Alcohol addiction cognitive explanations

What is the cognitive approach to alcohol use

Focuses on how an individual thinks about past traumatic experiences and current feelings of distress to form and maintain addictions

What is the cognitive approaches aim

Aims to explain the initiation, maintenance and relapse of disorder

What does khantizan (1985) say about initiation of addiction to alcohol

It can be explained by early childhood trauma - e.g. neglect, or a parent dying. A mental disorder (anxiety, depression) will likely develop and is accompanied by emotional distress - alcohol can alleviate these symptoms. This self medication has a soothing function helping the sufferer to manage their anxiety and pain and become emotionally stable

What is specificity

The choice of drugs is not random and it is used to manage negative feelings

Who is alcohol typically used by

People who experience anxiety because of its relaxing effects, as well as alcohols wide availability. Finding what works can be the outcome of experimentation,with people becoming addicted to alcohol before trying anything else

Maintenance of alcohol addiction through cognitive explanation

People with early trauma and current distress may not be in a position to care for themselves, lack self-esteem and may lack skills to cope in social situations.

What does self medicating with alcohol help

Someone to cope socially but usually these people cannot self-regulate

What does lack of self regulation lead to

Takes someone from being a user to an addict, as the start to rely on alcohol to build self esteem or self care - reinforcing the addiction

What is an important factor in the maintenance of an alcohol addiction

Stress relief

Why do alcoholics soothe themselves when they are stressed

They likely havent developed confidence to cope with

What is using alcohol

Counterproductive - self medicating creates rebound effect, worsening the symptoms or provokes a relapse - called a paradox of self medication

What does someone dependent on alcohol have

Increased stress withdrawal symptoms

What does lacking the self-esteem necessary to cope without alcohol make an alcoholic

More likely to return to alcohol to self- medicate to manage withdrawal symptoms

Self perpetuating cycle of distress

Occurs when the body remains in a stressed state due to unresolved triggers which in turn creates more stress

Self-medication model (SMHypothesis) of alcohol addiction

Suggests people use alcohol to cope with negative emotions, stress, or psychological conditions like depression, anxiety or trauma.

Evidence that supports the role of early trauma in alcohol addictions

Felitti et al (1998) used 10,000 pps who recorded sexual emotional and/or physical abuse in childhood, which was then correlated to alcohol addiction in adulthood. There is a strong relationship between early childhood trauma and addiction

Is the link between self medicating and risk addiction well supported

Yes. Lazareck et al (2012) found that pps who self medicate were 7 times more likely to develop a drug addiction, thus, self medicating is a substantial risk factor for the development of alcohol addiciton

Is there a lack of evidence for specificity

Yes. Kemble (2012) points out that people who abuse drugs typically use another equally as often. Further,pre adolescents with mental disorders typically self medicate with drugs common among their peers. This means relief from emotional stress is not the main motivator of the choice of drug

Do underlying mental health disorders cause addiction

No

What is needed for the model to be accurate

Alcoholics to be those with mental health disorders and early childhood trauma.

What did fergusson et al (2009) find

Not all alcoholics have mental health disorders and childhood trauma and alcohol can make someone depressed