Addiction Prevention and Intervention

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Theory of Reasoned Action (TRA)

AJZEN and FISHBEIN (1980) developed a theory to explain how beliefs are linked to intentions and how to behave. Behavioural intention is determined by percieved facts and their personal consequences and social norms. - enables clear predictions about behaviour to be made
- but the model assumes there is a direct link between thoughts and behaviour 
- model also limited the effect of attitudes and social norms on behavious and people behave rationally.

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Theory of Planned Behaviours (TPB)

AZJEN (1988) modefied the TRA model to introduce percieved control which is affected by past experience and current obstacles. Percieved control may act on behavioural intention or may act directly on behaviour and so explains why intention is not always linked to behaviour. - model assumes behaviours are consciencs , reasoned and planned. 
-TPB is supported by OH AND HSU (2001) who sent questionnaires to 400 gamblers living in the US asking them about past gambling behaviours, attitudes, social norms, percieved behavioural control and imtentions. Two months later they sent out a further questionnaire and found significant positive links between attitudes and behaviour.

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Biological Intervention

- Detoxification programmes: requires medical supervision. The approach is to gradually reduce the substance or quit in one go.
- Drug Maintenance therapy: subsitute drugs are given, such as nicotine gum for smokers and methadone for heroine addicts. Methadone can become addictive but it is given thru the mouth and it is not euphoric. 
- Antoganist drugs: block or change the effects of the addictive drug. for example the drug antabuse is given to alcoholic; if they drink anything alcoholic they feel nauseous similar to a hangover
- CALLAHAN (1980) found methadone therapy was successful as long as addicts were prevented from continuing with other substances.
- Detoxification programmes tend to have high drop out rates as they are not pleasant and take considerable willpower.
-biological treatments are not effective with psychological addictions 
- biological interventions assume addiction is purely biological, however most bio int should include psychological components to work. AMATO (2004) methadone treatment programmes had significantly improved success when used in combination with psychosocial interventions.

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Psychological Interventions

- Aversion therapy - a negative effect is paired with the abused substance to recondition the patient, like antabuse.
- Contingency Management (CM) - uses principles of operant conditioning; addicts are given rewards each time they preduce drug-free urine samples. HIGGINS (1994) found that 75% of cocaine addicts using CM plus psychotherapy completed the programme.
- Cognitive-behavioural therapy - self-help groups target the way a person thinks about their addiction. They include behavioural self-control training where patients are asked to keep a record of where and when they abuse, so they become aware of when they are at risk. Also taught coping stratagies such as relaxation to resist temptation.
- self-help groups, such as Alcoholics ananoymous provide social support and successful role models.
- GLASGOW (1985) found that people stop smoking by using oral substitues, or rewards for quitting and punishments for backsliding.
- FERRI (2006) reviewed research of AA 12 step programme and did not find any greater success than other programmes.
- US sergeon general found 95% smokers quit on their own.

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Public Health Intervention

- outlawing drugs may prevent some usage but it means that the sources are not regulated, allowing poor substance and association of crime. 
- MCGUIRE (1964) suggest that you can prepare people to resist temptation by giving a strong set of counter arguments and 'supportive defence'
-the use of fear may increase the persuasiveness of a message. Like anti-smoking campaigns that show a picture of a diseased lung.
- The New Zealand Gov has recently launched a campaign to reduce problem gambling. The primary target is raising general public awareness, but also to focus on high risk groups such as young males.
- campaigns that are based on models of behaviour change are more likely to become successful 
- the anti-smoking ban in the UK resulted in an 11% drop in cigarette sales during the first month of the ban.
- McAlister (1980) found local health promotion campaign used in high school reduced the likelihood of smoking by half.
- campaigns are more effective if they target 'risk' groups
- difficult to assess the effectiveness of any programme because of the different measures used.

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Vulnerability for Addiction

Low Self Esttem - likely to create dependancyneeds and lead to addiction
Higher rates of depression - addiction is a means of escaping reality
Greater risk takers and sensation seekers

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Attribution Theory

ATTRIBUTION THEORY is how we explain the causes of our own and other peoples behaviour.
- the fundamental attribution error, suggest people prefer to explain their own behaviour using situational attributions and tend to explain otheer peoples behaviour using dispositional expl.
- SENEVIRATNE AND SAUNDERS (2000) found alcoholics were more likely to belive their relapse was due to situational factors, whereas relapse in others was due to dispositional factos (like low willpower)
- ROBINS et al (1974) found US servicemen who were regular opium users in Vietnam found it easier to stop when returning to the US
- when people are successfully treated for addictions in a clinic they fail to transfer this to the outside world because they have attributed their behaviour to the clincal setting.

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Peer Influences/Poor Environmental Conditions

many addictions such as soking or alcohol are means of conforming to group norms and being accepted by the group. Addiction may determine ones group of friends
tension and poverty are linked with drug addiction

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