A2 Psychology Addictive Behaviour
Learning objectives:
What does it mean to be addicted?
How have psychologists explained addictive
behaviour?
Are certain people vulnerable to
addictions?
How do we reduce/help those with
addictions?
The psychology of addictive
behaviour
 Models of addictive behaviour • Biological, cognitive
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and learning models of addiction, including
Explanations for initiation, maintenance and relapse
Explanations for specific addictions, including smoking
and gambling
Factors affecting addictive behaviour
Vulnerability to addiction including self-esteem,
attributions for addiction and social context of
addiction
The role of media in addictive behaviour
Reducing addictive behaviour • Models of prevention,
including theory of reasoned action and theory of
planned behaviour
Types of intervention, including biological,
psychological, public health interventions and
legislation, and their effectiveness
What does it mean to be addicted?
1.Write a basic definition
2.What kinds of things can people be
addicted to?
3. What do you think causes a person to
become addicted?
Defining addiction
 ‘Addiction is a state of periodic or chronic
intoxication produced by repeated consumption of
a drug’
(WHO, 1957)
Definitions now include other behaviours, not just
drugs, e.g. sex, exercise, playing computer games,
gambling, overeating
Defining addiction
‘a repetitive habit pattern that increases the risk
of disease and/or associated personal and social
problems. Addictive behaviours are often
experienced subjectively as ‘loss of control’;
behaviour still occurs despite efforts to stop it.
Attempts to stop are often are marked with a
high relapse rate’
Marlatt et al (88)
Shared attributes of addictions
All addictions seem to be characterised by selfindulgent behaviour with short term
gratification at the cost of long term damage
Addictions lead to a powerful and rapid change
of mood and sensation
Celebrity addictions –do you know
what they suffer from?
Classifications of addictions
 DSM-IV and ICD-10 include disabling addictions
 WHO- prefers the term ‘dependence’ to addiction
 Dependence = characterised by intermittent
craving for substance to avoid a dysphoric state
(state of mind characterised by depression and
guilt)
 Dependence is differentiated- abuse and harmful
abuse
Differences in classifications for
addictions
 Smoking- substance related disorder
 Gambling- habit and impulse disorder
Explaining common addictions
 In groups- explain your groups addictions using
psychology theory/common sense
Chris and Farah – alcoholism
Ellie and Lucy- food addiction
Emily, Naeemah and Andy- gambling addictions
 http://www.youtube.com/watch?v=pHDYk15V6hE
Explaining addictions
Biological/medical/disease model
 Addiction is a specific diagnosis
 Addiction is an illness
 The problem lies in the individual
 The addiction is irreversible
 There is an emphasis on treatment
Genes and addictions
 Addiction reflects an underlying physiological
abnormality
 Genetics may play a role
 It is unlikely that a single gene is responsible
for addictive behaviour
 Very likely- multiple genes are involved and
different genes underlie different addictions
 E.g. link between tobacco smoking and genes
involved in dopamine regulation (Lerman et al,
99)
Genetic vulnerability
 Most research in this area focuses on alcohol
addiction
 Family studies and twin studies are used
Merikangas et al (98) 36% of the relatives of
individuals with an alcohol disorder had also
been diagnosed with an alcohol-use disorder
Difficult to separate genetics from the
environment
Adoption studies do however show a link
Twin studies; 60-70% concordance for nicotine
dependence (Kendler et al, 99); 34-60% for
alcohol abuse (Heath and Martin, 93)
Genetic predisposition for
addictions
 Whether this exists or not, you still need to be
exposed to a large amount of whatever to
become addicted
 Likely it is more complicated than genetics
Biochemistry
How the brain metabolises various addictive substances
2 key areas:
-the dopamine reward system
-the endogenous opioid system
Dopamine (neurotransmitter) has a vital role in the
regulation of mood and emotion and in motivation and
reward processes
Alcohol and nicotine affect the nervous system,
increasing levels of dopamine (Altman et al, 96)
It is possible those that are susceptible to addictions
might have inherited a more sensitive mesolimbic
dopamine pathway (Liebman and Cooper, 89)
Controlling our behaviour
 People have the ability to exercise choice over
whether we engage in behaviours and we mostly
maintain a balance so we don’t become addicted
 Over indulgences are temporary for most
 We can do this because we have the ability to
balance 2 competing neurochemical systemsreward reinforcement system and control
system
Serotonin
 Serotonin – plays an important role in control
 Serotonin- lower levels found in impulsive
people
 Oldham, Hallander and Skodal (90) –patients
who attempt compulsive suicides, impulsive
homicidal behaviour, early onset alcoholism and
bulimia –all have lower levels of serotonin
 Obsessive –patients have high metabolic rates
in the frontal areas of the brain and have high
levels of serotonin
The brain’s Opioid system
 Believed to be linked to addiction
 Opioid neurotransmitters include
enkephalin and the endorphins
 The opioid systems are activated in states
of pleasure and can be directly stimulated
by addictive drugs e.g. heroin, alcohol and
nicotine
 Naltrexone- used to treat alcohol
addiction, blocks opioid receptors in the
brain, preventing the rewarding effects of
alcohol
Neuroadaptation
Drug dependence- based on the idea of
neuroadaptation (Koob and LeMoal, 97)
Changes occur in the brain as result of the
taking of psychoactive drugs
Tolerance quickly happens and so doses need to
increase to have the same effect
Withdrawal symptoms- if drug taking stops
These symptoms will make people want to start
taking the substance again
Summary- Biological models
 Alcohol, nicotine, opiate drugs- change brain
mechanisms (these act on the central nervous
system)
 Gambling and other addictions where no chemical
substance is involved also change brain
mechanisms
 Evidence –correlational only
Sum up the biological model
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Provide 1 pro and 1 con
Learning (behavioural models)
1970s onwards
Addictive behaviours – not seen as illnesses
Seen as part of an individual’s repertoire of
behaviour
Addictive behavioursAcquired habits which are learned according to
the principles of SLT
Things that can be unlearned
Not all or nothing categories
No different from any other behaviours
Classical conditioning
Unconditional stimulus spontaneously produces an unconditional
response
If the US is frequently associated with a conditional stimulus this
CS will come to produce the conditional response
e.g. sitting with friends (US)= relaxed feeling (UR)
Smoking with friends, leads to smoking alone becoming the CS=
relaxed feeling (CR)
US-UR; CS-CR
US- can be either internal/external
Wikler (48) first applied this to people who were addicted to
opiate drugs. He noted withdrawal symptoms following the
stopping of consumption of a drug. An addict deals with these
feelings by hunting another dose, exposing them to a range of
cues which become associated to the withdrawal.
Cue exposure theory (Heather and Greeley, 90) could explain why
people suffer such intense cravings once they have been weaned
off their addictive substance.
Operant conditioning
 Depends on the consequences of actions
 Behaviours are likely to be repeated if they
are rewarded in some way
Positive reinforcement – reward is a desirable
consequence, e.g. feeling relaxed
Negative reinforcement- the reward is a
removal of an unpleasant consequence, e.g. the
relief from withdrawal symptoms if
smoking/drug taking continues
What is a reward varies- depending on the
individual, their past/experiences/ their own
needs etc
SLT
 This is SLT developed, going beyond simple
observation to account for some of the more
complex perceptual and reasoning skills of
humans.
 We learn through observing and hearing what
others do/say
 Significant people – make smoking etc
attractive and rewarding
 Also includes aspects of Cog Beh models –
labelling and outcome expectancy model
Cog Beh models
 Cognitive labelling models – an emotional
experience that is the result of an interaction
between physiological arousal and its
cognitive interpretation (the label). Cues to
emotional arousal are very powerful, e.g.
someone who is addicted to alcohol may smell
it near a club and want alcohol more
 Outcome expectancy model- cues set off
expectations about an addictive substance,
e.g. adverts of people drinking may trigger the
thought ‘I really want/need a drink’
Sum up the behavioural model
Provide one pro and one con
Usefulness of Behavioural
approaches
 Links to cognitive make it more able to give a
solid explanation
 Does stress the role of the media (advertising
for cigarettes/alcohol etc)
 However the theories of cognitive labelling and
outcome expectancy are simplistic (Tiffany,
99)
 Avoids the idea that humans are creative
thinkers
Cognitive models
 Emphasis on the processes that control mental functions such as
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communication, learning, problem-solving, planning
Self-regulation- weighing up the relative importance of social
and physical factors as well as one’s own personal goals when
planning behaviour
Addictive behaviour- more common in people who place
excessive reliance on external structures to maintain a balance
between their physical and psychological needs
Impaired control over actions lead to addictive behaviour
Rational people can behave like this if they have faulty ways of
thinking when exploring the consequences of their actions
Ainslie (92) all people can perfectly predict present and future
consequences but they attach different weightings to them,
mostly attaching greater weight to the present
Immediate reward over future benefit – called cognitive myopia
(Hernstein and Prelec, 92)
Beck et al (93)
 Addictive beliefs play an important part in the
development of addictive behaviours
 At first the individual thinks it would be
fun/exciting to drink/take drugs etc and then
gradually they become reliant on the substance
 These individuals often have very negative views
of themselves and may suffer depression/anxiety
The cognitive processing model
 Behaviours if repeated enough become
automatic
 Tiffany (90) argues that addictive behaviours
are regulated by automatic processing
 Drinking etc if repeated and repeated become
automatic, thus it is difficult to stop
automatic behaviour
 We are continuously faced with situations
that trigger automatic responses
 This could be possible if everything else in an
individual’s life is good, however if there are
stresses etc it becomes more difficult
Sum up the cognitive model
Provide one pro and one con
Evaluations of cognitive theories
 Useful for explaining the thinking processes of
people who become addicted to certain
behaviours
 Provides helpful treatments
 Also provides explanations for why relapses
occur
 Does not explain why such addictions start in
the first place
Use one of the models to explain
the following:
 Russel Brand’s sex addiction
 Pete Doherty’s drug addictions
 Michael Jackson’s prescribed drugs
 David Hasselhoff’s alcohol addiction
Explaining specific addictions
 SMOKING
1.1 billion people are estimated to be smokers
across the world (WHO)
4 million people are estimated to die from
smoke related illnesses (WHO)
Evidence links smoking to:
-high blood pressure; coronary heart disease;
lung disease; cancer and strokes
-pregnant women who smoke are more likely to
have premature babies
-smoke increases stress levels (Parrott, 00)
Why do people smoke cigarettes in
the face of the side effects?
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Smoking
 There are 3000 chemical components in
cigarette smoke- but nicotine is the active and
addictive component
 Hilts (94) compared nicotine to 5 other
psychoactive drugs-heroin, cocaine, alcohol,
caffeine and marijuana. He ranked nicotine
lowest for intoxication but highest in terms of
dependence
 Relapse rates- 70% in the first 3 months of
trying to give up. Individuals who give up
experience quite nasty withdrawal effects
Smoking
 It is classed as a psychoactive drug as it
directly affects the brain but it’s effects as
more subtle than most drugs
 Nicotine affects the central nervous
system, its estimated that nicotine once
smoked takes less than 25 secs to reach the
brain
 Nicotine has – stimulant and depressant
effect on the brain- increases the amount of
noradrenaline and adrenaline in the body
 It activates the MESOLIMBIC PATHWAYproducing positive effects-smokers explain it
has a relaxing yet arousing effect
Explaining smoking
 Biological factors
Genetic factors – Shields (42) looked at 42 twin
pairs who had been reared apart
Only 9 pairs were discordant for smoking
behaviour
Explaining smoking
Social factors
Most people start smoking in childhood
Traditional learning theory is able to explain
smoking behaviour quite well- using the
principles of operant conditioning
It is extremely common that the first
experience is unpleasant, difficult to explain
why children persist
SLT
 Children continue to smoke to imitate role
models
 Role models are more influential if the are the
same sex, age or ethnic background as the
observer
 Those with a higher status have more
influence (such as a celebrity) –Winnett et al,
89
 The observation of others enjoying the
experience leads to them persisting to expect
future enjoyment
The role of parents in their
children’s smoking behaviour
 A key influence on smoking behaviour is parents’
attitudes to smoking
 Children are twice as likely to smoke if their
parents are smokers (Lader and Matheson, 91)
 If parents’ attitudes are firmly against smoking,
the child is 7 times less likely to smoke (Murray
et al, 84)
Peer pressure
 Believed to be very important, exerting
pressures on those that do not smoke to start
.e.g. bullying
 Michell and West (96) adolescents are
considerably less susceptible to this kind of
pressure. They explain that some here show a
‘readiness’ for smoking
 Those not wanting to smoke, tend to adopt
strategies to avoid situations where smoking is
likely to be offered
 What are the implications here are for
health campaigns?
Individual differences
 Research in the US links smoking to certain
other traits such as poor performance at
school, low self-esteem, evidence of risk taking
behaviour (e.g drinking alcohol) –Mosbach and
Lenethal, 88
Cognitive factors
 TRA and TPB
 Conner et al (06)- role of planned behaviour in
smoking initiation in 11-12 year olds.
675 non-smoking adolescents were tested for baseline
measures including tpb
9 months later they checked if any of these adolescents
had taken up smoking
They used carbon monoxide poisoning instead of
subjective measures
Results- behavioural intentions were usually a good
predictor of smoking behaviour
In China childhood smoking is a big problem, Guo et al
(07) studied more than 14000 children with tra and
tpb and found they were useful predictors of smoking
behaviour
Problem gambling
 Explain what is meant by the above
 What causes such problems?
Problem gambling
Pathological gambling- term used to describe
those at the most extreme end of the
gambling behaviour spectrum
Problem gambling- gambling that is of a mild to
moderate problem for the sufferer
Difficulties- no clear cut definition of what
gambling is
General consensus- an activity where 2 / more
people agree to take part – usually the
operator and the person/persons who wish to
gamble, the stake is paid by the winner
DSM-IV – to be a problem gambler
you must have 5 or more:
Preoccupation with gambling
Need to gamble with increasing amounts
Repeated unsuccessful efforts to control or cut
down gambling
Restlessness/irritability when trying to cut down
Return to gambling even after losing huge amounts of
money
Jeopardising or losing relationships due to the
gambling
Committing illegal acts such as forgery to conceal
the gambling
Problem gambling
 Usually starts in adolescence for men
 Later in women
 Typically gradual- starting with social to more
frequent
 Gambling is common- millions report doing it each
year (National Centre for Social Research),
however gambling does not always lead to
addictions, e.g in Canada 0.6% of the population
are addicted to gambling
Explanations of gambling behaviour
 Biological accounts
Genetic vulnerability (Eisen, Lin and Lyons, 99)
Comings et al (01) argues the genetic vulnerability could be
explained in terms of genes controlling the activity of
DOPAMINE, SEROTONIN AND NOREPINEPHRINE
Gamblers often report enjoying a high/buzz from the
game/winning, problem gamblers have high levels of dopamine and
norepinephrine in the anticipatory stage before non-problem
gamblers
Meyers et al (04) compared 2 groups of problem gamblers- one
playing cards not for money; the other gambling for money.
Gamblers- raised heart rate and secreted more cortisol (both
are linked to acute stress)
Rosenthal and Lesieur (92) problem gamblers who stop gambling,
report withdrawal effects similar to drug addicts who stop
taking drugs
There is evidence to link dysfunction of the prefrontal lobe to
problem gambling (Cavendini et al, 02), high rates of EEG
abnormalities have been found (Regard et al, 03)
Explanations of gambling behaviour
Meyers et al (04) compared 2 groups of problem
gamblers- one playing cards not for money; the other
gambling for money. Gamblers- raised heart rate and
secreted more cortisol (both are linked to acute
stress)
Rosenthal and Lesieur (92) problem gamblers who stop
gambling, report withdrawal effects similar to drug
addicts who stop taking drugs
There is evidence to link dysfunction of the prefrontal
lobe to problem gambling (Cavendini et al, 02), high
rates of EEG abnormalities have been found (Regard
et al, 03)
Explanations of gambling behaviour
 Sociocultural accounts
Greater access to gambling opportunities are linked to
problem gambling
Ladouceur et al (99) –found that problem gambling
rates increased with greater availability
An Australian study- found gambling rates increased but
not rates of problem gambling when access increased
National Lottery (UK, introduced in 94)-concern it
would become addictive. GamCare survey in 98 found
that 65% of people had played the national lottery
compared to other countries where 90% in New
Zealand and Sweden
Alcohol consumption- believed to increase gambling
(evidence is inconsistent)
Explanations of gambling behaviour
 Psychological factors
One risk factor is impulsivity in childhood
ADHD is found in many problem-gamblers
(Carlson et al, 94)
Operant conditioning- gambling is reinforced
when gambling is successful (money and the
‘buzz’)
Schedules of reinforcement show that variable
successes are more powerful in making
behaviour last and make them difficult to stop
Can’t explain the origin though
Explanations of gambling behaviour
Parental attitudes to gambling – are very
influential particularly the father’s (Oei and
Rayhi, 04)
Irrational self talk –common in gamblers,
Winefield (99) found that 75% of game related
thoughts were irrational, encouraging risk taking
Mood state- contributes to gambling, with people
gambling to escape being depressed
Sharpe’s biopsychosocial model
(02)
 3 key contributing factors:
1. Bioloigcal vulnerability (involving the brain’s
reward system)
2. Family attitudes that support gambling
3. High levels of impulsivity
Nower et al (02) suggests a different
pathway1. Behaviourally conditioned
2. Emotionally vulnerable gamblers
3. Anti-social, impulsive problem gamblers (an
underlying biological dysfunction, e.g.
ADHD)
Vulnerability to addiction
All addictive behaviours take place within a society- which has norms,
values etc
 E.g. France, considered odd not to drink alcohol
SELF-ESTEEM
Low self-esteem is linked to addictive behaviour
ATTRIBUTIONS
Cognitive biases –such as those found in young males who are problem
gamblers, unrealistic ideas about risk and their chances of influencing
the outcome of their behaviour (Moore and Ohtsuka, 99)
PERSONALITY
Eysenck (97) ‘the addictive personality’ –addictive behaviour fulfils a
certain purpose related to the personality of the individual which are
inherited: personality is divided up into 3 areas:
1. PSYCHOTICISM (P)
2. NEUROTICISM (N)
3. EXTRAVERSION (E)
Evidence is mixed for high levels of P, but more convincing for N and E for
dependence to alcohol (Francis, 96)
Correlational evidence only
Link between alcohol addiction and personality disorder –alcoholism is
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Vulnerability to addiction
 Gender
Smoking- increase in female smoking in the US and UK,
male smoking has remained stable
Why might this be the case?
Ogden and Fox (94)
Gambling- males are more regular gamblers compared to
females (Jacobs, 00)
 Social context of addiction
Drinking, smoking and gambling to an extent- are
socially acceptable
Alcohol –linked to transition from childhood to
adulthood
People with antisocial behaviour are more likely to
develop substance use problems
Children with anxiety/depressive symptoms are more
likely to develop substance use problems and often it
Vulnerability to addiction
 Family influence
SLT predicts children’s behaviour will reflect similarities in their
parents.
Parents drugs use is linked to the onset of alcohol and cannabis use
Parents with a permissive attitude to drug use are more likely to
have children who are more likely to start taking drugs
Risk of substance abuse is higher where families have problems
Sociocultural background is also significant- Hall et al found that
people from lower social classes are more likely to develop
substance use problems, same for those with a lack of
educational experience
Problem gamblers show a wide range of school related difficultiestruancy etc (Fisher, 99)
Link between alcohol abuse and problem gambling in males (Vitaro
et al, 01)
What role does the media have in
causing addictions?
Group 1Group 2Group 3Group 4Group 5-
adverts
tv shows
role models
film
computer games
Education
 How do schools address the potential
problem of addictions?
 Does it work?
 What else could they do?
The role of the media in addictive
behaviour
TV shows such as Who Wants to be a
Millionaire
Advertising e.g. the National Lottery ‘It could
be you’
 Other forms of addictive behaviour – Chapman
and Fitzgerald (82) found that underage
smokers preferred heavily advertised brands
 Legislation has changed advertising
Models are used widely within tv shows/films
SLT- we learn through observation and vicarious
reinforcement
How can addictive behaviour be
reduced?
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Reducing addictive behaviour
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1.
2.
Models of prevention
Education – to raise awareness of the possible
consequences of excessive smoking, drinking etc
Introduction to social change – raising prices of
cigarettes etc, raising of age to buy products,
controlling adverts
TRA
 Interested in how health beliefs lead to
health behaviour
Fishbein and Azjen (75, 80)
Consists of 3 components:
-attitude
-behavioural intentions
-subjective norms
A person’s behaviour is influenced by an
interaction between their own views of their
behaviour and how they think others will view
it
TPB
 Azjen
 Later model
Includes perceived behavioural control
-subjective norm and attitude
Reducing gambling
 There is little research investigating the
effectiveness of reducing gambling
 Gadbury et al (93) conducted experiments with
high school students highlighting the
difficulties with gambling, it did raise
awareness but had little influence stopping
such behaviours