Taak 2 Addiction is learned behavior
Bron: Dummond
● Craving
○ Jellinek: craving for alcohol and relapse (or ‘loss of control’) are intimately related
■ Craving was in part due to a true physical demand for alcohol as a result
of changes in cellular metabolism
○ Beliefs that cravings are the ‘cause’ of addiction → because of clinical
observations
○ Craving had become a key symptom of alcoholism and later alcohol indepence
○ WHO regarded craving as the underlying basis of onset of addiction
○ Medication-reduced craving may not translate into the prevention of relapse
■ Craving and relapse are poorly related to each other
● What is craving?
○ “A strong desire” → dictionary
○ “Any desire or urge, even a weak one, to use that substance” →
addicts
○ Liking, wanting, urges, desires, need, intention or compulsion →
clinicians
○ In general: ‘the conscious experience of a desire to take a drug’
● Phenomenological models
○ Essentially descriptive rather than explanatory
■ Derived from interviews and observations of clinical addict populations
○ Subjective craving for drugs or alcohol has been characterized as having
obsessive elements
○ Strength: their attention to the human experience
■ Why: simplicity of having a ‘symptom’ for addiction
● This might form the basis or part of a diagnostic interview
■ Danger: assuming that craving is essential for diagnosing or that it should
be primary target for treatment
● Conditioning theories
○ Conditioned withdrawal model
■ Neutral stimuli in the environment can, over the course of many pairings
with drug taking, come to elicit conditioned repsonses through a process
of conditioned learning
● Has more to do with negative reinforcement: you take away
something
○ So in this case the drugs take away the negative things
which occur when not using drugs
,US: drugs, UR: respons to drugs, CS: ALWAYS the cues, CR: body respons for craving
for drugs → IN GENERAL!!!
○ Conditioned opponent process model
■ The body develops opponent processen that are homeostatic responses
which counteract the drug’s effect
● E.g. taking the drug → positive effect (pleasure) →
homeostatic
■ Most of the time the opponent process increases in size and duration and
this could account for the development of drug toleranze
● Because it ‘cancels out’ the drug effect
● So if somebody takes drugs in a different environment
gets different cues → body is always preparing for drugs
in a certain environment and they’re not in that
environment when taking the drugs → CONSEQUENCE:
overdose
■ US: drugs, UR: body’s counter reaction, CS: cues, CR: body’s
counterreaction
○ Conditioned drug-like model
■ The experience of craving can often be pleasurable rather than
withdrawallike
■ Environmental cues, following repeated pairings with drug taking and the
pleasurable drug effects, can come to elicit drug-like CRs.
● They prime the individual to take more drug through a process of
postive reinforcement
○ Two process theory
■ There is a relationship between operant and classical conditioning
● Conditioned withdrawal leads to drug taking through a process of
negative reinforcement
● Depending on the conditioning history of the animal and the
central emotional state a CS elicits, the effects of exposure to a
, CS may ,paradoxically, decrease rather than increase subsequent
drug taking.
○ Incentive sentitization theory
■ More a model of addiction and addictive behavior rather than craving
perse
● It does have relevance to theories of craving in that certain
predictions are made regarding the nature of craving within this
model
■ The neural system responsible for drug seeking and drug taking becomes
sensitized by repeated drug use
● This system is responsible for incentive motivation
■ Wanting → associated with the sensitized incentive motivational
system
● Not always conscious
○ Hence relapse may occur without conscious awareness
■ Liking → synonymous with craving
■ Craving is epiphenomenal to the hypothesized unconsious process
(wanting) driving addiction and relapse
○ Cue-reactivity model
■ Within this model cue-reactivity can be
● Autonomic (e.g. increased skin conductance, heart rate,
salivation)
● Cognitive-symbolic (e.g. subjective craving)
○ Changes in outcome and efficacy expectancies
■ May be important in subsequent drug-seeking
behavior
● Behavioral (e.g. drugseeking behavior)
■ Cue-elicited craving is not considered to be a necessary condition for
drug seeking or relapse to druk-taking
● Cognitive theories
○ Cognitive social learning theory
■ Predominantly a theory of relapse
● Also has relevance in to understanding craving and its role in
Bron: Dummond
● Craving
○ Jellinek: craving for alcohol and relapse (or ‘loss of control’) are intimately related
■ Craving was in part due to a true physical demand for alcohol as a result
of changes in cellular metabolism
○ Beliefs that cravings are the ‘cause’ of addiction → because of clinical
observations
○ Craving had become a key symptom of alcoholism and later alcohol indepence
○ WHO regarded craving as the underlying basis of onset of addiction
○ Medication-reduced craving may not translate into the prevention of relapse
■ Craving and relapse are poorly related to each other
● What is craving?
○ “A strong desire” → dictionary
○ “Any desire or urge, even a weak one, to use that substance” →
addicts
○ Liking, wanting, urges, desires, need, intention or compulsion →
clinicians
○ In general: ‘the conscious experience of a desire to take a drug’
● Phenomenological models
○ Essentially descriptive rather than explanatory
■ Derived from interviews and observations of clinical addict populations
○ Subjective craving for drugs or alcohol has been characterized as having
obsessive elements
○ Strength: their attention to the human experience
■ Why: simplicity of having a ‘symptom’ for addiction
● This might form the basis or part of a diagnostic interview
■ Danger: assuming that craving is essential for diagnosing or that it should
be primary target for treatment
● Conditioning theories
○ Conditioned withdrawal model
■ Neutral stimuli in the environment can, over the course of many pairings
with drug taking, come to elicit conditioned repsonses through a process
of conditioned learning
● Has more to do with negative reinforcement: you take away
something
○ So in this case the drugs take away the negative things
which occur when not using drugs
,US: drugs, UR: respons to drugs, CS: ALWAYS the cues, CR: body respons for craving
for drugs → IN GENERAL!!!
○ Conditioned opponent process model
■ The body develops opponent processen that are homeostatic responses
which counteract the drug’s effect
● E.g. taking the drug → positive effect (pleasure) →
homeostatic
■ Most of the time the opponent process increases in size and duration and
this could account for the development of drug toleranze
● Because it ‘cancels out’ the drug effect
● So if somebody takes drugs in a different environment
gets different cues → body is always preparing for drugs
in a certain environment and they’re not in that
environment when taking the drugs → CONSEQUENCE:
overdose
■ US: drugs, UR: body’s counter reaction, CS: cues, CR: body’s
counterreaction
○ Conditioned drug-like model
■ The experience of craving can often be pleasurable rather than
withdrawallike
■ Environmental cues, following repeated pairings with drug taking and the
pleasurable drug effects, can come to elicit drug-like CRs.
● They prime the individual to take more drug through a process of
postive reinforcement
○ Two process theory
■ There is a relationship between operant and classical conditioning
● Conditioned withdrawal leads to drug taking through a process of
negative reinforcement
● Depending on the conditioning history of the animal and the
central emotional state a CS elicits, the effects of exposure to a
, CS may ,paradoxically, decrease rather than increase subsequent
drug taking.
○ Incentive sentitization theory
■ More a model of addiction and addictive behavior rather than craving
perse
● It does have relevance to theories of craving in that certain
predictions are made regarding the nature of craving within this
model
■ The neural system responsible for drug seeking and drug taking becomes
sensitized by repeated drug use
● This system is responsible for incentive motivation
■ Wanting → associated with the sensitized incentive motivational
system
● Not always conscious
○ Hence relapse may occur without conscious awareness
■ Liking → synonymous with craving
■ Craving is epiphenomenal to the hypothesized unconsious process
(wanting) driving addiction and relapse
○ Cue-reactivity model
■ Within this model cue-reactivity can be
● Autonomic (e.g. increased skin conductance, heart rate,
salivation)
● Cognitive-symbolic (e.g. subjective craving)
○ Changes in outcome and efficacy expectancies
■ May be important in subsequent drug-seeking
behavior
● Behavioral (e.g. drugseeking behavior)
■ Cue-elicited craving is not considered to be a necessary condition for
drug seeking or relapse to druk-taking
● Cognitive theories
○ Cognitive social learning theory
■ Predominantly a theory of relapse
● Also has relevance in to understanding craving and its role in
