1. Biological, Cognitive and Learning
approaches to explaining initiation,
maintenance and relapse, and their
applications to smoking and gambling
Addictive Behaviour
2. Discussion
Addiction
Activities associated with addiction
Who is an addict?
Are addictions always harmful?
Celebrity stories
In small groups
complete the
discussion on the A3
sheet in front of you
3. Initiation Maintenance Relapse
Addiction
A repetitive habit pattern that
increases the risk of disease
and/or associated personal and
social problems
Often experienced
subjectively as a „loss of
control‟.
The behaviour continues
despite attempts to abstain
or moderate use
4. Biological Explanation
In groups identify key words that you
associate with the biological approach
to Psychology
How can we apply these terms to
addictive behaviour?
i) Genetic explanation
ii) Disease model
5. According to the Biological
Approach
• Addiction is a specific diagnosis (you
are either an addict or you are not – you
can‟t be slightly an addict)
• Addiction is an illness
• The problem lies within the individual
• The addiction is irreversible
• There is an emphasis on treatment
A01
6. Biological Approach to
Addiction (Initiation)
Initiation: How the behaviour gets started
The Biological approach suggests that
• a person may be most susceptible to addiction during
the initiation phase, because they have a predisposed
biological vulnerability.
• The initiation of addiction may therefore be viewed as
being due to a genetic vulnerability which could be
triggered by environmental stressors (i.e., diathesis-
stress). However, it is likely to be an environmental
trigger that initiates an addiction
A01
7. Genetic Explanation
(Initiation - smoking)
Researchers often carry out family studies to
investigate the possibility of genetic
transmission of addictive behaviour.
- Family studies of addictions have shown high
rates amongst relatives
A01
Shields (1962) looked at 42 MZ twin pairs who had been
reared apart. They were chosen to try to separate the
effects of genetics from family influence (separate
nature from nurture).
Only 9/42 pairs were discordant (what does this mean?)
Suggesting there might be an inherited component to
smoking addiction A02
8. Genetic Explanation
(Initiation - smoking)
• Maes et al (1999) studied 1412 MZ and DZ twin
pairs aged 8-16 and found a significant genetic
influence in the use of tobacco, alcohol and “other”
drugs.
• Kendler et al (1999) estimated heritability of
nicotine dependence to be between 60-70%.
These pieces of research show a wealth of
evidence from twin studies to demonstrate that
there is a genetic component to addictive
behaviours
A02
How can we link the genetic
explanations to explain why some
people are more resistant to
treatment?
9. However… can you think of any better explanations
that genetics for the initiation of smoking?
Merikangas et al…
Impossible to separate out the effects of genetics and
environmental influence (behaviour could be explained
by Social Learning Theory)
A02
But…could the link with addiction and genetics be indirect?
Jang et al (2000), completed a study with over 300 DZ twins
which looked at the relationship between alcohol use and
personality.
The study found a connection between genetics and anti-social
personality characteristics (including attention-seeking and
violence) and between these characteristics and alcoholism
A02
10. Nature Nurture
This means that the Biological approach should not be used in isolation of the
other approaches when explaining addictive behaviour.
A02
11. A02
Genetic Explanation
Q. Individual Differences?
A.Diathesis-stress model explains that an
individual has a biological predisposition but an
environmental trigger is required for the
behaviour to be exhibited
- Basically some people are more vulnerable to
develop an addiction because of their genes
Genetics cannot be the only cause of addiction
No research study into the genetic component of
addictive behaviour has demonstrated 100% heritability
in any addictive behaviour and therefore it can be
concluded that…
Genetic factors cannot possibly be solely responsible
for the development of addictive behaviours
12. Maintenance: what keeps the behaviour going
There is genetic evidence which indicates that some people are more
vulnerable than others to being dependent on substances such as
nicotine and these people would therefore be more likely to maintain
their “habit” and so remain dependent (it would also make them more
likely to relapse).
However, biological predispositions are less likely to have an effect
during the maintenance of an addiction.
The biological approach also suggests that neurobiological factors may
explain the maintenance of addiction, for example, maintenance can
occur because taking an addictive substance such as nicotine, alcohol
or cocaine can stimulate the pleasure and reward sites in the brain
(such as the mesocorticolimbic dopamine pathway – MDP) and the
person therefore seeks out these substances so that they can continue
to stimulate these pleasure areas in the brain.
13. Relapse: what makes the behaviour recur after it
has previously stopped
This is explained by the biological approach as the
individual wanting to satisfy any physiological cravings
(caused by activity in the caudomedial orbitofrontal
cortex) or to stop any unpleasant withdrawal
symptoms.
Mesocorticolimbic dopamine
pathway is involved in pleasure +
reinforcement
14. A study to support Maintenance
and Relapse
Small et al (2001)
Chocolate eaten by participants = they rated it as pleasurable = brain
imaging showed the MDP was being activated
When p‟s desired chocolate again = imaging showed the Caudomedial
Orbitofrontal Cortex was activated (this brain centre is implicated in
the physical craving)
So therefore the p‟s eat chocolate to ease the craving = this is then
rated pleasurable = activates MDP
The cycle continues.... and a chocoholic is born! This is how maintenance
and relapse of an addiction can be explained by the Biological
approach.
* Eating chocolate may also cause the secretion of endorphins (pleasure
chemicals through EOS
15. Genetic Explanation - MDP
(Maintenance & Relapse)
• The neurotransmitter most commonly implicated in
addictive behaviours is dopamine.
• In normal dopamine activity, cells in the mesolimbic
dopamine system are spontaneously active, releasing
small amounts of dopamine which maintains relatively
stable mood states. This enables us to maintain a
balance, between our reward reinforcement system
(MDP) and our control system which tells us that
we‟ve had enough (so that we don‟t become addicted).
A01
How can we link this to smoking behaviour?
16. Genetic Explanation - MDP
(Maintenance & Relapse)
• Supporting research by Altman et al (1996) found
that nicotine affects the nervous system by
increasing dopamine levels
• Liebman and Cooper (1989) suggest that people who
are susceptible to addictions might have inherited a
more sensitive mesolimbic dopamine pathway.
• Caine et al (2007) found that mice engineered to
lack a particular dopamine receptor do not develop a
taste for the drug cocaine (something both humans
and mice find highly addictive).
A02
17. Genetic Explanation - EOS
(Maintenance & Relapse)
• There is increasing evidence to suggest that the
brain‟s opioid system may also play an important role
in addiction. Opioid neurotransmitters in the brain
include enkephalin and the endorphins. The opioid
systems are activated during states of pleasure.
The EOS can be directly stimulated by addictive drugs
such as heroin, alcohol and nicotine.
A01
Maintenance: The person therefore desires the substance again and again in
order to feel the pleasure created by the secretion of chemicals in the
EOS.
Relapse: When the person does not take in the addictive substance they
still desire the pleasurable feelings associated with the substance and
therefore particularly in times of environmental stress
How can we link this to smoking behaviour?
18. Genetic Explanation – EOS
(Maintenance & Relapse)
• Calvert (2009) reported that smokers simply shown
cigarette packets experienced strong activation in
specific areas of the brain (e.g., ventral striatum – an
area well documented to be the site of rewarding
feeling)
What is happening to the addict here?
A02
• O’Malley et al (1999) There is evidence which shows
that long-term tobacco smoking disrupts the opioid
system
The area is associated with pleasure, nicotine affects
this area providing pleasure, individual enjoys the
feeling, wants to repeat (maintenance) once the feeling
ends on a long term basis the memory of it remains
(relapse)
19. Genetic Explanation
IDEA‟s /
A03
Approaches:
Biological – empirical,
objective and
measureable
Debates:
Determinism Vs. Free will
Nomothetic Vs.
Idiographic
Issues:
Biological reductionism
Ethics:
Human (social sensitivity?)
A03
- Scientific measurements
20. Gambling
• There is some confusion about terms
used to describe addictive gambling.
Pathological gambling is the term used to
describe a diagnosable psychiatric
behaviour.
Problem gambling is the term used to
describe mild to moderate problems
associated with gambling and as a general
overarching term for all levels of
potentially harmful gambling behaviours.
• Gambling usually starts in adolescence
for men and later in adulthood for
women
• It is often a gradual process with
individuals progressing from social to
frequent, problem and finally
pathological gambling.
21. Biological Approach to
Addiction (Initiation)
Initiation: How the behaviour gets started
The Biological approach suggests that a person
may be most susceptible to addiction during the
initiation phase, because they have a predisposed
biological vulnerability. The initiation of addiction
may therefore be viewed as being due to a
genetic vulnerability which could be triggered by
environmental stressors (i.e., diathesis- stress).
A01
22. Genetic Explanation
(Initiation - Gambling)
There is evidence that gambling runs in families.
Twin studies support the idea of genetic
vulnerability to pathological gambling - Shah et
al (2005) conducted a twin study and found
evidence of genetic transmission of gambling in
adult men.
A01
Comings et al (2001) suggested the possibility that the
genetic process involves the genes controlling the activity
of the brain neurotransmitters dopamine, serotonin and
norepinephrine.
A02
23. Genetic Explanation
(Initiation - Gambling)
Black et al (2006) also found that first-degree relatives of
pathological gamblers were more likely to suffer from pathological
gambling than were more distant relatives, thus demonstrating a
strong genetic link.
Slutske et al (2000) found that 64% of the variation in risk for
pathological gambling could be accounted for by genetic factors
alone. Familial environmental factors were less significant in their
contribution to gambling behaviour.
Eisen et al (2001) using twin studies found a correlation between
heredity and both problem gambling and alcoholism; suggesting
genetic factors may play a part in addictive behaviours generally.
A02
A03?
24. However… can you think of any better
explanations that genetics for the initiation of
gambling?
Financial
reasons?
Behavioural?
Thrill?
Interest?
25. Nature Nurture
This means that the Biological approach should not be used in isolation of the
other approaches when explaining addictive behaviour.
26. A02
Genetic Explanation
Q. Individual Differences?
A.Diathesis-stress model explains that an
individual has a biological predisposition but an
environmental trigger is required for the
behaviour to be exhibited
- Basically some people are more vulnerable to
develop an addiction because of their genes
Genetics cannot be the only cause of addiction
No research study into the genetic component of
addictive behaviour has demonstrated 100% heritability
in any addictive behaviour and therefore it can be
concluded that…
Genetic factors cannot possibly be solely responsible
for the development of addictive behaviours
27. Genetic Explanation - MDP
(Maintenance & Relapse)
• The neurotransmitter most commonly implicated in
addictive behaviours is dopamine.
• In normal dopamine activity, cells in the mesolimbic
dopamine system are spontaneously active, releasing
small amounts of dopamine which maintains relatively
stable mood states. This enables us to maintain a
balance, between our reward reinforcement system
(MDP) and our control system which tells us that
we‟ve had enough (so that we don‟t become addicted).
A01
How can we link this to gambling
behaviour?
28. Genetic Explanation - MDP
(Maintenance & Relapse)A01
One of the factors that seems to motivate
gamblers is the „high‟ or „buzz‟ they experience
when they seem close to winning. It has been found
that certain neurotransmitter levels rise in
gamblers after a winning streak.
Raised levels of dopamine and noradrenaline have
been found in people after episodes of gambling
and, in pathological gamblers, they have been found
in the anticipatory stage before the gambling
actually begins.
29. Genetic Explanation - MDP
(Maintenance & Relapse)
Meyer et al (2004) compared a group of problem
gamblers while they were engaged in gambling and
during a control condition when they were playing cards,
but not for money. They found increased secretion of
cortisol and increased heat rate in the gambling
condition compared to the control condition.
This provides evidence of a link between gambling and
an individuals‟ hormone secretion, i.e., a link between
addictive gambling and a biological reaction.
A02
30. Genetic Explanation - MDP
(Maintenance & Relapse)
• Roy et al (2004) found higher levels of
norepinephrine levels in chronic blackjack gamblers
and higher levels of dopamine in chronic casino
gamblers
This suggests that biological neuroendocrine
disturbances can account for dependency.
• Gross et al (2009) found that dopamine agonists
used to treat Parkinson‟s disease were turning 10% of
patients into pathological gamblers.
This suggests that dopamine is linked to gambling
dependency and so supports the biological explanation
A02
31. Genetic Explanation - MDP
(Maintenance & Relapse)
How can we apply this information
positively?
The fact that dopamine is linked to dependency may lead to the
manufacture of drugs acting upon dopamine production, which could reduce
not only gambling dependency, but other forms of addictive behaviour too.
A02
Kim and Grant (2001) found that the drug naltrexone (which acts
upon dopamine production) was successful in reducing compulsions
to gamble. This again adds support to the biological explanation of
addictions, but also shows how the biological approach can lead to
effective practical applications.
Paul (2008) reports that 20% of teenage gambling addicts
contemplate suicide, demonstrating the pressing need for valid
explanations of the condition in order for effective treatments to
be developed.
