Cognitive approach to addiction

Cognitive approach to addiction

1. Basics

   • Provides understanding for behaviour of addictions more so than chemicals
   • Focuses on faulty thinking processes (particularly in maintenance), irrational bias and justification of addiction
   • Assumes all have the potential to develop addiction but faulty thinking is what allows the addictive behaviour to develop.

2. Initiation

   • Gambling: Self-medication
     • Gelkopf et al. (2002) individuals intentionally use a behaviour (e.g. gambling) to treat psychological symptoms they suffer. Activity is not selected at random, but is perceived to help with particular issue. In the case of gambling it could be perceived to treat the depression associated with poverty. Might not actually help/treat the symptom but needs only to be judged as doing so by individual to become an addiction.
   • Smoking: Expectancy theory
     • Addicts have expectancies of positive versus negative effects of behaviour. Brandon et al. (1999) proposed behaviour escalates into addiction because of expectations that an individual has about the costs and benefits of the activity. Adolescent smokers report smoking when experiencing negative moods and expect smoking to decrease intensity of negative mood. Expectancy of positive mood (e.g. relaxation and increased self confidence) are reasons why adolescents begin to smoke.

3. Maintenance

   • Gambling: Cognitive Distortions and Irrational Beliefs
     • Despite objective probability of failure as with a game of chance, problem gamblers have irrational thoughts about their ability to influence the outcomes of their gambling. Cognitive distortions include "Gambler's fallacy" i.e. the belief that random events can be influenced by recent events. "Illusions of control" are demonstrated by the performance of superstitious behaviours that are believed to help manipulate the event outcome. Pathological gamblers also show exaggerated self confidence in their ability to "beat the system" and influence chance. Partly due to different attributions that many gamblers make about their gambling, with success being attributed to ability/skill and failure to chance e.g. bad luck.
   • Smoking: Automatic processing
     • Brandon et al. (1999) as an addiction develops activity is influenced less by conscious expectancies and more by unconscious expectancies involving automatic processing. Explains the loss of control experienced in addiction and difficulties with relapse. Tate et al (1994) found expectancies could be manipulated to prevent relapse. When participants were told to expect no negative side effects form abstaining, fewer reported somatic effects (shakes) and psychological effects (mood) than a control group. similarly those told they would experience somatic but not psychological problems reported severe somatic complaints but not psychological.

4. Relapse

   • Gambling: Recall Bias and "Just World" hypothesis
     • Pathological gamblers suffer from recall bias, the tendency to remember and overestimate wins whilst forgetting and underestimating/rationalising losses. Consequently a string of losses does not always act as a disincentive. individuals believe they will eventually be rewarded for their efforts and be motivated to return on subsequent occasions because of a belief that they "deserve to win" having lost so many times before.
   • Smoking: Assessing costs and benefits
     • Expectations of costs/benefits of smoking affect an individuals readiness to quit and also the likelihood of them relapsing after a period of abstinence. Many studies have demonstrated that smokers perceptions of pro's and cons of smoking and quitting affect their quitting behaviour. If perceive quitting to have fewer benefits than continuing to smoke/costs of quitting they are more likely to relapse and revert to smoking after attempting to quit.

5. Evaluation

   • Gambling
     • Problems with Cause and Effect
       • Self medication model argues that some form of psychological distress precedes addiction and evidence does support this as many pathological gamblers have major depressive disorder. however the correlation between gambling and depression does not mean that depression causes gambling could be other way round, depression is consequence of gambling, and other factors linked to gambling e.g personal and financial costs.
     • Non-supporting research
       • Delfabbro et al. (2006) found that pathological gamblers were more irrational in some gambling related cognitions than non gamblers but were just as accurate in estimating their odds of winning.
     • Supporting research
       • Griffiths (1994) compared verbalised thoughts of 30 regular gamblers to 30 non-gamblers. Found gamblers were more likely to make irrational comments when gambling and showed illusions of control such as an ability to "bluff" the machine. They also explained their loses as near misses/near wins i.e. not constantly losing but "nearly winning" - justifying their continuation.
   • Smoking
     • Addiciton or excess?
       • Much of the research around expectancy theory revolves around excess, not loss of control as addiction - individual is no longer able to control their behaviour. It is not clear what role expectancies might play in the development of this loss of control.
     • Importance of expectancies
       • Juliano and Brandon (2004) found that smokers reported greater expectancies that cigarettes alleviate negative mood and craving and had positive effect on weight control compared with the different forms of nicotine replacement therapy. therefore were more likely to not be able to cease smoking using this method as perceived more negative effects than positive ones associated with smoking.