Critically Evaluate the Cognitive Explanations of Addiction

With around a tierce of the population inveterate addicted to nicotine and the of all time increasing load of intoxicant related unwellness on the National Health Service, the survey of what causes and maintains dependence is one of the most of import psychological issues on the authorities ‘s wellness docket today. Coupled with progresss in medical and pharmacological interventions for dependence, which owing to the remit of the present reappraisal, are non discussed ; psychologists have sought cognitive accounts for the initiation, map, mechanisms and continuity of dependence and backsliding. Resultantly, the intent of this essay is double.

First, social-cognitive theories of influence and emotional factors such as emphasis are presented by manner of debut to mechanisms which may bring on and assist to keep dependence. This is followed by more micro-cognitive attacks from the country of cue-reactivity ; an country which has played an tremendous portion in set uping a possible function for preconscious pathological attentional prejudice toward habit-forming substances which may be responsible for the automatisation of dependence and for bring forthing more witting cognitive responses such as hungering. To reason, a biological acquisition and memory theory researching the implicit in nervous mechanisms of habit-forming knowledge is tentatively proposed as account of the motivational feature that drives the nut to devour and therefore the prevalence and continuity of backsliding after abstention. Finally, the 2nd purpose of this survey is to research, through the stuff covered, the construct of a ‘cognitive account ‘ which, it will be seen, refers to both complex meta-cognitions ( such as idea and belief ) and the elaboratenesss of nervous knowledge.

First, dependence has been studied as stemming from an interplay of complex societal factors such as emphasis, anxiousness and peer force per unit area. In such a state of affairs, dependence to alcohol and nicotine peculiarly consequences from both positive knowledges towards the socially rewarding effects of the drug, and substance dependence over the period of exposure. Described as the result anticipation theoretical account, dependence is represented in these surveies as a gradual displacement from positive anticipations and correlated substance usage, to increasing tolerance and finally physical dependance.

In a ‘drinking-to-cope ‘ experiment by Carrigan and co-workers ( 2008 ) , socially dying persons were identified from a group of pupils utilizing self-report ( the Social Interaction Anxiety Scale and the Social Phobia Scale ) and correlated with their inclination to mistreat intoxicant ( besides assessed by self-report ) against their non-anxious opposite numbers. Crucially, the survey besides measured their attitude towards intoxicant ‘s positive effects on societal header in order to research the extent to which positive result anticipation was a factor therefore spread outing on the findings by Cooper, Russell & A ; George ( 1988 ) that imbibing to get by behavior is merely correlated with intoxicant maltreatment if positive knowledges towards intoxicant ‘s positive effects are present. While their survey merely inferred imbibing motivations from steps of societal anxiousness, they did so happen that the ‘drinking to get by ‘ ( dying ) persons showed higher degrees of intoxicant ingestion and dependance symptoms ( besides assessed by self-report steps ) .

Overwhelmingly the literature on adolescent nicotine dependance characterises dependence as initiated by societal motivations. Research by Valente, Unger and Johnson ( 2005 ) into the ‘popularity-value ‘ of smoking in adolescent societal civilization has emphasised the nexus between societal desirableness and hence the positive expected result of take parting in behavior which my easy become habit-forming ( such as smoke ) . However, other surveies have besides highlighted the importance of knowledge post-addiction. In a recent survey in the Netherlands, Kleinjan et Al. ( 2009 ) found that, after exposure has led to dependence, striplings use rationalizations that trivialise the good known wellness hazards such as “ I live healthily otherwise ” and “ everyone acts unhealthily sometimes ” . This expanded a wealth of research happening the same consequence in grownup populations. Overwhelmingly they found that preparedness to discontinue and surcease were negatively correlated with such beliefs and reported that “ holding stronger disengagement beliefs is associated with higher nicotine dependance ” ( p. 443 ) .

This sum-up of their findings seems to propose a causal relationship between propensity to detachment and increasing nicotine dependence or that, while the knowledges are responsible for keeping the dependence, they are besides prognostic of the extent of dependence from the beginning. It may be nevertheless, that unconscious, automatic procedures are causative of increasing dependence and that the permissive knowledges described, arise so as to chase away cognitive disagreement between a remorse to smoke and knowledge of the wellness hazards.

Cue-reactivity theoreticians have proposed that an indispensable component of dependence is, at base, a discriminatory cognitive prejudice for substance related stimulations taking to basic autonomic responses, such as perspiration and palpitations. In bend, this elicits more complex subjective cravings which require the cognitive attempt necessary to bring forth witting idea. Addiction, hence, is seen as mostly an unconscious procedure and is assessed by experiments proving inexplicit associations happening before expressed result anticipations. For illustration, the dependence Stroop trial ( adapted from Stroop, 1935 ) consists of two classs of words, one substance-related and one neutral, which are matched for confusing variables such as word length and figure of syllables. In their experiment, Cox et. Al ( 2006 ) presented participants with the words in random order and coloured either bluish, ruddy, green or xanthous. Participants were required to give the name of the font-colour and non the word itself and steps of attentional prejudice were indexed as the difference between calling latency on substance-word-trials and neutral-trials.

Slower colour-naming on substance word tests were concluded to bespeak a stronger prejudice for the semantic significance of these words than for the impersonal stimulation. However, this has been challenged by other research workers such as Klein ( 2007 ) and Field and Cox ( 2008 ) who question latency as unambiguously stand foring attentional prejudice. For case, the survey by Klein repeated the methodological analysis used by Cox et Al. but with one elusive alteration ; inquiring half of the participants to stamp down ideas of intoxicant during the trial, and inquiring half to freely tie in. The consequences by Cox et Al. were merely reproduced for the group trying to stamp down their automatic attentional prejudice and no important difference was found for the group allowed to freely tie in. Furthermore, Field and Cox in their 2008 reappraisal, draw attending to Tiffany ‘s 1990 theory on the cognitive strain of suppression as a confusing variable in the Stroop undertaking, proposing that it may non be proving attentional prejudice at all, but simply that a general slow-down in cognitive processing occurs as hungering drains cognitive resources.

However, Field and Cox ( 2008 ) do non deny that this craving response is elicited by cue-reactivity and propose other, more valid paradigms for proving such a hypothesis. One such attack, the attentional cueing undertaking, has been used by research workers such as Mogg et Al. ( 2003 ) to prove the trouble with which tobacco users were able to deflect their attending from a drug-related cue on a computing machine screen. Controling for the jobs associated with reaction clip, as aforementioned, Mogg and co-workers besides recorded participants ‘ oculus motions as the stimulations were presented. In the attentional cueing undertaking, participants were presented with 20 drug-related and 20 impersonal cues all presented twice with extra filler images for filler tests. Drug related images were about indistinguishable to impersonal images nevertheless, for illustration, where a adult female was seen to be smoking in a drug-related image, she may be using lipstick in a impersonal image. On each test, two images appeared, one in the left and one the right ocular field for 2000 msecs, after which, a mark cue either ( : ) or ( .. ) appeared over one of the images. Participants were required to bespeak the individuality of the cue and horizontal oculus motion was recorded for each test. Finding that tobacco users, but non non-smokers, maintained their regard for longer on smoking-related cues and that they were faster to observe investigations that replaced smoking-related than control images, the writers concluded that their research supports an attentional prejudice hypothesis of dependence.

However, a critical inquiry remains answered by the grounds presented therefore far. That is, how does attentional prejudices lead to the behavioral forms observed in dependence? While cue-reactivity addresses the cognitive elements of perceptual experience and attending in drug dependence, it is non made explicitly clear how the initiation of subjective craving brings about the behavior necessary for drug seeking and ingestion. Furthermore, while it appears from the societal grounds presented that there is a societal wages for drug-taking behavior, be that the esteem of adolescent equals in smoke, or a sensed addition in societal ability in those enduring from societal anxiousness ; such societal and personality-based theories can non account for the reasonably consistent behavioral forms observed in serious drug dependence. The pathological acquisition and memory theory, developed by Steven Hyman, assesses cognitive procedures at their most crude functional degree to explicate the behavior of the nut.

Hyman ( 2005 ) suggests that, given current apprehensions of the nervous procedures of knowledge, dependence is a procedure of acquisition and memory hijacked by the positive and slightly overpowering effects of drugs – peculiarly illicit drugs of maltreatment. In his theoretical account, dependence becomes a basic homeostatic demand, frequently above hungriness and thirst as it mimics and supplants such natural consummatory behavior. He describes the procedure by which eating and hydrating become automatic as being overlearnt and suggests that drug ingestion becomes overlearnt by the same mechanisms. But how do drug processes become overlearnt and what gives certain drugs ( such as opioids and cocaine ) their particular quality to supplant other homeostatic behaviors?

For Hyman the cardinal construct is reward. Kelley and Berridge ( 2002 ) sketch a figure of surveies in their reappraisal proposing that drugs of maltreatment act on Centres within the encephalon usually associated with pleasances such as gustatory sensation and liking for nutrient and so mimic the normal procedures of pleasure-learning. For case, rats injected with an opioid compound have systematically been found to devour more sweet tasting sucrose H2O, in line with the anticipation that the drug enhanced nutrient palatableness. But, as Hyman and Kelley and Berridge have stated, unlike nutrient ingestion, which straight rewards enjoyable gustatory sensation Centres, it is non necessary for a drug to be gratifying in itself to bring forth honoring effects in multiple centripetal countries. In fact, in Hyman ‘s position, drugs of maltreatment gain their competitory advantage over normal wagess ( such as sweet gustatory sensations ) by bring forthing higher degrees of Dopastat than possible for the normal wages systems.

As such, it seems that an history of dependence could ( and has been ) construed in a strictly biological vena ; that dopamine acts hedonically to bring forth pleasance, and by increasing consumption of drugs arousing the dopamine ‘pleasure response ‘ the organic structure becomes physically addicted. However, when this has been tested in animate being theoretical accounts, by barricading, lesioning or taking the ability to react to dopamine post-addiction acquisition, animate beings continue to prefer the enjoyable consummatory behaviors ( e.g. an increased ingestion of sucrose H2O ) as earlier. ( see Berridge and Robinson, 1998 ; Cannon and Palmiter, 2003 ) .

Therefore Dopastat, Hyman argues is involved in a complex acquisition and memory procedure between Dopastat as a pleasance signal and normal manners of associatory acquisition and memory such as Long-run Potentiation. He refers to a series of experiments by Schultz and co-workers ( 1993 ) in which watchful monkeys were trained to anticipate sweet juice ( wages ) after a certain period of clip and a cue. Recording encephalon activity, they found that different spiels of Dopastat fire occurred when sweet juice was delivered on-time, when it was delivered tardily and when delivered before expected. As such, Hyman proposes that Dopastat signalling provides the motivational component to pleasure-learning by signalling behaviors that produce pleasance. These moving ridges of Dopastat activity are so associated by long-run memory processes with the exact cue, context and action that produced the pleasance and the dependence is committed to memory. Finally, the overwhelming and unnatural sums of Dopastat produced saturate these cognitive procedures and guarantee that the dependence is over-represented in memory as extremely enjoyable, contrary to cut down sensed feelings of being ‘high ‘ due to physical tolerance.

However these micro-cognitions do non be in isolation and it is through placing the footing of contextual acquisition that the wider constituents of dependence in perceptual and societal context can be to the full explained. Overall, all three attacks contribute to a full and elaborate apprehension of the mechanisms of dependence and, while there exist biological interventions to stamp down the remorse of intoxicant and other dependences, it will non be without continued advancement in all countries of the cognitive sphere that better dependence therapies will be created.