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Think about what you know of addiction already, do you think of these as facts or are they stereotypes you've come to think of when addiction is mentioned? Addiction is a complex issue that can be defined by its psychological and physical dependence qualities, with multiple risk factors, characteristics, and treatment options. Let's explore addiction further.
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Jetzt kostenlos anmeldenThink about what you know of addiction already, do you think of these as facts or are they stereotypes you've come to think of when addiction is mentioned? Addiction is a complex issue that can be defined by its psychological and physical dependence qualities, with multiple risk factors, characteristics, and treatment options. Let's explore addiction further.
Fig. 1 - Addiction is characterised by physical and psychological dependence.
Addiction is when an individual cannot stop engaging in an activity they find pleasurable, and involves tolerance and withdrawal symptoms alongside dependence (both physical and psychological). There are many types of addiction, but at its core, it is when a person is unable to stop engaging in their addiction even though it is causing them and others harm; they have become dependent on the object of their addiction.
Addiction is defined as when someone engages in a pleasurable activity that they then cannot stop doing. Addiction can even be detrimental to their everyday life, health, well-being, family, and friends.
There are some concepts within the topic of addiction that we will clarify below, including kinds of dependence, tolerance, withdrawal syndrome and some risk factors for addiction.
Addiction can form as a psychological dependence and/or a physical dependence on a substance or behaviour.
Psychological dependence is when someone becomes dependent on the object of addiction for psychological and emotional functioning. It is about your mental state. A person may act out emotionally or feel anxious when they cannot gain access to the drug or behaviour.
Physical dependence is when an addict cannot physically function without the object of addiction; the body is dependent on the drug and not partaking in the addiction can result in withdrawal symptoms. The drug or behaviour is the new normal, in a sense, and to regain that normal state, you need to take the drug again.
An example of psychological dependence can be seen in alcohol addiction. For instance, someone with alcohol addiction may become angry and aggressive if they haven't had a drink, meaning they are psychologically dependent on alcohol to behave normally and not resort to aggression.
An example of physical dependence includes an alcoholic experiencing shakes and tremors when unable to drink.
A person becomes tolerant of something when they are physically dependent on it to achieve a sense of normality. They engage in the object of addiction so often that it no longer has the same effect. As a result, they increase their 'dosage' to achieve the same effect.
For example, someone with an alcohol addiction may move on from weak beer to strong whiskey, as beer doesn't give them the same 'buzz' anymore. They may need to drink more beer to get drunk.
Withdrawal symptoms refer to the physical symptoms that someone experiences when they either reduce or stop partaking in the object of their addiction. They include but are not limited to, anxiety, insomnia, nausea and body aches. Withdrawal symptoms differ depending on the drug or behaviour.
An alcoholic may experience shaky hands and nausea, whereas a smoker experience headaches and hunger cravings.
Risk factors are things that might make someone more vulnerable to developing an addiction. They could be lone factors, but often addiction results in a combination of several. Risk factors for addiction could include:
Fig. 2 - Family and peer influence can be a risk factor for addiction.
It is important to recognise that genetic vulnerability does not connotate certainty - meaning that someone's genes do not guarantee that they will become addicted.
There are multiple types of addiction. In this section, we will look at two specific types of addiction, however: nicotine addiction and gambling addiction. We will look at how different approaches explain these addictions and how we can treat them.
Nicotine addiction is when someone is addicted to nicotine, through smoking cigarettes or chewing tobacco. Specifically, the DSM 5 defines nicotine addiction as:
Biological explanations of addiction centre around the brain's mesolimbic system, or reward system. The components of this system that influence addiction are:
Specifically, these systems regulate desensitisation, conditioning (reward systems), tolerance and changes within the brain which can all contribute to addiction. Notably, serotonin is also involved in the control of impulsiveness (control lowers impulses to engage in risky behaviours).
Learning theory explains nicotine addiction through conditioning. A person with nicotine addiction is not only rewarded with the pleasure of smoking a cigarette but may develop cue-reactivity, wherein objects associated with smoking trigger their addiction, e.g. a lighter.
Fig. 3 - Smoking can lead to nicotine addiction.
Gambling addiction is when someone is addicted to gambling. DSM 5 considers gambling to be a problematic disorder, leading to significant distress characterised by:
Gambling addiction could take many forms, from betting on sporting events to playing poker and slot machines. When someone is addicted to gambling there are a few approaches that could explain their behaviour, but in this section, we will explore learning theory, the cognitive approach and cognitive bias.
Learning theory explains gambling in terms of operant and classical conditioning. When the gambler wins they are rewarded, reinforcing their gambling behaviour. Although it is true that gambling is not reinforced every time someone gambles, the thrill and risk of placing a bet are, therefore, this uncertainty reinforces addiction.
The cognitive theory explains gambling in terms of irrational thoughts, including reasoning and cognitive bias such as illusions of control (a belief that the gambler can influence the outcome of their bet) and gambler’s fallacy (a belief that after a losing streak, a win is certain). Gambling can also be seen as a coping mechanism and distraction.
Cognitive bias is a thinking error that affects people's judgement, it occurs when people try to justify bad decisions in order to carry on repeating the behaviour. In gambling addiction this can include instances of focusing on nearly winning or only winning (rather than all the times lost), making people believe that they are more likely to win if they carry on gambling because they have won before.
The DSM 5 criteria for drug addiction is listed as 'substance-related and addictive disorders', including drugs such as alcohol, nicotine, caffeine, opioids, hallucinogenic, stimulants and cannabis. Drug addiction is categorised as:
The physical dependence on a substance that has impairment on the health and life of the user, especially when taken often, more than intended or with an inability to stop.
There are multiple ways to treat drug addictions, and this is seen through addressing the biological and psychological needs of the individual.
Biological treatments for drug addiction usually involve drug therapy. There are three main types of drugs that might be used:
Fig. 4 - Drug therapy can help in the treatment of addiction.
Methadone is an example of an agonist drug therapy treatment for heroin or opioid addiction, taken in controlled doses aiding in reducing the symptoms of withdrawal.
The common behavioural treatment for addiction is aversion therapy. Aversion therapy involves replacing the positive association the sufferer has with their addiction with a negative or aversive association.
Covert sensitisation is an alternative behavioural treatment for addiction. Covert sensitisation involves the same process as aversion therapy but the sufferer simply imagines the association rather than experiencing the aversive stimulus.
Cognitive behavioural therapy (CBT) is used as a cognitive treatment for addiction. It is based on the idea that addiction is caused by faulty thought processes, so if someone changes the way they think about their addiction, they can also break their addictive behaviour. The therapy (CBT) aims to allow people to recognise situations in which they turn to their addiction to replace their addiction with positive behaviour.
Alcohol addiction is categorised in the DSM 5 within the substance-related and addictive disorders, with the compulsive behaviour and related treatment being related to alcohol and personalised towards the individual seeking help. This again can include a mix of biological, behavioural and cognitive treatment.
Drug therapy treatments for alcohol addiction can include any of the same treatments listed in the drug addiction section (aversive, agonist, antagonist).
An example of an antagonist drug usually used in the treatment of alcohol addiction is naltrexone, which blocks the pleasurable effects of drinking alcohol, potentially making it easier to stop drinking as there are no positive effects felt anymore.
Drug therapy can overlap with behavioural treatment for alcohol addiction. Aversive drugs taken when drinking alcohol can cause severe nausea and sickness, which creates negative associations with the substance. This is a form of aversion therapy.
Cognitive Behavioural Therapy (CBT) is also recommended during the alcohol addiction treatment process. CBT is effective for the treatment of anxiety and depression, which are disorders and symptoms which may co-exist in someone with alcohol addiction.
CBT and other psychological treatments/talking therapies allow safe spaces for people to explore their harmful thoughts, beliefs and behaviours without judgement. This can aid in an individual's recovery and prevent relapse.
As mentioned when discussing risk factors for addiction, there are several things that can influence the development of addictive behaviour. Not necessarily having an addictive personality type, but genetic and environmental vulnerabilities or stressors that risky or pleasurable behaviour is used as a coping mechanism to manage.
There are a few theories on how to manage addictive behaviour that are not initially tailored towards a specific substance or behaviour and can be adapted based on the needs of the individual.
This theory was a development of Ajzen and Fienbein's (1970) theory of reasoned action. Ajzen (1989) proposed that behaviour is controlled by intentions which are influenced by various factors:
The theory states that behaviour can be changed by creating different attitudes towards addiction. This is achieved by showing the sufferer data about how many people engage in risky behaviour. This will give the sufferer the willpower to change their behaviour.
Can you see how the theory of planned behaviour could link to treatment for an addiction? In combination with drug and other cognitive therapy, this could help people to think about their attitude and behaviour in order to prevent relapses.
This model describes the six stages of behavioural change which can help a person overcome addiction. They are as follows:
Addiction is when someone engages in a pleasurable activity that they then cannot stop doing even though it may be detrimental to their well-being and loved ones.
Addiction is characterised by physical and psychological dependence as well as tolerance and withdrawal syndrome. The risk factors of addiction are stress, peer group, family and genetic vulnerability.
Psychologists use learning theory, cognitive approaches and biological theory as an explanation for addiction, such as nicotine and gambling.
Drug and alcohol addictions can be treated using drug therapy, aversion therapy, covert sensitisation and cognitive behavioural therapy.
Addictive behaviour can be managed using theories such as the theory of planned behaviour and Prochaska's six-stage model.
Addiction is defined as when someone engages in a pleasurable activity that they then cannot stop doing, due to physical and psychological dependence, as well as issues with tolerance and withdrawal symptoms. Addiction can be detrimental to their everyday life, health, well-being, family, and friends.
Always consult with a licensed professional when seeking treatment for addiction. Potential treatment avenues include medication, behavioural and cognitive therapy treatments, although treatments depend on the individual and other factors that affect success rates.
Addiction usually progresses in experimenting, casual use, high-risk use, and eventually, addiction.
Risk factors for addiction include stress, genetics, family influences, and peer group influences.
Drug addiction is the physical dependence on a substance that has an impairment on the health and life of the user, especially when taken often, more than intended or with an inability to stop
Define addiction
Addiction is when someone engages in a pleasurable activity that they then cannot stop doing. This can even be detrimental to their everyday life, health, wellbeing, family and friends.
When someone is an addict they become _______ dependent and psychologically dependent on the object of their addiction
Physically
Which of these is NOT a risk factor for addiction?
Class
What system are biological explanations for addiction based around?
The mesolimbic system
What is the learning theory of addiction based on?
Conditioning
How does cognitive theory explain addiction?
Irrational thoughts including reasoning and cognitive bias, such as illusions of control and gambler's fallacy
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