Biological Approach to Gambling
- Role of genetics- Runs in families, twin study by Shah et al found evidence of genetic transmission in gambling in men
- Black et al found that first degree relatives were more likely to suffer from gambling than distant relatives
- Pituitary - adrenal response - pathological gambling associated with an underactive - pituitary response to gambling
- Paris et al found that gamblers received no cortisol increase in response to preferred gambling stimuli
- Sensation seeking - Zuckerman individual needs in the need for optimal amounts of stimulation
- high sensation seekers have a lower appreciation of risk & anticipate more positive than low sensation - seekers
- Boredom avoidance Blaszynski et al said poor tolerance for boredom may contribute to repetitive gambling & higher proness scored to boredom than non gamblers, No difference in types of gambling.
(A02) Biological Approach to Gambling
Genetics can explain individual differences in gambling...
- Explains why some people develop gambling whilst others with same life pressures do not.
- Some are more vulnerable to addiction or more resistant to treatment because of genetic predisposition.
Biological explanations are reductionist ...
- Reduces complex down to simple explanation ( brain chemicals or genes)
- Potential advantages ( family history of addiction) limitations includes ignoring other influences
Research on Sensation Seeking...
- Bonnaire et al found that those who bet at race tracks had higher sensation seeking than those in cafes
- Shows two types of subgroups (racetrack) those that bet for arousal and (cafe) those that do it to avoid boredom
- Doesn't explain why some gambling is more additive than others
- Breen and Zimmer - 1 yr to addict to to online and 3 yrs for horse racing
Biological Approach to Smoking
- Role of genetics - twin and family studies estimate heritability of tobacco smoking to be between 39% and 80%
- Vink et al - individual differences in smoking initiation due to 44% genetic & 56% environment
- 348 (Mz) and 321 (Dz) twins heritability 42% ( Boardman)
- Effects of nicotine - regular tobacco use is linked to individual differences in nicotine metabolism (Vink et al)
- causes release of dopamine which creates short lived feelings of pleasure. avoid withdrawal
- prenatal exposure to nicotine children are more likely to smoke
- Xian et al found 54% of failure is due to heritability . Research tried to identify specific gene cluster to help stop smoking
(A02) Biological Approach to Smoking
Supporting evidence for genetic influence on smoking...
- Icelandic study identified gene variant chromosome 15 that influenced smokes per day
- Suggests genes dont affect initiation but maintenance
Limitations of biological approach...
- Neglect factors like social context of smoking
- However, if biologcial suggests that there are pharmacological methods to treat
Genetic approach has implications for treatment...
- Those with higher disposition can be advised and helped to stop habits
- Gartner et al suggests screening for genetic susceptibility is likely to be unsuccessful
Effectiveness of medication may be moderates by a person's genetic make up ...
- smokers with gene Asp40 variant of the mu - opioid gene are twice as likely to quit smoking with NRT
- smokers with Asn40 variant are equally likely to stop smoking regardless of NRT level
Cognitive Approach to Gambling
- Self - medication Gelkopf et al propose use pathological behaviour to 'treat' problems
- Activity an addict chooses tends to be on perceived as helping with a problem
- Role of irrational beliefs - Problem gamblers may believe they can affect outcome
- 'gamblers fallacy' illusions of control and self - confidence
- Recall bias and ' just world' hypothesis - remember wins and rationalises / ignores losses
- String of losses doesn't act as disincentive for future as gamblers believe will be rewarded for efforts
- Relapse as feel they deserve to win after having lost so often 'just world'
(A02) Cognitive Approach to Gambling
Research support for self - medication...
- Li et al found that pathological gamblers are more likely to have other substance dependencies if they gamble to escape life compare to those who gamble for pleasure
- Pathological gamblers motivated by self medication usually have subsitutue to satisfy goal
Problems determining cause and effect..
- Self medication model suggests distress must proceed problem.
- However may be other way round (evidence from Becona et al that depression is evident)
Implications for treatment...
- Beneficial to treat underlying problems
Research challenges role of irrational beliefs..
- Being knowledgeable does not make people less susceptible.
- Benhsain and Ladoucer found no diff in students strained in stats or not is succeptibilty
Cognitive Approach to Smoking
- Expectancy theories - behaviour turns into an addiction cause of expectancies individual has about costs and benefits
- Adolescents report smoking when in bad mood (Kassel et al) expect will decrease intensity (Brandon and Baker) also expect better moods (Mermelstein et al)
- Automatic processing - as an addiction develops, activity in influenced by unconscious or conscious expectancies
- Explains loss of control and difficulty abstaining
- Expectancies can be manipulates by relapse (Tate et al)
- Expectations of costs and benefits can effect wanting to quit and relapse after
- Those who feel it has benefits and quitting few are more likely to relapse
(A02) Cognitive Approach to Smoking
Distinction between 'addiction' and 'excess' ...
- Research focuses on 'problematic behaviour' rather than 'loss of control'
- Addiction usually means ' loss of control' in which case not clear what role expectancies play in development of addiction
Changing expectancies helps prevent relapse...
- Nicotine patchment studies are inconsistent
- Moolchan et al found nicotine patchment could work along side CBT
Expectancies are important in maintaining behaviour...
- Juliano and Brandon found smokers thought cigs would stop moods, cravings & weight gain
- This is compared to NRT but expectancies so no generalise so might explain modest success
Publication bias linked to expectancy theory...
- Negative results of expectancy and addiction less attention = publication bias
Learning Approach to Gambling
- Operant conditioning - Griffiths argues that gamblers playing slot machines become addictive beacus os rewards ( psychological (near misses) and social (peer praise))
- Generally gamblers loose but don't behave rationally and care more for the wins
- Intermittent reinforcement - become addicted cause of intermittent reinforcement characteristics. they become uses to long times of no wins and reinforced by win
- Social approval - maintained due to social approval ( Lambos et al )
- Conditioned cues - if come into contact with stimuli to gambling more likely to relapse
- Approach - avoidance conflict - has negative and positive outcomes.
- When faced with urge id due to ability to control arousal and delay need for reinforcement
(A02) Learning Approach to Gambling
Operant conditioning can't explain all types of gambling...
- Some gambling have shorter time period between behaviour and consequence (scratch cards)
- Others have longer time and more to do with skill (sports betting)
Different types of pathological gamblers...
- Behaviourally conditioned gamblers start due to peers. Most likely to seek help and lease sever gambling associated difficulties (Blaszcynski and Nower)
- Emotionally vulnerable gamblers have anx/dep and poor coping. Needs to be treated for.
Can only explain why some people become addicted...
- Lots of people receive rewards and do not become addicted. Other factors involved.
Occasional reinforcement may be enough ...
- Learn adaptive behaviours that work to advantage. Provided that there are wins sometimes.
Learning Approach to Smoking
- Availability of role models - Social learning theory - young people begin smoking cause of social role models who smoke around them. They learn to expect positive physical and social.
- Popularity as a positive reinforcer - being popular among peers is a positive reinforcer. Mayeux et al found a + correlation between smoking at 16 and popularity 2 yrs later
- Repetition leads to conditioned association between sensory & reinforcing effects of nicotine.
- Sensory cues become conditioned stimuli & activate same brain areas as nicotine making cessaition difficult cessation
- Conditioned Cues - cues associated with receiving nicotine makes more likely to smoke
- Refusal self-efficacy - those who smoke often have less confidence in ability to quit (Lawrence and Rubinson)
(A02) Learning Approach to Smoking
Research support for importance of role models ...
- Diblasio and Benda found adolescents who smoke 'hang out' with others who smoke
- Karcher and Finn found youths who parents smoke 2x likely to smoke. 8x likely if friends
Support for importance of conditioned cues...
- Thewissen et al tested importance of enviromental cues. (33 smokers room 1 cues for smoking room 2 no smoking.) cue to smoke led to greater urge to smoke
Role of conditioned cues has implications for treatment...
- Drummond et al treatment based on presenting cues without ability to smoke
- This leads to stimulus discrimination, without reinforcement association is extinguished
Gender bias in smoking research ...
- Development in addiction differs for men and women (Lopez)
- Women start smoking later (Nerin de le puerta and jane)
Risks in Development of Addiction (Stress & Peers)
- People report to smoke, gamble etc to cope with stress. stressors may contribute to initiations and continuation and also relapse (NIDA)
- People exposed to sever stress (abuse) are more vulnerable - PTSD is linked to addiction
- Driessen et al found that 30% of drug addicts and 15% of alcoholics suffer from PTSD
(Peers) Social learning theory
- Smoking is learned through observation of others and limitation of their behaviour
- Once smoking behaviour starts, individuals experiences with it & determines whether it persists
(Peers) Social identity theory
- Adopt to group identity. If dubbed 'smoker' or 'non smoker' more likely to be similar to each other.
(A02) Risks in Development of Addiction (Stress &
Smoking may increase rather than decrease stress...
- Smoking may actually increase stress - periods in between smoking can be stressful as desire for a fag can be a mental strain
Stress may create vulnerability for some but no all ...
- Cloniger suggests 2 types of alcoholics. (type one explains vulnerability)
- 1.to reduce tension (depression) 2.to relieve boredom (risk taker)
Research support for role of peer pressure...
- Duncan et al claims exposure to peer models increase likelihood teenagers will smoke
- Eiser et al claims perceived rewards like popularity is why youth begin to smoke.
Lack of support for Social learning theory as an explanation of smoking...
- Little is known about extent to which group influence members to smoke. Nor do we know if youth conform when behaviour contradicts beliefs (healthy life style)
Risks in Development of Addiction (Age & Personali
- Influence of peers on smoking and drug use decreases in later adolsecnets
- Close friends and romantic partners become more important on influence of attitudes on behaviours)
- 'addictive personality' can explain why some people get addicted when others dont despite the similar environment factors
- Neuroticism and psychoticism - Francis found a link between neuroticism ( prone to negative effect) and psychoticism ( prone to hostility and and impulsivity)
- Tri - dimensional theory of addictive behaviour - (Cloniger) three personality traits the predispose to substance dependence
- novelty seeking
- harm avoidance
- reward dependence
(A02) Risks in Development of Addiction (Age & Per
Ethical issues ...
- 'threat of sanction' - the possibility that research may revel incriminating info
- researcher must weigh the potential benefits of helping addicts against risks of discrimination
Research is only correlational...
- Teeson et al - difficult to see effect of personality on addiction.
Evidence personality is a cause of addiction...
- Belin et al placed rats in a device where could give cocaine on its own.
- 2 groups where 1 was sensation seekers took lots of high doses but 2 was high impulsive and became addicted.
Addictions may be rewarding for those with a hypersensitive dopamine system (HDS)...
- Buckholtz et al addictions are more rewarding for personalities as they have a HDS (anticipate reward)
Media Influences on Addiction ( Films)
- Method: 61 scenes from 47 films were analysed regarding addictions to sex, alcohol, drugs, tobacco and gambling
- Results: enjoyment of drugs was often contrasted with dullness of everyday life. Use of drugs was seen as way of alleviating problem
- in Human Traffic ecstasy was portrayed as relieving relationship problems for main characters
Waylen et al
- Suggests media can influence teens smoking
- Method: Examined 360 of top box office films between 2001 and 2005. Including ones that depicted smoking
- Results: They found teenagers that watched films showing smoking were more likely to start smoking. Even when factors like social influence were controlled.
- significant relationship between teens smoking and number of films with smoking seen
(A02) Media Influences on Addiction ( Films)
Do film Portrayals affect behaviour?...
- Sargent and Hanewinkel surveyed 4384 teens and resurveyed a year later
- Those who didn't smoke in first servey found films were predictor if they start year later
Importance of film representations of addiction...
- Byrne argues films like trainspotting is important as it educates public an addicts on addiction
- e.g knowledge of ECT doesn't come from writing but from one flew over the cuckoos nest
- Boyd argues films show negative affects not positive ones.
- e.g drug use is shown with prostitution, violence and worse morals
- Office for Substance Abuse Protection (OSAP) guidelines for drugs in films told to show as unhealthy. Presented as disease no 'recreational'
Media Influences on Addiction ( Change )
Suitable role for the media
- Tv and internet could be used for support to addicts.
- Increasingly being used to promote healthy lifestyles. (stopping smoking & getting fit)
Problem drinking TV programmes
- Bennett et al assessed psst...really useful guide to alcohol. viewers showed improved knowledge but no change in attitude or consumption
- Krammer et al assesses effectiveness of Drinking less? Do it Yourself! a 5 week self help intervention to stop drinking (intervention group was more successful than control in achieving low - risk problem drinking.)
- 2008 advert campaign launched in UK to show teens danger of cocaine.
- Dog (Pablo) that is used to carry Cocaine. Dog seeks out the users to see what happens after consumption
(A02) Media Influences on Addiction ( Change )
Competitive media drives people to use durgs...
- Brian Wilson - creator of Beach boys uses LSD and weed as influence.
- Cocaine addiction stopped contributing to creative process and was self - medication
- Krammer et al study - Drinking less? intervention group and control group who watched it after
- intervention group received weekly visits - attention may explain positive outcomes
- waiting list group may have postponed behaviour change until vists
Correlation isn't same as causality...
- Most of evidence is correlational - doesnt indicate relationship between exposure and addiction
Do antidrug campaign work?...
- Hornik et al found that that the national youth anti drug media campaign failed and had negative effects
- Adverts implied drug use was common so felt friends were probably doing it and so did it themselves
Theory of Planned Behaviour (Main assumptions)
A persons decision to engage in an behaviour can be predicted by their intention to engage. intention is a function of three factors...
1. Behavioural attitude
- Individual attitude towards the behaviour. This is formed on the basis os beliefs of consequences on performing this behaviour and an appraisal of the value of the consequences
- The individuals subjective awareness of social norms related to behaviour
- Includes 'injunctive norm' (perceived right thing) and 'descriptive norm' (what others do)
3. Percieved behavioural control
- More control people believe they have over a behaviour the stronger the intention to actually perform it will be
- An individual with higher perceived behavioural control is likely to try harder and persevere
(A02) Theory of Planned Behaviour (Main assumption
Theory of Planned Behaviour (TPB) had been criticised ad being too rational...
- Fails to account for emotions, compulsions or other irrational parts of human behaviour
- The presence of strong emotions may explain why some people act irrationally by failing to carry out intended behaviour even when best interest to do so (e.g stop drinking)
TPB ignores other factors...
- Topa and Moriano suggest that group variables such as identification with peers could play a mediating role in any addictive behaviour
- Klag studied 350 substance abusers in Australia and found recovery was more successful when choice to quit was own
Methodological issues with TPB...
- When attitudes and intentions are assessed by questionnaires it may be affected by self presentation biases so may be poor predicators of actual behaviour. (all correlational)
Theory of Planned Behaviour ( Addiction Prevention
Changing behavioural attitude -National Drug Control Policy seen to successfully lowered weed use by creating diff attitude
Changing subjective norms -When accurate data is given in campaigns it should corrcet subjective norms
Perceivedbehavioural control - Godin et al found three elements of the TPB explained intentions, whereas perceived behavioural control was most important predicator
Self - efficacy - The TPB proposes intentions to change behaviour will be stronger in people who have increased sense of control. it has been shown to be important preventing addicition.
Promoting health behaviour change - Webb et al analysed 85 studies of internet based interventions and concluded that those based on a theoretical model.
Addiction to sun - White et al examined sun protection intentions and behaviours of young people in Australia. Results showed TPB components were significant predictors of intentions to engage in sun protection. These intentions were significant predictors of actual sun protection behaviour.
(A02) Theory of Planned Behaviour (Addiction Preve
Implications when trying to change behaviour...
- Can distinguish between motivational phase that results in formation of a behavioural intention and post - decisional phase that involves behavioural initiation and maintenance
TPB doesn't distinguish between intention and expectation...
- Distinction should be made between persons planned behaviour and perceived likelihood
- intention may have a less casual effect on behaviour, a behavioural expectation is less likely to do so ( Armitage and Conner)
TPB predicts intention rather than behaviour change...
- Armitage and Conners meta analysis found more was successful in predicting intention to change rather than behavioural change
- TPB may be account for intention formation rather than specifying the process involved in translating the intention into action
Types of Intervention (Biological)
Heroin addiction and Methadone
- Methadone mimics the effects of heroin but is less addictive
- A drug abuser is given slowly increasing amounts of methadone to increase tolerance
- Then the dose is decreased until the addict no longer needs methadone or heroin
Drug treatments for gambling addiction
- Drug treatments haven't been approved for gambling in the UK but there is evidence it is effective
- SSRIs increase serotonin levels. Hollander et al - gamblers treated with DDRIs showed improvements compared to control group
- Naltrexone (Dopamine receptor antagonist) reduces the rewarding and reinforcing properties of gambling, thus reducing urge to gamble.
(A02) Types of Intervention (Biological)
Problems with methadone treatment...
- Some drug addicts can become as reliant to methadone as heroin so they are substituting one addiction for another addiction
- The use of methadone remains controversial. Stats show more than 300 methadone deaths in 07'. Methadone consumption is unsupervised which creates black market for methadone
Drug treatments for gambling addiction...
- Hollander study only involved 10 people. A bigger study (blanco et al) involved 32 peeps over 6 months and failed to demonstrate any superiority for the drug treatment over a placebo
- Use of naltrexone led to decrease in gambling thought and behaviours after 6 weeks treatment
- Cohen and Cohen - 'clinician's illusion' phenomenon
- Clinicians believe addictions are hard to treat as only come across advanced addicts
Types of Intervention (Psychological)
- One way to reduce addiction is to reward people in NOT partaking in the behaviour
- Sindelar et al tested people on methadone treatment (and counselling) one group was rewarded when tested negative for drugs. At the end the reward group and 60% less positive urine sample
Cognitive behavioural therapy (CBT)
- Main goal is to make people change the way they think of addiction and new ways to cope
- e.g. cognitive errors (believing say in outcome) is a major part in addiction. CBT can fix it.
(A02) Types of Intervention (Psychological)
Reinforcement does not address underlying problems...
- Although reinforcement studies have shown to be effective it doesn't address reason for addiction
- Although specific addiction had been death with individual may engage in new addiction
- Drug addict into alcoholic. However usually less big like excessive spending.
Research support for CBT...
- Ladouceur et al randomly allocated 66 pathological gamblers to a cognitive therapy or control group. 86% of treatment group were no longer classified pathological gambler (increased self - efficacy)
- Sylvian et al evaluated treatments that look at cognition and behaviour.
- cognitive therapy, social skills training and relapse prevention and improvements lasted a year
Types of Intervention (Public Health)
The NIDA study
- Government - sponsored intervention projects like the US National Institute on Drug Abuse (NIDA) collaborative cocaine treatment study are designed to intervene in the cycle of personal and social problems associated with drugs
'Quitlines' Telephone smoking
- Stead et al found smokers (18,000) who received many quitline calls increased odds of quitting by 50%
- This is compared to smokers who did self help or brief counselling
Prevention of youth gambling
- Messerlain proposed a prevention model based on research into pathological gambling in adolescents using demoralisation, protection, prevention & harm reduction principles
- Example: programmes based on prevention include early identification strategies as an attempt to avert at risk youth from gambling
(A02) Types of Intervention (Public Health)
Public health interventions...
- NIDA intervention led to reduce cocaine use
- Associated reduction in other studd (unprotected sex - less HIV) ( Crits - Christoph et al)
- Research hasn't shown one therapy more effective than another but that most effective when psychological therapies are sued with effective treatment
Real world application of 'Quitline'...
- Military often take up or increase smoking when abroad
- Beckham et al found quitline and nicotine replacement was effective in stopping smoking
Public health approach to youth gambling is important because...
- Proactive approach to potentially devastating problem. (Can lead to strained relationships, depression, and even suicide.)