Addiction
UNIT 4: PSYA4
lcb@beauchamp.org.uk
Content
The Psychology of Addictive Behaviour
Models of
Addictive
Behaviour

Biological, cognitive and learning approaches to
explaining initiation, maintenance and relapse, and
their applications to smoking and gambling.
Vulnerability to
Addiction

Risk factors in the development of addiction,
including stress, peers, age and personality.
Media influences on addictive behaviour.

Reducing
Addictive
Behaviour


The theory of planned behaviour as a model for
addiction prevention.
Types of intervention and their effectiveness,
including biological, psychological and public
health interventions.
 Starter 
Quiz on biological interventions
for addictive behaviour.
10 questions.
Work independently!
Psychological Interventions
 Combination of behavioural and
cognitive approaches.
 They are based on the assumption that
if we are able to learn addictive
behaviours, such as smoking and
gambling, then we are also able to
unlearn them.
Role of operant conditioning
The principles of operant conditioning have
been applied in the treatment of addictive
behaviours.
The idea behind this treatment is that by
giving people rewards for not engaging in
the addictive behaviour, this will actually
reduce the addcitive behaviour.
Supporting research: OC
Sindelar et al (2007)
Aim: investigated whether the provision of money as rewards
would produce better patient outcome for people on a methadone
treatment programme.
Procedure
 PTs randomly allocated - 2 conditions.
 Condition 1: reward (experimental group).
 Condition 2: no-reward (control group).
 Also received their usual care = daily dose of methadone and
individual and group counselling sessions.
 PTs in the reward condition drew for prizes of various monetary
value every time they tested negative for drugs (urine sample).
Supporting research: OC
Sindelar et al (2007)
Findings: It was found that drug use dropped
significantly in the reward condition, with the number of
negative urine samples being 66% higher than in the
control condition.
Conclusion: this suggests that the principles of operant
conditioning, in particular positive reinforcement, led
to the reduction of addictive behaviour. I.e. if rewarded for
not engaging in addiction, then behaviour was reduced.
CBT
 CBT is based on the idea that addictive behaviours
are maintained by the person’s thoughts about
these behaviours.
 The main goal of CBT is to help people change the
way that they think about their addiction
(cognition), and to learn new ways of coping more
effectively with the circumstances that led to these
behaviours in the past (behavioural), e.g. stressful
situations.
Relapse Prevention (CBT)
 Relapse prevention involves several cognitive and
behavioural strategies to help the individual stay
away from the addictive behaviour and also to
provide support for people who do relapse.
 Therapists help to identify situations that present a
risk for relapse for the individual.
 They also provide the addict with techniques to learn
how to cope with temptation (positive selfstatements and distracting activities) combined
with the use of covert modelling (e.g. practice the
coping skills in one’s imagination).
Evaluation
Behavioural therapy may eliminate
the behaviour but not the problem
The addiction could be due to an underlying
psychological problem rather than a learned
maladaptive behaviour (i.e. a behaviour that
causes an individual harm). Behavioural
therapies eliminate the addictive behaviour but
not the problem, may simply start to engage in
another addictive behaviour instead.
Evaluation
Behavioural therapies often
used in conjunction with other
addictive treatments.
It is difficult to evaluate the effectiveness
of behavioural therapies as often combined
with other techniques e.g. drugs.
Evaluation
The effectiveness of CBT.
Reasonably effective but more effective
when in combination with medication.
Feeney et al (2002) found that only
14% remained abstinent on CBT alone
compared to 38% who received medication
and CBT.
Exam focus
 Apply your psychological knowledge of
biological and psychological interventions to
the past-exam question (June 2012).
 In pairs, read the scenario and bullet point
ideas in your booklets.
 10 marks = 10 minutes.
Public Health Interventions
 Public health interventions are put into place by
governments and voluntary organisations
and are designed to prevent or treat addictive
behaviours.
 These are not targeted at individuals but at large
groups of people – i.e. the population!
 These include legislation (e.g. voluntary
workplace smoking ban and price increase) and
health education (e.g. advertising, leaflets, and
telephone ‘Quitline’).
Mass media strategies
 Mass media strategies are public health
interventions put into place by the
government and health departments to
target large groups of people.
 These interventions aim to prevent or
treat addictive behaviour, with the
main focus being on smoking
behaviour.
The NHS website
 Offers free help and support for people wanting to
quit smoking.
 www.smokefree.nhs.uk – order a free ‘Quit Kit’
online
 0800 022 4332 – SMOKEFREE helpline - free
support and guidance
 www.nhs.uk/Service-
Search/Smoking%20cessation%20clinic/.../636 free NHS smoking cessation clinics
Effectiveness of PHI: ‘Quitline’
Stead et al (2006)
 Meta-analysis of over 18,000 PTs.
 Found that people who received repeated
telephone calls from a counsellor increased their
odds of stopping smoking by 50% compared to
smokers who only received self-help materials
and/or brief counselling.
 Concluded that multiple call-back counselling
improves the LT probability of giving up smoking
for smokers who contact the Quitline services.
 Real-world applications – effective in reducing
nicotine dependence.
Use of advertising
 TV advertisements, radio advertisements,
leaflets, and posters.
1. ‘No Smoking Day,’
2. ‘Stoptober,’
3. The ‘NHS Scared and Worried Campaigns.’
‘No smoking’ day
 www.nosmokingday.org.uk – Wednesday 12th March
2014
 This is an annual event in March aimed at promoting
‘no smoking’ across the UK.
Effectiveness of ‘NSD’
Elton and Campbell (2008)
 Investigated the impact of ‘NSD’ in the English town
of Bury.
 Distributed a postal questionnaire before the day was
introduced to establish how many people smoked,
and how much.
 Repeated the survey 3 months after ‘NSD’ was
introduced and compared the level of smoking
behaviour.
Effectiveness of ‘NSD’
Elton and Campbell (2008)
 Response rates of smokers were similar – 22.4% smoked
in the first questionnaire and 22.6% in the second
questionnaire.
 However the number of cigarettes smoked a day fell
significantly from 27.6 to 21.8.
 This shows that, although the same amount of people
smoked, they had reduced their daily intake of cigarettes
following the ‘NSD’ indicating some level of effectiveness
of ‘NSD’ in reducing addictive behaviour.
‘Stoptober’
 www.stoptober.smokefree.nhs.uk - 28 day challenge
to stop smoking
 ‘Stoptober’ is an NHS campaign that runs for 28 days
in October every year. The aim behind the campaign
is that if smokers can give up smoking for 28 days
then they are more likely to quit full stop.
NHS ‘Scared and Worried’ Campaigns
 Part of the smoking is ‘the enemy of the family’ strategy and

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aimed to reinforce motivation for smokers to quit.
The campaigns looked at smoking from the perspective of a
concerned son or daughter.
The TV adverts showed children openly dismissing things that
would normally be perceived as scary or worrying.
What they actually viewed as scary or worrying was their
parent’s smoking.
Both campaigns successfully made 6 in 10 smokers
think they should stop smoking for their family and
made almost 50% of smokers think they should quit
now and made them feel uncomfortable about
smoking.
NHS ‘Scared and Worried’ Campaigns
 http://www.youtube.com/watch?v=TXMwP3nK2_o
 http://www.youtube.com/watch?v=P7L4LVfHCSE
 http://www.youtube.com/watch?v=TYah-yv646Q
Practical applications
 Public health interventions that increase the
cost of addictive substances (e.g. cigarettes)
could promote smoking cessation and even
discourage people from starting smoking in
the first place.
 An increase in the expense of smoking may
make the perceived cost of the addictive
behaviour greater than the perceived
benefits.
Strengths: Self-report techniques
+ Can be easily repeated so that data can be
collected from large numbers of people
relatively cheaply and quickly.
+ Respondents may be more willing to reveal
personal or confidential information than in
an interview – anonymous.
Weaknesses: Self-report techniques
- Answers may not be truthful – social
desirability bias.
- Sample may be biased as only certain kinds
of people fill in questionnaires e.g. those
willing to spend time completing and
returning.
Problem of cause and effect 
 Many public health interventions
may occur at the same time.
 Therefore it is difficult to establish
which one has been most effective.
General Evaluation
Defining ‘success’ in treatment can be
difficult.
In addiction treatment there are many problems
when evaluating the effectiveness of an
intervention – is ‘success’ defined as complete
abstinence or is ‘success’ simply reducing the
addictive behaviour?
E.g. if someone reduces their smoking by 50% is
that effective treatment?
General Evaluation
Effectiveness may depend on the
addiction.
It could be that biological interventions
(e.g. drugs) work better for chemical
addictions, and psychological
interventions (e.g. CBT) for behavioural
addictions.
Therefore further research is needed.
General Evaluation
Which treatment is most effective?
It doesn’t seem to matter which treatment an
addict engages in, as no single treatment has been
shown to be demonstrably better than any other.
Addiction interventions are often used in
combination – therefore it is difficult to establish
the effectiveness of each one individually.
General Evaluation
 Undergoing a variety of treatments
simultaneously appears to be beneficial in
treating addictive behaviours. E.g. Biological
and psychological in combination.
 Research evidence to support effectiveness
of all types of intervention.
END OF TOPIC!!!