susceptibility models of addiction Flashcards
exposure vs susceptibility, susceptibility factors, neurobehavioral disinhibition, risky decision making, punishment insensitivity, error detection (24 cards)
what are exposure models?
addiction caused by the drug and the neurological changes it promotes
withdrawal
opponent process
what are susceptibility models?
addiction is caused due to individual vulnerabilities (genetic, psychological or environmental factors)
what is the relationship between exposure and susceptibility models?
not two distinctly separate things - a combination underpins addiction
need exposure for susceptibility
not everyone has an “addictive personality” and not all drugs prompt addiction - so maybe a little reductive
does susceptibility vary?
if all equally susceptible, see more homogenous patterns
varying percentages of people try different drugs
what are susceptibility factors?
age and sex, genetics, drug availability in local area, prevalence of drug use in local area, neighbourhood (population density, permanence, crime rate), parental socioeconomic status, criminality in family, broken home, mental health of parents, parent-child attachment, peer group social norms, parent/sibling (attitude to) drug use, poor parenting style (e.g. abusive, negative, authoritative, inconsistent), failure at school, genetics and role modelling
how does age and sex affect susceptibility?
peak time = late teens and early twenties when prefrontal cortex still not finished
how does genetics affect susceptibility?
research suggests that 40-60% of addiction vulnerability is heredity
specific genes affect how individuals respond to substances and their likelihood of developing addictive behaviours
includes potential impact on dopamine system (fewer dopamine receptors or increased metabolism)
drug aversion
suggests predisposition, not a guarantee
big issues with nature vs nurture
why is it hard to establish specific susceptibility factors?
hard to disentangle cause and effect within studies
confounding variables
what was Tarter et al’s (2003) study?
rare longitudinal study
followed children from 10-19 years
split into high (with parent or sibling with substance use disorder) and low risk group
matched across household income, parent education, parent drug use (etc)
concluded that neurobehavioral disinhibition was greater in high risk group and predicted (transition to) illicit drug use
what is neurobehavioral disinhibition?
batteries of measures that can be used to test cognitive function
prefrontal cortex seems very involved
concluded that those at risk of drug (ab)use show disorganised behaviour, possibly stemming from abnormality in the frontal cortex, causing poor decision making
what is neurobehavioral disinhibition a composite score of?
difficult temperant (inflexible, distractable)
conduct disorder, oppositional defiant disorder
attention deficit hyperactivity disorder (ADHD)
depression
disruptive behaviour disorders (teacher ratings)
tests measuring low executive cognitive function
who was Phineas Gage (1823-1860)?
accident caused large railroad spike to impale his head
severe frontal lesion
unreliable at work, showed callous disregard
preserved some intellectual function (e.g. memory) but planning ability became very poor
became an alcoholic and hyper sexual
what does Phineas Gage’s case suggest?
prefrontal cortex associated functions (decision-making, long-term thinking, self-control, impulsivity, risk-taking tendencies) influence addiction behaviour
caused a battery of prefrontal cortex related tasks to develop
what was the Iowa gambling task?
4 deck of cards, goal to win money
participants told all cards results in some level of reward
occasionally choosing a card causes them to lose some money
A and B = “bad decks”
C and D = “good decks”
who frequently selects high reward decks despite net loss of points in the Iowa gambling task?
with frontal lesions/damage
in adolescence
with a conduct disorder
with ADHD
with schizophrenia
who indulge in drugs of all classes
what a reason that children may engage in more risky decision making behaviour?
underdeveloped prefrontal cortex
what is the cause and effect of drug use and risky decision making?
circular system/bad cycle
risky decision making seen in high risk children before any drug use
risky decision making predicted onset and magnitude of drug use
suggests prefrontal damage or dysregulation is a major susceptibility factor for become a drug user
what are the reasons for perseveration in selecting bad decks in Iowa task?
reward hypersensitivity
reward hyposensitivity
punishment insensitivity
faulty error detection
what is reward hypersensitivity?
if people are making bad decisions and everything in life must be motivated by some kind of reward, maybe addicts are super sensitive to reward
overactive mesolimbic system
what is reward hyposensitivity (insensitivity)?
conditioned tolerance
negative reinforcement seeking (withdrawal avoidance)
what is the clinical relevance of punishment insensitivity?
DSM drug dependence criteria - messing up family lives, jobs and body
continued use of drugs even though known to cause trouble with family and friends
job/study troubles because of drug use - missing too much work, being demoted/not doing work well, being suspended/losing a job, being expelled/dropping out of school
continued use of drugs even though to cause a health problem or make a health problem worse (e.g. lung cancer, liver disease, coke nose)
what was Deroshe-Gamonet et al’s (2004) study into punishment insensitivity?
trained rats to give themselves coke then put them through withdrawal
reintroduced coke and provided a cue that previously predicted coke delivery, some relapsed
introduced a small experimental punishment (small shock) for relapsed rats
some animals kept wanting the coke even when paired with a shock
what is faulty error detection?
addicts may have full knowledge of the adverse consequences of their drug taking but just not be able to use this knowledge to correct their behaviour
event-related potential (ERP) used to measure the responses of cocaine addicts to errors in their performance
what is the Flanker task in faulty error detection?
trials consisted of letter strings on the screen for 52 msec
tasked to identify the central letter
cocaine addicts showed reduced frontal activity in response to errors (suggesting reduced neural sensitivity to errors) and less post-error improvement in performance
suggests addicts may have less knowledge of the adverse consequences of their behaviours and so less ability to use this knowledge to modify their behaviour
controls show sensitivity in the prefrontal cortex when they make an error but coke addicts don’t
