This document summarizes several biological, learning, and cognitive models of smoking addiction. The biological models focus on genetic factors that influence susceptibility to initiation and maintenance of smoking through dopamine regulation and nicotine dependency. Learning models emphasize social learning and conditioning processes like classical conditioning of cues and operant conditioning of withdrawal symptoms that promote maintenance and relapse. Cognitive models suggest positive expectations of smoking's effects on mood influence initiation, and these expectations become reinforced through actual drug effects.
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Georgie Hartshorne Psychology - Biological and Learning Models of Smoking Addiction
1. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
Smoking:
Biological Explanation:
Initiation:
People mostsusceptibleinthe initiationphaseasthe model arguesthatpeople have apredisposed
biological vulnerability(alsomakingrelapse more likely).
Family/twinstudiesestimate heritabilitytobe around39% and 80%.
The linkbetweencigarettesmokingandgenesinvolvesdopamine regulationandnicotine
dependency.
Nicotine activates Nicotineacetylecholinereceptorswhichleadtothe releaseof dopamine inthe
brainspleasure centre –the Mesolimbic pathway (meaning‘doitagain’)
Repeatedexposure leadstoincreasingthe sensitivityof the braintotheirdesirabilitywhichcan
persisteveninthe absence of the drug.
The disease model: Lerman etal - Some people have norewardgene andlessdopamine receptorsin
the pleasure centresof brainandare therefore more likelytosmoke more togetthe same reward
as othersso are more likelytobecome addicted. Caineetal foundthatmice withoutthe D1 receptor
for dopamine donotself-administercocaine whengiventhe chance whennormal mice will and
therefore dopamine hasakeyrole inaddiction.
Vinket al - studied1572 Dutch twinpairs.Foundthat bothmale and female individual differencesin
initiationwereexplainedbygenetic(44%) andenvironment(56%).
Boardman etal - studied348 identical twinsand321 same-sex non-identicaltwinsandestimated
heritabilitytobe around42%.
Shield – lookedat 42 twinpairswhohad beenrearedapart.Only9 were discordant(one smoked
while the otherdidn’t).
Sabol– correctional studyon1107 smokers,formersmokersandnon-smokers.Peoplewiththe gene
variantSLC6A3-9 were lesslikelytosmoke andmore successful atquitting.Concludedthismaybe
the resultof themhavingan altereddopamine transmissionwhichreducedtheirneedforexternal
rewards(e.g. – cigarettes).
Volkowetal – gave Ritalin(ADHDdrug – gentlyliftsdopaminelevels) tovolunteers.Some likeit
while othersdidn’t –proposedthatitwas because those wholikedit(frombrainscans) hadfewer
dopamine receptorsandtherefore needthatextrakickforhappiness.Explainssmokersassome
have inherentvulnerabilitytosmokingandwill startto/continue tosmoke whereasotherswillstop.
Maintenance:
2. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
Vinket al – nicotine dependencywasinfluencedprimarilybygenetics(75%).Suggeststhatalthough
initiationisinfluencedbyenvironmental factors,maintenance ismore linkedtoindividual
differencesaroundnicotine metabolism.
Nicotine affectsbrainchemistry –triggersnicotinic acetylcholinereceptors(nAchRs) whichrelease
dopamine (apleasure hormone)
Highnicotine concentrationinblood equals short-livedpleasure,asitlowersitsequal mood
impairmentsandlossof concentrationinacouple of hours whichbecome the maindrivingforce
behindthe cravings, soaddictssmoke anothercigarette toavoidwithdrawal symptoms.
Chronicexposure tonicotine resultsinareductioninthe activityof positive rewardcircuitsinthe
brain(downregulation) creatingastressful situationforthe addictwithwithdrawal symptoms,
whichcausesthemto continue tosmoke.Theynolongertake the drugsto gain please,buttoavoid
withdrawal symptoms.
Thorgeirsson etal - Icelandicstudy.Identifiedspecificgene variantonchromosome 15that
influencedthe numberof cigarettessmokedperday,nicotinedependence andthe riskof
developingasmoking-relateddisease.Those smokinglessthan10a day were lesslikelytohave the
gene thanthose smokingmore thanten.Thissuggeststhatgeneticsmaynot be the cause of
initiation,butdomake it more likelyforsmokerstosubsequentlybecome addictedonce starting.
Buka et al - smokinginpregnancydoesn’tincrease initiationratesinchildren,but motherswho
smokedmore than20 a dayhad childrenwhowere more likelytobecome addictedthanthose with
motherssmokinglessonce theybegansmoking(dataon1,248 17-39 yearold womenbetween
1959-66.)
Shachter– comparedhowmany cigarettes differentsmokersneedaweek.Gave themeitherlow or
highnicotine cigarettes–those withlowsmokedmore (predictedbythe Nicotine RegulationModel)
as the highallowedthemtoreachthe neededlevel of nicotinewithless cigarettes.Resultsclearest
on heavysmokers –smokedonaverage 25% more low nicotine cigarettesthanhigh.Arguesthat
theycontinue tosmoke tomaintainnicotine inthe bodytoavoidwithdrawal.
Khaled et al – depressionishighestincurrentsmokersandlowestinnon-smokers–showingneedto
smoke togain rewardingfeelings.
Relapse:
Eventually,the desire forthe drugbecomesthe mostimportantdesire.Despite itnow givingless
pleasure,the brainstill receivesrewardsignalsthatforce the smokerstocontinue smoking.
Permanentrecoveryisdifficultasnicotine-inducedchangescreate lastingmemoriesof saiddrug.
Capacityfor self-control hadbeenweakenedandthe pre-frontalcortex isnow lesseffective at
decisionmaking/judgingconsequences.
Individualsare more vulnerable torelapse if theirbiological cravingislinkedtoenvironmental
stimuli (placestheyassociate withthe drug(pub)).
3. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
Sabol– correctional studyon1107 smokers,formersmokersandnon-smokers.Peoplewiththe gene
variantSLC6A3-9 were lesslikelytosmoke andmore successful atquitting.Concludedthismaybe
the resultof themhavingan altereddopamine transmissionwhichreducedtheirneedforexternal
rewards(e.g. – cigarettes).
Twinstudiesshowabilitytoquitsmokingisgenetic.
Xian et al - twinstudy;studiesgeneticriskfactorscontributingtorelapse.54% of relapse is
attributedtoheritability.
Uhl et al – attemptedtoattribute specificgene clustersassociatedwithquitsuccesstomatch
treatmentswithquitter.
Evaluation:
Negatives:
Limitations:Neglectingotherpossibledeterminingfactors,includingsocial factors(reductionist) and
alsonegatesthe problemtothe individual soastheyare the problemanditis irreversible.However,
by regardingsmokingasa biological problem, opensthe possibilityforapharmacological cure and
the emphasisisontreatment.
Reductionism:Biological explanationsforaddictionsare generallyreductionist;theyreduce a
complex phenomenondowntoa relativelysimple level of explanation. While thismayhave
advantages(allowingresearcherstostudyfamilygenetics),ithasitslimitations. Influence of
neurotransmitterssuchasdopamine isclearlyimportant,butreducingaddictiondownto
genes/chemicalsignoresall otherpotentialinfluences(irrational thoughprocess,socialcontext).
Deterministic:biological model assumptions –addictionspecifieddiagnosis(youcan’tbe ‘slightly
addicted’)
Research:usescorrelational evidence forgenesandlevelsof smoking –twinstudiesbutthese do
not showcause and effect.Caine study:animals.
Positives:
Researchevidence: Thorgeirsson etal- Thissuggeststhat geneticsmaynotbe the cause of
initiation, butdomake it more likelyforsmokerstosubsequentlybecome addictedonce starting.
Implicationsof treatments: Genomicmedicine involvesscreeningpeople toidentifywhatgenesthey
do/don’tcarry. Individualsfoundtobe ata highgeneticriskcould be advisedalifestyle change
(e.g.:stopsmoking) orseekmedical treatmenttoreduce riskof relateddiseases. Smokingappears
to be a goodcandidate forthisapproach; large publichealthburden. However, Gartneretal
suggestedthat,atpresent,screeningisunlikelytobe successfulbecause of the relativelysmall
associationsbetweenspecificgenesandasmokingaddiction. Also,allowstreatment –those with
specificgene clustersare givennicotinepatches sotheycontinue togetthe highwithoutthe danger
to keepwithdrawal symptomstoaminimum.
4. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
Geneticrole:Evidence suggeststhateffectivenessof medicationforsmokingcessationmaybe
moderatedbygenetics.Smokerswiththe Asp40variantof the mu-opioidgene are twice aslikelyto
quitwithhighdose nicotine replacementtherapyasalow dose.Smokerswithmore commonAsn40
variantwere equallylikelytostop,regardlessof the nicotinedose level.Consequently,genetic
testingmayalsoallowtherapiststochoose mostappropriate cessationtherapy(Lerman etal).
Scientificobjective evidence: gene mappingcannotbe influencedbydemandcharacteristics
therefore leadingtovalidresults(can’tchange genes).
Individual differences: Canbe usedto explainwhysome people developanaddictionwhile others
do notunderthe same social pressures.Some peopleare more vulnerable todevelopingaddictions
than othersbecause of theirgeneticpredispositions(explainedinthe Diathesis-stressModel).
Learning Explanation:
Initiation:
Social learningtheory:explainsof experimental smokingpropose thatyoungpeople beginsmoking
as a consequence of those social modelstheyhave aroundthemwhosmoke (Kandeland Wu).From
thisperspective,experimental smokingisprimarilyafunctionof parental andpeerrole modelling
and the vicariousreinforcementthatleadsyoungpeopletoexpectpositivephysical andsocial
consequencesfromsmoking. Negativeoutcomesobservedorexperiencedreduce the use of certain
drugsand the selectionof saferones.
Popularityasa positive reinforce:popularityamongpeersmayalsoserve asa positive reinforce in
the initiationof smoking. Mayeuxetal founda positive relationshipbetweensmokingatage 16 and
boys’popularity2yearslater.
Operantconditioning:positive reinforcement.All positivereinforcersreleasedopamine inthe
mesolimbicsystem. Natural reinforcersare drink,foodandsex.Predictably,addictive drugshave the
same effects(White).
Classical conditioning:secondaryreinforcersare those thingsthatprecede oroccurat the same time
as the addictionitself. Glautieretal foundthat the sightsand smellsof apub elicitedthe similar
physiological responsesasalcohol.
Maintenance:
The repetitionof the act of smokingthousandsof timesayeareventuallyleadstoastrong
conditionedassociationbetweenthe sensoryaspectsof smoking(the sightof cigarettes,smell of the
smoke) andthe reinforcingeffectsof nicotine.
Althoughthe effectsof nicotine inthe brainare importantwhenfirststartingtosmoke,smoking-
relatedsensorycuesrapidlybecomeconditionedstimuliandsoactivate the same brainareas,
makingcessationmore difficult(Franklin etal)
Operantconditioning: withdrawal fromthe drugcauses unpleasantfeelings(anegative situation).
5. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
Classical conditioning:maintenance iscontinuedthroughthe threatof withdrawal.
Social LearningTheory: West– suggestedthe observationof the positive andnegativeeffectsof
drugsforms the continual conflictbetweenthe seduction of the additionand itsavoidance.
Relapse:
Conditionedcues:cuesassociatedpreviouslywithreceivingnicotine,suchasthe availabilityof
cigarettesorthe smell of cigarettessmoke,increasethe likelihoodthatthe smokerwill respondby
smoking. Hogarthetal foundthatthe amountof craving increasedsignificantlywhenaconditioned
stimulusrelatedtosmokingwaspresented toa smoker.
Refusal self-efficacy:aconceptrelatedtothe social learningexplanationof smokingisself-efficacy,a
person’sbelief inhis/herabilitytosucceedinaparticularsituation.Amongadultsthose whosmoke
more frequentlyhave lessconfidence intheirabilitytoabstain(Lawranceand Rubinson) andsoare
more likelytorelapse. Lin showedthathighself-efficacyincreasesquitsuccessininternetaddicts.
Operantconditioning:the processof negative reinforcement.
Social LearningTheory: West– Claimsthatclassical conditioningincreasesthe likelihoodof relapse
as meetingotherusersorexperiencingthe shootingupritual willtriggerpositivememoriesand
therefore addictswillrelapse.
Marlattand George – suggestedthatthe presence of multiplecuestriggerpositivememoriesand
the likelihoodof relapse.
Evaluation:
Positives:
Real-worldApplication: Botvin suggeststhateffectiveformsof drugpreventionprogrammeshould
target beginneradolescents.Itisatthiscrucial developmental periodthatadolescentsare most
vulnerable tothe influencesof peersinparticularandthereforemostinneedof drugresistance
skillsandsocial skill development.Resistance trainingnotonlyteachesadolescentshow torefuse
drugssuch as cigarettes,butalsoinformsthemof the influencesof peersandadultsondruguse.
Botvinarguesthat itis imperativetoequipadolescencewiththe anti-smokingandanti-drug
messagesandargumentsneededtocounterthe pro-smokingandpro-drugmessagesreceivedfrom
theirenvironment.
Social LearningTheory: Lawrence– Suggestedthe self-efficacytheorysuggestssmokersare likelyto
be those whofeel the mostpressure toconform.
Conditionedcues:Thewissenetal testedthe importance of environmental contextsinthe urge to
smoke.Inone room,theyrepeatedlypresented33smokerswitha cue predictingsmoking,whilstin
a 2nd theypresentedacue predictingsmokingunavailability.Consistentwithexpectations,results
supportedthe viewthata cue predictingsmokinglaterledtoa greaterurge to smoke thandid a cue
associatedwithsmokingunavailability.
6. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
Role Models:Many of the claimsof social learninginfluencesonthe developmentof addictive
behaviourshave beensupportedbyresearchevidence.Forexample,researchfoundthatpeergroup
influencesare the primaryinfluence foradolescentswhosmoke/drugs(DiBlasio and Benda).Those
adolescentswhosmokedwere more likelyto‘hangout’withotheradolescentswhoalsosmoked.
Karcherand Finn foundthatyouthwhose parentssmokedwere 1.88times,siblingsmokedwere
2.64 timesandif close friendssmoked8timesmore likelythanif theirparents,siblingsandfriends
didnot smoke tostart smoking.
Implicationsfortreatment: Drummondetal propose a treatmentapproachbasedonthe ideathat
the cues associatedwithsmokingare animportantfactor inthe maintenance of addiction.Cue
Exposure (treatment)involvespresentingcueswithoutthe opportunitytosmoke after.Thisleadsto
stimulusdiscriminating;withoutthe reinforcementof the cueswithnicotine,the association
betweenthemextinguishes.
Classical conditioning: Robins –explainsthe desiretorelapse whenexposedtocues.FoundVietnam
veteransaddictedtoheroinwere lesslikelytorelapsewhenreturnedtohome environment.
Negatives:
Genderbiasinsmokingaddictionresearch: Nerin dela Puerta and Jane argue that there isan
inherentgenderbiasinmuchof the researchrelatingtosmokingaddiction.The onsetof smoking
and development of smokingaddictionfollowsadifferentpatterninmenandwomanaccordingto
Lopezet al.Theyfoundthat womenstartsmokinglaterthanmen,andthat there are gender-related
differencesinrelationtoboththe stagesand contextof smoking.Explanationsof smokingaddiction
generallyfail toaddressthese genderdifferences.
Operantconditioning: Robinson and Berridge–it failstoexplainhow agreatmany experimentwith
addictive drugsbutdonot become addictedandsothere therefore mustbe otherfactors.
Classical conditioning: Drummond–arguedthat repeatedexposure tosecondaryreinforcerswould
leadto extinctionif itwere notaccompaniedwiththe highof actual drug taking – knownas stimulus
discrimination.
Cognitive Explanation:
Initiation:
Addictsdifferfromnon-addictsintermsof theirperceived expectanciesaboutthe positivevs.
negative effectsof abehaviour andthe effectof psychoactive substances.Brandon etalproposed
that a behaviourescalatesintoanaddictionbecauseof the expectanciesthatanindividual hasabout
the cost and benefitsof thatactivity.
Adolescentsmokerscommonlysmoke whenhavingnegativemoods(Kasseletal) and expect
smokingtoreduce negativity/boredomandremovestress (Brandon and Baker).The expectancyof
positive moodsstates(e.g.relaxation) isareasonadolescentsbegintosmoke (Mermelstein etal).
Thisexpectationisfurtherreinforcedbythe actual effectsof the drug/behaviourtoescalate the
addiction.
7. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
Eiser et al – suggestedfrequentsmokerstransmitpositive expectationsof smokingtonoviceswho
mightotherwise be putoff bynegatives.
Self-medicationmodel:Gelkopf etalproposesthatindividualsintentionallyuse differentformsof
pathological behaviour(e.g.alcohol,drugs,gambling) totreatthe psychological symptomsfrom
whichtheysuffer.The particularactivityanaddictchoosesisnotselectedatrandom, buttendsto
be one that is perceivedashelpingwithaparticularproblem.Forexample,someactivitiesmaybe
chosenbecause theyhelpthe individual overcome anxiety,whereasothers(gambling) appearto
helpwithdepressionassociatedwithpovertyandsoon.Gamblingmightnotactuallymake things
better,butneedsonlytobe judgedasdoingso by the individual tobecome anaddiction asthe
gamblerexpectsgoodoutcomes.
Expectancytheory:heavierdrinkershave showntohave more positive expectanciesaboutthe
effectsof alcohol comparedtolighterdrinkers.
Self-efficacytheory:Bandura - referstoa beliefinone’sself toorganise andcontrol anyactions
requiredtomeetparticulargoals.Playsanimportantrole inwhetherornota personwill startand
addictive behaviour.
Rational choice theory: Beckerand Murphy – people becomeaddictsafterweighingupthe costs and
benefitsof the activity.Usesthe conceptof ‘utility’,weighingthe costsagainstthe benefitsof an
activity.Fromthisperspective,addictionisexperiencedasanincrease inconsumptionof ‘goods’
because the addictshave made a rational choice concerningtheircurrentandfuture ‘utility’of their
addiction.
Maintenance:
Brandon etal - suggeststhatas addictionsdevelop,itislessinfluencedbythe conscious
expectationsandmore bythe unconsciousexpectationsinvolvingautomaticprocessing,which
explainsthe lossof control thatmanyaddictshave and the difficultiesof quitting.Expectanciescan
alsobe manipulatedtopreventrelapse; Tateetal toldsmokerstheyshouldn’texperienceany
withdrawal symptomswhileabstainingfromtheiraddictionwhichleadtofewersomaticsymptoms
(shakes) andpsychological effects(mooddisturbance) thanacontrol group.Those toldtheywould
experience somaticbutnotpsychological experiencesmore numerousandseversomaticeffects
than a control group.
Self-perpetuatingcycle: smokersengageinsmoking,whichleadstomedical andfinancial problems,
whichthemleadstoa low,negative mood,whichthenleadstocontinuationof the smoking
behaviourinordertocope withthe depressingmood. Cohen and Lichtenstein foundthatsmoking
actuallyincreasesstresslevels,suggestingthatitisan irrational beliefthatsmokingdecreasesstress
level. Koski-Jannes –foundthataddictionsformbecause of short-sightedmeansof dealingswith
stressful events.Initiallygivingpositive effectsandlaternegativeconsequences.Leadingtoaself-
perpetuatingcycle regulatedbyself-servingthoughts.
Beck et al – viciouscycle:lowmoodcan be relievedbyaddictive behaviour.Addictionleadsto
financial/social/health problems,whichleadtoa low mood,resettingthe circle.
8. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
Self-medicationmodel:refertoinitiation.Manysmokersmention‘stressrelease’asamajor reason
for smoking–relieve stressof withdrawal symptoms.
Expectancytheory:Brandon etal – as addictiondevelops,the activityisinfluencedlessbyconscious
expectationsandmore byunconsciousexpectations,explainingthe lossof control manyaddictsfeel
and relapse difficulties
Self-efficacytheory:Bandura- referstoa belief inone’sself toorganise andcontrol anyactions
requiredtomeetparticulargoals (theyare nolongerconsciouslythinkingaboutthe outcomes).
Playsa role inwhetheranaddictbelievestheycandoanythingto stopthe addiction.
Rational choice theory: Beckerand Murphy – refertoinitiation.Accordingtothistheory,addictsare
rational consumerswholookaheadandbehave ina waythat islikelytomaximisethe preferences
theyhold.
Relapse:
Expectationsof the cost/benefitsof smokingaffectanindividual’sreadinesstoquitandthe
likelihoodof relapse. DeVriesand Backbierdemonstratedthatsmokers’perceptionof prosandcons
of smokingandof quittingaffecttheirquittingbehaviour.Accordingtothisperspective,those
individualswhoperceive smokingtohave manybenefitsandquittingtohave few are more likelyto
relapse.
Shiffman –interviewed143ex-smokerswhose call toa relapse helpline wasrecordedfindingthat
those whohad relapse crisis’shadlowerself-efficacy.
Eiser et al – studied10,000 Britishadolescencesfoundteenagesmokersacquiredexpectationsof
smokingfromveteransandhada greaterexternal locusof control abouttheirhealthcomparedto
non-smokers.
Attitudes/Intentions/Beliefs: manycognitive theoriesormodelsaimtoexplain failure toabstain
fromaddictive behavioure.g. –Locusof Control; those withanexternal locusof control mayfail to
take responsibilityforchangingtheirownbehaviour. Self-Efficacy;those withlow self-efficacymay
feelingcapableof changingtheiraddictive behaviour.We relapse if we have decreasedself-efficacy
(notbelievingtheyare able toquit).Relapsesalsoreduce self-efficacyandmake itmore likelythat
youwill relapse again(aviciouscycle). TheTheory of Planned Action (Ajzen):one’sownorothers
unhelpfulbeliefsandattitudesaboutthe benefitsof changingaddictive behaviourmaynegatively
affectthe intentiontodoso.
Self-medicationmodel:refertoinitiation.Manysmokersmention‘stressrelease’asamajor reason
for smoking–relieve stressof withdrawal symptoms.
Expectancytheory:Brandon etal – as addictiondevelops,the activityisinfluencedlessbyconscious
expectationsandmore byunconsciousexpectations,explainingthe lossof control manyaddictsfeel
and relapse difficulties(theyare nolongerconsciouslythinkingaboutthe outcomes).
9. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
Self-efficacytheory:Bandura - referstoa beliefinone’sself toorganise andcontrol anyactions
requiredtomeetparticulargoals(theyare nolongerconsciouslythinkingaboutthe outcomes).
Playsa role inwhetheranaddictbelievestheycan doanythingto stopthe addiction.
Rational choice theory: Beckerand Murphy – refertoinitiation.Accordingtothistheory,addictsare
rational consumerswholookaheadandbehave in a waythat islikelytomaximisethe preferences
theyhold.
Evaluation:
Strengths:
Importance of expectancies: Juliano and Brandon foundthatsmokersreportedgreaterexpectances
that cigarettesalleviate negative moodstates,andhada positive effecton weightcontrol compared
withthe differentformsonNRT.Therefore,smoker’spositiveexpectancesforthe effectsof smoking
do notappear to generalise toNRT,whichmayexplainitsmodestcessationrate.
Intervention:havingthisknowledge canallow us tointervene because we canadvise
parents/media/schoolshowtoshowchildrenthe negativeeffectsof the addictionsothattheydo
not developthese expectations.
Practical Application: smokerswhodonothave negative expectationsof quittingare more able to
quit.Managingexpectationscouldbe usedinrelease preventiontherapy.Also,researchshowsthat
highself-efficacyisakeyfactor inrelapse prevention,supportedbyTheoryof PlannedBehaviour.
Helpsexplainindividual differences:asin,millionsof people have smoked,butmostare not
addicted.Thisisexplainedbecausetheydonothave the faultythoughtprocessesthataddictshave.
Negatives:
Language:Attemptstounderstandthe nature of addictionsare cloudedbythe difficultiesof
obtainingobjective data. Daviesclaimsthataddictsdescribe theiraddiction,whentalkingtoheath
workeror police,byusingthe language of addiction,i.e.theirbehaviourisoutof control.However,
whentalkingtopeers,theyuse differentlanguage whichsuggeststheyare exercisingpreferences
that are rational andunderstandablegiventheircircumstances.Thissuggeststhatlanguage off
addictsservesanimportantfunctionforthe individual,i.e.mayserve toabsolve themof
responsibility
Expectancy theoriesandpublicationbias: The focusof researchintoexpectancytheoryhaslargely
beenonpositive researchfindings,withnegativeresultsreceivinglessattention.Forexample,
studieshave supportedanassociationbetweenexpectanciesandaddictive behaviourbutthis
constitutesapublicationbiasasthe selective publicationof positive resultsgivesan
unrepresentativeviewof aparticularresearcharea,particularlywhenthe numberof studies
publishedisrelativelysmall,replicationsare few andcontradictoryfindingsare frequent.
Addictionorexcess: Muchexpectancytheoryresearchisconcernedmore withexcessesof a
behaviourmore thanan addiction.Researchmayfocuson‘problematicbehaviour’(heavysmoking)
10. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
but not‘lossof control’.Addictioninvolvesthe addictbeingunabletocontrol theirbehaviour,in
whichcase it isnot clearwhat role expectanciesplayinthe developmentof thislossof control.
Researchsupportforlinkbetweenexpectanciesandrelapse: Studyfindingof effectivenessof
nicotine patches,smokingcessationandrelapse are inconsistent. Hurtetal foundthatusinga patch
didnot improve cessationinadolescentswhereas Moolchan etal foundthatpatchesdidincrease
cessationsuccessandreduce relapse rate,butonlywhenaccompaniedbyCBT.
MeasuringCognitive Factors: itisdifficulttomeasure cognitivefactors(expectancies/vicious
cycle/self-efficacy) because youhave touse self-reportstudiestofindoutaboutit soit will neverbe
trulyscientificevidence.
Gambling:
Biological Explanation:
Initiation:
Studiesshowthatpathological gamblingrunsinfamilies. Althoughmanyattribute thistolearning
theory,itispossible itisdowntogeneticsaswell.
Shah et al - twinstudyfoundevidence of genetictransmissionof gamblinginmen.
Black et al – foundthat first-degree relativesof pathological gamblersweremore likelytosuffer
fromthe addictionthanmore distantrelatives(stronggeneticlink).
Alessi – foundgeneticpredispositionsforgamblingmayworkindirectlythroughan‘impulsivity’trait
(consideredasignificantpredictorof sensationseekingbehaviours).
However,inheritance of an‘impulsivity’ gene onlyexplainshow peoplebecome addictedtorisk-
takingbehaviours,butdoesn’texplainwhysome become addictedtogamblingwhile some tosky-
diving. There istherefore aninteractionbetweengenes(‘impulsive’traits) andenvironment(typeof
activitiesthatare available).
Cavedini– compared20 gamblesto40 controlsona decisionmakinggamblingtaskinvolving
balancingimmediate rewardswithlongtermnegative consequences.Significantdifferencebetween
twogroups – gamblersmakinga patternof decisionsassociatedwithpatientswhohave lower
functioningpre-frontalcortex.
Wendy Slutske– lookedatthe concordance rates forabout 5,000 MZ and DZ twinsinrelationto
gamblingaddiction.Foundthatconcordance forMZ twinswas2x DZ concordance and genetics were
responsible for64%overall gamblingproblems.However,she pointsoutthatitisn’tpossible to
isolate the geneticeffectsfromenvironmental andsocial aspects,whichare accountable for36%.
Instead,she describesa‘perfectstorm’of inheritedvulnerabilityandgamblingrole models
(parents).Alsofocusesonmenandwomen(previousresearchjustmen) andshowsbothare at risk.
11. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
Zuckerman – studiedhighandlowsensationseekers.Highsensationseekershave alow appreciation
of riskand thinkof itmore positively.He believesthere are tworeinforcersforgambling –the
positive arousal duringthe time of riskof monetarylossandpositivereinforcementof winning.
Pathological gamblersneedintensestimulationandexcitement.
Blaszczynski- poortolerance forboredommaycontribute to repetitivegamblingbehaviour.
Pathological gamblershadsignificantlyhigherboredompronenessscoresthancontrol groupof non-
gambler. Nosignificantdifferencesbetweendifferentgamblingstyles.
Thisis intuitivelyagoodexplanation,aswhenpeopleare boredtheygamble,andsome people need
more stimulationthanothersandtherefore gamble more.But Coventry and Brown foundthat
horse-race gamblerswere lowersensationseekersthanacontrol,whichopposesthisexplanation.
However,theyalsofoundthatcasinogamblerswere highsensationseekers,suggestinggamblingis
more complex andthat there maybe 2+ typesof gamblers(Bonnaireetal).
Maintenance:
Pituitary-adrenal response:researchsuggestsgamblingisassociatedwithunderactive pituitary-
adrenal response togamblingstimuli,asinif there isa physiological rushassociatedwiththe
behaviouritismore likelytobe maintainedbecause of the activationof the dopamine reward
system. The release of the dopaminemayleadtothemcravingthat rush againand therefore
continuinggamblingbehaviour. Parisetal – measuresgamblers’cortisol(stresshormone)levels
before/afterwatchingavideoof theiraddiction.Andavideoof neutral stimuli (rollercoasterride).
Recreational gamblershadsignificantlyincreasedsalivarycortisol levelsafterboth,butaddictshad
no response toeither.
Notthe winthattheyplayfor, butthe adrenaline fromthe nearwin.
Sensation-seeking:Zuckerman - claimedthatthere are individual differencesinthe needforoptimal
amountsof stimulation. Sensationseekerslookforvaried/novelexperiences.Highsensation-seekers
have a lowerappreciationof riskandanticipate arousal asmore positive thandolow sensation-
seekers,andtherefore more likelytogamble.
Meyer- carriedout a repeatedmeasureslabexperimentwith10 male gamblers.The gamblers
played21 for money(experimentalcondition) orpoints(control).Alsotheywere measuringheart
rate andendocrine ata baseline,30minutesand60 minutesintothe game andalsoafterplaying.In
the experimental condition,heartrate andcortisol levelswere considerablyraisedby30minutes
and continuedtorise asa chemical indicationstress/excitement).
Beck et al – viciouscycle:lowmoodcan be relievedbyaddictive behaviour.Addictionleadsto
financial/social/healthproblems,whichleadtoa low mood,resettingthe circle.
Relapse:
Boredomavoidance:the pathological gamblerisseenasa personwhoneedsthisintensestimulation
and excitement. Blaszczynskietal – poor tolerance forboredommaycontribute to repetitive
13. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
pressure/free bets)andalcohol provisionwhile playing. Therefore,itismore likelythataddictionis
causedby biological dispositionsandexternal factors.
Explanatorylimitations: Biological explanationscannotexplain whysome typesof gambling
(online/video) are more addictivethanothers. Breen and Zimmerman - foundthatmenand women
whogot hookedonvideogamblingbecame compulsive gamblersinaroundayear,while those
addictedtobettingonhorses/sportstookover3.5 yearsbefore atriskto become addicted.
Deterministic:Ignorespeople’sdecisionmakingabilities –free will.
Small sample:Cavedini’sstudy(60participantstotal) andtherefore unrepresentative.
Learning Explanation:
Initiation:
Operantconditioning:prosesthatanybehaviourthatproducesaconsequencesthatthe individual
findsrewarding,thenbecomesmore frequent. Griffithsarguesthatgamblersplayingslotmachines
may become addictedbecause of the physiological rewards(gettingabuzzfromwinning),
psychological rewards(nearmiss),social rewards(peerpraise) andfinancial rewards(ifwin).This
may seemstrange giventhatthe gamblergenerallylosesbut,as Delfabbro and Winefield pointout,
gamblersare not alwaysrational intheirthinking,andgreaterweightmaybe giventothe
experience of winning.
Classical conditioning:secondaryreinforcersare those thingsthatprecede oroccurat the same time
as the addictionitself. Glautieretal foundthat the sightsand smellsof a pub elicitedthe similar
physiological responsesasalcohol.
Maintenance:
Intermittentreinforcement:the operantconditioningmodel proposesthatpeople continue to
gamble because of the intermittent(occasional)reinforcementthatischaracteristicof mosttypesof
gambling.Asa result,theybecome usedtolongperiodswithoutrewardandtheirgambling
behaviourisreinforcedbythe occasional pay-out.
Social approval:Thistype of behaviourmayalsobe maintainedbecausereinforcementisprovidedin
the form of social approval fromothers. Lambosetal foundthat peersandfamilymembersof
problemgamblerswere more likelytoapprove of gambling.Respondentswhoreceivedthisformof
reinforcementfortheirgamblingnotonlygambledmore thanotherrespondents,butalsomore
intendedtocontinue doingsointhe future.
Relapse:
Conditional cues: addictslearn(throughclassical conditioning) toassociate otherstimuli withtheir
gamblingbehaviour(e.g.the sightsandsoundof a casinoor the presence of othergamblers).These
stimuli actas triggersforgamblingbecause theyhave the abilitytoincrease arousal.If,afteraperiod
14. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
of absence,anindividual comesintocontactwithone of these conditional cues,theyare ata higher
riskof relapse.
Approach-avoidance conflict: because gamblinghasbothpositive andnegativeconsequencesforthe
individual,theyare motivatedtoapproachand to avoidsituationswhere gamblingisinvolved.This
createsan approach-avoidance conflict,where motivationfluctuatesbetweenwantingtogamble
and wantingtostop.Whetheror not the gamblerwill gamble whenfacedwithanurge todo so is
relatedtotheirabilitytocontrol the increasedarousal anddelaytheirneedforreinforcement.
Lin - showedthathigh self-efficacyincreasesquitsuccessininternetaddicts.
Evaluation:
Positives:
Researchapplications: Blaszczynskiand Nower- claimdifferentpathwaysof gamblingthatpredict
the likelihoodof treatmentbeingsuccessful.Gamblersinthe ‘behaviourally conditioned’pathway
may have begungamblingbecause of exposure togamblingthroughrole modelsorpeergroups.
Theytendto showthe leastsevere gamblersandgambling-associateddifficultiesof antpathological
gamblers,are motivatedtoentertreatmentandare more likelytobe successful incurbingtheir
gamblingasa result.However,asecondsubgrouptendstohave accompanyinganxietyand/or
depression,ahistoryof poorcopingskills,aswell asnegative backgroundexperiencesandlife
events.These factorsproduce an‘emotionallyvulnerable gambler’,whousesgamblingprimarilyto
relieve theiraversive emotional states.Unlike the behaviourallyconditionedgroup,the
accompanyingpsychological dysfunctional inthe emotionallyvulnerablegroupmakesthemmore
resilienttochange andnecessitatestreatmentthataddressesthe underlyingvulnerabilitiesaswell
as the gamblingbehaviour.
The significance of occasional reinforcement: Learningexplanationspropose thatpeople become
‘hooked’onspecificactivities(suchassmoking/gambling)because whentheyengage inthemit
leadstosome desiredconsequences(e.g.feelinglessdepressed).Inreal life thispositive
consequence islikelytobe occasional ratherthanconsistent,assmokingacigarette (or engagingin
gamblingbehaviour) will notalwaysproduce adesiredpositive moodstate orrelieveanegative one.
As the worldisan unpredictableplace,organismstendtolearnadaptive behavioursthatworkto
theiradvantage onaverage.Providedengaging inaparticularbehaviourproducesthe desired
consequencesnowandthen(e.g.makingthe personfeelbetter),thenapatternof addictive
behaviourwill become establishedandmaintained.
Negatives:
Can’texplainall forms: A problemforexplanationsof gamblingbasedonoperantconditioningis
that itis difficulttoapplythe same principlestoall differentformsof gambling.Forexample,some
formsof gamblinghave ashort time-periodbetweenthe behaviourandthe consequences(e.g.
scratch cards) whereasothers(suchassportsbetting) have amuch longerperiodbetweenbetand
outcome,whichisalsolesstodo withchance and more to do withthe skill of the individual.
Failsto explainwhyonlysomepeople becomeaddicted: Thisexplanationof pathological gambling
explainsaddictionintermsof the consequencesof the gamblingbehaviour.Althoughthismay
15. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
explainwhysome people initiallytake potentiallyaddictivedrugsorengage inpotentiallyaddictive
behaviour,there are aspectsof addictionthatare not dealtwithbythisexplanation.Althoughmany
people gamble atsome time duringtheirlivesandexperience the reinforcementsassociatedwith
thisbehaviour,relativelyfewbecome addicts.Thissuggests,therefore,that there are other
psychological factorsinvolvedinthe transitionfromgamblingbehaviourtogamblingaddiction.
Cognitive Explanation:
Initiation:
Self-medicationmodel:Gelkopf etal- proposesthatindividualsintentionallyuse differentformsof
pathological behaviour(e.g.alcohol,drugs,gambling) totreatthe psychological symptomsfrom
whichtheysuffer.The particularactivityanaddictchoosesisnotselectedatrandom, buttendsto
be one that is perceivedashelpingwithaparticularproblem.For example,someactivitiesmaybe
chosenbecause theyhelpthe individual overcome anxiety,whereasothers(gambling) appearto
helpwithdepressionassociatedwithpovertyandsoon.Gamblingmightnotactuallymake things
better,butneedsonlytobe judgedasdoingso by the individual tobecome anaddiction asthe
gamblerexpectsgoodoutcomes.
Casinosexploitthe sightof otherswinningtoencourage positive expectationsaboutthe successof
gambling.
Rational choice theory: Beckerand Murphy – people becomeaddictsafterweighingupthe costsand
benefitsof the activity.Usesthe conceptof ‘utility’,weighingthe costsagainstthe benefitsof an
activity.Fromthisperspective,addictionisexperiencedasanincrease inconsumptionof ‘goods’
because the addictshave made a rational choice concerningtheircurrentandfuture ‘utility’of their
addiction.DOESN’TWORKFORGAMBLING! Unlessyouinclude Griffiths study: gamblershave
irrational thoughtprocesses.
Griffiths – examinedscratchcard gamblinginadolescentmales.204 Birminghamboysaged11 to 16
were givenaquestionnaire abouttheirgambling.10children(12% of the gamblerswhohadbrought
the ticketsthemselves) metDSM-IV criteriaforpathological gambling.Also,asignificantrelationship
was foundbetweenparentsbuyingscratchcards and children’spurchases(supportingexpectancies
– see theirparent’sexpectationsandtherefore thinktheywill too).
Expectancytheory:heavierdrinkershave showntohave more positive expectanciesaboutthe
effectsof alcohol comparedtolighterdrinkers
Self-efficacytheory:Bandura - referstoa beliefinone’sself toorganise andcontrol anyactions
requiredtomeetparticulargoals.Playsanimportantrole inwhetherornota personwill startand
addictive behaviour.
Maintenance:
16. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
Role of irrational beliefs: cognitivedistortionsorirrational beliefsplayarole inthe maintenance of
pathological gamblingspecifically(Oeiand Gordon).Despite the objective probabilityof failure
relatedtoany gamesbasedonchance,problemgamblersfrequentlyhave irrationalperceptions
abouttheirabilitytoinfluence the outcomesof theirgambling.
Cognitive distortionsassociatedwithgamblinginclude the ‘gambler’sfallacy’,i.e.the belief that
completelyrandomeventsare influencedbyrecentevents.Forexample,runsof losseswill be
equalledoutbyrunsof wins.Illusionsof control are demonstratedthroughthe performance of
superstitiousbehaviours,whichgamblersbelieve helpsthemmanipulate the outcome.
Alsoshowexaggeratedself-confidence intheirabilityto‘beatthe system’ andinfluence chances.
Thisis part due to the differentattributesthatmanygamblersmake abouttheirgambling,with
successbeingattributedtotheirpersonal abilityorskill,andfailure attributedtochance factors,
such as bad luck.
Cognitive biasinfruitmachine gambling:Griffiths - setoutto discoverwhetherregulargamblers
thoughtand behaveddifferentlytonon-regulargamblers.He compared30 regularand 30 non-
regulargamblersintermsof theirverbalisationsastheyplayedafruitmachine (‘fruitskill’). Regular
gamblersbelievedtheywere more skilful thantheyactuallywere,andwere more likelytomake
irrational verbalisationsduringplay(e.g. –‘puttingonlyaquidin bluffsthe machine’).Theytended
to treat the machine asif it were a person(e.g. – ‘this‘fruity’isn'tinagood mood’).Regular
gamblersalsoexplainedawaytheirlossesbyseeing‘nearmisses’as‘nearwins’,i.e.theyweren’t
constantlylosing,butconstantly‘nearlywinning’,somethingthatjustifiedtheircontinuation.
Self-medicationmodel:refertoinitiation.Manysmokersmention‘stressrelease’asamajor reason
for smoking.
Expectancytheory:Brandon etal – as addiction develops,the activityisinfluencedlessbyconscious
expectationsandmore byunconsciousexpectations,explainingthe lossof control manyaddictsfeel
and relapse difficulties(theyare nolongerconsciouslythinkingaboutthe outcomes).
Self-efficacy theory:Bandura - referstoa beliefinone’sself toorganise andcontrol anyactions
requiredtomeetparticulargoals(theyare nolongerconsciouslythinkingaboutthe outcomes).
Playsa role inwhetheranaddictbelievestheycandoanythingto stopthe addiction.
Rational choice theory: Beckerand Murphy – refertoinitiation.Accordingtothistheory,addictsare
rational consumerswholookaheadandbehave ina waythat islikelytomaximisethe preferences
theyhold.
Relapse:
Recall biasandthe ‘justworld’hypothesis:pathological gamblersoftensufferfroma‘recall bias’,i.e.
the tendencytorememberandoverestimate winswhile forgettingabout,understandingor
rationalisinglosses(Blancoetal).Consequently,astringof lossesdoesnotalwaysactas a
disincentive forfuture gambling.Suchindividual believe theywill eventuallybe rewardedfortheir
effortsandcouldbe motivatedtoreturnon subsequentoccasionsbecause of abeliefthatthey
‘deserve’towin,havinglostsooftenonpreviousoccasions(the ‘justworldhypothesis).
17. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
Self-medicationmodel:refertoinitiation.Manysmokersmention‘stressrelease’asamajor reason
for smoking–relieve stressof withdrawal symptoms.
Expectancytheory:Brandon etal – as addictiondevelops, the activityisinfluencedlessbyconscious
expectationsandmore byunconsciousexpectations,explainingthe lossof control manyaddictsfeel
and relapse difficulties(theyare nolongerconsciouslythinkingaboutthe outcomes).
Self-efficacytheory:Bandura - referstoa beliefinone’sself toorganise andcontrol anyactions
requiredtomeetparticulargoals(theyare nolongerconsciouslythinkingaboutthe outcomes).
Playsa role inwhetheranaddictbelievestheycandoanythingto stopthe addiction.
Rational choice theory: Beckerand Murphy – refertoinitiation.Accordingtothistheory,addictsare
rational consumerswholookaheadandbehave ina waythat islikelytomaximisethe preferences
theyhold.
Evaluation:
Positives:
Researchsupport: Li et al - providedresearchsupportforthe self-medicationmodel.Theyfound
that, comparedtopathological gamblerswhogambledforpure pleasure,pathological gamblerswho
gambledtoescape the painful realityof life were significantlymore likelytohave othersubstance
dependencies.Theyalsofoundthatthese ‘self-medicating’gamblerswere lesslikelytocommit
crimesto finance theirgamblingbehaviourscomparedwithothertypesof pathological gamblers.
Pathological gamblersmotivatedbyself-medicationusuallyhave substitute meanstosatisfytheir
goal,whereasthose whogamble forpure pleasure donot.
Implicationsfortreatments:The evidence thatthere ismore thanone motivationforbecoming a
pathological gamblerimplies thatthere ismore thanone motivationforbecomingapathological
gamblerimpliesthatthere shouldbe differingapproachestohelpingintheirtreatment,depending
on theirmotivationforgambling.Forexample,forself-medicatinggamblers,itmightbe more
beneficial attemptingtogetthemtoquitgambling.Asirrational beliefssuchasthe gambler’sfallacy
playa keyrole in the initiationandmaintenance of gambling,cognitivetheoryattemptstocorrect
these cognitive errors,whichinturnreducesthe motivationtogamble.
Intervention:havingthisknowledge canallow ustointervene because we canadvise parentsto
showchildrenthe negative effectsof the gambling(losing) sothattheydonot developthese
expectations.
Helpsexplainindividual differences:asin,millionsof people have gambled,butmostare not
addicted.Thisisexplainedbecausetheydonothave the faultythoughtprocessesthataddictshave.
Negatives:
Expectancy theoriesandpublicationbias: The focusof researchintoexpectancy theoryhaslargely
beenonpositive researchfindings,withnegativeresultsreceivinglessattention.Forexample,
studieshave supportedanassociationbetweenexpectanciesandaddictive behaviourbutthis
constitutesapublicationbiasasthe selective publicationof positive resultsgivesan
18. Georgie Hartshorne Psychology – Unit 4 Modelsof addiction
unrepresentativeviewof aparticularresearcharea,particularlywhenthe numberof studies
publishedisrelativelysmall,replicationsare few andcontradictoryfindingsare frequent.
Language:Attemptstounderstandthe nature of addictionsare cloudedbythe difficultiesof
obtainingobjective data. Daviesclaimsthataddictsdescribe theiraddiction,whentalkingtoheath
workeror police,byusingthe language of addiction,i.e.theirbehaviourisoutof control.However,
whentalkingtopeers,theyuse differentlanguage whichsuggeststheyare exercisingpreferences
that are rational andunderstandablegiventheircircumstances.Thissuggeststhatlanguage off
addictsservesanimportantfunctionforthe individual,i.e.mayserve toabsolve themof
responsibility.
Opposingresearch: Despitethe logicunderlyingcognitive explanationsof pathological gambling,
researchsuggeststhatpossessingrelevantknowledgedoesnotmake peoplelesssusceptible to
cognitive distortions.Forexample, Benhsain and Ladouceuradministratedagambling-related
cognitive scale totwogroupsof universitystudents,one grouptrainedinstatisticsandthe otherina
non-statistical field.Theyfoundnodifference betweenthe twogroupsintheirsusceptibilityto
irrational gambling-relatedcognition,butwere justasaccurate as non-gamblersinestimatingthe
oddsof winning.
Problemsof cause andeffect: The self-medicationmodel arguesthatsome formof psychological
distressmustprecede druguse,asthe one necessitatesthe use of the other.There issome evidence
to supportthis,forexample researchhasshownthata majordepressive disorderisevidentinthe
majorityof pathological gamblers(Becona etal).However,thiscorrelationbetweendepressionand
gamblingdoesnotnecessarilymeanthatdepressionisthe cause of gambling.Indeed,itisequally
possible thatdepressionisaconsequenceof the personal andfinancialcostsof pathological
gambling.
Griffiths – foundthat regularplayerswere capable of gamblingonautopilotandwere therefore not
thinkingaboutwhattheywere doing,suggestingthe cognitive approachisnota majorrole inthe
maintenance of addiction.