ADDICTION
Describing addiction:
ADDICTION – a disorder in which an
individual takes a substance or engages
in a behaviour that is pleasurable but eventually becomes compulsive with
harmful consequences, marked by physiological and/or psychological
dependence, tolerance and withdrawal
DSM-V COMPONENTS – the six components associated with addictive
behaviour are:
Salience
Euphoria/mood modification
Tolerance
Withdrawal symptoms
Conflict
Relapse
PHYSICAL DEPENDENCE – defined in terms of withdrawal, said to have
occurred when a withdrawal syndrome is produced by stopping the drug
PSYCHOLOGICAL DEPENDENCE – the compulsion to experience the effects
of a drug, in terms of an increase in pleasure or lessening of discomfort
(feel that they cannot cope without it), a consequence is that the person
will continually take the drug/engage in a behaviour until it becomes a
habit despite harmful consequences, can occur in the absence of physical
dependence
TOLERANCE – when an individual’s response to a given amount of a drug is
reduced, so greater doses are needed to produce the same effect on
behaviour (caused by repeated previous exposure to the effects of a drug).
Behavioural tolerance – happens when the individual learns
through experience to adjust their behaviour to compensate for the
effects of a drug
Cross-tolerance – developing tolerance to one type of drug can
reduce sensitivity to another type, can be used therapeutically by
, giving benzodiazepines to people withdrawing from alcohol to reduce
the withdrawal syndrome
WITHDRAWAL SYNDROME – a collection of symptoms associated with
abstaining from a drug or reducing its use, almost always the exact
opposite of those created by the drug, and indicate that a physical
dependence has developed. Once a physical dependence develops, the
addicted person experiences some withdrawal symptoms whenever they
cannot get the drug. Their motivation for continuing to take the drug is to
avoid withdrawal symptoms (secondary form of psychological dependence)
Risk factors in the development of addiction:
GENETIC VULNERABILITY – any inherited predisposition that increases the
risk of a disorder or condition
GENETIC MECHANISMS – two plausible direct genetic mechanisms involved
in addiction:
Dopamine depends on the presence of
receptors on the surface of neurons,
one type of dopamine receptor is the D2
receptor, abnormally low numbers of which are thought to be
involved in addiction (proportion of all receptors in the brain is
determined genetically)
Some people are more able to metabolise (break down) certain
substances and this is linked to addiction, eg. Pianezza et al. (1998)
found that some people lack a fully functioning enzyme (CYP2A6)
which is mainly responsible for metabolizing nicotine, and smoked
less than those with the fully functioning version. Those with the fully
functioning enzyme are at greater genetic risk of nicotine addiction
EVALUATION – Kendler et al. (2012) found that adults who had been
adopted away from biological families in which one parent had an addiction
had an 8.6% risk of developing an addiction themselves compared to a
4.2% risk in those without a parent with addiction (strong evidence for the
role of genetic vulnerability as an important risk factor, but statistics are
low and insignificant)
STRESS – increased risk is linked with periods of chronic stress and
traumatic life events in childhood. Epstein et al. (1998) found a strong
2
, correlation between incidence of childhood rape and adult alcohol
addiction, but only for women diagnosed with PTSD (so no inevitable
relationship between childhood trauma and later addiction). A child will
only have an addiction problem if they have a vulnerability and a later
stressful situation. But individual differences (stress may only explain
addiction in certain people). Correlational, cause and effect cannot be
established
PERSONALITY – individual personality traits eg. hostility and neuroticism
are linked with addiction (Butler and Montgomery (2004)). The strongest
correlation has been found between addictive behaviour and antisocial
personality disorder (APD) where a key personality-related risk factor is
impulsivity; Ivanov et al (2008) concluded that many studies strongly
support the link between impulsivity and addiction – could be because they
share a neurological basis, or a common genetic component
CUNNINGHAM-WILLIAMS ET AL. (1998) – studied link
between gambling and mental disorders, 3000+
participants over 18 from five US cities using stratified
sampling, use of surveys and interviews, found that 46%
gambled recreationally, 9.2% were problem gamblers,
0.9% were pathological gamblers, and gamblers showed a greater level of
several psychiatric diagnoses (problem gamblers were 6x more likely to
show symptoms of anti-social personality disorder), so found positive
correlation between levels of APD and problem gambling
EVALUATION – use of stratified sampling so high representation and
reliability, but within the 3000 less than 30 were pathological gamblers,
interviewed using NIMH Diagnostic Interview Schedule so well
standardised, self-report techniques so risk of social desirability bias
affecting reliability of results esp. as involving retrospective info about
sensitive issues of gambling and mental health
FAMILY INFLUENCES – perceived parental approval is the most consistently
reliable risk factor (the extent to which
an adolescent believes that his parents
have positive attitudes towards a
particular drug/addictive behaviour). Key
determinant is the individual’s
perception of approval – adolescents
3
Describing addiction:
ADDICTION – a disorder in which an
individual takes a substance or engages
in a behaviour that is pleasurable but eventually becomes compulsive with
harmful consequences, marked by physiological and/or psychological
dependence, tolerance and withdrawal
DSM-V COMPONENTS – the six components associated with addictive
behaviour are:
Salience
Euphoria/mood modification
Tolerance
Withdrawal symptoms
Conflict
Relapse
PHYSICAL DEPENDENCE – defined in terms of withdrawal, said to have
occurred when a withdrawal syndrome is produced by stopping the drug
PSYCHOLOGICAL DEPENDENCE – the compulsion to experience the effects
of a drug, in terms of an increase in pleasure or lessening of discomfort
(feel that they cannot cope without it), a consequence is that the person
will continually take the drug/engage in a behaviour until it becomes a
habit despite harmful consequences, can occur in the absence of physical
dependence
TOLERANCE – when an individual’s response to a given amount of a drug is
reduced, so greater doses are needed to produce the same effect on
behaviour (caused by repeated previous exposure to the effects of a drug).
Behavioural tolerance – happens when the individual learns
through experience to adjust their behaviour to compensate for the
effects of a drug
Cross-tolerance – developing tolerance to one type of drug can
reduce sensitivity to another type, can be used therapeutically by
, giving benzodiazepines to people withdrawing from alcohol to reduce
the withdrawal syndrome
WITHDRAWAL SYNDROME – a collection of symptoms associated with
abstaining from a drug or reducing its use, almost always the exact
opposite of those created by the drug, and indicate that a physical
dependence has developed. Once a physical dependence develops, the
addicted person experiences some withdrawal symptoms whenever they
cannot get the drug. Their motivation for continuing to take the drug is to
avoid withdrawal symptoms (secondary form of psychological dependence)
Risk factors in the development of addiction:
GENETIC VULNERABILITY – any inherited predisposition that increases the
risk of a disorder or condition
GENETIC MECHANISMS – two plausible direct genetic mechanisms involved
in addiction:
Dopamine depends on the presence of
receptors on the surface of neurons,
one type of dopamine receptor is the D2
receptor, abnormally low numbers of which are thought to be
involved in addiction (proportion of all receptors in the brain is
determined genetically)
Some people are more able to metabolise (break down) certain
substances and this is linked to addiction, eg. Pianezza et al. (1998)
found that some people lack a fully functioning enzyme (CYP2A6)
which is mainly responsible for metabolizing nicotine, and smoked
less than those with the fully functioning version. Those with the fully
functioning enzyme are at greater genetic risk of nicotine addiction
EVALUATION – Kendler et al. (2012) found that adults who had been
adopted away from biological families in which one parent had an addiction
had an 8.6% risk of developing an addiction themselves compared to a
4.2% risk in those without a parent with addiction (strong evidence for the
role of genetic vulnerability as an important risk factor, but statistics are
low and insignificant)
STRESS – increased risk is linked with periods of chronic stress and
traumatic life events in childhood. Epstein et al. (1998) found a strong
2
, correlation between incidence of childhood rape and adult alcohol
addiction, but only for women diagnosed with PTSD (so no inevitable
relationship between childhood trauma and later addiction). A child will
only have an addiction problem if they have a vulnerability and a later
stressful situation. But individual differences (stress may only explain
addiction in certain people). Correlational, cause and effect cannot be
established
PERSONALITY – individual personality traits eg. hostility and neuroticism
are linked with addiction (Butler and Montgomery (2004)). The strongest
correlation has been found between addictive behaviour and antisocial
personality disorder (APD) where a key personality-related risk factor is
impulsivity; Ivanov et al (2008) concluded that many studies strongly
support the link between impulsivity and addiction – could be because they
share a neurological basis, or a common genetic component
CUNNINGHAM-WILLIAMS ET AL. (1998) – studied link
between gambling and mental disorders, 3000+
participants over 18 from five US cities using stratified
sampling, use of surveys and interviews, found that 46%
gambled recreationally, 9.2% were problem gamblers,
0.9% were pathological gamblers, and gamblers showed a greater level of
several psychiatric diagnoses (problem gamblers were 6x more likely to
show symptoms of anti-social personality disorder), so found positive
correlation between levels of APD and problem gambling
EVALUATION – use of stratified sampling so high representation and
reliability, but within the 3000 less than 30 were pathological gamblers,
interviewed using NIMH Diagnostic Interview Schedule so well
standardised, self-report techniques so risk of social desirability bias
affecting reliability of results esp. as involving retrospective info about
sensitive issues of gambling and mental health
FAMILY INFLUENCES – perceived parental approval is the most consistently
reliable risk factor (the extent to which
an adolescent believes that his parents
have positive attitudes towards a
particular drug/addictive behaviour). Key
determinant is the individual’s
perception of approval – adolescents
3
