Addiction

What are the key characteristics of an addiction?

physical and psychological dependence - tolerance - withdrawal syndrome

What is physical and psychological dependence?

physical - demonstrated by withdrawal symptoms if person suddenly abstains from drug so person depends on drug to avoid these + to function normally
psychological - occurs when drug becomes central part of an individuals thoughts + activities demonstated by strong urge to experience effects where feelings are rewarding so person keeps taking the substances until a habit regardless of harmful consequences
both types causes cravings (intense desire to repeat) where if attempt to cut down will experience intense cravings + if not met person feels very anxious + makes difficult to quit as unable to cope without substance or activity + desire takes over thinking

What is tolerance?

if substance is taken repeatedly tolerance can develop which means an individual no longer responds to the drug in the same way which results in larger doses needed in order to feel the same effects as before so person may gradually increase amount of substance
can happen by: enzymes responsible for metabolising the drug do so more efficiently over time metabolic tolerance results in reduced concentrations in blood making effect weaker
leads to changes in receptor density reducing response to normal dose of the drug + behavioural tolerance means experience reduced drug effects as learned to function normally when under the influence as adjust behaviour to compensate the effects of a substance
cross-tolerance is where person develops tolerance to one type of substance + this reduces sensitivity to another type eg alcohol can reduce your sensitivity to benzodiazepines but can reduce alcohol withdrawal syndrome

What is withdrawal syndrome?

collection of unpleasant symptoms associated when a person who is dependent on a substance abstain from a drug where stopping a drug causes withdrawal symptoms can occur as an effect wears off may experience increased anxiety,trembling,irritability + insomnia - these symptoms are different depending on the drug but all share negative impact on individuals who may then take the drug again to relieve these where these symptoms are an indication of the persons physical dependence on the drug
occur due to body attempting to deal with the absence of a drugs effects/sudden removal
maintained by a cycle of use then withdrawal which encouraged continued substance use as taking substance again to relieve unpleasant symptoms therefore further use

What are the two phases of withdrawal?

acute withdrawal phase - within hours of stopping and gradually resolves after a few weeks where physical cravings are intenses and persistent as body is yet to adjust to loss of the drug it had become used to
prolonged withdrawal phase - can last for months even years characterized by emotional and psychological turmoil as addicts become highly sensitive to cues eg rituals + locations they associate with the substance explaining why relapse is common

What is a risk factor and the three types?

internal or external influence that increase the likelihood of an individual starting to use a substance,developing an addiction or finding it difficult to quit - can also explain why a person increases their current level of use
genetic vulnerability - personality - social influence

How can genetic vulnerability lead to addition?

people appear to born with a genetic vulnerability to substance abuse as genes may determine neurotransmitter activity as may lead to behaviours such as impulsivity which could predispose a person
dopamine receptor gene where genetics determines how many dopamine receptors you have where D2 receptor density often found to be low for people with addictions meaning reduces effects of dopamine + certain drugs may compensate deficiency which encourage individual to seek out rewarding experiences
could be abnormally low levels of neurotransmitter dopamine + decreased ability to activate dopamine recepetors meaning anything that increases dopamine produces strong feelings of euphoria
nicotine enzymes (CYP2A6) where Pianezza et al found some lack a fully functional enzyme which metabolises nicotine so people smoked less nicotine as remained in their systems longer + milder withdrawal symptoms where if fully functioning nicotine cleared faster + intenses withdrawal symptoms + pressure to escape these feelings

How can personality lead to addiction?

certain personality characterists increase vulnerability to addiction
impulsive individuals more likely to act without considering consequences and engaged in risk-taking behaviours making them more likely to experiment with substances + continue despite negatives
recreational + problematic behaviours that lead to addiction are associated with certain personality traits such as hostility and neuroticism may increases addiction risk where Francis found a link between addiction and high scores in neuroticism
strong correlation between addiction-related behaviour + antisocial personality disorder as key components is impulsivity such as risk-taking where also alcohol use disorder has been associated with low scores in honesty-humility (Big five) + cannabis use disorder related to high score on openness to experience and gambiling linked to both

How can social influences lead to addiction?

risk factor as attitudes transmitted via family,peer groups and media platforms where exposure to an environment with models to substance use or permissive attitudes towards dependency significantly increases individuals vulnerability to addiction
also stress can increase vulnerabilty as addictive substances or behaviours may provide temporary relief where repealty used as way of coping can reinforce the behaviour

How can social learning theory explain addiction?

use SLT to explain our beliefs towards addictive behaviour are passed onto people who observe and imitate addictive behaviour of people they identify with (role models)
modelling addictive behaviour increases our vulnerability to addiction where absence of vicarious punishment can further reinforce addictive behaviours if role models not punished for their behaviour can lead to disinhibitng effect + at-risk person even more likely to imitate the addictive behaviour

How do family influences,peers and social media increase risk of addiction?

Biederman et al found adolescents with substance abusing parents more likely to abuse substances + if perceives parent not disapproving of addictive behaviour more likely to engage in similar activities also possible first-hand experience of living with a parent with an addiction may decrease likelihood of addiction - may also learn attitudes towards substances through observational learning if parents regularly use substances, this may make their use seem normal or acceptable
peer pressure common reason to start where McAlister et al believes increased smoking linked to peers encouragement and approval together with message smoking is activity that promotes popularity - provide accesses and act as role models
social media constructs powerful behavioural norms regarding drugs and gambling heavily shaping attitudes and habits of impressionable young people whereby partnerships between brands and high-profile celebs frequently foster positive attitudes to gambling + alcohol consumption where data driven algorithms can intentionally target vulnerable demographics making people more susceptible

What are protective influences?

some social factors can reduce, rather than increase, vulnerability to addiction:
positive family relationships – emotional support, open communication and clear boundaries can help young people cope with difficulties without turning to addiction - parental monitoring – supervision can reduce opportunities to access addictive substances + allow parents to recognise risky behaviour early - positive peer groups – friends who do not engage in addictive behaviours reduce exposure + peer pressure - effective coping strategies – being able to manage stress and difficult emotions in healthy ways reduces the need to use addictive substances or behaviours as a form of escape
important as risk factors do not inevitably lead to addiction - protective influences can reduce an individual's vulnerability even when they are exposed to factors such as stress or peer pressure.

What is evaluation of risk factors in general?

evaluation of each specificity

How can brain neurochemistry explain a nicotine addiction?

important area of brain nicotine affects is nucleus accumbens (reward centre of brain) - nicotine stimulates nicotine receptors in the ventral tegmental area (VTA) results in dopamine being transmitted along mesolimbic and mesocortical pathways to the nucleus accumbens the frontal cortex where dopamine then released into frontal cortex creatifn rewarding effects

How does dopamine explain a nicotine addiction?

neurotransmitter acetylcholine (ACh) responsible for transmitting nerve signals across synapses - are ACh receptors on surface of many neurones in central nervous system where a special subtype of ACh receptor called nicotinic acetylcholine receptors (nAChR) special because can be activated by ACh or nicotine - when nAChRs are activated by nicotine molecules the neurones transmits dopamine then shuts down within a few milliseconds + temporarily cannot repsond to any neurotransmitters - neuron desensitized during this time leading to downregulation which is a reduction in the number of active dopamine neurones as fewer available

What is desensitisation?

nicotinic acetylcholine receptors are found on the postsynaptic membranes of neurons including in the nucleus accumbens
normally, acetylcholine binds to these receptors and increases neural activity
nicotine can also bind to these receptors and mimics the effects of acetylcholine
repeated exposure to nicotine causes the receptors to become less sensitive (desensitised)
reduces their response to acetylcholine and changes neurotransmission in reward pathway
nicotine also stimulates the release of dopamine into the mesolimbic system producing feelings of pleasure and euphoria

How does operant conditioning play a role?

nictonie has positively reinforcing effect as nAChRs are concentrated in region of brain ventral tegmental area (VTA) where nicotine attached to neurones + triggers releases of dopamine along 2 pathways: mesolimbic pathway to brain region nucleus accumbens (NA) which releases dopamine into the frontal cortex + mesocortical pathway nictonie also stimulates release of neurotransmitter glutamate which triggers additional releases of dopamine directly into the frontal cortex
becomes addictive as activates areas of the brain that regulate pleasure where rewarding feelings of pleasure eg mild euphoria + reduction of anxiety positively reinforces smoking behaviour where pleasure + drive to repeat the process that leads to addiction

What is the nicotine regulation model in terms of withdrawal?

if smoking nAChRs continue to be desensitized where nictone is removed from bloodstream very quickly + dependent users need to smoke frequently to satisfy their craving + avoid withdrawal
when smoker goes without nictonine for prolonged time eg sleeping drug is metabolised + disappears allowing nAChRs to become functional again + dopamine neurones resensitise called upregulation as more receptors become functional creates actute withdrawal syndrome eg agitation as nAChRs become overstimulated by ACh as no nicotine to bind with them
(why first cig of day most enjoyable as strongly reactivates DA reward system)

What is the nicotine regulation model in terms of dependence and tolerance?

believes smoker motivated to avoid unpleasant physiological + psychological withdrawal states by having another cigarette + explains how nicotine dependence is maintained where daily cycle of daytime downregualtion and nigh-time upregulation creates long-term desensitisation of nAChRs where repetition of process creates chronic desensitisation of nAChRs + cause permanent change in brain neurochemistry a decrease in active receptors which can only be overcome by increasing nicotine intake so tolerance develops

What is upregulation and withdrawal?

when nicotine use is reduced or stopped receptors begin to upregulate nicotinic receptors become more sensitive again this changes neural activity in the nucleus accumbens
individual experiences withdrawal symptoms which can include anxiety irritability and nausea taking nicotine again causes the receptors to become desensitised, reducing the unpleasant withdrawal symptoms
creates a cycle: nicotine → receptor desensitisation → pleasure → nicotine reduced → receptor upregulation → withdrawal → nicotine use again
repeated nicotine use also leads to tolerance - as the receptors become increasingly desensitised more nicotine is needed to produce the same pleasurable effects individual therefore increases their nicotine consumption to achieve desired level of pleasure helps explain why nicotine addiction can become a cycle of increasing consumption + withdrawal

What is another explanation for smoking addiction?

learning theory where internal cues eg stress may prompt nicotine use in people who have learned negative feelings are rduece through further nicotine use example of opererant conditioning + external cues eg smell of vape liquid or object/location/people become associated with nicotine use an example of classical conditiong
theory suggests that nicotine addiction is a learned behaviour that develops and is maintained through conditioning and reinforcement.

How can classical conditioning explain addiction?

if an individual associates a neutral stimulus eg smell of vape liquid with something pleasent then the NS also becomes associated with thing that is pleasant where pleasurable effect of nicotine use (UCS) is an unconditioned response (UCR) - (considered unconditioned as involuntary effectc on the brains dopamine reward system)
suggests that smoking can initially develop through association: young person may already associate situations such as socialising with friends with positive feelings such as enjoyment if they repeatedly smoke in these situations smoking becomes associated with these positive feelings
over time smoking can become a conditioned stimulus triggering expectation of the pleasurable feelings associated with the situation - can increase the likelihood of smoking again, helping to explain the initiation of nicotine use

How can operant conditioning explain addiction?

positive reinforcement - if behaviour rewarded will be repeated where nicotine powerful reward as stimulates release of DA in nucleus accumbens producing feeling of pleasure act as a reward so likely to repeat behaviour and explains early stages of addiction and why people continue after first smoke
negative reinforcement - if avoid something unpleasant than avoidance behaviour more likely to occuring many report temporary decrease in tension following nicotine use creating negative reinforcement making use more likely as absence of tension rewarding - similary when person doesn’t smoke they experience unpleasant withdrawal symptoms then when they use nicotine unpleasant symptoms disappear making further use more likely explaining why quitting nicotine can be difficult as escape discomfort
smoking maintained through both gaining pleasure and avoiding unpleasant withdrawal symptoms

How can cue reactivity explain addiction?

any NS can become conditioned stimulus if is associated with nicotine intake (UCS) eg ashtrays or seeing someone smoking can become a CS means they elicit feelings of pleasure associated with nicotine use and can trigger cravings (UCS) and creates a desire for more nicotine these feelings are example of cue reactivity - the CS is the ‘cue’ and reaction is the physiological and psychological responses
repeated pairings between smoking and particular cues can mean that situations such as parties, seeing other people smoke, the smell of tobacco or seeing a cigarette packet become associated with nicotine's pleasurable effects
three main ways in which nicotine users react to cues:
1.subjective desire or craving for nicotine 2.physiological responses eg change in heart rate 3.objective behaviours eg how many inhalations are taken on a cigarette and how strongly
cues can trigger a craving to smoke even when nicotine has not been

consumed can help maintain the addiction response to these cues can also make relapse more likely after someone has attempted to quit so may lead to frequent relapses

evaluation

How can a gambling addiction be described by learning theory?

first component of theory is vicarious reinforcement where experience of seeing others rewarded for gambling through pleasure or payment may be enough to motivate them to imitate behaviour in hopes of receiving similar rewards which doesn’t have to be through direct observation but through newspapers and other media reporting positvely on big wins

How can operant conditioning explain a gambling addiction?

principles can be explained by this where two sources of positive reinforcement of winning money and the buzz that accompanies gambling making behaviour more frequent where Custer suggest difference between those who have problem and who don’t lies in intial experience where an early winning streak and big win might predispose individual to addiction + Griffiths believes buzz from winning and near misses and peer praise are rewarding
gambling can also be used as an escape for many offering a temporary distraction from aversive stimulus such as anxieties of everyday life relief provides make more likely to gamble when similar difficulties occur (negative reinforcement)

What are reinforcement schedules and the two types?

Skinner suggest winning provides unpredictable reinforcement only some bets rewarded results in learning of a pattern of behaviour with high response rate very resisitant to extinction can explain why people with addiction persist in playing even when losing
continuous reinforcement where reward after every correct response can easily lead to extinction however due to nature of gambling statistical chance only some response are rewarded known as partial reinforcement which can be fixed or variable

What is fixed reinforcement?

rewards given after fixed number of behaviours eg after every 5th behaviour it results in slower learning but less vulnerable to extinction
casinos use partial reinforcment schedules to attract gamblers where uncertainty of pay out is due keeps players playing for longer

What is variable reinforcement?

rewards given after variable number of behaviours eg average number of behaviours before rewarded may but 5 but intervals between them vary ie may be rewarded two turns in a row but then have to wait eight turns before next - leads to quick learning that is highly resistant to extinction
gambler knows there is a chance of winning but cannot predict exactly when the reward will occur - this uncertainty and anticipation encourages persistent betting because the next attempt could be successful

How can cue reactivity explain gambling addiction?

expalins how behavioural addictions can be maintained and reinstated after relapse where experienced gamblers have secondary reinforces eg stimuli that become reinforcing because of their association with exciting arousal eg atmosphere of betting shops,colourful lottery cards and sounds of TV hourseracing channel
secondary reinforces can cue arousal that gamblers (try use extended version) crave which are often everywhere including social media and therefore hard to avoid and offer continous low level reminders of pleasure of gambling making relapse likely

How do the reinforcement processes work together?

gambling can therefore become strongly maintained because the individual can gain pleasure,escape unpleasant feelings + receive rewards occasionally and unpredictably and observe other people being rewarded
at the same time gambling-related cues can trigger cravings and encourage continued gambling or relapse

evaluation

How can the cognitive theory explain gambling?

suggests that gambling addiction develops because gamblers have irrational expectations about the outcomes of gambling and develop cognitive biases that distort the way they think about wins and losses
suggests that gambling addiction is maintained because gamblers overestimate the likelihood and value of winning while cognitive biases cause them to misinterpret losses,remember wins and overestimate their control - people with distorted expectations are more likely to become addicted to gambling as gamble for longer and do not quit

What is the expectancy theory?

suggests that people are more likely to behave in a particular way when they expect the benefits to outweigh the costs
in gambling this expectation can become irrational: gamblers may believe that the potential rewards of gambling are greater than the possible losses - may focus their attention on winning,money + other positive outcomes while ignoring or minimising their losses creates a distorted view of the costs and benefits of gambling
as a result they continue gambling because they believe that the behaviour will eventually produce a positive outcome

What are cognitive biases and the four types?

systematic errors in thinking that can disort a gamblers judgement about likelihood of winning where leads to people taking greater risks + persist with gambling for longer with four types:
faulty perceptions - incorrect belief about chance - gamblers fallacy believeing after several losses a win is more likely as losing run can’t continue
selective recall - remembering wins and positives more easily than losses - focusing on time won large forgetting what lost overall known as recall bias
skills + judgement - overestimating own ability to control random events - illusion of control believing can influence which machines will win
personal traits - believing person characteristics or luck influence outcome or fulfilled a particular superstitious behaviour - having superstitions about particular machines or rituals
these biases can strengthen gamblers belief that gambling will eventually produce a reward encouraging them to continue despite repeated losses

What is evidence for the role of cognitive biases in gambling addiction?

Griffiths - regular gamblers were compared with occasional gamblers - regular gamblers made significantly more irrational verbalisations than non-regular gamblers (14% vs 2.5%) despite there being no difference in actual objective skill or money won
there was no difference in the amount of money won between the groups examples included statements such as “I have a knack for this machine” + “Everyone knows I can choose winning numbers!” treated machines as was a person
suggests that regular gamblers are more likely to use irrational thoughts and beliefs supporting the idea that cognitive distortions contribute to the maintenance of gambling addiction

What is self-efficacy?

is expectation we have about our ability to achieve a desired outcome such as stopping gambling where relapses often occur because person has biased belief not capable of abstaining from gambling permanently as believe do not have skill or motivation to do this and as a result set up a self-fulfilling prophecy that confirms their expectations that they can’t stop gambling