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  1. 1. AddictionExplanations of addictionJanuary 2013 - Outline how the learning approach would explain the maintenance of gambling. (4 marks)AO1 credit is awarded for an outline of the learning explanation of the maintenance of gambling. Maintenance of gambling can be explained by operant conditioning(positive reinforcement of winning or excitement of betting) or classical conditioning (association of gambling related stimuli such as lottery tickets/betting shop withexcitement). SLT can gain credit provided it is shaped to reinforcement of gambling. Partial reinforcement schedules can also obtain credit.June 2012 - Outline and evaluate the cognitive approach to explaining problem gambling. (4 marks + 6 marks)AO1 credit is awarded for the outline of the cognitive explanation of problem gambling. Candidates can refer to any or all of the stages of addiction (initiation, maintenanceand/or relapse). The cognitive model in general emphasises the importance of coping, expectancy and self-efficacy in addiction.Likely material includes:Expectancy plays an important role in the initiation of gambling. The benefits of winning money are seen as very high in gamblers who tend overestimate thelikelihood of winningGamblers often place a higher priority on present excitement than on future consequences (cognitive myopia)Gamblers who find themselves in financial difficulties may gamble more often in an attempt to increase their negative mood creating a vicious cycle (Beck)Gambling may help people to cope by reducing negative mood states (such as boredom) and increasing positive moods (excitement)AO2/AO3 credit is awarded for an evaluation of the cognitive explanation of problem gambling. Candidates may provide research studies which support the claims made bythe cognitive explanation. For example:There is strong evidence that gambling is used to improve moodsStudies have shown that gamblers engage in irrational self-talk and cognitive bias when gambling (Sharpe 1995), Griffiths (1994)Delfabbro and Winefield 1999 found that 75% of thoughts/self-talk during gambling are irrational - effectively gamblers tell themselves they are going to win!Candidates may also discuss the difficulties with gathering cognitive evidence and establishing cause and effect in studies of gambling. It is particularly difficult to separatethe effects of learning/association from cognitive factors. Candidates who present alternative explanations (eg Biological model) can receive credit provided the material isused effectively to comment on the limitations of cognitive explanations.January 2012 -Outline and evaluate the biological approach to explaining smoking behaviour. (4 marks + 4 marks)AO1 credit is awarded for an outline of the biological approach to explaining smoking behaviour. It is possible for candidates to refer to all three stages of smoking addiction,but maintenance and relapse are more likely than initiation. The biological model may be presented generically or candidates may focus in more detail on a single biologicalexplanation eg genetic or neurochemical. Examiners need to be aware of a breadth/ depth trade off.
  2. 2. AddictionPossible content includes:The processes of physical dependency and toleranceGenetic factorsNeurochemistry and the dopamine reward systemThe endogenous opoid system (encephalin and endorphins)Nicotine regulation model (Shachter 1977)For AO2/AO3 credit, candidates are required to evaluate the biological explanation of smoking. This is likely to consist of research evidence to support or contradict theclaims of the model.Possible content includes:Twin studies demonstrating genetic influences (Kendler 1999)Identification of specific genes (eg: SLC6A3-9) which regulate dopamine (Lerman 1999) and influence relapse (Sabol 1999)Animal research (eg Corigall and Coen 1991, Harrison 2002) which supports the dopamine reward modelCandidates may also discuss the relative weakness of the biological model in explaining initiation compared with behavioural and/or cognitive approaches. The diathesisstress model may also be used for evaluation.June 2011 -Outline the learning model of addiction. (5 marks)Candidates are required to outline the learning model of addiction. They are not asked to do this in the context of either gambling or smoking but it is perfectly acceptablefor candidates to take this approach. Similarly, they are not required to consider all aspects of addictive behaviour ie initiation, maintenance and relapse so answers whichconsider all, two or one of these are equally acceptable. There is, of course, a depth-breadth trade-off.The learning model incorporates classical and operant conditioning as well as social learning. Candidates might also legitimately describe cue-reactivity theory. Candidateswho outline learning mechanisms (eg classical conditioning) without application to addiction can achieve a maximum of 1 mark.Evaluation is not required here and is not creditworthy.January 2011 -Outline and evaluate the biological model as an explanation for the maintenance of oneaddictive behaviour. (4 marks + 4 marks)A01 = 4 marksAnswers should focus clearly on maintenance of an identifiable addictive behaviour.Candidates can interpret the biological model as an umbrella term or they can focus on one particular biological explanation of maintenance eg genetic or neurochemical iethey can choose to outline one in detail or more than one in less detail. Candidates who outline biological explanations of maintenance for more than one addictivebehaviour should have the best one credited.Answers that refer to addiction in general, maximum 3 marks.
  3. 3. AddictionAO2/3 = 4 marksCandidates may choose to evaluate specific explanations or offer a more general evaluation of biological explanations of the maintenance of an addictive behaviour.Answers need to relate to a particular addictive behaviour although reference to other behaviours is creditworthy if used as sustained commentary/comparison.January 2010 - Outline and evaluate one explanation of gambling addiction. (4 marks + 6 marks)The outline might address explanations of initiation, maintenance or relapse. There are various explanations of gambling addiction which could include:Irrational cognitive biases.Personal vulnerability factors (eg sensation-seeking personality).Classical and operant conditioning.Situational factors (eg accessibility to gambling activities).Structural characteristics (eg features of slot machines).Biological predisposition.‘One’ explanation can be interpreted broadly eg classical and operant conditioning or narrowly eg one particular underlying personality factor. The outline might addressexplanations for initiation or maintenance or relapse.Any appropriate explanation is creditworthy.Evaluation obviously depends on the chosen explanation. Candidates might refer to the effectiveness of the explanation. They might also refer to research studies whichsupport the various explanations. They could also gain AO2/3 credit by discussing different types of gambling eg lottery, slot machines, betting on the horses etc – someexplanations are better suited to one type of gambling rather than another. Candidates can also consider the multifaceted nature of gambling and whether it is possible toexplain it in terms of a single theoretical approach. Contrast/comparison with other explanations is also creditworthy as it is a consideration of the implications for policyand practice.Possible issues/debates/approaches include nature/nurture; reductionism; reliability/validity; ethical issues; contrasting approaches.January 2010 - ‘The relapse rate for smokers in the first three months after trying to give up is estimated at 70%.’ Discuss reasons why relapse occurs in people withaddictive behaviour. (5 marks + 5 marks)This question is framed in the context of smoking but candidates can access the full range of marks by discussing relapse in any type of addictive behaviour. It is acceptableto credit reasons extrapolated from explanations of relapse or vulnerability factors, influence of peers, parents attribution style etc. Reasons for relapse are related to theunderlying explanation of addiction. For example, according to the biological model smokers become physically dependent on nicotine. Stopping the behaviour causeswithdrawal symptoms which can bevery severe. To avoid these unpleasant consequences, the addict often relapses.The learning model predicts that addicts will relapse if
  4. 4. Addictionthey are presented with cues associated with their habit (eg seeing an ashtray, seeing scratch cards in a shop). The cognitive model explains relapse in terms of coping,expectancy and self-efficacy.Any appropriate reason is creditworthy.Evaluation/commentary will depend on the reasons chosen.Candidates can gain credit by referring to research studies which support or refute the relapse explanations. They might refer to individual differences and that peoplerelapse for different reasons or for a combination of reasons. A consideration of practical implications is also creditworthy eg methods of preventing relapse by using, forexample, agonist substitution, CBT etc.Possible issues/debates/approaches include nature/nurture; reductionism; free will/determinism; contrasting approaches.Vulnerability to addictionJanuary 2013 - Fifteen-year-old Jenny has recently started smoking. She believes that smoking will stop her putting on weight and help her to cope with stress. Most of herfriends smoke and she thinks that smoking helps her to fit in with the group of popular girls, whom she sees as fun-loving and cool.Using your knowledge of vulnerability to addiction, discuss some of the vulnerability factors that contribute to Jenny’s smoking. Refer to relevant research in your answer.(10 marks)AO2 credit is awarded for an application of knowledge to the scenario. The scenario contains references to a number of vulnerability factors relevant to Jenny, including age,stress and peer influence. There are also references to smoking in girls and the prevalent belief that smoking prevents weight gain.One route to AO2 credit is to provide research evidence that demonstrates how these factors affect vulnerability to smoking addiction. There are many research studiesdemonstrating the importance of these factors, including Bricker 2006 on peer influence, Amos and Bostock 2007 on age and gender and Childs 2007 on stress. Students mayalso refer to studies such as Ogden and Fox (1994) which demonstrates the use of smoking as weight control/diet strategy in teenage girls.Answers which identify and discuss relevant factors (eg age, stress and peer influence) without reference to research evidence can gain a maximum of 5 marks (Basic).Although the question refers to factors, there are no partial performance criteria in this question. However, answers that cover one factor only are unlikely to gain a mark inthe top band.June 2012 - Describe one way in which media may influence addictive behaviour. (4 marks)AO1 credit is awarded for a description of one way in which the media influences addictive behaviour. Description could refer to the processes involved in media influenceand/or research evidence related to media influence on addiction. Candidates could approach this question by presenting material related to negative or positive influencesof the media on addiction. Likely ways include:
  5. 5. AddictionTV advertising of alcohol, lottery tickets and other gambling outlets (eg scratch card instants) have been shown to encourage salesPassive advertising of cigarettes and gambling through sportInfluence of role models (films, TV, celebrities) who may glamorise or discourage addictive behavioursDeliberate use of media to reduce addictive behaviour through government health campaigns targeted at smoking/drinkingCandidates who present social learning theory (modelling) must apply this material to the learning of addictive behaviour. General descriptions of social learning (egBandura’s bobo dolls) cannot receive credit.Answers comprised only of examples of media influence eg alcohol adverts during sporting events will receive rudimentary credit.Where several ways are presented, the best one should be credited.January 2012 - Andy is in his first year at university. He is a shy young man who lacks confidence in himself and worries about meeting new people. Since starting university,Andy has preferred to stay in his room, playing strategy games on the internet with his old school friends. Andy often plays all night which means that he sleeps in andmisses his lectures. He is finding his course difficult and fears that he may fail his exams or drop out.Use your knowledge of risk factors in the development of addiction to explain Andy’s addiction to the internet. (6 marks)AO2/AO3 credit is obtained by applying knowledge of risk factors in the development of Andy’s addiction to the internet.The scenario contains references to the following risk factors associated with addiction in the context of internet games:StressPersonality factors such as lack of confidence and shynessRole of peersAgeCandidates should identify some of the relevant risk factors from the scenario and elaborate on how/why these factors might have led to the addictive behaviour depicted.They may demonstrate the importance of factors using relevant research studies on vulnerability to other addictions. There is a breadth/depth trade off here. Candidateswho correctly identify all four factors will provide less detail than those who explore one or two factors in depth.Both of these approaches can receive full credit. However, candidates who simply identify or name risk factors should be awarded a rudimentary mark.June 2011 - Explain how self-esteem can influence vulnerability to addiction.Candidates are required to explain how self-esteem can influence vulnerability to addiction. Research has shown that people with low self-esteem might be particularlysusceptible to peerpressure. They think that they might feel better about themselves if they belong to a particular social group. If smoking, gambling, drug-taking etc iscentral to this group, then the individual with low self-esteem will take up this behaviour in order to belong. Particular forms of addiction eg gambling might appeal topeople with low self-esteem because winning money could be perceived as a way of buying things to enhance their self-image. Low self-esteem can also be a factor in
  6. 6. Addictionmaintaining the addiction – for example, a gambler who has lost money, friends, and possibly job feels even less self-worth and does not have the strength of will to believein his/her ability to overcome the addiction. The relationship between high self-esteem and reduced vulnerability is also creditworthy.Candidates who describe research relating to self-esteem and addiction can receive up to 2 marks.January 2011 -‘The more young people see smoking in cinema and TV films, the more likely they are to start smoking themselves.’Use your knowledge of research into the role of media in addictive behaviour to explain why such films might encourage young people to start smoking. (4 marks)Candidates are likely to explain this in terms of social learning theory. For full marks, they need to explain why young people are likely to copy observed behaviour in films.For example, in terms of the attractiveness/likeability of the actors or the characters they play; positive outcomes etc.Candidates might refer to research that has specifically focused on the influence of film eg Gunakesera et al (2005), Dalton et al (2003), Distefan et al (1999).Answers which make no reference to psychological studies or theories cannot exceed 2 marks.June 2010 -‘Sally is a young woman who puts herself down all the time. She thinks that she is overweight and has started to diet. Like her parents and some of her friends,Sally smokes cigarettes. Her smoking habit has recently become excessive and she is now addicted to nicotine.’Using your knowledge of the psychology of addictive behaviour, explain some of the likely reasons why Sally has become addicted to smoking. (6 marks)The scenario contains references to a number of factors associated with smoking addiction ielow self-esteem, dieting in females, role models who smoke. Candidates couldelaborate on how these factors would influence vulnerability to addiction; they could also suggest other appropriate factors eg external locus of control. Explanations of anyappropriate factors are creditworthy.Prevention and InterventionJanuary 2013 - Outline one biological intervention for reducing addictive behaviour and evaluate the effectiveness of this intervention. (4 marks + 6 marks)AO1 credit is awarded for a description of one biological intervention for addiction. Biological treatments are generally divided into agonist substitution, partial agonist andantagonist treatment. Students are likely to refer to these in the context of smoking, but biological interventions for other addictions (eg methadone) are creditworthy.Agonist substitution (eg nicotine replacement therapy, methadone) these provide the person with a safer drug. Nicotine patches mimic or replace the effects ofnicotine. They may also desensitize nicotine receptors in the brain. They relieve withdrawal symptoms and stop cravings. The removal of withdrawal symptoms is anexample of negative reinforcement.Partial agonists, eg varenicline binds with acetylcholine receptors preventing nicotine binding and reducing the reinforcing effects of smoking.Antagonist treatments (eg Bupropion) block the effects of the substance/drug, ie block nicotine receptors
  7. 7. AddictionDescription could cover the biological action of the intervention as well as practical information (time taken, frequency, etc).Students can take a specific route focusing on a particular drug group or a more general approach focusing on different types of drug treatment, both are creditworthy.AO2/AO3 is awarded for evaluation of the effectiveness of the biological intervention presented as AO1. Students can refer to success rate, relapse/dropout rate, costeffectiveness. References to appropriateness must be explicitly linked to effectiveness to gain credit. Students may also make reference to outcome studies related to specificinterventions, for example Watts (2002), O’Brien (1996). Ethical issues can be credited if linked to effectiveness.June 2012 - Kerry has recently married and she and her partner would like to have a baby. She is keen to give up smoking. However, she has tried several times and findsthat she experiences unpleasant withdrawal symptoms. Kerry’s job is stressful and most of her co-workers also smoke. She has started to despair and thinks that she willnever succeed.Identify one or more interventions which could be used to help Kerry to stop smoking and explain, with reference to the scenario, why your chosen intervention(s) wouldbe appropriate for Kerry. (10 marks)Candidates are required to identify one or more interventions for reducing addictive behaviour and then justify their choice by referring to the scenario. Candidates canchoose to discuss biological and/or psychological interventions:Biological interventions: would be helpful at tackling Kerry’s unpleasant withdrawal symptoms and high levels of anxiety/ stress. Nicotine replacement therapywould be useful to reduce Kerry’s withdrawal symptoms. Bupropion would also be helpful at blocking pleasurable effects of smoking.CBT/cognitive restructuring: would be appropriate to tackle Kerry’s belief that she will not succeed and could be useful as a method of preventing relapse.Theory of planned behaviour (TPB): this approach focuses on developing a sense of perceived behavioural control/self-efficacy for smokers which would be helpfulfor Kerry and develop her belief that she can give up smoking.Candidates may also justify their choice of intervention with reference to research studies. This approach is creditworthy. Other interventions such as public healthinterventions eg Quitline should only receive credit if applied to Kerry.Up to a maximum of 2 marks for selecting intervention(s) appropriate to Kerry.January 2012 - Outline and evaluate one psychological intervention aimed at reducing addictive behaviour. (4 marks + 6 marks)AO1 credit is awarded for an outline of one psychological intervention aimed at reducing addictive behaviour. Answers may be based on any relevant psychologicalintervention including:cognitive behaviour therapy and CBT based approaches such as relapse preventionbehavioural approaches including aversion therapy, contingency contracting and cue exposureMotivational enhancement therapy.
  8. 8. Addictioneclectic approaches such as the matrix modelTheory of planned behaviour could be used if candidates shape this material to reducing addictive behaviour.Biological interventions should not be credited here. Public health interventions can only be credited if the candidate clearly addresses a psychological component within apublic health intervention (for example, banning advertising must be explicitly linked to social learning theory).AO2/AO3 credit is awarded for appropriate evaluation/commentary relating to the intervention presented. Examples of relevant issues include:effectiveness of the intervention including references to outcomes of researchshort-term versus long-term outcomespractical implications such as duration and availability of specialist resourcesethical issuesCredit may also be given for comparison of different types of intervention as long as it is part of a sustained commentary on the chosen intervention.June 2011 - A study into the effects of warnings on cigarette packets has found that these vary depending on the reason why people smoke in the first place. Collegestudents were given questionnaires to assess whether self-esteem played a role in their motivation to smoke. They were then shown cigarette packets with either death-related warnings (eg ‘smokers die young’) or death-neutral warnings (eg ‘smoking makes you unattractive’). Students, for whom smoking was important to their self-esteem, were not put off by warnings of death on cigarette packets. Surprisingly, their attitude to smoking became more positive after being shown such messages.However, warnings related to the source of their self-esteem, (eg ‘smoking makes you unattractive’), significantly reduced positive attitudes to smoking in this group. Thequestionnaires consisted of statements such as ‘Smoking makes me feel valued’ and students had to indicate in a tick box the extent to which they agreed/disagreed witheach statement.Using the findings from this study and other psychological research, discuss the effectiveness of different types of intervention. (10 mark)To achieve the top mark band, candidates must refer to the material in the study and to findings of other research. Although the question refers to types of interventionthere is no partial performance penalty.Candidates are required to discuss the effectiveness of interventions. Straight descriptions of different types of intervention are not creditworthy.The stem is mainly concerned with government interventions in the form of mandatory warnings on cigarette packets. Candidates could discuss the effectiveness ofinterventions which focus on arousing fear and consider whether campaigns such as this work for everyone – the research in the stem, for example, suggests that it candepend on peoples reasons for smoking in the first place. Other research has shown that people are more likely to quit smoking in a group than on their own which suggeststhat school/workplace interventions might be more successful than messages targeted at individuals.
  9. 9. AddictionCandidates can access marks by considering the effectiveness of specific types of interventions. The most likely interventions are those mentioned on the specificationiebiological, psychological, public health and legislation. They can also access marks by considering wider issues such as some of the problems involved in trying to measureeffectiveness. The stem refers to smoking, but it is perfectly acceptable to consider interventions designed to help people with other addictions.AO2/AO3 material should first be placed in the appropriate band according to the descriptors. However, not all the criteria need be satisfied for an answer to be placed in aparticular band. Weak performance in one area may be compensated for by strong performance in others.January 2011 -Discuss one type of intervention aimed at reducing addictive behaviour. (5 marks + 8 marks)Types of intervention included on the specification are: Biological, psychological, public health interventions and legislation. It is acceptable for candidates to describe onetype of intervention in a general way or in the context of a particular type of addiction eg smoking. Examiners should be mindful that there are only 5 AO1 marks availablefor this part of the question so should not expect too much detail. If candidates offer more than one intervention, credit the best one.The evaluation/commentary depends on the type of intervention chosen. Candidates are likely to focus on the effectiveness of each type of intervention since this is requiredon the specification, but any appropriate commentary is creditworthy. Candidates can gain credit by referring to other types of intervention provided that they do so as partof a sustained commentary on their chosen intervention. They might also gain credit by considering some of the ethical and/or practical implications.June 2010 - Outline the theory of planned behaviour action. (5 marks)This was first proposed by Ajzen and offers a way of understanding the factors involved in how people decide on their actions eg to start drinking/ smoking/ gambling in thefirst place or to give the habit up. It consists of three general componentsBehavioural attitudesubjective normPerceived behavioural controlThere is no requirement here to evaluate the theoryJune 2010 - Outline two examples of public health interventions aimed at reducing addictive behaviour. (4 marks)Candidates are required to outline two examples of public health intervention for AO1 credit.There are only 4 marks available here so examiners should not expect too much detail.Public health interventions include:advice from GPsworkplace interventionspublic health advertising campaigns
  10. 10. AddictionThere is considerable overlap between public health interventions and legislation so candidatescan also gain credit by outlining areas such as:restricting/banning advertisingincreasing the cost of alcohol/cigarettescontrolling, or even banning, salesbanning smoking in enclosed public placesIf only one example is outlined, a maximum of 2 marks. For full marks, each example needs to be a bit more than just naming/identifying.June 2010 - Assess the effectiveness of public health interventions and/or legislation in reducing addictive behaviour. (10 marks)The question requires assessment of the effectiveness of public health interventions and/or legislation. Candidates may approach this in a number of ways such as:Research evidence to support effectiveness.Difficulty in assessing impact, in particular isolating the effect of intervention and/or legislation.Comparison of different interventions and/or legislation.Appropriateness of intervention and/or legislation for target population and nature of behaviour to be changed.Credit other relevant approaches to assessing the effectiveness of public health intervention and/or legislation.MethodologyJune 2011 - A study into the effects of warnings on cigarette packets has found that these vary depending on the reason why people smoke in the first place. Collegestudents were given questionnaires to assess whether self-esteem played a role in their motivation to smoke. They were then shown cigarette packets with either death-related warnings (eg ‘smokers die young’) or death-neutral warnings (eg ‘smoking makes you unattractive’). Students, for whom smoking was important to their self-esteem, were not put off by warnings of death on cigarette packets. Surprisingly, their attitude to smoking became more positive after being shown such messages.However, warnings related to the source of their self-esteem, (eg ‘smoking makes you unattractive’), significantly reduced positive attitudes to smoking in this group. Thequestionnaires consisted of statements such as ‘Smoking makes me feel valued’ and students had to indicate in a tick box the extent to which they agreed/disagreed witheach statement.Explain one strength and one limitation of using a questionnaire in this study.(2 marks + 2 marks)2 marks for one strength and 2 marks for one limitationPossible strengths include: quick way of gathering data from lots of people; easy to score Likert-scale type items; people might be more prepared to self-disclose on asensitive topic such as this in an anonymous questionnaire rather than in a face-to-face interview Possible limitations include: people might be less honest in a questionnaireof this type rather than in a face-to-face interview with an interviewer; being able to look at all the questions might lead to demand characteristics; Likert-scale type items do
  11. 11. Addictionnot allow people to explain or qualify their answers in any way; people often tick the middle value onLikert-scale questionnaires or fall into a response set if thequestionnaire has not been carefully constructed. Any strength or limitation that could be relevant in this study is creditworthy.One mark for brief statement eg Questionnaires are quicker than interviews. One further mark for elaboration eg Because the questionnaire can be filled in by theparticipant without the researcher being there, it saves time.January 2010 -A recent large survey on behalf of the Gambling Commission provided a number of interesting findings about gambling behaviour in Great Britain. Forexample, 57% of the population had gambled on the National Lottery Draw in 2007, although the rate of problem gambling in the adult population was only about 0.6%.Explain some of the difficulties of gathering data about problem gambling. (5 marks)Methods might include eg surveys, questionnaires and explanation of strengths and limitations of such methods in the context of gambling research.Explanations of difficulties could include:Social desirability – people not wishing to admit to the full extent of their gambling or to be seen as an addict.Unreliability of data – problem gamblers are often in denial and might not be realistic in their responses.Compliance – problem gamblers might be unwilling to complete questionnaires or return them.Sampling – researchers might find it difficult to find ‘problem gamblers’ who fit their definition.Any appropriate answer is creditworthy. Answers which identify problems of obtaining data with no reference to gambling are basic and can earn a maximum of 2 marks.

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