Describing addiction
Physical dependence
⤷ to avoid withdrawal symptoms
Psychological dependence
⤷ compulsion to experience the effects of the substance to lessen discomfort (like anxiety)
and increase pleasure
Tolerance - when more substance is needed to create the same effects
⤷ cross tolerance - when building up a tolerance to one substance also builds tolerance for
another
⤷ behavioural tolerance - adjusting of behaviour to compensate for the effects of the
substance ( walking slower)
Withdrawal - opposite effect of substance , unpleasant
⤷ acute withdrawal - quick intense cravings which gradually diminish
⤷ prolonged withdrawal - cravings continue for a long period of time, high sensitivity to cues
Risk factors in the development of addiction
Family influences
⤷ belief that parents are not interested in monitoring behaviour = more likely to develop
addiction due to perception
⤷ livingston et al students allowed to drink alcohol at home are more likely to drink
excessively at college
V RS - Madras et al, strong positive correlation parental abuse and adolescent use of
cannabis - modelling
Stress
⤷ stress can have effects on the developing brain, teicher and anderson highlight the role of
adverse childhood experiences on development of addiction, triggers early vulnerability
X issue with causation - link between stress and addiction, but which one came first?-
cannot conclude significance
Personality
⤷ APD
V RS - Bahlmann et al , 18 had APD, developed around 4 years before addiction
Genetic vulnerability
⤷ number of dopamine receptors in the brain is genetically decided
V RS - Kendler et al, Sweden, adults who had been adopted as children from a family with
an addicted parent had a significantly greater risk of developing addiction.
Peers
⤷ more opportunities to drink, overestimation of quantity and attitudes/norms
V RW application - social norms marketing advertising ‘overestimation of 44%’ - practical
value
Biological explanation (role of neurochemistry and dopamine) of nicotine addiction
nAChRs and dopamine
⤷ ACh receptors in the CNS, nAChRs activated by nicotine, transmits dopamine then is shut
down (downregulation and desensitisation) - fewer active receptors
Pleasurable effect
⤷ nAChRs locates in the ventral tegmental area
⤷ dopamine transmitted down the mesolimbic pathway to the nucleus accumbens to the
frontal cortex, down the mesocortical pathway to the frontal cortex
, ⤷ part of reward system - operant conditioning
Withdrawal
⤷ when not smoking, nicotine disappears from body and nAChRs undergo upregulation and
resensitisation
⤷ overstimulated (first smoke of the day)
Dependence and tolerance
⤷ long term desensitization
⤷ cycle of downregulation and upregulation
⤷ permanent decrease in active receptors - more nicotine for same effects
V RW Application NRT
X biologically determinist - withdrawal is inevitable, cannot give it up -> some people can gie
up by deciding not to smoke - different factors (personality?)
V RS - McEvoy et al, smoking behaviour in people w/ SZ who were taking haloperidol,
antagonist + reduces dopamine transmission. significant increase in smoking to self
medicate
X limited explanation- dopamine system has complex interactions with several
neurochemical systems. Watkins et al said that those pathways include the serotonin and
GABA
Learning explanation of nicotine addiction
Operant conditioning
⤷ positive reinforcement - dopamine reward system
⤷ negative reinforcement - avoidance of withdrawal symptoms
V RS Levin et al rats
X animal studies
Cue reactivity
⤷ primary reinforcer - dopamine reward system
⤷ secondary reinforcer - feel of cigarette, look of lighter,
⤷ similar physiological and psychological response to nicotine - Subjective desire (craving),
Physiological signs of reactivity (heart rate), Objective behavioural indicators ( draws on a
cigarette / how strongly)
V RS Carter and tiffany stronger reaction to smoking imagery
V RW application counterconditioning w/ aversives
X research supporting the effectiveness of aversion therapy is weak - no control group = not
valid. Evidence from better quality studies suggest that the benefits of aversion therapy are
only short term.
Learning explanation of gambling addiction
Vicarious reinforcement
⤷ winning in the media - trigger for addiction
Direct positive and negative reinforcement
⤷ positive reinforcement - money
⤷ negative reinforcement - anxiety
V RS - Dickerson, high frequency, dependent gamblers = more likely to place bets in the
last 2 minutes - the build up which is most exciting- evidence of +ve reinforcement
⤷ methodological shortcomings - 14 weeks, 1 observer, no interobserver reliability=observer
bias - findings not valid
Physical dependence
⤷ to avoid withdrawal symptoms
Psychological dependence
⤷ compulsion to experience the effects of the substance to lessen discomfort (like anxiety)
and increase pleasure
Tolerance - when more substance is needed to create the same effects
⤷ cross tolerance - when building up a tolerance to one substance also builds tolerance for
another
⤷ behavioural tolerance - adjusting of behaviour to compensate for the effects of the
substance ( walking slower)
Withdrawal - opposite effect of substance , unpleasant
⤷ acute withdrawal - quick intense cravings which gradually diminish
⤷ prolonged withdrawal - cravings continue for a long period of time, high sensitivity to cues
Risk factors in the development of addiction
Family influences
⤷ belief that parents are not interested in monitoring behaviour = more likely to develop
addiction due to perception
⤷ livingston et al students allowed to drink alcohol at home are more likely to drink
excessively at college
V RS - Madras et al, strong positive correlation parental abuse and adolescent use of
cannabis - modelling
Stress
⤷ stress can have effects on the developing brain, teicher and anderson highlight the role of
adverse childhood experiences on development of addiction, triggers early vulnerability
X issue with causation - link between stress and addiction, but which one came first?-
cannot conclude significance
Personality
⤷ APD
V RS - Bahlmann et al , 18 had APD, developed around 4 years before addiction
Genetic vulnerability
⤷ number of dopamine receptors in the brain is genetically decided
V RS - Kendler et al, Sweden, adults who had been adopted as children from a family with
an addicted parent had a significantly greater risk of developing addiction.
Peers
⤷ more opportunities to drink, overestimation of quantity and attitudes/norms
V RW application - social norms marketing advertising ‘overestimation of 44%’ - practical
value
Biological explanation (role of neurochemistry and dopamine) of nicotine addiction
nAChRs and dopamine
⤷ ACh receptors in the CNS, nAChRs activated by nicotine, transmits dopamine then is shut
down (downregulation and desensitisation) - fewer active receptors
Pleasurable effect
⤷ nAChRs locates in the ventral tegmental area
⤷ dopamine transmitted down the mesolimbic pathway to the nucleus accumbens to the
frontal cortex, down the mesocortical pathway to the frontal cortex
, ⤷ part of reward system - operant conditioning
Withdrawal
⤷ when not smoking, nicotine disappears from body and nAChRs undergo upregulation and
resensitisation
⤷ overstimulated (first smoke of the day)
Dependence and tolerance
⤷ long term desensitization
⤷ cycle of downregulation and upregulation
⤷ permanent decrease in active receptors - more nicotine for same effects
V RW Application NRT
X biologically determinist - withdrawal is inevitable, cannot give it up -> some people can gie
up by deciding not to smoke - different factors (personality?)
V RS - McEvoy et al, smoking behaviour in people w/ SZ who were taking haloperidol,
antagonist + reduces dopamine transmission. significant increase in smoking to self
medicate
X limited explanation- dopamine system has complex interactions with several
neurochemical systems. Watkins et al said that those pathways include the serotonin and
GABA
Learning explanation of nicotine addiction
Operant conditioning
⤷ positive reinforcement - dopamine reward system
⤷ negative reinforcement - avoidance of withdrawal symptoms
V RS Levin et al rats
X animal studies
Cue reactivity
⤷ primary reinforcer - dopamine reward system
⤷ secondary reinforcer - feel of cigarette, look of lighter,
⤷ similar physiological and psychological response to nicotine - Subjective desire (craving),
Physiological signs of reactivity (heart rate), Objective behavioural indicators ( draws on a
cigarette / how strongly)
V RS Carter and tiffany stronger reaction to smoking imagery
V RW application counterconditioning w/ aversives
X research supporting the effectiveness of aversion therapy is weak - no control group = not
valid. Evidence from better quality studies suggest that the benefits of aversion therapy are
only short term.
Learning explanation of gambling addiction
Vicarious reinforcement
⤷ winning in the media - trigger for addiction
Direct positive and negative reinforcement
⤷ positive reinforcement - money
⤷ negative reinforcement - anxiety
V RS - Dickerson, high frequency, dependent gamblers = more likely to place bets in the
last 2 minutes - the build up which is most exciting- evidence of +ve reinforcement
⤷ methodological shortcomings - 14 weeks, 1 observer, no interobserver reliability=observer
bias - findings not valid