Social Learning and Drinking Behavior

Modelling and Social Learning

• Modelling provides an alternative explanation for why drinking behaviors seem to "run in families".
• Modelling, like operant learning, is another way in which people acquire favourable attitudes and expectations about drinking, which are important predictors of high-risk drinking.
• People can learn through observing others and experiencing the consequences of their actions.
• Social learning interventions focus on altering the client's relationship with their environment.

Cognitive and Cognitive-Behavioural Theory

• Cognitive model: focuses on the thoughts/beliefs and their impact on behaviors and feelings.
• The way people interpret specific situations influences feelings, motivations, and actions.
• Behaviors are only terminated when the individual makes the decision that the costs of continued use are vastly greater than the benefits.
• Example: Adolescents who view substance use in a positive light, whose peers use drugs, and whose parents and peers have attitudes that condone substance use are more likely to use substances (Ford, 2008).

Behavioural Theory

• Only considers observable/measurable behavior.
• Behavior is a consequence of learning.
• Four main types of conditioning:
  • Classical conditioning
  • Operant conditioning
  • Modelling
  • Tension reduction

Classical Conditioning

• Sights, smells, and sounds consistently associated with drug use elicit physiological and psychological responses that lead to drug-seeking behavior.
• Conditioned stimuli (CS) - cues and triggers.
• Conditioned response (CR) - physiological and psychological responses.
• CS more important than CR.

Operant Conditioning

• Focuses on the reinforcing properties of drugs and the likelihood of people repeating immediately pleasurable experiences (and avoiding unpleasurable experiences).
• Three main reinforcement types:
  • Positive reinforcement (e.g., drugs can cause pleasurable sensations)
  • Negative reinforcement (e.g., use to remove aversive experiences)
  • Punishment

Modelling

• Much of what we learn is acquired through observing others.
• The cerebral cortex (or higher brain) is divided into areas controlling specific functions and is the thinking center responsible for planning, problem-solving, decision-making, and impulse control.

Effects of Drug Use on the Brain

• Flipping the lid demonstrates how drug use affects the brain, leaving the lower brain in control.
• Flipping the lid occurs in response to immediate danger or intense emotions like anger and stress.
• Alcohol and drug use weaken the higher brain and strengthen the lower brain, leading to impulsive decision-making based on memory, reward, and pleasure.
• The impact of alcohol and drugs on brain function persists even after substance use has ceased, affecting decision-making and recovery.

Brain Function and Addiction

• The brain stem (or base brain) controls basic functions critical to life, such as heart rate, breathing, and sleeping.
• The limbic system (or lower brain) contains the brain's reward circuit, linking together brain structures that control and regulate our ability to feel pleasure, to feel emotions, and to have impulses as well as circuits involved in memory - especially memory involving emotion.

Psychoanalytic Theory

• Psychoanalytic theory holds that drug use is a sign of underlying psychological disorders.
• This indicates severe psychopathology.
• Psychological disorders are considered to cause substance misuse, but are not frequently identified as a result of use.
• Addiction is considered a universal disorder.

Nature and Nurture

• Psychoanalytic shared assumptions:
  • Unconscious processes of the id, ego, and superego
  • Attachment theory
  • Personality and addiction

Attachment Theory

• Attachment styles by Bowlby:
  • Secure attachment style
  • Ambivalent-avoidant insecure attachment style
  • Anxious-avoidant insecure attachment style
  • Disorganized-insecure attachment style

Personality and Addiction

• Distinct personality characteristics of alcoholics/drug users:
  • Limited evidence supports the concept of an 'addictive personality' as a predisposing factor.
  • Personality predictors of drug use (e.g., McGue 1995; Rassool, 2011)
  • Layers of beliefs - core beliefs / schemas
  • Cycle of conflicting desires

Cognitive-Behavioural Approaches

• Thoughts and behaviors can be 'unlearnt' through Cognitive-Behavioural Therapy (CBT).
• Incorporates Third Wave Psychotherapies like Acceptance and Commitment Therapy (ACT), Dialectical Behaviour Therapy (DBT), and Mindfulness-Based Relapse Prevention.

Motivation and Change Theories

• Transtheoretical Approach:
  • Increase client's awareness of problems, consequences, and risks to initiate behavior change.
  • Motivational interviewing emphasizes intrinsic motivation for change.

Family and Systems Theory; Socio-Cultural

• Determinants of behavior are based on an individual's role within a system.
• Focuses on society as a whole and not just on individuals.
• Family and other systems (e.g., peers) have a role in initiating and maintaining substance use.
• The type of society in which people live has an impact on their drug use.