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What is addiction?
Addiction is the compulsive ingestion of a substance or engagement in an activity that interferes with daily life and responsibilities
What is tolerance in addiction?
Tolerance is when, over time, larger doses of a substance are needed to achieve the same effect. For example, alcohol may affect a person less, or pain medication may become less effective.
What is substance dependence in addiction?
Substance dependence is the continued ingestion of a substance to avoid withdrawal symptoms. Withdrawal is an unpleasant state that occurs when substance use stops (Moss & Dyer, 2010).
What is behavioural dependence in addiction?
Behavioural dependence occurs when a person compulsively engages in activities like gambling, internet use, or pornography. Research by Reed et al. (2017) found that internet withdrawal can increase heart rate and blood pressure.
What are the psychological aspects of addiction?
The psychological aspects of addiction develop slowly and involve increasing use, tolerance, and withdrawal. Individuals may engage in behaviours to avoid withdrawal effects, leading to preoccupation. As a result, relationships, employment, and family commitments suffer. This creates a perpetuating cycle, where avoidant behaviours continue despite harm.
What are the diagnostic criteria for addiction according to ICD-10?
According to ICD-10, a diagnosis of addiction is made if three or more of the following occur in the past year:
A strong desire or compulsion to take the substance
Difficulty controlling substance use behaviour (onset, termination, levels)
Physiological withdrawal state
Evidence of tolerance
Neglect of alternative pleasures or interests
Persisting despite obvious harmful consequences
What does the psychodynamic theory say about addiction?
The psychodynamic theory, as proposed by Khantzian (2012), suggests that addiction is a self-regulation disorder. Individuals with addiction struggle to regulate emotions, relationships, behaviour, self-esteem, or cope with stress. These self-regulation difficulties lead to distress and pain, which may drive the person to self-medicate.
How does the psychodynamic theory view addiction as a form of self-medication?
According to the psychodynamic theory (Khantzian, 2012), drugs are used as a form of self-medication because they can enhance or inhibit feelings, affect one's sense of self and self-esteem, and influence our ability to care about or connect with others.
What is the psychodynamic treatment of addiction using free association?
In psychodynamic treatment, free association involves saying the first thing that comes to mind. The therapist analyses the content and looks for links between thoughts and conflicts, such as addiction. The aim is to discover what the person truly thinks and feels, override repression or denial, and reduce self-judgement while fostering self-acceptance.
How does classical conditioning relate to drug use?
In classical conditioning, an unconditioned stimulus (e.g., drug use) triggers an unconditioned response (e.g., feelings of pleasure). Moss and Dyer (2010) suggest that drug users sometimes learn to associate external cues, like the sight of a needle or a specific person, with drug use, which can trigger cravings and reinforce the behaviour.
How did Wickler (1948) explain conditioned withdrawal in opioid users?
Wickler (1948) found that opioid users in group therapy experienced withdrawal-like symptoms, such as tearing of the eyes, sniffing, and yawning, when discussing relapse. This conditioned withdrawal occurs because, through classical conditioning, these cues would trigger the same responses as pharmacological withdrawal.
What is contingency management and how did Nancy Petry apply it?
Contingency management, as developed by Nancy Petry, uses reinforcement theory to encourage drug abstinence. Participants (addicts) receive monetary rewards for submitting negative urine samples or breathalyser tests. This approach has been shown to be both highly effective and cost-effective in promoting abstinence.
What do cognitive accounts of addiction suggest about dysfunctional thinking?
According to Wright et al. (1994), cognitive accounts of addiction suggest that dysfunctional thinking patterns and beliefs contribute to addiction. Some individuals develop a cognitive vulnerability to drug abuse, where specific beliefs (e.g., "I can't socialise without getting high") are activated in certain circumstances, increasing the likelihood of substance use (Beck et al., 1990, 1992).
What are the three key categories of dysfunctional beliefs associated with substance abuse?
The three key categories of dysfunctional beliefs associated with the decision to engage in substance abuse are:
Anticipatory: Expecting positive outcomes, e.g., "I will feel great when I use."
Relief-oriented: Believing drug use will remove discomfort, e.g., "The cravings will go away."
Facilitative or permissive: Believing drug use is acceptable, e.g., "No harm in taking risks" or "I deserve this."
What are the four key components of case conceptualisation in cognitive treatment?
The four key components of case conceptualisation in cognitive treatment are:
Childhood experiences
Dysfunctional core beliefs
Conditional assumptions (implicit rules about the self)
Compensatory strategies (behaviours used to cope with difficult core beliefs, such as drug use).
What is an example of case conceptualisation in cognitive treatment?
An example of case conceptualisation in cognitive treatment:
Childhood experiences: Difficult family life with significant neglect
Dysfunctional core beliefs: "I am unlovable and inadequate"
Conditional assumptions: "If I do not do everything perfectly, then I will not be good enough"
Compensatory strategies: "I drink to feel more confident"
What is the focus of cognitive treatment in addressing drug use?
In cognitive treatment, the focus is on:
Identifying beliefs about drug use
Understanding which thoughts are maintaining drug use
Recognising which thoughts make the individual prone to relapse.
