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Defining addiction
What the Board expects you to know:
Models of addictive behaviour:
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Biological, cognitive and learning approaches to explaining
initiation, maintenance and relapse, and their applications
to smoking and gambling
Vulnerability to addiction:
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Risk factors in the development of addiction, including
stress, peers, age and personality.
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Media influences on addictive behaviour
Reducing addictive behaviour:
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The theory of planned behaviour as a model for addiction
prevention
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Types of intervention and their effectiveness, including
biological, psychological and public health interventions
Definition of addition:
Most of these only consider addiction to drugs (chemical addiction):
World Health Organisation (WHO): ‘a state of periodic or chronic
intoxication produced by repeated consumption of a drug; natural or
synthetic.’
Concise Oxford Dictionary: ‘An addict is a person addicted to a habit,
especially one dependent on a specific drug.’
However, although most early research centred on drug taking, other
behavioral addictions are now recognized, for example: gambling, eating,
sex, exercise, work, internet, shopping etc…
Most modern definitions of addictive behaviour involve ‘loss of control’
or ability to regulate behaviour:
‘A repeated 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’ – the behaviour
contrives to occur despite volitional attempts to abstain or moderate
use.’
Krivanck (1988) believes addiction is best seen as a process rather than
a behaviour or entity and also best explained on a spectrum of severity.
However, loss of control is subjective and raises ethical issues since
it suggests a certain level of culpability and blame.
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| Is sex
addiction an illness |
Steve McQueen discusses
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Addiction as Disease (AAD)
Our stereotypical view of an addict is likely to be based on one
addicted to drugs, particularly alcohol, cocaine or heroin. The tendency
is to view the issue as simply one of addiction. An addict:
1.
Is compelled by a physical need
2.
Suffers physical and psychological
symptoms on withdrawal
3.
Is changed for the worse in terms of
health, behavior, social role and self destruction, for example crime.
This is very much a physiological perspective.
It does benefit from one crucial observation. Regardless of the
addiction, chemical or behavioural, the patterns of brain activity in
all addicts are very similar.
However this overly simplistic model as serious issues: (Mostly Sussman
and Ames 2001):
It removes responsibility from the individual. They are labeled an
‘addict’ which now assumes a very simple underlying physical issue over
which they have little control. Confronted with their behavior, lies
etc. their excuse is simple… ‘I’m an addict. What do you expect?’
Physical disorders usually have a very obvious and easily identifiable
cause and effect. However, behavioural disorders are more difficult to
disentangle. This seems to be the case with addiction. For example,
having ‘cured’ the addiction and weaned the person off their problem,
they invariably relapse, suggesting more complex underlying issues.
As with most psychological or behavioural disorders there is an issue of
diagnosis. Think back to the issues with defining abnormality we saw at
AS. At what point does a pattern of behaviour become a problem, and who
decides? When does binge drinking become alcoholism. Different groups
of people will consider the answer differently.
Similarly there will be variation in the abuse itself. Does a person
who binge drinks have the same underlying issues as an alcoholic or a
person who drinks socially for confidence?
The aetiology of addiction also makes it difficult to disentangle the
symptoms. Addicts usually ignore other aspects of their life such as
diet, hygiene, sleep etc. Perhaps many of the effects we observe in
addicts are due to these secondary factors rather than to the addiction
per se.
So, although it can explain the underlying physiology, the AAD model
fails to consider other psychological, social, cultural and
environmental issues that are clearly involved in the addiction
process.
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