Theories of Addiction
State of being enslaved to a habit or to something that is psychologically or physically habit-forming, to such an extent that its cessation causes severe trauma
Biological 1990’s Nobel et al. A1 variant present in 2/3 deceased alcoholics 1/5 of deceased non-alcoholics. Also had fewer dopamine receptors. DRD2 gene as the ‘reward gene’ 48% severe alcoholics & 32% less severe alcoholics carried variant. Comings in 1991 A1 variant was present in those with autism and Tourette’s, the idea that this gene is known as the ‘reward gene’ really pleasure seeking? Fowler et al in 2009 genes & environment
Rational choice theory: Becker & Murphy 1988 'utility' addicted smokers continue may demonstrate control, perceive the costs of stopping to be greater than the benefits
CC. Drug’s effect UCS, defensive response UCR as it tries to restore the body back to normal.
Stimulus that precedes a drug CS leading to CR anticipation the body has on the drug effects. CR occur in the absence of drug effects out of equilibrium = withdrawal symptoms
Robins et al in 1975 Vietnam veterans less likely to relapse in addictions rather than civilians due to different environments. Drummond et al in 1990 treatment approach, presenting cues without chance to engage in the drug taking behaviour = stimulus discrimination, no reinforcement by the drug the association cue and drug taking is broken reduce cravings
Treatments of Addiction
state of mental or emotional strain or tension resulting from adverse or demanding circumstances e.g. fight or flight’ & GAS
Lazarus’ cognitive appraisal: stressor: prevent the experience of stress is to deal with the situation that triggers stress. Systematic desensitisation: perceived threat from stressor. Stree inooculation added by Meichenbaum. Conceptualisation, analyse diff features of situation. Skills training, real life application. EVAL: gain confidence but £ and time.
CBT: encourages participants to be realistic on ability to cope, considering alternative assumptions. Clark in 1999 looked at effectiveness of briefer (cost effective CBT form) p's had panic disorders FCT & BCT. Both significantly better than contol but no diff between 2 groups. Hardiness training: example of management, uses CBT. Assesses stress amount & hardiness of attitudes. Focusing: patients are trained to stop stress signs & identify stressors. Analyse these stressful situations & think of resolutions. Challenges to show how they cope.
US military personnel were assessed before combat. Experienced life threatening situations had higher hardiness levels = less likely to develop PTSD. Sample Bias & Ethics
Physiological: Beta-blockers, high BP BZ's enhances action of natural brain chemical, GABA excitatory NT reduced & p calmer. £ & work quick, addictive & SE, attack root cause?
Factors affecting Health
Age: childhood SLT. Ross 87, weight affected by parents’ exercise habits. Klesges et al 93 children can own decisions, TV viewing partly controlled important factor of weight gain, children are capable of making informed decisions but impact later life.
Adolescence: own decisions & social factors. Eiser (1997) estimated 50% adolescent illnesses & deaths preventable due to negative health behaviours e.g. substance abuse. 'invincibility fable’- where they believe it won’t happen to them. Adulthood: Greendale et al 95 retrospective study 1700 men and women to rate exercise levels as teenagers, at 30 and then at 50. Both sexes with highest activity levels had higher bone mineral density. remembered accurately? Elderly: Fiatarone 94 after 10 weeks, frail nursing home residents 72-98 resistance training 3 times a week were able to walk faster & increased stair-climbing ability by 28%.
S/E status: low paid & long hours. Warren & Schwartz 03 BP was lower in normal 9- 5 Generalise? Wealth = better HC. Blair 93 language is important, doctors of high SES more likely to be incomprehensible to patients of low SES status. Reliable?
Gender: Arber 1999 men 15-44, 3x higher mortality rate than women from accidents& suicide. Women mental health problems 'carer' provision focus on reproductive roles. Arber 1999 US females less likely to receive kidney transplants than men in the UK women are less likely to be offered a coronary heart bypass. Ethnocentric. 1994 statistics show that 15% of women over 65 suffered disabilities that needed daily help compared to 8.5% of men aged 65+
Issues in Health Promotion
process of enabling people to increase control & improve health. Moves beyond focus on individual behav towards range of S&En interventions.
Yale’s MoC, 1950's. Research programme set up as a response to increasing role of mass communication in £, P & S spheres. Hovland 1953: communicator - credibility source. communication - persuade someone their health is a risk, frighten people = more likely behaviour change, majority of health promotions contain element of fear arousal = ego defence mechanisms to cope = reduce chance of chane. audience = susceptible to persuasion ethics?
HBM) (Rosenstock 1966, Becker & Rosenstock 1984) helps to predict and explain people’s health behaviour. Influencing factors - internal = pains, external = health campaigns & social pressures. Beliefs of threat of illness & preventative action. Actions: action to prevent illness depending on both factors & beliefs. Specific. E.g. education on a population would be more beneficial for targeting certain perceptions, medical procedures (Reminders for screening tests) and barriers to use (challenge the social embarrassment to promote condom use) easily applied: Marks et al 2000 found only 10% accounted variance in behav when V & behav combined, only predict & purely a cognitive
Issues in Health Promotion 2
Locus of control Ajzen 1991, self-efficacy & perceived behavioural control the same. Povey (2000) argued that perceived control is made up of two components Bandura’s self-efficacy & perceived control over the behaviour. Wallston et al (1978) scale specifically designed to measure the extent to which people perceive their state of health as being under internal or external control. Multidimensional health locus of control scale (MHLC)
Internal Health locus of control: strong IHLC feels responsible for their health. . Powerful others health locus of control others are responsible for your own state of health, strong PHLC are less likely to take personal responsibility for changing. Chance health locus of control less likely to take responsibility for looking after their own health
Bandura 1977 self-efficacy: “belief in ones capabilities” 4 sources contribute to type of locus of control we have: social modelling (others succeed = motivation to do well) Mastery experiences (being able to successfully preform a task) social persuasion and our psychological responses.
Townsend 1993 adolescents 13-17, smokers and/or drinkers. Regular smokers = smoked at least 1 cigarette a week. Those who had lower internal locus of control were regular smokers & drinkers had low scores compared to powerful locus of control. Teenage smokers have lower belief in the ability to control their own health & as a result to strengthen self-efficacy could reduce smoking levels preventing issues in later life. Hard to generalise