Full psych paper 3

Addiction

A persistent, compulsive dependence on a behaviour or substance. Soper and Miller (1983) suggested it involves a lack of interest in other activities and primary associations with other addicts.

Physical dependence

This is a need from the individual to take the drug in order to feel “normal”. This means if they do not have the drug they can become physically ill.

Psychological dependence

This is when a drug becomes a central part of a person’s thoughts, emotions and activities. You can feel you need it and experience cravings and an inability to cope without that substance/activity. This can also produce physical symptoms.

Tolerance

When an individual no longer responds to a drug in the same way as before, and larger doses are required in order to experience the same effect

Metabolic tolerance

Enzymes become more efficient in dealing with the drugs, so symptoms wear off more rapidly

Changes in receptor density

Some dopamine receptors in the brain get less sensitive/ die so more of an activity/ drug may be required for the same effect

Learned tolerance

The individual learns to cope drunk/ hungover so they need more alcohol to have the same impact.

Withdrawal symptoms

These occur when the effect of a drug wears off/ stops being used and an individual may experience physical and psychological symptoms as the body attempts to deal with the absence of the drugs effects.

Acute withdrawal

This begins within hours of drug cessation and gradually resolves after a few weeks. A person can experience anxiety, shakes, sweatiness, loss of appetite etc in addition to persistent cravings.

Post-acute withdrawal

This can last for months or years after a person has stopped taking the drug. It is characterised by emotional and psychological turmoil as addicts experience alternating periods of dysfunction and near-normality as the brain slowly re-organises and re-balances itself.

AI variant of the DRD"2 gene

This is an inherited variant of a dopamine receptor gene which can lead to abnormally low levels of dopamine or dopamine receptors activating at a lower than accepted rate.

49-55% v. 21%

Concordance rates of an Australian study (almost 3,000 pairs of twins) for Gambling addictions

Stress

State of physiological arousal produced by demands from the environment.

Self-medication

This suggests that people purposely choose what they become addicted to by using specific things as stress relief.

Extroverted neuroticism

Addictive personalities often look like this.

91%

This percent of polydrug users had at least one personality disorder

Social identity theory

This suggests that a desire to be associated with the “ingroup” makes individuals more likely to adopt their behaviours - this is especially significant with young people.

Social networks

This is a peer explanation for vulnerabilities to addictions because addicts tend to befriend other addicts.

Ventral Tegmental Area

Part of the brain where nicotine first enters the brain and stimulates dopamine levels.

Glutamate

Excitatory neurotransmitter that speeds up dopamine release

GABA

Inhibitory neurotransmitter that reduces dopamine levels back to optimal levels.

MAO

Enzyme responsible for breaking down dopamine levels which is blocked by certain compounds within cigarette smoke.

Initiation, maintenance, cue reactivity (relapse)

3 key parts of learning theory to the development of smoking addictions.

Cue Exposure Therapy

RWA of learning theory for smoking addictions: a type of therapy where the cue is presented without the opportunity to engage in the addictive behaviour to reduce its impact.

Partial reinforcement schedule

Reinforcement schedule where only some responses are reinforced.

Variable reinforcement schedule

Reinforcement schedule where a response is rewarded after an unpredictable number of responses, it averages out at a specific rate.

Big win hypothesis

If a person wins a lot early on, they are REINFORCED to try to repeat this good experience.

Near miss (learning)

Reinforcement in the absence of a win because it is close e.g. some fruit machines are designed to generate a higher than average rate to keep people addicted

Cognitive biases

Irrational beliefs that are inconsistent with reality

Gambler’s fallacy

The belief that random chance is influenced by past events e.g. believing that a win is imminent after many losses or being able to influence a coin toss

Illusions of control

An overestimation of personal ability to influence the environment e.g. superstitious behaviours. Here, a win is seen as successfully beating the system whereas a loss is seen as chance.

Near miss bias (cognitive)

This occurs when an unsuccessful outcome is close to a win - the gambler may feel like they are not “constantly losing but constantly nearly winning” (Griffiths, 1991)

Recall bias

Cognitive reframing by which there is a tendency to exaggerate wins and forget/ rationalise losses.

Just world hypothesis (cognitive)

When gamblers believe that they will be rewarded for their efforts with an imminent win.

26/30

In Griffiths (1994) study where he explored verbalisations during fruit machines, this proportion of regular gamblers believed it was skill or equal skill or chance, whereas none of the non-regular gamblers believed this was the case.

80%

This percent of the verbalisations made by problem gamblers are irrational, suggesting that irrational beliefs sustain gambling (this was not the case in recreational gamblers).

Nicotine replacement therapy (NRT)

Drug therapy for nicotine addictions which gradually release nicotine into a person’s bloodstream to manage withdrawal symptoms.

Buproprion

Originally developed as an anti-depressant, this inhibits the reuptake of dopamine so it manages smoking withdrawal symptoms and is effective as a smoking cessation drug (Hughes et al, 2004).

70%

All types of NRT are this much more effective than placebo.

Opioid antagonists

These bind to opioid receptors in the body and block them to prevent an individuals from experiencing the particular rewarding response associated with a particular substance or behaviour. By reducing the rewards of gambling, the urge to gamble is reduced.

Naltrexone

An opioid antagonist drug used to target gambling addictions which targets D2 receptors. It is effective in controlling the frequency and intensity of urges (Kim et al, 2001), but it makes individuals lose interest in previously enjoyed activities e.g. sport or sex, because it blocks all reward systems in a crude way

Aversion therapy

This aims to decrease or eliminate the undesirable behaviours associated with addiction by associating them with unpleasant or uncomfortable sensations.

Rapid smoking

Smoking technique used in aversion therapy to hurt your throat or produce nausea by puffing every 6 sec.

Antabuse

A drug used to challenge alcohol addictions in aversion therapy which enhances hangovers and makes the individual very sick.

Covert sensitisation

A therapy which involves eliminating an unwanted behaviour by creating an imaginary association between the behaviour and an unpleasant stimulus or consequence.

90%

Kraft and Kraft claim covert sensitisation is this effective after using hypnotic suggestion to induce feelings of nausea to treat chocolate addictions.

CBT

A therapy given in 10 one hour sessions with 3 key parts: identifying and correcting cognitive biases, changing behaviour, relapse prevention.

Theory of planned behaviour

This model considers how intention leads to actual behaviour. It suggests that an individual’s decision to engage in a certain behaviour can be directly predicted by their intention which in turn is directly predicted by their behavioural attitude, subjective norms and perceived behavioural control.

Behavioural attitude

This is an individual’s personal views towards the behaviour. The attitude is formed based on perceived consequences and the appraisal (judgement) of their value (or whether that is a personal benefit or loss). This can be manipulated using national campaigns to show impacts (e.g. smoking pictures on cigarette packs) or challenge a person’s belief.

Injunctive norms

What we believe significant others think is the right thing to do

Descriptive norms

Our perceptions of what other people are doing

Perceived behavioural control

It is an individual’s belief about their ability to carry out certain behaviours, taking into account internal and external control factors.

Self-efficacy

Another name for an individual’s sense of control regarding reducing addictions. Majer et al concluded that it should be a priority in treatment plans because it is important in relapse prevention.

Prochaska’s model of behavioural change

This model sees people passing through six transitional stages when attempting to change a problematic behaviour. Individuals move through these stages in order but may relapse and have to revert to previous stages or to the beginning. It sees recovery as a gradual process rather than an event.

Precontemplation

Stage 1 - individuals have no intention to change their behaviour - they may be in denial and may only seek help because of pressure from others

Contemplation

Stage 2 - a person may be aware that a problem exists but they do not want to make a commitment to doing anything about it - they enjoy it and the barriers to quitting it seem too great (e.g. positive buzz from gambling or the effort required for recovery). An individual may stay in this stage for a very long time.

Preparation

Stage 3 - this stage combines intention to change with actual behavioural change - there may be small behavioural changes (baby steps) e.g. smoking fewer cigarettes

Action

Stage 4 - the most overt stage with clear behavioural modification and clear commitment on the part of the individual. Individuals are classified as being in this stage for the first 6 months of altering problem behaviours.

Maintenance

Stage 5 - continuation of the same and consolidation of the gains while putting measures in place to prevent relapse. An individual must have stayed free from the addiction for more than 6 months

Termination

Stage 6 - the individual is no longer tempted to revert to their former behaviours (e.g. never crave a cigarette again) and they are confident they can maintain the change. They keep building on initial successes and adding new goals. According to Prochaska, only 1/5 make it to this stage.

Schizophrenia

A type of psychosis where thoughts and emotions are so impaired that contact is lost with external reality.

Psychosis

An umbrella term about symptoms where there is a break from reality

Classification

The action of process of classifiying according to set criteria - what is Sz like?

Diagnosis

The identification of a disorder in an individual - does this person have Sz?

Positive symptoms

Symptoms that reflect an excess or distortion of normal functioning, they are often psychotic.

Hallucinations

Distortions or exaggerations of perception in any of the senses, usually auditory. They are sensory experiences in the absence of stimuli.

Delusions

Firmly-held erroneous beliefs that are caused by distortions of reasoning or misinterpretations of perceptions or experiences. These are either persecutory or delusions of grandiosity.

Negative symptoms

Symptoms that reflect the deficit or loss of typical functioning. These tend to be less extreme, but persistent.

Alogia

Lessening of speech fluency reflecting slowing or blocked thoughts (not confused speech but reduced or less complex)

Avolition

A reduction of motivation or drive to persist in both everyday behaviours and goal-directed behaviours. This is often mistaken for disinterest.

Co-morbidity

This refers to the co-occurance of 2 or more disorders simultaneously e.g. Sz and Dep.

Symptom overlap

This refers to when symptoms of a disorder may not be unique to that disorder but may be found in other disorders too. This makes accurate diagnosis difficult.

0.11

Whaley’s finding for correlation between psychiatrists diagnosing Sz.

Culture bias

This refers to the variation in rates of diagnosis of Sz between cultures, countries and ethnic groups within a country.

6x

Afro-Caribbean men were this many times more likely to be given a diagnosis.

Gender bias

This is the tendency to describe the behaviour of men and women in psychological theory, that may not represent their characteristics. It also refers to unconscious biases of the psychiatrists.

Behavioural genetics

This focuses on the increased risk of the development of the disorder when genetic material is shared with a person diagnosed with the disorder. This is why having a family member with sz increases a person’s risk so strongly e.g. 46% if both parents are diagnosed.

Molecular genetics

This focuses on the research into specific genes or groups of genes which appear to confer an increased risk of developing the disorder on the carrier.

108

This many candidate genes for the disorder - polygenetic.

Hyperdopaminergia

Excess of dopamine

Hypodopaminergia

Dopamine levels which are too low

Neural correlates

Patterns of structure or activity in the brain that co-occur with sz or a sz experience. Their co-occurance could lead us to believe that the patterns observed are implicated in causing sz, or maybe they just co-occur with symptoms.

Dysfunctional thought processing

Cognitive habits or biases that cause an individual to inaccurately interpret information.

Theory of Mind

An individual’s ability to identify their own behaviours through self-awareness and therefore attributing mental states and intentions to others.

Communication deviance

Lack of clarity in communication, it is a family variable where it could act as a predisposition or trigger for maladaptive behaviours.

Parts of the High EE environments

Direct verbal criticism, hostility and emotional over-involvement.

Double Bind communication

This refers to contradictory messages from parent to child (where there is hierarchy in the relationship) to create a state of confusion about reality. This child will be unable to please the parent as their responses are inevitably wrong.

Stages of CBTp

Assessment, Engagement and Empathy, ABC, Normalisation, Critical Collaborative Analysis, Alternative Explanations.

Function of family therapy

Support both the individual and their carers to reduce the burden of care (low EE is protective) through psychoeducation, alliances and problem solving.

Garety et al (2008)

Relapse rates were halved when family therapy was used alongside standard care.

Token Economy

A behavioural therapy that was used for the management of Sz in inpatient settings.

Interactionist approach to Sz

Suggests there are no necessary or sufficient causes for Sz, instead it develops as a probability when enough risk factors come together. It could even be suggested that these risk factors act in synergy, i.e. the existence of one may increase the severity of another.

Diathesis-Stress model

There is a predisposition and a trigger which results in the development of the disorder

Tienari (2004) Finnish adoptees study

At 21 years, 14/303 had developed Sz, 11 of these 14 were from the HR group. Those that were HR but low OPAS (good) were significantly less likely to develop Sz than HR and high OPAS (bad).

Tarrier et al (2004) treatment study

Used random allocation to allocate 315 patients to one of 3 conditions: anti-psychotics and CBTp, a-p and counselling, or a-p alone. There were lower symptom severity scores in both combination groups, but no difference in hospitalisation rates. This suggest that talking therapies are effective in easing symptoms of distress but not fully removing the disorder.

Sexual selection

A key part of Darwin’s theory explaining how evolution is driven by competition for mates, and the development of characteristics that ensure reproductive success. i.e it explains the characteristics that evolved for a reproductive advantage rather than a survival advantage.

Intrasexual selection

Selection where one sex (usually males) must outcompete other members of their sex in order to gain access to members of the other sex. So whatever characteristics lead to the most success in terms of mating, becomes more widespread in the gene pool.

Intersexual selection

Selection where members of one sex evolve preferences for desirable qualities in potential mates, this usually refers to females choosing a male. For example if being muscular attracts the most females, males will strive to be the most muscular.

Male preferences for female partners according to evolutionary explanations for behaviour

Indicators of fertility: waist-hip ratio of 0.7, childlike facial features including large eyes, small noses etc, and prominent cheekbones.

Female preferences for male partners

Someone that is older, taller, has a waist-shoulder ratio of 0.9, square jaws and small eyes. This apparently indicates that a person could be a resourceful provider.