Advanced Addiction Psychology Contemporary Perspectives

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Table of Contents

Introduction
Critical Discussion of Stroop Test
Critical Discussion of Flicker Paradigm and the Dot Probe
Critical Discussion of Attentional Biases
Analysis of the Models of Craving
Critical Discussion of Mechanisms of Addiction
Critical Discussion of Perceptions of Behavior
Models of Drug Usage and Aotomacity
Conclusion
References

Introduction

The ailment of substance abuse, addiction, craving of substances has been exhaustively researched by many scientists since the past few centuries. Since the past few decades, systematic study and research have provided a deeper insight into what makes people feel addicted to substances such as alcohol, tobacco, drugs and other substances. This paper provides a discussion on Advanced Addiction Psychology Contemporary Perspectives.

Critical Discussion of Stroop Test

Cox (et al. l, 2006) have critically reviewed the Stroop Test and have attempted to achieve a better understanding of the basic mechanisms that create an attentional bias for problems of addiction-related stimuli. The authors have suggested that the Stroop test is a psychological test of mental or attentional flexibility and vitality. The task takes advantage of the ability to read words more quickly and automatically than one can name colours. If a word is printed or displayed in colour different from the colour it actually names, one would say the word for the colour more readily than naming the colour in which it is displayed. The cognitive mechanism involved in this task is called directed attention, and one would have to manage the attention, inhibit or stop one response in order to say or do something else. The authors suggest that the relative speed of processing explanation is based on the premise that on trials that were incongruent, interference occurs because of a competition between two responses, alternatives word reading and colour naming. The study suggests that this occurs because of prior learning.

The aptest critique of the test is provided by the discussion that Cox (et al. l, 2006) has provided when they suggest that the test should be considered along with the connectionist model. The model assumes that the automatic nature of attention does not occur in stages but is a continuous phenomenon. Automaticity is modelled computationally as a function of the strength of the processing pathway, and this increases with practice. Interference is interpreted as the difference between two sources of information for which interaction depends on the strength of the corresponding pathways. The first source is created as a result of the relative strength of the processing pathways for colour naming versus word reading. The second source related to individuals attentional resources, such as the degree of attentional focus for resolving the conflict. One difficulty is that the model cannot readily account for the absence of a reverse Stroop effect when the weaker pathway is given a greater chance of being activated by priming the correct response.

The student of the paper would like to argue that the Stroop Effect couldn’t be conclusive at all as far as attentional bias is concerned. Indeed for the first time when the student took the test, the words with different colour meanings were slower to read. The student also admits that it took a long time to read words such as Blue (written in red), Yellow (written in green) and so on. But after the first few attempts, once the facts were known and the challenges about the trick became known, it was easy to beat the test. As suggested by Cox with reference to the connectionist model, the fact that our whole life of learning prevents us from making wrong associations is correct, but again the student would like to argue that the human mind is capable very well of learning new things very quickly and an intelligent person would be bound to make the Stroop Test as inconclusive. Addicts are not actually dumb people, but many of them have lead fruitful and eventful lives until some tragedy or event made them take up to substance abuse. In such cases, it can be argued that an addict, when he is under intoxication, would be bound to make errors and mistakes, the same way that a normal person who is not an alcoholic but has taken a few too many drinks would make. So the test is not reliable when it comes to analysis or the concept of attentional bias. We all have our bad days when even understanding simple road signs become difficult after a hard day; we have trouble finding keys, remembering people names, forgetting the birthdays of our friends and so on, and it has nothing to do with lack of attention or being an addict.

Critical Discussion of Flicker Paradigm and the Dot Probe

Barry (et al. l, 2003) has provided details of an experiment that was performed at a university campus where 200 volunteers with substance-related problems had agreed to be tested. The aim of the test was to apply a new paradigm by utilizing transient changes to visual scenes to explore information processing biases relating to any social levels of alcohol and cannabis use. The experiment was designed for inducing change blindness with lighter and heavier social uses of alcohol with a sample of 100 and social users non-users of cannabis with a sample size of 100. The experiment explored the association of a single substance-related or neutral change made to a scene of a grouped substance-related and neutral objects. The study utilized both the Stroop paradigm and the dot-probe paradigm. In the dot-probe paradigm, two words are displayed briefly on a computer monitor and are replaced by a single dot-probe in register with one of them. The task is to respond to its appearance, at which time probe detection is quicker for concern related than for neutral words. The paper has also suggested that the pictorial approach to social substance users through a novel application of the flicker paradigm for inducing change blindness. In the paradigm, a single feature of a visual scene is changed back and forth between successive presentations. The change was not detected immediately even when individuals were told that change would occur. The paper explains the latency of detection for a particular change in terms of the change’s grabbiness, and if this was the case, then the related changes might be expected to be grabbier when viewed by heavier rather than lighter users.

The student would like to argue that the tests are basically flawed. What the researcher ended up measuring was the intelligence level of the users. Even today, we do find puzzles in newspapers and magazines for kids where two identical pictures with small changes are displayed, and the reader is asked to ‘spot the differences. Some of us at some time of the day are able to crack the puzzle, while at other times, it becomes difficult. If the same test was given to two normal adults, then one would find the differences faster than the other, not because the second person is addicted to cannabis but because the first person was more alert or has taken these tests a few times and knows the tricks that such puzzle setters adopt. The student would like to suggest that the flicker paradigm test is basically flawed since the very obvious missing details would be quickly noticed. For example, if in a picture a person had ahead in the next sequence, the head was missing, then this would be immediately noticed by almost anyone. While if in another test, a picture was shown of a picture full of chairs, and in the other, if one of the legs was missing from a shadowy chair in a corner, then this would be hard to notice. Trained police personnel of high school level may perhaps be able to immediately find the difference, but in all possibilities, a brilliant nerdy computer programmer with thick glasses would find it difficult to notice the difference. The paper had, in fact, subjected computer students of Glasgow University to this test. So the student suggests that the Flicker Paradigm and the dot pointer tests present results that are highly biased and offer the wrong conclusion. When the results can be controversial and flawed for normal people, it is the student who suggests that subjecting addicts to this kind of test does not have any scientific standing.

Critical Discussion of Attentional Biases

Field (2006) has suggested that drug abuse and addiction are associated with biases in selective attention for drug-associated stimuli. Drug users are strongly influenced by the environment in which they exist, and the environmental stimuli exert powerful influences on cognition and behaviours. They are easily susceptible to visual stimuli, and for example, the sight of a lit cigarette or tobacco smoke would provide a strong stimulus for the smoker. The author speaks of addiction and suggests that addiction is through positive incentives or negative reinforcing cognitive factors. The author has again suggested that the Stroop test is widely applied to show the demonstrative cognitive biases in mood disorders. The Stroop tasks involved presenting words to participants who have to name the colour of the ink that the word is written in a while, ignoring the semantic content of the word. The author has again pointed out that colour naming interference of drugs and alcohol-related words has also been investigated in other addictions such as Cannabis, cocaine and others. Active users have difficulty in naming the colour of cocaine-related words and pictorial stimuli, but these biases were absent in non-users. The research presented by the author has focussed on the hypotheses that are obtained from different theories of addiction, and they predict the existence of these biases. The author has suggested that cues of attention bias must be utilized for the treatment of addicts by providing them with proper drugs.

Dannin (2007) also speaks of the research activity she has performed to understand the attentional bias for drugs, and the study was conducted to determine the levels of sensitisation stimulant drug users have to different drug-related cues. The author has also performed tests to determine the effect drug-related cues have on the attentional system of drug users vs naïve controls and another test to determine the brain regions active in visual attention tasks in drug users versus naïve controls.

The student would like to point out that, as suggested by Robinson (et al. l, 2001) that drugs produce long-lasting patterns of brain behaviour and thinking and addicts are always seeking out means to satisfy their craving for substances. The drugs modify and damage the neuro-motor cells in the brain and lead to substantial damage of the brain cells. These factors are more severe and lethal than the problems of addicts who may fail the Stroop test or have attentional biases. The student acknowledges that addicts may repeatedly display attentional deviation and other such problems and that these are caused by the substances that they consume, and attentional bias are secondary.

Analysis of the Models of Craving

Tiffany (1999) speaks of four models related to a craving for substances such as alcohol, and they are dual-affect, cognitive labelling, cognitive processing and outcome expectancy. These models are based on the cognitive concepts, such as memory of alcohol and its association with various imagined stimuli, expectancies of how a drink would help to remove feelings of boredom, interpretation, and automatic behaviour that compels people who have temporarily given up drinking to relapse and take up drinking again. The author has suggested that a person who has been drinking heavily and can be called an alcoholic would be subjected to the classical conditioning models. Such people have had a long history of drinking and tend to associate certain sights and smells, such as the sight of a bar, cigarette smoke and others, and these serve as a visual and aural stimulus. These stimuli have so much conditioned a person that they tend to induce the similar responses that would occur if the person had actually consumed alcohol. The stimuli further create an acute need for people and induce physiological reactions in them and make them seek alcohol. Such people have difficulty concentrating on their work, and all they seek is more and more alcohol. The author has suggested various definitions from other researchers for craving as craving would be seen when addicts try to withdraw from alcohol and experience conditioned withdrawal syndrome where they would experience an acute desire to consume alcohol. The author has also suggested that craving and addiction as “the memory of the positively reinforcing effects of alcohol and other drugs”. The four models of craving are briefly discussed below.

The Cognitive Labeling Model

Tiffany (1990) has suggested that the Cognitive Processing Model suggests an emotional experience occurs between the physiological arousal and e cognitive interpretation of the arousal. The interpretation creates an emotional tag that determines the pleasant or unpleasant quality of the emotional state. The severity of that emotion is given by the amount of the arousal, and the more the arousal, the more severe is the emotion. The model implies that visual stimuli for alcohol use, such as the sight of a bar, can create symptoms of physiological arousal such as a racing heart and also trigger memories of prior drinking sessions that set the situations for consumption of alcohol. This initiates in the alcoholic the physiological reactions called craving.

The Outcome Expectancy Model

Tiffany (1999) has suggested that hints and cues from the external environment in which the addict lives can give powerful expectations about the effects of alcohol, and those such expectations will have a strong influence on how the alcoholic behaves. The author suggests that this theory has two components – motivation and informational components. The first component shows the desire on the part of the addict to experience positive outcomes by drinking, and the addict may reason that when he sees his friends drinking and sees the enjoyment they are having, the addict wants to enjoy the pleasures. The informational component creates a sense of anticipation that alcohol would create relaxation, pleasure or relief from withdrawal.

The Dual-Affect Model

Tiffany (1999) has suggested that craving is monitored and controlled by negative and positive emotions, and these influence drug seeking needs, physiological responses and self-reports of craving and emotion. The author suggests that negative affect craving is initiated by certain negative feelings such as depression and anger or aversive events such as speaking in from of strangers and is heightened during withdrawal when it is known to the addict the alcohol or drug is not available. The positive affect craving is related to certain positive emotions such as pleasure or the positively reinforcing alcohol effects. The craving is initiated by positive emotional states and hints and cues that the substance is available. These two systems are declared as mutually inhibitory, and that the stimulation is one of these systems means that it depresses the other.

The Cognitive Processing Model

Tiffany (1990) has suggested that the Cognitive Processing Model suggests that the act of seeking and consuming substances such as alcohol have become automatic processes similar to how people wash their face, eat, go to sleep and so on and that the addicts do not realize what they are doing in a conscious manner. The theory suggests that the actions of addicts when they actively drink or are undergoing a relapse and that the drinking process is performed periodically and that the action can be triggered by a stimulus and is difficult to control and, in many cases, is executed without any awareness. The author argues that “They essentially think instinctively, short-circuiting both imagery and cognitions, and are inclined to act without knowing why. When alcohol becomes readily available, they drink before they think.” Tiffany has suggested that certain aspects of non-automatic processing also come into play, and these are identified as intention dependant, requiring cognitive effort, flexible and is impeded by the limited cognitive capacity. In the model, both automatic and non-automatic processes come into work, and this is best highlighted when the author speaks of an addict who finds the favourite bar closed. The first action of going to the bar was automatic, but then the non-automatic process comes into play, and the addict seeks another bar that would offer alcohol.

Tiffany (1990) has concluded that Stimuli related to Alcohol may be so attention-grabbing that they make the addict stop focusing on other work and tasks such as job, family, personal security, financial well being and so on. The visual and aural cues that are related to alcohol may induce some degree of general arousal that prevents the addict from completing secondary tasks. The visual cues of alcohol may create diverse and conflicting emotions, and memories and the negative recollections may reduce the addict’s motivation to perform. The acute instances of Craving may prime motor systems organized to seek and use drugs, and the activation of those systems may conflict with the motor demands of the other task. Craving may get so intense that it may affect the problem-solving activity and exhausts resources that might otherwise be devoted to responding quickly to the secondary task.

Critical Discussion of Mechanisms of Addiction

Robinson (et al. l, 2001) have suggested that the reasons why addicts take drugs and consume alcohol are not just for pleasure and to avoid withdrawal syndromes but due to four other reasons. Addictive drugs have the capacity to produce long-lasting changes in brain organization. The brain systems that are changed by the drugs include the ones that are normally involved in the process of incentive motivation and reward. The critical neuro-adaptations for addiction make the brain reward system sensitised to the drugs associated stimuli. The brain systems that are sensitised do not mediate the pleasurable and euphoric effects of drugs and drug liking, but they mediate a subcomponent of reward that is called incentive salience or wanting. The psychological process of incentive salience is responsible for drug-taking behaviour. When sensitised, the incentive salience process creates compulsive patterns of drug-seeking behaviour. The author speaks of psychomotor sensitisation when the repeated administration of drugs can create sensitisation or an increase in drug effect and involves the measures of the psychomotor activating effects of drugs such as their ability to enhance locomotors activity, rotational behaviour or stereotyped motor patterns. Repeated intermittent administrations of drugs result in a proportional rise in their psychomotor effects. The author has provided information on drugs such as cocaine, amphetamine, nicotine, ethanol and other drugs. According to the author, there is a large individual variation in susceptibility to sensitisation, and while some people display rapid and robust sensitisation, others may show very little or no sensitisation.

Robinson (et al. l, 2001) have suggested that there are four areas of incentive sensitisation, and they are that potentially addictive drugs have the ability to alter brain organization; the brain systems that are altered include those that are involved in the process of incentive motivation and rewards; the critical neuro adaptations for addiction render the brain reward systems are sensitised to drugs and their stimulus and that the brain systems that are sensitised do not mediate the pleasurable or euphoric effects of drugs but that they rather mediate a subcomponent reward. The authors have given evidence to show that psychomotor stimulants effects of drugs sensitise but also perform their rewarding effects. Behavioural sensitisation is associated with neuro-adaptations in dopamine and acumens related circuitry, and neuro systems play an important role in mediating the rewarding effects of drugs and other incentives. If sensitisation related neuro-adaptations are found in this circuitry, at least one neural system known to be critical for mediating drug reward undergoes neural sensitisation. The authors have shown previous research that shows that repeated exposure to amphetamine or cocaine results in a progressive increase in their psychotomimetic effects, and this enhanced sensitivity may persist long after the discontinuation of drug use. The authors argue that though little research has been conducted in humans and there are a number of technical limitations, the available research and evidence shows that repeated exposure to psychostimulant drugs can sensitise some drug effects in humans. The author has also discussed the issues of wanting and liking and the nature of incentive and reward function that is mediated by the circuitry. The incentive sensitisation theory suggests strongly the hedonic effect, which is either as subjective pleasure or its underlying core process, is not the component of drug reward that is sensitised in addiction and is not the psychological process that is mediated by dopamine systems. The process of incentive motivation can be subdivided into at least two components. The traditional models of incentive motivation suggested that a single process mediates both incentive value and hedonic value. Incentives were hypothesized to have incentive value because of their ability to give pleasure. So the wanting and liking were essentially connected and treated as explanations of positive reinforcement. The authors conclude by suggesting that the major feature of incentive motivation that distinguishes it from earlier models is that there are at least two distinct psychological processes involved in reward: subjective pleasure and incentive salience attribution. These two psychological processes are controlled by different neural systems. The neural systems that are sensitised by addictive drugs are those involved specifically in incentive salience attribution. The neural systems that mediate the hedonic effects of drugs do not appear to sensitise. This process shows the reason why addiction is characterized by an increasing dissociation between the incentive value of drugs and their subjective pleasurable effects. With the development of an addiction, drugs become pathologically wanted or craved, and this can occur even if drugs are not liked.

Critical Discussion of Perceptions of Behavior

Bargh (et al. l, 1999) have discussed in detail the ability of people to consciously and systematically process information to construe and plan their action plan and decide on the course of action. The authors suggest that in many cases, the ability to exercise such conscious and intentional control is limited by many factors and that many moments to moment psychological life has to occur by using non-conscious means. There are different mechanisms that work to produce automatic, environmental control over these various phenomena and review evidence establishing both the existence of these mechanisms as well as their consequences for judgments, emotions and behaviour. The authors have identified three major forms of automatic self-regulation, and they are an automatic effect of perception on the action, automatic goal pursuit and continual automatic evaluation of one’s experience. The discussion provided by the authors will help in increate a better understanding of the process of addiction and craving.

Bargh (et al. l, 1999) have suggested that humans have an inborn capacity for imitative behaviour and vicarious learning. The behaviour leads to the fact that there must be a strong associative connection between representations used in perceiving the behaviour of others and those used to behave in the same way oneself. The authors also speak of ideomotor action, in which merely thinking about an action increases the likelihood of occurrence. The concept of ideomotor action was that mere ideation about the behaviour was sufficient to cause one to act, and no separate act of violation was required. This theory suggests the reason why people take up substance abuse and why they develop an addiction over time till it becomes a craving. The authors have suggested that the external environment can direct behaviour non consciously through a two-stage process, an automatic perceptual activity that then automatically creates behavioural tendencies through the perception behaviour link. The entire environment perception behaviour sequence is automatic, and no role is played by conscious choice in producing the behaviour.

The student agrees with most of the discussion provided by Bargh (et al. l, 1999). I addition, the student would also like to suggest that the glorification of smoking, drinking, consuming drugs as portrayed in advertisements and by Rock, musicians have had a very strong goading effect on people, especially the younger people who are easily impressed by such behaviour and start on the road to later addiction, early in life.

Models of Drug Usage and Aotomacity

Tiffany (1990) has argued that models of drug urges can be classified as drug withdrawal and the positive reinforcement effects of drugs. The withdrawal base model of urges is based on the belief that drugs that support compulsive self-administration will produce a physiological dependence syndrome when the drug is withdrawn. The withdrawal signs seem like a pathognomonic sign of addiction in many definitions of addictive behaviour. On the other hand, the author suggests that the positive reinforcement effects of drugs relate more to the positive feelings of euphoria, increased arousal, strength and other acts that consumption of drugs and alcohol provides. The author also speaks of the theory of automaticity when consumption of the substances becomes automatic and repetitive, and addicts perform the act of consumption without any self-thought or cognitive effort. For the addict, the act of consumption becomes a habituated set of tasks that are completed without paying conscious thoughts on how the act is being performed.

Conclusion

The paper has discussed various concepts and theories of addiction and craving, and the discussion points out that that people take to addiction and develop a craving because they do not want to face the consequences of withdrawal symptoms and also because it infuses them with a positive feeling such as euphoria and well being. The paper has also examined four models of craving, and they are dual-affect, cognitive labelling, cognitive processing and outcome expectancy. These models are based on the cognitive concepts, such as memory of alcohol and its association with various imagined stimuli, expectancies of how a drink would help to remove feelings of boredom, interpretation, and automatic behaviour that compels people who have temporarily given up drinking to relapse and take up drinking again. The paper has also critically discussed tests such as the Stroop Test and the got pointer test and found that these tests cannot provide a reliable conclusion with reference to addicts. Other aspects such as attentional bias have also been critically examined. The paper shows that drug addiction is a type of disease as certain drugs create long term changes in the brain patterns and bring changes in the circuitry.

References

Bargh. John A. Chartrand Tanya L. (July 1999). The Unbearable Automaticity of Being. Journal of American Psychologist.. Volume 54. Issue 7. pp. 462-479

Barry T. Jones, Ben C. Jones, Helena Smith & Nicola Copley. (2003). A flicker paradigm for inducing change blindness reveals alcohol and cannabis information processing biases in social users. Journal of Addiction. Volume 98. pp. 235-244

Cox W. Miles, Fadardi Javad Salehi, Pothos Emmanuel M. (2006). The addiction stroop test: Theoretical considerations and procedural recommendations. Psychological Bulletin. Volume 132. No. 3. pp. 443-476

Dannin Emma. (2007). The neurological and subjective Aspects of attention bias to words and pictures in casual stimulant users. Research proposal Cogs 260

Field Matt. (2006). Attentional biases in drug abuse and addiction: cognitive mechanisms, causes, consequences and implications. (Eds) Cognition and Addiction edited by Marcus Munafo & Ian Albery. pp. 73-99

Robinson Terry E. Berridge C Kent. (2001). Mechanisms of Action of Addictive Stimuli: Incentive-sensitization and addiction. Journal of Addiction. Volume 96. pp. 103-114

Tiffany Stephen T. (1999). Cognitive Concepts of Craving. Journal of Alcohol Research and Health. Gale Group, Farmington Hills, Michigan

Tiffany Stephen T. (1990). A Cognitive Model of Drug Urges and Drug-Use Behavior: Role of Automatic and Nonautomatic Processes. Journal of Psychological Review. Volume 97. Issue 2. pp. 147-168

Weinstein Aviv. Kerem Ein. Cox W. Miles. (2006). Cognitive processing of drug-related stimuli: the role of memory and attention. Journal of Psychopharmacology. Volume 20. Issue 6. pp. 850-859

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