addiction case studies

andersen and teicher (2008)

early experiences of severe stress damage the brain and create vulnerabilities to stress later in life

person will be more likely to self medicate with drugs or alcohol

kendler (2012)

swedish adults adopted away from at least one addicted parent were at higher risk to develop addiction themselves

bahlmann (2002)

interviewed 55 alcohol dependent people of which 18 had apd

apd developed four years on average before addiction, showing personality as a risk factor

mcevoy (1995)

studied people who took haloperidol (blocks dopamine) for schizohphrenia

they all increased smoking behaviour to increase dopamine levels

levin (2010) + eval

rats licked the nicotine water spout more than the plain water spout

nicotine addiction in humans is more complex than in rats

unethical animal research

carter and tiffany (1999)

dependent smokers reacted more strongly to cues (cravings, physiological signs) than non smokers

smith (1988) + eval

52% of patients that did electric shock aversive therapy kept abstaining from smoking, only 25% of people that just chose to stop smoking kept abstaining

but this study had no placebo / control so comparison might not be valid

dickerson (1979) + eval

compared low frequency and high frequency betters in horse betting

high frequency more likely to bet in last two minutes, because the build up and rush is addictive

study done by single observer so no inter rater reliability

brown (1987)

learning theory doesn't explain how some people can dabble in gambling and not become addicted

rickwood (2010)

four cognitive biases:

believe they are skilled at gambling

have traits and rituals to try and win

selective recall of only their wins

faulty perceptions that a losing streak will always be followed by a win

griffith (1994) + eval

used thinking aloud method to compare cognitive processes of slot machine gamblers

thoughts were sorted into rational and irrational

regular gamblers made six times as many irrational verbalisations than occasional gamblers

think aloud method with off the cuff remarks might not represent their true deep thoughts

mccusker and gettings (1997)

gamblers struggled to name ink colour of gambling related words in stroll test

gamblers have a cognitive bias to pay more attention to gambling related cues than non gamblers

michalczuk (2011)

compared 30 addicted gambling participants with 30 non gamblers

gamblers were highly impulsive and would take a reward even if a better one was promised if they waited

aversives, agonists, antagonists, nrt

aversives - disulfiram causes vomiting with alcohol

agonists - substitutes like methadone so there can be a gradual reduction

antagonists - blocks receptor sites like naltrexone for heroin addiction

nrt - patches and gums that can activates nachrs in a non harmful way for controlled reduction

drugs eval

side effects like sleep issues and headaches which can cause people to drop out of drug programs

people that are treated quickly with drugs can leave long term hospitalisation

meta analysis of 65k patients, all forms of nrt were more effecting than no therapy or placebos

but this analysis only included published studies, may have publication bias as typically only positive results are published

do not treat social reasons for why addiction may occur

fuller (1986)

group on disulfiram and placebo group saw no significant difference between them in reduction of alcohol addiction

mcconaghy (1983) + eval

90% of covert sensitisation participants reduced gambling

only 30% of aversion participants reduced gambling

no control group / non behavioural therapy group

both methods only suppress addiction rather than treat

cowlishaw (2012)

meta analysis of 11 cbt studies for gambling addiction

cbt had large impacts on gambling, but after 9 months the outcomes were similar to control groups

cuijpers (2008)

cbt drop out is five times higher than other therapies because cbt is so demanding

ajzen theory of planned behaviour

unfavourable personal attitudes towards an addiction will make you more likely to want to quit

negative subjective norms and thinking other people don't approve of your addiction make you more likely to quit

high perceived behavioural control means you think it's in your control to quit an addiction

tpb eval

486 participants completed questionnaires and alcohol related behaviours, personal attitudes, subjective norms and pbc correlated significantly with intention to limit drinking

another meta analysis of tpb and correlation between intention to quit and actually quitting, could only predict quitting if the time between intention and behaviour is less than five weeks

tpb is better for predicting intention rather than behaviour

prochaska's six stage model

precontemplation - not thinking of changing behaviour

contemplation - thinking of changing but don't know how or don't have the means

preparation - are going to change behaviour

action - have done something to change their behaviour in the last six months

maintenance - maintained change in behaviour for more than six months

termination - new behaviour becomes automatic and person doesn't have to force themself to actively change their behaviour

six stages eval

considers relapse as part of the process which reduces shame of stigma

meta analysis of 24 model reviews found it was no more effective than appropriate alternatives for nicotine addiction

there isn't any evidence to properly distinguish all the stages from each other, probably could group them all as precontemplation and then all the other stages in one group

isn't really a model of behaviour change, because you can move through the stages without truly changing your addiction

eysenck (1997)

• neurotic and psychotic people are more likely to develop addictions

• neurotic people are highly anxious while psychotic people are more impulsive

mattick (2009)

• meta analysis of the use of methadone as replacement therapy for heroin compared to a placebo

• methadone was more effective at keeping addicts in recovery programs

hofmann (2012)

• meta analysis of cbt for addiction and found it highly effective for nicotine addiction

• effective but less so for alcohol