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Biological model of addiction

Initiation
Twins and families can be studied to determine how likely a person is to develop an addiction based
on how genetically related they are to others with an addiction.

Support Against
Agraval and Lynskey (2008): by comparing MZ and Heritability estimates are always below
DZ twins it has been found that 30-70% of drug 100% therefore environmental influences
addiction can be explained by genetics. should be taken into account

By genetically analysing individuals with addictions and comparing them to those without addictions
it is possible to determine what specific genes make a person more likely to start an addiction.
Specifically, addicts with an A1 variant of the dopamine receptor gene have fewer dopamine
receptors in the pleasure centres of their brains. Therefore, they are more likely to become addicted
to drugs/behaviour that increase dopamine levels, as this compensates for the deficiency by
stimulating the few dopamine receptors they have.

Support Against
Volkow et al. (2000): participants with fewer Comings et al. (1991): the A1 gene variant
dopamine receptors enjoyed the feeling of occurs in patients with disorders other than
Ritalin releasing dopamine in their brain addiction, such as autism and Tourettes,
compared to those with more dopamine indicating that the gene variant may not be
receptors. Those with less dopamine receptors specifically related to addiction.
are more vulnerable to drug stimulation which is
why some people continue to take drugs after
first trying them, whereas others do not have
more than one experience.
Comings et al. (1996): nearly 50% of smokers Volkow (2003): just because a person has fewer
and ex-smokers have the A1 variant. dopamine receptors and may be more
vulnerable, this doesnt mean that they will
definitely develop an addiction, because they
may be brought up in surroundings that are
stimulating enough to protect against addiction
e.g. if their parents encourage them to engage in
many sports and activities.
Genetic explanations help us to understand
individual differences concerning how some
people become addicted because they are
genetically vulnerable, compared to others who
do not develop an addiction despite having the
same environmental experiences.

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Maintenance
Repeated exposure to alcohol/drugs results in downregulation, which is the reduction in activity of
the reward circuit in the brain. This reduced activity causes an ongoing stressful situation for the
addict involving withdrawal symptoms and anxiety. This stress motivates them to seek more drugs,
therefore they are no longer taking drugs because they enjoy them, but instead because they are
trying to avoid their unpleasurable state of anxiety. Because the reward circuit becomes gradually
less able to respond, the addict has to consume more and more drugs to activate it.

Relapse
Drugs can affect the addicts brain by impairing their frontal cortex. This makes it more difficult for
them to make good decisions and to show self-control over their behaviour, which increases the risk
that the addict will relapse.

Cognitive models of addiction

Initiation
Self-medication model
Individuals intentionally use drugs to treat psychological symptoms from which they suffer. The
particular drug an addict uses is one that is perceived as helping with a particular problem. Initiation
of drug use, and the choice of drug, depends on the specific effect that an individual desires. Some
drugs may be chosen because they help the individual overcome anxiety, others because they
control aggressive urges. The drug may not actually improve their life, but for the individual to
become addicted it is more important that they think the drugs are relieving their symptoms.

Support Against
Sanjuan et al. (2009): sexually abused women There are many cases of addiction where there
were more likely to turn to alcohol to remove are no major psychological problems to be
sexual inhibitions. overcome.

Expectancy theories : drug use escalates into addiction because of the expectations that an
individual has about the benefits and costs of the addictive substance. Alcohol consumption is said
to be directly related to how much an individual believes it will deliver a positive effect.

Support Against
Southwick et al. (1981): heavier drinkers have Expectancy theory concerns the consumption of
more positive expectations about the effects of alcohol which may not reflect addiction, where
alcohol compared to light drinkers. there is a loss of control for addiction.
Brown (1985): heavier drinkers expect alcohol to Sher et al. (1996): gender differences should be
provide social and physical pleasure, reduce taken into consideration: men are more likely
tension and lead to greater sociability. than women to report positive expectations for
alcohol as a way of reducing tension and easing
social interactions.
Leigh (1987): people are more likely to abuse
more alcohol if they have a favourable
evaluation of it

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Maintenance
Self-medication model
When the person is addicted to the drug, the psychological symptoms they are trying to treat
become the withdrawal symptoms which are the result of not consuming the drug for a certain time.

Parrott (1998): in the short-term a cigarette relieves the stress from withdrawal symptoms, however
in the long-term, smoking increases stress so the addict needs to smoke more often. For alcohol, it
may help an individual put aside their worries and problems, however, when they develop an
addiction they will become more anxious and have more problems because of it which they require
even more alcohol to handle.

Expectancy
As an addiction develops, the activity is influenced less by conscious expectations and more by
unconscious expectations involving automatic processing, which results in the loss of control that
addicts have.

Learning model of addiction

Initiation
Operant conditioning
Any behaviour producing a consequence that the individual finds rewarding is likely to lead to the
behaviour becoming more frequent. All positive reinforcers have the same physiological effect in
that they increase the release of dopamine in the mesolimbic reward circuit. Addictive drugs
produce this biological effect. Gamblers playing slot machines become addicted because of the
physiological, psychological, social and financial rewards.

Support Against
Operant conditioning explains how an addiction Robinson and Berridge (1993): many people try
can develop without conscious awareness, which addictive drugs but only a few become addicts
makes it clearer how an addict may consciously which means that there have to be other factors
want to stop their addiction but their apart from reward which result in the change
unconscious impulsive desire causes them to from consumption to addiction.
continue.

Classical conditioning
Alcohol related stimuli elicit many of the same physiological responses as alcohol itself, such as
increased heart rate and arousal.

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Social learning theory

Learning of addictions can take place through observation and communication. Observing others
having positive experiences of drugs will increase repeated drug use. However observing adverse
drug taking experiences decreases the likelihood of the experience being imitated. The individual
observes the different effects drugs may have on people, which in turn may trigger them to take
certain drugs e.g. someone might smoke cannabis if they see that other users are relaxed by it.

Maintenance and relapse

Operant conditioning
After repeated exposure to drugs, withdrawal symptoms appear if the drug is discontinued. These
withdrawal symptoms can be reduced by using the drug again. The reduction of the unpleasant
withdrawal symptoms is negative reinforcement, so addicts constantly seek the drug to reduce such
symptoms.

Classical conditioning
The drug effect is an unconditioned stimulus which changes the biological balance inside the body.
In response to this change, there is an unconditioned response from the body as it tries to restore
balance. Any stimulus that comes before the drug is a conditioned stimulus resulting in the body
showing a conditioned response in anticipation of the effects of the drug. Conditioned responses
that occur in the absence of the anticipated drug put the body into a state of imbalance which
involves withdrawal symptoms. The individual is then motivated to continue taking the drug as a
way of reducing the symptoms from bodily imbalance which are caused by the conditioned stimulus.

Support
Robins et al. (1975): Soldiers who became addicted to heroin while in Vietnam and then returned
home to a completely different environment were less likely to relapse than those returning to an
environment similar to Vietnam which provided cues causing them to relapse.
Drummond et al. (1990): by understanding how classical conditioning leads to addiction it is possible
to apply the research to treat addiction by using cue exposure, which involves presenting the cues
associated with a drug (e.g. the sounds and smells of a night club) while preventing the opportunity
to consume drugs. Without reinforcement from the actual drug, the association between the cues
and the drug-taking is reduced (extinguished) which reduces the future cravings for the drug that
arise when exposed to the cues.

Social learning theory

Being surrounded by other drug-users who always seem to be enjoying themselves and having
positive experiences from drugs may encourage an individual to maintain their addiction.

Support
DiBlasio and Benda (1993): peer group influences are the primary influence for adolescents who
smoke or use drugs.
Botvin (2000): the social learning theory explanation of addiction can be applied to develop drug
prevention programmes. Training adolescents to refuse drugs and helping them to understand how
they are influenced by peers and adults helps adolescents to protect themselves against the drug-
taking influences in their environment.

Adam Clarke www.brain-freeze.co.uk

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Smoking
Initiation of smoking addiction
Learning model
Brynner (1969): the start of a smoking addiction can be explained by classical conditioning, through
which a person associates smoking with maturity and popularity. The strong association with such
benefits is enough for them to want to continue smoking more cigarettes even after the
unpleasantness of the first cigarette.

Social learning theory can also explain the initiation of smoking addiction, where children are twice
as likely to smoke if they have parents who also smoke. Their parents are a powerful influence on
them so the child may model their smoking behaviour. According to social learning theory, peers are
also important: 90% of US smokers claimed that they began smoking because they watched their
friends smoking (NIDA, 2000).

Jarvis (2004): children who view smoking as beneficial are more likely to come from backgrounds
that approve of smoking or from areas where smoking is common.

Maintenance of smoking addiction

Biological model: genetics of smoking addiction

Support Against
Stefansson et al. (2010): from studying over Charlesworth et al. (2010): rather than genes
140,000 participants it was found that there changing smoking behaviour, it could be that
were genetic mutations which increased the smoking changes genes, where many genes have
number of cigarettes smokers had daily and been found to be affected by nicotine.
these genes were related to nicotine
dependence.

Biological model : Effects of nicotine on the brain

Nicotine activates receptors which cause the release of dopamine in the brains reward circuit. This
release results in temporary feelings of pleasure, however such feelings fade quickly and within
hours of their last cigarette nicotine levels start to drop which result in lower mood and anxiety. The
smoker then reduces such anxiety by smoking another cigarette. Therefore the smoker has to keep
on smoking in order to reduce the withdrawal symptoms of not smoking.

Support
Khaled et al. (2009): long-term smoking can have a harmful effect on mood by changing the
chemistry of the brain, where smokers are more likely to be depressed. Their depression may make
them want to smoke more to make them feel less depressed.

Adam Clarke www.brain-freeze.co.uk

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Gambling addiction
Initiation of gambling addiction
Biological model: genetics of gambling addiction
Support Against
Black et al. (2006): first-degree relatives Coventry and Brown (1993): genetics may
(brothers, mothers etc.) of pathological gamblers influence addiction through personality,
are more likely to suffer from pathological however gamblers who betted on horse racing
gambling than more distant relatives (e.g. were found to be lower on sensation seeking
cousins). This indicates a genetic influence on than non-gamblers.
gambling because first degree relatives share
more genes in common than distant relatives.
Slutske (2010): in a study of almost 5000 male
and female twins it was found that identical
twins (who share 100% genes) were twice as
likely to develop a gambling addiction as non-
identical twins (who share 50% genes)
Alessi and Petry (2003): genetics may work
indirectly and result in impulsivity which can
increase the likelihood of developing pathological
gambling.

Learning model
According to social learning theory the desire to begin gambling can be triggered by seeing others
being rewarded for their gambling behaviour. Classical conditioning explains that the gambling
activity is associated with positive experiences.

Maintenance and relapse

Biological model
Winning in gambling triggers the release of dopamine in the brains reward circuit. Pathological
gamblers have increased activity in the reward circuit when they are gambling and even when they
anticipate gambling compared to social gamblers who tend to only have low activity in the reward
circuit while they are actually gambling.

Support
Chase and Clark (2010): pathological gamblers have more reward circuit activity while they are
gambling compared to casual gamblers.

Adam Clarke www.brain-freeze.co.uk

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Cognitive model

Gamblers often have biases, which are shortcuts in thinking that can lead to bad decisions. The
availability bias involves the belief that something is more likely to happen because it has occurred in
the past e.g. someone playing a slot machine may only remember the previous times they have won,
ignoring the times they have lost, which makes them want to play more. Gamblers also often have
an illusion of control, incorrectly believing that they can influence the outcomes of the gambling
activity.

Support Against
Griffiths (1994): Regular gamblers and occasional Dickenson and Baron (2000): the increased
gamblers expressed out loud what they were irrational talking could be due to demand
thinking while gambling. It was found that regular characteristics where the participants are
gamblers were more likely to express irrational trying to explain their behaviour to the
thoughts, such as believing that they had skill or researcher who is clearly observing them.
control over the gambling machines.

Learning model
Maintenance of gambling addiction can be explained by operant conditioning, specifically involving a
variable ratio of reinforcement. This is a predictable pattern of reinforcement, where for example
the gambler playing a slot machine may be reward after playing 10 times, then rewarded after 100
plays, 50 plays, 100 plays etc. The lack of predictability for when the reward may occur makes such
reward feel more intense and encourages the gambling behaviour to continue.

Adam Clarke www.brain-freeze.co.uk

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Risk factors
Stress
Everyday stress
Addiction is generally associated with relieving anxiety. People report that they drink, smoke, use
drugs, gamble etc. as a means of coping with daily hassles such as relationship problems, money
worries and workplace stress. Such daily stressors may contribute to initiation and continuation of
addictions, as well as to relapse after periods of abstinence.

Cloninger (1987): individual differences for reacting to stress have to be taken into consideration,
because stress can result in vulnerability to addiction for Type 1 alcoholics who drink because they
are trying to reduce worry, but not for Type 2 alcoholics who drink only to relieve boredom.

Traumatic stress
People exposed to severe stress are more vulnerable to addictions, especially children who have
experienced parental loss or child abuse.

Driessen et al. (2008): 30% of drug addicts and 15% of alcoholics also suffer from post-traumatic
stress disorder.

Peers
McAlister et al. (1984): a person may feel the need to smoke because of peer pressure, specifically
because of peer encouragement and approval of smoking as well as the belief that smoking will
make them more popular.

Eiser et al. (1991): those who give in to the peer pressure of friends who smoke are more likely to
have mostly friends that smoke, whereas those who do not smoke are more likely to be friends with
other non-smokers.

Social learning theory (Bandura, 1977): behaviours are learned through the observation of others
and subsequent modelling of this behaviour. Young people are most likely to imitate the behaviour
of those with whom they have the most social contact. After they have started smoking, whether
they continue to smoke depends on if they have good (e.g. meet new people who smoke) or bad
experiences (end up smoking outside on their own) with it.

Support
Duncan et al. (1995): exposure to peer models who smoke increases the likelihood that teenagers
will begin smoking.
Eiser et al. (1989): adolescents who perceive rewards such as higher social status and popularity
from smoking are more likely to smoke.

Adam Clarke www.brain-freeze.co.uk

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Social identity theory (Abrams and Hogg, 1990): group members adopt the norms and behaviours
that are central to the social identity of the group to which they belong. In peer groups where status
as smoker is central to the social identity of the group, individuals are more likely to be smokers. If
non-smoking status is central to the social identity of the group, they are more likely to be non-
smokers.

Support
Mitchell (1997): adolescents are motivated to begin smoking if they hold positive stereotypes about
what groups of smokers are like.

Age
Brown et al. (1997): peer influence on smoking and drug abuse becomes less powerful as the
adolescent grows up, where eventually the strongest influence is from only their close friends or
their romantic partner.

Personality
The way a person behaves can change from situation to situation, for example, you are unlikely to
behave in the same way with a teacher as you are at a party with friends. However, there is likely to
be some consistency in the way a person behaves in different situations and this is reflected by the
personality they have. To measure what kind of personality a person has, psychologists typically use
questionnaires and many have found that people with certain personalities are more likely to
become addicts.

Support Against
Francis (1996): addicts are more likely to score Teeson et al. (2002): It is difficult to determine
highly on neuroticism (experience a lot of whether personality increases the likelihood of
anxiety and depression) and psychoticism addiction or alternatively, that addictive
(hostile and impulsive). behaviour causes changes in personality.
Zuckerman (1983): high extraversion (often
bored and seeking arousal) makes a person more
likely to seek drugs or alcohol.
Cloninger (1987): a person is more likely to
become an addict if they have high scores on
novelty seeking (want new experiences), harm
avoidance (worry and fear of uncertainty) and
reward dependence (repeat behaviour which
provides reward).
Weintraub et al. (2010): People who are
naturally higher in impulsivity because of
increased dopamine levels are more likely to
become addicted.

Adam Clarke www.brain-freeze.co.uk

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Media influences on addictive behaviour

Support Against
Gunasekera et al. (2005): reviewed 87 of the Boyd (2008): films frequently do present the
most popular films over the past 20 years found negative consequences of alcohol and drug
that 1/3 of the movies portrayed alcohol use and dependence such as physical problems,
around 2/3 showed smoking. Only the positive experience of sexual abuse, and violence.
consequences of drug use were shown and not
the negative effects.
Sulkunen (2007): analysis of 47 films found that Bennett et al. (1991): viewers watching a TV
many of the scenes presented drug competence series for problem drinking had improved
as a way of reducing particular life problems as knowledge concerning alcohol, however, the
well as scenes involving enjoyment of the drug series was ineffective because it did not change
effects in contrast with the apparent dullness of their attitude or actual alcohol consumption.
daily life. This is evidence against media having a role in
changing addictions.
Sargent and Hanewinkel (2009): more than 4000 Hornik et al. (2008): an anti-drug media
teenagers were surveyed and it was found that campaign in the US used TV, radio and the
for those who were non-smokers, exposure to internet to spread messages concerning the
movie smoking over a year was a strong negative consequences of drug use. This
predictor of whether they had begun smoking a campaign was unsuccessful and may have
year later. increased marijuana use, possibly because it
included portrayals of groups of teenagers
consuming marijuana together, accidentally
emphasising the social benefits of marijuana use
to make teenagers more likely to consume it.
Kramer et al. (2009): a 5 week TV self-help
intervention for problem drinking was effective
in reducing alcohol intake. This shows that media
does have an influence on addictive behaviour
and that such influence can be positive.

Adam Clarke www.brain-freeze.co.uk

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Theory of planned behaviour

Attitude: this concerns how desirable a

person believes a behaviour is. It involves
beliefs about the consequences of
performing the behaviour (drinking
alcohol will make me think less) and an
appraisal of the value of the
consequences (this is good).

Subjective norms: beliefs about what

we think significant others feel is the
Intention: decision to
right thing to do and beliefs about what
engage in a behaviour Behaviour e.g. drinking
other people are actually doing e.g.
e.g. thinking about the alcohol
believing that friends think drinking
drinking alcohol
alcohol is acceptable and that many
friends are drinking a lot.

Perceived behavioural control: the

extent to which a person believes they
can perform the behaviour e.g. have
enough money to buy alcohol

Strengths Weaknesses
Slater et al. (2011): attitudes can be effectively Armitage et al. (1999): too rational and doesnt
targeted to reduce cannabis use by emphasising take into account emotions which drive their
that a positive attitude towards cannabis is behaviour in real life situations.
inconsistent with being independent and
achieving aspirations.
Wilson and Kolander (2003): adolescents often Klag (2006) motivation is not considered,
have inaccurate subjective norms and believe however it has been found that individuals who
that more people smoke than is true, therefore were self-motivated were more likely to be
smoking can be reduced by providing accurate successful in giving up their addiction compared
statistics about how few people actually smoke to others who were forced into giving up.
Godin et al. (2006): from interviews and surveys MacDonald et al. (1996): intentions are
of adults it was found that perceived measured when sober, however intentions can
behavioural control was the most important change because of alcohol. It was found that
predictor of giving up smoking. Anti-smoking being drunk led to intentions of having risky
interventions should emphasise that giving up unprotected sex.
smoking is not easy as it requires a lot of
willpower and effort. For example, Nicorette
adverts may be effective because at the end they
express Willpower required.

Adam Clarke www.brain-freeze.co.uk

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Types of intervention
Biological interventions
Methadone provides similar effects to heroin but is less harmful and less addictive therefore it can
be used to treat heroin addiction. A drug user can be prescribed methadone and the dose is
gradually reduced over time so that they can give up heroin without experiencing acute withdrawal
symptoms. SSRIs may be used as well: these increase the amounts of certain chemicals in the brain
which addicts have low levels of, such as serotonin.

Support Against
Hollander et al. (2000): 10 gamblers treated Some addicts can become as addicted to
with SSRIs (drugs which increase serotonin methadone as they were to heroin.
levels) became less addicted to gambling.
Blanco et al. (2002): for 32 gamblers over 6
months SSRIs were not found to be effective
Kim and Grant (2001): naltrexone can reduce
gambling thoughts and behaviour by reducing
the amount of dopamine in the brain which
makes gambling feel less rewarding.

Psychological interventions
Reinforcement
Addicts can be encouraged to stop consuming drugs if they are reinforced for not taking drugs.

Support Against
Sindelar et al. (2007): heroin addicts had lower Reinforcement does not solve the problem that
drug use if they were rewarded with prize caused the addiction in the first place. It is
money each time they tested negative for drugs. possible that they may develop an addiction to
something else instead. For example, a cocaine
addict may give up their addiction, but they may
still experience a lot of distress in their life and
so they could develop an addiction to alcohol
instead.

Cognitive behavioural therapy

CBT can reduce pathological gambling by helping addicts to correct their errors in thinking, where
for example they may incorrectly believe that they can control the outcomes of gambling.

Support
Ladouceur et al. (2001): after gambling addicts received cognitive therapy the majority of them
were no longer addicted to gambling. The therapy improved their belief that they could handle their
addiction.
Sylvain et al. (1997): cognitive therapy reduced gambling behaviour in a group of males even a year
after therapy was complete.

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Public health interventions

Crits-Christoph et al. (2003): interventions were provided to almost 500 cocaine addicts and it was
found that individual and group drug counselling was the most effective intervention at reducing
weekly cocaine consumption.

Stead et al. (2006): this meta-analysis found that smokers who received repeated telephone calls
from a counsellor as part of an intervention, were 50% more likely to stop smoking than smokers
who were only provided with self-help materials e.g. books with advice on quitting.

Beckham et al. (2008): from a group of 24 US military veterans provided with telephone calls from
counsellors (as well as medication) almost half had stopped smoking by their agreed quit date.

Adam Clarke www.brain-freeze.co.uk