that determines use is the balance between perceived risks and benefits associated with a substance. The rank-
ordering exercise that we went over in class on the first day of this section was intended to illustrate
one set of risk/benefit examples.
Looking at the qualities of many benefits and risks associated
with drug use, the BENEFITS tend to be more
*immediate* and *certain* whereas the RISKS
tend to be more *distal* and *uncertain*. As
we did in class, take cigarette smoking for example. Benefits can include positive feelings (relaxation AND
stimulation), clear-headedness, taste, and social benefits. For the addicted
smoker, smoking will also lead to the elimination of withdrawal symptoms. Risks or negative
effects include risk of cancer and heart disease, other lung diseases, putting loved
ones at greater risk for the same, bad breath, and a reduction in taste and smell
sensitivity. Clearly, the risks outweigh the benefits in severity. Based only on
that, we should assume that no one would ever smoke.
However, the benefits are certain
to happen and happen immediately upon using the drug (note, elimination
of withdrawal symptoms.) The negative effects may or may NOT happen
and have less control over current behavior because of the delays in their
occurrence (note heart disease or cancer). Principles of learning
theories based on consequences note that sure and immediate consequences
have significantly greater behavioral control than those that are uncertain
and removed by time (ex.: would you more likely work hard on a job
today if you expected payment today or if you expected payment 20 years from now?)
It was noted in class that one can group theories regarding
drug use in a number of ways. Essentially, theories can be grouped thus:
focus: As the name
suggests, these theories focus on the pharmacological effects of
substances on the body. These include a focus on the drug
itself (agent focused), or on aspects of the
person's physiological make-up (e.g., genetics).
Theories -- puts the focus on
the pharmacological properties of the drugs and the ways in which those
drugs alter physiological functioning. Primarily, what kinds of rewards
will a drug offer?
theories (physiological susceptibility to addiction)-- These
are biomedical models that look at individual differences, but
again at a physiological level. That is, are there people that are
more susceptible to the effects of certain drugs than others?
Perhaps making them more likely to become addicted?
theories tend to note ways in which people differ physiologically, thus
explaining why not ALL people abuse substances, nor the SAME substances.
Deficiencies-- either internally (genetically) brought about or externally
(where early experience can shape development of nervous system
leading to greater "need" for certain types of stimuli.)
Genes affect metabolism of drugs, responses to them, and
vulnerability to dependence. Clearly there is a genetic
component to alcoholism. However, a person doesn't have a gene
that says, "You will drink a pint of Jack Daniels each
day." More likely, genes set up one person to respond to
alcohol differently from another person.
This may be in how they
metabolize it (offspring of alcoholics seem to metabolize alcohol more
or how they respond to it (e.g., offspring of alcoholic
parents report more positive responses to drinking alcohol than do
These biomedical theories do
not look at the behavioral side of initiating use-- how rewarding can a drug be if a person never tries it???
To do that, one needs to look at consequences and external
pressures. This involves the environment.
on the Environment:
These theories focus on the influences of people, events, or
consequences outside the individual. When discussing
"peer pressure" or "rewards" and
"punishments" associated with drug use, we're discussing
environmental influences on behavior. These views included
operant and classical conditioning and
make up the bulk of the book's discussion on psychopharmacology.
(Operant procedures regarding reinforcement/punishment were
focused on more than classical conditioning. Classical
conditioning was discussed in relation to "Antabuse" and
alcohol and in conditioned withdrawal symptoms triggering
motivations for drug use can take two forms:
seeking the effects of the drug (e.g., drinking to get drunk)
escape-- escaping negative physical and/or
psychological feelings (e.g., drinking to relieve withdrawal symptoms or
to forget problems).
of these forms of motivation refer to consequences increasing the
behavior-- appetitive motivations being influenced by gaining
something; escape motivations being influenced by relieving
This also brings to the fore the differences between initiation
and continuation of
In general, appetitive motivations are
stronger at the start of drug use (that is, seeking out the effects of
the drug), whereas escape motivations are stronger once addiction
has set in (continuing use to avoid feeling bad from withdrawal
consequences that influence behavior make up the core of
can either lead to an increase in a behavior or a decrease.
If it increases the behavior, it's referred to as a reinforcer;
if the result is a decrease in behavior, it's referred to as a punisher.
aware that behaviors can be reinforced (increased) either by presenting
something or by taking something away. (See the table
that follow a response
Reinforcement = something that increases the probability
of a behavior occurring because of what was gained. So,
if a drug makes a person feel good, it will tend to increase the behavior
of taking the drug.]
Reinforcement-- The removal of something
increases the probability of repeating a behavior-- For example, taking
a Tylenol removes a headache, so when another headache occurs you'll be
more likely to repeat the behavior (taking the Tylenol). Likewise,
withdrawal symptoms are removed by taking the drug again. This
leads to repeated drug use to avoid those bad feelings.]
the punishment side, behaviors can be reduced by giving something
(a spanking, jail time, etc.), or by taking something away (loss of job
or privileges), referred to as "response cost".
behaviors can simply fade away because the consequences stop.
This is called extinction. If a drug ceases having
the desired effects (no longer get the thrill), a person won't feel
compelled to keep using it. This seems to be what happens with
LSD-- people simply get bored with it.
yourself on these ideas with this exercise:
Click here to open the review
exercise in a new window
on the individual: Both
the agent-related theories and the environmental theories suggest
that we're all equally prone to addiction. That doesn't
appear to be the case-- so what's different between those that do
end up using or abusing drugs and those that don't? These
theories focus on differences in personality and motivations.
We focused on Psychoanalytic
theories here, but also noted other views.
useful as the behavioral theories are, they do not provide an
understanding for why only some people begin using drugs or why
others do not develop an abusive pattern of use when
placed into similar environments. The
traditional operant and respondent theories do not attempt to
explain how individuals differ. Therefore
they fall short in explaining why individuals differ
pattern of differences will predict individuals' differing views.
psychoanalytic, theory of behavior originated with Sigmund
Freud (1856-1939) through his interpretations of problems presented to
him by patients, primarily middle to upper-class Austrian women
suffering from anxiety, depression, or other pathologies.
Much debate continues about some of Freud's key assumptions and
his focus on resolution of inner sexual conflicts as the source of
personality and psychological health.
Despite the controversies, and even overt errors, in Freud's
views, his impact on psychology and clinical practice has been
to Freud, much of our motivations come from areas of our mind that we
cannot readily access: our unconscious.
Freud assumed that a large proportion of who we are is beyond
our awareness; other psychoanalytic theorists disagree with the extent
of the unconscious. One
of the problematic aspects of psychodynamic views, from a scientific
point-of-view, is the inability to directly measure unconscious
the idea of unconscious motivations remains a cornerstone of
regard to drug addiction, the focus by psychodynamic theorists has
been on the role of underlying conflicts, unconscious
motivations, and early developmental events that would determine this
form of behavior. That
means that there would be conflicts and drives that push people to
engage in drug-abusing behaviors and the person may not even be aware
of the reasons why they have chosen to do this.
One of the major
differences between this and behavioral viewpoints is that, for the
psychodynamic view, the motivations are generated within the person
whereas, for the behaviorists, control over behavior is by the
views have focused on an inability to effectively develop a sense of
self separate from others and to see self as an object that can be
controlled and soothed by the person, leaving someone to addictive
according to this view, have an arrested development of self and tend
to either see themselves in grandiose terms or in terms of being such
an entity that needs and deserves total commitment and
care from others with no reciprocation.
Because the self is weak and there is little self-esteem, drugs
would become a crutch-- either to deal with the grandiose views
differing from the dependent views, or to make up for the failings of
others to nurture. Characteristically, substance users are described as
anti-social, impulsive, sensation-seekers that have difficulty
tolerating strong emotions and delaying gratification (Lang, 1983).
why drugs and not some other self-indulgent behaviors?
According to Brehm and Khantzian (1992), being able to achieve
feelings of inner balance and comfort (homeostasis) is a
"most crucial task" that an addict struggles with throughout
their life. In attempting
to develop, maintain, or return to an internal (mental) level of
comfort or balance, a person with poor ego strength will resort to
drugs or other "easy" fixes (Pine, 1990). That is, there is mental suffering if there is imbalance and
a person might seek drugs to correct that imbalance if unaware or
unable to find another means. The
focus, then, isn't so much to gain "reinforcing" kicks as it
is to avoid or eliminate negative feelings (negative reinforcement
in behaviorist language).
sum, current psychodynamic views
emphasize that substance use is a symptom of deeper disturbances and
an inability to cope with those disturbances.
Although the original formulations by Freud focused heavily on
child-parent (mother) interactions, the idea of deep-seated issues
leading to poor coping skills and seeking external stimulation are
still a part of the model and viewpoint.
It also suggests that long-term change will be affected only by
including therapy for underlying issues and developing better coping
of psychodynamic views of alcoholism and drug abuse abound.
The early overemphasis on sexual conflicts is a frequent source
of criticism because of a lack of empirical backing (Cox, 1987; Thombs,
1994). Beyond the role of
sexual conflict, such key elements as unconscious mind and drives also
lack empirical evidence or even a way to recognize and measure them.
More damaging for the more recent psychodynamic views of
addiction is a lack of evidence for distress of the kinds proposed by
Khantzian predisposing substance use (Cox, 1985; Schinka,
Curtiss, & Mulloy, 1994).
Whatever the short-comings of psychodynamic views, the idea
that certain, underlying characteristics will predict patterns of drug
and alcohol use remain popular. Much
time and effort has been spent trying to identify the elusive
can be defined as a pattern of
relatively enduring psychological and behavioral characteristics by
which each person can be compared and contrasted with others.
A major assumption of any personality-based theory of substance
abuse is that the personality characteristics were in place prior to
any substance use and that this set of characteristics directly
contributed to the uncontrolled use of the substance.
there may not be a one-to-one relationship between having a
maladjusted personality and whether or not one uses drugs.
Shedler and Block (1990) studied the personality profiles of
students from preschool through age 18 and found:
that had at some point experimented with drugs (primarily
marijuana) were the best adjusted.
who reported frequent drug use in their adolescence were described
as maladjusted, with a personality profile even at age 7 that
showed an inability to form good relationships, insecurity, and
that reported never trying marijuana or any other drug
were found to be relatively tense, over-controlled, emotionally
constricted, and lacking in interpersonal skills.
question then becomes one of whether these characteristics cause someone
to begin abusing substances. For
example, we should also expect risk-takers and sensation seekers to
engage in various sporting endeavors or be aggressive in fields of
conclusion that personality characteristics directly lead to any one
form of specific behaviors remains a sizable leap.
Accordingly, many have now begun referring to predisposing
characteristics-- the idea that having certain personality
characteristics can place one at greater risk for engaging in
abusive behaviors given appropriate environmental demands, structures,
and opportunities-- rather than there being some "addictive
places personality more into a role of being a possible ingredient in
substance use, but not by itself a sufficient cause (maybe not even a
between the person and environment:
Realizing that all of these views have some merit, what view is
correct? The short answer is that they're all right (and all
incomplete). Interactionistic theories, such as social
cognition (which focuses on how people interpret their
environments) attempt to explain how these different pieces
Albert Bandura's Social Learning Theory
1977; Bandura & Walters, 1963), sees
human behavior as a continuous, reciprocal interaction among
cognitive, behavioral, and environmental factors.
In this view, people are able to actively take a part in the
determination of their destiny, but within limits set up by the
reinforcements and punishments will influence behavior, but the extent
of that influence will be affected by cognitions (thoughts) that
environmental influences someone pays attention to,
they will be interpreted (e.g., good or bad),
they will be remembered, and
might affect future behavior.
difference between social learning and traditional behaviorist views
is that one does not have to directly experience a reinforcement or
punishment for a behavior to change in its likelihood.
Instead, as thinking beings, we're able to observe,
interpret, and expect what kind of consequence will occur.
last distinction is important for understanding why a person
might begin to experiment with a drug in the first place and why, even
with an initially negative experience (e.g., coughing on a cigarette,
nausea with drinking alcohol), experimentation might continue.
learning, or modeling, is a key part of social learning theory.
It can be defined as an acquisition of knowledge and behavior
by observing other people and events without directly engaging in
the behavior or personally experiencing consequences (Wilson, 1988). Modeling, then, may result in
discovery of new behaviors that the person was previously
unfamiliar (e.g., freebasing cocaine);
disinhibited about trying a behavior because of either seeing an
admired other (a "model") do it or see another person
experience reinforcement (or lack of punishment) after doing the
may serve as a point of comparison (e.g., clapping when others
clap; pacing one's drinking with others)
role of modeling would seem to be illustrated in the common findings
that people rarely use an unfamiliar drug for the first time alone
and that the best predictor of smoking is parental use.
however, will not lead one to automatically copy what they observe
another do. Remember that social learning stresses that there is a
continual interrelationship between environment, the person, and the
behavior. Accordingly, a
person doesn't just blindly follow what others do.
social learning theory includes the concept of self-regulation which
refers to the ways in which people incorporate observed information
and decide to act on it, even in the absence of external environmental
rewards (Abrams & Niaura, 1987).
particular self-regulation, then, may explain why they can go out
with friends and be the only one not drinking.
the other hand, another's self-regulation may explain why, after
experiencing repeated DWI arrests, they continue to drink and drive
when there seems to be little external reward for doing so.
how does one decide which course of action to take, especially when
one's own concepts seem to differ from those exhibited or expected by
others? An underlying
principle in social learning theory is self-efficacy.
Self-efficacy can be defined as a perception or judgment of
one's ability to carry out a particular course of action in order to
deal effectively with a situation (Abrams & Niaura, 1987).
is in part a judgment of one's own ability to carry out a
behavior to its intended conclusion and in part a judgment of whether
the conclusion is a desirable one.
was discussed in approaches to therapy, one's self-efficacy is also thought to
have particularly important effects on continued drug abstinence when
leaving treatment and returning to the community.
As noted in
class, the same drug is used
for everything from ceremonial occasions (e.g., weddings,
celebrations) to other social events such as parties and sporting
events to more intimate settings to drinking alone. The same
drug, then, is being used as an anti-anxiety drug or "social
lubricant" to liven things up; as a source for relaxation or as a
source for angry arousal being associated with assaultive crimes.
How can one single, simple, depressant
drug have such varied effects? A large number of alcohol's
supposed effects come from what people believe alcohol will do
to them. These expectations have a strong effect on
how people act and feel when "drunk." How, then, do we
tell the difference between what alcohol, as a pharmacological agent,
actually does to a person and what effects occur simply because
someone expects them to happen?
One technique used to separate
expectations from pharmacological effects is the balanced
placebo design. This technique involves measuring
how people act and feel when they think they've had alcohol
(but really haven't) and comparing that to actions and feelings when a
person has actually consumed alcohol, but didn't think that they were. In sum, the
balanced-placebo design looks like this:
BEVERAGE ACTUALLY RECEIVED BY SUBJECT
WHAT SUBJECT TOLD DRINK IS
This is the typical drinking condition-- person orders alcohol
and gets alcohol.
This is the placebo condition. Person thinks
they're drinking alcohol, but there's no alcohol in the
drink. This condition measures expectation effects.
This condition measures the pharmacological effects of alcohol
because the person thinks they're drinking tonic, but
there's enough alcohol in the drink to get them legally drunk.
This is the control condition where the person neither
expects alcohol nor gets any.
By comparing cells 2 and 3, one can get
an idea of what alcohol does as a drug (3) v. how people respond to
alcohol because that's what they expect (2). Over the years that
this has been done, it's been found that nearly all the effects one
thinks of in relation to alcohol-- increased violence, stress
reduction, decreased inhibitions, etc.-- are primarily expectation
effects. Based on these studies, only one pharmacological effect of alcohol comes out clearly and
decreases your ability to process complex cognitions (i.e., it
makes it harder to think clearly).
So how does that translate into all the
behaviors and feelings we see related to alcohol? Claude Steele
(1990) has developed a theory about alcohol myopia which
seems to explain this quite well (introduced
briefly in your textbook on p. 216). Consider the
situation introduced in class:
Stan's landlord is truly a crook. He makes shoddy repairs and
overcharges Stan and then charges him again when things fall
apart. He comes into Stan's apartment whenever he pleases and
Stan suspects the landlord goes through his stuff. So far, Stan has
kept his cool around him because he realizes he'll lose his security
deposit if he gets kicked out and other apartments aren't
available. One night, however, Stan's been drinking at the local
tavern, complaining about the landlord, when he comes in.
Already worked up, Stan picks a fight with the landlord and gets
Why did he choose to fight the landlord
when drunk, but not when sober? ("Because he was
drunk" is not an answer, by the way.) Claude Steele
would say that the alcohol affected Stan's ability to think about the
consequences of his actions (which he was able to do when
sober). Instead, Stan pays attention to the clearest thing in
his immediate environment-- the landlord whom he hates. That
focused attention without the restraint of the consequences leads to
an amplified response.
For those that prefer graphic
representations, click on the images below:
How Stan sees things when
or after drinking:
Similarly, alcohol can act as an
anti-anxiety agent (for the short term) if the environment that
one is drinking in is distracting enough to push the anxiety-producing
thoughts out of mind. However, alcohol can often have the effect
of making someone feel more miserable about their troubles because
they're unable to think of other things and put their problems into
perspective when drunk.