Changing the way you learn

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Outline the biological explanation for smoking initiation (4).	Smoking addiction may be influenced by genetic factors. Family and twin studies estimate the heritability of smoking to be between 39-80%. A specific gene variant associated with nicotine dependency may have been inherited from a first degree relative.
Outline the cognitive explanation for smoking initiation (4).	The cognitive model suggests that faulty or maladaptive thinking is the cause of addictive behaviour. Brandon et al suggested that a behaviour escalates into addiction because of the expectations an individual has about its costs and benefits. A smoker may have a positive expectancy bias towards the behaviour and be less inclined to quit as a result.
Outline the learning explanation for the initiation of smoking (4).	The learning model would explain smoking initiation through social learning theory. Youths may undergo vicarious reinforcement as a result of observing positive physical and social consequences of smoking in parental and/or peer models (e.g: popularity). They may then imitate the behaviour and undergo direct reinforcement as a consequence.
Outline the biological explanation for the maintenance of smoking behaviour (4).	The biological model would explain smoking maintenance through the physical effects of nicotine on the brain. Nicotine affects brain chemistry by activating nAchR (nicotine acetylcholine receptors), which leads to dopamine release. This chemical reaction increases pleasure and lowers it as the nicotine levels in the blood fall. Down regulation may result in higher tolerance levels so the smoker no longer smokes for pleasure but smokes to avoid the negative effects of withdrawal, maintaining the behaviour in doing so.
Outline the cognitive explanation for smoking maintenance (4).	The cognitive model states that people may maintain smoking due to expectancy bias, where the addict believes that smoking has more positive effects than negative when compared to a non-addict, and so would continue to smoke in order to reap the benefits associated with the behaviour. Brandon et al suggests that addictive behaviour can influenced less by conscious expectations and more by the unconscious, which can explain the loss of control that individuals may experience. Due to these positive and unconscious expectations, an addict may maintain their smoking behaviour.
Outline the learning explanation for smoking maintenance (4).	The learning model explains the initiation of smoking through classical conditioning. The repetition of smoking leads to a strong conditions association between the sensory aspects of smoking (e.g: the smell of cigarette smoke, sight of cigarettes) and the reinforcing effects of nicotine (e.g: the increase in dopamine activity in the brain). Therefore, it becomes harder to resist.
Outline the biological explanation for smoking relapse (4).	Relapse is when an individual has managed to give up an addictive behaviour but then the habit and symptoms of the behaviour start to show up again. The biological model would use the role of dopamine, which acts as the reward system in the brain, to explain relapse. Even though smoking may give little or no pleasure anymore, the brain still receives difficult to resist signals of immediate gratification, causing the addict to start smoking again. The frontal cortex has become less effective at making decisions and judging consequences throughout the addiction, therefore heightening the risk of relapse.
Outline the cognitive explanation for smoking relapse (4).	Relapse is when an individual has managed to give up an addictive behaviour but then the habit and symptoms of the behaviour start to show up again. The cognitive model for smoking suggests that smokers may relapse because of a positive expectancy bias towards the behaviour (there may be an expectancy of positive mood states such as stress-relieving relaxation in relation to the behaviour). If the benefits of smoking (the relief of stress) are seen to be greater than the costs (negative effects on health), this may affect the likelihood that a smoker will relapse.
Outline the learning explanation for smoking relapse (4).	Relapse is when an individual has managed to give up an addictive behaviour but then the habit and symptoms of the behaviour start to show up again. The learning model would explain the relapse of smoking through the individual's inability to resist reinforcers previously associated with receiving nicotine, through classical conditioning. Cues such as cigarette availability and the smell of cigarette smoke may affect the individual's perceived self-efficacy to abstain.
Outline the biological approach to explaining the initiation of gambling behaviour (4).	The biological model suggests that gambling initiation is a result of genetics. Research suggests that gamblers may inherit an underactive pituitary-adrenal response to gambling stimuli, which may lead to initiation (Paris et al). This might be because they do not feel that their stress levels (incurred by cortisol) are high enough to stop engaging in the behaviour.
Outline the biological approach to explaining the maintenance of gambling behaviour (4).	The biological model explains gambling maintenance through an underactive pituitary-adrenal response to gambling stimuli (Paris et al). This would lead to the continuance of gambling behaviour because the gambler would not feel that their current stress levels (incurred by cortisol) were high enough to prevent them from engaging in the behaviour. Zuckerman et al also suggested that there are individual differences in the amount of need for stimulation, which may be inherited. High sensation-seekers have a lower appreciation of risk and anticipate arousal as more positive than low sensation-seekers so they're more likely to continue to gamble as a result.
Outline the biological explanation for gambling relapse (4).	Relapse is when an individual has managed to give up an addictive behaviour but then the habit and symptoms of the behaviour start to show up again. The biological model would explain gambling relapse through boredom avoidance. The pathological gambler is seen as a person who needs intense stimulation or excitement so poor boredom tolerance may be seen as a sign that the individual may resort to gambling behaviours again, as a way to excite themselves.
Outline the learning approach to explaining the initiation of gambling behaviour (4).	The learning approach to gambling behaviour initiation proposes that gamblers become addicted through operant conditioning. When the behaviour produces a rewarding consequence it is more likely to be repeated. Griffiths found that there are plenty of physiological rewards (getting a buzz from winning), psychological rewards (the near miss - arousing moments where the gambler almost wins), social rewards (peer praise) and financial rewards on a slot machine for example. The fact that gamblers often place more cognitive emphasis on the winning experience reinforces the importance of operant conditioning within the addiction's initiation.
Outline the learning model's explanation of gambling maintenance (4).	Maintenance is when the individual continues to engage in the addictive behaviour in the face of adverse consequences. The learning model would propose that gambling maintenance can be explained through intermittent reinforcement. Operant conditioning suggests that people continue to gamble because of the occasional reinforcement that is characteristic of the gambling behaviour (e.g: getting a buzz from winning). Through this process they also learn to associate these with other stimuli e.g: the sights and sounds of a casino, making it harder to stop.
Outline the learning model's explanation for gambling relapse (4).	The learning model would explain gambling relapse through classical conditioning. The addict learns to associate gambling related sights with the behaviour (e.g: the sights and sounds of a casino). These may act as triggers because they can increase arousal. If the individual comes into contact with one of these cues they may be more likely to relapse. The approach-avoidance conflict is also an important factor. Since gambling has positive and negative consequences the gambler is motivated to approach and avoid situations where it is involved. Their motivation fluctuates between wanting to gamble and wanting to stop. Whether the gambler will act on the urge depends on their ability to control their increased arousal and delay their need for reinforcement.
Outline the cognitive approach to gambling initiation (4).	The cognitive approach would explain gambling initiation through the self medication model (Gelkopf et al). This states that individuals intentionally use different forms of pathological behaviour to treat their psychological problems. For example, gambling activities may be chosen because they are perceived to help the individual overcome the depression associated with poverty, since they can win money from slot machines to improve their situation.
Outline the cognitive approach to explaining the maintenance of gambling behaviour (4).	The cognitive approach explains the maintenance of gambling behaviour through the gambler's fallacy: the belief that random events (e.g: a coin toss) are influenced by recent events (e.g: if lots of heads show up in a row the gambler may assume that tails has to be next). Illusions of control are also very important to gambling maintenance and are often conceived in the form of superstitious behaviours (e.g: blowing on the dice for good luck), which the gambler may believe helps them to manipulate the event outcome favourably. Cognitive biases also encourage the gambler to continue their gambling behaviour because they view the outcome more positively, seeing near misses instead of constant losses.
Outline the cognitive approach to explaining the relapse of gambling behaviour (4).	Gambling relapse can be explained through the just world hypothesis. This hypothesis suggests that a string of losses does not always act as a disincentive of future gambling because such individuals believe they'll eventually be rewarded for their efforts. The individual could be motivated to return later because they "deserve" to win, having lost so often before. This could encourage relapse of the behaviour.
Outline public health interventions (2).	Public health interventions are interventions aimed at the general public. They are designed to educate people about the risks (e.g: the health impact of smoking and consequences of addictive behaviour (e.g: the financial costs of gambling) and discourage initiation.
Outline GamCare (2).	GamCare is an organisation funded by the Responsible Gambling Trust. It helps gamblers, friends and families to deal with their addiction. The organisation provides counselling and has a public health intervention based education awareness team, which aims to prevent problem gambling before it starts.
Outline group behavioural therapy for smoking (2).	Psychological interventions can be done in a group. This allows people to establish an awareness and motivation to change their behaviour. An ideal group consists of 4-8 people with a therapist for an hour. Follow-up phone calls may also be included afterwards.
Outline telephone quitline services for smoking (2).	Even a 5-10 minute call from a smoking cessation counsellor can be useful. The counsellor can provide advice on how to avoid relapse and provides a chance for the smoker to counteract their cognitive biases towards their behaviour.
Outline drug treatments for gambling (4).	No drug treatments have been approved in the UK to treat patholoical gambling however, treatments in regards to serotonin or dopamine may be beneficial. The use of SSRIs is being investigated as they increase levels of serotonin. This neurotransmitter has been linked to raised mood. Since gamblers may gamble to avoid low mood (self-medication) SSRIs may prevent the urge to gamble in order to improve mood.
Outline CBT (4).	Cognitive behavioural therapy (CBT) is based on the principle that behaviour is maintained through cognitive biases towards its consequences (e.g: gamblers viewing constant losses as near misses). Gambling may have initially begun as a form of self-medication (e.g: treating the depression associated with poverty by getting money). CBT aims to change these faulty behavioural beliefs. It can help the gambler find other ways to combat their self-medication and encourage them to develop more realistic expectations of the behaviour (gambling is often maintained by the fact that the individual feels in control of what they're doing).
Outline nicotine replacement therapy (4).	Nicotine replacement therapy (NRT) treats smoking through agonist substitution. It replaces the effects of nicotine that a smoker receives from tobacco with a replacement chemical. The aim is to use smaller quantities of the replacement until it's no longer needed and withdrawal effects aren't experienced. The lower nicotine doses can be taken via gum, patches or nasal spray and can be easily self-administered. E-cigarettes are a recent innovation. They contain a nicotine-based liquid, which can be flavoured and is vaporised and inhaled to simulate smoking.
Outline the theory of planned behaviour as a model for addiction prevention (4).	The theory of planned behaviour proposes that 3 different behavioural aspects can affect our intentions and therefore our likelihood to perform a behaviour. Behavioural attitudes (made up of our behavioural beliefs), subjective norms (a more predictive factor that concerns what we think referent others think of our behaviour and whether we're likely to follow their beliefs) and perceived behavioural control (factors that can directly influence our behaviour such as self-efficacy and actual behavioural control). This model can be used to prevent initiation since we can alter our behavioural attitudes towards the behaviour so they are no longer positive, the provision of social support could rectify incorrect subjective norms and, in order to prevent the addiction, the individual must have confidence in their ability to abstain.
Outline government initiatives (2).	These are often launched to target public health issues in communities, schools and workplaces. Government bans (e.g: smoking ban) and media campaigns (e.g: ads, posters) are good examples of this.
Outline the EPI (2).	Eysenck's Personality Inventory is a questionnaire designed to measure emotional stability against neuroticism and extraversion against introversion. He later included a section to look at psychoticism. This scale has been used to measure the link between different personality traits and addiction.
Outline Cloniger (2).	Cloniger proposed 3 personality traits that predispose people towards substance dpendence: novelty-seeking, harm avoidance (includes worry and pessimism) and reward dependence (the extent to which you learn quickly from rewarding experiences and repeat rewarded behaviours).
Outline media campaigns (4).	Health campaigners often use the TV and the internet to raise awareness of addictive behaviour and help prevent it. The internet can target people more specifically through cookies monitoring their progress whilst messages can be delivered implicitly through TV plots (e.g: soaps) where the audience tends to identify better with the characters involved.
Outline traumatic stress (1).	People exposed to severe, traumatic stress are more vulnerable to addiction, especially children.
Outline everyday stress (1).	People report that they smoke and/or gamble to cope with everyday stressors such as daily hassles (e.g: money worries, relationship problems etc).
Outline the self-medication model (2).	The self-medication model proposes that individuals intentionally use different forms of pathological behaviour to treat their psychological problems. For example, an individual may gamble to overcome the stress associated with financial worries.
Outline age as a risk factor for addiction (4).	Most people start smoking between the ages of 14-16. There's a positive correlation between early smoking initiation and likely continued maintenance/relapse. This may be because the prefrontal cortex (an area of the brain involved in decision making and risk taking) isn't fully matured until we're about 20. This means that, as a teenager, we may not fully consider the consequences and implications of smoking initiation. We may also be more vulnerable to the influences of peer pressure as we define our social identity, this puts us more at risk of developing an addiction.
Outline peers as a risk factor for addiction (4)	Social learning theory proposes that the individual experiences vicarious reinforcement (e.g: observing the popularity and social acceptance of peers who smoke) and imitates the behaviour of the social models around them to receive direct reinforcement. Youths are more vulnerable to peer pressure in this form because social support is important during the teenage years as we are still trying to define our social identity. This may lead to smoking initiation.
Outline media influences as a risk factor for addictive behaviour (4).	We experience vicarious reinforcement through observing social models in the media (e.g: celebrities) who may engage in addictive behaviour. We may imitate these models to experience direct reinforcement (e.g: social approval, the physiological buzz of gambling). Exposure to such models makes us more susceptible to developing an addiction.
UK smoking ban	An estimated 250,000 quit smoking, many in the months prior to the ban.
Irish smoking ban	Smoking figures initially dropped but rose in 2008, suggesting that other factors can affect the individual's motivation to smoke.
Evaluate public health interventions in terms of limited effects	However, public health interventions usually have a limited effect on the population. This may be due to the fact that they tend to target large groups of people at once instead of those who are affected or at risk. A humanistic, psychological therapy on a one-to-one basis may be more effective (e.g: CBT to combat cognitive biases associated with the behaviour).
Evaluate the public smoking ban in terms of the theory of planned behaviour	The public smoking ban stops others from smoking so we're less likely to follow their behaviour. This also increases actual behavioural control of quitting, alongside the ability to say no. This increase in self-efficacy may lead to abstinence.

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	Created by Hazel Meades over 9 years ago