Week 3 Flashcards
(20 cards)
moral model
- substance use is a matter of personal choice and weakness
- intoxication is immoral
- individual is to blame for failure to conform
- individual is morally repugnant and to blame for negative outcomes
- Canadian law enforcement and criminal justice system follow this model
accountability
* criminalization: through laws, regulations, punishment
* informal social sanctions: expressed disapproval of immoral behavior by family and friends to losing a job or place to live
disease/medical model
- more humanitarian approach
- uncontrollable or harmful use is a disease (not general use)
- assumes people who develop dependence are victimes bc of loss of control and biological or brain condition
- rehab/treatment is possible and necessary
- treatment is by medical professionals –> or 12 step programs like AA
reaction: not blaming people
condition: not someone’s fault
criticisms of disease model
- substance use is not a dichotomy (diseased/not diseased)
- not a scientific fact (socially constructed)
- has never been able to fully explain susbtance dependence
- the 12-steps don’t address the complexities of substance dependence
- faills to fully remove shame and stigma (Alcoholics Anonymous – if u have to be anonymous feels like stigma)
biological explanations
- nature/drive theories
- genetic theories
- neurobiological theories
Nature/drive theories
everyone has the potential to use and become dependent
- humans are naturally compelled to alter their state of consciousness
BUT
-> not all groups through time have used substances
-> drugs are different from food and sexual behavior
says there is an inherent drive within us to use substances because we have an underlying urge to
genetic theories
- assumes theres an inheritable genes that can explain differential susceptibility
- genetic traits affect how we metabolize and experience substances
-> asians more vulnerable to negative consequences of alcohol
-> black people metabolize alcohol quicker
adoption of twin studies
* effect of genetics on substance use ranges between 30-70% depending on substance, gender, age, and cultural characteristics
there are more differences within races than between races (categories)
problems with genetic theories
- genetics aren’t invariably and fully determinative
- no addiction gene has been discovered
- no genetic evidence found for alcohol problems among indigenous populations
- there are many more biological, psychological, and sociological factors that influence drug use
Genetic theories - limitations to adoption and twin studies
selective placement effect: given up for adoption by people with history of substance use -> naturally occuring and has nothing to do with genes
- ignores potential trauma of separation
- adopted and non-adopted siblings don’t share identical genes
neurobiological theories
lots of support and funding
- aimed at understanding how people process information (learning, emotions, perceptions, sensations)
potential mechanisms
* intracellular signalling -> nerve cells adapt to changes produced by external influences like psychoactive drugs
* synaptic plasticity: environmental stimuli become associated with drug use and become linked to positive memories and sensations
-> focused on brain function and biological functioning
problems with neurobiological theories
is it another name for the disease model?
- these mechanisms occur for all human biological adaptation to stimuli or environmental stressors
- reductionist view that can’t account for complexity of human behaviour
these theories try to look for an easy answer but it’s very complicated behaviour
important note about biological explanations
they aren’t deterministic
they are predispositions that complement psychological and sociological explanations
psychological explanations
- personality theories
- behavioral theories
- psychopathology
personality theories
Widely used and studied: five-factor model of personality
* neuroticism
* agreeableness
* conscientiousness
* extraversion
* openness to experiences
believed to be consistent across time and place
some evidence that
* more neuroticism, openness, and lacking conscientiousness = higher risk of substance use
- more agreeableness: decreased likelihood of alcohol use and problems associated with alcoholism
- conscientiousness can change with the potential effects of other traits
problems with personality theories
- lack consistency of measurement of personality and operationalization of substance use
- after decades of research, personality still only accounts for a small proportion of alcohol dependency
- human behavior is not 100% attributable to personality characteristics
behavioural theories
- social learning theory
- cognitive behavioral theory
social learning theory
- people learn how to use and misuse substances from watching and modelling others behaviors
- operant conditioning: positive & negative reinforcement
positive reinforcement: good things occur because of use
negative reinforcement: bad things cause continued use
punishment: decreases likelihood of behaviour but not as much as positive reinforcement
extinction: positive reinforcement for drug use gradually diminishes
cognitive behavioral theory
supported by clinical therapy
how people think about themselves affects behavior
behavior can be changed by learning new, positive ways of thinking
* skills training to change thought
* requires attitude of non-judgemental acceptance
* counsellor draws on daily life examples of cognitions and behaviors
* client learns to gain control over active decision making
* recovering from drug dependence is learning process that takes time
psychopathology: connecting substance use to mental disorders
concurrent disorders (aka co-morbidity or dual diagnoses)
- research connects mental health disorders with drug dependence
–> over 1/2 of people with substance dependence have mental health disorders
–> up to 20% of people with a mental disorder are dependent on psychoactive substances
theories of concurrent disorder
* similar brain processes
* common elements in environment or biology
* self-medicating for mental disorder
research on specific mental disorders
similar brain processes in ADHD & substance dependence –> high rate of dependence among those with ADHD
- substance use might induce depression and anxiety
- people with schizophrenia often use tobacco or cannabis
–> tobacco can diminish some aspects of schizophrenia but no effects on disorder
–> cannabis can trigger or exacerbate symptoms of schizophrenia, especially to people with biological predisposition
BUT: is person self-medicating to deal with undiagnosed mental illness, or did substance use develop or trigger mental illness?
problems with psychopathology
- disorders are classified in Diagnostic and Statistical manual (heavily criticized)
- criticized because of the assumption that it is easy to identify disorder
major challenge:
–> which comes first
–> many possible combinations of disorders and use/dependence
