Griffiths (2005) defined addiction as any behaviour that features all of these 6 core

components: Salience, Tolerance, Mood Modification, Conflict, Withdrawal and Relapse. Salience
refers to when a particular activity becomes the most important activity in a persons life. Tolerance
refers to the process in which the particular activity needs to be consistently increased in order for
the individual to feel the strength of the former effects.

Impulse control disorders (ICDs) are characterised by a failure to resist a temptation, an urge or an
impulse that may be harmful to oneself or others. Examples of ICDs include Kleptomania (failure to
resist the urge to steal items for no rational reason) and compulsive gambling (the failure to resist
gambling urges). Impulsivity has 5 distinct stages of behaviour. The patient first experiences an
impulse and tries to resist it. The resistance causes them to experience a growing tension. The
person finally acts on his/her impulse which then gives them a sense of pleasure or gratification. The
person feels relief as the tension subsides. The person may or may not feel a sense of guilt
afterwards.

Physical dependence is characterised by the appearance of withdrawal symptoms such as sweating

or tremors, when the chronic use of a substance is stopped whereas the withdrawal symptoms of
Psychological dependence is related to the mind such as insomnia, irritability and depression.

One cause of addiction is genetics. In alcohol addiction, the importance of genetics is

supported by the familial nature of this disorder, there is a fourfold higher risk for developing
alcoholism in the children of alcoholics, even when the children were adopted away at birth.
(Bohman & Sigvardsson,1981). Based on this evidence, researchers tried to identify possible
genetically influenced factors that might contribute to alcoholism risk. Schuckit (1985) found that
40% of the sons of alcoholics, compared to only 10% of the sons of non-alcoholics, show decreased
sensitivity to alcohol in terms of feelings of drunkenness, hand eye-coordination performance and
hormone levels, despite having the same blood alcohol levels. This suggests a potential importance
of a decreased intensity of reaction to alcohol as part of a predisposition towards alcoholism.

The biochemical explanations is centered on the dopamine hypothesis. Dopamine is part of

the reward system of the brain. Adaptive behaviours such as eating and having sex and maladaptive
Behaviours such as gambling and drug taking, both cause dopamine release which lets the brain
know that it should repeat the behaviour. Repeated exposure to a dopamine-releasing behaviour
will cause reduced sensitivity to the dopamine through a process called down regulation. Behaviour
is then maintained due to a disequilibrium in the dopamine system when behaviour is stopped.

The behavioural model explains addictions and ICDs through classical and operant conditioning.
The feeling-state theory proposes that ICDs are formed when positive feelings are associated with
specific objects or behaviours. The addiction is maintained when the good feeling the person gets
from their actions positively reinforces the person to repeat the behaviour more frequently. To
replicate the same feeling, the person compulsively repeats the behaviour, even if it is detrimental
to their themselves.

Addiction can also be explained through the cognitive model. A heuristic is a rule or shortcut
that we use when we make a decision. Griffiths (1994) suggested a number of illogical heuristics that
compulsive gamblers possess which causes them to continue gambling even though they keep
losing. One such heuristic is the Gamblers fallacy which is the idea that random events equal
themselves out over time. For example, its been heads four times so its bound to be tails this
time. There is also the expectancy model which discusses a self-fulfilling prophecy. This means
that whatever one expects will happen, will actually happen. For example, a person who expects to
be less inhibited when he drinks alcohol will act so when he actually drinks alcohol or a placebo
(Cooper et al 1992).

One way to cope or reduce addiction and ICDs is by using the token economy. Token
economy is a system of behaviour modification based on the principles of operant conditioning
where an individual receives tokens as positive reinforcement for non-impulsive behaviour. Tokens
can later be exchanged for backup reinforcers or highly desired items and privileges.

Aversion therapy is based on the principles of classical conditioning which involves

associating an undesirable behaviour with an unpleasant conditioned response. For example, the
drug antabuse is an emetic drug which induces vomiting when the patient is drunk. Here, the
patient will be pairing drinking with a nauseating feeling. The underlying rationale is that the fear of
or prior experience with this unpleasant result will deter the individual from drinking further.

Besides that, cognitive behavioural therapy has been used successfully in the treatment of
kleptomania. CBT can include covert sensitization, behavioural-chaining, problem-solving and
cognitive restructuring. Kohn (2002) used CBT in a case study of a 39-year-old man named Jay who
had shoplifted since he was six. It was reported that symptoms of depression and kleptomania
decreased during treatment and remained low at a follow up 16 weeks after.
ICD Evaluative

Addictions are due to nurture. This is supported by the feeling-state theory derived from the
behavioural model. A specific object or behaviour is associated with a positive feeling through
classical conditioning and subsequently maintained by the positive feeling (positive reinforcement)
and the avoidance of unpleasant withdrawal symptoms (negative conditioning) through operant
conditioning. For example, a stressed businessman may feel less tense when he drinks. Thus, he may
start drinking alcohol more frequently in order to release his stress. The repetition of this behaviour
eventually turns into an addiction. However, based on this argument, all people who drink should
then have developed an addiction to alcohol but this is not true. People with addictions and impulse
control disorders (ICDs) still make up only a minority of the population. There is also the social
learning theory in which behaviour can be learned through the observation of other people. DiBlasio
& Benda (1993) found that adolescents who smoked associated themselves with other smokers, and
were more likely to conform to the social norm of a smoking group.

Addictions are due to nature. This is supported by the biological model which places the fault of
developing these disorders on genes. People are born with a certain set of genes that cannot be
changed, thus it is innate in the individual. For example, Peters and Preedy (2002) found that alcohol
misuse is familial with up to 50% of patients having an affected first-degree relative. Several studies
have also shown that illicit drug abuse and dependence have heritability estimates ranging from 45
to 79% (Agrawal and Lynskey 2006). However, the fact that the heritability estimates are not 100%
suggests that addictions are not purely due to genetics. Other influences such as cognitive and
behavioural or environmental factors may also play a role.

In conclusion, there may be a diathesis-stress model at play where inherited genes may have
predisposed an individual to be at risk of developing alcoholism but

DISCUSSION ABT COMPETING EXPLANATIONS

One of the strengths of the cognitive explanation is that it can explain individual differences in the
development of addictions and ICDs. Many people have drunk alcohol and played in casinos but only
a minority develops an addiction. Cognitive explanation can account for these individual differences
as only those who have faulty cognitive biases will be more likely to develop problems. Another
strength is that it is provides a powerful means for professionals to deter young people from
drinking by altering their expectancies before they even start drinking. One weakness of this model
is that it places the blame on patients. Because the patient is responsible for their faulty cognitions,
the cognitive model thus implies that patients are at fault for their maladptive behaviour. This may
be unethical as it may cause patients to be distressed. Another problem is with the cause and effect
relationship of addictions and cognitions. It is unclear whether faulty cognitions cause the addiction
or that cognitions are caused by the addiction.

Similar to cognitive explanations, one strength of the biological explanation can also be used to
explain individual differences in addictions and ICD through a diathesis-stress model. This means
that genes may predispose a person to be more vulnerable to addictive behaviour but it will only
manifest in the right circumstances such as stress of boredom that cause them to develop the
addiction. This explains why many people are exposed to the same stimuli but only a minority
actually develop addictions. One weakness of biological explanations is that it is reductionist. This is
because it ignores other factors such as environmental stressors and illogical thinking in causing
addictions. Besides that, it also takes the blame away from the patients. The biological hypothesis
suggests that addictions are caused by inherited genetics and that individuals have no control over
these factors. This takes responsibility from the patient and may cause them to not be held
accountable for their deliberate actions such as gambling and smoking. This may even cause them to
refuse treatment as treatment seems futile when the cause is innate and out of their control.

COGNITIVE VS BEHAVIOURAL TREATMENT (ADDICTION)

The behavioural treatment for Addiction refers to the use of aversion therapy. One strength of
aversion therapy is that it is effective. Meyer and Chesser (1970) used aversion therapy to treat
alcoholics. After twelve months, the success rate was put at around 50%. Another strength is that it
is quick and thus is useful in the short-term. One problem with the token economy is relapse. Away
from the controlled lab environment where the associations are made, it is common for the
addictions to return. The behavioural model does not account for cognitions and rationality of
humans. For example, a patient after undergoing therapy may return to the addiction because he
has the capacity to rationalize that the aversive consequences will only occur in the treatment
centre and not in real life. Another problem is that it is unethical. Aversion therapy is a highly
controversial treatment as it is based on administering pain or nausea to treat addiction.

One strength of the cognitive-behavioural therapy for addictions is that it is also very effective.
Caroll et al (1994) found CBT to be more effective than the antidepressant in treating cocaine
addiction and this effectiveness was maintained twelve months later. Another strength of CBT is that
it can be empowering as the sufferer is provided with the tools to self-manage his/her own
condition. This is in contrast with other therapies in which the patient is told that their behaviour is
determined by the biological or environmental factors and that there is nothing the sufferer can do
to prevent it. One weakness of CBT is that it takes longer than many other approaches thus making it
less useful for reducing addiction in the short run. T

In conclusion, each treatment has its own strengths and weaknesses, but Cognitive treatments may
be better as it is more ethical. Behavioural treatments like aversion therapy can be used when
patients are not responding to CBT.

INDIVIDUAL DIFFERENCES