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4.1 Addiction week 2 summary
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Addiction notes week 2CONDITIONING AND CRAVING
Jellinek website – alcohol, nicotine and cocaine? just getting an idea of how they work
should be fine
MOSS & DYER CHAPTER 3
- people engage in addictive behaviors even when they experience obvious harms
- why addictive behavior develops and why it’s so difficult to overcome can be
explained by learning theories
- learning theories generally suggest that behavior can be understood by examining
the rewards and punishments people experience during their lives
Learning theory
Operant conditioning
- process by which various rewards and punishments increase or decrease the
likelihood of people repeating a particular action in the future
- positive reinforcement:
o increases the probability of a behavior by giving a reward, which leads to the
activation of the reward pathways
- negative reinforcement:
o increases probability of a behavior by removing discomfort
o e.g. withdrawal: someone who decides to stop smoking will have withdrawal
symptoms, removal of this negative state is neg. reinforcement bc it increases
likelihood of smoking to stop the withdrawal symptoms
- punishment:
o decreases the probability of a behavior as we attempt to avoid punishment
o but why do people still engage in addictive behaviors when according to this
theory presence of punishments should stop their behavior?
o people learn better when reinforcements or punishments are contiguous with
their actions and closely linked in time
- contiguity:
o reinforcements for most addictive behaviors (relaxation, getting high,
alleviation of withdrawal symptoms etc.) are much more closely linked in time
to the addictive behavior itself than the punishment and neg. consequences
(health problems, breakdown of close relationships etc.)
o routes of administration such as inhaling or injecting are more reinforcing
than drugs through oral route
Classical (pavlovian) conditioning
- learning to associate stimuli that frequently co-occur together (contiguously)
- in the context of addictive behaviors, it can work against us
- e.g. injecting drug users can associate a needle with drug use, a gambler can
associate payday with going to the casino etc.
- unconditioned response (UCR) (salivating) + unconditioned stimulus (US) (sight/smell
of food)
, - neutral stimulus (NS) (bell) that doesn’t produce UCR
- NS is repeatedly presented with US
- over time, conditioned response (CR) (salivating) to conditioned stimulus (CS) (bell)
- extinction: repeatedly presenting CS alone until CS continually fails to elicit CR
Conditioned drug responses
- during drug use many cues in the environment get associated with drug use
- best predictors of successfully giving up a drug occurs when the person leaves the
environment in which they used the drug
Studies of conditioning phenomena
- conditioned withdrawal:
o after leaving treatment and returning to normal life, (which involves
situations associated with drug use) people can experience withdrawal
symptoms even though they are no longer physically dependent
o relapse stories represent classically conditioned responses
o environmental stimuli have the ability through classical conditioning to elicit
symptoms of pharmacological withdrawal
- categories of conditioned responses
- 1. drug opposite CRs include conditioned withdrawal and conditioned tolerance
- 2. drug-like CRs include euphoria (needle freaking phenomenon) and placebo effects
of drugs
drug opposite CRs
- repetitive use of same drug can produce CRs opposite to the effects of the drug
o e.g. opioid injections increase skin temperature
o so, stimuli that have repeatedly preceded opioid injections, can start to
produce decreases in skin temperature alone
o as if the body is anticipating the arrival of the drug to minimize the intensity
of the effect
o the attenuation of drug effects can also be seen as tolerance and may be a
partial explanation to diminished drug effects with repeated administration
under similar circumstances of the same dose
- these CRs can cause relapse, because of places, people, or certain moods present
when drug was obtained or used
- conditioned withdrawal:
o as few as 7 pairings between mild opioid withdrawal symptoms (UCR) and
neutral stimuli (peppermint spray) (CS)
o people begin to show signs of withdrawal (CR) when exposed to CS alone
o explains the onset of withdrawal symptoms when a drug-free patient returns
to on environment in which withdrawal had occurred in the past
- conditioned tolerance:
o tolerance: reduction in the magnitude of a drug’s effect with repeated
administrations
o drug opposite conditioned responses counteract the anticipated effects of
drugs
, o if conditioned response is activated by a cue but no drug is administered, the
person will experience withdrawal
o experiment: when opioids were given without warning, participants showed
greater physiological responses than when the same dose was expected
o situation-specific tolerance can protect against overdose (tolerance in usual
drug taking situation causes person to increase dose for compensation, in a
new environment tolerance is not the same so the same dose can be
dangerous)
drug-like CRs
- needle freaking phenomenon:
o when heroin is unavailable, users go through the same ritual but insert a
different substance (saline)
o they report mild physiological signs and some reversal of withdrawal
symptoms
- experience with a drug can cause reactions in the absence of any drug effect
- drug-like CRs are rare, drug-opposite CRs are more common
Social learning theory
- learning theory and behaviorism restrict our understanding of human behavior
- social learning theory includes both internal and external causes
o form of reciprocal determinism: environment can affect us, but we can also
influence out environment
- Key concepts:
- 1. modeling: learning occurs via observation of others
o learn about outcomes (reward, punishment)
o person must be paying attention and retaining information
o person must be capable of imitating the behavior and have the motivation to
do so
- 2. learning is not necessarily linked to behavior
- 3. reinforcements and punishments are indirect factors
o whereas learning theory says learning is a direct result of reinf. and punish.
- 4.expectation of reinforcement or punishment can be just as powerful as motivation
as actual reinf. and punish.
Self-efficacy and addictive behavior
- the degree to which a person feels competent to perform an action
- belief in one’s ability to quit smoking is one of the strongest predictors in successful
abstinence
- self-efficacy beliefs are learned through past experiences
- 5 types of self-efficacies:
o resistance
important for prevention
avoiding an addictive behavior in the first place
low resistance SE predicts onset of adolescent drug use when peer
pressure is present
o harm-reduction
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