to the role model
INITIATION Lader and Matheson 1991
One main influence on smoking in children is parents attitudes to smoking: children are twice as likely to smoke if their parents smoke. Harakeh 2007
Investigated the influence of peers and siblings on smoking initiation

428 families, 2 adolescent children between 13 and 17 were analysed

Info was taken from a previous large-scale study on health issues over a period of time

Non-smoking adolescents with older siblings who smoked and those with a smoking best friend were more likely to have started smoking one year later

Older adolescents with younger smoking siblings were not affected

Friends and older siblings influence initiation of smoking in adolescents INITIATION/ MAINTINENCE
Positive reinforces have the same physiological effect - increase dopamine in reward centres
Schedules of reinforcement are also important in addiction
Fixed schedule - reward each time with high - smoking
Variable ratio schedule - reward on average every x time - gambling

INITIATION
Negative reinforcement involves the removal of unpleasant situation - bullied by friends to do it - therefore, takes part in the activity

MAINTINENCE
Negative reinforcement of withdrawal symptoms - smoking by getting rid of withdrawal

RELAPSE
Negative reinforcement of withdrawal symptoms - smoking by getting rid of withdrawal Griffiths 2009
Argued that gamblers playing slot machines may become addicted because of the physiological rewards (adrenaline rush) physiological rewards (near miss) social rewards (peer praise) as well as financial rewards if they win Gilbert 2007
Interviews carried out with young smokers - found that fear if rejection by their peer groups was one motivation to start smoking Letourneau 2007
Studied women who stopped smoking while pregnant but stared again after their babies were born
Found main reasons given were being around others who smoked but also in repose to stress they now experienced as mothers BEFORE CONDITIONING DURING CONDITIONING AFTER CONDITIONING Pavlov's Dog
Neutral stimulus (NS)


Unconditioned stimulus (UCS)


UCS + NS
Repeatedly paired


Conditioned stimulus (CS) No Effect


Unconditioned response (UCR)


UCR


Conditioned response (CR) + Unconditioned stimulus - being with a group of friends
produced an unconditioned response - feeling relaxed
If the UCS is frequently paired with the neutral stimulus - smoking
the NS will become conditioned stimulus
producing a controlled response, so they associate being with those friends and smoking
MAINTINENCE
The addiction will be maintained through the NS producing an reduced high - can produce strong cravings to seek out the actual addiction Pavlov's Dog Kusher et al 2008
Found that problem gamblers experienced a stronger urge to gamble in a stimulated casino environment then a neutral environment particularly if they had gambled there before. Cues may also be relevant to relapse
This research suggests that the environment that the gambler is in can cause temptation to take part in the addiction Gruesser et al 2005
Found pathological gamblers still had physical response to cues even after abstinence for more then a year Leshner 1999
Environmental cues are paired in time with an individuals initial drug-use experiences and through classical conditioning take on conditional stimulus properties
When those cues are presented at a later time, they elicit anticipation of a drug experience and generate drug craving - link with rewards and relief of withdrawal Determinism
Classical and operant conditioning suggests that addiction is inevitable due to environment and reinforcement of the behaviour, operant suggests you will continue the behaviour due to the reinforcement

Freewill
However, social learning theory uses more thought processes and has an element of freewill as you can decide who you imitate and who your models are Individual Differences
The model suggests that with unique learning experiences (parents that smoke) you are more likely to develop an addiction due to acceptance or praise. therefore, it account for individual differences

However, it doesn't account for individual differences because it cannot explain why some people with the same unique learning experiences do not develop an addiction. This means the biological model could be a better explanation for individual differences and addiction Implications of Treatment
Reverse modelling - adverts - portray negatively
Aversion therapy - negative response
Behaviour modification - token - abstinence is good Scientific evidence

Learning model principles based on robust scientific evidence - animal studies - high levels of control

Humans are more complex - self report data

Cannot generalise animal research to humans Cognitive Model Theory of Planned Behaviour May engage in the behaviour after weighing up the pro's and the con's - it could have a positive effect on their life Motivation, therefore, initiation of addictive behaviour Conner et al 2006
Investigated the theory of planned behaviour in smoking initiation in 11-12 year olds.
675 non-smoking adolescence with various baseline measures (TPB)
9 months later they checked if they had begun smoking (by using carbon-monoxide breath monitor to avoid subject judgement)
Behavioural intentions are generally a good predictor of later smoking Guo et al 2007
14,000 chinese school children with TRA and TPB measures found both were useful predictors of later smoking behaviour. Positive Feelings/Thoughts Addictive behaviour - positive feelings - if successful and satisfying
Positive feelings result in positive thoughts and beliefs about the activitiy.
once initiated - difficult to change.
Experiences associated with the behaviour have a similar effect and therefore, strengthen the positive thoughts/cognitions about the behaviour. Initiation Relapse Maintenance Kenny and Makou
Nicotine results in addictive effects, such as mild euphoria and enhanced cognitions.
Effects create positive cognitions about smoking and motivate future smoking. Sharpe and Tarrier
Propose physiological 'high' of gambling makes individuals have a positive perceptions of gamlbing and that occasional wins further reinforce these positive cognitions. Irrational Biases People who have irrational beliefs are more likely to acquire an addiction.
Irrational beliefs can include distorted perceptions of control Individuals with an addiction are often in denial - believe they have the ability to stop whenever they want or alternatively think that the only way to have control over their life is by doing the addiction Another irrational bias includes overestimating their ability to predict or influence the outcomes of their addiction Often have distorted views of they previous experiences or other peoples experienced Irrational beliefs results in the individual continuing to engage in the behaviour. After quitting they may have distorted views about their addiction and therefore, go back to doing it "I can stop, easy, no need to worry" "By doing this i will be cool" "I know I can win" "I've won more money than I've lost" "My gran smoked all her life, it didn't affect her" Maintenance Relapse Brandon 2004
As the addiction develops the activity is influenced less by conscious thought and more by automatic processing
Supports the idea of irrational beliefs about loss of control/ability to cope without the addiction, which many addicts experience Delfabbro and Winefield 1999
Found that 75% of game related thoughts during gambling were irrational and encouraged further risk taking might well maintain arousal during gambling episodes. Griffiths 1994
Investigated whether gamblers thought and behaved differently to non-gamblers
Compared 30 regular to 30 non-regular in terms of their verbalisations as they played fruit machines
Regular gamblers believed they were more skilled then they actually were - more likely to make irrational verbalisations during play


They treated the machine like it was a person
Explained away loses - constantly 'nearly' winning - justified their continuation "that was a near win!" Dysfunctional Thinking Beck et al 1993
Cues can lead to the activation of core personal beliefs and beliefs about the addictive behaviour which leads to associated automatic thoughts and so cravings are experienced
Craving activates permissive beliefs trying to justify engaging in the behaviours leading to cognitive ways to plan how to engage in the behaviour
Once engaged in the behaviour the cognitive links with the cues which are strengthened External - friends doing drugs
Internal - feeling bored "I have no control" "I might feel better if I do it" "I will go get the stuff" "It's okay, loads of people my age do it" "How can I do it?" "It worked for me before" Beliefs about the behaviour
"I might feel better if I do it" Activating stimulus: Internal or external cues Activation of core personal beliefs
"I have no control" Cravings are experienced Leads to associated automatic thoughts
"I will do the behavious" Activates beliefs trying to justify engaging int he behaviour
"Lots of people do it" Cognitive ways of planning how to do the behaviour
"How shall I do it?" Do the behaviour Cognitive links with the external/internal cues are strengthened resulting in continued behaviour
"It worked before" Brandon 2004
Suggested as the addiction, such as smoking develops, the activity is influences less by consious thought and more by automatic processing
Supports the associated automatic thoughts about the addiction - can explain why the addiction continues Tiffany 1990
Suggested that addictive behaviours are regulated by automatic processing
Cognitive processes model suggests drinking and smoking etc over a period of time become automatic and it is difficult to stop them
Faced with situations that trigger the addictive behaviour
Resisting these require mental effort, it can be even harder depending on the individual having other stressors Determinism
Positive feelings and thoughts suggest that your behaviour is determined by the positive feelings that you get which gave you positive thoughts meaning you will repeat the behaviour. Therefore, you have no choice in the matter. Freewill
Theory of planned behaviour is based on freewill as you are weighing up the pros and cons of the behaviour meaning you can make your own choice. Individual Differences
Cannot account for individual differences as addictive behaviour is perceived and portrayed negatively. Therefore, we should all have a negative view of it.
However, it does account for individual differences as it explains why some people become addicted, due to the fact that the theory of planned behaviour suggests you weigh up the pros and the cons and some may see more cons than pros and therefore, choose not to do it Implication for Treatment
Development of therapies - CBT could be slightly better than the biological approach as it looks into the thought processes surrounding the addiction.
However, these therapies are expensive and time consuming compared to biological treatments. Scientific Evidence
Some evidence attempts to employ more objective methods (Griffiths - verbalisating thoughts)
Less scientific
Cognitions cannot be seen
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