Section B Addictive behaviour

Models of addictive behaviour

• Biological, cognitive and learning approaches to explaining initiation, maintenance and relapse, and their applications to smoking and gambling

Vulnerability to addiction

• Risk factors in the development of addiction, including stress, peers, age and personality

• Media influences on addictive behaviour

Reducing addictive behaviour

• The theory of planned behaviour as a model for addiction prevention

• Types of intervention and their effectiveness, including biological, psychological and public health interventions

Unit 4 Section B is differentOutline and evaluate the biological approach to explaining smoking behaviour. (4 marks + 6 marks)

A recent large survey on behalf of the Gambling Commission provided a number of interesting findings about gambling behaviour in Great Britain. For example, 57% of the population had gambled on the National Lottery Draw in 2007, although the rate of problem gambling in the adult population was only about 0.6%.

Explain some of the difficulties of gathering data about problem gambling. (5 marks)

Andy is in his first year at university. He is a shy young man who lacks confidence in himself and worries about meeting new people. Since starting university, Andy has preferred to stay in his room, playing strategy games on the internet with his old school friends. Andy often plays all night which means that he sleeps in and misses his lectures. He is finding his course difficult and fears that he may fail his exams or drop out.

Use your knowledge of risk factors in the development of addiction to explain Andy’s addiction to the internet. (6 marks)

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Three styles, five topics

Topic Mini essay Method Application of

knowledge

Biological, cognitive, learningInitiation, maintenance, relapseSmoking and gamblingRisk factors (stress, peers age, personality)

Media influences

Theory of planned behaviour

Interventions (biological, psychological and public health)

January 2010A large survey on behalf of the Gambling Commission provided a number of interesting findings about gambling behaviour in Great Britain. For example, 57% of the population had gambled on the National Lottery Draw in 2007, although the rate of problem gambling in the adult population was only about 0.6%.(i) Explain some of the difficulties of gathering data about problem gambling. (5 marks)

June 2011

A study into the effects of warnings on cigarette packets has found that these vary depending on the reason why people smoke in the first place. College students were given questionnaires to assess whether self-esteem self-esteem not in spec played a role in their motivation to smoke. They were then shown cigarette packets with either death-related warnings (eg ‘smokers die young’) or death-neutral warnings (eg ‘smoking makes you unattractive’). Students, to whom smoking was important to their self-esteem, were not put off by warnings of death on cigarette packets. Surprisingly, their attitude to smoking became more positive after being shown such messages. However, warnings related to the source of their self-esteem, (eg ‘smoking makes you unattractive’), significantly reduced positive attitudes to smoking in this group.

The questionnaires consisted of statements such as ‘Smoking makes me feel valued’ and students had to indicate in a tick box the extent to which they agreed/disagreed with each statement.

10 Suggest one other possible statement that could have been used to assess the role of self-esteem. State whether this kind of data is qualitative or quantitative. (2 marks)

1 1 Explain one strength and one limitation of using a questionnaire in this study. (2 marks + 2 marks)

Provided a question instead of a statement.

Many thought if words were involved it must be qualitative.

Methods

Biological, cognitive, learningInitiation, maintenance, relapse

Smoking and gambling

January 2010(a) Outline and evaluate one explanation of gambling

addiction. (4 marks + 6 marks)(b) 'The relapse rate for smokers in the first three

months after trying to give up is estimated at 70%.’ Discuss reasons why relapse occurs in people with

addictive behaviour. (5 marks + 5 marks)

(a) Discussed addiction in general rather than gambling.

(b) Many discussed maintenance rather than relapse. Some didn’t do any evaluation.

January 20111 1 Outline and evaluate the biological model as an explanation for the maintenance of smoking or gambling one addictive behaviour. (4 marks + 4 marks)

The requirement to select material caused problems (the biological model and maintenance and just one addictive behaviour).

June 2011

0 8 Outline the learning model of addiction. (5 marks)

Mixing up CC and OC and SLT.

Not related to addiction.January 20120 9 Outline and evaluate the biological approach to explaining smoking behaviour. (4 marks + 4 marks)

Weaker answers offered generic evaluation and not specific to smoking.

June 20120 9 Outline and evaluate the cognitive approach to explaining problem gambling. (4 marks + 6 marks)

Students who did best structured their description around the stages of gambling addiction (initiation, maintenance and relapse).

Biological, cognitive, learningInitiation, maintenance, relapse

• Relapse in general: Discuss reasons why relapse occurs in people with addictive behaviour. (5 marks + 5 marks)

• Maintenance specific to one model: Outline and evaluate the biological model as an explanation for the maintenance of smoking. (4 marks + 4 marks)

• Answers must be specific to gambling / smoking.

• Answers must be specific to initiation / maintenance /relapse

Smoking and gambling

Biological Cognitive Learning

Initiation 2 marks AO12 marks AO2

Maintenance

Relapse

Gambling

Biological Cognitive Learning

Initiation 2 marks AO12 marks AO2

Maintenance

Relapse

Smoking

2 marks worth = 50

words

Mark Analysis, understanding and

intepretation

Focus Elaboration Line of argument

6 Sound Well focused Coherent Clear5-4 Reasonable Generally

focusedReasonable Evident

3-2 Basic. superficial Sometimes focused

Some evidence

1 Rudimentary, very limited understanding

Weak, muddled, incomplete

Not used effectively

May be mainly irrelevant

0 No creditworthy materialQuality of written communication also assessed

Mark Knowledge and Understanding Organisation and structure

4 Reasonably thorough, accurate Coherent

3-2 Limited, generally accurate Reasonably coherent

1 Rudimentary, muddled and/or inaccurate Lacking

0 No creditworthy material

Biological, cognitive, learningInitiation, maintenance, relapse

Smoking and gambling

Outline and evaluate one explanation of gambling addiction. (4 marks + 6 marks)You can explain gambling in terms of genetics. There is evidence that gambling runs in families which could be due to genetic factors. Shah et al. conducted a twin study and found that there was a genetic factor in men. Furthermore Black et al found that first degree relatives were at a higher risk of developing gambling than more distant relatives. One particular gene has been identified, the D2 dopamine receptor gene, which is common in people who have addiction problems, such as gamblers. Gamblers experience physiological arousal when gambling which results in the release of dopamine in their brain, thus linking to the D2 receptor gene. However it is difficult to be sure that it was genetic factors and not environmental factors in the gambling in men. Another problem with this research is that not all of the men in the same family become gamblers so this doesn’t support the genetic interpretation. It is difficult to identify particular genes for the addiction problems and without such genes it is hard to claim a cause and effect relationship. 178 words (10 marks should be 200 words)

Risk factors Stress, peers, age, personalityJune 20101 0 ‘Sally is a young woman who puts herself down all the time. She thinks that she is overweight and has started to diet. Like her parents and some of her friends, Sally smokes cigarettes. Her smoking habit has recently become excessive and she is now addicted to nicotine.’ Triggers relate to old specUsing your knowledge of the psychology of addictive behaviour, explain some of the likely reasons why Sally has become addicted to smoking. (6 marks)

Some well-informed answers gained little credit because not linked to Sally’s problems.

June 2011

0 9 Explain how self-esteem stress or personality or … can influence vulnerability to addiction. (4 marks)

Lots of anecdotes. ‘Explanation’ not addressed.

January 20121 0 Andy is in his first year at university. He is a shy young man who lacks confidence in himself and worries about meeting new people. Since starting university, Andy has preferred to stay in his room, playing strategy games on the internet with his old school friends. Andy often plays all night which means that he sleeps in and misses his lectures. He is finding his course difficult and fears that he may fail his exams or drop out. Use your knowledge of risk factors in the development of addiction to explain Andy’s addiction to the internet. (6 marks)

The scenario made reference to the four named factors on the specification: stress, peers, age and personality. Either cover all in less detail or a couple of factors in greater detail. Best to identify a risk factor (eg stress) explain how and why this could influence vulnerability to internet addiction using relevant research findings.

Risk factors

• Scenario will mention risk factors.• Best to identify a risk factor (eg stress)

explain how and why this could influence vulnerability to internet addiction using relevant research findings.

Andy is in his first year at university. He is a shy young man who lacks confidence in himself and worries about meeting new people. Since starting university, Andy has preferred to stay in his room, playing strategy games on the internet with his old school friends. Andy often plays all night which means that he sleeps in and misses his lectures. He is finding his course difficult and fears that he may fail his exams or drop out. (6 marks)

Stress, peers, age, personality

Application questions

Andy is shy. Research has shown …

Andy worries about meeting new people and is also finding his course difficult. This means that he is stressed. Research has shown …

Andy is young, as he has just started university. Research has shown …

Andy is still involved with his school friends. Research has shown …

Link to psychology

Risk factors Stress, peers, age, personality

Andy is shy. Research has shown …

Extraversion rather than introversion linked to addiction.

Andy worries about meeting new people and is also finding his course difficult. This means that he is stressed. Research has shown …

… that stress is linked to addiction. Certainly people report that the a major reason for there is to relive stress and NIDA reported that stress contributes to initiation, maintenance and relapse. However this is not true of everyone.

Andy is young, as he has just started university. Research has shown …

… that age is linked to addiction. In later adolescence individuals are more affected by their peer group than at other ages. This means he will be affected by the behaviour of those around him.

Andy is still involved with his school friends. Research has shown …

… that we learn through social identity (Bandura). Identification with peers means individuals model that behaviour. Social identity theory could also explain peer influences …

Application questions

Mark Application Focus

6 Sound analysis Well focused and effective5-4 Reasonable analysis Generally focused3-2 Basic, superficial Sometimes focused1 Rudimentary, very limited

understandingWeak, muddled, may be largely irrelevant

0 No creditworthy material

Quality of written communication also assessed

Application mark scheme

Just identifying risk factors would result in a mark of 1.

Media influencesJanuary 20111 2 ‘The more young people see smoking in cinema and TV films, the more likely they are to start smoking themselves.’ Use your knowledge of research into the role of media in addictive behaviour to explain why such films might encourage young people to start smoking. (4 marks)

Research not included in answers.

Maximum 2 marks for no reference to research.

June 2012

1 0 Describe one way in which media may influence addictive behaviour. (4 marks)

Weaker students presented anecdotal answers but included little by way of evidence or psychology to inform their responses.

Answer could refer to anti-drug campaigns.

Social learning theory Initiation of smoking through identification with role models on TV.Modelling this behaviour because of vicarious reinforcement.

Waylen et al. Teenagers who watched films where actors smoked were more likely to take up smoking.

2 marks worth = 50

words

Media influences

Explanation of influence

Evaluation

Social learning theory

Initiation of smoking through identification with role models on TV.Modelling this behaviour because of vicarious reinforcement.

Media does not always provide vicarious reinforcement …

Films show moral decline and physical deterioration (Boyd).

Example

Teenagers who watched films where actors smoked were more likely to take up smoking (Waylen et al.)

Research support …

Sargent and Hanewinkel surveyed over 4000 adolescents. After 1 year those who watched more films were more likely to have taken up smoking.

Theory of planned behaviourJune 20101 1 Outline the theory of reasoned action planned behaviour. (5 marks)

Surprising number of candidates didn’t know the theory.

Six things I would say (6 marks, 150 words)

Three evaluative points (6 marks)

A cognitive theory Too rational

Strong emotions may influence behaviour (Armitage et al.)Behavioural

attitudeSubjective norms Influence of alcohol and

drugs

Measurements made soberPerceived behavioural controlIntention Predicts intention rather than

behaviour change (Armitage and Conner)

Especially for difficult behaviours

Behaviour

Intervention Biological, psychological and public health

June 20101 2 Outline two examples of public health interventions aimed at reducing addictive behaviour. (4 marks)

1 3 Assess the effectiveness of public health interventions and/or legislation in reducing addictive behaviour. (10 marks)

12 Candidates wrote about biological or psychological therapies – wrong.

Smoking ban or advertising – good.

13 Poor answers, often repeating part 12.

Good answers included considerations of the problems assessing effectiveness.

January 20111 3 Discuss one type of intervention aimed at reducing addictive behaviour. (5 marks + 8 marks)

No credit for models of prevention.

Many candidates considered effectiveness and used relevant studies to support their point.

June 2011

1 2 Using the findings from this study [refers to study the effects of warnings on cigarette packets] and other psychological research, discuss the effectiveness of different types of intervention. (10 marks)

Really bad, not relating to findings of study (attitudes became more positive).

Giving examples of intervention but not effectiveness.

Missing the question.

Don’t say whether they actually work.January 2012

1 1 Outline and evaluate one psychological intervention aimed at reducing addictive behaviour. (4 marks + 6 marks)

AO2/3 use research evidence to consider the effectiveness of the intervention.

AO2 Effectiveness

Intervention Biological, psychological and public health

June 2012

1 1 Kerry has recently married and she and her partner would like to have a baby. She is keen to give up smoking. However, she has tried several times and finds that she experiences unpleasant withdrawal symptoms. Kerry’s job is stressful and most of her co-workers also smoke. She has started to despair and thinks that she will never succeed.

Identify one or more interventions which could be used to help Kerry to stop smoking and explain, with reference to the scenario, why your chosen intervention(s) would be appropriate for Kerry. (10 marks)

Application and good psychology was key to higher marks.

The most successful students identified one of the cues in the scenario (e.g. withdrawal symptoms), linked this to an appropriate intervention (nicotine patches or gum) and explained how and why this might be useful for ‘Kerry’ .

Mark Application Focus

6 Sound analysis Well focused and effective5-4 Reasonable analysis Generally focused3-2 Basic, superficial Sometimes focused1 Rudimentary, very limited

understandingWeak, muddled, may be largely irrelevant

0 No creditworthy material

Quality of written communication also assessed

Application mark scheme

Just identifying risk factors would result in a mark of 1.

Intervention

The first step for Kerry would be to attend motivational interview sessions as these would help to change her attitude so she is back into the frameset of ‘I want to make a change’. This intervention is based upon the cognitive approach because it aims to replace the thoughts of dependency and despair with a more positive outlook. Also clients should feel empowered and even more inspired to quit, without these cognitions it is very unlikely that someone will be successful in changing their behaviour and stopping an addiction. Kerry may also find combining biological therapies helpful as they work to block the unpleasant withdrawal symptoms by filling the craving with a substitute substance. By using the substitute cravings are no more but there is no positive reward associated therefore the person can be weaned off the substitute drug in comfort. However a problem with biological therapies is that they only tackle the addictive behaviour, rather than the underlying causes of what made the person start in the first place. In order to solve this Kerry should also participate in some sort of rehabilitation in order to ensure that abstinence from smoking is maintained. This will ensure that she does not form an addiction to the substitute drug that decreases the craving for nicotine. One rehabilitation example is if she joins a self help group therapy. These are based on a 12 step guide to quitting, the steps being personal to each group. They are run by addicts who provide inspiration to new members. During therapy addicts learn to accept responsibility for their actions and learn that addictions cannot be treated but merely arrested. Kerry would find these sessions beneficial as the other group members would support through quitting smoking but also they would provide positive reinforcement through appraisal of maintaining abstinence from cigarettes. 304 words (10 marks = 250 words)

Biological, psychological and public health

Covered:• Motivational interview –

cognitive• Biological therapies• Problem• Maintenance programme e.g.

self group therapy• Beneficial because social

support

Intervention

• Know one very well

• Biological interventione.g. Use of SSRIs to increase serotonin for gambling (Hollander et al.)

• Psychological interventione.g. CBT can address cognitive biases.

• Public healthe.g. Quitlines, repeated callbacks from a counsellor.

AO2 Effectiveness

Some evidence that it is not effective. Hollander was very small (N=10). Larger and longer study (32 Ps, 6 months) found no benefit (Blanco et al.)

Significant improvements in male pathological gamblers (Sylvain et al.), even at one year follow up (relapse prevention).

More effective by 50% than brief counselling / self-help materials (Stead et al.)

Biological, psychological and public health

Wrapping it upEssay possibilities

• 8+16 marks• 4 + 8 marks• 4 + 6• 3 + 6• 2 + 8• 2 + 4• 0 + 8• 4 + 0

Research methods

1 mark = 25 wordsKnow what 25 words looks like

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