Psychology-Addiction

What is a withdrawal syndrome

A collection of symptoms associated with abstaining from a drug or reducing its use.

Define psychological dependence

A compulsion to continue taking a drug because its use is rewarding

Define addiction

A disorder in which an individual takes a substance or engages in a behaviour that is pleasurable but eventually becomes compulsive with a harmful consequence. Marked by physiological and/or psychological dependence, tolerance and withdrawal

Define stress

A physiological and psychological state of arousal that arises when we believe we do not share the ability to cope with a perceived threat (stressor).

Define tolerance

A reduction is response to a drug, so that the addicted individual needs more to get the same effect

Define withdrawal syndrome

A set of symptoms that develop when the addicted person abstains from or reduces their drug use

Define physical dependence

A state of the body due to habitual drug use and which results in a syndrome when the use of the drug is reduced or stopped

How is dopamine involved in addiction

Abnormally low numbers of the D2 receptor are thought to be involved in addiction.

How does peers have an impact on the development of addiction

Amongst older children, peer relationships become the most important psychological risk factor, outstripping even family influences. This is true even in cases where peers have not used drugs themselves. Mary O'Connell et al suggested that there are three major elements to peer influence as a risk factor for alcohol addiction: An at risk adolescents attitudes and norms about drinking are influenced by associating with peers who use alcohol These experienced peers provide more opportunities for the at-risk individual to use alcohol The individual over estimates how much their peers are drinking, which means they drink more to keep up with the perceived norm Peers attitudes that ultimately influence drug use do not have to specifically concern drugs. What is influential is the creation is a group norm that favours rule-breaking generally, and drug use is just one instance of this.

Define genetic vulnerability

Any inherited predisposition that increases the risk of a disorder or condition

Define risk factors

Any internal or external influence that increases the likelihood that someone will start using the drug or engage in addictive behaviours

Why is cross tolerance an issue in surgery

Because people who have developed a tolerance to the sleep-inducing effects of alcohol need higher doses of anaesthetics

How can cross-tolerance be used therapeutically

By giving benzodiazepines to people withdrawing from alcohol to reduce the withdrawal syndrome

What is tolerance caused by

By repeated previous exposure to the effects of a drug

What is cross-tolerance

Developing tolerance to one type of drug, which can reduce sensitivity to another type (benzodiazepines)

What are the 2 direct genetic mechanisms involved in addiction

Dopamine (A type of neurotransmitter)

What is not an inevitable cause of addition on their own

Genes

Give an evaluation point for genetic vulnerability in the development of addiction

Genetic factors may play an indirect role in increasing risk by determining certain addiction-related behavioural characteristics. For example, self control and the ability to regulate emotions may well be at least partly genetically determined. A young person who is less able to control their behaviour might have difficulty in concentrating on the kinds of tasks that are typical of schoolwork. If an individual does not function well in school, they could be caught up in self fulfilling downwards spiral of negative attitudes, disruptive behaviour, poor reputation and low achievement. They may gravitate towards friends who share such characteristics, leading ultimately to involvement with drugs. Genetic vulnerability is therefore a significant risk factor, as it might influence addiction risk more than it appears because some of its affects are indirect

What did Pianezza (1998) find about being able to metabolise substances and addiction

He found that some people lack a fully functioning enzyme (CYP2A6) which is mainly responsible for metabolising nicotine. They also smoked significantly less than those smokers with the fully functioning version. Because expression of the CYP2A6 enzyme is genetically determined, individuals with the fully functioning version are at greater risk of nicotine addiction.

How does stress have an impact on the development of addiction

Increased risk is linked with peroids of chronic, long-lasting stress and traumatic life events in childhood. Epstein (1998) looked at data from the National Womens Study. They found a strong correlation between incidence of childhood rape and adult alcohol addiction, but only for those women that were diagnosed with post-traumatic stress disorder (PTSD). So it appears that there is not an inevitable relationship between a traumatic childhood event and later addiction. A child only has an addictive problem if they have a vulnerability (eg. early abuse) and a later stressful situation (eg. PTSD). Andersen and Teicher (2008) suggested that early experiences of severe stress have damaging effects on the brain in the sensitive period of development. This creates a vulnerability to addiction by adolescence or young adulthood

What motivates the addicted person to take the drug

Is partly to avoid the withdrawal symptoms, a secondary form of psychological dependence

What is the research support for genetic vulnerability in the development of addiction

Kendler et al used data from the National Swedish Adoption Study. They looked especially at adults who had been adopted away as children, from biological families in which at least one parent had an addiction. These people had significantly greater risk of developing an addiction themselves (8.6%), compared with adopted away individuals with no addicted parent in their biological families (4.2%). This is strong evidence for the role of genetic vulnerability as an important risk factor.

Give a study which demonstrates that family influence can have an impact on the development of addiction

Livingston et al (2010) found that final year high school students who were allowed by their parents to drink alcohol at home were significantly more likely to drink excessively the following year at college

Evaluation: Interactions between all risk factors (Risk factors in the development of addiction-Part 2)

Not one risk factors casual in addiction; combinations of risk matter more than one single factors. Linda Mayes and Nancy Suchman point out that different combinations of risk factors partly determine the nature and the severity of an addiction. Furthermore, the factors that we have described so far as 'risky' can also be protective. Some personality traits, genetic characteristics , family and peer influences make addiction less likely (for example greater parental monitoring, lower levels of impulsivity). Therefore, there are many pathways to addiction . This is a much more complex, interesting and realistic picture of addiction vulnerability than the simplistic suggestion that one risk factor is hugely more important than any other

How does family influences have an impact on the development of addiction

Of all the ways in which family influences can create vulnerability to addiction, perceived parental approval is perhaps the most consistently reliable risk factor. This is the extent to which an adolescent believes that his or her parents have positive attitudes towards a particular drug or drugs in general, or potentially addictive behaviours such as gambling. The key determinant is the at-risk individuals perception of approval. On what basis is this formed? Adolescents who believe that their parents have little or no interest in monitoring their behaviour (eg. internet use, peer relationships) are significantly more likely to start using alcohol in families where it is an everyday feature of family life or where there is a history of alcohol addiction.

Define personality

Patterns of thinking, feeling and behaving that differ between individuals. These are relatively consistent from one situation to another, and over time

Define peers

People who share our interests and are of similar age, social status and background to ourselves. Peers become more influential in adolescence, when we spend more time with them and less with family

How does personality have an impact on the development of addiction

Psychologists generally agree that there is no such thing as an overarching 'addictive personality. However that does not mean that individual personality traits such as hostility and neuroticism are not linked with addiction (Butler and Montgomery 2004). The strongest correlation has been found between addictive-related behaviour and antisocial personality disorder (ASPD). Antisocial personality disorder begins early in adolescence and incorporates many personality-related risk factor, but the key one is impulsivity. This is marked by a lack of planning, a high degree of risk taking, a preference for immediate gratification of desires and a chaotic lifestyle. In a review of relevant research, Ivanov et al (2008) concluded that many studies strongly support the link between impulsivity and addiction. The researchers speculated that this could be because they share a neurological basis., or even a common genetic component.

How often will an addicted person experience withdrawal symptoms

Relatively often, so they become familiar with these symptoms

Methodological issues (Risk factors in the development of addiction-Part 2)

Research into risk factors associated with addictions has been very productive. But a significant methodological problem is the retrospective nature of many studies. Assessing some major risk factors requires participants to recall incidences of stress, trauma and family behaviours from the past, sometimes from years previously. Such incidents may be especially difficult to recall accurately because of the related stress or trauma

Evaluation: Cause and effect (Risk factors in the development of addiction-Part 2)

Research into risk factors is often correlational, which raises serious issues of cause and effect. For example, many studies have shown there is a strong correlational between stressful experiences and addiction-related behaviours. However many addictions can create general levels of stress because of their generally negative effects on lifestyle, relationships, financial affairs ect. Because risk factors and addiction co-relate in these ways, it is difficult to separate out the effects of one upon another. In the case of peer influences, adolescents who are already vulnerable to drug use (because of other risk factors such as family influences), are attracted to a peer group which enjoys rule breaking. As Michael Vaughn points out, 'Risk factors are not in and of themselves causes but are instead correlates unless tested....as such' (for example in longitudinal studies)

Real life Applications: (Risk factors in the development of addiction-Part 2)

Researchers such as David Hawkins et al (1992) believe that a focus on risk factors is a highly promising strategy for preventing and treating addictions. If we can understand what the risk factors are, and more importantly how they react, then we have an opportunity to identify those in the population who are most at risk. For example Nancy Tobler et al. (2000) created a peer pressure resistance training programme to help prevent young people taking up smoking

What is the second genetic reason for addiction

Some individuals are more able to metabolise (break down) certain substances, and this is linked to addiction. Individuals with the fully functioning version are at greater risk of nicotine addiction.

Proximate and ultimate risk factors (Risk factors in the development of addiction-Part 2)

Some risk factors may be partly genetically determined. Eg. Lara Ray and her colleagues have shown that novelty seeking (in which the individual continually craves new experiences) may be associated with genetic markers for D4 dopamine receptor. This research also shows that novelty-seekers are more likely to become problematic alcohol users. Perhaps this is because they are more sensitive to the rewarding effects of dopamine activation brought about by drug use. This suggests that some risk factors for addiction may not be all they seem. The personality trait of novelty seeking is a proximate risk factor, because it is the immediate influence on addiction. But to fully understand the role of risk factors, and to use this understanding to help people who are addicted , we have to look further back in the chains of influences to the ultimate risk factor. In many cases it is genetic. This is another reason why genetic vulnerability may be the most significant risk factor in addiction, because it has the ultimate influence on all the others

What are the risk factors in the development of addiction

Stress Personality Family influences Peers Genetic vulnerability

Define family influences

The effects that other members of our families have on our thoughts, feelings and behaviours over the course of our development

Genetic vulnerability can also help to explain...

The progression from occasional use of a drug to outright dependence on it

Explain the role of dopamine in addicton

The way in which dopamine communicates in the brain depends on the presence of receptors for dopamine molecules on the surface of neurons. There are different types of dopamine receptors. One of these is the D2 receptor

When does tolerance occur

When an individuals response to a given amount of a drug is reduced. This means they need ever greater dose to produce the same effect on behaviour

Give an example of behavioural tolerance

When people addicted to alcohol learn to walk more slowly when they are drunk to avoid falling over

When does behavioural tolerance occur

When the individual learns through experience to adjust their behaviour to compensate for the effect of a drug

What are the types of tolerance

behavioural tolerance and cross-tolerance

What are the key features of addiction

dependence, tolerance and withdrawal symptoms

But once a person is exposed to a drug....

genetic vulnerability can help explain why some become dependant and others do not

The proportion of all receptors in the brains of individuals are determined..

genetically

What are the withdrawal symptoms of nicotine

irritability, anxiety, restlessness, increased appetite and weight gain

An individual will never become addicted to a drug if they've...

never taken it

What is inherited is not an addiction itself, but a...

predisposition or vulnerability to the drug dependence

Whether or not an individual takes a drug will mostly depend on...

psychological factors

In physical and psychological dependance...

taking the drug is followed by a reward

Once a physical dependence develops....

the addicted person experiences some symptoms of withdrawal whenever they cannot get the drug.

What does psychological dependance refer to

the compulsion to experience the effects of a drug, usually in terms of an increase in pleasure or a lessening of discomfort

The withdrawal symptoms are always

the opposite of the ones created by the drug, and indicate tat a physical dependence has developed.

What is a consequence of psychological dependance

the person will continue to take the drug (or engage in behaviour) until it becomes a habit, despite the harmful consequences.

When is it said that a physical dependence has occurred

when a withdrawal symptom is produced by stopping the drug

When is it possible to establish if someone is physically dependant on a substance

when they abstain from it