Models of addiction

Specific diagnosis - either addcited or not

more susceptible to addiction in initiation phase

3 main explanations 

1. Neurotransmitter imbalance

Neurotransmitters = chemical messengers, If the checmical is blocked or re-uptaken too quickly, it affects psyiological system, cogitions, mood and behaviour. Most common neurotransmitter in addiction is Dopamine.

Dopamine has a role in the regulation of mood, emotion and in motivation and the reward process. 

There are several Dopamine systems in the brain, the most developed one is the Mesolimbic Dopamine.

In normal dopamine activity, the mesolimbic system releases small amounts of deopamine into the synaptic gap. Low levels of dopamine lead to relatively stable mood states.

Specific diagnosis - either addcited or not

more susceptible to addiction in initiation phase

3 main explanations 

2. Brain structure 

Leibman and cooper (page 5) - people who are susceptible to addictions might have inherited a more sensitive Mesolimbic Dopamine Pathway.

Some people may have a more sensitive Nucleus Accumbens, which is a collection of cells in the mesolimbic system which triggers the reward pathway in the brain. A more sensitive collection of these cells leads to an overproduction of dopamine, which leaves the person at greater risk of developing an addiction.

Specific diagnosis - either addcited or not

more susceptible to addiction in initiation phase

3 main explanations 

3.Gennetic inheritance 

Overstreet et al - genetic preference in alcohol for rats
Nielsen et al - found a relationship between certain gene varients and heroin addiction

Growing eviddence that addictions can be casued by genetic inheritance. Can be a lack of a gene that makes someone more vulnerable to addiction.

There is evidence that genetics can cause people to take up smoking.

Lerman et al - have shown that people who inherit the SLC6A3-9 gene are less likely to take up smoking that those without it. The gene has a role in controlling levels of dopamine 

Smoking causes activation of pleasure centres of the brain, such as the Mesolimbic Dopmaine Pathway.

Physical dependance theory suggests people become addicted to smoking because they have become tolerant to nicotene, so will need to smoke more to get the same effect.

Stopping smoking can result in unpleasant side effects when withdrawing from their addicctive behaviour, such as sweating, shaking and increased heart rate ad blood pressure.

Shacter - compared how many cigarettes different smokers needed to smoke each week. Some participants were given cigarettes with a low nicotine content, some where given high nicotine content cigarettes. Participants smoking low nicotine cigarettes smoked more than those with high nicotine cigarattes, on average 25% more. This was refered to as the Nicotine regulation model.

Harrison et al - Rats trained to give self nicotine and electirc shocks at the same time, when stopped they experienced withdrawl symptoms, and self administration increased, suggesting nicotine makes other behaviours more enjoyable.

Altman et al - Suggests nicotine affects central nervous system by increasing dopamine levels.

Corrigal and Coen - Showed it is possible to train rats to slef administer nicotine to provide posistive feelings.

Sabol et al - SLC6A3-9 gene increased peoples ability to quit, not having it, meant people were more likely to maintain

Kendler et al - Suggests heritability of nicotine dependence is estimated between 60-70%

Physical dependence theory means that people who have maintained will have a high tolerance, and will therefore be intaking high levels of nicotine, this means withdrawl symptoms will be worsened. withdrawl symptons can be stopped by relapsing and resuming smoking.

Lerman et al- Smokers who are deprived of nicotine show increased blood flow to certain parts of the brain, shown on a scan. Tested regular smokers just after a cigarette, and then after a single night of abstaining. Results showed that after that night, there was increased blood flow to parts of the brain concerned with attention, memory and reward. These parts of the brain are active when craving a cigarette.

Research also suggested that some people are more prone than others to cravings because changes in brain chemistry, which helps to understand why some people are more likely to relapse than others.

biological explanation says that initiations could be explained by the physical response that gambling generates in the body. Placing a bet is followed by a period of  anticipation where the body responds and prepares with increased heart rate, and a flow of adrenaline. Burst of energy associated with adrenaline rush is highly addictive. Initiation is directly related to positive reward of adrenaline rush.

Comings et al - found pathological gamblers were more likely to carry the D2A1 gene, suggesting a genetic predisposition to gambling

Rugle andMelamed - Showed EEG scans of problem gamblers are similar to children with ADHD. suggests that gambling addicts have trouble controlling their behaviour.

Wray and Dickerson - gamblers who are prevented from gambling often report changes that are simialr to withdrawl symptoms. Not as intense as smoking withdrawl symptoms, but are still highly influential in helping a gambler to decide whether to maintain their behaviour.

Potenza et al - investigated men diagnosed with pathological gambling disorder. Showed the gamblers and non gamblers tapes of gambling. Gamblers showed diffrent blood flow in their brains, compared to non gamblers, usually a decrease in blood flow to an area of the brain that regulates impulse control. Differences not observed when showed neutral videotapes, so must have been connected to gambling

An addiction to gambling could have alot to do with a gamblers inability to control their behaviour, meaning they cant stop themselves.

It was also found that gamblers lack control in other control areas such as aggression, and decision making. 

Gamblers experience withdrawl symptoms. Milder than quitting a drug but are still felt. Withdrawl symptoms can be stopped by re-engaging in addictive behaviour

withdrawl symptomscan include: anxiety, increased heart rate, raised blood pressure, mild tremors and sweating. 

Rosenthal and Lesieur - over 60% of pathological gamblers reported these side effects durring withdrawl, and were even sometimes more severe than those reported by a comparison group withdrawing from drugs.

Ciarrochi et al  - gambling addicts often have other addictions. \when giving up gambling, people may switch their attention to their other addicitive behaviour. When that becomes to much of a problem they switch back to gambling to maintain a rewarding feeling.

The cognitive model of addiction is based on the way peoeple think and faulty processes or biases. Faulty cognitions are thought to effects maintenance but not inititation.
Split into 3 main points

Coping 
The idea that peoeple engage in addicitive behaciours because they think it will help them cope better with stress in their lives, in 3 main ways
1. mood regulation - (increase positive moods and decrese negative moods)
2. Performance enhancement - (might make the person feel more alert)
3. Providing a distraction - (distraction from less pleasant life experiences)

Expenctancy
If people have positive expectations about a behaviour they are more likely to want to do it. If their expectations are negative they are less likely. Hansen - alcoholics expected fewer negative consequences from drinking.

Self-efficacy
(Bandura) Refers to our belief of whether or not we can control our behaviour, and its effetcs. High self efficacy means we are more likely to undertake the behaviour.

Smokers have high expectations of smoking including

• looing attractive to the opposite sex
• facillitating social interaction
• control apetite and weight gain

Use it to cope with boredom, stress etc.

Self efficacy can be applied, as people think it may be asy to quit before they start, ("I can quit anytime, I won't get addicted) 

Becks vicious circle of addiction 

• Low mood
• Using (smoking)
• Problems (health)
• back to Low mood

Coping can also help explain why people maintain their addictictive behaviour. People continue to smoke because nicotine allows them to concentrate longer or engage in repetitive tasks without getting bored.

Self efficacy - when a person starts smoking they usually believe they can quit at any time, if they still thought it was easy to quit then they might do so. 

Coping, Self efficacy and expectancy can all be used to explain relapse.

Coping - negative feeling of withdrawl can be relieved by smoking another cigarette. Helps them cope with withdrawl symptoms. 

Self efficacy -  if a relapsed smoker has given up once they may feel they can do it again whenever they want

Expectations  - high expectations about winning may influence a person to start gambling

Coping - gamlbing may help a person cope with boredom 

Self efficacy - believes they won't get addicted because it is not physical, will be able to control behaviour

Beck's vicious circle - 

• Low mood
• Gambling 
• Financial/social problems

Coping - ocassional win makes them feel good, helps them cope with negative experiences

Self-efficacy - people don't see it as a problem, "it's just a bit of fun"

Expectancy - perceived benfits can be huge, motivated by storied of people winning millions on lottery, horse racing etc.
Gamblers see a possibilty that their actions will be life changing, ocassional wins reinforce these expectancies
Delfabbro and winefield - 75% of game related thoughts in gamblers are irrational and encourage futher risk taking  
Sharpe, Tarrier and Schott - irrational cognitions helps maintain arousal

Relapse can help them cope with the boredom of not gambling

Griffiths - 30 regular and 30 non regular gamblers given £3 to gamble on a machine that gave 30 free spins. each gambler was set the objective to stay on and try to break even in 60 gambles, and win back the £3. If they succesfuully completed the 60 gambles they could choose to keep the money or carry on. Half the group were asked to talk aloud to gain direct access to thoughts and thinking processes.

The result was that the regular gamblers had more irrational thoughts (14%) compared to non regular gamblers (2.5%). They also believede more skill was involved in gambling.

• regular gamblers believe they are more skillful than they are
• Gamblers know they will lose and play with money not for it
• regular gamblers make more irrational verbalisations demonstrating cognitive bias

split into behaviourism (classical and operant conditioning) and social learning theory (0bservation and imitation of role models through vicarious re-inforcement). These ideas often overlap with each other.

Claasical Conditioning - A person growing up in a family of smokers may have witnessed how those people respond to the experience, and will be conditioned to associate smoking with satisfaction, and pleasure making them more likely to start smoking

Social Learning - A person may have observed significant role models smoking and seen the rewards that the smoker gets such as relaxation and pleasure. 

Peer pressure can also influence a person to start smoking, friends and colleagues making fun, name calling and taunting won't stop until a the person smokes a cigarette. Smoking will also allow them to access the social network, and reduces the teasing, making them feel happier

Bandura - proposed that observing a role model getting pleasure from a cigraette might be enough for a child to start smoking , Supported by:
National Institude on Drug Abuse - 90% of american smokers started as an adolescent
Winett et al - role models with a higher social status are more influencial
Brynner - Media images of smoking show it as attractive and tough supportin SLT
DiBlasio and Bend - Found that initiation of smoking was found to be heavily influenced by peer group association

Classical Conditioning (Cue reactivity) - Addicts react to cues associated with smoking. Cues could be lighters, boxes of cigarettes, lighters etc.

Peer Pressure - Pressure people feel to take up smoking remains dominant throughout their smoking life. People mix with smokers, making it more difficult to quit.

Smoking can be a ritualised habit

Ogden - found a relationship between peer group identity and tobacco use in the USA, suggesting it is an important factor in the maintenance of smoking 

Cue reactivity theory - cues may make an ex smoker crave a cigarette, pressure to return to smoking is all around them. 

Shiffman - Administered a questionnaire to ex-smokers who had relapsed, asking them why they had started smoking again. reported that smokers were more liely to relapse if they were in the presence of other smokers or cigarettes were readily available.

Start of gambling behaviour  can be explained in a similar way to smoking. Person sees another winning on a slot machine or reads about a person winning the lottery, anticipation of a win may drive them to place first bet.

Bandura -  observing a role model winning on a fruit machine might be enough for a child to begin gambling. 
Once they have started, the excitement thy experience associated with gambling reinforces posistive feelings about it. 
Early successes, and ocassional wins also help reinforce this.
Gambler becomes addicted to behaviour as this continues 

Sharpe - large pay outs and big wins early in the gambling career help to establish and sustain patholgical gambling.

Gambler continues addictive behaviour because of rewards they recieve, (monetary - money, or physical - excitement of gambling). Placing a bet provides the encouragement and reward to continue gambling. Constant association with excitement also reinforces the relationship between the two.
Gamblers don't win all the time, making the urge to gamble stronger. This is because gambling provides partial reinforcement, a shedule of reinforcement which produces very persistent learned behaviours. Infrequency of winning maintains behaviour

Skinner - found infrequency of wins were a strong preditor of behaviour. e.g if you play and are rewarded every 5th time it increases behaviour, if you win every time, the urge would not be as strong 

Peter and Griffiths - Lights, colours and sound effects of a fruit machine might affect likelyhood and strength of addiction, by offering positive reinforcement of behaviour and its environment 

Cue reactivity - cue assoiated with gamlbing are all around: arcased, betting shops, scratch crds etc. Fruit machines are also found in public places and the internet has many online casinos, and opportunities to gamble. Cues generate feeling associated with gambling including anticipation and excitement, and can lead to relapse

Cummings et al - Gamblers more likely to relapse when experiencing negative emotional states. 20% of all relapses attributed to social pressure.

Cue reactivity - cue assoiated with gamlbing are all around: arcased, betting shops, scratch crds etc. Fruit machines are also found in public places and the internet has many online casinos, and opportunities to gamble. Cues generate feeling associated with gambling including anticipation and excitement, and can lead to relapse

Cummings et al - Gamblers more likely to relapse when experiencing negative emotional states. 20% of all relapses attributed to social pressure.

Cue reactivity - cue assoiated with gamlbing are all around: arcased, betting shops, scratch crds etc. Fruit machines are also found in public places and the internet has many online casinos, and opportunities to gamble. Cues generate feeling associated with gambling including anticipation and excitement, and can lead to relapse

Cummings et al - Gamblers more likely to relapse when experiencing negative emotional states. 20% of all relapses attributed to social pressure.

Cue reactivity - cue assoiated with gamlbing are all around: arcased, betting shops, scratch crds etc. Fruit machines are also found in public places and the internet has many online casinos, and opportunities to gamble. Cues generate feeling associated with gambling including anticipation and excitement, and can lead to relapse

Cummings et al - Gamblers more likely to relapse when experiencing negative emotional states. 20% of all relapses attributed to social pressure.