Summary readings RBAA
Introductory video
Lecture 1
Sussman 2017
Introductory case study: - Johnny energetic kid mom puts TV on to calm kid
Johnny - Johnny sporty during high-school
- Got injured stop running gained weight started drinking
- Felt good and comfortable bcs drinking made it habit
- Combination with weed and other drugs habit
- Became overeater
- Became worried about his habits
- Experienced craving, loneliness in crowd, discomfort in own skin
- Quit some habits but vulnerable to falling back into it
- Some addictions not formally recognized
Substance and - Substance and behavioural addictions: behaviour that results in
behavioural addictions clinically significant impairment
Substance addiction: repetitive intake of drug
Behavioural addiction: engaging in behaviour repetitively
- Previously: addiction considered seriously if drugs were
misused, leading to physiological withdrawal symptoms
- Researchers: objects to which you can become addicted could
only be drugs which cross blood-brain barrier (filter of certain
substances)
Additionally: this object has to block, facilitate or mimic
endogenous ligand functions as exogenous ligands
- Twelve-step organizations came about to battle addictions
Behavioural addictions
- These addictions alter endogenous ligand functions
- Imagining things can alter dopamine or serotonin levels
- Neurotransmission release can become reliant on participation
, in certain behavioural addiction
- Withdrawal symptoms if behaviour stops
The reality of multiple General theoretical considerations
types of addictions - More behaviours become considered as addictions
- Definitions of addiction often encapsulate both substance and
behavioural addictions
- Measurable description of scientific concept useful to be able to
make inferences regarding how concept is related to other
concepts
Also how concept can guide development of useful
applications (policy, prevention, control)
- Description of addiction can help in explaining environment of
the addiction, serving prevention
- Currently definitions not mutually exclusive (blurred boundaries)
can lead to concept becoming trivial or used to loosely
- Concepts can be wrongfully used when talking about individual
while concept is about society or the other way around
Evolution of definitions - Latin origin of word addiction has to do with binding, enslaving
of addictions person to a thing or another
Highly devoted to thing, person or activity or engaging in
behaviour habitually
- Addiction became considered as disease-like
- Addiction was seen as malfunction of central nervous system
now this has more neurobiological underpinnings and is seen as
brain disease
History of substance Tobacco addiction
addictions - In 1770s tobacco was sometimes sent instead of money to the
battlefield, so this highlights its importance suggests
compulsive use
- Identification of nicotine in 1920s, 1930s resulted in consensus
that nicotine was addictive
Alcohol addiction
- Substance from which the 12-step movement arose
influenced general concept of addiction
- Most known and recognized form of addiction
Opium-related addiction
- Dangerous drug bcs described by users as divine enjoyment
- Tendency to result in dangerous behaviour
- Big social and economic problems in countries where it was
used (China and UK predominantly)
Cocaine addiction
- Cocaine used as medication to treat opiate addictions
- Many negative consequences
Marijuana addiction
- Many use it daily, engage in socially embarrassing behaviour
- Want to stay in the high otherwise craving, depression,
abnormal dreaming
, Food addiction
- Binging and purging eating behaviours noted in history but no
reflections of consistent patterns of dysfunctional behaviours
- Recent development in area of addiction
History of behavioural - History of gambling and sex addictions
addictions - Matthey (1816): diseases of the spirit (manias) impacted
conceptualization of behavioural addictions
- Nineteenth century: suggestion that certain behaviours were
morally wrong or problematic
- Out-of-self-control behaviours considered forms of mania or
morbid appetites like kleptomania (craving to steal)
- 12-step organizations only really after 1970s, before that much
written about addictions
- Behavioural addictions studied empirically since 1980s, referred
to as process addictions
- For years, behaviours like the above seen as vice: pleasurable,
popular, possibly voluntary, and wicked
This was possibly grounded in the seven sins of the bible
from which all sins come forth
- Common thread in behavioural addictions: repetitively unusual
in manifestation, involving motivated behaviour of some type,
loss of control, resulting in clinically significant impairment in
one or more life domains
Important points about addiction in history
- Engagement in certain behaviour
- Difficulties stopping the behaviour
- Thinking or acting bizarrely
- Sleep difficulties
- Social withdrawal
- Depression symptoms
- Placing self in danger for behaviour
Intensional and Intensional definition of addiction
extensional conceptions - Causal or process model type statements of addictions
of addiction - Describe addictive behavioural process
- Describes sometimes an etiology (causal story)
- Explanatory power but distant from observables than
descriptive (extensional) models
Extensional definition of addiction
- Listing-type definitions
- Classification of addiction features, taxonomy of addiction
elements
- Listing can be implemented in intensional theory-based
perspective
Major examples of - Most popular intensional-type conceptions currently used are in
intensional definitions of Bold
addiction Physiological and psychological dependence
- Prolonged engagement in behaviour resulting in continued
, performance necessary for physiological and psychological
equilibrium
- Trapped in pattern of increasing involvement with behaviour,
while feeling negative when trying to stop behaviour
Tolerance
- Need to engage in behaviour more than before to achieve same
level of appetitive effects
- More time spent to achieve wanted level
Withdrawal
- Abstinence syndrome: physical disturbances in case of drug
abuse
- Can vary depending on what drug was used
- Sedative drugs can cause a symptom of hyperactivity
catecholamine storm: flooding of central nervous system with
neurotransmitters upon withdrawal
- Behavioural addictions exert withdrawal-like symptoms:
irritability, anxiety, tension, depression, craving
Craving
- Criteria of substance use disorder in DSM-V
- Craving is intense desire to engage in specific act
- Someone often gives in to this desire
- Repeated participation in behaviour may lead to psychic drive
that requires continuous engagement to avoid craving
Summary
- Many drug and non-drug addictions don’t produce obvious
physical dependence (physiological-based tolerance and
withdrawal effects)
- They do create subjective need to increase involvement in
behaviour
- Termination of use or behaviour leads to all kinds of symptoms
- Addictive behaviour seems to be like best way to solve negative
symptoms
Impulsive-obsessive/compulsive behaviour
- Focus on release: engagement in addictive behaviour leading to
pleasure or relief rather than focussing on maintaining
equilibrium
- Two variants:
Positive reinforcement
- Impulsive-obsessive/compulsive definition of addiction:
engaging in behaviour due to building up tension which is
released, resulting in pleasure and later to self-reproach
- It’s cyclical bcs when stopped, craving occurs, resulting in more
built-up tension positive reinforcement
Negative reinforcement
- Building up tension, anxiety and stress which is released,
resulting in relief but no pleasure leads to obsessions which
produce anxiety and stress leading to craving for relief again
