The Cognitive Model

• Studies on the effectiveness of the nicotine patch treatment on smoking cessation and relapse have revealed inconsistent findings. Some studies (such as Hurt et al 2000) found that the use of nicotine patches did not improve cessation rates among adolescents. (Cessation rates= numbers of people who have stopped smoking.) On the other hand, Moolchan et al (2005) showed that the use of nicotine patches could reduce relapse rates. This is only when accompanied by CBT to change the positive expectancies of smoking behaviour.
  • SMOKING
  • Initiation of a Smoking Addiction
  • Expectancy Theory: Brandon et al (1999)
  • They propose that behaviour escalates into addiction because of the expectancies that an individual has about the costs and benefits of the activity.
  • Adolescent smokers commonly report smoking when they are experiencing negative moods (Kassel et al 2007) and expect that smoking will reduce their negative mood. (Brandon and Baker 1991)
  • The expectancy of positive moods (relaxation and self confidence) is also reasons for adolescents. (Mermelstein et al 2009)
  • Maintenance of a Smoking Addiction
  • Can be explanation due to Becks Vicious Circle. E.g. a person may be unhappy and to combat this they start smoking meaning that the addiction initiates. This could then lead to medical problems due to the poor health associated with smoking. It could also lead to financial problems as for example a pack of 20 cigarettes cost approx. £7. A two pack a day person will spend almost £100 a week and £400 a month. This could lead to social problems as people may have low opinions of someone in the situation. This will add to their low mood and the circle will continue.
  • Relapse of a Smoking Addiction
  • Expectations of the costs and benefits of smoking affect an individual’s readiness to quit and also the likelihood of relapse. Several studies shave demonstrated that smoker’s perceptions of the pros and cons of smoking and of quitting affect their quitting behaviour. (Devries and Beckbier 1994) According to this perspective, those who perceive, those who perceive smoking t have many benefits and few implications are most likely to relapse.
  • AO2According to Beck et al (2001) cognitive addiction is a vicious circle.

Much of the research relating to the expectancy theory is concerned with the excesses of a particular behaviour, rather than an addiction to it. Research might focus on ‘problematic behaviour’ such as heavy smoking, but rarely does it consider ‘loss of control’. Addiction normally involves the individual being unable to control their behaviour in which case it is not clear what role expectancies might play in the development of their loss of control.

There is evidence to suggest why NRT (nicotine replacement therapy) doesn’t have a high success rate for smoking cessation. Juliano and Brandon (2004) found that smokers reported greater expectancies of the possibility that cigarettes alleviate negative mood states and cravings and have positive effects on weight control compared to forms of NRT. Therefore due to their expectancies, NRT may not work as well as participants see cigarettes as more positive.

GAMBLING

Initiation of a Gambling Addiction

Self- medication:

Gelkopf et al (2002) propose that individuals intentionally use different forms of pathological behaviour to treat the psychological symptoms they suffer with. The activity chosen is perceived as helping with a particular problem. E.g. some activities help anxiety and Gambling helps with the depression associated with poverty.

Maintenance of a Gambling Addiction

The role of irrational beliefs:

Cognitive distortions and irrational beliefs influence the maintenance of a gambling addiction. Despite the likelihood of failure of gambling type games, gambler frequently have irrational perceptions about their ability to alter the likelihood of the outcome- i.e. the chance that they will win. Cognitive distortions include ‘gamblers fallacy’ i.e. the beliefs that random events are somehow influences by recent events (2 losses= 1 win).

Illusions of control are demonstrated through superstitious behaviour that they believe will help influence the outcome. They may also display exaggerated self-confidence. This is due to the belief that success is due to skill but a loss is due to fate/ bad luck.

Relapse of a Smoking Addiction

Pathological gamblers also suffer from a ‘recall bias’. This is the tendency to remember and over-exaggerate their wins but forget and underestimate and rationalise their losses. (Blanco et al 2000)

Consequently a string of loses doesn’t act as a disincentive for future gambling. Such individuals believe that they will eventually be rewarded for their efforts and could be motivated to persist due to the belief that they deserve to win. This is the ‘just world’ hypothesis.

AO2

There is supporting evidence for the self-medication model claim. Li et al (2008) found that pathological gamblers who gambled to escape the painful reality of life were significantly more likely to have other substance dependencies. They also found that the ‘self-medicating’ gamblers were less likely to commit crimes to fund their addiction compared to other types of gamblers.

There is however, non-supporting evidence for the cognitive explanation. Research suggests that possessing relevant knowledge does not make people less susceptible to cognitive distortions. Benhsain and Ladoucer (2004) found no difference in students trained in statistics or a non-statistical field, in their susceptibility to irrational gambling related cognitions. Similarly, Delfabbro et al (2006) found that pathological gamblers were more irrational in some forms of gambling related cognition but were just as accurate as non-gamblers in estimating the odds of winning.

One problem with the cognitive model is the problem of cause and effect. The self-medication model argues that some form of psychological distress mist come before drug use, as one necessitates the other. There is some evidence to support this, for example, research has shown that a depressive disorder is present in the majority of pathological gamblers. (Becona et al 1996) However, it is equally possible that depression is a consequence of the personal and financial costs of gambling.